Protective role of SIRT1 (rs3758391 T > C) polymorphism against T2DM and its complications: Influence on GPx activity.

Background and Aims: Sirtuin-1 (SIRT1) has antidiabetic effects through the regulation of insulin secretion and modulation of inflammation. The SIRT1 rs3758391 gene polymorphism affects the level of SIRT1. The current study aimed to investigate the possible influence of SIRT1 gene variants in relation to oxidative stress parameters on the susceptibility to type 2 diabetes mellitus (T2DM) and its microvascular complications. Methods: In this case-control study 398 individuals including 300 patients with T2DM (100 T2DM without complication, 100 diabetic neuropathy patients and 100 patients with diabetic retinopathy) and 98 healthy subjects were studied for SIRT1 rs3758391 T > C variants. Also, the glutathione peroxidase (GPx) activity and the levels of glutathione (GSH), malondialdehyde (MDA), total antioxidant capacity (TAC), and total oxidative status (TOS) were determined by colorimetric methods. SIRT1 genotypes were detected using the polymerase chain reaction-restriction fragment length polymorphism method. Results: The C allele of SIRT1 reduced the risk of T2DM, diabetic neuropathy and diabetic retinopathy. Significantly lower levels of GSH, GPx, and TAC were found in diabetic patients compared to control group. However, the level of MDA was significantly higher in patients compared to healthy individuals. Considering all individuals, the GPx activity increased in the presence of the SIRT1 CC, and TC genotypes compared to the TT genotype. Among all studied individuals the activity of GPx was significantly higher in normal body mass index (BMI) subjects than overweight, and obese individuals. However, among overweight and obese diabetic, diabetic retinopathy and diabetic neuropathy patients the mean level of TOS was significantly higher compared to patients with normal BMI. Conclusions: Our findings suggest a protective role for SIRT1 C allele against T2DM and diabetic neuropathy and diabetic retinopathy. We found in the presence of this allele the GPx activity increased. Also, we detected an enhanced oxidative stress level among overweight and obese patients with diabetes and its complications that could be involved in the pathogenesis of the disease.

Lubratex eye ointment with polyethylene cover significantly reduces corneal abrasion in ICU patients: a randomized controlled trial.

Corneal abrasion is a frequent complication in critically ill, intubated patients, potentially leading to visual impairment. This study compares the efficacy of three ocular care methods in preventing corneal abrasion among this vulnerable population. We conducted a randomized controlled trial involving 156 intubated adult patients admitted to the ICU. Participants were randomly allocated to one of three intervention groups (n = 52 per group): (1) polyethylene cover only, (2) polyethylene cover with artificial tear drops, and (3) polyethylene cover with Lubratex eye ointment. One eye per patient was randomly assigned as the control, receiving standard ICU eye care. Daily assessments over five days included a standardized dryness and corneal abrasion checklist, graded strip evaluation of eye dryness, and documentation of corneal abrasion incidence. Data were analyzed using descriptive and inferential statistics (SPSS-18). The incidence of corneal abrasion was significantly lower in the group receiving polyethylene cover with Lubratex eye ointment (4%) compared to the polyethylene cover with artificial tears group (36%, p < 0.001) and the polyethylene cover only group (60%, p < 0.001). The combined application of a polyethylene cover with Lubratex eye ointment effectively prevents corneal abrasion in intubated ICU patients. This method demonstrates superior efficacy compared to polyethylene covers used alone or with artificial tears. We recommend its implementation as standard practice for corneal abrasion prophylaxis in this high-risk population.Trial Registration. This study is registered with the Iranian Registry of Clinical Trials (IRCT201506294736N8) and can be accessed at www.IRCT.ir .

The effects of positive psychology and physical activity on depression, anxiety, and stress among students with premenstrual syndrome: a single-blind, randomized controlled trial.

BACKGROUND: Premenstrual syndrome affects many women in their reproductive years and often disrupts their social connections and work. This study aimed to compare the effects of positive psychology and physical activity on depression, anxiety, and stress among students with premenstrual syndrome. METHODS: In this four-group parallel clinical trial with blinded data analysis, 120 eligible students who experienced premenstrual syndrome were recruited based on inclusion/exclusion criteria and randomly allocated to four groups (n = 30) including three experiment groups as positive psychology, physical activity, and positive psychology, physical activity, and control group, using a simple randomization method. All four groups completed premenstrual syndrome screening and the DASS-21 questionnaire before the intervention. Then, the positive psychology intervention group received eight sessions of 70-90 min weekly intervention, the second group received eight weeks of aerobic physical activity intervention, and the third group received positive psychology and physical activity intervention for eight weeks. The control group did not receive any interventions. The DASS-21 was completed immediately after the intervention and two months later by all four groups. In this study, the participants and investigators were not blinded; however, the analysts were. The recruitment process took place from September 2018 to March 2019. One hundred twenty participants fulfilled the study. The Data were collected and analyzed using SPSS (v18). RESULTS: Before and immediately after the intervention, there was no statistically significant difference in depression, anxiety, and stress mean scores among the positive psychology, physical activity, positive psychology, and physical activity and control groups (p ≥ 0.05). However, two months after the intervention, a significant difference was observed between the four groups so there was a difference between the scores of the three intervention groups and the control group (p < 0.05). There was no significant difference between positive psychology, and physical activity groups. No significant adverse events or side effects were observed. CONCLUSION: Our findings supported the use of aerobic physical activity and educational interventions based on positive psychology as non-pharmacologic interventions to reduce anxiety, depression, and stress. This research should be replicated in different settings. TRIAL REGISTRATION CLINICAL TRIALS: Iranian Registry of Clinical Trials; https://irct.behdasht.gov.ir/trial/32363 (IRCT20130812014333N97), registered (11/08/2018).

The most important variables associated with death due to COVID-19 disease, based on three data mining models Decision Tree, AdaBoost, and Support Vector Machine: A cross-sectional study.

Introduction: Death due to covid-19 is one of the biggest health challenges in the world. There are many models that can predict death due to COVID-19. This study aimed to fit and compare Decision Tree (DT), Support Vector Machine (SVM), and AdaBoost models to predict death due to COVID-19. Methods: To describe the variables, mean (SD) and frequency (%) were reported. To determine the relationship between the variables and the death caused by COVID-19, chi-square test was performed with a significance level of 0.05. To compare DT, SVM and AdaBoost models for predicting death due to COVID-19 from sensitivity, specificity, accuracy and the area under the rock curve under R software using psych, caTools, random over-sampling examples, rpart, rpartplot packages was done. Results: Out of the total of 23,054 patients studied, 10,935 cases (46.5%) were women, and 12,569 cases (53.5%) were men. Additionally, the mean age of the patients was 54.9 ± 21.0 years. There is a statistically significant relationship between gender, fever, cough, muscle pain, smell and taste, abdominal pain, nausea and vomiting, diarrhea, anorexia, dizziness, chest pain, intubation, cancer, diabetes, chronic blood disease, Violation of immunity, pregnancy, Dialysis, chronic lung disease with the death of covid-19 patients showed (p < 0.05). The results showed that the sensitivity, specificity, accuracy and the area under the receiver operating characteristic curve were respectively 0.60, 0.68, 0.71, and 0.75 in the DT model, 0.54, 0.62, 0.63, and 0.71 in the SVM model, and 0.59, 0.65, 0.69 and 0.74 in the AdaBoost model. Conclusion: The results showed that DT had a high predictive power compared to other data mining models. Therefore, it is suggested to researchers in different fields to use DT to predict the studied variables. Also, it is suggested to use other approaches such as random forest or XGBoost to improve the accuracy in future studies.

Effect of casein bioactive peptides on performance, nutrient digestibility, enzyme activity and intestinal microbial population in broiler chickens.

This experiment was carried out to investigate the effect of bioactive peptides derived from casein on performance, nutrient digestibility, enzyme activity and intestinal microbial population in broiler chickens. In this study, 350 1-day-old male Ross 308 broiler chicks were distributed among 35 pens in a completely randomized design with seven treatments, five replicates and 10 chicks in each replicate. The experimental treatments included: basal diet without any additives (control), basal diet + Avilamycin antibiotic, basal diet + 200, 400, 600, 800 and 1000 mg of peptides per kg of diet. Results showed no significant effects of the experimental treatments on weight gain and feed conversion ratio during the starter period, but there was a significant improvement in weight gain in grower, finisher and whole periods in chicks fed with diet containing 1000 mg/kg peptides (p < 0.05). Adding peptides improved intestinal morphology (in duodenum and ileum) (p < 0.05). Supplementation of casein peptides significantly reduced thiobarbituric acid reactive substances concentration in breast and thigh meat. The activity of amylase, lipase and protease enzymes improved in treatments containing 800 and 1000 mg peptides in comparison to the control treatment. The use of casein-peptides increased intestinal Lactobacillus and decreased Coliform populations.

Effect of monosodium glutamate supplementation in diet on fatty acid profiles, genes expression related to lipid metabolism and egg yolk cholesterol in late phase of production in laying hens.

In an experiment with four treatments and five replicates, the effects of adding monosodium glutamate (MSG) to the diet in late phase of egg production was studied on performance, and lipid metabolism in laying hens. Dietary treatments included the control basal diet without MSG and the other treatments adding 0.4%, 0.8% and 1.2% MSG in the control diet respectively. The effect of supplementation of MSG on egg weight, egg production, feed conversion ratio and egg mass was insignificant (p < 0.05). Adding MSG to the diet significantly increased feed intake and blood polyunsaturated fatty acids concentration (p < 0.05). Intake of 0.8% and 1.2% MSG in the diet up regulated the mRNA expression of acetyl-coenzyme A carboxylase, fatty acid synthase and lipoprotein lipase in the abdominal and liver tissues in comparison to the control group. Blood very low-density lipoprotein-cholesterol, triglycerides and cholesterol concentration were increased in treatment fed with a diet containing 0.8% MSG compared to the control group (p < 0.05). The effect of MSG on total egg yolk cholesterol concentration was not significant. In conclusion, the results of the present experiment indicated that adding MSG increased feed intake and blood polyunsaturated fatty acid concentration.

Association between epidural analgesia and postpartum psychiatric disorders: A meta-analysis.

Aim: Women during the postpartum period are at risk for psychiatric disorders such as postpartum depression (PPD), post-traumatic stress disorder (PTSD), and anxiety. It is controversial whether labour epidural analgesia have a protective role on PPD, PTSD, and anxiety or not. This study is a meta-analysis of previously published observational studies to investigate the association between epidural analgesia and PPD, PTSD, and anxiety. Methods: We searched Cochran Library, PubMed, ProQuest, EMBASE, Scopus, Web of Science, PsycINFO, and MEDLINE from inception until December 2022. The outcome measures were positive screen of PPD, PTSD, and anxiety among women who received labour epidural analgesia. The Newcastle-Ottawa Scale was used to assess the quality of the observational studies. Statistical analysis was performed using Stata 17.0 software. The mean differences or odds ratios were pooled based on random effect. Results: We included 31 studies (12,064 women) in the review. The meta-analysis of PPD studies reported mean (standard deviation) showed no significant association between epidural analgesia and PPD (Mean Difference = 0.01; 95% Confidence Interval = -0.14 to 0.16; p-value = 0.88). The meta-analysis of PPD studies reported percentage showed no statistically significant difference in terms of the chance of depression between the exposed and non-exposed groups (Log Odds Ratio = -0.61; 95% CI = -1.48 to 0.26; p-value = 0.17). The meta-analysis of PPD studies reported OR showed indicate a lower chance of depression in the epidural group compared to the non-epidural group (Effect size = 1.01; 95% CI = 0.64 to 1.38; P-value = 0.00). In the case of PTSD, due to the heterogeneity of the tools and the methodology of the studies, it was impossible to reach a definitive conclusion and measure the studies in a meta-analysis. The meta-analysis of anxiety studies showed that no significant association between epidural analgesia and anxiety (MD = -1.36; 95% CI = -3.38 to 1.14; p-value = 0.29). Conclusion: Based on the meta-analysis of observational studies, epidural analgesia for labour pain relief has no protective effect on postpartum psychiatric disorders.

Comparing the effects of rosemary aromatherapy and music therapy on anxiety levels in patients undergoing general surgery: A randomized controlled clinical trial.

BACKGROUND: Preoperative anxiety is a prevalent concern among patients undergoing surgery, potentially elevating the risk of postoperative complications. This study aimed to compare the effectiveness of inhalation aromatherapy using rosemary essential oil and music therapy in reducing anxiety levels among general surgery patients. METHODS: This study employed a randomized controlled clinical trial design involving 236 patients scheduled for general surgery. The participants were randomly assigned to one of four groups: aromatherapy with Rosmarinus officinalis L. essential oil (n = 59), music therapy (n = 59), combined aromatherapy and music therapy (n = 59), and a control group (n = 59). Data collection instruments consisted of the Spielberger State Anxiety Inventory, a personal information form, a music player, and wireless headphones. In the aromatherapy group, patients were instructed to inhale three drops of 25% rosemary essential oil. The music therapy group listened to instrumental music through headphones, while the combined group received both inhalation aromatherapy with rosemary essential oil and music therapy. The control group received three drops of an aromatic placebo. The interventions were administered for a duration of 30 min, starting one hour before surgery. Inferential statistics, including the Kolmogorov-Smirnov test, chi-square test, paired t-test, one-way analysis of variance, and LSD post-hoc test, were employed for data analysis. RESULTS: The study findings demonstrated significant effectiveness in reducing anxiety among surgical patients for aromatherapy (P = 0.001), music therapy (P < 0.001), and combined aromatherapy and music therapy (P = 0.001). Aromatherapy showed the highest anxiety-reducing effect, whereas combined therapy exhibited the lowest effect. CONCLUSION: The results indicate that inhalation aromatherapy, music therapy, and combined aromatherapy and music therapy are all effective approaches for anxiety reduction in surgical patients. Hence, the implementation of these cost-effective and non-invasive interventions is recommended to alleviate anxiety among surgical patients.

The effect of interventions in alleviating fear of childbirth in pregnant women: a systematic review.

BACKGROUND: The Fear of Childbirth (FOC) is regarded as a general problem, which affects women's health and well-being, justifying demanding caesarean section. Several primary studies have been performed in relation to the interventions performed to reduce the fear of childbirth, which show contradictions between the results of these studies. OBJECTIVE: This review aims to provide a comprehensive review of the different types of interventions used to reduce the fear of childbirth in pregnant mothers. METHODS: In this study, systematic review of study information related to the effect of different therapies on reducing the fear of childbirth using subject-related keywords and validated with MeSH in SID, MagIran, IranMedex, IranDoc, Embase, ProQuest, Scopus, PubMed, Web of Science (ISI) databases and Google Scholar Search Engine were extracted without any time limit until February 2021. RESULTS: After removing duplicates and irrelevant works from among the 5396 articles found, 63 articles remained in the study. The participants in these 63 articles were 5415 cases and 5770 controls. In addition, three studies were on epidural anesthesia, 33 on the effects of psychotherapy, 19 on the effects of education, and eight on the influence of other interventions on alleviating FOC. As shown by the results, psychotherapy intervention and education decreased FOC significantly. CONCLUSION: According to the results of this study, to prevent the fear of childbirth, pregnancy training and prenatal preparation courses are recommended to empower pregnant women. It also seems beneficial to use psychotherapy approaches for women who are afraid of childbirth.

The relationship between pregnancy and birth experience with maternal-fetal attachment and mother-child bonding: a descriptive-analytical study.

BACKGROUND: Pregnancy and childbirth experience can be important factors for a pleasant relationship between mother and baby. This study assessed the relationship between the pregnancy and birth experience with maternal-fetal attachment (MFA) and mother-child bonding. METHODS: A descriptive-analytical study was conducted among 228 pregnant women in Tabriz, Iran February 2022 to March 2023. Using cluster random sampling method, we included 228 women with gestational age 28-36 weeks and followed them up until six weeks postpartum. Data were collected in two stages using the following questionnaires: Pregnancy Experience Scale (hassles and uplifts), Maternal-Fetal Attachment Questionnaire (during the third trimester of pregnancy), Postpartum Bonding Questionnaire, and Childbirth Experience Questionnaire (six weeks postpartum). Data were analyzed using Pearson's correlation test and general linear model. RESULTS: The mean score of MFA was significantly higher among women with feelings of being uplifted during pregnancy [ß (95% CI) = 1.14 (0.87 to 1.41); p < 0.001]. However, there was no statistically significant relationship between pregnancy hassles and MFA and mother-child bonding (p > 0.05). Also, there was no statistically significant relationship between childbirth experience and mother-child bonding (p > 0.05). CONCLUSION: According to the results of this study, pregnancy uplifts have a positive role in improving MFA. Therefore, it is recommended to plan interventions to make pregnancy period a pleasant experience for mothers.

Comparison of side effects of the dose-1 of AstraZeneca and Sinopharm vaccines in patients with multiple sclerosis in Kermanshah, Iran (2021).

Background: Coronavirus 2019 (COVID-19) vaccination is recommended for people with multiple sclerosis (MS). This study evaluated the side effects of Sinopharm and AstraZeneca vaccines in MS patients. Methods: In this cross-sectional study among MS patients in Kermanshah province, Iran, who received Sinopharm or AstraZeneca vaccine, sampling was performed through convenience sampling according to the nationwide MS registry of Iran (NMSRI). Demographic and clinical information of the participants and data on the side effects of vaccines were collected by telephone after the first dose. The data were analyzed in SPSS software. Results: 264 vaccinated MS patients (217 with Sinopharm and 47 with AstraZeneca) were studied. In the Sinopharm and AstraZeneca groups, respectively, 58.5% and 73.3% of patients had side effects that were not significantly different between the 2 groups (P = 0.064). In the AstraZeneca group, the severity of side effects and prevalence of taking painkillers were significantly higher (P < 0.050) and the interval between vaccination and side effects onset was significantly shorter (P = 0.013). The most commonly experienced side effects in the Sinopharm group were fatigue (29.0%), myalgia (24.9%), fever (24.0%), and headache (21.7%), and in the AstraZeneca group were fever (59.6%), chills (51.1%), myalgia (40.4%), and fatigue (34.0%). Logistic regression by controlling for confounding variables showed that considering some factors as confounding factors did not show a significant difference between the 2 vaccines in the experience of side effects (P = 0.104). Conclusion: The AstraZeneca vaccine caused more severe side effects in MS patients than the Sinopharm vaccine. Most of the side effects were moderate in severity and transient.

Qualitative Exploration of the Needs of Pregnant Women to Manage the Fear of Childbirth.

Background: Some women experience the Fear of Childbirth (FOC) during pregnancy, labor, and birth which can have consequences for their health and well-being. To provide the right conditions for having a positive experience of childbirth, the needs of pregnant women must be correctly recognized. The present study was conducted with the aim of investigating the needs of women in managing the FOC with a qualitative design. Materials and Methods: This qualitative study was conducted using conventional content analysis from January to November 2021. To this aim, 15 pregnant women, 21 healthcare providers, and four maternal health policymakers were purposefully selected from Kermanshah health centers, with maximum diversity. Data were collected through in-depth semi-structured interviews. Data accuracy was guaranteed using Lincoln and Guba criteria. The MAXQDA software was used for data analysis. Results: From the analysis of the data obtained from the interviews, three main categories emerged concerning the needs of mothers to properly manage the FOC: "need to provide awareness and empowerment of mother and family," and "the need to pay attention to the mental health of pregnant women," and "supporting needs (seeking support)." Conclusions: Identifying and paying attention to woman's needs in the areas of education, mental health, and support can help them manage crisis-ridden situations, including the FOC. In response to the needs of mothers to empower them in managing the FOC, it is recommended to formulate special guidelines in this field.

The role of risk perception, risk communication, and demographic factors in COVID-19 preventive behaviors: an online survey in Iran.

OBJECTIVES: This study investigated preventive behaviors toward coronavirus disease 2019 (COVID-19) and related factors in a Kurdish Iranian sample. METHODS: This online survey was conducted among the population aged 18 and above in Kermanshah Province, in western Iran, in April 2020. Samples were invited and recruited through social media. Data were collected using a questionnaire consisting of 4 sections (questions on demographic variables, risk perception, risk communication, and COVID-19 preventive behaviors) and analyzed using Stata ver. 8. RESULTS: The Pearson correlation test showed that risk communication was significantly correlated with COVID-19 preventive behaviors (r=0.320, p<0.01). In the final model, where the explanatory power increased with the entry of the risk communication variable, the variables explained a total of 14% of variance in COVID-19 preventive behaviors. Sex (ß=-0.482), risk perception (ß=0.047), and risk communication (ß=0.662) were significant determinants. CONCLUSION: Risk communication and risk perception related to COVID-19, as well as being a woman, were determinants of COVID-19 preventive behaviors.

A brief review of malaria epidemiological trend in Kermanshah province, Iran, 1986-2014.

Malaria is the most severe protozoan disease in the world. As a result of strict malaria control programs, malaria's epidemiological model has changed. Knowing this epidemiological model and its effects will help us predict and prevent a new epidemic. This research was conducted to review the epidemiological trend of malaria in the Kermanshah province of Iran and some of its effective factors. Data were extracted from the registers in the disease control unit of the province, national population census, and annual rainfall report. The data was processed by SPSS16. There has been an evident decrease in malaria cases over the last 30 years in Kermanshah. This decreasing trend began especially after 1994, and since then, just 6% of all cases have happened. Between 1990 to 1997, an epidemic occurred, and more than 80% of positive cases were registered in these years. P. vivax malaria was the most common type (99.32%), and P. falciparum malaria was the second, with a very egregious difference (0.68%). The average age was 23.1 years, and men were infected twice more than women. There was a positive relation between annual rainfall level and positive malaria cases in these cities. After the major changes in malaria control programs in Kermanshah province, the number of positive cases fell noticeably, and now it is in the elimination stage. All cases of malaria were imported in the last years, and no resistance type was ever seen.

Effects of acid-hydrolyzed soybean meal on growth performance, jejunal morphology, digestive enzyme activities, nutrient utilization, and intestinal microbial population in broiler chickens.

The objective of this study was to investigate the effects of soybean meal (SBM) treated with acetic or citric acids on growth performance, microbial population, digestive enzyme activities, nutrient digestibility, and jejunal morphology in broiler chickens. A total of 350 one-day-old male broiler chicks (Ross 308) were randomly distributed into 7 experimental groups with 5 replicates per each. Experimental treatments were diets containing untreated SBM (control) and SBM treated with two acid sources and their concentrations including 5, 10, and 15% acetic acid (A1, A2, and A3) or 0.25, 0.50, and 0.75% citric acid (C1, C2, and C3). Results showed that trypsin inhibitors and lectins as the main SBM anti-nutrients significantly reduced in acid-treated SBM compared with untreated SBM (P < 0.05). During 1-24 days, body weight gain increased in chicks fed the C2 diet (P < 0.05). Feeding of the C2 diet increased feed intake compared with A1, A2, and C3 groups (P < 0.05). Feed conversion ratio improved in chicks fed with C2, C3, and A2 diets compared with the control group (P < 0.05). The greatest villus length, villus length to crypt depth ratio, and villus surface area were observed in the C2 diet (P < 0.05). A significant increase in protease and lipase activity was found in broilers which received a C2 diet compared with the control group (P < 0.05). Broiler chickens fed with the C2 diet had a higher organic matter and crude protein digestibility than the chicks which received the control diet (P < 0.05) and dry matter digestibility was the lowest in broilers fed with the A3 diet (P < 0.05). In conclusion, the acid hydrolyzing process had a beneficial effect on the nutritional value of SBM. In addition, data showed that acid-hydrolyzed SBM had the potential to exert positive influences on growth performance, jejunal morphology, and nutrient utilization in broiler chickens.

Identification of the opportunities and threats of using social media among Iranian adolescent girls.

Background: The use of the Social Media (SM) has increased dramatically among adolescents. Social media are full of opportunities and threats. The present study aims at identification of opportunities and threats of using social media among Iranian adolescent girls. Methods: This study was conducted using a qualitative approach and content analysis in 2019 in the city of Kermanshah, western Iran. Data were collected through individual semi-structured interviews and focus group discussions with 36 adolescent girls aged 12-18 years who were selected by theoretical and purposive sampling. ATLAS.ti-2019 software and Graneheim and Lundman analysis method were used to analyze the data and Guba and Lincoln criteria were used to evaluate the transferability of the results. Results: The results showed that social media is both a threat and a flourishing platform for adolescents. Findings were classified into 2 main categories and 8 subcategories: threats of using social media including 5 subcategories such as unhealthy lifestyle, increased risky sexual behaviors, academic challenges, tensions, psychological effects, and unconditional freedom, and opportunities to using social media including 3 subcategories such as psychosocial development, knowledge gain, and increased interactions. Conclusion: To strengthen social media opportunities in the face of its challenges, measures such as strengthening media literacy and teaching the correct use of the Internet and social media, educating adolescents and parents about the dangers of social media, educating and empowering parents to effectively communicate with children, producing content tailored to the cultural context and interests of adolescents, using affirmative approaches and removing access restrictions can be helpful.

Treatment of recalcitrant vitiligo by autologous non-cultured and trypsinized melanocyte grafting in the west of Iran.

BACKGROUND: Vitiligo is a common disease with a high burden, and its recalcitrant type is unresponsive to current medical treatments. Autologous non-cultured and trypsinized melanocyte grafting, which is a simple and experience-based procedure, has been suggested for the treatment of vitiligo. OBJECTIVE: To assess autologous non-cultured and trypsinised melanocyte grafting in recalcitrant vitiligo. METHODS: This clinical trial was done on 28 patients (20 females and 8 males). After demarcation and preparation of both donor and recipient sites, both sites were shaved by a curette. The materials harvested from the donor site were trypsinized and centrifuged. The resulting suspension was mixed with hyaluronic acid gel and was spread over the shaved recipient area. RESULTS: Twenty-eight patients with a total of 108 lesions and a mean age of 25.93 ± 7.11 years were included in the present study. Generalized vitiligo (57.1%) was the most common clinical type and the face and neck regions (38%) were the most frequent treated sites. Good to excellent repigmentation was seen in the face and neck, trunk, upper extremity, and genitals in 31 (57.4%), 11 (20.4%), 9 (16.7%) and 3 (5.5%) patients, respectively. Face and neck showed significantly better results (p < 0.05). STUDY LIMITATIONS: Low sample size and single-center study. CONCLUSION: Autologous non-cultured and trypsinized melanocyte grafting is a safe method with satisfactory outcomes in recalcitrant vitiligo. Appropriate training of physicians and proper use of specialists' experiences can be effective in increasing the improvement rate.

Prevalence of Multiple sclerosis and its clinical and demographic characteristics in Kurdish populations in western Iran (2020).

BACKGROUND: Multiple Sclerosis (MS) is a costly burdensome nervous system disorder leading several disabilities in young and middle-aged people. Knowing MS clinical, epidemiologic and demographic characteristics may help to estimate and predict the required health services and medication facilities for the affected people. This study was aimed to determine the prevalence of MS and its demographic characteristic in about 2 million Kurdish populations in western Iran in 2020. METHODS: This cross-sectional study was conducted in 2020 on MS patients with Kurdish Ethnicity living in Kermanshah /western Iran which is a Mountainous area in. MS patients were registered and recruited to this study from several centers. The settings have been approved by the nationwide MS registry of Iran (NMSRI). Using two questioners, a questionnaire included sex, age, the age in which the MS symptoms onset, the age of diagnosis, family history of MS, and type of MS, and second one was the Expanded Disability Status Scale (EDSS) checklist. The demographic information of Kermanshah province was adopted from the Statistical Center of Iran. In addition to descriptive statistics, U-Mann-Whitney and Chi-square tests were also used. RESULTS: A total of 1557 MS patients with a mean age (±SD) of 38.66 ± 9.9 years were recruited in this study. Of them, 1216 (78.1%) were female. The majority of patients, 300 patients (19.3%), were in the age range 35-39 years, and the highest prevalence (184.82 per 100,000 populations) was observed in the age range 40-44 years. The prevalence of MS in Kermanshah province is estimated 79.50 per 100,000 people, 125.71 per 100,000 in female and 34.41 per 100,000 in male. This prevalence was higher in female (female to male was 3.65 to 1). The EDSS score was significantly higher in male than in female (3.06 ± 2.2 in male versus 2.42 ± 1.8 in female) (p = 0.001). The type of MS was significantly different between male and female, so that SPMS and PPMS were more common in male (31(10.3%), 22(7.3%)) than female (81(7.5%), 39(3.6%)) (p = 0.012). A positive family history of MS was found in 12.6% of patients. CONCLUSION: Given the information about prevalence of MS in Kermanshah (in 2012), the prevalence of MS in Kermanshah has increased during last decade. MS disabilities were more extensive in male rather than female.

Modeling the Number of Confirmed Cases and Deaths from the COVID-19 Pandemic in the UK and Forecasting from April 15 to May 30, 2020.

OBJECTIVE: The UK is one of the epicenters of coronavirus disease (COVID-19) in the world. As of April 14, there have been 93 873 confirmed patients of COVID-19 in the UK and 12 107 deaths with confirmed infection. On April 14, it was reported that COVID-19 was the cause of more than half of the deaths in London. METHODS: The present paper addresses the modeling and forecasting of the outbreak of COVID-19 in the UK. This modeling must be accomplished through a 2-part time series model to study the number of confirmed cases and deaths. The period we aimed at a forecast was 46 days from April 15 to May 30, 2020. All the computations and simulations were conducted on Matlab R2015b, and the average curves and confidence intervals were calculated based on 100 simulations of the fitted models. RESULTS: According to the obtained model, we expect that the cumulative number of confirmed cases will reach 282 000 with an 80% confidence interval (242 000 to 316 500) on May 30, from 93 873 on April 14. In addition, it is expected that, over this period, the number of daily new confirmed cases will fall to the interval 1330 to 6450 with the probability of 0.80 by the point estimation around 3100. Regarding death, our model establishes that the real case fatality rate of the pandemic in the UK approaches 11% (80% confidence interval: 8%-15%). Accordingly, we forecast that the total death in the UK will rise to 35 000 (28 000-50 000 with the probability of 80%). CONCLUSIONS: The drawback of this study is the shortage of observations. Also, to conduct a more exact study, it is possible to take the number of the tests into account as an explanatory variable besides time.

Comparison of attitude of nurses and nursing students toward euthanasia.

BACKGROUND: Euthanasia is a controversial issue in many countries. However, there is little evidence about attitudes of nurses and nursing students toward euthanasia. RESEARCH AIMS: The present study aimed to compare nurses and nursing students' attitudes toward euthanasia. RESEARCH DESIGN: This is a descriptive cross-sectional study. PARTICIPANTS AND RESEARCH CONTEXT: Using census sampling, 390 nurses and 125 nursing students were enrolled in this study. METHODS: Data were collected using a socio-demographic questionnaire and Euthanasia Attitude Scale that included 20 items that sought to record participants' level of agreement with euthanasia based on a Likert-type scale. ETHICAL CONSIDERATIONS: Objectives of the study were stated for all samples, and emphasized the confidentiality of their specifics and responses, and informed written consent was obtained from all participants. FINDINGS: The mean score of nurses and nursing students' attitudes about euthanasia was 3.14 ± 0.26 and 3.22 ± 0.24 out of 5, respectively. The majority of nurses (n = 250, 65.78%) and nursing students (n = 97, 80.83%) had a positive attitude toward euthanasia. There was a significant statistical difference between the attitudes of nurses and nursing students to euthanasia (p = .005). DISCUSSION: The results indicated that the majority of students and nurses had a positive attitude regarding euthanasia. CONCLUSION: It was recommended to conduct more studies on euthanasia in Iran.