Training in child care and carrying out auriculotherapy techniques for mothers of premature newborns: double-blind clinical trial / Treinamento em cuidados infantis e técnicas de auriculoterapia a mães de recém-nascidos prematuros: ensaio clínico duplo-cego

Abstract Objectives: this study aimed to investigate the effect of education and auriculotherapy on stress, anxiety, and depression, and coping responses in mothers with premature infants. Methods: this is a randomized clinical trial study at Bahar Hospital carried out with 90 mothers with premature infants admitted to the neonatal intensive care unit. Those eligible for hospitalization were included in the study and distributed into three groups before intervention: (30 ones in the control, training, and auriculotherapy groups, respectively). The mean stress, anxiety, depression, and coping responses in mothers were measured both at the beginning of the study and before neonatal discharge. Results: there was no statistically significant difference in terms of anxiety, stress, and depression scores between the three groups before the intervention. However, after the intervention, there was a significant statistical difference between these three groups, which was among the mean scores of anxiety, stress, and depression. In terms of coping responses, the mean emotional and problem-oriented score in all three groups before and after the intervention is statistically significant. Conclusions: educating mothers and auriculotherapy pressure therapy are simple and practical methods in reducing anxiety, stress, depression, and increase coping responses; consequently, they can be used in neonatal intensive care.

Resumo Objetivos: este estudo teve como objetivo investigar o efeito da educação e da auriculoterapia no estresse, ansiedade e depressão e nas respostas de enfrentamento em mães com bebês prematuros. Métodos: este é um estudo de ensaio clínico randomizado no Bahar Hospital realizado com 90 mães de bebês prematuros internados em unidade de terapia intensiva neonatal. Os elegíveis para internação foram incluídos no estudo e distribuídos em três grupos antes da intervenção: (30 nos grupos controle, treinamento e auriculoterapia, respectivamente). O estresse médio, ansiedade, depressão e respostas de enfrentamento em mães foram medidas no início do estudo e antes da alta neonatal. Resultados: não houve diferença estatisticamente significativa nos escores de ansiedade, estresse e depressão entre os três grupos antes da intervenção. No entanto, após a intervenção, houve uma diferença estatística significativa entre esses três grupos, que foi entre a pontuação média de ansiedade, estresse e depressão. Em termos de respostas de enfrentamento, a pontuação média emocional e orientada para o problema em todos os três grupos antes e depois da intervenção é estatisticamente significativa. Conclusões: a educação das mães e a terapia de pressão com auriculoterapia são métodos simples e práticos na redução da ansiedade, estresse, depressão e aumento das respostas de enfrentamento; conseqüentemente, podem ser utilizados em terapia intensiva neonatal.

Efficacy of drug regimen with and without oseltamivir in hospitalized patients with COVID-19: A retrospective study.

Introduction: Coronavirus disease 2019 (COVID-19) is the most critical issue in nowadays medicine. We aimed to evaluate the use and therapeutic outcomes of oseltamivir, an antiviral drug for patients with COVID-19. Materials and method: In an observational study conducted at Imam Khomeini Hospital in Amol, Iran, data for 544 patients with laboratory and CT scan result confirmed COVID-19 were retrospectively collected between February 24th and April 13th 2020. To compare the characteristics of patients based on gender, the chi-square test was used. Logistic regression was used to evaluate the effect of oseltamivir on the outcome of treatment. Logrank test were used to compare the length of hospital stay in people treated with oseltamivir and drugs other than oseltamivir. Results: Kaplan-Meier and logrank test showed no significant reduction in hospitalization time and survival rate following treatment with oseltamivir. However, a significant increase in lymphocytes count and reduction of C-reactive protein (CRP) level detected. Conclusion: Administration of oseltamivir for patients with COVID-19 didn't show any improvement in hospitalization duration and survival rate.

Introducción: la enfermedad por coronavirus 2019 (COVID-19) es el tema más crítico en la medicina actual. Nuestro objetivo fue evaluar el uso y los resultados terapéuticos de oseltamivir, un medicamento antiviral para pacientes con COVID-19. Materiales y método: en un estudio observacional realizado en el Hospital Imam Khomeini en Amol, Irán, los datos de 544 pacientes con resultados de laboratorio y tomografía computarizada confirmados de COVID-19 se recopilaron retrospectivamente entre el 24 de febrero y el 13 de abril de 2020. Para comparar las características de los pacientes en función del género se utilizó la prueba de chi-cuadrado. Se utilizó regresión logística para evaluar el efecto de oseltamivir en el resultado del tratamiento. Se utilizó la prueba de rango logarítmico para comparar la duración de la estancia hospitalaria en personas tratadas con oseltamivir y otros fármacos distintos del oseltamivir. Resultados: Kaplan­Meier y la prueba de rango logarítmico no mostraron una reducción significativa en el tiempo de hospitalización y la tasa de supervivencia después del tratamiento con oseltamivir. Sin embargo, se detectó un aumento significativo en el recuento de linfocitos y una reducción del nivel de proteína C reactiva (PCR). Conclusión: la administración de oseltamivir para pacientes con COVID-19 no mostró ninguna mejora en la duración de la hospitalización y la tasa de supervivencia.

Comparing the Effect of Premature Infant Care Training and Performing Auriculotherapy Techniques on Anxiety, General Self-Efficacy and Breastfeeding Self-Efficacy of Mothers with Premature Infants.

Background: A preterm birth exposes the mother to many challenges in caring for and supporting the baby. This study aims to use training and auriculotherapy techniques as two simple methods to reduce anxiety and increase the mother's self-efficacy. Materials and Methods: This single-blind three-group clinical trial study was conducted in the Bahar Hospital in Shahroud, Iran, in 2019. The target group of primiparous mothers was premature infants. For the first group, premature infant care training was provided, and for the second group, auriculotherapy techniques were performed, and the third group (the control group) received routine care. Anxiety, general self-efficacy, and maternal breastfeeding self-efficacy were measured at the beginning of the study and before neonatal discharge. Results: Before the intervention, three groups were not significantly different in demographic characteristics, obvious and hidden anxiety scores, and general self-efficacy and lactation (p > 0.05). There was a significant difference between the control group and the two intervention groups with ANOVA test for self-efficacy (F2,87 = 6.60, p = 0.002), breastfeeding self-efficacy (F2,87 = 15.20, p < 0.001), obvious anxiety (F2,87 = 56.20, p < 0.001), hidden anxiety (F2.87 = 62.90, p < 0.001), after the intervention. In addition, there was no significant difference in the length of hospital stay in the neonatal intensive care unit (p = 0.732). Still, the neonate's infant's mean weight before discharge in the two intervention groups was significantly different from the control group (p = 0.034). Conclusions: Teaching mothers how to care for premature infants and implement auriculotherapy techniques reduces anxiety and increases mothers' general self-efficacy and breastfeeding.

Assessing the impact of stigma reduction interventions in Iran: A qualitative study from the perspective of mental health stakeholders.

Introduction: The fear and embarrassment associated with stigmas discourage patients from help seeking behavior, which may explain why even the patients' loved ones advise them to discontinue treatment to avoid being labeled. In addition, stigmas can lead to personal and family issues, causing patients to disregard their illness. As such, their disease may develop into a chronic condition. This being said, the present study aims to investigate the challenges, solutions, and successes associated with stigmatization in Iran from the perspective of mental health stakeholders. Method: A qualitative study was conducted in the summer of 2022. Purposive sampling was utilized to recruit participants. The primary data collection method involved a focus group interview that lasted 110 min. The project manager monitored the interviews, and all research team members attended the meetings, took notes, and made the necessary preparations. After explaining the study's purpose and ensuring the data's confidentiality, the interviewer led a focus group discussion. The interviews were recorded with the participants' consent. A focus group was used to conduct interviews with 13 individuals until data saturation was reached. Findings: Ten psychologists, psychiatrists, and managers responsible for mental health, two patients, and one patient's family member participated in the current study as eligible participants. Repeated readings led to the emergence of three main classes under the headings of challenges, solutions, and successes of stigma management in Iran, each containing subclasses. Conclusion: The majority of the proposed solutions in this study centered on raising awareness and training diverse individuals and groups to lessen stigmas. The most crucial de-stigmatization measure is to offer training that will cause the current stereotypes to change. This must be taken by patients and their families as well as therapists, leaders, policymakers, the general public, and the media. Ideally, younger members of the target groups should be considered for these pieces of training, which must be based on research and derived from cultural and localized needs.

Clergy's Viewpoint Change Toward Mental Health and Stigma on Mental Illness: A Short Course Training.

Background: As stigma is one of the main barriers in promoting the mental health, the present study was designed with the purpose of reviewing clergy's viewpoint regarding the effect of mental health workshops on these barriers. Methods: For this study, by order of Iran's Health Ministry, a questionnaire was designed to examine the clergy's viewpoint related to mental illnesses and the consequent stigma. Ten faculty members and psychiatrists confirmed the questionnaire's validity after some modifications. In this research, 30 members of the clergy from the main religious city in Iran's "Qom" Seminary attended the training workshops for 2 days. The data obtained from the clergy's responses were analyzed using the SPSS software (ver.16) and descriptive and analytical tests. Also, the significance level was considered p < 0.05 in all tests. The results exhibited that the mean and standard deviation (Mean ± SD) of the clergy's attitude domain and awareness before the workshop was 1.90 ± 26.30 and 8.31 ± 1.64, respectively. Also, average and standard deviation (Mean ± SD) of their attitude domain and awareness after the workshop was 1.95 ± 29.73 and 1.18 ± 10.70, respectively. Discussion: The present study, which was designed to examine the clergy's viewpoint toward mental illnesses and the consequent stigma in the most considerable religious base in the country, illustrated that one strategy for reducing mental illness stigma in religious communities can be by holding training sessions to promote the clergy's awareness of and attitude toward mental health. Conclusion: There was a significant statistical difference between their awareness and attitude scores before and after the workshop (p < 0.01). In the present research, the awareness and attitude of clergy toward mental health and stigma due to mental illness was relatively good and significantly increased by holding the workshop.

Investigating the prevalence of intestinal parasites with an emphasis on Strongyloides stercoralis infection in hospitalized patients: a regional report from Iran.

Intestinal parasitic infections such as strongyloidosis are more common among individuals with immune deficiency and sometimes accompanied by severe symptoms. The purpose of this cross-sectional study was to evaluate the prevalence of intestinal parasites with focus on strongyloidosis in hospitalized patients. A total number of 566 faecal samples were obtained from different wards and assessed by the use of direct smear, formalin-ether concentration, and agar plate culture procedures in order to find parasitic protozoa and helminthes. The findings revealed that 10.1% (n=57) of the examined samples were positive for intestinal parasites. The highest prevalence rate was related to Entamoeba coli (4.6%, n=26) and the lowest one was related to Strongyloides stercoralis (0.5%, n=3). In addition, Giardia lamblia prevalence rate was 3.2% (n=18) and the prevalence rate of Blastocystis hominis was 1.8% (n=10). The sensitivity of S. stercoralis diagnosis was equal for agar plate culture and formalin-ether concentration methods. This study demonstrated the significance of focus on intestinal parasites in hospitalized patients and highlighted the necessity of improving the insight in health care providers about the occurrence of parasitic infections especially strongyloidiasis in these patients.