Journal of Iranian Medical Council
Volume:6 Issue: 3, Summer 2023

Chemical warfare agents are chemical, usually extremely toxic weapons of mass destruction, which, although they have been used for centuries, have not yet been fully and comprehensively described. Nowadays they are classified as nerve agents, blistering agents, blood agents, choking agents, tear gases, psychomimetic agents, and toxins. The mass production, and consequently, widespread deployment of these agents has been documented since the 19th century after the expansion of industrial chemistry. Since then, several large-scale attacks using them have been reported (1). Chemical weapons can be viewed from various aspects, including environmental, legal, ethical, medical, etc.; insufficient attention has been paid to its psychiatric aspect and considerations. The psychiatric aspect of chemical attacks has been neglected, or at least not sufficiently addressed. Indeed, if medical preparation for chemical attacks were to be practiced, it would probably not involve psychiatrists or consider sufficient psychiatric assistance. Meanwhile, mood, cognitive, and behavioral disorders are common due to trauma and chemical agents, both short-term and long-term. Psychiatrists have considerable multifaceted roles and duties in such a crisis, including helping to differentiate somatization and anxiety in patients referred to the emergency room, treating short-term and long-term psychiatric disorders, crisis management intervention to health workers, and providing recommendations and guidance to decision-makers (2). Several effects of chemicals on mental health in people exposed to them in war or research have been reported, including intellectual impairment, problems in concentration, anxiety disorders, sleep disorders, psychomotor retardation, depression, social withdrawal, antisocial thoughts, fatigue, amnesia, restlessness, and irritability (2-4). Psychiatric disorders caused by chemical weapons can afflict people long after the attack so that a study showed that psychiatric and psychological findings, including somatization, obsessive-compulsive disorder, depression, anxiety, and hostility, were higher in the population exposed to sulfur mustard and horror and fears, even up to 20 years after exposure (4). Sulfur mustard is a blister agent that still has no effective antidote. The city of Sardasht, West Azerbaijan, Iran was the victim of a chemical attack on June 28, 1987, during the invasion of Iran. On that sunset, many people were massacred, and since then, many people have suffered from the consequences, the psychiatric side of which is only a small part.

The recent rapid developments in medical science and technologies have brought about powerful medical tools; however, the professional commitment has failed to keep pace. Professionals’ reluctance or failure to practice professional behavior has significantly challenged society’s trust in professionalism. Consistent assessment of the profession, at least through measuring the capabilities and encouraging the elimination of shortcomings, can serve as an effective tool to preserve or restore this trust. Numerous assessment methods are recommended to measure the level of professionalism among the members of the medical society. Sometimes, professionalism is defined using shared values and sometimes various lists of professional behaviors are suggested. However, no comprehensive definition has been proposed for professionalism. Professionalism is normally individual. This study sought to provide a comprehensive definition of professionalism and accordingly explains organizational professionalism. In addition, it tried to define profession assessment through a non-systematic review of online resources using Web of Science, Science Direct, and PubMed databases. Professionalism is a belief system or a driving force to create these lists to improve healthcare, according to which professionalism requires collective action. The philosophy underlying the common standards of physicians regarding the patient-physician relationship confirms the importance of teamwork and organizational professionalism. Following professional autonomy, assessment of the members of a profession is carried out via self-assessment. Meanwhile, the continuation of the self-assessment system entails patients’ trust in their physician and society’s trust in the profession of medicine. Furthermore, the medical profession should operate with more transparency, thus the society can feel that the self-assessment is really effective. Thus, constant and dynamic self-assessment is started with the physicians and expanded through the clinical team. The profession should administer systematic professionalism in all dimensions of the health system. In addition, it should guard its self-assessment privileges obtained from society and seek the assistance of ordinary individuals in society, patients, and experts in fulfilling this task.

In addition to morbidity and mortality, the COVID-19 pandemic affected various fields such as medical and academic education. The purpose of this study was to investigate the types of social media used in medical and academic education and identify their advantages and disadvantages.

A systematic search of PubMed, Scopus, and Web of Science was conducted to identify published studies related to the effects of social media on medical and academic education during the COVID-19 pandemic. The retrieved records were screened in a two-step process; first by title/abstract and then by full text by two independent researchers and the most relevant studies were selected applying the eligibility criteria.

Facebook, YouTube, Zoom, WhatsApp, Moodle, and Skype were the most used platforms. The main purpose of using these applications was to provide distance education to students in the pandemic era. The advantages of using online platforms outweighed the disadvantages. Advantages include the availability of information at any time and place, maintaining communication between students and classmates and instructors, and the possibility of presenting conferences and assignments. Disadvantages comprised infrastructure and internet problems.

Social media and messengers have a great potential to meet educational purposes in the epidemic era. Although online platforms can serve as an efficient public repository of learning resources, achieving this needs some prerequisite and infrastructural tasks.

One of the most common complaints following a stroke is loss of balance, which affects around half of all stroke patients. Nevertheless, there is no general physiotherapy method that proved to be more effective in improving post-stroke balance. This study aimed to investigate literature regarding the use of aquatic dual-task exercises for improving balance ability post-stroke.

A literature search was performed with the help of Cochrane Library, PubMed, and Embase databases to select the studies related to aquatic dual-task training on balance improvement in stroke patients. The inclusion criteria were full-text published articles in English, studies that included patients above the age of 18 years with diagnosed stroke, which investigated any form of aquatic exercise therapy with a dual-task aimed at improving post-stroke balance control while comparing pre-intervention and post-intervention outcome measures.

With the help of given keywords, 573 articles were found initially. After excluding articles for various reasons, three articles were finally included in the review.

According to the results of this study, it can be concluded that aquatic dual-task training has a positive impact on the balance improvement of stroke patients.

 Given the catastrophic results of antiphospholipid syndrome (APS) left untreated, the possible role of non-criteria antiphospholipid (aPL) in the diagnosis of seronegative (SN)-APS patients, and its impact on the timely treatment of people with SN-APS, the present review aimed to gather the available literature up to 2022 focusing on the role of non-criteria aPL in the diagnosis of SN cases suspected of APS using non-criteria aPL. 

 All published papers focusing mainly on the diagnosis of the SN-APS patients by non-criteria aPL were searched in four databases of PubMed, Scopus, Medline, and Web of Sciences, followed by manual search up to 20 February 2022 using such keywords as “Antiphospholipid Syndrome”, “Seronegative”, and “Non-Criteria”. Finally, 15 studies were selected after the detailed evaluation of the full-text versions.

 Based on the obtained results of our study, 24% to 81.9% of the SN-APS cases were positive for at least one isotype of non-criteria aPL. Thrombophilia events were more frequent in the APS population, compared to SN-APS; however, obstetric manifestations were more frequent in the SN-APS population, compared to seropositive-APS. Antivimentin/cardiolipin and antiphosphatidylserine/prothrombin IgG/IgM were introduced as the best non-criteria aPL to detect seronegative cases that were correlated with clinical manifestations.

 It seems that a combination of testing for non-criteria aPL should be performed for cases suspected of APS with negative criteria markers.

 This study was conducted to understand and compare the Iranian students’ attitudes toward patients with mental illnesses in different college majors. 

 In this cross-sectional study, information about students’ attitudes toward patients with mental illnesses was gathered through “The social distancing” and “The dangerousness” questionnaires. 

 A total of 243 Iranian students in four different college majors: medicine, art, law, and engineering, participated in the study. The “social distance scale” was significantly different between the college majors (p=0.03), as the art students had the least stigmatizing attitude. Furthermore, there was no significant difference in the “dangerousness scale” between different college majors (p=0.93).

 Understanding the attitude of students toward patients with mental illnesses and their differences is vital to perform proper interventions on stigmatizing behaviors for students as future specialists. Also, the underlying reasons for having a less stigmatizing attitude in certain groups should be recognized and employed to reduce stigmatizing attitudes in other groups.

Today, the impact of oral health on indicators of quality of life is of great importance. As few studies have evaluated dental students who are future dentists of a society, this study was performed to assess the impact of awareness on oral health-related quality of life on first, third- and sixth-year Shahid Beheshti dental students in 2017-2018.

This descriptive cross-sectional and analytical study was conducted on 220 Shahid Beheshti dental students. The required data was collected by using a sociodemographic questionnaire (including gender, academic year indicating level of awareness, and GPA) and Persian version of oral health-related quality of life questionnaire, OHIP-14. The questionnaires’ scores were compared by one-way analysis of variance (ANOVA) or Welch’s t-test.

The average total score of OHIP-14 questionnaire in dental students was 8.26 (SD=7.41). A significant relationship between the academic year and oral health-related quality of life was not noticed except in “Psychological Discomfort” domain where oral health-related quality of life deteriorated with an increase in the academic year (p=0.0001).

Oral health-related quality of life in dental students did not change significantly with an increase in the academic year except in “Psychological Discomfort” domain.

Assessment of the Quality of Life (QOL) is increasingly performed as an efficient method to assess the quality of care provided for patients with schizophrenia. Also, the QOL assessment performed by patients themselves is more affected by the symptoms of schizophrenia. Therefore, a mental health professional evaluation may provide more objective information. This study was undertaken to objectively assess QOL in a group of remitted patients with schizophrenia in Iran by using Quality of Life Scale (QLS).

This descriptive cross-sectional study was performed on 85 remitted patients with schizophrenia consecutively referred to Roozbeh Hospital. The mean age of the participants was 37.81±9.92 years, 54 (63.53%) were male, 16 (18.8%) were married, and 19 (22.4%) were employed. The Quality of Life Scale (QLS) was used to collect data through face-to-face interviews.

The total score of QLS for patients is 2.95±0.93. Among subscales, the interpersonal relations scores (2.44±1.10) and intrapsychic foundations scores (2.90±1.07) were lower than the other domains scores. The QLS score was higher in patients with an associate degree or higher level of education (p-value<0.01) and those living with family members (p-value<0.01). The overall employment rate was low among the patients. There was no significant relationship between current doses of various medications and any QLS domain scores; however, a significant inverse relationship was between the current doses of first- and second-generation antipsychotics and the instrumental role domain score.

The findings of this study showed that the scores of different domains of QLS were low in the remitted patients with schizophrenia. The impact of different antipsychotic treatments and their side effects on the QOL should be addressed in future studies.

This study aimed to evaluate the effectiveness of music therapy on the components of sensitivity, memory, and auditory sequence of 7 to 9-year-old girls with reading disorders.

The selected method for the present study was quasi-experimental with a pretest-posttest design and a control group. The statistical population of the present study comprised 30 volunteer girls aged 7 to 9 (Persian speaking) with reading disorders who were randomly placed in experimental and control groups (15 people each). The experimental group participated in music therapy sessions for 30 minutes twice a week for four months. First, to increase their proportion of focusing on music little by little; second, to increase the speed of the music gradually during the sessions; and third, to replace the active method slowly with the passive approach and move the tendency of the selected melodies from monophonic and vocal-less texture to polyphonic and vocal orchestral texture.

The data were analyzed using paired t-test. The results showed that the experimental group’s sensitivity, memory, and auditory sequence were significantly higher than those in the control group post-test (p<0.001).

Music as an applied method can effectively improve the auditory symptoms of children with reading disorders.

The current study decided to assess CT scan findings in patients with any kind of pleural effusion to obtain any diagnostic value of this modality of imaging to discriminate malignant conditions from benign ones, especially pleural or pulmonary tuberculosis.

Through a cross-sectional design, patients with pleural effusion enrolled in this study when their diagnosis was known as malignancy or tuberculosis. The findings of chest CT-scan were compared between the two conditions and the frequency and statistically different variables were reported as discriminating factors between malignancy and tuberculosis.

Among our findings, male sex was prone to tuberculosis, but pleural thickening >10 mm, lung collapse and lung mass in CT-scan, were the most prevalent findings in malignancy and absent in tuberculosis cases. No significant differences were observed in the free or loculated effusion, air-fluid level and gas, Hounsfield score and loculation involvement between groups.

CT scan, despite its unconfirmed diagnostic values, could be considered as a very useful part of diagnosing malignancies against benign or infective causes of pleural effusion, especially in terms of pleural thickening more than 10 mm, lung collapse and lung mass disregarding transudative or exudative as well as uni- or bilateral, free or loculated, mild or severe, or other kinds. CT scan scoring system may be the next topic to work on by authors.

 Some dietary patterns like Dietary Approaches to Stopping Hypertension (DASH) and/or Mediterranean Diet (MED) are often recommended to prevent Cardio Vascular Diseases (CVDs) based on their effects on lipid profile. Thus, we aimed to investigate the relationship between the DASH diet score and Mediterranean diet score with lipid profile in healthy individuals aged 20-50 years in Shiraz, Iran. 

  In this cross-sectional study, 236 participants were selected from Shiraz (Iran) medical centers through random cluster sampling. Information about food intake was collected using a 168-item Food Frequency Questionnaire (FFQ), then DASH score and MED diet score were calculated. Logistic regression was used to evaluate the relation between DASH and MED score adherence and lipid profile.

 Individuals in the highest tertile of MED and DASH pattern adherence had significantly lower Low-Density Lipoprotein (LDL) compared with those in the first tertile (p<0.05). In both crude and adjusted model, higher adherence to the MED pattern was associated with reduced odds of Total Cholesterol (TC) (OR: 0.30; 95% CI: 0.13–0.66 and OR: 0.27; 95% CI: 0.12–0.61) and LDL (OR: 0.36; 95% CI: 0.17–0.77 and OR: 0.32; 95% CI: 0.15–0.70). Moreover, higher adherence to the DASH pattern was associated with reduced OR of LDL in crude (OR: 0.43; 95% CI: 0.19–0.94) and TC in adjusted model (OR: 0.44; 95% CI: 0.20–0.96). 

 The study illustrated a negative association between the MED diet and serum levels of TC and LDL. Also, a higher DASH score was associated with lower TC. Future studies are necessary to confirm these findings.

Psoriasis is recognized as a chronic immune system disease with unknown etiology that affects the skin. It might lead to psychological issues and pose considerable distress. The purpose of this study was to investigate the rate of social acceptance in psoriasis patients.

This was a cross-sectional study which was carried out on all the patients (n=100) referred to specialized skin diseases clinic in Yazd, Iran. 100 psoriasis patients and 100 healthy people as a control group were enlisted. The patients were eliminated from the research in case they had other chronic medical conditions since it could affect social acceptance. The patients completed a social acceptability questionnaire (Marlowe–Crowne Social Desirability Scale) and demographic information was also collected. Data were analyzed by ANOVA and chi square test in the form of descriptive and inferential statistics using SPSS-24 software.

The mean of patients’ age was 36.97±13.94 years old and 66% of the patients were female. Mean score of social acceptance was 18.04±4.4. The mean score of social acceptance in psoriasis patients’ group (>40 years old) was estimated higher than in other groups (p>0.05). The results revealed that only the job variable affected the Mean±SD of social acceptance in these patients. The rate of social acceptance in psoriasis patients was higher in those with governmental jobs in comparison to those with self-employment jobs. Overall, the level of social acceptance in people with psoriasis was lower than in the control group.

This study showed that psoriasis patients who had governmental jobs received a great deal of acceptance via the people around them and they generally had a better quality of life.

More than 80 genes are involved in the pathogenesis of the most common single gene peripheral neuropathies denoted as Charcot-Marie-Tooth (CMT). Only a few studies have investigated the pathological molecular mechanisms of Iranian patients affected with CMT. The aim of this study is to identify the clinical manifestation, mutational spectrum and phenotypic correlation of a cohort of patients with Charcot-Marie-Tooth disease (CMT) in Iran.

We conducted a comprehensive gene panel sequencing consisting of 80 genes in a cohort of 23 patients with CMT referred between January 2015 and March 2021. The recruited samples indicated almost an equal distribution of demyelinating and axonal types of CMT, with practically no difference between AD or AR patterns of inheritance.

Four novel mutations, including c.271C>T in LITAF and c.205+1delG in NDRG1, c.2455A>C in KIF1B and c.1728A>G in FIGF were detected in four patients affected with demyelinating CMT types (CMT1C and CMT4D), and characterized phenotypically.

Our promising results unravel the complicated genetic architecture of Iranian CMT patients and help physicians and researchers achieve earlier diagnosis, better clinical management and recognizing high risk families. Further large-scale studies are needed to improve our understanding of CMT complex genetic architecture

Eccentric exercise makes more tensions in active muscle fibers, resulting in muscle damage and delayed pain. Therefore, Delayed-Onset Muscle Soreness (DOMS) is a common result of severe eccentric contractions. This study aimed to clarify the combined effect of taurine and omega-3 supplementation on DOMS and muscle damage after high-intensity eccentric exercise in young untrained men.

Forty-eight young untrained males were assigned to four groups (taurine+omega-3 [combined], taurine, omega-3, and one placebo group) and given 1,500 mg taurine and 1,500 mg omega-3 or 1,500 mg taurine or 1,500 mg omega-3 or placebo twice a day respectively. Each group received its supplements for twenty-eight days. DOMS and muscle damage in the lower body developed using a leg press with a weight equivalent to 70% of 1RM (One-Repetition Maximum). Lactate dehydrogenase (LDH), Creatine kinase (CK) and perceived muscle soreness measures were repeated before, immediately, 24, 48, and 72 hr after eccentric activity. p<0.05 was considered to be statistically significant.

In the combined group, there was no increase in CK and LDH in immediate time and 72 hr after the exercise, respectively, compared to the period before the workout. At 24 and 48 hr after the training, there was a significant decrease in muscle pain perception in all groups compared to placebo (p<0.05).

Coclusion: 

A combination of 1500 mg taurine and 1500 mg omega-3, two times a day, for four weeks can reduce the levels of CK and LDH enzymes as some indicators of muscle damage. It also attenuates exercise-induced DOMS and muscle damage.

According to World Health Organization report, poisoning with phosphides is the most common fatal poisoning in most of the world, especially developing countries. One of the leading causes of morbidity and mortality in these patients is cardiovascular complications; therefore, the researchers aimed to study the prevalence and type of electrocardiographic changes, especially life-threatening electrocardiographic changes observed in poisoned patients with aluminum Phosphide.

This retrospective cohort study was carried out on all the individuals poisoned with aluminum phosphide tablet and were admitted to the toxicology center in northwest Iran and met the inclusion criteria and no exclusion criteria. After categorization, the data were entered into SPSS (SPSS Inc, Chicago, USA) software, and appropriate statistical analyses were done. In all the tests, p<0.05 was considered statistically significant. 

Our findings pointed out that the majority of the patients were in the 20-40 age group and male-to-female ratio was 2.00. Electrocardiographic changes were prevalent in 86.1 percent of the patients who consumed aluminum phosphide. The most common change was sinus bradycardia. The mean consumed aluminum phosphide was 1.93±1.88 tablets, and the mean interval from consumption to medical care was 3.67±2.05 hr which did not have significant correlations with electrocardiographic changes.

The most common electrocardiographic change is bradycardia, but the most lethal is ventricular tachycardia; therefore, taking repeated electrocardiograms and echocardiography could help the decision making in the process of patient management. Definitive conclusions need further studies.

One of the effective methods to control chronic hemophilic synovitis is radiosynovectomy. Rhenium-188 is a new radionuclide, and its half-life is 0.7 day. This study aimed to investigate the effect of radiosynovectomy with Rhenium-188 on the knee joint of hemophilic patients. 

Thirty patients with hemophilic synovitis of the knee visited in the orthopedic clinic in 2019 and 2020, entered the study. They all had at least two bleeding per month; in the supine position with slight knee flexion, after local sterilization, 550 to 750 MBq Rhenium-188 was injected into the knee. A splint was installed for five days. The demographic characteristics, radiography, articular line tenderness, joint line tenderness, flexion and extension restrictions, and joint volume characteristics were evaluated before and six months after injection. 

The amount of monthly injected factors (VIII and IX) 6 months after injection was decreased from 5260.2±1836 units to 3870.83±1106 units (p<0.001). The radiographic classification has not changed within six months. The average knee pain score decreased from 7.3±1.2 to 2.3±1.1, after six months (p<0.001), and knee flexion increased from 84.6±26.22 to 114±21.58 degrees (p<0.001). None of the patients have experienced complications such as skin necrosis or joint infection. All patients have reported that the pain increases 24 hr after the injection were manageable.

The use of Rhenium-188 radiopharmaceutical in radiosynovectomy of 30 hemophilic patients’ knees is effective in reducing pain, tenderness of the joint line, and the number of bleeding episodes, and it improved knee range of motion in the short term (6 months). 

Vitiligo is an acquired, auto-immune chronic skin disorder with different treatment modalities. Insufficient adherence to treatment is closely related to the efficacy of a prescribed treatment, and also, there are some associations between adherence behaviour and personality. Therefore, the study aimed to assess a relationship between five-factor personality traits and treatment adherence in patients with vitiligo.

In this cross-sectional study, patients with vitiligo who received Ultraviolet B (UVB) phototherapy were recruited. The Morisky Medication Adherence Scale (MMAS-8) assessed treatment adherence, and personality factors were evaluated by NEO Five-Factor Personality Inventory (NEO-FFI). Data were analysed using t-tests, correlations, and multiple regression.

Among 70 participants, 62.9% had low adherence, 24.3% had medium adherence, and 12.9 % had high adherence. There was a positive correlation between neuroticism (p<0.001) and adherence score. Furthermore, a negative correlation between Agreeableness (p=0.13), Conscientiousness (p<0.001), Openness to experiences (p=005), Extraversion (p<0.001), and adherence score was obtained. In the regression analysis method, only the factors of neuroticism (p<0.001) and openness ( p=0.001), and conscientiousness ( p=0.016) predicted the dependent variable (adherence score) at the significance level.

This study demonstrated that openness to experience and conscientiousness positively affected adherence, while Neuroticism negatively affected adherence. Considering these personality factors can effectively screen poor adherence and improve treatment adherence.

The aim of this study was to compare postural control between Adolescents with Idiopathic Scoliosis (AIS) and healthy adolescents.

In this cross-sectional study, 20 AIS adolescents with a right thoracic curvature between 10 and 45 degrees and 20 healthy adolescents were matched to compare postural control. Postural control assessments included Center of Pressure (COP) range and COP velocity in the Anteroposterior (AP) and Mediolateral (ML) directions, and the COP sway area in the standing position with opened eyes and closed eyes by the force plate.

This study showed that the postural control variables in AIS adolescents and healthy adolescents in terms of COP range, COP velocity, and COP sway area in standing positions with open and closed eyes were significantly different with those of AIS adolescents being worse than those of healthy adolescents (all p<0.001). The interaction between Group and Condition (eyes open and eyes closed) was not significant for all variables (all p>0.05).

Differences in the postural control measures indicate postural instability in adolescents with AIS compared to healthy adolescents.

Despite patients’ and caregivers’ approval of the importance of compassionate care, without proper measurement, we cannot know the level of compassion or the effectiveness of interventions. Thus, the aim of this study was to assess the reliability and validity of the Persian version of the Schwartz for Compassionate Care scale.

The scale was translated using the back and forward technique. The construct validity was assessed using confirmatory factor analysis. Concurrent validity was examined by Pearson’s correlations between this scale and the patient satisfaction with nursing care quality questionnaire. The reliability was assessed using test-retest and internal consistency methods.

The results of the confirmatory factor analysis reported almost adequate values for all fit indices (χ2/df = 2/85, RMSEA= 0/07, CFI= 0/88, GFI=0/92, AGFI=0/88 TLI=0/90) and concurrent validity was high. Cronbach’s alpha was reported as 0.95 and the results of the test-retest in checking the time stability of the scale were reported as 0.78. 

It can be concluded that Schwartz’s Compassionate Care scale had almost acceptable validity and reliability for Iranian nurses’ caring behavior. Therefore, the Persian version of this scale should be used with caution in Iran.

This is a case-control study aimed at investigating the predictors of sexual function, depression levels, and quality of life in cervical cancer patients.

The study enrolled women aged 18 years and older who were at least six months post cervical cancer diagnosis and treatment in a single institution and underwent surgery or radiotherapy. The control group was selected from women referred for routine gynecologic screening. The study excluded women who had a history of sexual trauma and mental disorders, any general health problems, and therapy potentially affecting sexual life, such as hormonal therapies other than contraception. Demographic and clinical data of all participants were gathered, and all participants were asked to respond to two questionnaires: the Female Sexual Function Index (FSFI) and the Medical Outcomes Study 12-item Short Form health survey (SF-12) in a face-to-face interview. The study analyzed the data using descriptive statistics and comparison of demographics, clinical data, tumor and surgical characteristics. Linear regression tests were used to predict numerical outcomes, and a p-value <0.05 was considered statistically significant.

The study concluded that there were no baseline characteristics identified to have statistically significant differences among study groups, and all three groups had similar distributions of socioeconomic and demographic variables.

This study showed that cervical cancer and route of treatment may affect the patients’ quality of life and sexual health. Health care systems and health care providers may screen these patients and take early actions to prevent more morbidities.

The study focused on analysing the mental health such as emotional, social and psychological well-beings of the teenage girls towards the pregnancy and investigate the various factors such as sexual relationship associated with teenage pregnancy.

The study took a cross-sectional approach and adopted convenient sampling method for data collection. Data was collected from teenage girls aged 12 to 21 years from the state of Sabah. Data collection accomplished through survey data assessment, with survey responses data being collected through structured questionnaire as the effective research tool. The collected data is then statistically analysed for regression, ANOVA, one-way ANOVA and correlation analysis.

Exploratory data analysis about the participants were explicated using frequency analysis. The statistical Test outcomes delineated the occurrence of significant relationship between engagements in sexual relationship with the age, marital status, distance of education, school attitude, self-esteem, self-efficacy, perceived social support, Peer community influences, Edinburgh Postnatal Depression Scale (EPDS), coping ability variables and other predictor variables. Similarly One-Way anova test, reveals the existence of statistical significant mean differences among age attribute of teenage girls, their engagement in sexual activity, predictor variables and their demographic details.

The life of the teenagers who are engaged in sexual activity were observed to be more challenging in terms of medically, psychologically, and physically. The present study strongly recommends that social activists would adopt possible measures in revealing a better solution towards the teenage pregnancy.

Elevated Mean Platelet Volume (MPV) can indicate the activation of platelets and the coagulation cascade, which has been suggested as a predictor of mortality in some diseases. The aim of this study was to investigate the role of MPV in predicting hospital mortality in patients with Covid-19.

This was a cross-sectional single-center retrospective study. The data of all patients with a PCR-confirmed diagnosis of Covid-19 hospitalized within a 3-month period were analyzed. The patients’ files were reviewed, and the data were recorded into a checklist, including demographic characteristics, underlying diseases, and laboratory test results. Hospital mortality was designated as the main outcome of the study.

A total of 201 Covid-19 patients, confirmed by PCR, were included in this study. In-hospital mortality was observed in 28 patients (13.9%). The results of univariate regression analysis revealed that the triage level, history of chronic pulmonary disease, age, oxygen saturation, lymphocyte count, BUN, Cr, and CRP were significantly related to in-hospital mortality. However, MPV showed no significant relationship with in-hospital mortality.

Low triage level, advanced age and hypoxia predicted a higher risk of in-hospital mortality in Covid-19 patients. The role of MPV as a predictor of patient outcome in Covid-19 remains inconclusive, necessitating further studies with larger sample sizes.