The frequency of asthma and its related factors: results of the enrolment phase of Tabari cohort study.

INTRODUCTION: A large portion of the world's population has asthma. This study aimed to ascertain asthma prevalence and related factors in the Tabari cohort study (TCS). METHODS: The TCS included 10,255 35-70-year-olds from urban and mountainous Sari (northern Iran) between June 2015 and November 2017. Education, occupation, domicile, socioeconomic position, history of psychiatric disorders, smoking (including hookah smoking), opium usage, and daily physical activity level were determined. RESULTS: The final analysis included 9939 individuals. The asthma rate was 7.4%. Multiple factors increased asthma risk, according to statistical analysis. These factors included being female (OR, 1.337; 95% CI, 1.142-1.565), retired (OR, 1.553; 95% CI, 1.205-2.002), living in the city (OR, 1.268; 95% CI, 1.083-1.484), using opioids (OR, 1.689; 95% CI, 1.299-2.197), having lower socioeconomic status (SES) (OR, 0.723; 95% CI, 0.579-0.903), history of psychiatric disorders (OR, 2.313; 95% CI, 1.826-2.930), and aged 60-70 (OR, 2.325; 95% CI, 1.765-3.064), and BMI above 30 kg/m2 (OR, 1.499; 95% CI, 1.220-1.841). Several factors increased asthma probability in multivariate regression analysis. These factors include being female (OR = 1.389, p = 0.015), ages between 60 and 70 (OR = 2.034, p < 0.001), using opioids (OR = 1.940, p < 0.001), lower SES (OR = 0.738, p = 0.012), history of psychiatric disorders (OR = 2.035, p < 0.001), BMI above 30 kg/m2 (OR = 1.518, p < 0.001), and being a smoker (OR = 1.337, p = 0.056). CONCLUSION: This study has identified that the prevalence of asthma in the Tabari cohort group is high. In addition, it was demonstrated that various factors are related to asthma.

Sexual health literacy level and its related factors among married medical sciences college students in an Iranian setting: a web­based cross­sectional study.

BACKGROUND: Sexual health literacy (SHL) leads to the development of personal ability, understanding, evaluation and use of information related to sexual health. The purpose of this study was to assess the sexual health literacy level and its related factors among married college students at Mazandaran University of Medical Sciences (MAZUMS). METHODS: A web-based cross-sectional online study was conducted on married college students at Mazandaran University of Medical Sciences between January and November 2020. All students were included in the study by census, and the study method was explained by telephone. If they agreed to participate in the study, the online link to the questionnaire, including sociodemographic and clinical information and Sexual Health Literacy for Iranian Adults (SHELIA), was emailed. The Statistical Package for the Social Sciences (SPSS) software version 26 was used for data analysis. Univariate and multivariate logistic regression tests were used to assess factors related to sexual health literacy. RESULTS: The sample consisted of 277 male and 123 female students. Sexual Health Literacy Level and all subscales are at the sufficient level (66.1-88). Among the participants, 20.5% had limited sexual health literacy. Multivariate analysis found factors related to sexual health literacy among students: economic status (OR 0.03; 95% CI 0.0-0.55) and faculty (OR 0.07; 95% CI 0.01-0.52) is related to decrease and subscription to social media for sexual health (OR 3.27; 95% CI 1.53-7.01), information source of channels and cyberspace (OR 3.23; 95% CI 1.41-7.39), educational level (OR 16.39; 95% CI 2.16-32.70), Internet search information source (OR 1.91; 95% CI 1.00-3.64) is related to increase, were statistically significant factors. CONCLUSION: In Iran, medical sciences college students, who constitute a significant portion of the country's population, are responsible for sexual health education. Government agencies, with the collaboration of all stakeholders, should develop policies and programs for implementing and evaluating integrated and comprehensive sexual health literacy promotion programs for them.

Hematological parameters in patients with recurrent Aphthous Stomatitis: a systematic review and meta-analysis.

OBJECTIVES: Recurrent Aphthous Stomatitis (RAS) known as recurrent aphthous ulcer is a common and painful ulcerations in oral cavity. It has been suggested that hematological parameters seems to be considered as an etiologic factor. So, this meta-analysis and systematic review was aimed to examine the relationship between RAS and hematological parameters. METHODS: Relevant studies were found using online international databases including Scopus, Science direct, Web of science (ISI), PubMed, and Google Scholar search engine between 2000 and October 2023. The quality of all papers was determined by NOS checklist. Heterogeneity between the results of primary studies was evaluated with I-square index and publication bias was performed by Egger's test and funnel plots. Also, sensitivity analysis was done to check the effect of each of the primary studies on the overall estimate. Also, the statistical analyses were done using Stata software Ver. 11. RESULTS: By combining the results of primary studies, the standardized mean difference (SMD) of vitamin B12, ferritin, folic acid, hemoglobin, iron and zinc indices with a 95% confidence interval (CI) between the case (patients with RAS) and control (Healthy) groups were estimated -0.52(-0.89, -0.14), -0.20(-0.51, 0.11), -0.42(-0.95, 0.11), -0.58(-0.90, -0.27), 0.01(-0.12, 0.15), -0.33(-0.81, 0.14) respectively. The patients with vitamin B12, ferritin, folic acid, and iron deficiencies and reduced hemoglobin (Hb) level reported 2.93(2.28, 3.78), 2.50(1.48, 4.22), 1.51(0.53, 4.29), 1.46(0.70, 3.03), and 2.14(1.38, 3.32), times more susceptible to develop RAS than healthy individuals. CONCLUSION: The results of the meta-analysis indicated that the SMD of vitamin B12 serum and Hb levels in the case group was 52%. Our result have also showed that the odds ratio of vitamin B12, ferritin deficiencies, and decreased Hb level in case group was 2.93, 2.50, and 2.14 times more than healthy group.

The efficacy of earplugs and eye masks for delirium severity and sleep quality in patients undergoing coronary artery bypass grafting in cardiac intensive care units: A single-blind, randomised controlled trial.

BACKGROUND AND PURPOSE: Delirium is a neuropsychiatric syndrome with a wide range of possible causes and multiple complications in patients admitted to intensive care units. It is, therefore, necessary to seek appropriate and safe strategies to prevent and manage delirium. This study is intended to examine the efficacy of eye masks and earplugs for delirium severity and sleep quality in patients with coronary artery bypass grafting in a cardiac intensive care unit. MATERIALS AND METHODS: This single-blind, randomised controlled trial was conducted on 114 patients who were consecutively enrolled and randomly assigned to either the experimental group or the control group. The experimental group received routine care plus eye masks and earplugs, and the control group received only routine care. The delirium severity and sleep quality were measured with the Neelon and Champagne confusion scale and the Verran and Snyder-Halpern sleep scale. RESULTS: The mean delirium severity score differed significantly between the two groups on the second, third, and fourth postoperative days (p < 0.001). Although the trend of changes in the mean delirium severity score from the first postoperative day (before the intervention) to the second, third, and fourth postoperative days was downward in the two groups (trending towards higher delirium severity), the control group experienced greater changes than the experimental group. An intragroup analysis of delirium severity detected a statistically significant difference in both the experimental and control groups (p < 0.001). The sleep quality domains (sleep disturbance, sleep effectiveness, sleep supplementation) showed a statistically significant difference between the two groups across the three intervention days (p < 0.001). CONCLUSION: The overnight use of eye masks and earplugs were found to have positive effects on sleep quality domains (sleep disturbance, sleep effectiveness, sleep supplementation) and delirium severity in coronary artery bypass grafting patients admitted to the cardiac intensive care unit for several days. It was also found that a significant interaction effect between the sleep disturbance subscale and delirium severity exists. CLINICAL TRIAL REGISTRATION NUMBER: (https://en.irct.ir): IRCT20210523051370N2.

Seroprevalence and geographical distribution of parvovirus B19 antibodies in pregnant women: A-meta analysis.

Parvovirus B19 has been identified to infect pregnant women and cause anemia, spontaneous abortion, and fetal death. Given the significance of parvovirus B19 complications, this study aims to determine the seroprevalence and geographical distribution of parvovirus B19 antibodies in pregnant women to improve health control policies in the community. Online international databases and national Persian databases were used to define appropriate studies published between 2000 and January 2021. The quality of all papers was determined by a Newcastle-Ottawa Scale (NOS) checklist. The statistical analyses were performed using the Stata version 11 package (StataCorp, College Station, TX, USA) software. Heterogeneity among the primary studies was calculated using Cochran's Q-test and I2 index. The Egger test and the funnel plot chart with a significance level of less than 0.1 were used to evaluate the publishing bias. The seroprevalence of parvovirus B19 IgG antibodies among pregnant and non-pregnant women in Iran was assessed in 12 primary studies. Our finding showed that the seroprevalence of parvovirus B19 IgG antibodies among pregnant women varies from 21% to 76%. Combining the results of 5 primary studies based on the random effect model, the seroprevalence of parvovirus B19 IgG antibody among pregnant women in Iran was estimated to be 54% (95% CI:33-76). The seroprevalence of parvovirus B19 IgM antibodies has been reported in 9 studies. By combining the results of these studies using a random effect model, the seroprevalence of parvovirus B19 IgM antibody among pregnant women was estimated to be 3% (95% CI: 1-6). Generally, it is suggested that appropriate screening programs should be performed for the treatment and prevention of diseases. According to this point, the prevalence of parvovirus B19 is low among pregnant women, but it can cause serious manifestations such as hydrops fetalis and severe anemia, therefore, antibody determination using ELISA can be recommended for all pregnant women.

Inhalation phage therapy as a new approach to preventing secondary bacterial pneumonia in patients with moderate to severe COVID-19: A double-blind clinical trial study.

Inhalation phage therapy is proposed as a replacement approach for antibiotics in the treatment of pulmonary bacterial infections. This study investigates phage therapy on bacterial pneumonia in patients with moderate to severe COVID-19 via the inhalation route. In this double-blind clinical trial, 60 patients with positive COVID-19 hospitalized in three central Mazandaran hospitals were chosen and randomly divided into two intervention and control groups. Standard country protocol drugs plus 10 mL of phage suspension every 12 h with a mesh nebulizer was prescribed for 7 days in the intervention group. The two groups were compared in terms of O2Sat, survival rate, severe secondary pulmonary bacterial infection and duration of hospitalization. Comparing the results between the intervention and control group, in terms of the trend of O2Sat change, negative sputum culture, no fever, no dyspnea, duration of hospitalization, duration of intubation and under ventilation, showed that the difference between these two groups was statistically different (P value < 0.05). In conclusion, inhalation phage therapy may have a potential effect on secondary infection and in the outcome of COVID-19 patients. However, more clinical trials with control confounding factors are needed to further support this concept.

Atorvastatin mucoadhesive tablets in the management of recurrent aphthous stomatitis: a randomized clinical study.

BACKGROUND: Aphthous stomatitis is one of the most common oral mucosal diseases. Due to the commonness of recurrent aphthous stomatitis and considering the anti-inflammatory, analgesic, and tissue regenerative properties of atorvastatin and the lack of a study on the effect of statins on minor recurrent aphthous stomatitis, this study investigates the effect of atorvastatin mucoadhesive tablets as a topical treatment on reduction of symptoms and duration of this disease. METHODS: This study is a randomized, double-blinded clinical trial. Patients were divided into two groups, atorvastatin and, placebo; each of the patients received three mucoadhesive tablets daily in the morning, noon, and night. Finally, the patients were examined on days 0 (baseline), 3, 5, and 7 to determine the diameter of the inflammatory halo. The VAS scale was used to evaluate pain intensity for up to 7 days after each meal. The data was entered into SPSS 24 software and analyzed. RESULTS: The halo diameter did not significantly differ between the two groups on baseline (P > 0.05). However, on the study's third, fifth, and seventh days, the difference between the two groups was remarkable, so in the atorvastatin group, the size of the lesions decreased in shorter healing time (P < 0.05). In addition, the patient's pain intensity (VAS) also showed a significant decrease in the atorvastatin group except on the first, second, and seventh days of the study (P < 0.05). CONCLUSION: Atorvastatin mucoadhesive tablets effectively reduce the pain of patients with minor recurrent aphthous stomatitis and reduce the size and healing time of the lesions, so their application should be considered in treating minor recurrent aphthous stomatitis. The present study was approved by the Medical Ethics Committee of Mazandaran University of Medical Sciences with the ethics code IR.MAZUMS.REC.1400.8346. Also, this study received code IRCT20170430033722N4.

A tangible prospect for the treatment of gingivitis using a potentially probiotic strain Lactobacillus plantarum MK06 isolated from traditional dairy products: a triple blind randomized clinical trial.

BACKGROUND: Frequent bacterial plaque buildup at the gingival margin and crevice can provoke an inflammatory reaction in gingival tissues which manifests as gingivitis. Probiotics could serve as a beneficial complementary therapy for treating gingival inflammation. The main aim of this research was to investigate the effect of the Lactobacillus plantarum MK06 probiotic strain on the treatment of gingivitis. METHODS: Patients with gingivitis, who were referred to a private clinic and were systematically healthy, were included in this randomized, triple-blind, placebo-controlled trial. They were instructed to use either placebo or Lactobacillus plantarum suspensions for one minute two times a day after tooth-brushing for four weeks. Then, the clinical parameters of gingivitis, including plaque index (PI), gingival index (GI), bleeding on probing (BOP), and oral hygiene index (OHI-s), were measured in the first, second, and fourth weeks. A total of forty-two patients were randomly assigned to the experimental (n = 21) and control (n = 21) groups. The mean age of the experimental and control groups was 29.10 and 28.48, respectively. RESULTS: The mean scores of BOP, GI, PI, and OHI-s reduced over time in both the control and test groups. However, according to the Mann-Whitney test, the difference between the two groups was not significant at the same time intervals (P ≥ 0.05) and only GI showed a significant difference in the fourth week (GI-3, P = 0.006). Nevertheless, the experimental group experienced a higher overall reduction rate than the control group. The BOP, GI, PI, and OHI-s scores decreased by 0.081, 0.204, 0.186, and 0.172 times in the second week, respectively, resulting from the interaction of time and the intervention, which considerably diminished these indices. CONCLUSION: This study shows the potential of the probiotic Lactobacillus plantarum MK06 suspension as a promoting therapeutic adjuvant in the treatment of gingivitis.

Combination therapy of tocilizumab and steroid for COVID-19 patients: A meta-analysis.

The coagulation markers, pro-inflammatory cytokines (such as IL-2R, IL-6, IL-10, and TNF-a) and lymphopenia are associated with the severity of coronavirus disease 2019 (COVID-19) disease. The use of anti-inflammatory agents, such as corticosteroids (CS) or tosilizumab (TCZ), has been suggested for the treatment of advanced stage of COVID-19 and the reduction of mechanical ventilators and mortality. The aim of this meta-analysis is to determine the role of combination therapy with tocilizumab and steroids in COVID-19 patients. Relevant studies were found using online international databases, and suitable studies were selected and assessed by two independent researchers. The quality of all papers was determined by a checklist. Heterogeneity assay among the primary studies was evaluated by Cochran's Q-test and I2 index. The statistical analyses were done using the Stata ver. 14 package (StataCorp) software. Publication bias was estimated through Egger's test, and the impact of each study on the overall estimate was assessed by sensitivity analysis. Five studies were entered into this meta-analysis. The results of these studies showed that the risk of death for COVID-19 patients treated with the combination of corticosteroids and tocilizumab compared to tocilizumab and the control group was 0.74 (95% confidence interval [CI]: 0.36-1.50) and 0.48 (95% CI: 0.31-0.74), respectively. This meta-analysis showed that the risk of death in COVID-19 patients who were treated with corticosteroids and tocilizumab was lower than the tocilizumab alone and control groups (26% and 52%, respectively).

Occupational burnout in Iranian health care workers during the COVID-19 pandemic.

BACKGROUND AND AIM: Health care workers (HCWs), mostly frontliners, are encountering numerous physical and psychosocial stressors, and even managing some conflicts over the course of the novel coronavirus disease 2019 (COVID-19). In this respect, the present study was to investigate the prevalence rate of occupational burnout (OB) in such workers during this pandemic. MATERIALS AND METHODS: This cross-sectional study was conducted between April 6 and May 30, 2020, via an online survey in 31 provinces of Iran, on HCWs selected based on convenience sampling method. For data collection, a socio-demographic information form and the Maslach Burnout Inventory (MBI) was utilized. Descriptive statistics, Chi-square test, and multivariate regression analysis were also applied to test the research hypotheses. RESULTS: In total, 7626 HCWs participated in the present study. Accordingly, 73.2 and 26.8% of the workers were female and male, respectively. As well, 57.8% of the respondents were nurses and 14.4% of the cases were clinicians. Moreover, 44.8% of the participants had thus far worked in isolation wards and 40.3% of these individuals reported working for 4-8 hours with COVID-19 patients. The prevalence rate of OB was 18.3%. Besides, 34.2, 48.7, and 56.1% of the respondents had severe levels of emotional exhaustion (EE), higher depersonalization (DP), and decreased sense of personal accomplishment (PA), respectively. Besides, the HCWs at the age range of 20 to 30, having female gender, no children, and a bachelor's degree, and working in isolation wards showed the higher levels of OB with reference to the Chi-square test results (p < 0.001). Accordingly, the statistical test outcomes demonstrated that a history of physical illnesses (p = 0.001) and psychiatric disorders (p = 0.044) could be the best predictor of OB throughout the first peak of the COVID-19 pandemic. CONCLUSION: Regarding the high prevalence rate of OB among the HCWs and the remaining COVID-19 journey in Iran, health care managers are recommended to orient the required management and coping strategies toward improving mental health in these individuals.

Socioeconomic inequalities in prevalence, awareness, treatment and control of hypertension: evidence from the PERSIAN cohort study.

BACKGROUND: Elevated blood pressure is associated with cardiovascular disease, stroke and chronic kidney disease. In this study, we examined the socioeconomic inequality and its related factors in prevalence, Awareness, Treatment and Control (ATC) of hypertension (HTN) in Iran. METHOD: The study used data from the recruitment phase of The Prospective Epidemiological Research Studies in IrAN (PERSIAN). A sample of 162,842 adults aged > = 35 years was analyzed. HTN was defined according to the Joint National Committee)JNC-7(. socioeconomic inequality was measured using concentration index (Cn) and curve. RESULTS: The mean age of participants was 49.38(SD = ± 9.14) years and 44.74% of the them were men. The prevalence of HTN in the total population was 22.3%(95% CI: 20.6%; 24.1%), and 18.8%(95% CI: 16.8%; 20.9%) and 25.2%(95% CI: 24.2%; 27.7%) in men and women, respectively. The percentage of awareness treatment and control among individuals with HTN were 77.5%(95% CI: 73.3%; 81.8%), 82.2%(95% CI: 70.2%; 81.6%) and 75.9%(95% CI: 70.2%; 81.6%), respectively. The Cn for prevalence of HTN was -0.084. Two factors, age (58.46%) and wealth (32.40%), contributed most to the socioeconomic inequality in the prevalence of HTN. CONCLUSION: The prevalence of HTN was higher among low-SES individuals, who also showed higher levels of awareness. However, treatment and control of HTN were more concentrated among those who had higher levels of SES, indicating that people at a higher risk of adverse event related to HTN (the low SES individuals) are not benefiting from the advantage of treatment and control of HTN. Such a gap between diagnosis (prevalence) and control (treatment and control) of HTN needs to be addressed by public health policymakers.

Investigation of vaginal and rectal swabs of women infected with COVID-19 in two hospitals covered by Mazandaran University of Medical Sciences, 2020.

Due to the emergence of COVID-19 virus worldwide and need to identify ways of transmitting the virus, we conducted a cross-sectional study from July to November 2020 on 80 women with COVID-19 infection was confirmed by nasopharyngeal proper time polymerase chain reaction (RT-PCR). We investigated SARS-CoV-2 in their vaginal and rectal swabs. The results showed that (n = 6, 7.5%) patients had positive rectal PCR and (n = 10, 12.5%) had positive vaginal PCR. There was a statistically significant relationship between positive rectal test and positive vaginal test (p=.001). Positive rectal PCR was significantly higher in women over 60 years old than in other age groups (p=.004).Impact StatementWhat is already known on this subject? In the past studies, the presence of the virus in the vagina and rectum was less or not confirmed.What do the results of this study add? The results of our study showed that the COVID-19 virus can infect the vagina and rectum of women.What are the implications of these findings for clinical practice and/or further research? This finding should be considered in sexual transmission and mother to child transmission and also vaginal colonisation, especially at the time of delivery.

Evaluation of cinnamaldehyde mucoadhesive patches on minor recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND & OBJECTIVE: The use of herbal medicines to treat common oral diseases increases rapidly. Recurrent aphthous stomatitis is one of the most common oral mucosal diseases, which has an unclear etiology and could lead to severe pain and dysfunction. Cinnamaldehyde is a major component of cinnamon bark oil. Biological properties of cinnamaldehyde, such as antioxidant, antitumor, antifungal, cytotoxic, and anti-mutational characteristics, have been identified. Considering the prevalence of recurrent aphthous stomatitis and the importance of using herbal resources for treatment, the present study aimed to evaluate the effect of mucosal adhesive patches containing Cinnamaldehyde on minor recurrent aphthous stomatitis lesions. MATERIAL & METHODS: In this randomized, double-blind clinical trial, patients were divided into two groups. The intervention group received three daily mucosal adhesive patches to be used in the morning, afternoon, and night. The control group also did the same with a placebo. To evaluate the healing and determine the diameter of the lesions, patients were clinically examined on days zero, 3, 5, and 7. The VAS scale evaluated pain at baseline and after each meal for seven days. The Fisher's exact test, t-test, Shapiro Wilk test, Friedman test, and the Mann-Whitney test were used to analyze the data using the SPSS 20 software. RESULTS: There was no statistically significant difference in the mean diameter of the inflammatory lesion and pain intensity in the two groups in the baseline (p > 0.05). However, the ulcer size was significantly reduced in the cinnamaldehyde group on the third, fifth, and seventh days of the study. Except for baseline, the mean pain intensity significantly decreased in the cinnamaldehyde group compared to the placebo group (p < 0.05). CONCLUSION: Cinnamaldehyde mucoadhesive patches effectively reduced and improved aphthous lesions and pain intensity in patients and can be considered a treatment for RAS. REGISTRATION NUMBER: IRCT20180312039060N2-First registration date: 20/07/2018. The present study was registered as a retrospective study.

A Systematic Review of Death Anxiety and Related Factors Among Nurses.

This systematic review aimed to summarize the evidence regarding death anxiety (DA) and related factors among nurses. Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) databases were extensively searched using purpose-related keywords from the earliest to October 5, 2021. A total of 6819 nurses were included in 31 studies. The DA of nurses based on the Templer's Death Anxiety Scale was moderate. Factors such as personal anxiety, frequency and severity of job stress, burnout, dying patient avoidance behavior, euthanasia, sex, mental health status, social desirability, attitude toward the elderly, humor, social maturity, psychological hardiness, quality of life, lack of social activity, self-efficacy, coping with death, and life satisfaction were associated with nurses' DA. Therefore, nursing policymakers can promote nurses' health to improve the quality of nursing care by considering these related factors.

Nanocurcumin as an Add-on to Antipsychotic Drugs for Treatment of Negative Symptoms in Patients With Chronic Schizophrenia: A Randomized, Double-Blind, Placebo-Controlled Study.

PURPOSE/BACKGROUND: It is well documented that one of the pathophysiological mechanisms of negative symptoms in patients with schizophrenia is hypofunction of N-methyl-d-aspartate receptors. This double-blind, placebo-controlled clinical trial was designed to assess the efficacy and safety of nanocurcumin as an adjuvant agent on psychotic symptoms, especially negative symptoms, in patients with chronic schizophrenia. METHODS/PROCEDURES: Fifty-six inpatients with stable chronic schizophrenia and predominant negative symptoms were randomized in a 1:1 ratio to nanocurcumin soft gel capsule (160 mg/d) and control groups, along with their antipsychotic regimen for 16 weeks. The efficacy of treatment was assessed by Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, Clinical Global Impressions-Severity, and Clinical Global Impressions-Improvement scales. Extrapyramidal symptoms were evaluated by Simpson-Angus Scale and Barnes Akathisia Rating Scale. Patients were assessed at baseline and weeks 4, 8, 12, and 16 after the medication started. FINDINGS/RESULTS: No significant differences were observed in demographic or clinical variables between both groups at baseline. The nanocurcumin group showed significantly greater improvement on the negative subscale (P = 0.05), the general psychopathology subscale (P < 0.001), the positive subscale (P = 0.004), total Positive and Negative Syndrome Scale (P < 0.001), Clinical Global Impressions-Severity (P < 0.001), and Clinical Global Impressions-Improvement scores (P < 0.001) in comparison with the control group at the endpoint. Extrapyramidal symptom rating scales and Calgary Depression Scale for Schizophrenia and frequency of other adverse effects were comparable between 2 groups. IMPLICATIONS/CONCLUSIONS: The present study indicates nanocurcumin as a safe and potential adjunctive treatment strategy for treatment of primary negative symptoms of schizophrenia.

The Iranian version of theory-based intention for cesarean section (IR-TBICS) scale: development and first evaluation.

BACKGROUND: The rate at which mothers experience a cesarean section in the absence of medical signs is growing worldwide. Women's beliefs and intentions play an essential role in the request or choice of a delivery method. At present, there is no comprehensive, validated scale for assessing pregnant women's beliefs about cesarean section in the Iranian population. This study was performed to develop and assess the validity and reliability of the intention-based cesarean section scale using the theory of reasoned action (TRA) constructs as a theoretical framework for measuring intention toward the selection of a delivery method. METHODS: In this cross-sectional validation study, 480 pregnant women were recruited from Sari, in northern Iran, through a multistage random sampling approach. Content validity was examined using the content validity index (CVI) and content validity ratio (CVR). Furthermore, both exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were applied to assess the construct validity of the developed scale. Reliability was measured by internal consistency and the intraclass correlation coefficient (ICC). Quality criteria for floor and ceiling effects were derived from existing guidelines and consensus within our research group. RESULTS: The results obtained from the factor analysis showed that the data were fit to the model (χ2 = 2298.389, P < 0.001). The TRA comprised 24 items assessing five domains, which described 62.46% of the common variance. The CFA showed a model with suitable fitness for the data. Cronbach's alpha coefficient for the domains of the scale ranged from 0.609 to 0.843, and the ICC value ranged from 0.71 to 0.84, which is within the satisfactory range. The IR-TBICS scale had no floor or ceiling effect on the total score or any of the dimensions. CONCLUSIONS: The belief-based cesarean section scale appears to be a reliable instrument. It is considered suitable and can be applied in other research in Iran.

Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image.

BACKGROUND: Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image (GSI). METHODS: This was a descriptive, correlational, cross-sectional study performed using the two-stage cluster sampling method between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R). RESULTS: Analysis of Variance (ANOVA) showed significant differences in the mean scores of SD between the groups with varying degrees of depression, anxiety, and stress (P <  0.001) and in the mean score of GSI between the groups with varying degrees of depression (P = 0.01) and anxiety (P <  0.001). In multivariate linear regression analysis, higher (worse) depression, anxiety, and stress scores were found in women with more advanced age and higher SD scores; however, these scores were lower (better) in those with increased gestational age. Lower depression and anxiety scores were associated with moderate satisfaction with income, moderate satisfaction with BI in pregnancy, and lower stress and depression scores were linked to planned pregnancy. Higher (better) GSI score was a predictor of lower depression score, complication in a previous pregnancy was a predictor of higher stress score, and finally, fear of fetal abortion and being a housewife were predictors of a higher anxiety score. CONCLUSION: Various factors contribute to the development of antenatal depression, anxiety, and stress. A positive correlation was found between SD and the severity of depression, anxiety, and stress, while a negative correlation was noted between GSI and the severity of depression and anxiety. Therefore, raising awareness regarding SD and GSI through screening and counseling sessions can have beneficial effects for mothers and their fetuses.

Oral contraceptives and hypertension in women: results of the enrolment phase of Tabari Cohort Study.

BACKGROUND: The association between oral contraceptives (OCP) and hypertension has been reported in the literature with controversial results. According to the growing use of OCPs among women in Iran, this study aims to investigate the association between the duration of the OCP consumption and risk of hypertension among Iranian women. METHODS: In the current study, the data collected during the enrolment phase of the Tabari cohort were analyzed. Of 6106 women recruited in the cohort, 133 pregnant women were excluded. Epidemiological variables were collected using pre-designed questionnaires as well as the health insurance evidences. In addition, blood pressure and anthropometric factors were measured based on the standard guidelines. Chi square and partial correlation tests as well as logistic regression models were applied for data analysis. RESULTS: Frequency of oral contraceptive use among 35-70 year-old women in Tabari cohort study (TCS) was 42.2% (2520/5973). Hypertension was observed among 25% (1793/5973) of them. The adjusted odds ratio for OCP use was 1.23 (95% confidence interval: 1.08, 1.40, p = 0.002). The corresponding odds ratios for 61-120 months and more than 120 months OCP use were 1.39 (1.12,1.73) and 1.47 (1.16,1.87) respectively. CONCLUSIONS: Oral contraceptives especially in long term use can be associated with hypertension.

Cardiovascular diseases burden in COVID-19: Systematic review and meta-analysis.

BACKGROUND: High rate of cardiovascular disease (CVD) have been reported among patients with novel coronavirus disease (COVID-19). Meanwhile there were controversies among different studies about CVD burden in COVID-19 patients. Hence, we aimed to study CVD burden among COVID-19 patients, using a systematic review and meta-analysis. METHODS: We have systematically searched databases including PubMed, Embase, Cochrane Library, Scopus, Web of Science as well as medRxiv pre-print database. Hand searched was also conducted in journal websites and Google Scholar. Meta-analyses were carried out for Odds Ratio (OR) of mortality and Intensive Care Unit (ICU) admission for different CVDs. We have also performed a descriptive meta-analysis on different CVDs. RESULTS: Fifty-six studies entered into meta-analysis for ICU admission and mortality outcome and 198 papers for descriptive outcomes, including 159,698 COVID-19 patients. Results of meta-analysis indicated that acute cardiac injury, (OR: 13.29, 95% CI 7.35-24.03), hypertension (OR: 2.60, 95% CI 2.11-3.19), heart Failure (OR: 6.72, 95% CI 3.34-13.52), arrhythmia (OR: 2.75, 95% CI 1.43-5.25), coronary artery disease (OR: 3.78, 95% CI 2.42-5.90), and cardiovascular disease (OR: 2.61, 95% CI 1.89-3.62) were significantly associated with mortality. Arrhythmia (OR: 7.03, 95% CI 2.79-17.69), acute cardiac injury (OR: 15.58, 95% CI 5.15-47.12), coronary heart disease (OR: 2.61, 95% CI 1.09-6.26), cardiovascular disease (OR: 3.11, 95% CI 1.59-6.09), and hypertension (OR: 1.95, 95% CI 1.41-2.68) were also significantly associated with ICU admission in COVID-19 patients. CONCLUSION: Findings of this study revealed a high burden of CVDs among COVID-19 patients, which was significantly associated with mortality and ICU admission. Proper management of CVD patients with COVID-19 and monitoring COVID-19 patients for acute cardiac conditions is highly recommended to prevent mortality and critical situations.

Effectiveness of Pistacia atlantica on older adult knee osteoarthritis, a randomized triple blind clinical trial.

Osteoarthritis is the most common cause of disability and aging is the major risk factor. One of the low-risk herbal medicines for reducing pain and inflammation in persian medicine is Pistacia atlantica gum. A triple-blind placebo-controlled clinical trial was performed in order to evaluate the efficacy of P. atlantica gum ointment on knee osteoarthritis in elderly people. A total of 60 patients were randomly allocated to two groups. The intervention group used 4% P. atlantica ointment and the control group used placebo, topically applied three times a day, for 8 weeks. The patients were evaluated before and after the intervention using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale. There were significant differences (p < .001) between two the groups in terms of joint stiffness and pain as well as function. Within groups, regarding the effect size (EF) in joint stiffness was 2.82 and 0.74 in the Pistacia and placebo groups, respectively. Regarding pain, the effect size of the intervention and placebo groups were 3.90 and 0.99, respectively. In addition, regarding function, the effect size of the intervention and the placebo groups were 4.33 and 1.17, respectively. Therefore, it seems that topical P. atlantica is significantly better than the placebo in the old patients with knee osteoarthritis.