نشریه تحقیق و توسعه سلامت
پیاپی 1 (پاییز 1402)

Covid-19 epidemic is the most important global health problem. The aim of this study was to compare the epidemiological status waves of Covid-19 in the southern Fars, Iran.

This descriptive study with secondary data analysis of 47161 outpatients and hospitalized Covid-19 from the Center for Disease Control and Prevention and the Medical Care Monitoring Center (MCMC) of Jahrom University of Medical Sciences from the beginning of March to 2020 to the end of May 2021. During this period, three waves occurred in Jahrom city.

A total of 41421 patients(87.82%) were outpatients and 5740 patients (12.18%) were hospitalized. Most cases in the first and third waves were in the age group of 20-49 years and in the second wave were 50-69 years (p <0.001).The percentage of patients who died in the first to third waves were 8%, 10.4% and 4.1%, respectively(p <0.001). People with high blood pressure (27.9%) and heart disease (21%) are the most hospitalized. In general, the most common clinical symptoms were dyspnea (52.3%), cough(44%) and fever(36.2%). The proportion of patients with po2<93% in all three waves were 33.7%, 47.5% and 32.1%, respectively and the proportion of patients receiving oxygen was 1.6, 56.9 and 42.3%, respectively.

The symptoms of Covid-19 in patients admitted in three waves were not much different and were almost similar in terms of disease severity. The increase in deaths in the second wave is mostly due to differences in age groups or people with underlying diseases.

Epidemiological studies show that long-term exposure to aluminum (Al) nanoparticles in occupational environments leads to cognitive impairment and neurotoxicity. Al is a relatively widespread neurotoxin associated with motor and cognitive disorders and associated with neurological diseases. For many years, Al has been implicated in the etiology of Alzheimer's disease (AD) in the so-called "Al in AD hypothesis". Recently, most studies have described how it plays a role in the onset, aggressive nature, and progression of AD. The toxicity of Al is related to its pro-oxidant activity, which acts through the formation of Al superoxide radical cation. At present, while the role of Al in AD is becoming clearer, the underlying mechanism of toxicity is still not understood. In this study, we investigate the effect of phosphorylated tau and cognitive impairment due to exposure to very fine aluminum particles.

Thalassemia is a common genetic blood disorder that is chronic and is associated with a wide range of serious psychological and clinical challenges, affecting an individual's psychological well-being similar to other chronic illnesses. This study aimed to determine the prevalence of depression in patients with thalassemia major and thalassemia intermedia related to blood disorders.

In this cross-sectional descriptive study, 61 patients with thalassemia major and nine patients with thalassemia intermedia from Jahrom city participated in the year 2019. Data collection tools included a demographic information questionnaire and the Beck Depression Inventory. Data analysis was performed using SPSS version 16, and descriptive and analytical statistics were applied.

The prevalence of depression in patients with thalassemia major was 42.6%. Eight individuals (1.13%) had mild depression, 13 individuals (3.21%) had moderate depression, and five individuals (2.8%) had severe depression. The average depression score did not differ between male and female thalassemia major patients (P > 0.05). This average score was 53.9 ±17.52 for patients with below diploma education, 29.7 ± 11.92 for diploma holders, and 51.3 ± 4.51 for bachelor's degree holders (P < 0.05). Additionally, the prevalence of depression in patients with blood-related intermediate thalassemia was 33.3%. Mild depression was present in 2.22%, and severe depression in 1.11% of these patients.

The prevalence of depression in patients with thalassemia major is higher than in those with thalassemia intermedia. It is recommended that healthcare and psychological services for patients with thalassemia major and intermedia be designed to improve their quality of life and reduce depression. Furthermore, providing education and increasing awareness about depression management and the importance of social support for these patients can be effective.

Excessive bleeding during and after childbirth is a serious complication that can endanger the life of the mother. The present study reported a case of active arterial bleeding after normal delivery.

The patient is a 22-year-old woman, G2L1 (second pregnancy), who underwent natural childbirth due to labor pains, decreased fetal movements, and exceeding the due date. The baby girl was born naturally without any complications, with an Apgar score of 9 and a weight of 3050 grams, without dystocia or any specific abnormalities. Approximately three hours after delivery, the mother experienced dizziness and fainting while trying to get out of bed. At that time, the patient's pulse was 120 bpm, and she appeared pale. The patient's blood pressure was reported as 60/90, and there was no vaginal bleeding. The uterus was palpated in its normal position above the suprapubic area. The vagina and cervix were checked again and found to be without any abnormalities or bleeding. Due to the persistence of the patient's symptoms, an emergency abdominal and pelvic ultrasound was requested, which was performed after several hours of delay. Consultation with a urologist was requested, and it was suggested to perform a cystogram and abdominal ultrasound on the patient. The abdominal ultrasound reported a large hematoma measuring 3.14 x 7.5 x 17 cm in front of the uterus and behind the bladder. The patient was transferred to the operating room and underwent general anesthesia. The abdomen was opened through a wide incision. A large hematoma measuring 17 x 18 cm was found in the area behind the bladder and in front of the uterus, extending up to the fundus of the uterus and broad ligaments. The hematoma was drained and found to be located in the lower uterine segment, without any connection to the cervix or inside the uterus.

Active primary and secondary intra-abdominal hemorrhage is one of the surgical emergencies after delivery. The patient should undergo surgery immediately and the bleeding should be controlled.

Considering the important issue of hospital deductions and the benefits of reducing them which increase the satisfaction of physicians, hospitals and patients, increase hospital income and efficiency, increase the quality of health care and prevent waste of hospital financial resources, this study was conducted to compare the insurance deductions of inpatient records of Shahid Rahnemoon Hospital in Yazd province in 2021 and 2022.

This descriptive study was performed on all records of hospitalized patients in Shahid Rahnemoon Hospital, affiliated to Shahid Sadoughi University of Medical Sciences, Yazd.

The highest deductions in 2020 were in June (13.8%) and the lowest was in February (0.09%) and February (0.06%). Also, the highest deductions in 1400 were in September (10.37%) and the lowest was in April (7.97%). The findings showed that there was no significant relationship between occupied beds, number of discharged and length of stay with deductions in 2020 and 1400 (p>0.05), however, there was a significant relationship between bed occupancy percentage and deductions in 2020 and 2020 (p<0.05).

According to the principle of parting and in order to effective intervention in order to reduce deductions, it is suggested that special attention be paid to the main causes of deductions identified and codified programs including solutions to reduce deductions of bills and hospital dissatisfaction with payment of receivables.

Medical personnel, as the people who are on the front line of the fight against the Covid-19 disease, and at risk of acquiring the disease due to in contact with or care for patients with COVID-19. The aim of the present study was to evaluate the quality of protective equipment used by medical personnel during the Covid-19 pandemic.

The present study was conducted cross-sectionally on the medical personnel in three hospitals in the south of Fars province in 2021year. The data collected in the present study was based on the risk assessment and management of exposure of health care workers in the context of COVID-19 tool by World Health Organization.

The study conducted on 800 medical personnel, 54.7% (350 N) had a history of contracting covid-19. The most protective equipment used during a health care interaction with a COVID-19 patient were hand hygiene 95.6% (610 N), hand sanitizers 92.5 (588 N) and medical masks 92% (586 N). The least protective equipment used during aerosol-generating procedures on a COVID-19 patients were the waterproof apron %54.3 (343 N), protective glasses 60.5% (383 N) and N95 mask (398 N).

According to the survey conducted, the quality of protective equipment used in medical personnel is low and the risk of exposure to the Covid-19 virus is high. Ongoing training on infection control principle and closely monitor these principles could be effective in increasing the perceived threats of medical personnel and their adherence of it.

Disasters can lead to large human casualties, destruction of property and economic and environmental resources. The purpose of the present study was to determine the status of risk perception and behaviors related to reducing the risk of natural disasters in the south of Kerman province.

This quantitative and cross-sectional study was conducted on 528 households in Jiroft city. Sampling was done by combined method. A total of 528 households were included. The tools for collecting data were demographic information and a researcher-made questionnaire related to risk perception and preventive behaviors from the harmful effects of natural disasters. Data was analyzed using SPSS v21 software, and the necessary analyzes  (descriptive tests, chi-square and Pearson's correlation test) were performed at a significance level of 0.05.

The results showed 51.7% lived in the city and 62.1% of residential buildings were of brick without markings. There is a significant difference between preventive behaviors and direct exposure to disasters (p<0.001), education (p=0.004), monthly income (p=0.004) and source of information (p=0.040). There was also a significant correlation between preventive behaviors and the number of vulnerable family members (p=0.001, r=0.160). Also, the status of understanding the risk of the harmful effects of natural disasters was in the medium range, and a positive and significant relationship was found between the understanding of the risk of natural disasters and preventive behaviors from the harmful effects of natural disasters (r=0.312, P=0.000).

According to the results of the study, it is suggested that health planners design and implement educational interventions based on the state of risk perception and the state of preventive behaviors against natural disasters to increase the preparedness of households against natural disasters.

The importance of spiritual health, about preventing health-threatening behaviors and adherence to maintaining existing health, has been considered, especially among young people. The present study aimed to investigate the relationship between spiritual health and the intention to engage in risky behaviors in the students of Jiroft City in 2021.

The present study is a descriptive and correlational study that was conducted by census method on 608 students of Jiroft University of Medical Sciences. Data collection tools were standard questionnaires of high-risk behaviors and spiritual health. Data analysis was done using SPSS version 18 software and Pearson correlation, independent t-tests, and one-way analysis of variance.

The results showed that more than 72% of the students participating in the study were girls. The mean and standard deviation of spiritual health (72.53±10.86) were in the average range. Dimensions of religious health, existential health, and spiritual health had a significant difference between male and female students (p<0.001). Also, there was a significant negative relationship between spiritual health and the intention of risky behaviors (p<0.001).

Considering the inverse relationship between spiritual health and the intention to engage in high-risk behaviors in medical students of Jiroft, conducting educational interventions using solutions that focus on increasing spiritual health can reduce the tendency to risky behaviors and their physical, psychological, and social consequences in students.