 Subjects -> GEOGRAPHY (Total: 493 journals)
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- Prevalence of Vertebral Compression Fracture Among Rheumatoid Arthritis
Patients in Sulaymaniyah
Abstract: Background: The risk of fractured vertebral increases in patients with rheumatoid arthritis as they are more likely to suffer from osteopenia, and osteoporosis.Objectives: This study aimed to investigating the rate and risk factors of vertebral fractures in patients with rheumatoid arthritis.Methods: We recruited 201 patients aged between 30 and 70 who attended the rheumatology department at Shahid Hemn Teaching Hospital in Sulaymaniyah, between January and September 2022. Medical records were reviewed for disease and treatment characteristics while also clinically evaluated by a rheumatologist. Spinal radiographs were assessed by two experienced radiologists blinded to patients’ clinical diagnosis and status. Compression fractures were classified by using the Genant semiquantitative method, and the type of fracture was classified as wedged fracture, biconcave fracture, or crushed fracture.Results: Of the 201 included participants, 151 were female, and 50 were male. The BMI of women was higher than men by nearly four points (P<0.001). Most women were also illiterate (68/151, 45.0%) and unemployed (139/151, 92.1%). Hypertension (28.4%) and diabetes mellitus (14.4%) were the most reported comorbidities. Women were more likely to have higher DAS28 scores while men had more vertebral fractures (P=0.003). The probability of fractures increased with age, male sex, and illiteracy compared to primary school, osteopenia, and osteoporosis through simple and multiple logistic regression models.Conclusion: With at least one fracture affects females and males at a rate of 27.8% and 52.0%, respectively. Also reported that age, male sex, illiteracy, osteopenia, and osteoporosis significantly increase the risk of fractures.
- Adjuvant Perioperative Intravenous Lidocaine is Effective and Safe for
Postoperative Pain Management and Rehabilitation in Gynecology Surgery: A
Randomized, Single-Blind, Placebo-Controlled Trial
Abstract: Background: There is scant data on the effectiveness and safety of adjuvant perioperative intravenous (IV) lidocaine in procuring postoperative analgesia and rehabilitation in gynecology surgery in low-resource settings.Objectives: To evaluate the effects of IV lidocaine on postoperative pain and rehabilitation gynecology surgery.Methods: We carried out a randomized single-blinded controlled trial from April to August 2017 (5 months) at the Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital, Cameroon. The study population was made up of ASA 1 and 2, women admitted for elective gynecological surgery under general anesthesia divided into two groups of 17 patients: those to receive IV lidocaine and those to receive normal saline as placebo both intra-and postoperatively as an adjuvant to standard care. The variables studied included the additional doses of fentanyl, postoperative pain, side effects of lidocaine, time to first bowel sounds, the ease with which patients were mobilized and patient satisfaction.Results: Compared to patients in the placebo group, those in the lidocaine group had fewer mean amounts of fentanyl reinjections (P<0.0001), shorter recovery time (P=0.0044), reported lesser pain in the immediate postoperative period (P=0.012) till the 3rd postoperative hour (P<0.001), had more early postoperative bowel sounds (94.1% vs. 11.8%), rehabilitated earlier (P<0.001) and were more satisfied with pain management (P=0.001). The lone observed side effect of IV lidocaine was tolerable bradycardia in six (35.3%) patients.Conclusion: Adjuvant IV lidocaine can be effectively used in gynecological surgery, with the advantage of better postoperative analgesia, quicker rehabilitation and minimal side effects.
- Racial and Ethnic Differences in the Protective Effect of Educational
Attainment on Chronic Pain
Abstract: Background: The broad scientific community generally associates high socioeconomic status (SES) with better health. However, the protective effects of high educational attainment on health may be weaker for racial and ethnic minorities than non-Latino White individuals. It is important to study whether this difference holds for chronic pain among Black and Latino individuals.Objectives: To compare the association between educational attainment and chronic pain in the US, considering the racial and ethnic background of individuals.Methods: The current study used baseline data from the Population Assessment of Tobacco and Health (PATH-Adults) study. All participants were 18+years old. A total number of 28204 Non-Latino, Latino, White, and Black individuals were enrolled. The outcome was chronic pain treated as a continuous measure. The predictor was educational attainment. Moderators were race and ethnicity.Results: Our linear regressions in the pooled sample showed that higher educational attainment was associated with a lower level of chronic pain; however, this association was weaker for Latinos and Blacks compared to non-Latino and White individuals. Our stratified models also showed that higher educational attainment was more consistently associated with a lower level of chronic pain for non-Latino White individuals than racial and ethnic minorities.Conclusion: The presumed protective effect of educational attainment against chronic pain among individuals varies between different racial and ethnic groups. Future research should test the role of stressful jobs and working conditions in weakening the protective effects of SES against chronic pain for Blacks and Latinos compared to non-Latino White individuals.
- A Retrospective Study: ABO and Rh Phenotype Blood Group Distribution
Amongst Different Types of Craniosynostosis Patients
Abstract: Background: Craniosynostosis refers to the premature fusion of cranial sutures. Premature closure can impair brain development and cognitive problems. Only available treatment of craniosynostosis is through surgical intervention which is associated with excessive blood loss.Objectives: In this study, we investigate the prevalence of each ABO/Rh blood group amongst patients with different types of craniosynostosis.Methods: We included 163 patients, under craniosynostosis treatment, in Imam Hossein children’s hospital at Isfahan, Iran. A retrospective analysis was performed and the frequency of blood groups as well as types of craniosynostosis were reported. Moreover, the connection between ABO/Rh blood groups and the types of craniosynostosis was examined by chi-square test.Results: Of 163 cases reviewed; The majority of participants had blood group A positive (32.5%), followed by O positive (31.3%). The rest of the blood groups were reported in order: B positive (22.1%), B negative (4.9%), AB positive (4.3%), O negative (2.5%), A negative (1.8%), AB negative (0.6%). Also, the most common type of craniosynostosis was metopic (27%) and the other types were pansynostosis (23.9%), sagittal (21.5%), coronal (16.6%), multisuture (10.4%) and lambdoid (0.6%) respectively. Due to connection between ABO/Rh blood groups and the types of craniosynostosis, no significant relationship was observed.Conclusion: Based on the results of the present study, it was found that the frequency of ABO blood groups in children with craniosynostosis can be different from the population of the same area. Also, the ratio of different types of craniosynostosis was different from previous data.
- An Investigation of the COVID-19-Related Anxiety Levels of Individuals
According to Some Demographic Variables
Abstract: Background: Pandemics such as COVID-19 create heightened fear and anxiety, causing deterioration in the behaviours, social and psychological well-being of people. It can be thought that the anxiety levels of healthcare workers will increase more because they have a higher risk of contamination, work under COVID-19 isolation-measures and heavy workload.Objectives: The aim of this study is to determine the COVID-19-related anxiety levels of individuals, the ways of coping with, the demographic factors affecting anxiety, and whether the anxiety level of healthcare workers is different from others.Methods: This study was carried out with data obtained from 1017 participants via google forms between May-July 2020. In the collection of data, the 12-item COVID-19-related anxiety scale, which was developed by researcher and analysed for validity and reliability; 13 items for ways of coping; some demographic questions were used. The COVID-19-related anxiety scale consisted of three dimensions: “cognitive”, “physiological and emotional”, “behavioural”, which explained 71% of the variance. The Cronbach alpha of scale was 0.85.Results: The COVID-19-related anxiety levels of participants were slightly above the moderate level (2.83±0.72). The anxiety levels of healthcare workers were not different from others. There was a difference in anxiety levels according to demographic characteristics of participants, such as age, gender, living in Turkey or abroad, working status/type, and smoking addiction. Cognitive coping, social support, distraction, relaxation techniques were identified as ways of coping with anxiety.Conclusion: COVID-19 pandemic created anxiety in people. More studies need to understand the long-term effects of the pandemic.
- Serum Vitamin D, Renal Biomarkers, Protein Profile and Some Electrolytes
in Chronic Kidney Disease Patients With a Clinical Trial of Vitamin D
Therapy
Abstract: Background: Vitamin D deficiency is involved in a broad spectrum of diseases including chronic kidney disease (CKD).Objectives: This study was designed to assess serum vitamin D, renal biomarkers, protein profile, and electrolytes in CKD patients with a clinical trial of vitamin D therapy.Methods: This case-control follow-up interventional study comprised 42 CKD patients and 42 apparently healthy controls. Patients and controls were matched for age and gender. Patients were assigned to receive, a weekly oral dose of vitamin D3 (50000 IU) for 3 successive months. The follow-up therapy was conducted under direct and full physician supervision.Results: Vitamin D was significantly lower in CKD patients compared to controls (29.6±12.4 versus 35.2±9.9 ng/dL, P=0.033). Significant increases were shown in the urea, creatinine, and uric acid in patients compared to controls whereas glomerular filtration rate (GFR), total protein, albumin, and calcium were significantly lower in patients. A significant improvement was noted for vitamin D and calcium where they registered mean values of 43.8±9.1 ng/dL and 9.65±0.70 mg/dL at the end of the therapeutic period compared to 29.6±12.4 ng/dL and 8.61±0.77 mg/dL in patients before vitamin D therapy (P=0.028 and P=0.033, respectively).Conclusion: General amelioration of the metabolic profile of CKD patients in response to vitamin D therapy has been shown. Besides a significant improvement in vitamin D and calcium. Consequently, vitamin D is a useful candidate in clinical settings for the improvement of renal function and controlling of CKD, and more importantly its complications.
- Determined the Frequency of Neurosurgeries Canceled Due to the
Asymptomatic COVID-19 in the Patients
Abstract: Background: The COVID‑19 pandemic has caused severe complications, deaths, and damage to societies, and the disease course is unpredictable and ranges from asymptomatic infections to multi‑organ failure and death.Objectives: The present study determined the frequency of neurosurgeries canceled owing to the asymptomatic COVID‑19 in the patients.Methods: The present study was descriptive‑analytical and was conducted on all neurosurgeries in Kashani hospital, Isfahan, Iran in 2021. Moreover, 116 (52.5%) out of 2100 neurosurgeries were canceled, among which 41 cases (35.4%) were related to asymptomatic COVID‑19. The necessary data were extracted from the information in the patients’ medical files and were included in the data collection forms. The data were analyzed in SPSS 22 after collection.Results: Among 41 people, whose neurosurgery was canceled, 7 had asymptomatic COVID‑19 with few or mild symptoms, and 34 were asymptomatic. The patients of the two groups with asymptomatic and symptomatic COVID‑19 were significantly different in age, albumin level, C‑reactive protein, and serum creatinine (P<0.05) as the mean age, albumin, and C‑reactive protein levels were lower, and serum creatinine was higher in the group of patients with asymptomatic COVID‑19.Conclusion: The prevention of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infections played a crucial role in the unhindered transmission of this virus and was the turning point in controlling the pandemic.
- Investigating the Effect of Post-Delivery Telephone Counseling on the Rate
of Exclusive Breastfeeding Among Infants
Abstract: Background: Owing to the crucial role of nutrition with breast milk for both the mother and infant, the implementation of programs that support breastfeeding seems essential.Objective: This study aims to determine the effect of post-delivery telephone counseling on the rate of exclusive breastfeeding among infants.Methods: This study, as a randomized clinical trial, investigated 170 women who delivered their children in the Sabzevar Shahidan Mobini hospital, Iran in 2017. After acquiring the written informed consent, the researchers randomly assigned the subjects into two groups, including the telephone counseling recipient group (intervention) and the telephone counseling non-recipient group (control). The data collection instruments were questionnaires and checklists. The collected data were analyzed by the SPSS 18 software.Results: The findings of the study showed that 73.8% of the counseling non-recipient group had exclusive breastfeeding, and 26.2% did not have exclusive breastfeeding. In the telephone counseling recipient group, 90.4% exclusively breastfed their infants, while 9.6% did not. Thus, there was a statistically significant difference between the two understudy groups (P<0.05).Conclusion: This research revealed that although mothers were trained how to breastfeed when they were pregnant or were discharged from hospitals, and exclusive breastfeeding was emphasized, implementing the counseling program, even telephonic, and responding mothers’ questions regarding breastfeeding and prevalent problems in this period could be helpful in the first two months after delivery.
- Assessment of Medical Ward Bathrooms and Toilets in RIPAS Hospital, Brunei
Darussalam
Abstract: Letter to Editor
- Exploring Local Literature Bias: A Critical Evaluation of Iranian Trials
on the Efficacy of Psychotherapy for Chronic Pain
Abstract: Background: Seeking local evidence on treatment efficacy is necessary if cultural factors are involved, as in psychotherapy for chronic pain (CP). Yet, local evidence is known to be prone to bias, making it difficult to reach reliable conclusions.Objectives: This study aimed to critically evaluate our local evidence on the efficacy of psychotherapy on quality of life and disability in CP. We elaborate that, with some requirements, common meta-analytic tools can be utilized to detect and correct local evidence bias. We then provide a corrected estimate of the treatment efficacy.Methods: The protocol was registered on PROSPERO, Record [deleted for blind review]. Elmnet, Pubmed, and ProQuest were searched for randomized trials. A multilevel meta-analysis was used to capture the hierarchical structure of the data, and robust variance estimation was used for inference. Several moderation analyses were conducted, and publication and other related sources of bias were examined.Results: Forty-two trials were initially included. Six were excluded before the analysis due to serious reporting problems undermining their validity. The SMD from 185 effect sizes was 1.08 [.87, 1.3]. The funnel plot showed a strong bias. The bias-corrected estimate from a regression-based method was 0.45 [0.04, 0.87], and from the trim-and-fill was 0.75 [0.48, 1.0].Conclusion: While our original estimate was large, the corrected estimate showed a medium effect, fairly comparable to the international estimates. Current evidence on different sources of bias in our literature suggests low quality and questionable research practice as the first suspects for our local evidence bias.
- Analgesic Response to Fentanyl in Compare with Morphine Among Adult
Traumatic Patients in Emergency Department: A Randomized Clinical Trial
Abstract: Background: Several studies were performed to evaluate the efficacy of different pain management in patients with trauma, using different methods.Objectives: To compare intravenous (IV) morphine vs. fentanyl for analgesic response, the time to reach lowest pain score, and adverse effects in patients with trauma who were referred to Emergency Department (ED).Methods: This double-blind randomized controlled trial (June-December 2017) was performed on adult traumatic patients, who were referred to the EDs of two main trauma centers (Affiliated with Shiraz University of Medical Sciences), in southern Iran. The inclusion criteria were acute pain >4 on a numeric rating scale (NRS) 0-10 upon presentation. The patients were randomly allocated to receive a single dose of IV morphine (0.1 mg/kg) or IV fentanyl (2 µg/kg). The pain score was recorded at baseline, 5, 10, 30, and 120 minutes after administration of either morphine or fentanyl, as well as adverse effects. Then, the data were analyzed.Results: 167 patients were enrolled. The initial NRS in both groups was similar. The mean±SD of NRS at all times was higher in fentanyl group, except in 10 minutes, but only in 120 minutes, this difference was statistically significant (P=0.01). The mean±SD of pain reduction at all times was similar in both groups. The incidence of adverse effects in both groups were not different (P=0.18).Conclusion: IV fentanyl had a similar analgesic effect to IV morphine in traumatic patients with acute pain. Also, there was no significant difference in terms of adverse effects between groups.
- A Comparative Study of the Level of Compliance with the Standards of the
Green Hospitals in Teaching hospitals of Yazd City
Abstract: Background: A green hospital is a hospital that improves people's health by continuously reducing environmental consequences and eliminating its harmful effects. Therefore, in recent years, the concept of "green hospital" has been created due to sustainable development with the aim of controlling costs and protecting the environment.Objectives: The purpose of this study was to determine and compare the level of compliance with the standards of green hospitals in teaching hospitals in Yazd.Methods: This descriptive-applied present study was conducted in 2022. A standard checklist was used to collect data. This checklist included 11 areas and 96 questions. For data analysis, frequency and percentage were used in SPSS v26 software.Results: The level of compliance with the standards of the green hospital was 75.88%, the highest score was related to Shahid Dr. Rahnamon Hospital (80.55%) and the lowest score was related to Shohadai Mehrab Hospital (70.13%). The waste water management variable was obtained with 61.3% as a priority for improvement, and the highest score was obtained in the area of hazardous consumables (90.73%).Conclusion: It seems that the teaching hospitals of Yazd had an average status in the field of environmental protection and controlling costs and pollution as well. Therefore, in order to comply with the standards of Green Hospital, comprehensive planning is required regarding the 11 studied areas, so in addition to focusing on their strengths and improving them, also covering the weaknesses and bringing them to an acceptable level is recommended.
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