Sexual health literacy level and its related factors among married medical sciences college students in an Iranian setting: a web­based cross­sectional study.

BACKGROUND: Sexual health literacy (SHL) leads to the development of personal ability, understanding, evaluation and use of information related to sexual health. The purpose of this study was to assess the sexual health literacy level and its related factors among married college students at Mazandaran University of Medical Sciences (MAZUMS). METHODS: A web-based cross-sectional online study was conducted on married college students at Mazandaran University of Medical Sciences between January and November 2020. All students were included in the study by census, and the study method was explained by telephone. If they agreed to participate in the study, the online link to the questionnaire, including sociodemographic and clinical information and Sexual Health Literacy for Iranian Adults (SHELIA), was emailed. The Statistical Package for the Social Sciences (SPSS) software version 26 was used for data analysis. Univariate and multivariate logistic regression tests were used to assess factors related to sexual health literacy. RESULTS: The sample consisted of 277 male and 123 female students. Sexual Health Literacy Level and all subscales are at the sufficient level (66.1-88). Among the participants, 20.5% had limited sexual health literacy. Multivariate analysis found factors related to sexual health literacy among students: economic status (OR 0.03; 95% CI 0.0-0.55) and faculty (OR 0.07; 95% CI 0.01-0.52) is related to decrease and subscription to social media for sexual health (OR 3.27; 95% CI 1.53-7.01), information source of channels and cyberspace (OR 3.23; 95% CI 1.41-7.39), educational level (OR 16.39; 95% CI 2.16-32.70), Internet search information source (OR 1.91; 95% CI 1.00-3.64) is related to increase, were statistically significant factors. CONCLUSION: In Iran, medical sciences college students, who constitute a significant portion of the country's population, are responsible for sexual health education. Government agencies, with the collaboration of all stakeholders, should develop policies and programs for implementing and evaluating integrated and comprehensive sexual health literacy promotion programs for them.

The frequency of asthma and its related factors: results of the enrolment phase of Tabari cohort study.

INTRODUCTION: A large portion of the world's population has asthma. This study aimed to ascertain asthma prevalence and related factors in the Tabari cohort study (TCS). METHODS: The TCS included 10,255 35-70-year-olds from urban and mountainous Sari (northern Iran) between June 2015 and November 2017. Education, occupation, domicile, socioeconomic position, history of psychiatric disorders, smoking (including hookah smoking), opium usage, and daily physical activity level were determined. RESULTS: The final analysis included 9939 individuals. The asthma rate was 7.4%. Multiple factors increased asthma risk, according to statistical analysis. These factors included being female (OR, 1.337; 95% CI, 1.142-1.565), retired (OR, 1.553; 95% CI, 1.205-2.002), living in the city (OR, 1.268; 95% CI, 1.083-1.484), using opioids (OR, 1.689; 95% CI, 1.299-2.197), having lower socioeconomic status (SES) (OR, 0.723; 95% CI, 0.579-0.903), history of psychiatric disorders (OR, 2.313; 95% CI, 1.826-2.930), and aged 60-70 (OR, 2.325; 95% CI, 1.765-3.064), and BMI above 30 kg/m2 (OR, 1.499; 95% CI, 1.220-1.841). Several factors increased asthma probability in multivariate regression analysis. These factors include being female (OR = 1.389, p = 0.015), ages between 60 and 70 (OR = 2.034, p < 0.001), using opioids (OR = 1.940, p < 0.001), lower SES (OR = 0.738, p = 0.012), history of psychiatric disorders (OR = 2.035, p < 0.001), BMI above 30 kg/m2 (OR = 1.518, p < 0.001), and being a smoker (OR = 1.337, p = 0.056). CONCLUSION: This study has identified that the prevalence of asthma in the Tabari cohort group is high. In addition, it was demonstrated that various factors are related to asthma.

Hematological parameters in patients with recurrent Aphthous Stomatitis: a systematic review and meta-analysis.

OBJECTIVES: Recurrent Aphthous Stomatitis (RAS) known as recurrent aphthous ulcer is a common and painful ulcerations in oral cavity. It has been suggested that hematological parameters seems to be considered as an etiologic factor. So, this meta-analysis and systematic review was aimed to examine the relationship between RAS and hematological parameters. METHODS: Relevant studies were found using online international databases including Scopus, Science direct, Web of science (ISI), PubMed, and Google Scholar search engine between 2000 and October 2023. The quality of all papers was determined by NOS checklist. Heterogeneity between the results of primary studies was evaluated with I-square index and publication bias was performed by Egger's test and funnel plots. Also, sensitivity analysis was done to check the effect of each of the primary studies on the overall estimate. Also, the statistical analyses were done using Stata software Ver. 11. RESULTS: By combining the results of primary studies, the standardized mean difference (SMD) of vitamin B12, ferritin, folic acid, hemoglobin, iron and zinc indices with a 95% confidence interval (CI) between the case (patients with RAS) and control (Healthy) groups were estimated -0.52(-0.89, -0.14), -0.20(-0.51, 0.11), -0.42(-0.95, 0.11), -0.58(-0.90, -0.27), 0.01(-0.12, 0.15), -0.33(-0.81, 0.14) respectively. The patients with vitamin B12, ferritin, folic acid, and iron deficiencies and reduced hemoglobin (Hb) level reported 2.93(2.28, 3.78), 2.50(1.48, 4.22), 1.51(0.53, 4.29), 1.46(0.70, 3.03), and 2.14(1.38, 3.32), times more susceptible to develop RAS than healthy individuals. CONCLUSION: The results of the meta-analysis indicated that the SMD of vitamin B12 serum and Hb levels in the case group was 52%. Our result have also showed that the odds ratio of vitamin B12, ferritin deficiencies, and decreased Hb level in case group was 2.93, 2.50, and 2.14 times more than healthy group.

Evaluating the factors affecting clinical outcomes in critically ill COVID-19 unvaccinated patients admitted to the intensive care unit in a lower-middle-income country.

Background: COVID-19, the most destructive pandemic of this century, caused the highest mortality rate among ICU patients. The evaluation of these patients is insufficient in lower-middle-income countries with limited resources during pandemics. As a result, our primary goal was to examine the characteristics of patients at baseline as well as their survival outcomes, and propose mortality predictors for identifying and managing the most vulnerable patients more effectively and quickly. Methods: A prospective analysis of COVID-19 ICU-admitted patients was conducted in our healthcare centre in Iran, from 1 April until 20 May 2020. Ninety-three patients were included in the study, and all were unvaccinated. A multi-variate logistic regression was conducted to evaluate mortality-associated factors. Results: There were 53 non-survivors among our ICU-admitted patients. The mean duration from symptoms' onset to hospitalization was 6.92 ± 4.27 days, and from hospitalization to ICU admission was 2.52 ± 3.61 days. The average hospital stay for patients was 13.23 ± 10.43 days, with 8.84 ± 7.53 days in the ICU. Non-survivors were significantly older, had significantly lower haemoglobin levels and higher creatine phosphokinase levels compared to survivors. They had marginally lower SpO2 levels at admission, higher vasopressor administrations, and were intubated more significantly during their ICU stay. The use of immunosuppressive drugs was also significantly higher in non-survivors. Logistic regression revealed that a one-point increase in APACHE II score at ICU admission increased mortality by 6%, and the presence of underlying diseases increased mortality by 4.27 times. Conclusion: The authors presented clinical mortality prediction factors for critically ill patients infected with COVID-19. Additional studies are necessary to identify more generalized mortality indicators for these patients in lower-middle-income countries.

The efficacy of earplugs and eye masks for delirium severity and sleep quality in patients undergoing coronary artery bypass grafting in cardiac intensive care units: A single-blind, randomised controlled trial.

BACKGROUND AND PURPOSE: Delirium is a neuropsychiatric syndrome with a wide range of possible causes and multiple complications in patients admitted to intensive care units. It is, therefore, necessary to seek appropriate and safe strategies to prevent and manage delirium. This study is intended to examine the efficacy of eye masks and earplugs for delirium severity and sleep quality in patients with coronary artery bypass grafting in a cardiac intensive care unit. MATERIALS AND METHODS: This single-blind, randomised controlled trial was conducted on 114 patients who were consecutively enrolled and randomly assigned to either the experimental group or the control group. The experimental group received routine care plus eye masks and earplugs, and the control group received only routine care. The delirium severity and sleep quality were measured with the Neelon and Champagne confusion scale and the Verran and Snyder-Halpern sleep scale. RESULTS: The mean delirium severity score differed significantly between the two groups on the second, third, and fourth postoperative days (p < 0.001). Although the trend of changes in the mean delirium severity score from the first postoperative day (before the intervention) to the second, third, and fourth postoperative days was downward in the two groups (trending towards higher delirium severity), the control group experienced greater changes than the experimental group. An intragroup analysis of delirium severity detected a statistically significant difference in both the experimental and control groups (p < 0.001). The sleep quality domains (sleep disturbance, sleep effectiveness, sleep supplementation) showed a statistically significant difference between the two groups across the three intervention days (p < 0.001). CONCLUSION: The overnight use of eye masks and earplugs were found to have positive effects on sleep quality domains (sleep disturbance, sleep effectiveness, sleep supplementation) and delirium severity in coronary artery bypass grafting patients admitted to the cardiac intensive care unit for several days. It was also found that a significant interaction effect between the sleep disturbance subscale and delirium severity exists. CLINICAL TRIAL REGISTRATION NUMBER: (https://en.irct.ir): IRCT20210523051370N2.

Toxoplasma gondii infection and ABO blood groups: a systematic review and meta-analysis.

The current study aimed to determine the prevalence of Toxoplasma gondii in ABO blood groups and assess the relationship between the prevalence of T. gondii and blood groups. A literature search was carried out for epidemiological studies that were published through December 2022. A random effects model was used to determine the OR and the pooled prevalence with a 95% CI. The estimated pooled prevalences of T. gondii infection in the A, B, AB and O blood groups were 38% (95% CI 27 to 48%), 38% (95% CI 29 to 47%), 36% (95% CI 26 to 45%) and 36% (95% CI 27 to 45%), respectively. Also, the pooled ORs of the relationship between the prevalence of T. gondii infection and the A, B, AB and O blood groups were 1.08 (95% CI 0.97 to 1.19), 1.10 (95% CI 0.95 to 1.28), 1.08 (95% CI 0.92 to 1.27) and 0.89 (95% CI 0.80 to 1.00), respectively. This meta-analysis did not show any relationship between the prevalence of T. gondii infection and ABO blood groups.

The Association between Occupational Burnout and Spiritual Well-being in Emergency Nurses: A Cross-Sectional Study.

Objective: This study evaluated the occupational burnout (OB) and spiritual well-being (SWB) of emergency nurses as well as the associations between these variables. Method: This cross-sectional study was conducted in six hospitals and emergency medical centers affiliated with Ardebil University of Medical Sciences (Ardebil, Iran), in 2020. Data were collected via socio-demographic, Spiritual Well-Being Scale (SWBS), and Maslach Burnout Inventory (MBI) questionnaires. Results: This study included 239 emergency department nurses. The mean age of the participants was 34.4±6.4 years. The mean of existential well-being and religious well-being was 40.3±8.7 and 41.0±9.2, respectively. The results indicated that moderate (P=0.007) and severe (P<0.001) personal accomplishment was a positive and significant predictor of the SWB in emergency department nurses. Conclusion: Proper planning and provision of suitable educational programs in the dimension of the SWB of nurses prevent the creation and continuation of OB and increase the self-efficacy and job satisfaction of emergency medical staff, resulting in better patient care.

Relationship between smoking and tuberculosis recurrence: A systematic review and meta-analysis.

INTRODUCTION: Of the problems in tuberculosis (TB) control program is the recurrence of this disease. In some studies, smoking has been reported as the most important risk factor. Therefore, the present study aimed at examining the association between smoking and tuberculosis recurrence using meta-analysis. METHODS: To report the findings of this meta-analysis, we used PRISMA. The protocol of this study has been recorded in PROSPERO. The research question has been formulated based on PICO, and the search was performed using both MeSH and non-MeSH keywords. After screening and selecting the articles and evaluating their quality using the NOS checklist, the overall estimate of the odds ratio of tuberculosis recurrence in smokers was assessed with a 95% confidence interval. RESULTS: Fourteen studies met the inclusion criteria. The total number of samples in the group of patients with tuberculosis recurrence was 1988 with 855 (43%) smokers, and in the group of patients affected by tuberculosis without recurrence, it was 27,226 with 7503 (27.56%) smokers. In 13 studies, the odds ratio of tuberculosis recurrence was higher in smokers; this difference was statistically significant in 12 of them. Combining the results of these 14 studies, the odds ratio of tuberculosis recurrence in smokers was 2.10 times higher, using the random effects model (95% CI:1.69, 2.61). CONCLUSION: Based on the results of study present, smoking increases the risk of tuberculosis recurrence. Therefore, to eradicate tuberculosis by 2030, more serious interventions should be taken to quit smoking, which in turn reduces the incidence of tuberculosis.

A tangible prospect for the treatment of gingivitis using a potentially probiotic strain Lactobacillus plantarum MK06 isolated from traditional dairy products: a triple blind randomized clinical trial.

BACKGROUND: Frequent bacterial plaque buildup at the gingival margin and crevice can provoke an inflammatory reaction in gingival tissues which manifests as gingivitis. Probiotics could serve as a beneficial complementary therapy for treating gingival inflammation. The main aim of this research was to investigate the effect of the Lactobacillus plantarum MK06 probiotic strain on the treatment of gingivitis. METHODS: Patients with gingivitis, who were referred to a private clinic and were systematically healthy, were included in this randomized, triple-blind, placebo-controlled trial. They were instructed to use either placebo or Lactobacillus plantarum suspensions for one minute two times a day after tooth-brushing for four weeks. Then, the clinical parameters of gingivitis, including plaque index (PI), gingival index (GI), bleeding on probing (BOP), and oral hygiene index (OHI-s), were measured in the first, second, and fourth weeks. A total of forty-two patients were randomly assigned to the experimental (n = 21) and control (n = 21) groups. The mean age of the experimental and control groups was 29.10 and 28.48, respectively. RESULTS: The mean scores of BOP, GI, PI, and OHI-s reduced over time in both the control and test groups. However, according to the Mann-Whitney test, the difference between the two groups was not significant at the same time intervals (P ≥ 0.05) and only GI showed a significant difference in the fourth week (GI-3, P = 0.006). Nevertheless, the experimental group experienced a higher overall reduction rate than the control group. The BOP, GI, PI, and OHI-s scores decreased by 0.081, 0.204, 0.186, and 0.172 times in the second week, respectively, resulting from the interaction of time and the intervention, which considerably diminished these indices. CONCLUSION: This study shows the potential of the probiotic Lactobacillus plantarum MK06 suspension as a promoting therapeutic adjuvant in the treatment of gingivitis.

Association between perceived stress and cardio-metabolic risk factors: preliminary results of NURSE (Nursing Unacquainted Related Stress Etiologies) study.

Objective: Stress is known as a conventional risk factor of cardiovascular disease. Nurses work in stressful environment and could be one of the target populations to be assessed for cardio metabolic risk factor. This study aimed to identify the association between perceived stress and cardio-metabolic risk factors in nurses who are prone for various metabolic diseases. Method: In this cross-sectional study, nurses from five different educational hospitals of Tehran University of Medical Science attended the study. A self-administered questionnaire as well as Perceived Stress scale were completed. All anthropometric indices and blood pressure were measured. After 10-12 hours of fasting, venous blood samples were taken and level of total cholesterol, triglyceride, high-density and low-density lipoprotein cholesterol, fasting blood sugar and insulin level were determined. Data were analyzed using SPSS version 16 and a p value less than 0.05 was considered statistically significant. Results: In total 273 nurses were recruited in this study. The mean age of participants was 35.01 ± 0.399 years old. The mean of perceived stress was 15.55 ± 5.04 with the minimum of 3 and maximum of 30. There was no significant association between perceived stress and cardio-metabolic risk factors. Results showed that there was a negative association between perceived stress and insulin level only in nurses who worked rotationally (ß = - 0.195, p = 0.048). This association remained significant after adjustment for age and sex (ß = - 0.181, P = 0.041). Conclusion: Finding of the current study showed that negative association between perceived stress and insulin level and there is no significant association between stress and cardio-metabolic risk factors in nurses.

Comparing Vitamin D Level Between Patients with Psoriasis and Healthy Individuals: A Systematic Review and Meta-Analysis.

BACKGROUND: Psoriasis is nowadays regarded as a systemic inflammatory disorder. Among the topicals, vitamin D derivates are often applied on the skin for their anti-inflammatory and immune-modulatory properties. Vitamin D serum levels in psoriasis (PsO) patients are still debated and an eventual depletion may offer the rational to integrate anti-psoriatic therapies with oral vitamin D. Then, we aimed to perform a systematic review and meta-analysis on the current evidence towards serum vitamin D level in PsO. METHODS: We searched in PubMed, Scopus, Web of Sciences, ScienceDirect and Science Information Database (SID) using the terms "Vitamin D" and "Psoriasis" including manuscripts in English, Italian and Persian. Duplications were excluded using EndNote software and records were screened by title, abstract and full-text. Quality assessment of studies was assessed using Newcastle Ottawa Checklist (NOS). Psoriasis odds ratio (OR) and mean serum vitamin D levels were calculated and displayed in Forest-plots. Heterogeneity indexes were evaluated using I2 and Q. Sensitivity analysis and publication biases were also considered. RESULTS: From 3006 records extracted, after removing duplicates and analyzing full texts we finally included 19 manuscripts involving a total of 1387 PsO cases and 6939 controls. PsO patients exhibited a substantial odds ratio (3.07, 95% CI: 1.56-6.04) for lower serum vitamin D levels compared to the control group. Standardized Mean Difference (SMD) of vitamin D in PsO versus controls was -0.92 (-1.33 to -0.51). CONCLUSION: Psoriatic patients displayed higher risk to have a vitamin D deficiency. Interventional studies to verify the preventive value are mandatory.

Predominance of Trichophyton tonsurans causing tinea capitis: A 12-year retrospective study in the north of Iran.

Background and Purpose: Among different clinical entities of dermatophytosis, tinea capitis (TC) is considered a major public health challenge in the world, especially in regions with poor health and low income. Therefore, this study aimed to provide a retrospective analysis of the patients suspected of TC who were referred to the medical mycology laboratory of Mazandaran, a northern province of Iran. Materials and Methods: A retrospective analysis was performed on the patients suspected of TC who were referred to the medical mycology laboratory from July 2009 to April 2022. Hair roots and skin scrapings were collected from the participants. The laboratory diagnosis was confirmed by direct microscopic examination and culture. Finally, 921 out of 11095 (8.3%) patients were suspected of TC. Results: Based on the findings, TC was confirmed in 209 out of 921 patients (22.7%). In terms of gender, 209 TC patients (75.1%) were male. Moreover, the male to female ratio of TC patients was 1:3.0. Trichophyton tonsurans (146/174, 83.91%) was the most etiological agent, followed by T. mentagrophytes (13/174, 7.47%), T. violaceum (9/174, 5.17%), Microsporum canis (3/174, 1.71%), T. verrucosum (2/174, 1.15%) and T. rubrum (1/174, 0.57%). Besides, endothrix (77.0%) was the most prevalent type of hair invasion. Conclusion: The results revealed the predominance of T. tonsurans, as a causative agent of TC. Despite the prevalence of TC, the absence of appropriate consideration highlights that it is a neglected complication among children.

Comparing the Effects of Acupressure and Clonazepam Tablets on Sleep Quality of Hemodialysis Patients: A Randomized Controlled Trial.

Objective: The current study aimed to compare the impact of acupressure and clonazepam tablets on the quality of sleep in hemodialysis patients in light of the rising prevalence of chronic kidney disease (CKD), the high prevalence of sleep disturbance in these patients, and the side effects of hypnotic drugs. Method : A total of 60 patients were selected for this randomized, controlled clinical trial and randomly assigned to two groups. For two weeks during the researcher's evening shift, one group received acupressure (six spots bilaterally for three minutes each day). The opposing group was administered clonazepam tablets (0.5 mg) for two weeks. The Pittsburgh Sleep Quality Index (PSQI), which measures sleep quality, was used to compare sleep in the two groups before and after the intervention. Results: There was no statistically significant difference between the two groups prior to the intervention (P = 0.75) in terms of the mean pre-intervention PSQI scores for the acupressure and clonazepam groups, which were 15.83 ± 1.51 and 16.17 ± 0.91, respectively. However, the average PSQI scores after the intervention in the clonazepam and acupressure groups were 13.25 ± 2.88 and 8.97 ± 4.29, respectively, indicating a statistically significant difference (P < 0.0001). Both the acupressure and the clonazepam groups showed improvements in their post-intervention sleep quality among the patients. However, when the percentage changed in the mean scores of the total score and all of the PSQI components were calculated for each group, it became clear that acupressure was more effective at enhancing sleep than clonazepam tablets. Conclusion: The findings of the present investigation demonstrate that acupressure has a greater impact on patients' sleep quality compared to clonazepam tablets. Depending on the circumstances, acupressure can be used as a simple, safe, and non-drug way to enhance hemodialysis patients' quality of sleep.

Perceived stress reduction through an infertility coaching program: a randomized controlled clinical trial.

Infertility has been recognized as a distressing experience among couples worldwide, cutting across various cultures. This present study was conducted to assess the impact of a supportive stress management program led by an infertility coach for women undergoing fertility treatment. This randomized controlled clinical trial study was performed on 60 infertile women undergoing assisted reproductive techniques at Maryam Infertility Center located in Sari in 2018. After random allocation in two groups, 30 individuals were in the intervention group and 30 in the control group. The intervention program was implemented according to the infertility coach's counseling protocol in six stages. The control group received only routine ward counseling. In order to measure stress, the Newton Infertility Stress Questionnaire was used firstly before intervention and then after oocyte puncture, embryo transfer, and pregnancy testing. Data analysis was performed using SPSS statistical software version 18 and Shapiro-Wilk, Chi-square, Mann-Whitney, independent t-test, Friedman test, Wilcoxon test, GEE test, and Cohen's effect size. Our analysis approach has also been based on the analysis of (ITT). The significance level was 0.05. The mean ± SD scores of infertility perceived stress before the intervention in the control was 146.16 ± 16.90 and the intervention group was 156.53 ± 9.31, after intervention at the time of oocyte puncture in the controls was 165.36 ± 8.98 and the intervention group was 155.83 ± 10.70, at the day of embryo transfer in the control group was 156.35 ± 14.45 and in the intervention group was 123.58 ± 22.9 and in the pregnancy test day in the control group was 185.76 ± 26.56 and in the intervention group was 127.61 ± 21.57 (P < 0.001). According to Friedman test, the mean of stress in three situations after the intervention showed a significant difference in reduction of the mean of stress (P < 0.001). In the control group, the stress score of the samples had an increasing trend, which was significant during the measurement steps based on Friedman test results (P < 0.001). In the intervention group, paired t-test results showed no significant comparing mean score of Newton's infertility stress before and after oocyte puncture day (P = 0.711), comparing the mean of stress before and after pregnancy test day (P = 0.003) and also comparing of mean stress before and after pregnancy on the day of embryo transfer according to Wilcoxon test (P < 0.001). And comparing mean stress before and after pregnancy test day, paired t-test (P = 0.001) showed significant statistical differences. According to the results of the GEE test, changes in stress scores over time were significant between the two groups (P < 0.001), as well as the effect of stress on oocyte puncture day (0.41), embryo transfer day (1.69), pregnancy test day (P < 0.001) (2.46) had a significant effect on the day of embryo transfer and pregnancy test day. Based on the results of this study, the infertility coach program demonstrated the ability to decrease the perceived stress related to infertility. Additionally, it showed potential in enhancing treatment outcomes, such as oocyte count and positive pregnancy results, among infertile women undergoing assisted reproductive techniques.Trial registration: Iranian Registry for Clinical Trial (the link to trial: https://www.irct.ir/trial/33357 ). Registered 11-11-2018.

Prevalence and predictors of sexual distress in married reproductive-age women: A cross-sectional study from Iran.

Background and Aim: Although various surveys have been conducted for sexual problems, there is a lack of population-based studies on sexual distress in Iran. Thus, we sought to determine the prevalence and predictive factors of sexual distress in this population. Methods: Overall, 1000 married women aged 16-49 years were enrolled in this study using the two-stage cluster sampling method. To identify sexual distress, the female sexual distress scale-revised (FSDS-R) was completed. The predictive factors were assessed using a checklist. Results: A total of 318 women (31.8%) suffered from sexual distress. Among socio-demographic factors, satisfaction with marriage (p = 0.001), among personal factors history of infertility and fear of contracting sexually transmitted infections (p < 0.01), and among sexual and interpersonal factors satisfaction with the level of sexual desire (p = 0.01), pain during sexual intercourse (p < 0.01), premature ejaculation disorders in the partner (p < 0.05), and sexual satisfaction (p < 0.001) were significantly associated with sexual distress. Conclusion: Clinicians should evaluate sexual distress comprehensively and consider all the related dimensions. The high overall prevalence of sexual distress, with or without an identifiable dysfunction, signals the importance of health professionals being adequately prepared to discuss sexual health concerns.

The association between early menarche and higher-risk cardiometabolic profile: a dose-response analysis of the Tabari cohort at enrollment phase.

Objectives: The association between age at menarche and higher-risk cardiometabolic factors is controversial and more strands of evidence are required. Therefore, in this study, we aimed to investigate the effect of early menarche on cardiometabolic profile in a large-scale cohort population. Study design: Data collected in the enrollment phase of the Tabari cohort study were utilized for the present study. We analyzed data from 6,103 women aged 35-70 years. Logistic regression and dose-response (trend) analyses were used to investigate the effect of early menarche on prevalence of diabetes, dyslipidemia, obesity, high waist circumference (WC), high waist-to-hip ratio (WHR), and high waist-to-height ratio (WHtR). Results: The results of the adjusted logistic regression analysis showed that women who experienced early menarche had significantly higher odds of obesity (odds ratio: 1.64, 95% CI: 1.36-1.99, P for trend <0.001), high WC (odds ratio: 1.34, 95% CI: 1.07-1.67, P for trend = 0.035), high WHR (odds ratio: 1.32, 95% CI: 1.05-1.66, P for trend = 0.057), and high WHtR (odds ratio: 1.83, 95% CI: 1.22-2.74, P for trend = 0.006) compared to those aged ≥14 at menarche. The prevalence of dyslipidemia was also higher among women who experienced early menarche than in women aged ≥14 at menarche (79.9% vs. 76.6%), but the difference was not statistically significant (P = 0.098). Additionally, each year of earlier menarche was significantly associated with an increase in the chance of diabetes (by 5%), obesity (10%), high WC (5%), and high WHtR (13%). Conclusion: The present study showed that early menarche is a strong predictor for later development of obesity and diabetes, and for high WC, WHR, and WHtR. Among all factors examined, age at menarche had the greatest predictive power for WHtR. As an age-dependent anthropometric index for central obesity, WHtR is more suitable as an index for identification of individuals with increased cardiometabolic risk.

Effects of acupressure on intestinal function in patients with coronary artery bypass graft surgery: a randomized clinical trial.

Aim: This study aimed to determine the effects of acupressure on the intestinal function of patients undergoing Coronary Artery Bypass Graft (CABG) surgery. Background: Studies indicated that cardiovascular patients are prone to constipation. Acupressure is one of the therapeutic and palliative approaches that can be used by doctors, nurses, and even patients themselves. Methods: The present three-group randomized clinical trial study was conducted on 90 patients undergoing CABG surgery. In the intervention group, 48 hours after surgery the patients received acupressure points LI4 and ST25 twice a day (10 am and 6 pm) for three sequential days. In the sham group, the patients received acupressure at a 1.5 cm distance from the LI4-ST25 points, and the patients in the control group received only the usual care. This research used a demographic and medical information questionnaire, Rome IV scale, Bristol stool scale, symptom registration checklist, and daily excretion assessment checklist. The intestinal function indices were completed 24 hours after surgery (before intervention), 48, 72, 96, and 120 hours after surgery. Results: All three intervention, sham, and control groups were without defecation in 24 hours (before intervention) and 48 hours after surgery. There was a significant difference between the three intervention, sham, and control groups in the number of stools after 72 hours, 96 hours, and 120 hours after the intervention (p<0.001). Also, a significant difference was observed among the three groups in terms of stool consistency 96 hours after the start of the intervention (p=0.032) and 120 hours after the start of the intervention (p<0.001). Conclusion: The results showed that patients had a significant improvement in the number of bowel movements and stool consistency in the intervention group. In acute conditions, acupressure on LI4-ST25 points can positively affect intestinal function when patients are hospitalized in the intensive care unit.

The effect of melatonin on sleep quality and cognitive function of individuals undergoing hemodialysis.

BACKGROUND: and purpose: This study aimed to investigate the effect of melatonin on sleep quality and cognitive function of individuals undergoing hemodialysis. MATERIALS AND METHODS: In this randomized controlled clinical trial, 102 eligible individuals were assigned to two equal intervention and control groups. The intervention group received melatonin 3 mg tablets half an hour before going to bed for six weeks, while the control group was given a placebo with similar conditions. RESULTS: This study had 102 participants who were divided into intervention and control groups. The mean age of the participants was 58.30 (SD = 12.10). Among the participants, 54.90% were female. Moreover, 33.33% of the individuals received dialysis for four years or longer. After the intervention, the mean and standard deviation of the Pittsburgh Sleep Quality Index (PSQI) was 12.66 (SD = 3.09) in the intervention group and 18.86 (SD = 3.8) in the control group (P < 0.001). Moreover, the mean sleep quality index in the intervention group showed a statistically significant difference before and after the intervention (P < 0.001); the PSQI score declined from 20.21 to 12.66. Likewise, there was a statistically significant difference between the two groups after intervention in the mean Montreal Cognitive Assessment (MoCA) index (P = 0.002); it was 24.27 (SD = 3.42) in the intervention group and 22.15 (SD = 2.3) in the control group. The mean MoCA score in the intervention group showed a significant difference before and after the intervention (P < 0.001), increasing from 21.19 to 24.27. CONCLUSION: According to the study's findings, melatonin can improve individuals undergoing hemodialysis' cognitive function and sleep quality.

Gingivectomy with Diode Laser Versus the Conventional Scalpel Surgery and Nonsurgical Periodontal Therapy in Treatment of Orthodontic Treatment-Induced Gingival Enlargement: A Systematic Review.

Background and objective: Some studies support the superiority of diode laser gingivectomy to scalpel surgery and nonsurgical treatments. However, a systematic review on this topic is lacking. This study aimed to compare gingivectomy with diode laser versus the conventional scalpel surgery and nonsurgical periodontal therapy (NSPT) in the treatment of orthodontic treatment-induced gingival enlargement (GE). Materials and methods: In this systematic review, an electronic search of the relevant literature was conducted in Web of Science, Medline/PubMed, Scopus, Cochrane Central Register of Controlled Trials, and ProQuest with no language restriction. Randomized clinical trials published between 1985 and 2020 on comparative treatment of orthodontic treatment-induced GE by diode laser gingivectomy and scalpel surgery or NSPT regarding intraoperative and postoperative bleeding and/or pain were included. Risk of bias was assessed by the Cochrane 1 tool. Results: Of the initially retrieved 288 articles, 40 were duplicates and excluded; 236 articles were excluded following title and abstract screening, and 5 others were excluded following full-text assessment. Finally, 7 studies underwent systematic review. In the risk-of-bias assessment, 5 studies scored 2, and 2 studies scored 3 out of 6. Intraoperative and postoperative bleeding and pain were found to be significantly lower in the laser group. Conclusions: Within the limitations of this systematic review and with respect to the quality of evidence, the present results revealed lower level of pain and bleeding in diode laser gingivectomy compared with the conventional scalpel surgery and NSPT for treatment of orthodontic treatment-induced GE.

The correlation between epicardial fat thickness and longitudinal left atrial reservoir strain in patients with type 2 diabetes mellitus and controls.

BACKGROUND: Diabetes mellitus (DM) has been documented among the strongest risk factors for developing heart failure with preserved ejection fraction (HFpEF). The earliest imaging changes in patients with DM are the left atrial (LA) functional and volumetric changes. The aim of this study was to determine the correlation between epicardial fat thickness (EFT) and longitudinal LA reservoir strain (LARS) in patients with type 2 DM (T2DM), as compared with non-diabetic controls. RESULTS: The study samples in this case-control study comprised of consecutive patients with T2DM (n=64) and matched non-diabetic controls (n=30). An echocardiography was performed on all patients and EFT, volumetric and longitudinal LARS, left ventricular (LV) global longitudinal strain (LVGLS), pulsed-wave Doppler-derived transmitral early (E wave) and late (A wave) diastolic velocities, and tissue-Doppler-derived mitral annular early diastolic (e') and peak systolic (s') velocities were obtained. The study results demonstrated that the patients with T2DM had thicker EFT (5.96±2.13 vs. 4.10±3.11 mm) and increased LA volume index (LAVI) (43.05± 44.40 vs. 29.10±11.34 ml/m2) in comparison with the non-diabetic ones (p-value: 0.005 and 0.022, respectively). On the other hand, a direct association was observed between EFT and the E/e' ratio, and an inverse correlation was established between EFT and LARS in patients with T2DM (r=0.299, p-value=0.020 and r=- 0.256, p-value=0.043, respectively). However, regression analysis showed only LV mass index (LVMI) (ß=0.012, 95% CI 0.006-0.019, p-value<0.001), LAVI (ß=- 0.034, 95% CI - 0.05-0.017, p-value<0.001), and EFT (ß=- 0.143, 95% CI - 0.264-- 0.021, p-value=0.021) were independently correlated with LARS. CONCLUSIONS: LARS is considered as an important early marker of subclinical cardiac dysfunction. Thickened epicardial fat may be an independent risk factor for decreased LA reservoir strain. Diabetics are especially considered as a high risk group due to having an increased epicardial adipose tissue thickness.