Demographic characteristics and mental health condition of Tehran Municipality employees during the COVID-19 pandemic.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a global health issue with various effects on the physical and mental state of the societies. The aim of this study was to identify the demographic characteristics and mental health condition of Tehran Municipality employees during the COVID-19 pandemic. METHODS: This cross-sectional study was performed on Tehran Municipality employees in 2020-2021. Participants were selected using stratified random sampling and were divided into COVID-19 and uninfected groups. Demographic characteristics, COVID-19 risk behaviors, General Health Questionnaire-28 (GHQ-28), and Well- Being Social Inventory were filled for all participants. RESULTS: A total of 510 participants (363 uninfected participants and 147 participants with COVID-19) were evaluated. The prevalence of female gender was significantly higher in COVID-19 group compared to uninfected group (p < 0.001). There was a significant difference between groups in terms of education level (p < 0.001), prevalence of excess weight (p < 0.001), and working sector (p < 0.001). The uninfected group mainly had low contact with clients (p < 0.001) and few underlying diseases (p = 0.004) compared to the COVID-19 group. The mean GHQ-28 and Well- Being Social Inventory were significantly higher in the uninfected group compared to the COVID-19 group (p = 0.002 and p < 0.001, respectively). The prevalence of no and low contact level was significantly higher in the high infection cluster compared to moderate and low infection clusters (p = 0.024). CONCLUSIONS: The findings of this study indicated that all workers should be educated about the significance of social distancing and follow the recommendations regardless of their level of contact with clients.

The impact of covid-19 pandemic on pregnancy outcome.

BACKGROUND: The acute respiratory disease caused by the coronavirus (COVID-19) has spread rapidly worldwide yet has not been eliminated. The infection is especially deadly in vulnerable populations. The current studies indicate that pregnant women are at greater risk of getting seriously ill. Even though fetuses protect against disease, the additional finding showed that the COVID-19 pandemic could increase fetal and maternal morbidities. In a situation where COVID-19 and new strains of the virus are still not controlled, scientists predicted that the world might experience another pandemic. Consequently, more research about the effects of COVID-19 infection on pregnancy outcomes is needed. This study aimed to compare the pregnancy outcomes of Iranian pregnant women in the first year of the pandemic with the previous year. METHODS: This prospective cross-sectional study was performed to compare the pregnancy outcome during the COVID-19 pandemic among Iranian pregnant women who gave birth during the pandemic and one year before the pandemic (2019-2020 and 2020-2021). The sample size was 2,371,332 births registered at hospitals and birth centers platforms. The studied variables include stillbirth, congenital anomaly, birth weight, preeclampsia, gestational diabetes, cesarean section, ICU admission, mean of the gestational age at birth, preterm births, NICU admission, neonatal mortality and the percentage of deliveries with at least one complication such as blood transfusion and postpartum ICU admission. Analyzing data was done by using SPSS version 25 software. RESULTS: We found statistical differences between pregnancy and birth outcomes during the COVID-19 pandemic compared to one year before. The risk of preeclampsia, gestational diabetes, cesarean section, preterm birth and NICU admission were clinically significant. Also, there was a significant decrease in mean gestational age. CONCLUSION: The COVID-19 pandemic has affected the pregnancy outcome by increasing morbidities and complications during pregnancy, birth, and postpartum. In addition, extensive quarantine outbreaks disrupted the healthcare system and hindered access to prenatal services. It is necessary to develop preventive and therapeutic care protocols for similar pandemic conditions.

Evaluating the effect of ursodeoxycholic acid on total bilirubin of neonates with glucose-6-phosphate dehydrogenase deficiency complicated by indirect hyperbilirubinaemia.

AIM: This study aimed to investigate the effect of adding ursodeoxycholic acid (UDCA) to phototherapy in neonates with glucose-6-phosphate dehydrogenase (G6PD) deficiency and hyperbilirubinaemia. G6PD deficiency is a common cause of severe hyperbilirubinaemia in neonates. METHODS: This study was a triple blind, clinical trial study of 40 neonates with G6PD deficiency and hyperbilirubinaemia who admitted for phototherapy in hospitals affiliated to the University of Medical Sciences. The treatment group (n = 20) received UDCA 10 mg/kg (2 cc/kg) daily divided into 2 doses every 12 h. The control group (n = 20) received the same volume of placebo syrup. The drug and placebo treatments were continued until the bilirubin level dropped below 171 µmol/L. Both the control and treatment group received continuous phototherapy. Independent sample t-test, survival analysis and logrank test were used to statistically analyse the results. RESULTS: The mean total bilirubin level was 231.9 ± 18.8 µmol/L and 184.3 ± 18.6 µmol/L in the control and intervention group respectively, 24 h after drug administration and 209.7 ± 19.3 µmol/L and 157.4 ± 16.4 µmol/L, respectively, 48 h after intervention (P < 0.05). The median length of hospitalisation in the treatment group was approximately 1 day lower than the control group (logrank test P value: <0.001). CONCLUSION: The study showed that the addition of UDCA to phototherapy accelerates the reduction of total bilirubin level in neonates with G6PD deficiency and can reduce the duration of hospitalisation.

Unveiling the dynamic and thermodynamic interactions of hydrocortisone with ß-cyclodextrin and its methylated derivatives through insights from molecular dynamics simulations.

Cyclodextrins (CDs) can enhance the stability and bioavailability of pharmaceutical compounds by encapsulating them within their cavities. This study utilized molecular dynamics simulations to investigate the interaction mechanisms between hydrocortisone (HC) and various methylated CD derivatives. The results reveal that the loading of HC into CD cavities follows different mechanisms depending on the degree and position of methylation. Loading into ßCD and 6-MeßCD was more complete, with the hydroxyl groups of HC facing the primary hydroxyl rim (PHR) and the ketone side facing the secondary hydroxyl rim (SHR). In contrast, 2,3-D-MeßCD and 2,6-D-MeßCD showed a different loading mechanism, with the ketone side facing the PHR and the hydroxyl groups facing the SHR. The root mean square fluctuation (RMSF) analysis demonstrated that methylation increases the flexibility of CD heavy atoms, with 3-MeßCD and 2,3-D-MeßCD exhibiting the highest flexibility. However, upon inclusion of HC, 3-MeßCD, 2,3-D-MeßCD, 2-MeßCD, and 6-MeßCD showed a significant reduction in flexibility, suggesting a more rigid structure that effectively retains HC within their cavities. The radial distribution function revealed a significant reduction in the number of water molecules within the innermost layer of the methylated CD cavities, particularly in TMeßCD, indicating a decrease in polarity. The presence of HC led to the release of high-energy water molecules, creating more favorable conditions for HC loading. Conformational analysis showed that methylation caused a partial decrease in the area of the PHR, a significant decrease in the area of the middle rim, and a notable decrease in the area of the SHR. The loading of HC increased the area of the PHR in most derivatives, with the most pronounced increase observed in 2,6-D-MeßCD and 6-MeßCD. The analysis of interaction energies and binding free energies demonstrated that the binding of HC to methylated CD derivatives is thermodynamically more favorable than to ßCD, with the strongest association observed for 6-MeßCD, 2-MeßCD, and 2,3-D-MeßCD.

Therapeutic touch for nausea in breast cancer patients receiving chemotherapy: Composing a treatment.

BACKGROUND AND OBJECTIVE: Therapeutic touch (TT) is independent nursing intervention which is effective on nausea induced by chemotherapy but technique, steps and variables affected by this therapy are not yet well known. The aim of this study was to elicit descriptions of how TT is used with cancer patients, providing a basis for the systematic use and evaluation of TT with patients. MATERIALS AND METHOD: In this research, 108 patients were examined with intentional sampling and random allocation in 3 groups (control, placebo and intervention) in 2013 (each group 36). Intervention received therapeutic touch (touching of first energy layer) and demographic form, visual analog scale (VAS) for intensity of nausea, check list for duration and times of nausea in the morning, noon, afternoon and night at acute phase were used. Data were analyzed by Kruskal Wallis, χ(2) and analysis of variance (ANOVA). RESULTS: Duration, frequency and intensity of nausea were significantly lower in the test group (P < 0.001, P < 0.001 and P < 0.001). The mean duration of intervention (whole process) was 21.38 min [SD 6.04]. In 69.4% of women there was a need for re-intervention after reassessment phase. CONCLUSION: Results of this randomized control trial showed that TT is effective on duration, times and intensity of nausea; therefore, TT can be used as an alternative method for patients who are willing to use this technique.

Factors influencing menarcheal age: results from the cohort of tehran lipid and glucose study.

BACKGROUND: Menarche is considered as a milestone in the women's reproductive life. Most existing studies on factors influencing menarcheal age had cross-sectional designs and their finding were controversial. OBJECTIVES: We aimed to determine some factors affecting the age at menarche in a cohort study with an average of ten-year follow-up; the study was conducted within the framework of Tehran Lipid and Glucose Study (TLGS). MATERIALS AND METHODS: For the purpose of the present study, we recruited all the females aged 12 to 18 years participated in TLGS whose menarche had not begun at the initiation of the study, but occurred during their follow-up. The effect of premenarcheal status of various factors including socioeconomic and anthropometric parameters, physical activity, energy expenditure, and exposure to tobacco smoke on menarcheal age was explored. RESULTS: The mean of age at menarche was 13.06 ± 1.24 years. There were significant statistical associations between age of the participants' mothers at menarche (r = 0.66, P < 0.001), maternal education (r = -0.04, P = 0.002), and body mass index (BMI) before menarcheal (r = 0.25, P = 0.027) with age at menarche. There was no significant correlation between age at menarche, with either of maternal employment, premenarcheal physical activity, energy expenditure, and passive smoking. CONCLUSIONS: Among various factor influencing menarcheal age, premenarcheal BMI is modifiable, and considering its significance, could prevent early or late menarches.

Secular trend of menopausal age and related factors among Tehrani women born from 1930 to 1960; Tehran Lipid and Glucose Study.

BACKGROUND: Menopause is an important milestone of a woman's reproductive life. There is limited data on the secular trend of menopausal age. The purpose of this study is to identify the secular trend of menopausal age and its related factors among Tehrani women born during 1930 - 1960. METHODS: A total number of 2266 women, born between 1930 and 1960, were recruited among TLGS participants. The World Health Organization classification was used to define menopause status. Birth cohorts were created using 10-year periods, and statistical comparisons were performed with analysis of covariance (ANCOVA). RESULTS: The means for menopausal age of women born in the 1930s, 1940s and 1950s were 48.5, 49.5 and 49.9 years, respectively. After adjustment for possible confounding factors in the linear regression model, the increasing trend of menopausal age was constant (P = 0.029). CONCLUSION: There is an increasing trend in menopausal age in female residents of Tehran. These findings have implications for endogenous lifetime exposure of women to gonadal steroids.

Intake of dairy products, calcium, magnesium, and phosphorus in childhood and age at menarche in the Tehran Lipid and Glucose Study.

PURPOSE: Studies indicate that milk intake is associated with insulin-like growth factor 1 (IGF-1) concentrations and height in childhood, whether milk and other dairy products promote puberty remains unclear. This study aimed to investigate influences of pre-pubertal intakes of milk, yogurt and cheese on menarcheal age in Tehranian girls. The associations of total dietary calcium (Ca), magnesium (Mg), and phosphorus (P) with menarcheal age were also examined. METHODS: This prospective study was conducted on 134 pre-pubertal girls, aged 4-12 years at baseline, who participated in the Tehran Lipid and Glucose Study (TLGS), and were followed for a median of 6.5 years. Dietary intakes were determined at initiation of the study using two non-consecutive 24-h dietary recalls and the age of menarche was documented during the follow-up. Logistic regression was used to calculate the risk of reaching menarche ≤ 12 years according to pre-pubertal levels of dairy or mineral intakes. RESULTS: The risk of earlier menarche was higher in girls with higher intakes of milk [OR: 2.28 (95% CI: 1.03-5.05)], Ca [OR: 3.20 (95%CI: 1.39-7.42)], Mg [OR: 2.43 (95% CI: 1.12-5.27)] and P [OR: 3.37 (95 % CI: 1.44-7.87) after controlling for energy and protein intake, interval between the age at study initiation and the age of menarche, and maternal age at menarche (Model 1). Girls in the middle tertile of cheese intakes had a lower risk of reaching menarche ≤ 12 years than those in the lowest tertile after controlling for covariates in model 1. These associations remained significant after further adjustment of BMI Z-score at baseline. The relationship of Ca, Mg, and P with menarche remained after further adjustment for height Z-score at baseline, whereas the association between milk and cheese intakes became non-significant. CONCLUSIONS: Pre-pubertal intake of milk, but not cheese and yogurt, may hasten age at menarche.

Evaluation of sexual attitude and sexual function in menopausal age; a population based cross-sectional study.

UNLABELLED:   BACKGROUND: Menopause and its physical, hormonal and psychosocial changes could affect women's sexual function. There are controversial results regarding relationship between sexual attitudes and function. OBJECTIVE: We aimed to evaluate sexual attitudes and sexual function among Iranian menopausal age women. MATERIALS AND METHODS: This population based cross-sectional study was carried out on 225 menopausal women, aged 45-65 years. Based on a self-made questionnaire data were collected about women's socio-demographic characteristics, attitudes regarding sexuality and sexual function. Data were analyzed using SPSS and sexual function was compared between three groups of women who had positive, medium and negative attitudes regarding sexuality. RESULTS: The mean age of women was 53.11±4.56 years. Seventy percent of them had at least one sexual problem. Feeling of dyspareunia was significantly different between three categories of attitudes regarding sexuality (p=0.03). Comparing data obtained on their attitudes, sexual desire, orgasm and dyspareunia demonstrated significant differences (p=0.03, 0.04, and 0.04 respectively). CONCLUSION: Attitude regarding sexual function has a great impact on sexual activity of postmenopausal women that need to be considered in their health care programming.

Rise in cesarean section rate over a 30-year period in a public hospital in Tehran, Iran.

BACKGROUND: Numerous studies show a growing trend in cesarean section rates throughout the world, including Iran. However, existing evidence in our country is scant and previous reports are restricted to short time periods. The aim of the current study is to measure the trend in cesarean sections (CS) rates over the past 30 years in a referral hospital in Tehran. METHODS: We routinely collected data on the demographic characteristics of all women who gave birth in the hospital during the study period. The mode of delivery and the personnel in charge of delivery has likewise been recorded for each birth during the study period. The data were extracted from medical records and entered into a structured checklist. RESULTS: The rate of CS out of all deliveries increased from 14.3% in 1979 to 22.7% in 1989, 52.5% in 1999, and 85.3% in 2009 (P < 0.001). The most common reason for CS was a repeated section. The percentage of vaginal deliveries performed by midwives has not changed significantly and the number of both midwives and obstetricians per 1000 births has increased, from 2.8 to 15.4 midwives per 1000 births and from 5.5 to 23.0 obstetricians per 1000 births. CONCLUSION: Immediate strategies should be adopted to prevent the rising trend and increasing number of unnecessary CS in Iran.