Quality of Life Assessment in Patients with Behçet's Disease using the Persian Version of the Leeds BD-QoL Questionnaire.

BACKGROUND: Behçet's disease (BD) can negatively impact the quality of life (QoL) of the affected patients. The present study aimed to assess the QoL of BD patients using the Leeds BD-QoL and compare its results with the WHOQOL-BREF questionnaire. METHODS: In the present cross-sectional study, 179 BD patients and 304 healthy individuals (the control group) were recruited in Shiraz, 2017. The Persian version of the Leeds BD-QoL and WHOQOL-BREF questionnaires were used to assess the QoL of patients with BD. The QoL in the patient and control groups was compared after controlling the effect of some variables (age, sex, marital status, and educational level) using the multiple linear regression analysis. Spearman's correlation coefficient was calculated for the Leeds BD-QoL and WHOQOL-BREF scores. Disease activity was measured using the Behçet's Disease Current Activity Form. All the statistical analysis was performed using SPSS software (version 21.0). P<0.05 was considered statistically significant. RESULTS: The mean of the Leeds BD-QoL total score in the patient group was 12.3±8.7. The control group had significantly higher scores in the WHOQOL-BREF total score and the physical health and psychological health domains compared with the patient group; mean difference of 10.24, 10.8, and 4.62, respectively (P<0.001). The Spearman's correlation coefficient for the Leeds BD-QoL score and WHOQOL-BREF total score and its domains (physical health, psychological health, social relationships, and environment) was -0.669, -0.713, -0.714, -0.536, and -0.550, respectively. The disease activity score was correlated with the Leeds BD-QoL score (r=0.361, P<0.001). CONCLUSION: BD patients had a lower QoL than healthy individuals, specifically in the physical health and psychological health domains. An increase in disease activity and severity was associated with a reduced QoL. The Persian version of the Leeds BD-QoL questionnaire had an acceptable correlation with the WHOQOL-BREF questionnaire.

The Prevalence of Complementary and Alternative Medicine Use among Dermatologic Outpatients in Shiraz, Iran.

BACKGROUND: The use of complementary and alternative medicine (CAM) has been increasing among patients worldwide. The objective of this study was to assess CAM use and its related factors among Iranian dermatologic outpatients in Shiraz, Iran. METHODS: This cross-sectional study was conducted in Shiraz, Iran. Six hundred dermatologic outpatients were randomly selected. We used a self-structured questionnaire with 14 items to assess CAM use and its related factors among our participants. We used descriptive statistics reported as mean±SD and frequency by Mann-Whitney U test, chi square and binary logistic regression tests for statistical analysis. RESULTS: Among the 600 participants, 188 (31.3%) had used one of the CAM methods for resolving their dermatologic problems. The most frequent method used was herbal medicine (89.9%). The mean age and years of duration of the skin condition were significantly higher in patients using CAM compared to non-users (P=0.001 and 0.037, respectively). Patients with acne, alopecia, and hair loss significantly used CAM more than other diseases (OR: 2.48, CI 95%: 1.28-4.78) and (OR: 3.19, CI 95%: 1.62-6.27), respectively. There was a significant relationship between education and using CAM (P<0.001). CONCLUSION: Community member's behavior in CAM use without adequate knowledge may have a noticeable influence on each other. Since it is a prevalent matter, we should think of ways of educating the general population about CAM methods and its potential risks and benefits. We also should encourage our healthcare workers to communicate such materials with their patients.

Visual Impairment Prevalence, Causes, and Role of Healthcare Access: A Systematic Review and Meta-Analysis in Iran.

PURPOSE: Healthcare access is one of the determinants of visual impairment (VI), as a public health problem. The objective of this study was to estimate VI prevalence, related causes, and its correlation with access to physicians in Iran. METHODS: : This systematic review and meta-analysis include observational studies published in Iran. PubMed, Web of Science, Scopus, Google Scholar, and local databases were systematically searched by using the MeSH headings. Data on the provincial distribution of physicians, as an index of access to healthcare, was retrieved. A random-effect meta-analysis was performed to assess. RESULTS: Eight articles were included. The pooled prevalence of blindness, low vision, and VI was 0.80% (95% CI: 0.61-0.99%), 2.92% (95% CI: 2.40-3.44%), and 5.57% (95% CI: 4.71-6.43%). Refractive errors were the most common causes of VI based on PVA with the pooled prevalence of 54.6% (95% CI: 43.4-65.8%). Based on BCVA, we found that the pooled prevalence of cataracts was 37.4% (95% CI: 29.5-45.3%) as the most common cause of VI. The results of metaregression showed that the greater number of general practitioners (GPs) (P value = 0.01) and pharmacists (P value = 0.024) per population were associated with a lower prevalence of blindness. CONCLUSION: Some of the main causes of visual impairment in Iran are preventable. Access to healthcare services may lead to early diagnosis of preventable causes of VI. Further well-designed studies and national surveys should be conducted to provide accurate data from different regions of Iran.

Corneal endothelial cell injury induced by mitomycin-C in photorefractive keratectomy: nonrandomized controlled trial.

PURPOSE: To evaluate the effect of intraoperative use of mitomycin-C (MMC) on the corneal endothelium during excimer laser photorefractive keratectomy (PRK). SETTING: Vanak Eye Surgery Center, Tehran, Iran. METHODS: This nonrandomized trial comprised 81 patients (162 eyes) with bilateral low to moderate myopia and adequate corneal thickness to allow PRK (estimated postoperative residual stromal thickness >350 microm without considering epithelial thickness). The indication for intraoperative application of MMC 0.02% (0.2 mg/mL) was an ablation depth of 75 microm or more. Patients were divided into 3 groups: bilateral (both eyes treated with MMC), unilateral (only 1 eye treated with MMC), and untreated (no eye treated with MMC). Visual acuity, refraction, endothelial cell density (ECD), and corneal thickness were measured preoperatively as well as 1 week and 1, 3, and 6 months postoperatively. RESULTS: Overall, 76 eyes were treated with MMC. Eyes treated with MMC and untreated eyes were comparable in postoperative visual acuity and refraction. Preoperative to postoperative changes in ECD were statistically significantly greater in the treated eyes (-14.8%) than in untreated eyes (-5.1%) 6 months after PRK (P<.001). Longer MMC contact time (P<.001) and male sex (P= .04) were the only factors independently associated with greater endothelial cell loss. CONCLUSIONS: The prophylactic use of diluted intraoperative MMC 0.02% solution caused corneal endothelial cell loss. The rate of cell loss was correlated with the duration of MMC exposure.

Seroprevalence of sandfly fever virus infection in military personnel on the western border of Iran.

Military troops deployed to endemic areas are at risk of contracting sandfly fever, an arthropod-borne viral infection. Although typically a self-limited disease, sandfly fever can cause significant morbidity and loss of function among soldiers. We conducted this study to determine the extent of past SFV infection in a group of healthy Iranian military personnel in Ilam province on the western border of Iran. A total of 201 serum samples were tested by indirect immunofluorescence assay (IFA) to detect four common sandfly fever virus serotypes. Demographic data were also collected. Overall, 37 samples (18.4%) were positive for specific IgG antibodies to sandfly viruses. Sandfly fever Sicilian virus (SFSV) and sandfly fever Naples virus (SFNV) were the most common serotypes. A positive test was inversely related to nativity (P<0.01) but was not associated with age (P=0.163), duration of presence in the border region (P=0.08) or employment status (P=0.179). Our findings indicate that past SFV infection is common among military personnel in the western border region of Iran, a Leishmania-endemic region. Therefore, it should be considered in the differential diagnosis of troops presenting with acute febrile illness in similar settings.

The Prevalence of Complementary and Alternative Medicine Use Among Dermatology Outpatients in Shiraz, Iran.

The objective of this study was to assess complementary and alternative medicine use and its related factors among Iranian dermatology outpatients. In this cross-sectional study, a self-structured questionnaire was administered to 600 dermatology outpatients. Mann-Whitney U test, chi-square test, and binary logistic regression test were used. A total of 188 (31.3%) patients had used one of complementary and alternative medicine methods. The most frequent method used was herbal medicine (89.9%). The mean years of duration of the skin condition were significantly higher in complementary and alternative medicine users compared with nonusers ( P = .037). Patients with acne and alopecia significantly used more complementary and alternative medicine (odds ratio: 2.48 and 3.19, respectively). There was a significant relationship between education and using complementary and alternative medicine ( P < .001). Complementary and alternative medicine use is prevalent among our patients and we should think of ways of educating general population about complementary and alternative medicine methods and their potential risks and benefits and encourage our health care workers to communicate these materials with their patients.

The Effect of Black Tea (Camellia sinensis (L) Kuntze) on Pediatrics With Acute Nonbacterial Diarrhea: A Randomized Controlled Trial.

We aimed to evaluate the antidiarrheal effect of black tea in pediatric patients with acute nonbacterial diarrhea. This single-blind randomized clinical trial study was performed on 2 to 12-year-old patients, with acceptable criteria for acute nonbacterial diarrhea in Shiraz, Iran. In total, 120 patients took part in this study. Blocked randomization method was used to allocate them into 2 groups of intervention (black tea tablet + standard treatment) and control group (standard treatment; 60 patients in each). Frequency of defecation, volume, and consistency of stool were registered on arrival and 24 hours later. We used χ2 test, t test, and Mann-Whitney U test. After a 24-hour follow-up, the proportion of patients with formed stool was higher in the intervention group when compared with the control group (P < .001). There was a significant difference between the mean number of defecations per 24 hours in both groups, after treatment (P < .001). We found a possible antidiarrheal effect of black tea.

Assessment of Mental Health among Iranian Medical Students: A Cross-Sectional Study.

OBJECTIVES: More mental morbidities were reported in medical students than their nonmedical peers, which may negatively influence their lives and future career. The aim of this study was to assess the mental health status among medical students of Shiraz University of Medical Sciences. METHOD: Two hundred and eight 1(st) to 4(th) year Medical students took part in this cross-sectional study. General Health Questionnaire with 28 items (GHQ-28) was used for data collection. We performed descriptive statistics, Mann Whitney U test, one way ANOVA and Tukey's post hoc and Kruskal Wallis H and Chi square test for statistical analysis. RESULTS: The mean age of participants was 20.70 ± 1.14 (mean ± SD) years. More than half of them (54.4%) had total GHQ score above the cut-off point considered as probably abnormal mental health status. Years of education, positive family history and low satisfaction of the medicine discipline affected their mental health. Third and fourth year students had significantly higher mean scores of total GHQ (p-value = 0.009) and anxiety, somatic and social subscales (p-value = 0.001, 0.004 and 0.026). Students with positive family history of mental illness and low satisfaction of field of the study significantly had higher GHQ scores (p-value = 0.012 and < 0.001 respectively). CONCLUSION: Poor mental health prevalence is high among medical students in Shiraz. Proper changes in educational programs and other effective interventions to raise the students' satisfaction may reduce the effect of other stress reasons and improve their mental health status.

Assessment of students' perspectives about master of public health program in medical school of Shiraz University.

INTRODUCTION: Integration of public health and medical education has been thought to have an important role in medical students' training. Shiraz University of Medical Sciences has developed an MD/MPH dual degree educational program for the talented volunteer students. The aim of this study was to assess the students' viewpoints about various aspects of Shiraz MD/MPH program. METHODS: This cross-sectional study was conducted on Shiraz undergraduate medical students, who were enrolled in MD/MPH program. A self-structured questionnaire in Persian consisting of 4 parts was used; it included demographic factors including 16 questions which evaluated the students' perspective of the goals, content, skill development, applicability and meeting their expectations; 7 questions evaluating the self-reported increase of knowledge; and 3 multiple choice questions to assess the students' motivations and opinions on the impact of the program on their future career. Descriptive statistics was used for data analysis. RESULTS: All MD/MPH students (89) with a mean age of 21.4±1.34 participated in this study. Forty one of the students (46.1%) were male and 48 (53.9%) female. Overall, 86.1% of them had positive views about the goals of the program; also, 83.5%, 81.2% and 81.9% of them reported a positive viewpoint about the contents, the applicability and development of specific skills, and meeting their expectations, respectively. The students' most frequent motivation was "learning how to research systematically" (73%). The majority of the students reported this program to be moderately to highly effective in increasing their knowledge in the provided courses. CONCLUSION: The students had a positive view about almost all of the aspects of the MD/MPH program; this may be indicative of the program being successful in delivering the goals, increasing the students' knowledge and skills, and meeting their expectations to date. Students' enthusiasm for the educational program may lead to their motivation for better learning and thus in the program's success.

Iranian healthcare workers' perspective on hand hygiene: a qualitative study.

BACKGROUND: Hand hygiene (HH) has been identified as one of the simplest, but most important, methods to prevent cross-infection in healthcare facilities. In spite of this fact, the HH compliance rate remains low among healthcare workers (HCWs). Several factors may affect HH behavior. In this study, we aimed to assess various aspects of HH from the perspective of HCWs. METHOD: This qualitative study was conducted in two hospital settings in Shiraz, Iran. Eight focus group discussions (FGDs) and six in-depth interview sessions were held with ICU and surgical ward nurses, attending physicians, medical and nursing students and supporting staff. Each FGD and interview was transcribed verbatim, open codes were extracted, and thematic analysis was conducted. RESULTS: Three themes emerged from the thematic analysis including: "the relationship between personal factors and HH compliance," "the relationship between environmental factors and HH compliance" and "the impact of the health system on HH adherence, including the role of adequate health systems, administrative obligations and the effect of surveillance systems." CONCLUSION: Several factors played a significant role in improving HCWs HH compliance, such as the regular adherence to health system tenets. HH compliance may be improved through application of realistic policies and better supervision. In addition, appropriate education may positively affect HH behavior and attitudes.

Surveillance, control and management of infections in intensive care units in Southern Europe, Turkey and Iran--a prospective multicenter point prevalence study.

OBJECTIVE: We aimed to compare the features of intensive care units (ICUs), their antimicrobial resistance patterns, infection control policies, and distribution of infectious diseases from central Europe to Mid-West Asia. METHODS: A cross-sectional point prevalence study was performed in 88 ICUs from 12 countries. Characteristics of ICUs, patient and antibiotic therapy data were collected with a standard form by infectious diseases specialists. RESULTS: Out of 749, 305 patients at least with one infectious disease were assessed and 254 patients were reported to have coexistent medical problems. When primary infectious diseases diagnoses of the patients were evaluated, 69 had community-acquired, 61 had healthcare-associated, and 176 had hospital-acquired infections. Pneumonia was the most frequent ICU infection seen in half of the patients. Distribution of frequent pathogens was as follows: Enteric Gram-negatives (n = 62, 28.8%), Acinetobacter spp. (n = 47, 21.9%), Pseudomonas aeruginosa (n = 29, 13.5%). Multidrug resistance profiles of the infecting microorganisms seem to have a uniform pattern throughout Southern Europe and Turkey. On the other hand, active and device-associated infection surveillance was performed in Turkey more than Iran and Southeastern Europe (p < 0.05). However, designing antibiotic treatment according to culture results was highest in Southeastern Europe (p < 0.05). The most frequently used antibiotics were carbapenems (n = 92, 30.2%), followed by anti-gram positive agents (vancomycin, teicoplanin, linezolid, daptomycin, and tigecycline; n = 79, 25.9%), beta-lactam/beta lactamase inhibitors (n = 78, 25.6%), and extended-spectrum cephalosporins (n = 73, 23.9%). CONCLUSION: ICU features appears to have similar characteristics from the infectious diseases perspective, although variability seems to exist in this large geographical area.