The effect of educational intervention on efficacy of 1% permethrin shampoo and 4% dimeticone lotion to treat head lice infestation using propensity score matching (PSM).

BACKGROUND: Head lice are a main public health problem and the most important human ectoparasites and the use of pediculicides is the most common way to control it. One of the possible causes of treatment failure is the lack of improper application of pediculicide. The aim of this study was to assess the effect of education on efficacy of 1% permethrin or 4% dimeticone lotion to treat head lice infestation. METHODS: This quasi-experimental study included 100 individuals with head lice infestation from comprehensive urban health centers in Ardabil as the intervention group, and 400 individuals from East Azerbaijan and West Azerbaijan provinces as the control group, from April to March 2019. The data collection tools included a demographic questionnaire and an examination recording sheet, which documented the presence of adult lice or nits. Due to the inability to perform random assignment and control for numerous observed covariates, propensity score matching (PSM) was used. RESULTS: The outcome of treatment included elimination of head lice infestation on is 7, and in the case of recurrence, it was considered on days 14 and 30 after treatment. The results showed that the educational intervention program had a significant positive effect on the efficacy of both treatments. The likelihood of improvement was approximately three times greater in the intervention group compared to the control group. CONCLUSION: Participants who received the training intervention (OR = 3.29; CI 95%: 2.21-4.88) were more likely to have a successful treatment than control group. In the case of providing proper training on the use of pediculicides and observing hygiene tips to patients with pediculosis, could help to successful treatment of pediculosis.

The Intention of Waterpipe Tobacco Smoking by Women in the COVID-19 Pandemic and its Contributing Factors: a Nonparametric Path Analysis.

Background: People with waterpipe tobacco smoking (WTS) seem to be more at risk for the serious complications of coronavirus disease 2019 (COVID-19). This study aimed at assessing the behavioral intention (BI) of WTS by women in the COVID-19 pandemic and its contributing factors. Methods: This cross-sectional descriptive-correlational study was conducted in 2020 (ie, during the COVID-19 pandemic). Participants were 300 women randomly selected through multistage sampling from comprehensive healthcare centers in Khorramabad, Iran. Data collection instrument was a 42-item questionnaire with 4 main subscales, namely knowledge, attitude, differential association, and BI. Data were collected through both online and phone-based methods and were analyzed using non-parametirc path analysis. Results: The prevalence of WTS among women was 13% (95% CI, 11.06-14.94) and the mean scores of attitude, differential association, and behavioral intention among participants with WTS were significantly higher than participants without WTS (P < 0.001). Moreover, 46.12% (95% CI, 38.12-54.08) of participants with WTS reported intention to quit WTS due to the COVID-19 pandemic and 43.6% (95% CI, 35.66-51.54) of women with WTS and 16.5% (95% CI, 14.20-18.80) of women without WTS believed in the protective effects of WTS against COVID-19. The path analysis model showed that the BI of WTS had a significant inverse relationship with knowledge and a significant direct relationship with attitude and differential association. Conclusion: This study suggests the need for quality educational and counseling interventions for the general public to correct popular misconceptions about the protective effects of WTS against COVID-19.

The links between microclimatic and particulate matter concentration in a multi-storey car parking: a case study iran.

Multi-storey cars increasing with population growth have excellent security and temporary parking for cars in big cities, which isn't suitable for parking in the streets. The goals of this study are (1) to determine PM concentrations in the ZGP and (2) to investigate the effect of temperature and humidity on PM concentration in ZGP. This study measured the levels of emitted PM1, PM2.5, and PM10 by GRIMM EDM 107 laser dust monitor in a busy multi-storey parking garage located in Qom. Moreover, the relationship between microclimatic parameters and the contaminants mentioned above was investigated. Samples were collected in two stages in different spatiotemporal conditions, namely, the summer and autumn of 2017. The results indicate that during the sampling period, the daily mean ± standard deviation of PM10, PM2.5, and PM1 were 120.9 ± 90.6, 28.5 ± 10.4, and 10.8 ± 3.8 µg/m3, respectively. A decrease in pollution level was observed during the measurement period. During rush hours, the levels of particulate matter increased. Also, a significant positive relationship between indoor humidity and particle level was observed, while there was a meaningful, inverse relationship between temperature and particle level. The high PM concentration in the parking garage indicates the necessity of proper management and planning.

Linking mental health to safety behavior in construction workers: The mediating effect of work ability and sleep quality.

BACKGROUND: The severity of occupational accidents and injuries in the construction industry is the greatest across all industries. Few studies have examined the causal relationships among physical and psychological variables affecting the safety behavior of construction workers. OBJECTIVE: This study aimed to investigate the relationships among three factors (metal health, work ability and sleep quality) influencing the safety behavior of construction workers. METHODS: This cross-sectional study was conducted on 204 workers in civil construction projects in Iran. The data were gathered via self-reporting questionnaires. The acquired data were analyzed by the Smart PLS3 software using structural equation modeling with the partial least squares (PLS) regression approach. RESULTS: The R square revealed an acceptable fineness of the structural model. Similarly, as Q square values were higher than 0.15 for all factors, the predictability of the model was approved. The direct effect of mental health on safety behavior was not significant, but work ability and sleep quality had significant direct effects on safety behavior. Moreover, a decrease in mental health significantly reduced construction workers' sleep quality and work ability. CONCLUSION: The results of this study prove that sleep quality and work ability mediate the relationship between mental health and safety behavior. The deterioration of construction workers' mental health can increase the risk of unsafe behavior and occupational injuries. Therefore, appropriate measures need to be taken to maintain and improve the mental health of construction workers.

In vitro evaluation of albendazole nanocrystals against Echinococcus granulosus protoscolices.

Echinococcus granulosus is a zoonotic parasite causing hydatidosis in humans and animals. This study has been done in order to investigate the effect of albendazole nanocrystals on the viability of E. granulosus protoscolices. The average size and hydrodynamic diameter of albendazole nanocrystals were 976±218 and 1334±502 nm, respectively. Fertile hydatid cysts were isolated from the liver of slaughtered sheep. The isolated cysts were further identified using morphological and molecular techniques. The nucleotide sequence analysis indicated that the genotype of the protoscolices was E. granulosus sensu stricto with 100% similarity. The parasites were examined precisely for susceptibility to albendazole nanocrystals. The results revealed that albendazole nanocrystals are effective in removing protoscolices. It was observed that 1 µg/ml albendazole nanocrystals and albendazole completely inhibited the viability of the protoscolices within 17 and 23 days, respectively. The results suggested that albendazole nanocrystals can be used as an alternative effective treatment for E. granulosus infection.

The Granger causality analysis of the impact of climatic factors on visceral leishmaniasis in northwestern Iran in 1995-2019.

Visceral leishmaniasis (VL) as a vector-borne disease, is an endemic in the northwest and south of Iran and sporadic in other areas in the country. This study was performed to investigate the Granger causality analysis of the impacts of climatic factors on VL in northwestern Iran throughout the period from 1995 to 2019. In a longitudinal study, the epidemiological data of patients suffering from VL were collected from the health centers and hospitals in Meshkinshahr County, Ardabil province, between 1995 and 2019. Moreover, the environmental and climatic data of each location, such as temperature, humidity, rainfall, the number of frost and warm days in the year, were obtained from the meteorological center of the county and put into the Excel software. The incidence rate of VL was modeled by time series analysis and to compare its relationship with other time series covariates, the Granger causality analysis was used. The results of Granger causality analysis showed that some climatic variables including daily mean temperature, absolute minimum temperature, maximum and minimum temperature and maximum humidity were the main factors affecting the prevalence of VL in northwestern Iran. The findings greatly demonstrated that the potential of Granger causality in epidemiologic status of VL in northwestern Iran. Moreover, the results suggest that in addition to patient-related and biological factors, environmental and climatic factors such as temperature and humidity also play a major role in completing the transmittance cycle of VL in an endemic focus.

Epidemiological features of brucellosis and factors affecting its treatment failure and relapse in Qom Province, Iran.

Background: Brucellosis is one of the major health problems in many areas of the world, especially in the Mediterranean and the Middle East regions. Objective: To determine the epidemiological characteristics, clinical signs, and risk factors of relapse rate in patients with brucellosis, Qom Province, Iran. Methods: A descriptive-analytic study was conducted on 410 confirmed brucellosis cases in Qom Province, central Iran, from 2015 to 2019, based on epidemiological checklists and according to the Iran Ministry of Health and Medical Education (MOHME). Univariate and multiple logistic regression analyses were conducted using Stata software version 14. Results: The relapse rate of brucellosis was 6.6% until nine months after starting the treatment, and all recurrent cases were infected by Brucella melitensis. Based on univariate logistic regression analysis, the delayed treatment and type species of Brucella were significant factors affecting the relapse of brucellosis. The relapse rates were 5.4%, 6.2%, and 20.0% in patients whose delayed treatments were <50, 51-150, and >151days, respectively. Based on the multiple logistic regression, it was observed that delayed treatment >50 days increased the rate of relapse more than four times. Conclusion: The delayed initiation of treatment was a significant factor influencing the relapse of brucellosis; therefore, it is necessary to provide enough diagnostic and laboratory facilities, and people need to be educated about the signs and symptoms of the disease. Funding: Funding for this research was provided by the Research and Technology Center of Qom University of Medical Sciences, Qom, Iran.

The effectiveness of in-service training "pharmacopeia home health" based on Kirkpatrick's model: A quasi-experimental study.

BACKGROUND: Assessing the effectiveness of in-service training courses in order to achieve the desired goals and reduce the waste of costs and opportunities in the system is necessary. The purpose of this study was to determine the effectiveness of the "pharmacopeia home health" course considering its importance in different aspects using the Kirkpatrick model. MATERIALS AND METHODS: The present study was a quasi-experimental conducted at community health workers (CHWs) on three levels of reaction, learning, and behavior. In each phase, a valid questionnaire was used to measure the outcome according to the Ministry of Health guidelines with pretest and posttest measurements. The data were analyzed through SPSS 23, using descriptive statistics and repeated measures test and general linear model. RESULTS: The results of the study showed that at the level of reaction in terms of content and holding, conditions of implementation were favorable. Findings at the level of learning showed that the training course was only effective in enhancing the knowledge and awareness about drug maintenance and had no significant effect on other areas. In the third level, the results of the CHWs' performance showed that in some areas, the results were influenced by the demographic variables. CONCLUSION: The present study showed the effectiveness of education in different areas using on the Kirkpatrick model. Given the lack of impact of education in some areas in the present study and on the other, it is necessary to consider cooperative learning methods in order to develop the effectiveness of the courses.

Relationship between Some Environmental and Climatic Factors on Outbreak of Whiteflies, the Human Annoying Insects.

BACKGROUND: The reports of numerous outbreaks of whiteflies from different parts of the world have increased its medical importance. The aim of this study was to determine relationship between environmental changes and climatic factors with the outbreak of the whitefly population in Tehran, the capital of Iran. METHODS: This study was carried out in urban areas of Tehran, where the increasing population of whiteflies was reported frequently during 2018. In order to entrap the whiteflies, 20 yellow sticky cards smeared with white refined grease were installed on the trunks of the trees at twice per month as trapping time intervals. The captured flies were transferred and conserved in cans containing 70% alcohol and were counted accurately under a stereomicroscope. To determine the relationship between air quality index, precipitation, air temperature and air humidity as environmental and climatic factors with the abundance of whiteflies, change point analysis and Generalized Estimating Equations (GEE) was used. RESULTS: The most density of white flies per trap was 256.6 and 155.6 in early October and late September respectively. The number moved closer to zero from November to April. The population of whiteflies was inversely correlated with the level of air quality index (p= 0.99) and precipitation (p= 0.95), and it had a direct correlation with the high temperature. Also, the population of whiteflies had a direct correlation with the level of air humidity in the first half of the year. CONCLUSION: According to these findings, during spring and summer from early May to early October.

Assessing genetic evolution and detecting human papillomavirus by matching two complementary highly sensitive approaches, nested-qPCR and sequencing.

Becoming armed with an appropriate strategy to isolate the minimum number of human papillomaviruses (HPV), regardless of DNA extraction method, can be a huge step in preventing false negative; it has a significant effect on the management and control of HPV infection among women's population. This study was conducted in Qom province, considering the risk factors associated with HPV. It was able to analyze genetic evolution in its genotypes and evaluated the limit of detection by a new diagnostic approach. Totally, 486 Pap smear samples were tested; then, the HPV DNA was developed by a semi-nested quantification PCR. Positive samples were sequenced and submitted to the GenBank (MG825048-MG825061). After alignment, phylogenetic and polymorphism analyses were performed on the sequenced samples with a number of GenBank sequences. The overall HPV prevalence among all women in Qom was 11.7%. HPV6 (43.24%) and HPV16 (6.75%) were the most frequent LR and HR genotypes, respectively. Although the Tajima's D of all genotypes was positive, it was negative individually. The position of genotypes 6, 11, and 73 was controversial on phylogenetic trees. Limit of detection (LOD) was obtained as about 10-100 copies per reaction in various genotypes of HPV by semi-nested qPCR. The nature of HPV could be preserved during natural selection. This research, through innovative usage of the primers, could detect different genotypes of the HPV, and inform the women society of the probable risk through its prevalence determination.

Insulin Resistance and Colorectal Cancer Risk: the Role of Elevated Plasma Resistin Levels.

PURPOSE: Given the important role of resistin in insulin resistance (IR) and obesity, as well as the associations between both IR and obesity and increased risk of colorectal cancer (CRC), we investigated whether plasma resistin levels were associated with CRC risk. Furthermore, the possible correlations between resistin and insulin, IR, and obesity in patients with CRC and controls were explored. METHODS: This study was conducted as a case-control study and 170 subjects, including 88 controls and 82 cases with CRC, were enrolled and their plasma levels of glucoe, insulin, and resistin were measured using glucose oxidase or ELISA methods. Moreover, IR was calculated according to HOMA-IR index. RESULTS: The cases with CRC had a higher HOMA-IR than the controls (1.8 ± 0.4 versus 1.4 ± 0.3, P < 0.001). Additionally, after the stratification of the cases with CRC by tumor site, higher levels of resistin and insulin, and a higher HOMA-IR in the cases with rectal cancer than in the controls were observed (resistin 5.9 ± 1.2 versus 5.4 ± 1.3, P = 0.043; insulin 5.9 ± 1.2 versus 5.4 ± 1.3, P = 0.039; HOMA- IR 1.9 ± 0.4 versus 1.3 ± 0.3, P < 0.001). Furthermore, resistin was positively correlated with insulin in the controls (r = 0.737, P < 0.001), the cases with CRC (r = 0.881, P < 0.001), the cases with colon cancer (r = 0.811, P < 0.001), and the cases with rectal cancer (r = 0.990, P < 0.001). All these differences remained significant after adjustment for confounding factors. CONCLUSIONS: The findings of the present study reinforce the hypothesis that higher plasma levels of resistin in connection with insulin resistance play a role in susceptibility to colorectal, notably rectal, cancer. Nevertheless, further studies with bigger sample sizes are required to validate these findings.

Forecasting delay times in post-exposure prophylaxis to human animal bite injuries in Central Iran: A decision tree analysis.

BACKGROUND AND AIM: Data mining in medical sciences provides countless opportunities for demonstrating hidden patterns of a data set. These patterns can help general physicians and health workers in preventing diseases. This study aimed to forecast delay times in post-exposure prophylaxis (PEP) to human animal bite injuries in central Iran using a decision tree analysis. MATERIALS AND METHODS: The data of 2072 human animal bite cases were collected from Centers for Disease Control and Prevention unit of Qom Provincial Health Center, Iran from January 2017 to December 2018. The information related to animal bite incidents, including the biting animal characteristics and data on the bitten humans, was obtained by investigating the epidemiological survey forms of human animal bites. The decision tree model was applied to forecast the delay time of receiving PEP. RESULTS: A delay of more than 48 h in the initiation of PEP was estimated among 12.73% of animal bite victims. The most important variables to predict delay time of receiving PEP were the species of biting animal, time and cause of animal bite occurrences in 24 h a day, respectively. Hence, the model showed a delay in the initiation of PEP if the biting animal was a cattle or, a carnivore, and the time of being bitten was from 7 am to 1 pm, or if the animal was carnivore and the time of being bitten was between 1 and 7 pm, and the cause of animal bite was playing with the animal. CONCLUSION: Based on the findings of the study on different variables affecting the initiation of PEP, the concepts related to animal bite and rabies, including the timely injection of anti-rabies vaccine to prevent rabies, it is a must to educate and train, all the people, especially housewives and students.

Evaluation of the thermal stability of live-attenuated Rubella vaccine (Takahashi strain) formulated and lyophilized in different stabilizers.

Live attenuated viral vaccines are difficult to handle and often sensitive to temperature. The viral titer may drop during the processing and storing stage, especially at high temperatures. Using live attenuated viral vaccines successfully depends on keeping the sufficient potency required for an immune response. Although freeze-drying makes the vaccine more stable, in the absence of appropriate stabilizer the process may affect the structure and viability of the viruses. Therefore, the formulation of vaccine by means of an appropriate stabilizer plays a crucial role in the stability of viral structure and potency of the vaccine. This study aimed to evaluate the effect of two new stabilizers, including a Trehalose-based stabilizer (T) and a stabilizer containing sucrose, human serum albumin and sorbitol (S) on the thermal stability of lyophilized live-attenuated Rubella virus (Takahashi strain). Two Rubella vaccines were formulated using different stabilizers and were lyophilized. The potency of produced vaccines was investigated using accelerated stability test. To determine the pattern of thermal stability of reconstituted vaccines in 24 h, incubating at three different temperatures and continuous sampling was also included in this study. The viral titer was calculated by TCID50 method. The regression analysis revealed that T vaccine found the sufficient stability compared to commercial Rubella vaccine containing a gelatin-based (G) stabilizer.

Adherence to Principles of Medical Ethics Among Physicians in Mazandaran Province, Iran.

BACKGROUND: Considering that medical ethics is an applied subject providing systematic solutions to help physicians with moral issues, this research aimed to evaluate adherence to the principles of medical ethics among physicians on the basis of attitude of physicians of Mazandaran province. METHODS: This cross-sectional study was conducted in Mazandaran province, Iran during 2015. A researcher-made questionnaire was used for data collection. The questionnaire was first completed by 40 physicians and its reliability was confirmed by obtaining a Cronbach's alpha coefficient equal to 0.818. Its validity was confirmed by medical ethics experts. Therefore, the questionnaire was reliable and valid. Analytical and descriptive analysis were performed. RESULTS: According to our findings, there is a significant correlation between some of variables of medical ethics principles. The results show that adherence to indicators of beneficence, non-maleficence and justice has been almost good; however, physicians' ethical behaviors which pertain towards the principle of autonomy have not been acceptable. There was not any significant difference in adherence to the principles of autonomy, beneficence and non-maleficence, and justice on the basis of sex, residency, education and occupation. CONCLUSION: According to the present study, more training is required to improve physicians' adherence to the principles of medical ethics .

Simultaneous effect of shift work on blood pressure and lipid profile: a path analysis.

The aim of this study was to assess the direct and indirect effects of shift work (SW) on the systolic blood pressure (SBP) and lipid profile of male workers. For this purpose, a cross-sectional study was conducted involving 6539 male workers of Esfahan Mobarakeh Steel Company. From all of the participants, 3065 (46.8%) were day workers and the remainder were shift workers. The results of path analysis revealed that the most effective variables on SBP were body mass index, fasting blood sugar, triglycerides and SW with a total effect of 0.241, 0.095, 0.064 and 0.056, respectively.

Path analysis of the risk of low birth weight for multipara.

BACKGROUND: LBW rate is one of the most important health indices in every society. It reveals mothers and their new-born infants' health. OBJECTIVES: Our aim, in the present paper, was to present a new statistical framework for analysis based on path analysis techniques. PATIENTS AND METHODS: A prospective study was conducted in two maternity wards, (privet & governmental hospital) in Sari, Iran. In this research a check-list containing 25 questions about mother's demographic information and her new-born infant was prepared. Every new born infant who was born weighing less than 2500 g was entered in our study and just next the newborn infant who was normal all of his/her information use to be taken too, (n = 190). Path analysis, an extension of the regression model, was used in this study. RESULTS: Obviously exactly half of the infants were LBW, and the remainder were normal. There were 97 boys and 93 girls. The percentage of IUGR among mothers who had preterm delivery was 19, while this percentage for mothers who had term delivery was 11.5 (P value = 0.167). LBW infants were 36.7% unexpected, while this percent for normal infants was 15.5 (P value < 0.001). Preterm delivery has a significant and direct effect on LBW (p value < 0.001), and its positive sign of path coefficient shows that if it occurs, the probability of LBW will increase, the second important was IUGR, the results showed unexpected pregnancy had direct effect on LBW but this wasn't significant (P value = 0.292). CONCLUSIONS: By preventing unnecessary termination of pregnancy and keeping fit, the chances of LBW can be reduced.