Delay in Regular Visits of Chronic Disease Patients and Its Associated Factors during the COVID-19 Pandemic.

Background: Chronic patients need regular follow-ups. During the COVID-19 pandemic, these regular visits can be affected. The delay of chronic patients and its contributing factors in their periodic visits during the COVID-19 pandemic are examined here. Methods: This cross-sectional study was conducted between February and June 2021, in Fars, Iran. Two hundred and eighty-six households with at least one chronic patient were recruited. Then, several trained questioners called the studied households and asked about the studied variables. The dependent variable was the number of delays in regular visits during the COVID-19 pandemic. The results were analyzed through Poisson regression by SPSS Statistics version 22 and GraphPad Prism software version 9. A significance level of 0.05 was considered for this study. Results: Out of 286 households 113 (73.4%) fathers, 138 (70.1%) mothers, and 17 (58.6%) children in the households reported delayed referral. In fathers, referring to the health center was significantly associated with a decrease in the number of delays (P=0.033). The higher age of the householder (P=0.005), the higher number of children (P=0.043), and having a family physician (P=0.007) in the mothers' group, also the number of children in households (P=0.001) in the children group were significantly associated with increasing the number of delays. Conclusion: COVID-19 pandemic not only creates direct harmful effects but also adversely affects people in danger of chronic diseases. Delays in follow-ups are taken into account as a major challenge during the COVID-19 pandemic. This issue is not limited to rural or urban residency.

Comparison of Male and Female Sexual Dysfunction between Hemodialysis and Peritoneal Dialysis in Patients with End-Stage Renal Disease: An Analytical Cross-Sectional Study.

Background: Maintenance dialysis is the most common treatment for end-stage renal disease (ESRD) patients. One of the most ignored but important health issue among dialysis patients is sexual dysfunction, which interferes with quality of life (QoL). Studies showed that the side effects of the two conventional methods of dialysis (hemodialysis (HD) and peritoneal dialysis (PD)) are different on a patient's health. Therefore, we sought to compare the sexual dysfunction score, both male and female, between patients undergoing HD and PD. Methods: One hundred seventy adults (85 HD and 85 PD) subject with end-stage renal disease (ESRD) on dialysis for at least 2 months were included. For male subjects, the erectile function (EF) domain of the International Index of Erectile Function (IIEF) questionnaire was calculated. Moreover, the Female Sexual Function Index (FSFI) questionnaire was calculated for females. Data were analyzed via SPSS software. Two independent sample t-test with two-sided significance level of 5% was used for comparing the sexual dysfunction score between HD and PD patients. Results: Out of 170 patients with mean age of 49.34 ± 11.7 years, 52.9% were female. Better sexual function scores were obtained in the HD group's females for desire, orgasm, and satisfaction domains, as well as the total score (P = 0.03, 0.016, 0.02, and 0.039, respectively). The erectile function was significantly better in the PD group's males (P). Conclusion: We found better sexual life in the HD group's females and PD group's males. Considering dialysis as a life-long treatment of CKD patients, this part of a patient's life must be taken seriously by the healthcare providers to choose the most suitable method for patients based on their personalized conditions.

A descriptive report on short QT interval in Kherameh branch of the PERSIAN cohort study.

Short QT-interval is a condition that bear the suspicion of short QT syndrome (SQTS). SQTS is known to increase risk of life-threatening arrythmias and sudden cardiac death (SCD). Due to the insufficient population-based studies and use of various QT cut-off values, it accounts for as an undiagnosed condition. In this study, we sought for prevalence of short QT interval in Kherameh cohort study, one of the southern branches of the Prospective Epidemiological Research Studies in Iran (PERSIAN). Data of 4363 adult subjects were analyzed from phase 1 of the cohort during 2014-2017. The corrected QT (QTc) intervals were calculated and electrocardiograms (ECGs) with QTc of less than 370 ms (msec) were reanalyzed for bradycardia, early repolarization, atrial fibrillation (AF), arrhythmias, and other electrical conduction abnormalities. Seventy-two subjects (1.65%) had a QTc of less than 370 ms (mean QTc of 360.72 ± 11.72). A male predominance and a lower mean heart rate observed in SQTS susceptible group (M/F of 1/0.26 vs. 1/1.145, p-value < 0.0001; 58.389 ± 9.787 vs. 70.899 ± 11.775; p-value < 0.0001) compare to the subjects with normal QTc. At least, 2 subjects with high-probability SQTS and 3 with intermediate-probability SQTS identified. The frequency of AF, syncope, bradycardia, early repolarization, low voltage ECG, and infantile SCD in first- and second-degree relatives were 16.67, 4.17, 33.33, 11.11, 11.11, 11.11%, respectively. The prevalence of short QT interval in our cohort was in line with previous studies. The incidence of cardiac symptoms/events, familial SCDs and ECG derived specific findings were high amongst SQTS-susceptible index persons. However, these variables could not predict the symptomatic subjects, which emphasizes gene studies and family screening.

Work-related Musculoskeletal Symptoms among Agricultural Workers: A Cross-sectional Study in Iran.

Objective: In Iran, as in most developing countries, agriculture is considered a hazardous industry. Musculoskeletal disorders (MSD) have been shown to be the most common occupational injury among farmers. The present study was carried out among agricultural workers of Fars province, Iran to determine the prevalence of musculoskeletal symptoms and to assess working postures and ergonomic working conditions to identify the major risk factors associated with MSD. Methods: This cross-sectional study was conducted on 1501 randomly selected Iranian agricultural workers with at least 1 year of job tenure. Data were collected using demographic/occupational questionnaire, Nordic Musculoskeletal Questionnaire (NMQ), Quick Exposure Check (QEC) technique, and ergonomic working conditions checklist. Results: The mean age of the participants was 41.39 ± 13.64 years. The results of NMQ showed the highest prevalence of MSD symptoms was related to lower back (59.3%), knees (36.9%), and upper back (36.6%). Indeed, the QEC score was high or very high (action levels 3 and 4) in 83.1% of the farmers. Moreover, the ergonomic working conditions checklist revealed that the participants' "working postures" index had the lowest mean, indicating poor ergonomic conditions, while "hand tools" had the highest mean, indicating proper ergonomic conditions. Conclusions: The results demonstrated the high prevalence of MSD symptoms among Iranian agricultural workers. Elimination of harmful working postures was recommended to improve working conditions.

Appropriateness of Congenital Hypothyroidism Screening Program in Fars Province, Iran: A Retrospective Study from 2005 to 2015.

Congenital hypothyroidism (CH) may lead to irreversible mental retardation. To prevent the complication, screening was conducted routinely for all neonates in Iran. This study aimed to evaluate the appropriateness of CH screening programs in Fars province, southern Iran. This retrospective study (February-May, 2017) was conducted in the Health System Research Center of Shiraz University of Medical Sciences (SUMS). The data were obtained from the non-communicable diseases' unit of SUMS regarding congenital hypothyroidism screening of all neonates born in Fars province from 2005 to 2015. We evaluated the coverage of CH screening, the incidence rate of CH, the percentage of the neonates screened for CH in ideal time, and neonates with CH treated in appropriate time. Descriptive statistics were used to determine the indices. To compare the incidence rate of boys and girls, we used Chi-square test. The coverage of CH screening in Fars Province increased from 50.0% in 2005 to 99.7% in 2015. Furthermore, the percentage of the neonates screened in the ideal time and the neonates with CH treated in an appropriate time increased from 26.0% and 78.0% in 2005 to 86.6% and 99.7% in 2015, respectively. In the evaluated period, the coverage of CH screening in Fars province (98.1%) was higher than that of the other provinces of Iran (83.0%). The study showed good screening coverage in Fars Province from 2005 to 2015. The coverage was considerably better than other provinces of Iran and improved during the study period. Also, over the course of time, more neonates were screened in an ideal time and treated in the appropriate time.

Who is sleeping more efficient? Patients on peritoneal dialysis or hemodialysis.

Sleep disorder, a common complaint among patients with the end-stage renal disease can affect most aspects of life. Therefore, we aimed to compare sleep quality of patients with peritoneal dialysis (PD) and hemodialysis (HD). This cross-sectional study was conducted on patients on dialysis who were referred to three major centers of Shiraz. The Pittsburgh Sleep Quality Index (PSQI) was used to compare sleep quality between patients on PD and HD. We also assessed some baseline characteristics to find out if they were independent predictors of sleep quality. Spearman correlation coefficients, one and two sample t-test, Chi-square, or Fisher's exact test were used to analyze the data. P <0.05 was considered statistically significant. The Statistical Package for Social Sciences version 18.0 for Windows was used for data analyzing. A total of 144 patients including 63 (43.8%) men and 81 (56.2%) women with the mean age of 54.4 ± 11.8 years completed the questionnaire survey. The total PSQI score showed that 77 (54.6%) of all patients had sleep disturbances without statistical difference between genders (P >0.05). On the other hand, the prevalence of sleep disturbance in HD patients (70.1%) was significantly higher than PD patients (35.9%), (P <0.001). HD patients had a higher rate of poor sleep quality than PD patients. Further studies are necessary to investigate the causes of poor quality of sleep in these patients and also to investigate methods to improve sleep quality in this population.

Production and characterization of an acido-thermophilic, organic solvent stable cellulase from Bacillus sonorensis HSC7 by conversion of lignocellulosic wastes.

The acidophilic and thermophilic cellulase would facilitate the conversion of lignocellulosic biomass to biofuel. In this study, Bacillus sonorensis HSC7 isolated as the best thermophilic cellulose degrading bacterium from Gorooh hot spring. 16S rRNA gene sequencing showed that, this strain closely related to the B. sonorensis. CMCase production was considered under varying environmental parameters. Results showed that, sucrose and (NH4)2SO4 were obtained as the best carbon and nitrogen sources for CMCase production. B. sonorensis HSC7 produced CMCase during the growth in optimized medium supplemented with agricultural wastes as sole carbon sources. The enzyme was active with optimum temperature of 70 °C and the optimum CMCase activity and stability observed at pH 4.0 and 5.0, respectively. These are characteristics indicating that, this enzyme could be an acidophilic and thermophilic CMCase. Furthermore, the CMCase activity improved by methanol (166%), chloroform (152%), while it was inhibited by DMF (61%). The CMCase activity was enhanced in the presence of Mg+2 (110%), Cu+2 (116%), Triton X-100 (118%) and it retained 57% of its activity at 30% NaCl. The compatibility of HSC7 CMCase varied for each laundry detergent, with higher stability being observed in the presence of Taj® and darya®. This enzyme, that is able to work under extreme conditions, has potential applications in various industries.

Purification and biochemical properties of a thermostable, haloalkaline cellulase from Bacillus licheniformis AMF-07 and its application for hydrolysis of different cellulosic substrates to bioethanol production.

A thermophilic strain AMF-07, hydrolyzing carboxymethylcellulose (CMC) was isolated from Kerman hot spring and was identified as Bacillus licheniformis based on 16S rRNA sequence homology. The carboxymethylcellulase (CMCase) enzyme produced by the B. licheniformis was purified by (NH4)2SO4 precipitation, ion exchange and gel filtration chromatography. The purified enzyme gave a single band on SDS- PAGE with a molecular weight of 37 kDa. The CMCase enzyme was highly active and stable over broad ranges of temperature (40-80ºC), pH (6.0-10.0) and NaCl concentration (10-25%) with an optimum at 70ºC, pH 9.0 and 20% NaCl, which showed excellent thermostable, alkali-stable and halostable properties. Moreover, it displayed high activity in the presence of cyclohexane (134%) and chloroform (120%). Saccharification of rice bran and wheat bran by the CMCase enzyme resulted in respective yields of 24 and 32 g L-1 reducing sugars. The enzymatic hydrolysates of rice bran were then used as the substrate for ethanol production by Saccharomyces cerevisiae. Fermentation of cellulosic hydrolysate using S. cerevisiae, reached maximum ethanol production about 0.125 g g-1 dry substrate (pretreated wheat bran). Thus, the purified cellulase from B. licheniformis AMF-07 utilizing lignocellulosic biomass could be greatly useful to develop industrial processes.