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Mahmoudi M, Ghorbani AA, Pourasghar M, Balaghafari A, Charati JY, Ghahrani N, Amini F. Designing, implementation and evaluation of story reading: a solution to increase general empathy in medical students. BMC Med Educ 2024; 24:477. [PMID: 38689266 PMCID: PMC11061996 DOI: 10.1186/s12909-024-05384-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 04/03/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Communication and mutual understanding among healthcare providers is a significant concern within the healthcare system, and enhancing empathy is one way to foster effective communication and mutual understanding. The aim of this research is to evaluate and compare the impact of story reading on the level of empathy in medical students at Mazandaran University of Medical Sciences. METHODS The study employed an intervention educational design (a quasi-experimental), with a convenience sample of 51 medical students selected as the statistical population. The process of story reading was conducted over six two-hour virtual sessions in the students' classroom, spanning six weeks. Selected stories were discussed in an online virtual class under the supervision of an instructor, focusing on story elements. To assess students' empathy in this educational program, the Davis General Empathy Questionnaire was administered before each of the six sessions, after, and one week later at the end of the course. Statistical analysis of the collected data was performed using repeated measures analysis of variance and Bonferroni's post hoc test through SPSS version 28 software, with a significance level set at 0.05. RESULTS The findings revealed that 27 participants (58.7%) were female students, with the remaining being male students, having an average age of 19.5 ± 0.86 years. The level of general empathy among the students significantly increased after the intervention compared to before the intervention (P<0.001). Furthermore, the analysis of variance with repeated measures indicated a significant effect of the story reading program on enhancing empathy in terms of emotional and cognitive transfer among students in the intervention group (P<0.001). CONCLUSIONS The research findings suggest that the story reading program effectively enhances the overall sense of empathy among medical students at the University of Medical Sciences. Therefore, implementing this method in universities, higher education centers, libraries, and psychology centers for teaching empathy can be valuable in fostering empathy skills and improving healthcare.
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Affiliation(s)
- Masoumeh Mahmoudi
- Department of General Education, School of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Asghar Ghorbani
- School of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mehdi Pourasghar
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Azita Balaghafari
- Department of Health Information Technology, School of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics and Epidemiology, School of Health, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Farzaneh Amini
- Department of Biostatistics and Epidemiology, Student Research Committee, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
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Kermani F, Yazdani Charati J, Roohi B, Moslemi A, Bandeghani A, Faeli L, Shokohi T, Roilides E. A systematic review and disability-adjusted life years of Scedosporium/Lomentospora infection in patients after near-drowning. Mycoses 2024; 67:e13703. [PMID: 38345265 DOI: 10.1111/myc.13703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/18/2024] [Accepted: 01/26/2024] [Indexed: 02/15/2024]
Abstract
Scedosporium/Lomentospora species exist as saprophytic moulds that can potentially lead to serious infections in patients who have experienced near-drowning incidents. Scedosporium species are distributed across different regions of the world while Lomentospora prolificans has quite a restricted geographic distribution. We aimed to systematically review scedosporiosis cases after near-drowning, their clinical manifestations, underlying diseases, treatments, outcomes and its impact through disability-adjusted life years (DALYs). Five available sources were searched from 1 January 2007, to 20 April 2022. Thirty-eight studies, including 41 patients, were evaluated. Mean age was 33.6 ± 18.6 years (range 1-68), and 28 were male (68.3%). Central nervous system (CNS) dissemination predominated (36/41; 87.8%), presenting mainly as multiple brain abscesses (26/41; 63.4%), followed by lung involvement (22/41; 56.4%). Scedosporium apiospermum species complex was the most causative agent (38/41; 92.7%). Overall mortality was 51.2%. Half of the patients (18/37) were cured after receiving proper treatment, and in most cases, voriconazole alone or in combination with surgery or other antifungals caused survival. The mean survival time was 123 ± 27 days. Mean DALYs in 1980-2022 were 46.110 ± 3.318 (39.607-52.612). Time to diagnosis was estimated to be 120 days, and there was no association between time to diagnosis and outcome. Voriconazole is a potentially effective therapy, and combination of surgery and antifungal treatment may lead to more favourable outcome. Advances in early diagnosis and appropriate antifungal therapy may have contributed to reducing its mortality.
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Affiliation(s)
- Firoozeh Kermani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Behrad Roohi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Azam Moslemi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Azadeh Bandeghani
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Leila Faeli
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahereh Shokohi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Emmanuel Roilides
- Infectious Diseases Section, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
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Farsavian AA, Ghadirzadeh E, Yazdani Charati J, Rahmanzade H, Khalilizad M, Abedi SM. Evaluation of myocardial viability by a secondary delayed 99mTc-MIBI nuclear scanning in ST-elevation myocardial infarction patients with delay in referral and nonviable myocardium in the first scintigraphy: a preliminary cohort study. Nucl Med Commun 2023:00006231-990000000-00163. [PMID: 37272296 DOI: 10.1097/mnm.0000000000001716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE In the management of ST-segment elevation myocardial infarction (STEMI), if the treatment has not been initiated within the first 24 h and the patient no longer exhibits any symptoms, the decision to begin revascularization therapy is based on myocardial viability. If the tissue is nonviable, current guidelines advise against further revascularization therapy; however, collateral vessels represent an alternative source of blood supply and may help the damaged tissue to resume function; though at first, this tissue may not be considered viable. Thus, in patients whose first myocardial perfusion scintigraphy (MPS) revealed nonviable myocardium, a secondary MPS to assess viability may be beneficial and alter the course of treatment strategies. METHODS This prospective cohort study was conducted on 30 STEMI patients referred to Mazandaran Heart Center. If no myocardial viability was found using 99mTc-MIBI MPS, the patient was referred for a secondary MPS after 3 months. RESULTS In total, out of 30 patients, 3 became viable. There was no significant relationship between the viability of different Rentrop classes. Comparison of viability between patients with different numbers of occluded vessels showed no significant relationship. Three patients (17%) among 17 patients with Rentrop class nonzero became viable in the second MPS. Also, among four patients (13.3%) with Rentrop class three, one patient (25%) became viable and among seven patients (23.3%) with Rentrop class one, two patients (28.6%) became viable. CONCLUSION Considering the results of this study, although nonsignificant, this subject requires further investigation to reach a definite conclusion.
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Affiliation(s)
| | - Erfan Ghadirzadeh
- Student Research Committee, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences
| | | | - Hadi Rahmanzade
- Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari
| | - Majid Khalilizad
- Fellowship of Knee, Department of Orthopaedic and Trauma Surgery, Shahid Beheshti Hospital
- Department of Orthopaedics, Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol
| | - Seyed Mohammad Abedi
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Jalalian R, Bagheri B, Yazdani Charati J, Khalaghi S, Iranian M, Mohammadi M. Impact of maintenance dose of eptifibatide in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention. Egypt Heart J 2023; 75:28. [PMID: 37060533 PMCID: PMC10105801 DOI: 10.1186/s43044-023-00355-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/09/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND ST-segment elevation myocardial infarction (STEMI) is usually caused by a rupture in the atherosclerotic plaque, followed by platelet aggregation which ultimately leads to acute coronary artery occlusion. So far, few studies have investigated the effect of maintenance dose of Eptifibatide (glycoprotein IIb/IIIa inhibitor) in STEMI patients who underwent primary percutaneous coronary intervention (PPCI). Therefore, in this study, we investigated the effect of maintenance dose of Eptifibatide in patients with STEMI who underwent PPCI. 264 patients who had acute chest pain suggestive of STEMI were entered in the study. All patients received the same dose of bolus dose of Eptifibatide in the cardiac catheterization laboratory. Then the patients were randomly divided into two groups, one group (n = 147) received a maintenance dose of intravenous Eptifibatide (infusion of 2 μg/kg/min) and the other group (n = 117) did not receive this treatment. Standard medical treatment of STEMI after PPCI was performed based on guidelines and the same in both groups. All patients were evaluated 1, 2, and 3 months after the start of treatment in terms of predicted outcomes. RESULTS The occurrence of 3-month major adverse cardiovascular events (MACE) between the case and control groups did not have a statistically significant difference (28.6% versus 35.0%; P value: 0.286). Also, investigations showed that the rate of re-infarction (P value: 0.024) and target lesion revascularization (P value: 0.003) was significantly lower in the group that received Eptifibatide infusion. CONCLUSIONS Eptifibatide maintenance dose infusion in patients who undergo PPCI in the context of STEMI, does not significantly reduce MACE, although it does significantly reduce re-infarction and target lesion revascularization. It also does not increase the risk of bleeding and cerebrovascular events.
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Affiliation(s)
- Rozita Jalalian
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Babak Bagheri
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahrnaz Khalaghi
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammadreza Iranian
- Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Mahsa Mohammadi
- Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Fazeli-Dinan M, Osia-Laghab SH, Amini M, Davoodi A, Nikookar SH, Yazdani Charati J, Azadbakht M, Enayati A. Phytochemical composition, toxicity, and repellent effects of medicinal plants Peganum harmala, Pterocarya fraxinifolia, and Tanacetum parthenium extracts against Sitophilus oryzae L. TOXIN REV 2023. [DOI: 10.1080/15569543.2023.2178013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- Mahmoud Fazeli-Dinan
- Department of Medical Entomology and Vector Control, Health Sciences Research Center, Addiction Institute, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Hanif Osia-Laghab
- Department of Pharmacognosy and Biotechnology, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mina Amini
- Food and Drug Deputy, Mazandaran University of Medical Sciences, Sari, Iran
- The Health of Plant and Livestock Products Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Davoodi
- Department of Pharmacognosy and Biotechnology, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Hassan Nikookar
- Department of Medical Entomology and Vector Control, Health Sciences Research Center, Addiction Institute, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Azadbakht
- Department of Pharmacognosy and Biotechnology, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Iran
| | - Ahmadali Enayati
- Department of Medical Entomology and Vector Control, Health Sciences Research Center, Addiction Institute, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
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Ahmadzadeh Amiri A, Genevay S, Ahmadzadeh Amiri A, Daneshvar F, Yazdani Charati J, Ghafouri M, Moghadam N, Kordi R. Adding a back care package to the primary healthcare; a community-based cluster-randomized trial. Brain Spine 2023; 3:101714. [PMID: 37383449 PMCID: PMC10293304 DOI: 10.1016/j.bas.2023.101714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/07/2023] [Accepted: 01/18/2023] [Indexed: 06/30/2023]
Abstract
Introduction The clinical course of LBP is complex and chronicity is more frequent than once thought. Moreover, insufficient evidence was found in support of any specific approach at the level of the general population. Research question This study aimed to evaluate the effectiveness of providing a back care package through the primary healthcare system in decreasing the rate of CLBP in the community. Material and methods Clusters were primary healthcare units with the covered population as participants. The intervention package comprised both exercise and educational content in the form of booklets. Data regarding LBP were collected at baseline, 3 and 9-month follow-ups. The LBP prevalence and the incidence of CLBP in the intervention group compared to the control group were analyzed using logistic regression through GEE. Results Eleven clusters were randomized including 3521 enrolled subjects. At 9 months, the intervention group showed a statistically significant decrease in both the prevalence and the incidence of CLBP, compared to the control group (OR = 0.44; 95% CI = 0.30-0.65; P < 0.001 and OR = 0.48; 95% CI = 0.31-0.74; P < 0.001, respectively). Discussion and conclusion The population-based intervention was effective in reducing the LBP prevalence and CLBP incidence. Our results suggest that preventing CLBP through a primary healthcare package including exercise and educational content is achievable.
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Affiliation(s)
- Ali Ahmadzadeh Amiri
- Sports Medicine Research Center, Neuroscience institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Stéphane Genevay
- Division of Rheumatology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Amir Ahmadzadeh Amiri
- Sports Medicine Research Center, Neuroscience institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Daneshvar
- Department of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Health Sciences Research Center, Biostatistics Department, Addiction Institute, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Ghafouri
- Sports Medicine Research Center, Neuroscience institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Navid Moghadam
- Sports Medicine Research Center, Neuroscience institute, Tehran University of Medical Sciences, Tehran, Iran
- Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Kordi
- Sports Medicine Research Center, Neuroscience institute, Tehran University of Medical Sciences, Tehran, Iran
- Spine Center of Excellence, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Lye MS, Zarghami M, Charati JY, Abdollahi F. Impact of Intimate Partner Violence on Iranian Children's Growth and Development: A Descriptive-analytical Study. Oman Med J 2023; 38:e464. [PMID: 36937772 PMCID: PMC10015342 DOI: 10.5001/omj.2023.51] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/07/2022] [Indexed: 11/03/2022] Open
Abstract
Objectives This study aimed to determine the prevalence of different types of intimate partner violence (IPV) experienced by married Iranian women and their impact on the growth and development of their children. Methods For this descriptive-analytical study, we recruited the mothers of one-year-old children attending primary health centers in Gonbad-e-Kavoos city, Iran. The data was collected using a questionnaire comprising the World Health Organization Domestic Violence, Ages and Stages Questionnaire-12; and queries related to the participants' socio-economic, obstetrics, demographic, and anthropometric characteristics. The body mass index z (BMI z) scores of the children were divided into five categories based on the World Health Organization's classification: severely underweight (z < -3), underweight (-3 ≤ z < -2), normal (-2 ≤ z < 1), overweight (1 ≤ z ≤ 2), and obese (z > 2). The data were subjected to descriptive analysis, chi-square test, and regression. Results A total of 596 of mother-child dyads were included in this study. The prevalence of psychological, physical, and sexual IPV was 29.5%, 7.4%, and 2.4%, respectively. Most children (91.7%) had normal weight while the rest were overweight or obese. Developmental problems were reported in 1.7% of children. The education level of the father was significantly related to IPV (p =0.001) while the type of his occupation was related to delay in child growth (p =0.020). There was no significant difference between BMI z-score and developmental disabilities in the children of women exposed and not exposed to any type of IPV. Conclusions The prevalence of psychological IPV was high while those of physical and sexual IPV were low. The rates of poor child growth and development were also low. The father's educational and socio-economic status influenced IPV and the children's growth deficits.
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Affiliation(s)
- Munn-Sann Lye
- Department of Community of Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia
| | - Mehran Zarghami
- Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Abdollahi
- Department of Public Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
- Corresponding author:
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Movahedi FS, Yazdani Charati J, Baba Mahmoudi F, Abdollahi F, Safari Hajikalai F. Clinical Characteristics and Outcomes of COVID-19 Patients in Mazandaran Province, Iran. Tanaffos 2023; 22:102-111. [PMID: 37920321 PMCID: PMC10618590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/18/2022] [Indexed: 11/04/2023]
Abstract
Background The problem issue of coronaviruses is one of the most serious problems in the world. The present study aimed to investigate and describe the clinical characteristics, risk factors of fatality rate, and length of hospital stay in patients with COVID-19 in Mazandaran province. Materials and Methods In this epidemiological study, data from COVID-19 patients admitted to hospitals in Mazandaran province from July 22 to August 21, 2020, were reported. Multivariate logistic regression methods and the Cox proportional hazards model were used to determine the risk factors of fatality. Results Out of the 6759 hospitalized patients, 3111(46.03%) patients had comorbidity; 19.77% of them had diabetes, 19.97% had hypertension, and 15.28% had heart failure. Cox regression model on COVID-19 patient data showed that risk factors for fatality including having age over 60 years (HR: 1.93; P< 0.001), intubation (HR: 4.22; P<0.001), SpO2≤ 93% (HR: 2.57; P=0.006), comorbidities of cancer (HR: 1.87; P=0.006), chronic blood diseases (HR: 1.83; P=0.049), heart failure (HR: 1.63; P<0.001), and chronic kidney disease (HR: 1.98; P<0.001). Conclusion Paying much attention to risk factors for fatality can help identify patients with a poor prognosis in the early stages. More assessments should also be performed to examine the underlying mechanisms of these risk factors. Highlighting death-relate d risk factors is crucial to increase preparedness through appropriate medical care and prevention regulations.
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Affiliation(s)
- Faezeh Sadat Movahedi
- Student Research Committee, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, School of Health, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farhang Baba Mahmoudi
- Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Abdollahi
- Department of Public Health, School of Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Safari Hajikalai
- Student Research Committee, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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Ghazanfari M, Yazdani Charati J, Keikha N, Kholoujini M, Kermani F, Nasirzadeh Y, Roohi B, Minooeianhaghighi MH, Salari B, Jeddi SA, Didehdar M, Shokri A, Ameri Seyahooei S, Aslani N, Nazeri M, Ghojoghi A, Amirizad K, Azish M, Nosratabadi M, Zakerian MR, Hedayati S, Hatamipour H, Abastabar M, Haghani I, T. Hedayati M. Indoor environment assessment of special wards of educational hospitals for the detection of fungal contamination sources: A multi-center study (2019-2021). Curr Med Mycol 2022; 8:1-8. [PMID: 37736609 PMCID: PMC10509496 DOI: 10.32598/cmm.2023.1370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/28/2022] [Accepted: 01/24/2023] [Indexed: 09/23/2023] Open
Abstract
Background and Purpose The hospital environment was reported as a real habitat for different microorganisms, especially mold fungi. On the other hand, these opportunistic fungi were considered hospital-acquired mold infections in patients with weak immune status. Therefore, this multi-center study aimed to evaluate 23 hospitals in 18 provinces of Iran for fungal contamination sources. Materials and Methods In total, 43 opened Petri plates and 213 surface samples were collected throughout different wards of 23 hospitals. All collected samples were inoculated into Sabouraud Dextrose Agar containing Chloramphenicol (SC), and the plates were then incubated at 27-30ºC for 7-14 days. Results A total of 210 fungal colonies from equipment (162, 77.1%) and air (48, 22.9%) were identified. The most predominant isolated genus was Aspergillus (47.5%), followed by Rhizopus (14.2%), Mucor (11.7%), and Cladosporium (9.2%). Aspergillus (39.5%), Cladosporium (16.6%), as well as Penicillium and Sterile hyphae (10.4% each), were the most isolates from the air samples. Moreover, intensive care units (38.5%) and operating rooms (21.9%) had the highest number of isolated fungal colonies. Out of 256 collected samples from equipment and air, 163 (63.7%) were positive for fungal growth. The rate of fungal contamination in instrument and air samples was 128/213 (60.1%) and 35/43 (81.2%), respectively. Among the isolated species of Aspergillus, A. flavus complex (38/96, 39.6%), A. niger complex (31/96, 32.3%), and A. fumigatus complex (15/96, 15.6%) were the commonest species. Conclusion According to our findings, in addition to air, equipment and instrument should be considered among the significant sources of fungal contamination in the indoor environment of hospitals.
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Affiliation(s)
- Mona Ghazanfari
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nasser Keikha
- Infectious Disease and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahdi Kholoujini
- Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Firoozeh Kermani
- Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Yaser Nasirzadeh
- Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Behrad Roohi
- Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Hassan Minooeianhaghighi
- Department of Medical Microbiology, Faculty of Medicine, Infectious Diseases Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Bahram Salari
- Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Ali Jeddi
- Department of Laboratory Sciences, School of Allied Sciences, Abadan University of Medical Sciences, Abadan, Iran
| | - Mojtaba Didehdar
- Department of Medical Parasitology and Mycology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Azar Shokri
- Vector-Borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | | | | | | | | | | | | | - Mohsen Nosratabadi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | | | | | - Hedieh Hatamipour
- Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad T. Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Shokri F, Rezapoor S, Najafi M, Asadi M, Karimi alavije M, Abolhassani M, Moieneddin MH, Ashrafi AM, Gholipour N, Naderi P, Charati JY, Alizadeh-Navaei R, Saeedi M, Heidary M, Rostamnezhad M. Efficacy of drug regimen with and without oseltamivir in hospitalized patients with COVID-19: A retrospective study. Vacunas 2022; 24:141-149. [PMID: 36211984 PMCID: PMC9531663 DOI: 10.1016/j.vacun.2022.09.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/16/2022] [Indexed: 11/05/2022]
Abstract
Introduction Coronavirus disease 2019 (COVID-19) is the most critical issue in nowadays medicine. We aimed to evaluate the use and therapeutic outcomes of oseltamivir, an antiviral drug for patients with COVID-19. Materials and method In an observational study conducted at Imam Khomeini Hospital in Amol, Iran, data for 544 patients with laboratory and CT scan result confirmed COVID-19 were retrospectively collected between February 24th and April 13th 2020. To compare the characteristics of patients based on gender, the chi-square test was used. Logistic regression was used to evaluate the effect of oseltamivir on the outcome of treatment. Logrank test were used to compare the length of hospital stay in people treated with oseltamivir and drugs other than oseltamivir. Results Kaplan–Meier and logrank test showed no significant reduction in hospitalization time and survival rate following treatment with oseltamivir. However, a significant increase in lymphocytes count and reduction of C-reactive protein (CRP) level detected. Conclusion Administration of oseltamivir for patients with COVID-19 didn't show any improvement in hospitalization duration and survival rate.
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Affiliation(s)
- Fazlollah Shokri
- Department of Medical Genetics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Rezapoor
- Department of Radiology, Imam Khomeini Hospital, Amol, Iran
| | - Masoud Najafi
- Medical Technology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran,Radiology and Nuclear Medicine Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Asadi
- Department of Hematology and Blood Banking, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Moussa Abolhassani
- International Federation of Inventors' Associations (IFIA), Geneva, Switzerland
| | | | - Amir Muhammad Ashrafi
- Student Research Committee, Amol Faculty of Nursing, Mazandaran University of Medical Sciences, Sari, Iran
| | - Narges Gholipour
- Student Research Committee, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Parisa Naderi
- Department of Biology, Faculty of Cellular and Molecular Sciences, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Saeedi
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Science, Sari, Iran
| | - Mohsen Heidary
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran,Corresponding authors
| | - Mostafa Rostamnezhad
- Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran,Corresponding authors
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11
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Hedayati M, Ghazanfari M, Charati JY, Davoodi L, Arastehfar A, Moazeni M, Abastabar M, Haghani I, Mayahi S, Hoenigl M, Pan W. P424 Comparative analysis of Galactomannan Lateral Flow Assay, Galactomannan Enzyme Immunoassay and BAL culture for diagnosis of COVID-19-associated pulmonary aspergillosis. Med Mycol 2022. [PMCID: PMC9494456 DOI: 10.1093/mmy/myac072.p424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objectives Invasive pulmonary aspergillosis is a well-known complication in COVID-19 patients. A reliable and early diagnosis is essential for the early initiation of antifungal therapy. On the other hand, conventional Bronchoalveolar lavage (BAL) culture may lack the specificity of differentiating between colonization and infection. Here, we aimed a comparative analysis of Galactomannan Lateral Flow Assay (GM-LFA), Galactomannan Enzyme Immunoassay (GM-EIA), and BAL culture for diagnosis of COVID-19-associated pulmonary aspergillosis (CAPA). Methods BAL (n = 105) and serum samples (n = 101) from COVID-19 patients who were mechanically ventilated for ≥4 days in intensive care units (ICUs) were evaluated by GM-LFA and GM-EIA. All BAL samples were cultured on Sabouraud-Chloramphenicol dextrose Agar. Diagnostic performance of GM-LFA and GM-EIA in BAL (GM indexes ≥1) and serum (GM indexes >0.5) were evaluated and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and Roc curve compared with BAL culture calculated. Results The Aspergillus GM-LFA for serum and BAL samples showed a sensitivity of 46.9% and 54.5%, specificity of 100% and 91.7%, PPV of 100% and 75%, and NPV of 80.2% and 81.5%, when compared with BAL culture, respectively. GM-EIA showed sensitivities of 56.3% and 60.6%, specificities of 94.2% and 88.9%, PPVs of 81.8% and 71.4%, and NPVs of 82.3% and 83.1% for serum and BAL samples, respectively. Conclusion According to our results BAL GM detection using both EIA and LFA may be a promising approach for early diagnosis of CAPA and differentiating between colonization and invasive infection.
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Affiliation(s)
| | | | | | | | - Amir Arastehfar
- Center for Discovery and Innovation , Hackensack Meridian Health, NJ , USA
| | | | | | - Iman Haghani
- Mazandaran University of Medical Sciences , Sari , Iran
| | - Sabah Mayahi
- Mazandaran University of Medical Sciences , Sari , Iran
| | - Martin Hoenigl
- Division of Infectious Diseases and Global Public Health , Department of Medicine, University of California, San Diego, CA 92093 , USA
| | - Weihua Pan
- Medical Mycology , Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003 , China
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12
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Emadi SA, Baradari AG, Charati JY, Taghavi F, Kiabi FH. SOFA and modified SOFA score for accessing outcomes among trauma patients in intensive care unit. International Journal of Surgery Open 2022. [DOI: 10.1016/j.ijso.2022.100559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Ghazanfari M, Yazdani Charati J, Davoodi L, Arastehfar A, Moazeni M, Abastabar M, Haghani I, Mayahi S, Hoenigl M, Pan W, Hedayati MT. Comparative analysis of Galactomannan Lateral Flow Assay, Galactomannan Enzyme Immunoassay and BAL culture for Diagnosis of COVID-19 associated pulmonary aspergillosis. Mycoses 2022; 65:960-968. [PMID: 35979737 PMCID: PMC9538082 DOI: 10.1111/myc.13518] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Galactomannan Enzyme Immunoassay (GM-EIA) is proved to be a cornerstone in the diagnosis of COVID-19-associated pulmonary aspergillosis (CAPA), its use is limited in middle and low-income countries, where the application of simple and rapid test, including Galactomannan Lateral Flow Assay (GM-LFA), is highly appreciated. Despite such merits, limited studies directly compared GM-LFA to GM-EIA. Herein we compared the diagnostic features of GM-LFA, GM-EIA, and BAL culture for CAPA diagnosis in Iran, a developing country. MATERIALS/METHODS Diagnostic performance of GM-LFA and GM-EIA in BAL (GM indexes ≥ 1) and serum (GM indexes > 0.5), i.e., sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and areas under the curve (AUC), were evaluated using BAL (n=105) and serum (n=101) samples from mechanically ventilated COVID-19 patients in intensive care units. Patients were classified based on the presence of host factors, radiological findings, and mycological evidences according to 2020 ECMM/ISHAM consensus criteria for CAPA diagnosis. RESULTS The Aspergillus GM-LFA for serum and BAL samples showed a sensitivity of 56.3% and 60.6%, specificity of 94.2% and 88.9%, PPV of 81.8% and 71.4%, NPV of 82.3% and 83.1%, when compared to BAL culture, respectively. GM-EIA showed sensitivities of 46.9% and 54.5%, specificities of 100% and 91.7%, PPVs of 100% and 75%, NPVs of 80.2% and 81.5% for serum and BAL samples, respectively. CONCLUSION Our study found GM-LFA as a reliable simple and rapid diagnostic tool, which could circumvent the shortcomings of culture and GM-EIA and be pivotal in timely initiation of antifungal treatment.
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Affiliation(s)
- Mona Ghazanfari
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Lotfollah Davoodi
- Antimicrobial Resistance Research Center/ Department of Infectious Diseases, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Arastehfar
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA
| | - Maryam Moazeni
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sabah Mayahi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Martin Hoenigl
- Clinical and Translational Fungal-Working Group, University of California San Diego, La Jolla, CA, USA.,Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Austria.,Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, CA, USA
| | - Weihua Pan
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Mohammad T Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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14
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Charati FG, Shojaee L, Haghighat S, Esmaeili R, Madani Z, Charati JY, Hosseini SH, Shafipour V. Motor exercises effect on improving shoulders functioning, functional ability, quality of life, depression and anxiety for women with breast cancer. Clin Breast Cancer 2022; 22:666-673. [DOI: 10.1016/j.clbc.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 11/03/2022]
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15
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Karami H, Lashtoo Aghaee B, Yazdani Charati J, Abedi A. Quality of Life for Children With Functional Abdominal Pain and Their Parents Copmared to Healthy Individuals. JPR 2022. [DOI: 10.32598/jpr.10.3.1018.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Objectives: Functional abdominal pain (FAP) is a debilitating disorder that has a high prevalence among children. The goal of this study is to evaluate patients’ and parents’ perceptions of health-related quality of life (QoL) for children with FAP. Methods: Between April 2018 and June 2019, a total of 200 children (including 100 with FAP and 100 healthy individuals) and 200 parents participated in this study. The participants completed a health-related QoL scale (pediatric quality of life inventory) that is scored on a scale from 0 (poor) to 100 (best). Children with FAP and their parents were compared to a control group consisting of healthy children. Results: Children with FAP had lower self-report QoL scores (46.97±17.43) compared to their healthy peers (78.69±13.02) and the difference was significant (P<0.05). Parents of children with FAP reported lower QoL scores compared to parents of the control group (45.56±14.19 vs 75.94±15.06, P<0.05) but it was similar to the scores for their children. Conclusions: The present study demonstrated that children with FAP and their parents experience a poor QoL compared to their healthy peers.
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16
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Abedian Kasgri K, Abazari M, Tehrani H, Yazdani Charati J, Momeni Badeleh S, Momeni Badeleh K, Mahdizadeh M, Peyman N. A systematic review for evaluation of specialized programs for addressing young women with breast cancer problems. Oncol Res Treat 2022; 45:504-524. [PMID: 35700693 DOI: 10.1159/000525413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/03/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Breast cancer (BC) is one of the most common health concerns among women and is the leading cause of cancer-related death around the world. Women, in particular young women facing unique and complex problems with breast cancer. Physical, psychological, emotional, educational, and long-term breast cancer-related problems have been recognized for these vulnerable populations. Besides BC patients, their families and relatives challenge with various problems such as financial and supportive issues in supporting these patients. METHODS The main objective of the present study was to evaluate the BC patient's major problems and describe current supportive initiatives and programs that support these patients, their advancements to date, existing challenges, and possible future actions. Data collection took place by conducting a comprehensive search on the internet, Medline, PubMed, and google scholar databases. We also discuss the contingency options, which lead to improving medical and supportive care, as well as overcoming barriers to providing comprehensive and optimal care and support for these unique groups of patients. RESULTS The result revealed that several comprehensive and well-developed breast cancer programs and initiatives have been established around the world for providing and focusing on BC patient's clinical care, supportive care, education, survivorship, navigation, and research. However, despite considerable advancement in this area, there are still significant challenges in addressing the BC patient's needs. CONCLUSION Evaluation of the current situation of BC patient's treatment and quality of life highlighted the importance of developing and implementing the new and most efficient healthcare programs and protocols, as well as improving and optimizing the existing ones to improve and enhance the survival rate and quality of life of BC patients.
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Affiliation(s)
- Kobra Abedian Kasgri
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Morteza Abazari
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Zanjan University of Medical Sciences, Mashhad, Iran,
| | - Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Safa Momeni Badeleh
- Department of Food and Drug Control, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Mehrsadat Mahdizadeh
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Peyman
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Farhadi R, Saffar MJ, Monfared FT, Larijani LV, Kenari SA, Charati JY. Prevalence, risk factors and molecular analysis of vancomycin-resistant Enterococci colonization in a referral neonatal intensive care unit: A prospective study in northern Iran. J Glob Antimicrob Resist 2022; 30:474-479. [DOI: 10.1016/j.jgar.2022.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/15/2022] [Accepted: 05/20/2022] [Indexed: 11/26/2022] Open
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18
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Fallah S, Nasehi M, Etemadinezhad S, Fallah S, Yazdani Charati J. A Five-Year Epidemiological Study of Extra-Pulmonary Tuberculosis and Its Related Risk Factors in Iran. Tanaffos 2022; 21:221-229. [PMID: 36879733 PMCID: PMC9985131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/10/2021] [Indexed: 06/18/2023]
Abstract
BACKGROUND Tuberculosis is the most common worldwide cause of death from microbial diseases. Extra-pulmonary tuberculosis accounts for 20% to 25% of all cases. In this study, we used generalized estimation equations to investigate the trend of changes in extra-pulmonary tuberculosis incidence. MATERIALS AND METHODS The recorded data of all patients with extra-pulmonary tuberculosis from 2015 to 2019 in Iran's National Tuberculosis Registration Center were included. The trend of standardized incidence changes in provinces of Iran was calculated and reported linearly. Also, we identified the risk factors related to the extra-pulmonary tuberculosis incidence in five consecutive years using generalized estimating equations. RESULTS We studied the data of 12,537 patients with extra-pulmonary tuberculosis, of whom 50.3% were female. The mean age of the subjects was 43.61±19.88 years. Around 15.4% of all patients had a history of contact with a tuberculosis patient, 43% had a history of hospital stay, and 2.6% had a human immunodeficiency virus infection. Regarding disease types, 25% were lymphatic, 22% were pleural, and 14% were bone. Golestan province had the highest (average of 28.50 ± 8.65 cases), and Fars province had the lowest (average of 3.06 ± 0.75 cases) standardized incidences in these five years. Also, time trend (P < 0.001), employment rate (P = 0.037), and average annual rural income (P = 0.001) had a significant effect on reducing extra-pulmonary tuberculosis incidence. CONCLUSION Extra-pulmonary tuberculosis has a decreasing trend in Iran. Still, Golestan, Sistan and Baluchestan, Hormozgan, and Khuzestan provinces have a higher incidence rate compared to the other provinces.
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Affiliation(s)
- Sahar Fallah
- Faculty of Health, Mazandaran university of Medical Sciences, Sari, Iran
| | - Mahshid Nasehi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Siavash Etemadinezhad
- Department of Occupational Health and Ergonomics, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Simin Fallah
- Department of Linguistics, School of Literature and Human Sciences, Razi University, Kermanshah, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
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19
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Alvandipour M, Karami MY, Azadfar M, Yazdani Charati J. Inter sphincter rectal resection with and without Malone ante grade continence enema in cases with low rectal cancer: A randomized, prospective, single-blind, clinical trial. Caspian J Intern Med 2022; 13:546-554. [PMID: 35974933 PMCID: PMC9348201 DOI: 10.22088/cjim.13.3.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/09/2021] [Accepted: 12/04/2021] [Indexed: 11/21/2022]
Abstract
Background Fecal incontinence is the main morbidity of inter-sphincteric resection (ISR) in ultra-low rectal cancer. Malone Ante grade Continence Enema (MACE) has been proposed for these patients. We aimed to compare the quality of life outcomes in cases with ultra-low rectal cancer who had undergone ISR±MACE. Methods The current randomized clinical study was accomplished for two years from December 2016 to February 2018 in Imam Khomeini Hospital (Sari City, I.R.Iran) on 30 patients (15 in each group) with rectal cancer. The inclusion criteria of the study were stage 1 and 2a of low rectal cancer with type 2 and 3 of Rullier's classification, those who received neoadjuvant chemo radiotherapy. The exclusion criteria were comorbidity diseases, immune deficiency, poor follow-up. The follow-up period was one year. The Quality of Life (Qol) was reported as primary endpoint. The EORTC QLQ-C30 score and Wexner questionnaires were used. SPSS Version 22 was used. A p-value less than 0.05 was considered statistically significant. Results The mean age of patients was 56.23± 8.72 years. The overall Qol score was better in the ISR-MACE (P=0.023). The overall Qol was lower in women than in men in both groups. Low anterior resection syndrome score was lower in the ISR plus MACE group than the ISR group (P=0.030). The Wexner score revealed better scores in the ISR with MACE group than the ISR without MACE group (p<0.0001). Conclusion Patients who underwent ISR plus MACE surgery had better defecation control and better quality of life than patients without MACE.
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Affiliation(s)
- Mina Alvandipour
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Science, Sari, Iran
| | - Mohammad Yasin Karami
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Correspondence: Mohammad Yasin Karami, Department of Surgery, Shiraz University of Medical Sciences, Zand Ave, Shiraz, Iran. E-mail: , Tel: 0098 7132236001, Fax: 0098 7132236001
| | - Mahmood Azadfar
- Department of Suregry, Mazandaran University of Medical Science, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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20
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Heidarian Naeini A, Mahmoudi G, Yazdani Charati J. Health care quality model of family physician program in Iran (mixed method). Caspian J Intern Med 2022; 13:666-674. [PMID: 36420344 PMCID: PMC9659823 DOI: 10.22088/cjim.13.4.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND There has been a growing international evolution of the role and purpose of quality improvement in primary health care. The present study aimed to develop a quality model of the Family Physician program in Iran. METHODS In the qualitative part of these mixed-method studies, grounded theory was used according to the systematic method of Strauss and Corbin. Semi-structured interviews were conducted with recipients and providers of Family Physician cares in the pilot provinces of Iran in 2020 to 2021 and continued until the theoretical saturation based on the purposive technique. The qualitative evaluation of the model was performed and approved. Structural equation modeling and Amos software were used to quantify the model. RESULTS The results of the structural equation analysis showed that the conceptual model of the research with chi-square test was 2.96 and RMSEA= 0.066, GFI=0.860 are well fitted. Structure, context, process, accountability, attitude, and empowerment factors directly and indirectly provide good predictors for the quality of care in the family physician program. The most important research findings in the field of quality improvement in the family physician's cares included factors such as developing the attitude and vision of society, providers and policymakers in health subject and health needs, simultaneously corrections in all levels of the referral system, attention and adaptation to the context of society, developing the infrastructures and improving the related processes, systematic appraisal, and accountability and pay attention to the empowerment. CONCLUSION To achieve the quality of care in the family physician program, we need change and development in our attitudes, context, infrastructures and processes, accountability and empowerment systems, and overall modification .
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Affiliation(s)
| | - Ghahraman Mahmoudi
- Health Services Management, Islamic Azad University, Sari Branch, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Epidemiology and Biostatistics, Mazandaran University of Medical Sciences, Sari, Iran
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21
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Mahmoudi G, Asadi Abu Kheili M, Yazdani Charati J. Exploring health-care providers understanding and experiences of providing patient-centered care in hospitalized patients based on patient's bill of rights: A qualitative study. J Nurs Midwifery Sci 2022. [DOI: 10.4103/jnms.jnms_38_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Zazouli MA, Hezarjaribi HZ, Charati JY, Ahmadnezhad A, Mahvi AH, Asgharnia H. Investigating the effects of vermicomposting process using Eisenia Fetida earthworms on the reduction of parasites population. J Environ Health Sci Eng 2021; 19:1623-1633. [PMID: 34900293 DOI: 10.1007/s40201-021-00718-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/28/2021] [Indexed: 12/07/2022]
Abstract
Purpose The existence of parasite agents in natural organic fertilizers can lead to health problems and infection transmission. The aim of the present study was to survey the parasites' population reduction during the vermicomposting of the mixtures of municipal sewage sludge (SS) and cow dung (CD) using E. fetida earthworms. Methods The vermicomposting process was performed by using earthworms of E. fetida species. The composting process was conducted in 27 pilots for 3 months. The identification and counting of the parasites' population were carried out by Mac Master Slide, according to Bailenger method. Results The results indicated that the type and number of parasite elements decreased with increasing vermicomposting time. The cumulative removal percent of parasites for sewage sludge (96.10%) was more than the SS + CD (93.65%) and CD (92.93%) treatments. The results showed that after 90 days of vermicomposting, the highest cumulative reduction in the number of parasites was obtained for the treatments with 40 earthworms (98.48%), while the corresponding value for the treatments without earthworms was (88.66%). The statistical analysis indicated that in terms of the parasite's population, a significant difference was observed for the three kinds of compostable materials (P < 0.05), however, this difference was not significant for the three levels of the earthworms (P > 0.05). Conclusion The results showed that the mixture of sewage sludge and cow dung in combination with sawdust could lead to greater and faster reduction in the parasite's population. In addition, the bio-transformed product can be used as useful manure.
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Affiliation(s)
- Mohammad Ali Zazouli
- Department of Environmental Health Engineering, Faculty of Health, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hajar Ziaei Hezarjaribi
- Department of Parasitology, School of Paramedical, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, School of Public Health, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abbas Ahmadnezhad
- Environmental Health Engineering, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Hossein Mahvi
- Center for Solid Waste Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosseinali Asgharnia
- Department of Environmental Health Engineering, School of Public Health, Babol University of Medical Sciences, Babol, I.R. Iran.,Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran
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Abbaskhanian A, Sheidaee K, Charati JY. Comparison of the effect of continuous intravenous infusion of sodium valproate and midazolam on management of status epilepticus in children. Arch Pediatr 2021; 28:696-701. [PMID: 34706856 DOI: 10.1016/j.arcped.2021.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/09/2021] [Accepted: 09/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Status epilepticus as a pediatric emergency requires rapid seizure control in order to prevent subsequent disabilities. Therefore, the present study was conducted to compare the efficacy and side effects of continuous intravenous infusion of sodium valproate versus midazolam as a third-line treatment of status epilepticus in children. METHODOLOGY This randomized clinical trial study included all children with convulsive and non-convulsive status epilepticus admitted to the pediatric intensive care unit (PICU) of the Bu-Ali Sina Hospital in Sari City (Mazandaran Province, Iran) who had not responded to first-line treatment with diazepam and second-line treatment with phenytoin or phenobarbital. They were consequently treated with continuous intravenous infusion of sodium valproate or midazolam to control persistent seizures. RESULTS The study comprised 70 patients who were randomly assigned to two equal groups of sodium valproate or midazolam treatment. The mean age of patients in group A (sodium valproate) and group B (midazolam) was 3.97 ± 3.33 and 3.84 ± 2.93 years, respectively. In the present study, the most common etiology of status epilepticus was remote symptomatic, accounting for 35% of cases in the two groups. Sodium valproate was effective in controlling status epilepticus in 91.4% of patients, while midazolam was found to be effective in 85.7% of patients (p > 0.05). Patients who received sodium valproate had shorter seizure duration after administration of the drug compared to those who received midazolam (p = 0.01). Eight patients in the midazolam group and two patients in the sodium valproate group were intubated (p = 0.023). The mean duration of stay in the PICU was 3.2 ± 1.4 and 5.6 ± 2.8 days in groups A and B, respectively, showing a significant difference (p = 0.001). CONCLUSION According to our findings, intravenous infusion of sodium valproate can be used as an effective and relatively safe treatment in children with all types of status epilepticus, especially in challenging situations such as lack of intensive care units or respiratory problems.
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Affiliation(s)
- Ali Abbaskhanian
- Department of Pediatric Neurology, Bu-Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kobra Sheidaee
- Department of Pediatric Neurology, Bu-Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Jamshid Yazdani Charati
- Department of Epidemiology and Biostatistics, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
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24
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Bagherzadeh M, Jafari H, Charati JY, Shafipour V. The effect of an empowerment program on the moral sensitivity and caring behaviors of emergency nurses in Iran. Nurse Educ Pract 2021; 57:103243. [PMID: 34717168 DOI: 10.1016/j.nepr.2021.103243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 09/06/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Abstract
AIM The present study aimed to evaluate the effect of an empowerment program on the moral sensitivity and caring behaviors of nurses in emergency departments in Iran. BACKGROUND Emergency department is often a high stress environment. Nurses who worked in the emergency departments are expected to work under pressure to many standards, guidelines and protocols related to patient care. It will expose emergency department nurses to psychological pressures and moral conflicts. A nurse's sensitivity to ethical issues is necessary to provide humane care; it is considered to be a professional competence for nurses. METHODS This study had a controlled quasi-experimental design. Data were collected before, immediately after, and 1 month after the intervention using a moral sensitivity questionnaire and a caring behavior questionnaire. A total of 131 emergency department nurses from 4 teaching hospitals were divided into an intervention group and a control group. The intervention group received six 60-minute training sessions; the control group did not receive the training. RESULTS The mean moral sensitivity and caring behavior scores for both groups increased significantly immediately and 1 month after the intervention. However, the significance was higher in the intervention group than in the control group. A comparison of the mean moral sensitivity and caring behavior scores between the groups immediately and 1 month after the intervention did not show a statistically significant difference. CONCLUSIONS Implementing a training program on ethical issues could thus have a significant impact on the clinical performance of nurses, which could be maintained through follow-up.
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Affiliation(s)
- Mahboubeh Bagherzadeh
- Student Research Committee, Nasibeh Nursing and Midwifery Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hedayat Jafari
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vida Shafipour
- Department of Medical-Surgical Nursing, Nasibeh Nursing and Midwifery Faculty, Mazandaran University of Medical Sciences, Sari, Iran.
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25
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Kalamaki FR, Mahmoudi G, Charati JY. A Model for Organizational Entrepreneurship with Organizational Culture Approach in Iran's Teaching Hospitals. Ethiop J Health Sci 2021; 31:419-428. [PMID: 34158794 PMCID: PMC8188084 DOI: 10.4314/ejhs.v31i2.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background One of the most basic tools and strategies for developing new ideas and entrepreneurship is establishing the entrepreneurial culture in the organization. Thus, the purpose of this study was to examine the effect of organizational culture on entrepreneurship of district 1 teaching hospitals in Iran. Method The study was applied in terms of purpose and descriptive-analytical of survey type in terms of nature that was conducted in 2019 on 946 staff members of district 1 teaching hospitals in Iran using census sampling method. The measurement tools used were standard questionnaires of Margaret Hill Entrepreneurship and Edgar Schein Organizational Culture. Pearson correlation coefficient was used to determine the relationship between organizational culture and organizational entrepreneurship. Partial least squares (PLS) was used for structural equation modeling (SEM) and analyzed in Smart pls2 software. Results The results showed that there is a significant direct relationship between the organizational culture and organizational entrepreneurship (r=0.94). Also, there was a relationship between the internal consistency component with organizational entrepreneurship (r=0.93), between the external compatibility component with organizational entrepreneurship (r=0.90). (p≤0.05). Conclusion The results indicated a positive and significant relationship between organizational culture and its dimensions (internal consistency and external compatibility) with organizational entrepreneurship. Thus, making the decisions that concentrate on the organizational culture of the hospitals and taking steps to coordinate people's values and norms that promote organizational culture and enhance organizational entrepreneurship are recommended.
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Affiliation(s)
| | - Ghahraman Mahmoudi
- Hospital Administration Research Center, Sari Branch, Islamic Azad University, Sari, Iran
| | - Jamshid Yazdani Charati
- Biostatistics department, health science research center, addiction institute, Mazandaran university of medical sciences, sari, Iran
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26
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Karami Salaheddin Kola M, Jafari H, Charati JY, Shafipour V. Comparing the effects of teach-back method, multimedia and blended training on self-care and social support in patients with heart failure: A randomized clinical trial. J Educ Health Promot 2021; 10:248. [PMID: 34485545 PMCID: PMC8395889 DOI: 10.4103/jehp.jehp_1481_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 12/10/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND The knowledge level of caregivers and their support for patients can affect the self-care of patients with heart failure (HF). The present study was conducted to compare the effects of teach-back, multimedia, and blended training methods on self-care and social support in patients with HF and on knowledge in their caregivers. MATERIALS AND METHODS In a randomized clinical trial, a total of 150 HF patient-caregiver dyads were randomly allocated into three equally sized training groups, using a simple number table (n = 50). The study was conducted between May to October 2018 in Sari, northern Iran. In the teach-back, multimedia and blended training groups, patient-caregiver dyads participated in 20-30-min training sessions held face-to-face, using digital video disc (DVD) and combination of teach-back and DVD on 4 consecutive days at the bedside of hospitalized patients in coronary care unit, respectively. Data were collected using the European Heart Failure Self-Care Behaviour Scale and the multidimensional scale of perceived social support for patients. Caregivers' level of knowledge was measured using the HF Knowledge Scale. Data were measured on the first day of hospitalization, 1 day before discharge and 4 and 8 weeks after patients' discharge. Data were analyzed using SPSS version 18 (SPSS Inc., Chicago, IL, USA). RESULTS All three educational methods improved self-care behaviors in patients. The comparison of self-care behavior scores in patients with HF among the three groups at different time points showed no statistically significant differences (P > 0.05), except 1 day before discharge (P = 0.04). There were no statistically-significant differences between the teach-back, multimedia and the blended training group in terms of perceived social support at any of the four-time points (P > 0.05). All three training methods improved the level of knowledge of caregivers. However, the score in the blended training groups was higher than the other groups (P < 0.001). CONCLUSION According to the results of the present study, it seems that all three educational interventions can improve self-care behaviors in HF patients and increase knowledge in their caregivers. However, using the blended training method was associated with better outcomes.
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Affiliation(s)
| | - Hedayat Jafari
- Traditional and Complementary Medicine Research Center, Addiction Institute Mazandaran University of Medical Science, Sari, Iran
| | - Jamshid Yazdani Charati
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Science, Sari, Iran
| | - Vida Shafipour
- Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Rouhani S, Esmaeili R, Yazdani Charati J, Khandehroo M. The impacts of family physician plan and health transformation plan on hospitalization rates in Iran: an interrupted time series. BMC Health Serv Res 2021; 21:658. [PMID: 34225708 PMCID: PMC8259001 DOI: 10.1186/s12913-021-06685-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low and middle income countries has recently implemented various reforms toward Universal Health Coverage (UHC). This study aims to assess the impact of Family Physician Plan (FPP) and Health Transformation Plan (HTP) on hospitalization rate in Iran. METHODS We conducted an Interrupted Time Series (ITS) design. The data was monthly hospitalization of Mazandaran province over a period of 7 years. Segmented regression analysis was applied in R version 3.6.1. RESULTS A decreasing trend by - 0.056 for every month was found after implementation of Family Physician Plan, but this was not significant. Significant level change was appeared at the beginning of Health Transformation Plan and average of hospitalization rate increased by 1.04 (P < 0.001). Also hospitalization trend increased significantly nearly 0.09 every month in period after Health Transformation Plan (P < 0.001). CONCLUSIONS Family physician created a decreasing trend for hospitalization in urban area of Mazandaran province in Iran. HTP with lower user fee in governmental public hospitals and clinics as well as fee-for-service mechanisms, stimulated both level and trend changes in hospital admissions. Some integrated health policy is required to optimize the implementation of diverse simultaneous reforms in low and middle-income countries.
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Affiliation(s)
- Samad Rouhani
- Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Esmaeili
- Department of Public Health, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Khandehroo
- Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran.
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Ghazanfari M, Arastehfar A, Davoodi L, Yazdani Charati J, Moazeni M, Abastabar M, Haghani I, Mirzakhani R, Mayahi S, Fang W, Liao W, Nguyen MH, Perlin DS, Hoenigl M, Pan W, Hedayati MT. Pervasive but Neglected: A Perspective on COVID-19-Associated Pulmonary Mold Infections Among Mechanically Ventilated COVID-19 Patients. Front Med (Lausanne) 2021; 8:649675. [PMID: 34195207 PMCID: PMC8236642 DOI: 10.3389/fmed.2021.649675] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Recent studies from multiple countries have shown a high prevalence of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) among severely ill patients. Despite providing valuable insight into the clinical management of CAPA, large-scale prospective studies are limited. Here, we report on one of the largest multicenter epidemiological studies to explore the clinical features and prevalence of COVID-19-associated pulmonary mold infections (CAPMIs) among mechanically ventilated patients. Methods: Bronchoalveolar lavage (BAL) and serum samples were collected for culture, galactomannan (GM), and β-D-glucan (BDG) testing. Patients were classified as probable CAPMI based on the presence of host factors, radiological findings, and mycological criteria. Results: During the study period, 302 COVID-19 patients were admitted to intensive care units (ICUs), among whom 105 were mechanically ventilated for ≥4 days. Probable CAPMI was observed among 38% of patients (40/105), among whom BAL culture of 29 patients turned positive for molds, while galactomannan testing on BAL (GM index ≥1) and serum (GM index >0.5) samples were positive for 60% (24/40) and 37.5% (15/39) of patients, respectively. Aspergillus (22/29; 75.8%) and Fusarium (6/29; 20.6%) constituted 96.5% of the molds isolated. Diaporthe foeniculina was isolated from a COVID-19 patient. None of the patients who presented with CAPMI were treated with antifungal drugs. Conclusion: Despite being prevalent, the absence of appropriate antifungal treatment highlights that CAPMI is a neglected complication among mechanically ventilated COVID-19 patients admitted to ICUs. CAPMI can be caused by species other than Aspergillus.
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Affiliation(s)
- Mona Ghazanfari
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Arastehfar
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States
| | - Lotfollah Davoodi
- Antimicrobial Resistance Research Center/Department of Infectious Diseases, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Moazeni
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roghayeh Mirzakhani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sabah Mayahi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Wenjie Fang
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wanqing Liao
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - M Hong Nguyen
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - David S Perlin
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States
| | - Martin Hoenigl
- Clinical and Translational Fungal-Working Group, University of California, San Diego, La Jolla, CA, United States.,Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, San Diego, CA, United States
| | - Weihua Pan
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Mohammad T Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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29
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Ghazanfari M, Arastehfar A, Davoodi L, Yazdani Charati J, Moazeni M, Abastabar M, Haghani I, Mirzakhani R, Mayahi S, Fang W, Liao W, Nguyen MH, Perlin DS, Hoenigl M, Pan W, Hedayati MT. Pervasive but Neglected: A Perspective on COVID-19-Associated Pulmonary Mold Infections Among Mechanically Ventilated COVID-19 Patients. Front Med (Lausanne) 2021; 8:649675. [PMID: 34195207 PMCID: PMC8236642 DOI: 10.3389/fmed.2021.649675; doi: 10.3389/fmed.2021.649675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/03/2021] [Indexed: 09/17/2023] Open
Abstract
Background: Recent studies from multiple countries have shown a high prevalence of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) among severely ill patients. Despite providing valuable insight into the clinical management of CAPA, large-scale prospective studies are limited. Here, we report on one of the largest multicenter epidemiological studies to explore the clinical features and prevalence of COVID-19-associated pulmonary mold infections (CAPMIs) among mechanically ventilated patients. Methods: Bronchoalveolar lavage (BAL) and serum samples were collected for culture, galactomannan (GM), and β-D-glucan (BDG) testing. Patients were classified as probable CAPMI based on the presence of host factors, radiological findings, and mycological criteria. Results: During the study period, 302 COVID-19 patients were admitted to intensive care units (ICUs), among whom 105 were mechanically ventilated for ≥4 days. Probable CAPMI was observed among 38% of patients (40/105), among whom BAL culture of 29 patients turned positive for molds, while galactomannan testing on BAL (GM index ≥1) and serum (GM index >0.5) samples were positive for 60% (24/40) and 37.5% (15/39) of patients, respectively. Aspergillus (22/29; 75.8%) and Fusarium (6/29; 20.6%) constituted 96.5% of the molds isolated. Diaporthe foeniculina was isolated from a COVID-19 patient. None of the patients who presented with CAPMI were treated with antifungal drugs. Conclusion: Despite being prevalent, the absence of appropriate antifungal treatment highlights that CAPMI is a neglected complication among mechanically ventilated COVID-19 patients admitted to ICUs. CAPMI can be caused by species other than Aspergillus.
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Affiliation(s)
- Mona Ghazanfari
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Arastehfar
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States
| | - Lotfollah Davoodi
- Antimicrobial Resistance Research Center/Department of Infectious Diseases, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Moazeni
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roghayeh Mirzakhani
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sabah Mayahi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Wenjie Fang
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wanqing Liao
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - M. Hong Nguyen
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - David S. Perlin
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, United States
| | - Martin Hoenigl
- Clinical and Translational Fungal-Working Group, University of California, San Diego, La Jolla, CA, United States
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, San Diego, CA, United States
| | - Weihua Pan
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Mohammad T. Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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30
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Esmaeili R, Rouhani S, Yazdani Charati J, Khandehroo M. Change in health spending after implementation of a health transformation plan in Iran: an interrupted time series analysis. Cost Eff Resour Alloc 2021; 19:32. [PMID: 34082756 PMCID: PMC8173793 DOI: 10.1186/s12962-021-00286-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/22/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Health transformation plan (HTP) implemented in Iran since 2014 to improve accessibility and financial protection of patients. This study aimed to assess the impact of HTP on health spending in Iran. METHODS This was a quasi-experimental design using Interrupted Time Series. All registered impatient records in Iran health insurance organization (IHIO) for the population of Mazandaran province (1,628,919 population in 2011), north of Iran from March 2010 to February 2019 were included. Data for three depended variables: hospitalization rate, average inpatient cost and inpatient expenditure per capita was extracted in 96 monthly observations. Segmented regression analysis was done in R version 3.6.1. RESULTS Hospitalization rate in 2010 was 6.6 in 1000 people and its level change was 0/799 immediately after HTP (P < 001). Post-reform level and trend changes for monthly average inpatient cost of registered admissions in IHIO were also significant (P < 001). IHIO inpatient expenditure per capita for 1,628,919 population in Mazandaran province was 24,436 Rials in 2011 and increased significantly immediately following HTP as 34,459 Rials (P < 001). CONCLUSIONS Three important components of health spending including hospitalization rate, average inpatient cost and inpatient expenditure per capita were increased dramatically after HTP. Cost containment strategies and strengthening the preventive care initiatives is required to control the escalating trends of inpatient expenditure in Iran.
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Affiliation(s)
- Reza Esmaeili
- Department of Public Health, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Samad Rouhani
- Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Khandehroo
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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31
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Fakhar M, Ghaffari J, Dabbaghzadeh A, Charati JY, Ghaffari B, Esboei BR. Prevalence of Intestinal Parasites among Patients with Chronic Urticaria in Northern Iran. Infect Disord Drug Targets 2021; 21:130-133. [PMID: 32342822 DOI: 10.2174/1871526520666200428095729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 12/15/2019] [Accepted: 03/14/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Chronic urticaria (CU) has a range of clinical demonstrations and causes. Parasitic infections are mentioned as one of the main causes of the CU. OBJECTIVES The aim of this study was to investigate the prevalence of intestinal parasites in patients with CU (with duration time of more than 6 weeks) compared healthy subjects. METHODS A total of 169 cases and 210 controls were included in this study. Ages ranged from 1 to 77 years old. Three samples were gathered from each patients and direct wet mount, formol-ether concentration, Ziehl-Neelsen and trichrome staining were used. RESULTS Out of the 379 individuals examined here, 208 were from urban areas and 171 from rural areas. Three stool samples were taken from each patient in three consecutive days. Based on parasitological tests, 7 (4.1%) cases from 169 patients with CU and 6 (2.9%) cases from 210 non- CU group individuals were positive for intestinal parasites. CONCLUSION The prevalence of various parasites between case and control groups was not significant.
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Affiliation(s)
- Mahdi Fakhar
- Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Mazandaran University of Medical Sciences, Sari, Iran
| | - Javad Ghaffari
- Pediatric Infectious Diseases Research Center, Mazandaran University of medical sciences, Sari, Iran
| | - Abbas Dabbaghzadeh
- Pediatric Infectious Diseases Research Center, Mazandaran University of medical sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Bahman Ghaffari
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Bahman Rahimi Esboei
- Department of Parasitology and Mycology, Tonekabon Branch, Faculty of Medicine, Islamic Azad University, Tonekabon, Iran
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Zakeri S, Shafipour V, Yazdani Charati J, Ghasemi Charati F, Jafari H. Investigating the effect of seeing patients' pre-burn face photo on the quality of care and level of empathy of nurses with patients admitted to BICU. Burns 2021; 47:1906-1911. [PMID: 33536121 DOI: 10.1016/j.burns.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/11/2020] [Accepted: 01/06/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND One of the results of burn injuries is the appearance of scars and deformities in various organs of the body, which can cause many physical and psychological challenges to burn patients. Lack of proper communication between nurse and patient leads to inaccurate identification of psychological and social needs of these patients and thus affects the quality of care. AIM This study aimed to investigate the effect of seeing the patient's pre-burn face photo on the quality of care and empathy of nurses with patients admitted to the burn intensive care unit. METHODS The present study is a quasi-experimental interventional study conducted on 26 Burn Intensive Care Unit (BICU) nurses who were selected by census sampling method in 2018. Data were collected through QUALPAC Nursing Care Quality Questionnaire, Lumonica Empathy Questionnaire and Demographic Questionnaire, which were completed by nurses before and after the intervention. Pre-burn photos of patients with facial burns were displayed at the nursing station for one month and the data were compared before and after the intervention. Descriptive statistics and paired t-test and independent t-test, Mann-Whitney and Pearson correlation tests were used to analyze the data. FINDINGS The results of present study showed that there was a statistically significant difference between the quality of nursing care (p = 0.001) and its psychological dimension (p < 0.001) before and after the intervention in the group of nurses. However, no significant relationship was found between nurses' empathy with patients before (p = 0.901) and after intervention (p = 0.001). CONCLUSION Seeing the photo of the patient's pre-burn face and establishing a relationship between the nurse and the patient had an effect on the quality of nursing care and especially its psychological dimension. However, in order to generalize the results and implement this low-cost, convenient and low-complication intervention for all patients admitted to the intensive care unit, more studies are needed in this field.
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Affiliation(s)
- Sahar Zakeri
- Nasibeh Faculty of Nursing and Midwifery, Sari, Iran
| | - Vida Shafipour
- Nasibeh Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics and Epidemiology, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fahimeh Ghasemi Charati
- Department of Medical Surgical Nursing, Nasibeh Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hedayat Jafari
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
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Arab-Nozari M, Shokrzadeh M, Zamehran N, Yazdani Charati J, Nahvi A. Trimming and pH Effects on Nickel Ion Release from Stainless Trimming and pH Effects on Nickel Ion Release from Stainless Steel Crowns of Primary Teeth Steel Crowns of. J Dent Indones 2020. [DOI: 10.14693/jdi.v27i3.1135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: Stainless steel crowns (SSCs) are preformed metal crowns used to restore severely decayed primary teeth. The aim of this study is to evaluate the effects of pH changes and SSC margin trimming on nickel release in artificial saliva solution. Methods: A total of 90 SSCs were divided into three groups and placed in 35 ml of artificial saliva of pH 6.8, 5, and 3.5. Another group consisting 30 SSCs with trimmed margins was placed in saliva of pH 6.8. All SSCs were incubated at 37°C. The concentration of released nickel was assessed on days 1, 7, 14, 21, and 28 by atomic absorption spectrophotometry. Results: The highest concentrations of nickel were released on the first day in all groups. Nickel release increased with decreasing pH, and the differences observed were statistically significant on days 1, 7, 14, and 28. SSC trimming caused a significant increase in nickel release on all days except day 21. Conclusion: The concentration of nickel increased in saliva of low pH. The highest levels of nickel were released with SSC margin trimming because of the loss of integrity of the margins.
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Nazar E, Baghishani H, Doosti H, Ghavami V, Aryan E, Nasehi M, Sharafi S, Esmaily H, Yazdani Charati J. Bayesian Spatial Survival Analysis of Duration to Cure among New Smear-Positive Pulmonary Tuberculosis (PTB) Patients in Iran, during 2011-2018. Int J Environ Res Public Health 2020; 18:ijerph18010054. [PMID: 33374751 PMCID: PMC7794786 DOI: 10.3390/ijerph18010054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 12/01/2022]
Abstract
Mycobacterium tuberculosis is the causative agent of tuberculosis (TB), and pulmonary TB is the most prevalent form of the disease worldwide. One of the most concrete actions to ensure an effective TB control program is monitoring TB treatment outcomes, particularly duration to cure; but, there is no strong evidence in this respect. Thus, the primary aim of this study was to examine the possible spatial variations of duration to cure and its associated factors in Iran using the Bayesian spatial survival model. All new smear-positive PTB patients have diagnosed from March 2011 to March 2018 were included in the study. Out of 34,744 patients, 27,752 (79.90%) patients cured and 6992 (20.10%) cases were censored. For inferential purposes, the Markov chain Monte Carlo algorithms are applied in a Bayesian framework. According to the Bayesian estimates of the regression parameters in the proposed model, a Bayesian spatial log-logistic model, the variables gender (male vs. female, TR = 1.09), altitude (>750 m vs. ≤750 m, TR = 1.05), bacilli density in initial smear (3+ and 2+ vs. 1–9 Basil & 1+, TR = 1.09 and TR = 1.02, respectively), delayed diagnosis (>3 months vs. <1 month, TR = 1.02), nationality (Iranian vs. other, TR = 1.02), and location (urban vs. rural, TR = 1.02) had a significant influence on prolonging the duration to cure. Indeed, pretreatment weight (TR = 0.99) was substantially associated with shorter duration to cure. In summary, the spatial log-logistic model with convolution prior represented a better performance to analyze the duration to cure of PTB patients. Also, our results provide valuable information on critical determinants of duration to cure. Prolonged duration to cure was observed in provinces with low TB incidence and high average altitude as well. Accordingly, it is essential to pay a special attention to such provinces and monitor them carefully to reduce the duration to cure while maintaining a focus on high-risk provinces in terms of TB prevalence.
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Affiliation(s)
- Eisa Nazar
- Department of Biostatistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad 913767-3119, Iran;
| | - Hossein Baghishani
- Department of Statistics, Faculty of Mathematical Sciences, Shahrood University of Technology, Shahrood 316-3619995161, Iran;
| | - Hassan Doosti
- Department of Mathematics and Statistics, Macquarie University, Sydney, NSW 2109, Australia;
| | - Vahid Ghavami
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad 913767-3119, Iran;
| | - Ehsan Aryan
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad 917669-9199, Iran;
| | - Mahshid Nasehi
- Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran 141994-3471, Iran; (M.N.); (S.S.)
| | - Saeid Sharafi
- Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran 141994-3471, Iran; (M.N.); (S.S.)
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad 913767-3119, Iran;
- Correspondence: (H.E.); (J.Y.C.)
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari 484711-6548, Iran
- Correspondence: (H.E.); (J.Y.C.)
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Mortezaee V, Mahdaviani SA, Pourabdollah M, Hassanzad M, Mirenayat MS, Mehrian P, Behnampour N, Yazdani Charati J, Peirovi Z, Sharifynia S, Seyedmousavi S, Hedayati MT. Diagnosis of allergic bronchopulmonary aspergillosis in patients with persistent allergic asthma using three different diagnostic algorithms. Mycoses 2020; 64:272-281. [PMID: 33219548 DOI: 10.1111/myc.13217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Allergic bronchopulmonary aspergillosis (ABPA) has been reported in various degrees among patients with persistent allergic asthma (PAA). Currently, there is no gold standard approach for diagnosis of ABPA. OBJECTIVES In the current study, we aimed the evaluation of three different mainly used algorithms as Rosenberg & Patterson (A), ISHAM Working Group (B) and Greenberger (C) for diagnosis of ABPA in 200 patients with underlying PAA. METHODS All patients were evaluated using Aspergillus skin prick test (SPTAf), Aspergillus-specific IgE (sIgEAf) and IgG (sIgGAf), total IgE (tIgE), pulmonary function tests, radiological findings and peripheral blood eosinophil count. The prevalence rate of ABPA in PAA patients was estimated by three diagnostic criteria. We used Latent Class Analysis for the evaluation of different diagnostic parameters in different applied ABPA diagnostic algorithms. RESULTS Aspergillus sensitisation was observed in 30 (15.0%) patients. According to algorithms A, B and C, nine (4.5%), six (3.0%) and 11 (5.5%) of patients were diagnosed with ABPA, respectively. The sensitivity and specificity of criteria B and C were (55.6% and 99.5%) and (100.0% and 98.9%) respectively. sIgEAf and sIgGAf showed the high significant sensitivity. The performance of algorithm A, in terms of sensitivity and specificity, was somewhat better than algorithm B. CONCLUSION Our study demonstrated that the sensitivity of different diagnostic algorithms could change the prevalence rate of ABPA. We also found that all of three criteria resulted an adequate specificity for ABPA diagnosis. A consensus patterns combining elements of all three criteria may warrant a better diagnostic algorithm.
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Affiliation(s)
- Vida Mortezaee
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Alireza Mahdaviani
- Paediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Mihan Pourabdollah
- Paediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Hassanzad
- Paediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Sadat Mirenayat
- Lung Transplantation Research Center (LTRC), National Research Institute of Tuberculosis and Lung Diseases (NIRTLD), Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Payam Mehrian
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Naser Behnampour
- Department of Biostatistics, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Peirovi
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Sharifynia
- Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedmojtaba Seyedmousavi
- Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA.,Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad T Hedayati
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Vakili M, Aliyali M, Mortezaee V, Mahdaviani SA, Poorabdollah M, Mirenayat MS, Fakharian A, Hassanzad M, Abastabar M, Yazdani Charati J, Haghani I, Tavakoli M, Maleki M, Armstrong-James D, Hedayati MT. Relationship between spirometry results and colonisation of Aspergillus species in allergic asthma. Clin Respir J 2020; 14:748-757. [PMID: 32216055 DOI: 10.1111/crj.13192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 01/21/2020] [Accepted: 03/17/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND OBJECTIVES Exposure to fungi in patients with asthma leads to the release of various fungal antigens, which can increase the severity of asthma. Regarding this, the present study was conducted to evaluate the relationship between the colonisation of Aspergillus species and spirometry results in allergic asthma. MATERIALS AND METHODS Two hundred sixteen patients with mild to severe asthma and 30 healthy controls were included. All participants underwent pulmonary function tests. Furthermore, sputum samples were collected from each subject. Each sputum sample was subjected to direct microscopic examination and fungal culture. All cultured Aspergillus colonies were identified at species level by molecular methods. Finally, all available data from sputum culture and spirometry test were analysed. RESULTS Out of 216 sputum samples, 145 (67.1%) were positive for fungal growth. Furthermore, out of 264 grown fungal colonies, 137 (51.9%) were Aspergillus species. Among the Aspergillus isolates, A. flavus (29.2%) was the most prevalent species, followed by A. fumigatus (27.7%). The mean forced expiratory volume in one second (FEV1) in the mild, moderate and severe asthmatic patients with a positive sputum culture for fungi were obtained as 90.0 ± 11.1, 71.1 ± 15.9 and 54.9 ± 16.4, respectively. In general, Aspergillus species colonisation had no statistically significant effect on spirometry results of study patients. CONCLUSION Our results showed that there is no difference in the FEV1 and forced vital capacity between Aspergillus positive and negative patients in any asthma severity group.
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Affiliation(s)
- Mahshid Vakili
- Student Research Committee, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Aliyali
- Pulmonary and Critical Care Division, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vida Mortezaee
- Student Research Committee, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Alireza Mahdaviani
- Paediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mihan Poorabdollah
- Paediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Sadat Mirenayat
- Lung Transplantation Research Center (LTRC), National Research Institute of Tuberculosis and Lung Diseases (NIRTLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atefeh Fakharian
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Hassanzad
- Paediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Abastabar
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Statistic, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahin Tavakoli
- Student Research Committee, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maedeh Maleki
- Student Research Committee, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Darius Armstrong-James
- Fungal Pathogens Laboratory, National Heart and Lung Institute, Imperial College London, London, UK
| | - Mohammad T Hedayati
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Nazar E, Yazdani Charati J, Pazoki H, Saki A, Fakhar M, Boroumand F, Rasooli SA. Modelling the number of dermal lesions in anthroponotic cutaneous leishmaniasis and its associated factors in Herat province, western Afghanistan, during 2012-2013. Transbound Emerg Dis 2020; 67:2692-2701. [PMID: 32403184 DOI: 10.1111/tbed.13623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 11/28/2022]
Abstract
Cutaneous leishmaniasis (CL), caused by Leishmania tropica, is the main causative agent of CL in the Herat province, western Afghanistan. In CL patients, one of the most important indicators for reducing the amount of body damage and the choice of treatment is the number of dermal lesions, but there is no strong evidence in this regard. Therefore, using count regression models, the main objective of this historical cohort study was to identify the distribution of the number of dermal lesions and determine the associated factors among CL patients referring to leishmaniasis reference laboratory in Herat province, from January 2012 to December 2013. In a total of 4,127 clinically suspected CL cases, 50.20% were female and 49.80% male. Based on the results of ZINB model, which is the best model suggested by goodness-of-fit criteria, age variables (IRR = 1.007), duration of lesion (6-12 weeks compared to < 6 weeks with IRR = 1.36 and >12 weeks with IRR = 1.39 compared to <6 weeks), type of lesion(both nodule and ulcer compared to papule with IRR = 2.03), location of lesion (trunk with IRR = 1.90, upper with IRR = 1.66, lower with IRR = 1.61 and mix with IRR = 10.35 compared to head/neck/ears) and type of lesion (ulcer compared to papule with IRR = 0.50, nodule and lupoid, respectively, as IRR = 0.72 and IRR = 0.51 compared to papule) had a significant effect on the mean number of dermal lesions (p < .05). Also, our results showed that among four models used, the ZINB model represented a better performance to determine the associated probable factors about the number of dermal lesions in ACL patients. Moreover, there was a direct association between age and number of dermal lesions; in addition, duration of lesion, type of lesion and location of lesion had a significant effect on the number of dermal lesions. Therefore, a comprehensive planning is necessary for controlling and reducing the number of dermal lesions.
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Affiliation(s)
- Eisa Nazar
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Pazoki
- Student Research Committee, Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Saki
- Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.,Social Determinants of Health Research Centre, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Fakhar
- Department of Parasitology, School of Medicine, Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farzaneh Boroumand
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sayed Abobakar Rasooli
- National Health Coordinator (NHC) and Head of Herat WHO Sub-office, Herat Province, Afghanistan
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Gheisari M, Basharzad N, Yazdani Charati J, Mirenayat MS, Pourabdollah M, Ansari S, Mortezaee V, Abastabar M, Jafarzadeh J, Haghani I, Hedayati MT. Galactomannan detection in bronchoalveolar lavage fluids: A diagnostic approach for fungus ball in patients with pulmonary tuberculosis? Mycoses 2020; 63:755-761. [PMID: 32385921 DOI: 10.1111/myc.13099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/30/2020] [Accepted: 05/02/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Several previous studies have shown cavitary lung lesions in old pulmonary tuberculosis (PTB) increase the risk of fungus ball. Detection of galactomannan (GM) in bronchoalveolar lavage (BAL) is also proposed as a diagnostic approach for the fungus ball. OBJECTIVES We evaluated the diagnosis of fungus balls and GM levels in BAL samples in PTB patients. METHODS A total of 110 PTB patients were evaluated for fungus ball during 2017-2019. The patients were evaluated for radiological, histopathological results and mycological findings of BAL including GM detection and culture. The sensitivity, specificity and positive and negative predictive value for GM test were calculated. The optimal cut-off for BAL GM testing was determined by receiver operating characteristic (ROC). RESULTS Of 110 PTB patients, nine (8.18%) showed fungus ball, all with old PTB. The molecularly confirmed Aspergillus species were A. flavus, A. fumigatus and A. ochraceus. The sensitivity and specificity of BAL GM ≥ 0.5 in old PTB patients with fungus ball were 100%, 41.5%, respectively. The statistical analysis of the mean ± SEM of BAL GM levels was demonstrated a higher levels of GM in patients with fungus ball/aspergilloma compared to old PTB patients without fungus ball/aspergilloma. The optimal cut-off value for BAL GM was determined as 0.50 by ROC curve analysis. CONCLUSION According to our results, we can recommend the detection of GM in BAL samples as a diagnostic approach for fungus ball in PTB patients.
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Affiliation(s)
- Maryam Gheisari
- Invasive Fungi Research Center/Department of Medical mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Niloofar Basharzad
- Department of Pulmonology and Intensive Care, Labbafinejad Hospital, Shaheed Beheshti University of Medical Science, Tehran, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Sadat Mirenayat
- Lung Transplantation Research Center (LTRC), National Research Institute of Tuberculosis and Lung Diseases (NIRTLD), Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Mihan Pourabdollah
- Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Saham Ansari
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vida Mortezaee
- Invasive Fungi Research Center/Department of Medical mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Abastabar
- Invasive Fungi Research Center/Department of Medical mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jalal Jafarzadeh
- Invasive Fungi Research Center/Department of Medical mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Haghani
- Invasive Fungi Research Center/Department of Medical mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad T Hedayati
- Invasive Fungi Research Center/Department of Medical mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Taherian T, Shorofi SA, Zeydi AE, Charati JY, Pouresmail Z, Jafari H. The effects of Hegu point ice massage on post-sternotomy pain in patients undergoing coronary artery bypass grafting: A single–blind, randomized, clinical trial. Advances in Integrative Medicine 2020. [DOI: 10.1016/j.aimed.2019.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ahmadi M, Mortezapour A, Kalteh HO, Emadi A, Charati JY, Etemadinezhad S. Comprehensibility of pharmaceutical pictograms: Effect of prospective-user factors and cognitive sign design features. Res Social Adm Pharm 2020; 17:356-361. [PMID: 32307318 DOI: 10.1016/j.sapharm.2020.03.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/27/2020] [Accepted: 03/28/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The people's comprehensibility regarding the meaning of internationally recommended pictograms is an important factor in the correct usage of medications. OBJECTIVE To investigate the relationship between the guessability of the pharmaceutical pictograms, the cognitive sign features, and prospective-user factors. METHODS A total of 351 Iranian people participated in this study. Two questionnaires were used to measure guessability and cognitive design features regarding the pharmaceutical pictograms. A single-sheet questionnaire was also developed to collect demographic data. RESULTS According to the 67% correctness criterion suggested by ISO 3864:P3, 18 pictograms were understandable by the participants. Moreover, of the five cognitive features, "semantic closeness" and "meaningfulness" had the most correlation with the guessability score. In terms of personal factors, understanding of the pictograms' meaning was negatively correlated with age, while it had no association with the occupation. CONCLUSIONS Some pharmaceutical pictograms developed by reliable international organizations can be used in a community only after redesigning and testing among the prospective users. The findings indicated that some pharmaceutical pictograms were not comprehensible for most participants. It is therefore expected that using a combination of pictograms with written messages and training could help in conveying the messages by pharmaceutical pictograms.
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Affiliation(s)
- Mojtaba Ahmadi
- Department of Occupational Health Engineering, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Mortezapour
- Department of Ergonomics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Haji Omid Kalteh
- Department of Occupational Health Engineering, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Atieh Emadi
- Department of Occupational Health Engineering, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavash Etemadinezhad
- Department of Occupational Health Engineering, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran.
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Abdollahi F, Yazdani Charati J, Lye MS. Midwives' perceptions of Complementary and Alternative Medicines' during pregnancy. Complement Ther Med 2020; 49:102323. [PMID: 32147049 DOI: 10.1016/j.ctim.2020.102323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 01/19/2020] [Accepted: 01/20/2020] [Indexed: 11/30/2022] Open
Abstract
Using Complementary and Alternative Medicine (CAMs) is growing worldwide. This study determined the midwives' attitude toward CAMs in general and their view on its safety and efficacy during pregnancy. Via a random sampling method, 344 midwives working in Mazandaran primary health centers (PHC) were recruited from March to November 2017. The data were analyzed using descriptive statistics. The majority of the midwives had positive view on the usefulness of CAMs in general (74.3 %) and thought they should have more knowledge about it (76.7 %). While 50-83 % of the midwives considered some CAM-therapies safe and beneficial, a small number of them referred the patients for CAM-therapy during pregnancy (1.2-5.4 %). A minority of the midwives stated that CAM may be a threat to public health (12.7 %). The midwives' perception toward the usefulness of CAM in general was positive; although, they approved the benefit of few CAMs during pregnancy. A small minority of the midwives considered CAMs as a threat to public health, and few of them advised the patients to use CAMs during pregnancy. As most midwives are interested in learning in this field, it is recommended to run some training programs on the benefit and side effects of CAMs.
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Affiliation(s)
- Fatemeh Abdollahi
- Department of Public Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran; Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Jamshid Yazdani Charati
- Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran; Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Science, Sari, Iran.
| | - Munn-Sann Lye
- Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia.
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Alipour N, Sheikhi M, Yazdani Charati J, Mohsenipouya H, Shabankhani B, Rezaii MS. Total delay and associated factors in pulmonary tuberculosis patients in Golestan province. Caspian J Intern Med 2020; 11:67-74. [PMID: 32042389 PMCID: PMC6992724 DOI: 10.22088/cjim.11.1.67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Background Delay in diagnosis and treatment of TB is a critical component in TB control program which thereby spreading illness in the community. Sicnce Golestan province has the high risk with high rates of tuberculosis in the country, therefore, the analysis of the factors associated with treatment delay in this province for effective interventions and proper planning is considered necessary. Methods 689 patients documents of TB cases in the health department of Golestan University of Medical Sciences in 2016 were enrolled in this survey. The response variable in this study was having the delay or not (via determining the 34 day as cut-off point in the interval between the date of onset of the symptoms and the date of treatment start-up). The data were analyzed using SPSS 24 software and final significant level for multivariate logistic regression model was considered 0.05. Results Median (mean) treatment delay was calculated 49(77.75) days. In the current study 60.4% of patients had total delay greater than 34 days. In final model variables such as type of PTB (OR=0.645), contact history (patients who had no contact with TB patients (OR=1.441)) and patients who their contact history were unknown (OR=1.654)) had significant relationship with delay in starting treatment after 34 days of onset of symptoms of PTB patients in Golestan (p<0.05). Conclusion It should beam emphasis on increasing the community's awareness of the symptoms of tuberculosis and effective collaboration should be made between the Infectious Disease Control Center and the private and public sectors.
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Affiliation(s)
- Nadia Alipour
- Student Research Committee, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Jamshid Yazdani Charati
- Department of Biostatistics, Faculty of Health, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Bizhan Shabankhani
- Research center for Hospital Infections, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Sadegh Rezaii
- Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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Rahimi E, Yazdani Charati J, Mohammad pour Tahamtan R, Maleki I. Evaluation of demographic, pathologic, and clinical characteristics and overall survival of patients with colon cancer in Northern Iran (Mazandaran Province) during 2012-2019. Gastroenterol Hepatol Bed Bench 2020; 13:209-218. [PMID: 32821350 PMCID: PMC7417496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/19/2020] [Indexed: 11/20/2022]
Abstract
AIM The present study aimed at evaluating the demographic, pathological and clinical characteristics of patients with colon cancer and also the survival rate and its related factors. BACKGROUND Cancer is the most important barrier to increasing life expectancy in the world. Furthermore, colon cancer is the fourth leading cause of cancer in Iran. METHODS In this descriptive-analytical study, 219 patients with colon cancer were investigated. Data were analyzed through descriptive and univariate methods using R software. Kaplan-Meier survival analysis and log-rank test were used to evaluate the survival rate of the patients. RESULTS In the present study, 25% of patients were below 50 years of age. A family history of cancer was positive in 30% of the patients. According to the clinical symptoms of the patients, rectorrhagia was higher in patients with sigmoid tumor site, abdominal pain was higher in patients with transverse and ascending tumor sites, and anemia was higher in patients with ascending and caecum tumor sites (p< 0.05). The mean life expectancy of the patients was 53.71±2.07 months. Three-year, five-year and seven-year survival rates were 70, 49, and 37 %, respectively. CONCLUSION Half of the patients were diagnosed at advanced stage and the mean survival time at advanced stage was approximately four years. One-third of the patients had local recurrence. It is recommended that patients refer to specialists at specified time intervals for timely diagnosis of the disease and prevention of its recurrence. Providing effective training for people in order for them to acquire more knowledge, and performing screening tests will lead to early diagnosis and lower mortality.
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Affiliation(s)
- Elahe Rahimi
- Student Research Committee, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Professor of Biostatistics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Rezaaali Mohammad pour Tahamtan
- Asociate professor of Biostatistics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iradj Maleki
- Associate professor ,Gut and Liver Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Tavakoli M, Rivero-Menendez O, Abastabar M, Hedayati MT, Sabino R, Siopi M, Zarrinfar H, Nouripour-Sisakht S, van der Lee H, Valadan R, Meletiadis J, Yazdani Charati J, Seyedmousavi S, Alastruey-Izquierdo A. Genetic diversity and antifungal susceptibility patterns of Aspergillus nidulans complex obtained from clinical and environmental sources. Mycoses 2019; 63:78-88. [PMID: 31609022 DOI: 10.1111/myc.13019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/05/2019] [Accepted: 10/08/2019] [Indexed: 11/27/2022]
Abstract
The molecular epidemiology and antifungal susceptibility of Aspergillus nidulans species complex has not been well studied. To evaluate the genetic diversity and antifungal susceptibility patterns of clinical and environmental isolates of A. nidulans complex. Sixty clinical and environmental isolates of Aspergillus section Nidulantes were collected from five countries (Iran, The Netherlands, Spain, Portugal and Greece). The species were molecularly identified by sequencing of β-tubulin gene. The genetic diversity of A nidulans complex isolates (n = 54) was determined with a microsatellite genotyping assay. Antifungal susceptibility profile was determined using EUCAST method. The isolates were classified as A nidulans (46.7%), A spinulosporus (26.6%), A quadrilineatus (10%), A pachycristatus (3.3%), A rugulosus (3.3%), A unguis (5%), A creber, (1.7%), A olivicola (1.7%) and A sydowii (1.7%). Thirty-four sequence types (STs) were identified among the 54 A nidulans complex isolates. A high level of genetic diversity was found among A nidulans sensu stricto strains but low diversity was found among A spinulosporus strains. Amphotericin B showed high MICs to all species. The most active azole was posaconazole (GM = 0.64 mg/L), while itraconazole showed the highest MICs among azoles (GM = 2.95 mg/L). A spinulosporus showed higher MICs than A nidulans sensu stricto for all antifungals except for micafungin and anidulafungin. Interspecies variations may result in differences in antifungal susceptibility patterns and challenge antifungal therapy in infections caused by A nidulans. Differences in the distribution of STs or persistence of multiple STs might be related to the sources of isolation and niche specialisation.
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Affiliation(s)
- Mahin Tavakoli
- Student Research Committee, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Olga Rivero-Menendez
- Medical Mycology Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Mahdi Abastabar
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad T Hedayati
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Raquel Sabino
- Department of Infectious Diseases/Reference Unit for Parasitic and Fungal Infections, Lisbon, Portugal
| | - Maria Siopi
- Clinical Microbiology Laboratory, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Hossein Zarrinfar
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Henrich van der Lee
- Department of Medical Microbiology, Radboud University Medical Center, Center of Expertise Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | - Reza Valadan
- Molecular and Cell Biology Research Center (MCBRC), Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Jamshid Yazdani Charati
- Department of Statistic, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyedmojtaba Seyedmousavi
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Center of Expertise in Microbiology, Infection Biology and Antimicrobial Pharmacology, Tehran, Iran.,Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Ana Alastruey-Izquierdo
- Medical Mycology Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
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Talebi Ghadicolaei H, Heydary Gorji MA, Bagheri B, Yazdani Charati J, Hadinejad Z. The Effect of Warm Footbath on the Quality of Sleep on Patients with Acute Coronary Syndrome in Cardiac Care Unit. J Caring Sci 2019; 8:137-142. [PMID: 31598506 PMCID: PMC6778315 DOI: 10.15171/jcs.2019.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 10/03/2018] [Indexed: 12/31/2022] Open
Abstract
Introduction: This study aimed to determine the effect of warm footbath before bedtime on the quality of sleep on patients with acute Coronary Syndrome in Cardiac Care Unit. Methods: This study was conducted on 120 patients admitted to CCU at Mazandaran Heart Center and randomly divided into two groups of intervention and control. In the intervention group, warm footbath was performed after the second night in hospital before bed time by 41 C water for 20 minutes for three consecutive nights; in contrast, the control group did not receive anything of this sort. The next day, St Mary's Hospital Sleep Questionnaire was completed to evaluate sleep quality. Then, the obtained data were analyzed using SPSS software and Friedman, Wilcoxon exact statistical tests. Results: The quality of sleep in the first night of hospitalization was different from the third night after the intervention in both groups and the improvement process of sleep quality was observed in both groups. Most patients had moderate impairments (23-36), which had not changed during the intervention. In intervention groups, 8 patients had severe sleep disorders (greater than 37), which declined to 1 after three nights of intervention. While, in the control group this number fell from 10 patients with severe sleep disorders to 5. Warm footbath had a great positive impact on patients suffering from severe sleep disorders (P<0.05). Conclusion: Although warm footbath did not improve the quality of sleep in all patients, it reduced the number of patients who had severe sleep disturbances.
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Affiliation(s)
- Hassan Talebi Ghadicolaei
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Ali Heydary Gorji
- Department of Intensive Care Nursing, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Babak Bagheri
- Department of Cardiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics and epidemiology, Faculty of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zoya Hadinejad
- Department of Emergency Medical Service, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
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Tavakoli M, Yazdani Charati J, Hedayati MT, Moosazadeh M, Badiee P, Seyedmousavi S, Denning DW. National trends in incidence, prevalence and disability-adjusted life years of invasive aspergillosis in Iran: a systematic review and meta-analysis. Expert Rev Respir Med 2019; 13:1121-1134. [PMID: 31426666 DOI: 10.1080/17476348.2019.1657835] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: We aimed to study the epidemiology, prevalence, incidence, clinical manifestations, underlying diseases, treatments, outcomes, and societal impact through disability-adjusted life years (DALYs) of IA in Iran. Methods: A random-effect meta-analytic model was fitted to estimate the prevalence and incidence of IA in Iran. We also calculated DALYs. Results: Out of 79 published studies during the past 25 years from Iran, 23 met the inclusion criteria. A total of 2947 patients were included, of whom 396 (13.4%) patients were diagnosed with IA according to EORTC/MSG and ICU criteria. The main underlying condition for IA was hematologic disorders (39.4%). A. flavus 86 (43%) was the most common isolate. The pooled prevalence and incidence rates were 20.5 (95% CI 12.5 to 29.9) and 4.8 (95% CI 2.3-8.2) per 100,000 population, respectively. Total DALYs was estimated 164.13 per 100,000 population. YLLs constitute the majority of IA burden compared to YLDs (162.80 YLLs/100,000 population vs 1.33 YLDs per 100,000 population). The highest YLL rates were found in people aged 45-49 (62.9 YLLs/100,000 population) and 30-34 years (45.2 YLLs/100,000 population), respectively. Conclusion: This study indicates an increasing burden of IA in Iran, despite the extensive use of prophylaxis, challenging the public health, especially immunocompromised patients.
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Affiliation(s)
- Mahin Tavakoli
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences , Sari , Iran
| | - Jamshid Yazdani Charati
- Department of statistic, Faculty of Health, Mazandaran University of Medical Sciences , Sari , Iran
| | - Mohammad T Hedayati
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences , Sari , Iran.,Department of Medical mycology, Mazandaran University of Medical Sciences , Sari , Iran
| | - Mahmood Moosazadeh
- Health Sciences Research center, Addiction Institute, Mazandaran University of Medical Sciences , Sari , Iran
| | - Parisa Badiee
- Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Seyedmojtaba Seyedmousavi
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences , Sari , Iran.,Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health , Bethesda , MD , USA
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Alvandipour M, Zamani MS, Ghorbani M, Charati JY, Karami MY. Comparison of Limberg Flap and Karydakis Flap Surgery for the Treatment of Patients With Pilonidal Sinus Disease: A Single-Blinded Parallel Randomized Study. Ann Coloproctol 2019:313-318. [PMID: 31113167 PMCID: PMC6968717 DOI: 10.3393/ac.2018.09.27] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 09/27/2018] [Indexed: 12/20/2022] Open
Abstract
Purpose Pilonidal sinus disease is a common condition, which mostly affects young men. While various surgical techniques have been introduced for treating intergluteal pilonidal disease (IPD), controversies still exist regarding the best surgical approach. The purpose of this study was to compare the efficiency and the short-term outcomes of Limberg flap and Karydakis flap surgeries for the treatments of patients with IPD. Methods A total of 80 patients with IPD who had underwent either Karydakis flap (KF group: n = 37) or Limberg flap (LF group: n = 27) surgery between January 2015 and January 2016 at Imam Khomeini Hospital of Sari in the North of Iran were recruited for inclusion in this randomized, single-blind study. Results Compared to the KF group, the LF group showed faster complete wound healing, longer duration of surgery and hospital stay, larger wound size, and shorter period of incapacity for work. The overall patient satisfaction in the LF group was significantly higher than that in the KF group. The visual analogue scale score of pain was lower in the LF group than in the KF group. Also, the overall frequency of postoperative complications was higher in the KF group than in the LF group. Recurrence was reported in one patient from the KF group. Conclusion Given the lower rate of postoperative complications and greater cosmetic satisfaction of patients, the Limberg flap procedure should be selected, instead of the Karydakis flap procedure, as the standard technique for treating patients with IPD.
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Affiliation(s)
- Mina Alvandipour
- Department of Colorectal Surgery, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mojtaba Ghorbani
- Department of Colorectal Surgery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
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Nikpour A, khalilian A, Maleki I, Mohsenipouya H, Yazdani Charati J. Survival of gastric cancer patients based on pathologic and demographic characteristics in Mazandaran between 2007 and 2013. Gastroenterol Hepatol Bed Bench 2019; 12:315-321. [PMID: 31749920 PMCID: PMC6820842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM Survey of the survival levels of gastric cancer and its effective causes. BACKGROUND The survival of gastric cancer because of the advances in this type of cancer cures has been increased during the last decades. METHODS 643 patients evolved by gastric cancer referred to Imam Khomeini hospital of Sari (2007- 2013) were studied. According to this method, the numbers of 74 patients were neglected because of defective data, and the number of 569 patients went under study. The level of survival was determined by use of Kaplan Meier, so to determine the causes affecting on the patients' survival, the univariate analysis of Log-rank test was used. RESULTS Regarding the follow up of these patients during 2013 Nov-Dec the one, 2, 3, 4 and 5 years of survival of these patients were estimated equal to 0.77, 0.65, 0.52, 0.44, 0.27 percent and the survival median equal to 19 months, so survival means equal to 24.49 months. Based on the ranked logarithm test and FDR method some variables like stage (p<0.001) Radiotherapy (p<0.005) and undergo Surgery before Adjuvant chemotherapy (p<0.001) were determined as the effective factors on the survival probability. CONCLUSION The life length of the patients under this article in comparison with developed countries is shallow that might be because of late reference or delayed diagnosis and the shortness of cure facilities. In this way, some materials like soon diagnosis and screen methods could be effective on the increase in patients' survival.
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Affiliation(s)
- Abolfazl Nikpour
- Student Research Committee, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza khalilian
- Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iradj Maleki
- Faculty of Nursing, Mazandaran University of Medical Sciences, Behshahr, Iran
| | | | - Jamshid Yazdani Charati
- Department of Biostatistics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Azimi Lolaty H, Ramzani A, Zarghami M, Yazdani Charati J, Bagheri M. Relationship between Self-efficacy and Perceived Burden among Schizophrenic Patients' Caregivers. J Nurs Midwifery Sci 2019. [DOI: 10.4103/jnms.jnms_13_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Hedayati MT, Taghizadeh Armaki M, Yazdani Charati J, Hedayati N, Seyedmousavi S, Denning DW. Burden of fungal infections in Iran. J Infect Dev Ctries 2018; 12:910-918. [PMID: 32004161 DOI: 10.3855/jidc.10476] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/13/2018] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION The number of fungal infections occurring each year in Iran is not known. As the burden of fungal disease is a measure used to assess and compare the relative impact of different type of fungal diseases on populations, we have estimated the burden of fungal diseases in Iran. METHODOLOGY We estimated the burden of human fungal diseases based on the specific populations at risk, existing epidemiological data in both local and international databases, and modelling previously described by the LIFE program (http://www.LIFE-worldwide.org). RESULTS Among the population of Iran (79,926,270 in 2016), 6,670,813 (8.3%) individuals are estimated to suffer from a fungal infection each year. A total of 2,791,568 women aged between 15 and 50 years are estimated to suffer from recurrent vulvovaginal candidiasis, annually. In addition, considering the 13.3% prevalence rate of tinea capitis in children, a total of 2,552,624 cases per year are estimated. The estimated burden of invasive aspergillosis in the 3 groups of patients with hematologic malignancy, lung cancer and chronic pulmonary obstructive disease was 6394 (8.0 per 100,000). The estimate for the burden of allergic disease related to fungi including allergic bronchopulmonary aspergillosis, severe asthma with fungal sensitization and allergic fungal rhinosinusitis was 272,095 (340 per 100,000). Based on the 28,663 cases of HIV infection reported, an estimated 900 and 113 cases with pneumocystosis and cryptococcal meningitis are annually anticipated, respectively. CONCLUSION Our estimates indicate that the importance of fungal infections is high but overlooked in Iran, which warrants further actions by health care authorities.
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Affiliation(s)
- Mohammad T Hedayati
- Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
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