Fatemeh Vara, M. Amini, M. Moosavi, Amir Askarinejad, Sarvin Sasannia, Parinaz Tabari, M. Sagheb, Amirarsalan Bahrani Kazeronian
Background: The COVID-19 pandemic has induced fear and mental health problems in the community and among healthcare workers. Empathy with patients may be difficult in such situations due to urgent conditions. Objectives: We aimed to evaluate medical students’ empathy and fear toward COVID-19 patients during the pandemic. Methods: This cross-sectional study recruited 107 medical students from Shiraz Medical School in 2021. A Persian version of the Jefferson Scale of Physician Empathy (JSPE) was used to assess the participants’ empathy toward COVID-19 patients. The internal validity of the Persian version of JSPE was 0.78, and its test-retest reliability after 14 days was 0.92 in a previous study. The participants were requested to fill out a fear of COVID-19 scale (FCV-19S) previously developed to assess their fear of affliction with COVID-19. Since the normality of data distribution was not approved, we used nonparametric tests, namely, the Mann-Whitney U test and the Spearman correlation coefficient. Results: The mean empathy score based on the Persian version JSPE was 71.94 ± 12.83 out of 140, which was higher in male students and those who resided in dormitories. The mean fear score was 24.93 ± 6.16 out of 35. Participants living out of dormitories feared COVID-19 to a greater extent. No statistically significant association was found between the age of the participants and these two parameters. The Spearman correlation coefficient test showed that students with a history of COVID-19 had less fear and more empathy because of their experience with COVID-19 (r = -0.249, P-value = 0.02). Conclusions: This study highlights the impact of the pandemic on the interaction between medical students as healthcare professionals and patients by affecting medical students’ fear and empathy. The study indicates ways to improve readiness for future pandemics. Our study showed that living far away from families in dormitories may influence students’ fear and empathy. Moreover, empathy, unlike fear, was affected by gender. A reverse correlation existed between fear and empathy in students with a history of COVID-19, indicating that the more they had empathy, the less they experienced fear.
{"title":"Fear and Empathy with COVID-19 Patients Among Medical Students","authors":"Fatemeh Vara, M. Amini, M. Moosavi, Amir Askarinejad, Sarvin Sasannia, Parinaz Tabari, M. Sagheb, Amirarsalan Bahrani Kazeronian","doi":"10.5812/semj-130631","DOIUrl":"https://doi.org/10.5812/semj-130631","url":null,"abstract":"Background: The COVID-19 pandemic has induced fear and mental health problems in the community and among healthcare workers. Empathy with patients may be difficult in such situations due to urgent conditions. Objectives: We aimed to evaluate medical students’ empathy and fear toward COVID-19 patients during the pandemic. Methods: This cross-sectional study recruited 107 medical students from Shiraz Medical School in 2021. A Persian version of the Jefferson Scale of Physician Empathy (JSPE) was used to assess the participants’ empathy toward COVID-19 patients. The internal validity of the Persian version of JSPE was 0.78, and its test-retest reliability after 14 days was 0.92 in a previous study. The participants were requested to fill out a fear of COVID-19 scale (FCV-19S) previously developed to assess their fear of affliction with COVID-19. Since the normality of data distribution was not approved, we used nonparametric tests, namely, the Mann-Whitney U test and the Spearman correlation coefficient. Results: The mean empathy score based on the Persian version JSPE was 71.94 ± 12.83 out of 140, which was higher in male students and those who resided in dormitories. The mean fear score was 24.93 ± 6.16 out of 35. Participants living out of dormitories feared COVID-19 to a greater extent. No statistically significant association was found between the age of the participants and these two parameters. The Spearman correlation coefficient test showed that students with a history of COVID-19 had less fear and more empathy because of their experience with COVID-19 (r = -0.249, P-value = 0.02). Conclusions: This study highlights the impact of the pandemic on the interaction between medical students as healthcare professionals and patients by affecting medical students’ fear and empathy. The study indicates ways to improve readiness for future pandemics. Our study showed that living far away from families in dormitories may influence students’ fear and empathy. Moreover, empathy, unlike fear, was affected by gender. A reverse correlation existed between fear and empathy in students with a history of COVID-19, indicating that the more they had empathy, the less they experienced fear.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87144351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Jahangirimehr, Azam Honarmandpour, Azam Khalighi, Marzieh Najafi, M. Kalantar, Elham Abdolahi Shahvali, A. Hemmatipour, Sahel Heydarheydari
Background: COVID-19 has become a serious health problem worldwide. Objectives: The current study investigated the prognostic factors associated with demographical parameters, clinical and vital signs, and laboratory results for predicting severity and mortality in patients infected with COVID-19. Methods: This retrospective analysis was conducted on the medical records of 372 COVID-19-positive patients hospitalized at the Khatam al-Anbiya Hospital, Shoushtar, Iran, from Sep 2020 to Sep 2021. The association of demographic parameters, clinical and vital signs, and laboratory results with severity and patients' outcomes (survival/mortality) was studied. The patients were divided into the non-severe group (n = 275) and the severe group (n = 97). COVID-19 disease severity was determined based on the severity of pulmonary involvement using CT chest images. The collected data were analyzed using IBM SPSS software for Windows (version 18). Logistic regression analysis was employed using the Forward LR method to predict COVID-19 severity and mortality. Results: The rates of mortality and the severe form of the disease were 87.1% (n = 324) and 12.9% (n = 48), respectively. A prognostic value was observed in predicting COVID-19 severity and mortality for some clinical and vital signs (diabetes (P < 0.001, P = 0.019), hypertension (P = 0.024, P = 0.012), pulmonary diseases (P = 0.038, P < 0.001), and anosmia (P = 0.043, P = 0.044) and paraclinical parameters (FBS (P = 0.014, P = 0.045), BUN (P = 0.045, 0.001), Cr (P = 0.027, P = 0.047), Neut (P = 0.002, P = 0.005), and SpO2 (P = 0.014, P = 0.001)). Cardiovascular disorders (P = 0.037), fever (P = 0.008), and dyspnea (P = 0.020) were also effective at predicting disease-related mortality. Multiple logistic regression analyses showed that diabetes disease, the place of residence, PCO2, and BUN with R2 = 0.18, and age, pulmonary diseases, and BUN with R2 = 0.21 were involved in predicting the severity and mortality, respectively. Conclusions: It seems that in addition to the BUN, diabetes and pulmonary diseases play a more significant role in predicting the severity and mortality due to COVID-19, respectively.
背景:COVID-19已成为全球严重的健康问题。目的:本研究探讨与人口统计学参数、临床和生命体征以及实验室结果相关的预测COVID-19患者严重程度和死亡率的预后因素。方法:回顾性分析2020年9月至2021年9月在伊朗舒什塔尔Khatam al-Anbiya医院住院的372例covid -19阳性患者的病历。研究了人口统计学参数、临床和生命体征以及实验室结果与严重程度和患者结局(生存/死亡率)的关系。将患者分为非重症组(n = 275)和重症组(n = 97)。根据CT胸部图像肺部受累程度确定COVID-19疾病严重程度。使用IBM SPSS for Windows (version 18)软件对收集的数据进行分析。采用Forward LR方法进行Logistic回归分析，预测COVID-19严重程度和死亡率。结果:本组病死率为87.1% (n = 324)，重症为12.9% (n = 48)。观察预后价值预测COVID-19严重程度和死亡率对一些临床和生命体征(糖尿病(P < 0.001, P = 0.019),高血压(P = 0.024, P = 0.012),肺疾病(P = 0.038, P < 0.001),和嗅觉缺失症(P = 0.043, P = 0.044)和paraclinical参数(的边后卫(P = 0.014, P = 0.045),面包(P = 0.045, 0.001), Cr (P = 0.027, P = 0.047),中性粒细胞(P = 0.002, P = 0.005),和动脉血氧饱和度(P = 0.014, P = 0.001)。心血管疾病(P = 0.037)、发热(P = 0.008)和呼吸困难(P = 0.020)也是预测疾病相关死亡率的有效指标。多元logistic回归分析显示，糖尿病、居住地、PCO2、BUN (R2 = 0.18)和年龄、肺部疾病、BUN (R2 = 0.21)分别与病情严重程度和死亡率相关。结论:除BUN外，糖尿病和肺部疾病在预测COVID-19严重程度和死亡率方面的作用更为显著。
{"title":"Prognostic Factors for Predicting COVID-19 Severity and Mortality","authors":"A. Jahangirimehr, Azam Honarmandpour, Azam Khalighi, Marzieh Najafi, M. Kalantar, Elham Abdolahi Shahvali, A. Hemmatipour, Sahel Heydarheydari","doi":"10.5812/semj-129546","DOIUrl":"https://doi.org/10.5812/semj-129546","url":null,"abstract":"Background: COVID-19 has become a serious health problem worldwide. Objectives: The current study investigated the prognostic factors associated with demographical parameters, clinical and vital signs, and laboratory results for predicting severity and mortality in patients infected with COVID-19. Methods: This retrospective analysis was conducted on the medical records of 372 COVID-19-positive patients hospitalized at the Khatam al-Anbiya Hospital, Shoushtar, Iran, from Sep 2020 to Sep 2021. The association of demographic parameters, clinical and vital signs, and laboratory results with severity and patients' outcomes (survival/mortality) was studied. The patients were divided into the non-severe group (n = 275) and the severe group (n = 97). COVID-19 disease severity was determined based on the severity of pulmonary involvement using CT chest images. The collected data were analyzed using IBM SPSS software for Windows (version 18). Logistic regression analysis was employed using the Forward LR method to predict COVID-19 severity and mortality. Results: The rates of mortality and the severe form of the disease were 87.1% (n = 324) and 12.9% (n = 48), respectively. A prognostic value was observed in predicting COVID-19 severity and mortality for some clinical and vital signs (diabetes (P < 0.001, P = 0.019), hypertension (P = 0.024, P = 0.012), pulmonary diseases (P = 0.038, P < 0.001), and anosmia (P = 0.043, P = 0.044) and paraclinical parameters (FBS (P = 0.014, P = 0.045), BUN (P = 0.045, 0.001), Cr (P = 0.027, P = 0.047), Neut (P = 0.002, P = 0.005), and SpO2 (P = 0.014, P = 0.001)). Cardiovascular disorders (P = 0.037), fever (P = 0.008), and dyspnea (P = 0.020) were also effective at predicting disease-related mortality. Multiple logistic regression analyses showed that diabetes disease, the place of residence, PCO2, and BUN with R2 = 0.18, and age, pulmonary diseases, and BUN with R2 = 0.21 were involved in predicting the severity and mortality, respectively. Conclusions: It seems that in addition to the BUN, diabetes and pulmonary diseases play a more significant role in predicting the severity and mortality due to COVID-19, respectively.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87667496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. sharifi, Kamyab Shahrivar, Maryam Habibagah, M. Ahadi, Banafsheh Shakiba, Nastaran Momtahan, Parisa Gholikhani, M. Sayadi, A. Attar
Background: In various situations, such as determining nutrition requirements, medication dosage, mechanical ventilation, and resuscitation, height, weight, and BMI are considered. Anthropometric body measurements differ among populations of different genders and ethnicities. Objectives: This study aimed to develop gender-specific equations for estimating body weight and height based on anthropometric measurements in Iranian adults. Methods: This cross-sectional study was conducted in Shiraz, Iran, over six months. Healthy volunteers aged 18-80 were included. Exclusion criteria were limb(s) amputation or immobilization and pregnancy. Participants were randomly divided into modeling (n = 400) and validation (n = 78) groups. We used the modeling group to generate regression equations based on gender and the validation group to test them. Results: Demi-span, age, knee height, and arm span could predict height with reasonable accuracy. Calf, waist, neck, and wrist circumferences entered our regression for predicting weight. Waist and calf circumferences entered the regression for BMI prediction in both genders. Arm circumference in men and neck circumference in women is strongly correlated with BMI. Conclusions: Many different equations have been suggested to predict height, weight, and BMI. Linear and circumferential body measures are usually used to predict height and weight. The suggested equations in this study are simple, and the anthropometric measurements require only a cloth tape measure and have good predictive ability. Complimentary studies are necessary to evaluate the precision of these formulas in other samples from other regions of Iran and in immobilized patients.
{"title":"Development of Gender-specific Equations for Estimating Body Weight and Height Based on Anthropometric Measurements in Adults from Shiraz, Iran","authors":"Z. sharifi, Kamyab Shahrivar, Maryam Habibagah, M. Ahadi, Banafsheh Shakiba, Nastaran Momtahan, Parisa Gholikhani, M. Sayadi, A. Attar","doi":"10.5812/semj-130492","DOIUrl":"https://doi.org/10.5812/semj-130492","url":null,"abstract":"Background: In various situations, such as determining nutrition requirements, medication dosage, mechanical ventilation, and resuscitation, height, weight, and BMI are considered. Anthropometric body measurements differ among populations of different genders and ethnicities. Objectives: This study aimed to develop gender-specific equations for estimating body weight and height based on anthropometric measurements in Iranian adults. Methods: This cross-sectional study was conducted in Shiraz, Iran, over six months. Healthy volunteers aged 18-80 were included. Exclusion criteria were limb(s) amputation or immobilization and pregnancy. Participants were randomly divided into modeling (n = 400) and validation (n = 78) groups. We used the modeling group to generate regression equations based on gender and the validation group to test them. Results: Demi-span, age, knee height, and arm span could predict height with reasonable accuracy. Calf, waist, neck, and wrist circumferences entered our regression for predicting weight. Waist and calf circumferences entered the regression for BMI prediction in both genders. Arm circumference in men and neck circumference in women is strongly correlated with BMI. Conclusions: Many different equations have been suggested to predict height, weight, and BMI. Linear and circumferential body measures are usually used to predict height and weight. The suggested equations in this study are simple, and the anthropometric measurements require only a cloth tape measure and have good predictive ability. Complimentary studies are necessary to evaluate the precision of these formulas in other samples from other regions of Iran and in immobilized patients.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"700 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80679507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Health insurance is one of the important parts of financing in the health system to reduce inequality in household health expenditures. Objectives: This study aimed to investigate the role of health insurance in facing health expenditures among urban female-headed households in Iran. Methods: This descriptive-analytical applied study was performed cross-sectionally using the double-sample selection econometrics method in Stata software (version 16) in 2021. The sample included 2645 female-headed households, and the data were prepared by the Statistics Center of Iran using a questionnaire. Results: The results showed that social security insurance, private insurance, and insurance of special organizations led to an increase in the health expenditures of female-headed households by 159896, 334137, and 18332 Rials, respectively. Increasing household size, having children, having an elderly person, increasing per capita income, and per capita tobacco expenditures led to an increase in the health expenditures of female-headed households by 875260, 1545153, 2441094, 0.32, and 1.65 Rials, respectively. Conclusions: Private insurance, social security insurance, and insurance of special organizations had the greatest impact on increasing the health expenditures of female-headed households, respectively. Therefore, it is necessary to create an integrated health insurance system that reduces insurance organizations and funds and provides the same level of coverage for health goods and services. It is also suggested to adopt policies to increase the educational level of female-headed households to reduce health expenditures.
{"title":"Role of Health Insurance in Facing Health Expenditures Among Urban Female-headed Households in Iran","authors":"S. Ghaderi","doi":"10.5812/semj-121263","DOIUrl":"https://doi.org/10.5812/semj-121263","url":null,"abstract":"Background: Health insurance is one of the important parts of financing in the health system to reduce inequality in household health expenditures. Objectives: This study aimed to investigate the role of health insurance in facing health expenditures among urban female-headed households in Iran. Methods: This descriptive-analytical applied study was performed cross-sectionally using the double-sample selection econometrics method in Stata software (version 16) in 2021. The sample included 2645 female-headed households, and the data were prepared by the Statistics Center of Iran using a questionnaire. Results: The results showed that social security insurance, private insurance, and insurance of special organizations led to an increase in the health expenditures of female-headed households by 159896, 334137, and 18332 Rials, respectively. Increasing household size, having children, having an elderly person, increasing per capita income, and per capita tobacco expenditures led to an increase in the health expenditures of female-headed households by 875260, 1545153, 2441094, 0.32, and 1.65 Rials, respectively. Conclusions: Private insurance, social security insurance, and insurance of special organizations had the greatest impact on increasing the health expenditures of female-headed households, respectively. Therefore, it is necessary to create an integrated health insurance system that reduces insurance organizations and funds and provides the same level of coverage for health goods and services. It is also suggested to adopt policies to increase the educational level of female-headed households to reduce health expenditures.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90935535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maryam Hosseini, Seyede Mohadese Mousavi Moghadam, Mohaddeseh Azadvari, S. Z. Emami Razavi
Background: Low back pain is one of the most common causes of clinic referrals. In most patients, radicular pain results from the compression or injury of the proximal nerve root or dorsal root ganglion. Objectives: This study aimed to investigate the electrodiagnostic involvement of lumbar nerve roots in patients with lumbar radicular pain undergoing electromyography (EMG) and nerve conduction study. Methods: The sample population was selected from 18-70-year-old patients who had files in the clinic, complaining of lumbar pain radiating to the lower extremities for at least 2 months. Patient data were extracted from the available data and recorded in a separate anonymous information sheet. Results: This study was carried out on 352 patients with lumbar radicular pain. In addition to radicular pain, paresthesia was present in 86 patients (24.4%). Out of 352 patients with radicular pain, 294 cases (83.52%) showed unilateral or bilateral involvement in EMG. Among those who had paresthesia, 74 patients (86%) showed nerve root involvement in EMG. Conclusions: This study indicated the compatibility between lumbar radicular pain symptoms and the features observed in EMG, particularly in areas of paresthesia or the side of pain. Therefore, the patient’s symptoms can help predict nerve root involvement in the electrodiagnostic study before conducting this test.
{"title":"Prevalence of Electrodiagnostic Lumbosacral Nerve Root Involvement in Patients Presenting with Radicular Low Back Pain Referred to Physical Medicine and Rehabilitation Clinic of Imam Khomeini Hospital in Tehran, Iran, Within 2017 - 2020","authors":"Maryam Hosseini, Seyede Mohadese Mousavi Moghadam, Mohaddeseh Azadvari, S. Z. Emami Razavi","doi":"10.5812/semj-128459","DOIUrl":"https://doi.org/10.5812/semj-128459","url":null,"abstract":"Background: Low back pain is one of the most common causes of clinic referrals. In most patients, radicular pain results from the compression or injury of the proximal nerve root or dorsal root ganglion. Objectives: This study aimed to investigate the electrodiagnostic involvement of lumbar nerve roots in patients with lumbar radicular pain undergoing electromyography (EMG) and nerve conduction study. Methods: The sample population was selected from 18-70-year-old patients who had files in the clinic, complaining of lumbar pain radiating to the lower extremities for at least 2 months. Patient data were extracted from the available data and recorded in a separate anonymous information sheet. Results: This study was carried out on 352 patients with lumbar radicular pain. In addition to radicular pain, paresthesia was present in 86 patients (24.4%). Out of 352 patients with radicular pain, 294 cases (83.52%) showed unilateral or bilateral involvement in EMG. Among those who had paresthesia, 74 patients (86%) showed nerve root involvement in EMG. Conclusions: This study indicated the compatibility between lumbar radicular pain symptoms and the features observed in EMG, particularly in areas of paresthesia or the side of pain. Therefore, the patient’s symptoms can help predict nerve root involvement in the electrodiagnostic study before conducting this test.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84990309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What if We Replace Pass/Fail Grading with Decision Making by Machine? Toward Competency-based Medical Education","authors":"Haniye Mastour, Toktam Dehghani, Saeid Eslami","doi":"10.5812/semj-131552","DOIUrl":"https://doi.org/10.5812/semj-131552","url":null,"abstract":"<jats:p />","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77861371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nahid Motamedi Mohamad-Abadi, Somayeh Haghighat, Mohammad Tajmir-Riahi, S. Asgary, Maryam Eghbali-Babadi
Background: Coronary artery bypass graft (CABG) is a common surgical procedure in patients with heart disease associated with pain and problems with great saphenous veins (GSVs) wound healing. Objectives: We aimed to determine the effect of aloe vera gel on pain intensity, and GSVs wound healing in non-diabetic patients undergoing CABG. Methods: In this clinical trial, 35 CABG candidate patients fulfilling admission criteria were selected by convenience sampling, and their lower limbs were randomly assigned to the intervention or control group. The wound care for both groups was the same except for using aloe vera gel for the intervention group from the first to the fourth days after surgery. Pain intensity and GSVs wound healing data were collected by Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scale and Visual Analog Scale (VAS) questionnaires on the first, fourth, seventh, and fourteenth days and analyzed by SPSS software. Results: On the seventh day, the mean pain intensity in the intervention group was significantly lower (P = 0.01). The mean scores of wound healing in the intervention limb decreased faster; however, the wound healing score was not significantly different between the two groups at any time (P > 0.05). Using aloe vera gel reduced ecchymosis on the seventh and fourteenth days and reduced pain on the seventh day compared to the control limb (P < 0.001). Conclusions: Aloe vera gel can effectively reduce GSVs' pain intensity and ecchymosis from the seventh day. The topical application of this herb can have various degrees of effectiveness in decreasing pain and speeding up the healing of surgical wounds.
{"title":"The Effect of Aloe Vera Gel on Saphenous Vein Harvest Wound Healing and Local Pain in Non-diabetic Patients Undergoing CABG Surgery: A Clinical Trial","authors":"Nahid Motamedi Mohamad-Abadi, Somayeh Haghighat, Mohammad Tajmir-Riahi, S. Asgary, Maryam Eghbali-Babadi","doi":"10.5812/semj-122766","DOIUrl":"https://doi.org/10.5812/semj-122766","url":null,"abstract":"Background: Coronary artery bypass graft (CABG) is a common surgical procedure in patients with heart disease associated with pain and problems with great saphenous veins (GSVs) wound healing. Objectives: We aimed to determine the effect of aloe vera gel on pain intensity, and GSVs wound healing in non-diabetic patients undergoing CABG. Methods: In this clinical trial, 35 CABG candidate patients fulfilling admission criteria were selected by convenience sampling, and their lower limbs were randomly assigned to the intervention or control group. The wound care for both groups was the same except for using aloe vera gel for the intervention group from the first to the fourth days after surgery. Pain intensity and GSVs wound healing data were collected by Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scale and Visual Analog Scale (VAS) questionnaires on the first, fourth, seventh, and fourteenth days and analyzed by SPSS software. Results: On the seventh day, the mean pain intensity in the intervention group was significantly lower (P = 0.01). The mean scores of wound healing in the intervention limb decreased faster; however, the wound healing score was not significantly different between the two groups at any time (P > 0.05). Using aloe vera gel reduced ecchymosis on the seventh and fourteenth days and reduced pain on the seventh day compared to the control limb (P < 0.001). Conclusions: Aloe vera gel can effectively reduce GSVs' pain intensity and ecchymosis from the seventh day. The topical application of this herb can have various degrees of effectiveness in decreasing pain and speeding up the healing of surgical wounds.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"246 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76136081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lahya Afshari Saleh, F. Rahimpour, E. Rafeemanesh, F. Ahmadi, Vida Vakili, Faezeh Yazdani
Background: Shift work disrupts the sleep rhythm and leads to daily sleepiness and physical and mental complications. Objectives: This study aimed to investigate the predictive role of shift work in poor sleep quality and daytime sleepiness in railway personnel. Methods: This descriptive-analytical and cross-sectional study was conducted on the employees of the Khorasan railway in Iran in 2021, 450 individuals of whom were selected as a sample using the census sampling method. The data collection method was through a checklist containing demographic information and related factors (e.g., employment history) and through a physician to evaluate underlying diseases, body mass index (BMI), smoking and use of substances (past medical history), and completion of standard questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Karolinska Sleepiness Scale (KSS), and STOP-BANG questionnaire. The data were analyzed using the t-test and simultaneous multivariate regression analysis by SPSS software (version 24). Results: Out of 450 employees, 144 (32%) and 306 (68%) subjects were day workers and shift workers, respectively. The average age of the participants was 40 ± 5.97 years. A significant difference was observed between the BMI with PSQI, KSS, and STOP-BANG scores (P = 0.001). Additionally, binary logistic regression analysis showed that shift work had a significant effect as a risk factor on both PSQI scores (CR = 1.25, 95% CI: 1.16-1.32, P = 0.001) and KSS scores (CR = 1.43, 95% CI: 1.29 - 1.59, P = 0.001). Conclusions: Shift work could increase the amount of sleepiness during work in personnel as the main cause, along with other effective factors, such as personal and occupational characteristics.
{"title":"Shift Work as a Risk Factor for Poor Sleep Quality and Daytime Sleepiness in Khorasan Railway Personnel in Iran","authors":"Lahya Afshari Saleh, F. Rahimpour, E. Rafeemanesh, F. Ahmadi, Vida Vakili, Faezeh Yazdani","doi":"10.5812/semj-130052","DOIUrl":"https://doi.org/10.5812/semj-130052","url":null,"abstract":"Background: Shift work disrupts the sleep rhythm and leads to daily sleepiness and physical and mental complications. Objectives: This study aimed to investigate the predictive role of shift work in poor sleep quality and daytime sleepiness in railway personnel. Methods: This descriptive-analytical and cross-sectional study was conducted on the employees of the Khorasan railway in Iran in 2021, 450 individuals of whom were selected as a sample using the census sampling method. The data collection method was through a checklist containing demographic information and related factors (e.g., employment history) and through a physician to evaluate underlying diseases, body mass index (BMI), smoking and use of substances (past medical history), and completion of standard questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Karolinska Sleepiness Scale (KSS), and STOP-BANG questionnaire. The data were analyzed using the t-test and simultaneous multivariate regression analysis by SPSS software (version 24). Results: Out of 450 employees, 144 (32%) and 306 (68%) subjects were day workers and shift workers, respectively. The average age of the participants was 40 ± 5.97 years. A significant difference was observed between the BMI with PSQI, KSS, and STOP-BANG scores (P = 0.001). Additionally, binary logistic regression analysis showed that shift work had a significant effect as a risk factor on both PSQI scores (CR = 1.25, 95% CI: 1.16-1.32, P = 0.001) and KSS scores (CR = 1.43, 95% CI: 1.29 - 1.59, P = 0.001). Conclusions: Shift work could increase the amount of sleepiness during work in personnel as the main cause, along with other effective factors, such as personal and occupational characteristics.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86613534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Gharibi, Atefeh As’habi, M. Nazari, M. Haghi, Masoumeh Ebrahimi Tavani
Context: Iranian community health workers (known as behvarzes) have played an undeniable role in improving the health status of the rural community in recent decades. Therefore, this study aimed to identify the performance challenges faced by behvarzes using a literature review. Methods: This systematic review searched the Web of Science, Scopus, Science Direct, Springer, PubMed, ProQuest, SID, and Magiran databases/search engines in January 2020. There were 2 inclusion criteria, namely articles published in English or Persian languages and those published in or after 2000. The search strategy resulted in the retrieval of 1,472 primary articles, 16 of which were finally included in the study, and their related contents were entered into extraction tables. Then, the identified challenges were categorized based on the context, input, process, and product (CIPP) model. Results: The study results recognized the major challenges in 5 dimensions, including context (i.e., changes in societal, cultural, demographical, and epidemiological characteristics of rural communities), input (i.e., inadequate number of behvarzes, their insufficient competencies, and limited resources), process (i.e., increase in healthcare process complexity and the number of bahvarzes’ tasks and managerial problems), output (i.e., decrease in the quality, efficiency, accessibility, continuity, utilization, and effectiveness of services provided by behvarzes, poor health literacy of rural population and their weak involvement in health affairs, and emerging mental health problems in behvarzes), and outcome (i.e., low equity, urban-rural disparity in the diagnosis and treatment of diseases, and dissatisfaction of behvarzes and caregivers). Conclusions: This study revealed numerous important challenges faced by behvarzes, which need effective intervention by policymakers.
背景:近几十年来，伊朗社区卫生工作者(被称为behvarzes)在改善农村社区健康状况方面发挥了不可否认的作用。因此，本研究旨在通过文献综述来确定行为行为所面临的绩效挑战。方法:本系统综述于2020年1月检索了Web of Science、Scopus、Science Direct、施普林格、PubMed、ProQuest、SID和Magiran数据库/搜索引擎。有两项纳入标准，即以英语或波斯语发表的文章以及在2000年或之后发表的文章。通过检索策略，共检索到1472篇主要文献，其中16篇最终纳入本研究，并将其相关内容录入提取表。然后，根据上下文、输入、过程和产品(CIPP)模型对确定的挑战进行分类。结果:研究结果确认了5个方面的主要挑战，包括环境(即农村社区的社会、文化、人口和流行病学特征的变化)、投入(即行为者数量不足、能力不足和资源有限)、过程(即卫生保健过程复杂性和行为者的任务和管理问题的数量增加)、产出(即质量、效率、可及性、连续性和质量的下降)。医院提供的服务的利用率和有效性、农村人口卫生素养差和他们对卫生事务的参与程度低、医院中出现的心理健康问题以及结果(即公平性低、疾病诊断和治疗方面的城乡差距、医院和护理人员的不满)。结论:本研究揭示了行为面临的许多重要挑战，需要决策者进行有效干预。
{"title":"Performance Challenges Faced by “Behvarzes” as Community Health Workers of Iran: A Systematic Review of Literature","authors":"F. Gharibi, Atefeh As’habi, M. Nazari, M. Haghi, Masoumeh Ebrahimi Tavani","doi":"10.5812/semj-131792","DOIUrl":"https://doi.org/10.5812/semj-131792","url":null,"abstract":"Context: Iranian community health workers (known as behvarzes) have played an undeniable role in improving the health status of the rural community in recent decades. Therefore, this study aimed to identify the performance challenges faced by behvarzes using a literature review. Methods: This systematic review searched the Web of Science, Scopus, Science Direct, Springer, PubMed, ProQuest, SID, and Magiran databases/search engines in January 2020. There were 2 inclusion criteria, namely articles published in English or Persian languages and those published in or after 2000. The search strategy resulted in the retrieval of 1,472 primary articles, 16 of which were finally included in the study, and their related contents were entered into extraction tables. Then, the identified challenges were categorized based on the context, input, process, and product (CIPP) model. Results: The study results recognized the major challenges in 5 dimensions, including context (i.e., changes in societal, cultural, demographical, and epidemiological characteristics of rural communities), input (i.e., inadequate number of behvarzes, their insufficient competencies, and limited resources), process (i.e., increase in healthcare process complexity and the number of bahvarzes’ tasks and managerial problems), output (i.e., decrease in the quality, efficiency, accessibility, continuity, utilization, and effectiveness of services provided by behvarzes, poor health literacy of rural population and their weak involvement in health affairs, and emerging mental health problems in behvarzes), and outcome (i.e., low equity, urban-rural disparity in the diagnosis and treatment of diseases, and dissatisfaction of behvarzes and caregivers). Conclusions: This study revealed numerous important challenges faced by behvarzes, which need effective intervention by policymakers.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88050052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Infectious hospital waste, including needles and sharp instruments, is one of the most important causes of needle sticks. Objectives: The study aimed to investigate the factors affecting the disposal of special medical waste with needle sticks among healthcare workers in hospitals at the Iran University of Medical Sciences. Methods: This descriptive-analytical, retrospective, and cross-sectional study were done regarding the data in the autumn of 2019. Among 6119 medical-service staff, 180 subjects have been exposed to the needle stick at least once. Data were collected in two parts. The data were analyzed using correlation tests by SPSS software version 25. Results: The most devices leading to injury were needles (58%), angiocatheter (21%), ampoules (17%), suture needles (12%), scalpels (9%), other tools (8%), and razor blades (7%). The five wards with the highest needle sticks were the operating room (24.44%), surgery (22.22%), emergency (15%), internal wards (10%), and paraclinical (8.33%). Also, several factors, such as work shifts and the amount of work experience of individuals, can play an essential role in the rate of needle stitching of medical personnel. Importantly, we found a significant relationship between the volume of medical waste and employee needlestick rates. Conclusions: According to the results, we found a significant positive relationship between the volume of medical waste and employees' needle sticking rate. The observance of standard guidelines and the development and increase of occupational safety protection training courses have the most significant role in reducing needle sticks.
{"title":"Investigating the Relationship Between Special Medical Waste Disposal and Needle Sticking of Staff in Hospitals of Iran University of Medical Sciences","authors":"M. Maleki, Hamid Pourasghari, Hamideh Nafar","doi":"10.5812/semj-127475","DOIUrl":"https://doi.org/10.5812/semj-127475","url":null,"abstract":"Background: Infectious hospital waste, including needles and sharp instruments, is one of the most important causes of needle sticks. Objectives: The study aimed to investigate the factors affecting the disposal of special medical waste with needle sticks among healthcare workers in hospitals at the Iran University of Medical Sciences. Methods: This descriptive-analytical, retrospective, and cross-sectional study were done regarding the data in the autumn of 2019. Among 6119 medical-service staff, 180 subjects have been exposed to the needle stick at least once. Data were collected in two parts. The data were analyzed using correlation tests by SPSS software version 25. Results: The most devices leading to injury were needles (58%), angiocatheter (21%), ampoules (17%), suture needles (12%), scalpels (9%), other tools (8%), and razor blades (7%). The five wards with the highest needle sticks were the operating room (24.44%), surgery (22.22%), emergency (15%), internal wards (10%), and paraclinical (8.33%). Also, several factors, such as work shifts and the amount of work experience of individuals, can play an essential role in the rate of needle stitching of medical personnel. Importantly, we found a significant relationship between the volume of medical waste and employee needlestick rates. Conclusions: According to the results, we found a significant positive relationship between the volume of medical waste and employees' needle sticking rate. The observance of standard guidelines and the development and increase of occupational safety protection training courses have the most significant role in reducing needle sticks.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75727439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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