Shiraz Emedical Journal
Volume:23 Issue: 12, Dec 2022

Electroconvulsive therapy (ECT) is a vital treatment strategy for psychiatric patients, and cancellation of the procedure negatively impacts the recovery process. However, it may happen due to the lack of optimal conditions at admission.

This retrospective study occurred at Shafa Hospital, an academic center affiliated with the Guilan University of Medical Sciences (GUMS). The ECT anesthesia team developed an ECT patient preparation checklist, which was shared with psychiatrists. The rate and some related factors of case cancellation were compared between the two years before presenting the checklist, from May 2019 to May 2020, and the next year, from June 2020 to May 2021. The patients’ files were reviewed, and the required information was documented.

One hundred fifty-one cancellations were recorded during the two years of study, 82 cases in the first year and 69 in the second year. The most common reason for the cancellation was inadequate consultations followed by abnormal lab tests. In comparing the number of cancellations between the two years, before and after the checklist was provided, no significant difference was observed in terms of age (P = 0.288), gender (P = 0.24), psychiatric disorder (P = 0.399), and the number of ECT sessions (P = 0.36). However, the number of cancellations due to incomplete consultation significantly decreased after developing the checklist (P = 0.049), while unstable hemodynamics and changing patients’ conditions on an intended day also increased (P = 0.024). Residency visits did not significantly affect the number of cancellations over 2 years (P = 0.139).

This study concluded that preparing ECT patients according to the checklist led to better conditions and fewer cancellations. However, preventable causes still exist.

 Emerging COVID-19 pandemic has posed numerous ethical challenges to frontline healthcare professionals.

 This study aimed to explain the ethical challenges experienced by physicians and nurses in caring for COVID-19 patients during the early phases of the pandemic.

 This qualitative study was conducted using by content analysis approach. Twenty-two semi-structured in-depth interviews were conducted with 18 physicians and nurses working in medical centers and hospitals of the public or private sectors, in Tehran, the capital of Iran, from July to October 2020. The Graneheim and Lundman approach was applied to analyze the data. MAXQDA 10 software was used to facilitate the data analysis process.

 The ethical challenges are categorized into four categories (and 11 subcategories), including poor professional care, preference for public interests over individual care, difficult decision-making, and moral distress. Most participants experienced poor professional care, non-compassionate care, lack of family-centered care, being forced to choose, lack of emotional and anger control and coping skills, an undermined ethical climate, and emotional fatigue during the early phases of the pandemic.

 The findings indicate the attenuation of professional care and the need to develop evidence-based ethical and clinical guidelines concerning the resulting insights. In addition, devising appropriate interventions is recommended for their psycho-emotional support.

 Sarcoidosis is a granulomatous inflammatory disorder characterized by the presence of non-caseating granulomas in affected tissues, such as lungs and lymph nodes. The precise etiology of sarcoidosis is not known yet. There are some reports on the association of sarcoidosis and other disorders that may similarly have an immunological basis, such as inflammatory bowel disease. In this study, we introduce a patient with ulcerative colitis (UC), whose disease was in remission for about 20 years, before presentation of her sarcoidosis.

 A 48-year-old woman, a known case of UC for a period of 20 years, presented to the Adult Pulmonology Clinic with complaints of chronic non-productive cough, episodic night sweats, progressive dyspnea (initially on exertion, then at rest), fatigue, and significant weight loss. Her clinical manifestations began since about 1 year ago and aggravated over time. She was on regular follow-up by a gastroenterologist, and her UC was in remission. At the first visit, the patient’s physical examination showed stable hemodynamics, and normal breath sounds, and cardiac auscultation. Also, no significant finding was noted in her abdominal examination.

 Patients with UC who possess HLA-A*01 phenotype may possibly be more susceptible to developing sarcoidosis.

Mobile health (mHealth) apps play an emerging role in managing chronic conditions. This study aimed to design, develop, and evaluate the usability of an exercise therapy mHealth app in individuals with patellofemoral pain syndrome (PFPS).

This paper presents the design, development, and evaluation procedures of the conceptual mHelath app, called Vitoapp, using the progressive web application (PWA) approach.

A mixed-method approach using both qualitative interviews (n = 8 adults with PFPS) and quantitative usability evaluations (n = 30, including 15 adults with PFPS and 15 physical therapists as experts) was adopted.

The results showed high levels of system usability (75.1 out of 100) and the mHealth App usability (127.2/147).

This study can contribute to the design and development of the physical therapy mHealth app to provide evidence-based therapeutic exercise and remotely monitor adul

Mobile health (mHealth) apps play an emerging role in managing chronic conditions. This study aimed to design, develop, and evaluate the usability of an exercise therapy mHealth app in individuals with patellofemoral pain syndrome (PFPS).

This paper presents the design, development, and evaluation procedures of the conceptual mHelath app, called Vitoapp, using the progressive web application (PWA) approach.

A mixed-method approach using both qualitative interviews (n = 8 adults with PFPS) and quantitative usability evaluations (n = 30, including 15 adults with PFPS and 15 physical therapists as experts) was adopted.

The results showed high levels of system usability (75.1 out of 100) and the mHealth App usability (127.2/147).

This study can contribute to the design and development of the physical therapy mHealth app to provide evidence-based therapeutic exercise and remotely monitor adults with chronic pain conditions, including PFPS.s with chronic pain conditions, including PFPS.

 Vaginitis is one of the most common complaints in women around the world. Cinnamon is one of the medicinal plants for which there is contradictory evidence of its effect on vaginitis.

 This study aimed to evaluate the effect of cinnamon on the treatment and recurrence of candidal vaginitis.

 We performed this randomized, double-blind, placebo-controlled trial from April to August 2018 in Tehran, Iran. Totally 120 women aged 15 to 45 years clinically and paraclinical approved candidiasis vaginitis were included by convenient sampling at first and then were randomly allocated to 2 groups. The intervention group received 2.5 g of cinnamon powder. The control group received 2.5 g of placebo. Both groups should apply a vaginal applicator of clotrimazole cream (1%) daily. Vaginitis symptoms were evaluated with the researcher-made questionnaire and checklist at baseline, 4th, and 7th days of the treatment. Recurrence was evaluated 2 months later.

 A significant decrease was seen in itching (from 83% to 11%) (P-value = 0.001), burning (from 71% to 5%) (P-value = 0.003), suprapelvic pain (from 65% to 3.3%) (P-value = 0.001), dyspareunia (from 80% to 7%) (P-value = 0.001) on the 7th day of the treatment in the cinnamon group. In the placebo group, a significant decrease was shown in itching (from 90% to 20%) (P-value = 0.001), burning (from 81.7% to 8.3%) (P-value = 0.001), dyspareunia (from 78% to 35%) (P-value = 0.001) and suprapubic pain (from 68% to 16.7%) (P-value = 0.001). After 2 months, recurrence was 45% in the cinnamon group (P-value = 0.001), but it was 71.7% in the placebo group (P-value = 0.003). No adverse effects of cinnamon were recorded.

 The efficacy of oral cinnamon capsule is better than clotrimazole vaginal cream in the treatment and recurrence of vaginal candidiasis. Therefore, the use of these products may be an effective remedy for vaginal candidiasis.

 Risk communication is a complex, multifaceted process that plays a significant role in disaster management. One of the criticisms of Iran's health system risk communication is the existence of legal gaps and deficiencies in upstream documents.

 This research evaluated national documents to identify and assess the legislative gap in health system risk communication.

 This research is a gap analysis study using the qualitative content analysis method. National documents from 2002 to 2022 related to disaster management were collected. Documents were entered into the blueprint designed by the researcher and analyzed.

 In the present study, 58 documents due to disaster management were extracted. After the initial review, 36 documents involving 266 items concentrating on risk communication were included in the research. In initial thematic analysis, 47 approvals due to the mitigation phase (five subcategories of information, education and public awareness, infrastructure development, community engagement, and preparation and maintenance of information systems), 61 approvals due to the preparedness phase (nine subcategories of monitoring, information and maintenance of database, creation and maintenance of network and communication infrastructure, coordination, organizational training, planning, determining level of access to information, communication, monitoring and evaluation), 133 approvals due to the response phase (11 subcategories of information management, informing, communication management, media management, trust building, organization and coordination, appointing a spokesperson, monitoring and control, use and management of social media, content production, and supply and maintenance of equipment and infrastructure), 25 approvals due to the phase of rehabilitation and reconstruction (four subcategories of documentation, information, training, and community engagement).

 The field of risk communication has been mentioned according to the revision and updating of documents in recent years, but in these documents, many aspects of risk communication were dim; therefore, experts in the field of disaster management should pay more attention to a review of these papers and the creation of a special document on risk communication.

 Poor menstrual health is a risk factor for genital infections and infertility and may affect family health and the community’s future.

 This study aimed to determine the effect of educational intervention based on the PRECEDE model on improving menstrual health behaviors among female students.

 This quasi-experimental study was conducted on 130 first-grade high school female students and their mothers randomly selected from six schools and divided into intervention and control groups. Three two-hour educational sessions were conducted for the students and their mothers in the intervention group based on the pretest results. Data were collected immediately and three months after the educational sessions using a questionnaire with confirmed validity and reliability. Data were analyzed using SPSS v. 21 with repeated-measures ANOVA and t-test. The significance level was considered at 0.05.

 The educational intervention based on the PRECEDE model increased the mean scores of predisposing, enabling, and reinforcing factors in the intervention group and finally increased the mean score of health behavior immediately (24.1 ± 4.62, P < 0.001) and three months after the intervention (22.84 ± 4.04, P = 0.02) compared to before intervention (19.68 ± 5.48).

 The results showed a change in factors affecting behavior (predisposing, enabling, and reinforcing factors). The PRECEDE model changed the menstrual health behaviors among the students.

 Deficiencies of micronutrients increase the risk of various infections in HIV-infected patients. Zinc deficiency in HIV-infected patients may be associated with decreased CD4 cell counts.

 In this regard, the present study investigated the association between serum zinc levels, macro/micronutrient intake, and CD4 counts in HIV patients.

 The research population of this study included 194 adult HIV patients aged 18 to 70 years referred to Shiraz Behavioral Diseases Center, Shiraz, Iran. The CD4 cell counts were extracted from patients’ records. Serum zinc level was measured using atomic absorption method. Univariate and multivariate comparison of macro/micronutrient and food items with CD4 cells was performed using linear regression and SPSS20, and P < 0.05 was considered statistically significant.

 Fifty-seven percent were male, and the mean age and SD of total participants was 43.76 ± 9.06 years. The association between serum zinc levels and CD4 serum count is close to the significance level (P = 0.05), but the dietary zinc intake was not significantly correlated with serum CD4 counts (P = 0.26). Vegetable intake (P < 0.001) and fruits (P = 0.01) as well as absorption of vitamin A (P = 0.002), vitamin C (P < 0.001), beta-carotene (P = 0.002), folate (P = 0.05), and fiber (P = 0.01) from diet showed a direct and significant association with serum CD4 levels in HIV patients. Consumption of hydrogenated oils (P = 0.04) showed a significant inverse association with serum CD4 levels in these patients.

 Evaluation of serum micro/macronutrients can play an essential role in the development of appropriate dietary and supplement guidelines provided by the healthcare system for HIV-infected patients, and it can influence the decision- and policy-making regarding the control of non-pharmacological management of these patients.