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Background: The COVID-19 pandemic has profoundly affected healthcare systems worldwide, with significant collateral damage to vulnerable populations, including the perinatal population. This study sought to compare pregnancy-related complications before and during the COVID-19 pandemic in Iran. Methods: This retrospective data analysis was performed from February 20 to August 20, 2019 (prior to the onset of the COVID-19 pandemic) and from February 20 to August 20, 2020 (during the pandemic), encompassing the initial wave of the pandemic and the subsequent lockdown. To collect data, we utilized the medical records of 168,358 women obtained from the Iranian Maternal and Neonatal Network, which is a comprehensive electronic health record database management system specifically designed to store information pertaining to maternal and neonatal health. Results: A total of 168,358 medical records were analyzed, with 87 388 (51.9%) and 80 970 (48.1%) before and during the pandemic, respectively. The occurrence of pregnancy complications was found to be significantly more frequent during the pandemic compared to the pre-pandemic period. Notably, there was a higher likelihood of experiencing preeclampsia (odds ratio [OR] = 1.14, 95% confidence interval [CI]: 1.07-1.22, P = 0.0001) and gestational diabetes (OR = 1.14, 95% CI: 1.09-1.19, P = 0.0001) during the pandemic. Furthermore, cesarean section (CS) became more prevalent during the pandemic in comparison to vaginal delivery (OR = 1.19, 95% CI: 1.17-1.22, P = 0.0001). Conclusion: Our findings demonstrated a significant association between the COVID-19 pandemic and an escalation in adverse pregnancy outcomes, notably preeclampsia, gestational diabetes, and CS deliveries. However, further research is warranted to gain a richer understanding of the intricate interplay between the COVID-19 pandemic and pregnancy complications. This is particularly crucial in light of the evolving landscape of new coronavirus variants. [ABSTRACT FROM AUTHOR]

Background: There is scattered evidence of the impact of workplace interventions in improving employees' physical activity. This systematic review was performed to evaluate the strategies of workplace interventions and their effectiveness, as reported in primary studies. Method: Primary experimental trials, both randomized controlled trials (RCTs) and non‐RCTs, which examined interventions to increase healthy adult employees' physical activity were included in this review. Studies in English or Persian published between 2009 and 2019 with access to full text of resources were considered. Google Scholar, PubMed, Web of Science, Scopus and Cochrane Library, ProQuest (Thesis) and World Health Organization Clinical Trial Registration Databases and Persian databases such as SID, Magiran, IranMedex, Irandoc were searched. All the stages of review were conducted based on PRISMA. RoB and ROBINS‐I were used to assess the risk of bias of the primary studies. Results: Thirty‐nine studies, with a total of 18 494 participants, met the inclusion criteria. Of these, 22 were RCTs, 17 were non‐RCTs. Effective interventions were reported in 15 RCTs and 14 non‐RCTs. Four main strategies of interventions were identified, consisting of motivation and support; monitoring and feedback; information and education; and activity. Thirteen different behavior change techniques (BCT) were identified with self‐determination theory (SDT) being the most frequent behavior change theory used. Conclusion: It seems that a multi‐strategy intervention that one of the strategies of which is physical activity in the workplace (Activity), the use of behavioral change theories, especially SDT, may be indicative of a more effective intervention. It is recommended that BCTs be considered when designing physical activity interventions. [ABSTRACT FROM AUTHOR]

Background: Oils and fats are among the important constituents of foods. Lipid oxidation can cause changes in taste, flavor, smell, color, texture, and nutritional value of the foods. Deep-fat frying (temperatures of 150 to 200 °C) leads to a series of chemical and physical reactions, so that the oil is oxidized, polymerized, and hydrolyzed. Methods: In a current descriptive cross-sectional study, 100 oil samples were obtained from fast food shops in Yazd city during the spring and summer of 2018. A checklist was prepared including the oil type (oil or fat), odor, color, smoke, and duration of use. The peroxide value (PV), p-anisidine value (p- AV), free fatty acid (FFA) levels, and total polar compound (TPC) of the samples were examined. Results: We found that 93% of the oil samples were in form of liquid. In term of color, 45% of the samples had a dark color and about 57% had an undesirable odor during cooking. In 23% of the fast food shops in Yazd, oil is used more than two days. The measurement of peroxide value showed that 73 samples had peroxide values higher than the allowable limits. The allowable average peroxide value was estimated as 2.33 meq/kg. Results showed that 56 samples had allowable FFA level (less than one), while the others were classified as oxidized oils. The p-AV in 55% of the oil samples were higher than 4. According to the results, 46% of the frying oil samples had TPC of higher than 25%, which showed that they should be discarded. Conclusion: The results showed that majority of the fast food shops in Yazd used highly oxidized oils to prepare their food. The absorption of such oils by food can endanger the public health. Therefore, continuous monitoring of fast foods and restaurants as well as training the staff seem necessary. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common malignancy among Iranian women and is a significant stressor in women's life that may affect their coping strategies and quality of life. This study aimed to investigate coping strategies, quality of life and pain of women with breast cancer. Materials and Methods: This was a cross-sectional study which held in Seyed-AL shohada hospital and two private offices in Isfahan, Iran. Target population was women with confirmed diagnosis of breast cancer in a recent year and between 18 and 60 years old. Data were collected via3 questionnaires (Brief cope, EORTC QLQ-C30 and Brief pain Inventory). The reliability and validity of these questionnaires were confirmed in different studies. Sixty-two patients completed the questionnaires. Analysis included descriptive statistics and Pearson correlation coefficient and t-test where necessary. All analysis were conducted using the SPSS version 16.0 and P-value of less than 0.05 considered as statistically significant. Results: Sixty-two women with breast cancer completed questionnaires. The mean age of respondents was 45/81±6/78 years; most married (93/5%), high school-educated (41/97%), house wife (82/3%) and stage II (46/8%). The most common coping strategies were religion, acceptance, self-distraction, planning, active coping, positive reframing and denial. Mean score for the worst pain during the past 24 hours was 6/24 ± 2/55 and for the least pain was 3/19 ± 2/17. The global health scale was 60.34 ± 21.10. Emotion-focused coping strategies were positively and significantly related to symptom aspect of quality of life (r = 0/43 P ⩽ 0/01) and affective interference of pain (r = 0/36 P = 0/004) and also was inversely correlated to functional health status (r = -0/38 P = 0/002). There was no significant correlation between problem-focused coping strategies and dimensions of quality of life and also different aspects of pain. Conclusions: The findings of this study indicated that the care of breast cancer should address physical, psychological and social wellbeing and the findings point to the importance of taking individual coping strategies into account when evaluating the impact of breast cancer on psychosocial wellbeing. Description of coping strategies might be useful for identifying patients in need to particular counseling and support. [ABSTRACT FROM AUTHOR]

Objective Design Setting Population Methods Main Outcome Measures Results Conclusions To compare stillbirth rates and risks for small for gestational age (SGA), large for gestational age (LGA) and appropriate for gestational age (AGA) pregnancies at 24–44 completed weeks of gestation using a birth‐based and fetuses‐at‐risk approachs.Population‐based, multi‐country study.National data systems in 15 high‐ and middle‐income countries.Live births and stillbirths.A total of 151 country‐years of data, including 126 543 070 births across 15 countries from 2000 to 2020, were compiled. Births were categorised into SGA, AGA and LGA using INTERGROWTH‐21st standards. Gestation‐specific stillbirth rates, with total births as the denominator, and gestation‐specific stillbirth risks, with fetuses still in utero as the denominator, were calculated from 24 to 44 weeks of gestation.Gestation‐specific stillbirth rates and risks according to size at birth.The overall stillbirth rate was 4.22 per 1000 total births (95% CI 4.22–4.23) across all gestations. Applying the birth‐based approach, the stillbirth rates were highest at 24 weeks of gestation, with 621.6 per 1000 total births (95% CI 620.9–622.2) for SGA pregnancies, 298.4 per 1000 total births (95% CI 298.1–298.7) for AGA pregnancies and 338.5 per 1000 total births (95% CI 337.9–339.0) for LGA pregnancies. Applying the fetuses‐at‐risk approach, the gestation‐specific stillbirth risk was highest for SGA pregnancies (1.3–1.4 per 1000 fetuses at risk) prior to 29 weeks of gestation. The risk remained stable between 30 and 34 weeks of gestation, and then increased gradually from 35 weeks of gestation to the highest rate of 8.4 per 1000 fetuses at risk (95% CI 8.3–8.4) at ≥42 weeks of gestation. The stillbirth risk ratio (RR) was consistently high for SGA compared with AGA pregnancies, with the highest RR observed at ≥42 weeks of gestation (RR 9.2, 95% CI 15.2–13.2), and with the lowest RR observed at 24 weeks of gestation (RR 3.1, 95% CI 1.9–4.3). The stillbirth RR was also consistently high for SGA compared with AGA pregnancies across all countries, with national variability ranging from RR 0.70 (95% CI 0.43–0.97) in Mexico to RR 8.6 (95% CI 8.1–9.1) in Uruguay. No increased risk for LGA pregnancies was observed.Small for gestational age (SGA) was strongly associated with stillbirth risk in this study based on high‐quality data from high‐ and middle‐income countries. The highest RRs were seen in preterm gestations, with two‐thirds of the stillbirths born as preterm births. To advance our understanding of stillbirth, further analyses should be conducted using high‐quality data sets from low‐income settings, particularly those with relatively high rates of SGA. [ABSTRACT FROM AUTHOR]

Objective Design Setting Sample Methods Main outcome measures Results Conclusions To examine the contribution of preterm birth and size‐for‐gestational age in stillbirths using six ‘newborn types’.Population‐based multi‐country analyses.Births collected through routine data systems in 13 countries.125 419 255 total births from 22+0 to 44+6 weeks’ gestation identified from 2000 to 2020.We included 635 107 stillbirths from 22+0 weeks’ gestation from 13 countries. We classified all births, including stillbirths, into six ‘newborn types’ based on gestational age information (preterm, PT, <37+0 weeks versus term, T, ≥37+0 weeks) and size‐for‐gestational age defined as small (SGA, <10th centile), appropriate (AGA, 10th–90th centiles) or large (LGA, >90th centile) for gestational age, according to the international newborn size for gestational age and sex INTERGROWTH‐21st standards.Distribution of stillbirths, stillbirth rates and rate ratios according to six newborn types.635 107 (0.5%) of the 125 419 255 total births resulted in stillbirth after 22+0 weeks. Most stillbirths (74.3%) were preterm. Around 21.2% were SGA types (PT + SGA [16.2%], PT + AGA [48.3%], T + SGA [5.0%]) and 14.1% were LGA types (PT + LGA [9.9%], T + LGA [4.2%]). The median rate ratio (RR) for stillbirth was highest in PT + SGA babies (RR 81.1, interquartile range [IQR], 68.8–118.8) followed by PT + AGA (RR 25.0, IQR, 20.0–34.3), PT + LGA (RR 25.9, IQR, 13.8–28.7) and T + SGA (RR 5.6, IQR, 5.1–6.0) compared with T + AGA. Stillbirth rate ratios were similar for T + LGA versus T + AGA (RR 0.7, IQR, 0.7–1.1). At the population level, 25% of stillbirths were attributable to small‐for‐gestational‐age.In these high‐quality data from high/middle income countries, almost three‐quarters of stillbirths were born preterm and a fifth small‐for‐gestational age, with the highest stillbirth rates associated with the coexistence of preterm and SGA. Further analyses are needed to better understand patterns of gestation‐specific risk in these populations, as well as patterns in lower‐income contexts, especially those with higher rates of intrapartum stillbirth and SGA. [ABSTRACT FROM AUTHOR]

Background: The Global burden of disease and injuries study (GBD 2015) reports expected measures for years of life lost (YLL) based on socio-demographic index (SDI) of countries, as well as the observed measures. In this extended GBD 2015 report, we reviewed total and cause-specific deaths and YLL for Iran and all its neighboring countries between 1990 and 2015. Methods: We extracted data from the GBD 2015 database. Observed YLL measures were calculated by multiplying the number of deaths by standard life expectancy at each age. SDI was a composite index, calculated based on income per capita, average years of schooling, and total fertility rate. The GBD world population was used for age standardization. Results: All-ages crude death rate in Iran reduced from 665.6 per 100,000 population (95% uncertainty interval: 599.3-731.6) in 1990 to 487.2 (414.9-566.1) in 2015. The ratio of observed to expected YLL (O/E ratio) for all-causes ranged between 0.54 (Turkey) and 1.95 (Russia) in 2015. For Iran, the all-causes O/E ratio was less than 1 in all years (1990-2015), except 2003. However, cause-specific O/E ratio was more than 1 for some causes, including the top leading causes of YLL (ischemic heart disease, road injuries, and cerebrovascular disorders). Ischemic heart disease was the first or second cause of YLL in all comparator countries except Afghanistan. Conclusion: The leading YLL causes with high O/E ratios should be prioritized in public health efforts. In addition to research evidence, countries with low O/E ratios should be scrutinized to find feasible innovative interventions. [ABSTRACT FROM AUTHOR]

Objective: The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on pregnant women and neonates in Iran. This retrospective study describes the national experience among neonates having suspected and confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection following hospital admission to examine the epidemiology, demographic, and clinical features., Study Design: All nationwide cases of suspected and confirmed neonatal SARS-CoV-2 infection were drawn from the Iranian Maternal and Neonatal Network (IMaN) between February 2020 and February 2021. IMaN registers demographic, maternal, and neonatal health data throughout Iran. Statistical analysis of demographic, epidemiological, and clinical data were performed., Results: There were 4,015 liveborn neonates having suspected or confirmed SARS-CoV-2 infection that fulfilled the study inclusion criteria identified in the IMaN registry from 187 hospitals throughout Iran. There were 1,392 (34.6%) neonates that were preterm, including 304 (7.6%) less than 32 weeks' gestation. Among the 2,567 newborns admitted to the hospital immediately after birth, the most common clinical problems were respiratory distress (1,095 cases; 42.6%), sepsis-like syndrome (355; 13.8%), and cyanosis (300 cases; 11.6%). Of 683 neonates transferred from another hospital, the most frequent problems were respiratory distress (388; 56.8%), sepsis-like syndrome (152; 22.2%), and cyanosis (134; 19.6%). Among 765 neonates discharged home after birth and subsequently admitted to the hospital, sepsis-like syndrome (244 cases; 31.8%), fever (210; 27.4%), and respiratory distress (185; 24.1%) were most frequent. A total of 2,331 (58%) of neonates required respiratory care, with 2,044 surviving and 287 having a neonatal death. Approximately 55% of surviving neonates received respiratory support, compared with 97% of neonates who expired. Laboratory abnormalities included elevations of white blood cell count, creatine phosphokinase, liver enzymes, and C-reactive protein., Conclusion: This report adds the national experience of Iran to the list of reports from multiple countries describing their experience with COVID-19 in neonates, demonstrating that newborns are not exempt from COVID-19-morbidity and mortality., Key Points: · Most common clinical problem was respiratory distress.. · Sepsis-like syndrome was also frequently present.. · A total of 58% of all neonates required respiratory care.., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Background: Workplace physical activity plays an important role in employees' health. As university employees are a population at risk for a sedentary working pattern, this study aimed to investigate the physical activity status of employees of Iran University of Medical Sciences (IUMS) and its subsequent effects on their well-being. Methods: This cross-sectional study included 472 employees from different units of IUMS in Tehran. The participants were selected by a multistage sampling method. Interviews were conducted by using an international physical activity questionnaire, a questionnaire for stages of behavioral change, the World Health Organization Well-being Questionnaire, and a demographic checklist from July to October 2019. Analysis of variance, t test, and logistic regression analysis were used. Data were analyzed using IBM SPSS (Version 21.0). Results: Total physical activity in the study population was 6216.58 ± 5886.09 MET-minutes/week. The mean score of the well-being index was 54.72 ± 22.4; there was an association between sex and location of work with physical activity in domains ( p <0.05). The highest prevalence rates for change of stage of physical activity were found in the maintenance stage for men and the contemplation stage for women. There was a significant difference between men and women's well-being index-men reported being more active and energetic than women ( p <0.001). Results also revealed that having vigorous physical activity compared with a moderate level could increase the well-being index. Conclusion: Physical activity behavior at the workplace was associated with well-being level. It could, therefore, be postulated that enhancing physical activity may be beneficial to improving well-being in an academic environment., (© 2022 Iran University of Medical Sciences.)

Background: Under Every Newborn Action Plan (ENAP), stillbirth rate in every country should be reduced by 12 or fewer per 1000 total births by 2030. The aims of this study were to determine stillbirth rate at national and subnational levels and to investigate its associated risk factors in Iran. Methods: Using all data from Iranian Maternal and Neonatal Network (IMaN), we calculated stillbirth rate of Iran from 2014-2016. This network registers information of almost all births across the country. The logistic regression was used to estimate the adjusted odds ratio (aOR) with 95% confidence intervals (CIs) for stillbirth. Results: In 2014, still birth rate was 7.40 per 1000 births. In 2015 and 2016, stillbirth rates were 7.22 per 1000 births and 7.63 per 1000 births, respectively. The most important related factors of stillbirth were preterm birth (aOR= 62.53, 95% CI; 60.77-64.34), sexual ambiguity (aOR= 14.51, 95% CI; 12.76-16.50), and post term birth (aOR= 3.31, 95% CI; 2.66-4.13). Conclusion: Under Every Newborn Action Plan (ENAP), stillbirth rate in every country should be reduced by 12 or fewer per 1000 total births by 2030. Iran has achieved stillbirth target of ENAP at national level. It is important for the health care system to establish and improve specific and focused policies, interventions, and programs for achieving this target even in the most deprived areas., (© 2020 Iran University of Medical Sciences.)

Background: Pain is an important consideration after renal surgery. A multimodal approach to postoperative pain management could enhance analgesia by risking fewer side effects after surgery., Objectives: The aim of this study was to evaluate the clinical efficacy of the subcutaneous infiltration of ketamine and tramadol at the incision site to reduce postoperative pain., Methods: Sixty-four patients between 18 and 80 years old who were scheduled for elective renal surgery were enrolled in a double-blind randomized controlled study. At the end of the surgery, patients were divided into four groups with 16 patients in each group: the saline group, who were treated with 10 mL of saline solution; the K group, who were treated with 1 mg/kg etamine in 10 mL of saline solution; the T group, who were treated with 1 mg/kg tramadol in 10 mL of saline solution; and the K/T group, who were treated with 0.5 mg/kg ketamine with 0.5 mg/kg tramadol in 10 mL of saline solution. In each group, the solution was infiltrated subcutaneously at the incision site. The postoperative pain scores and rescue analgesic consumption of the patients in each group were recorded for 24 hours and compared. The primary goal of the study was to compare the results of patients treated with a combined ketamine and tramadol subcutaneous wound infiltration, patients treated with a tramadol subcutaneous wound infiltration, and patients treated with a ketamine subcutaneous wound infiltration., Results: Sixty-four patients were enrolled in the study. Pain intensity and cumulative meperidine consumption were significantly lower in the K/T group (27 mg; 95% confidence interval, 25.2 - 53.2) in comparison with the group that received a saline infusion during the first 24 hours after surgery (P < 0.001). The sedation score of the K, T, and K/T groups were significantly higher than the saline group (P < 0.001)., Conclusions: The combined subcutaneous infiltration of ketamine and tramadol at the incision site produces better analgesia and an opioid-sparing effect during the first 24 hours when compared with the control group and the groups that received a subcutaneous infiltration of only ketamine or tramadol.

Context: In the present review study, authors investigated Iran's activities regarding prevention, abuse and harm reduction of drugs nationwide. The issue appears to be important in order to show the trend of activities in the country., Evidence Acquisition: In this report, authors gathered data from different Farsi/English peer review journals issued both in printed and online versions. These journals have been indexed in PubMed, ISI, ISC, SID, Magiran, UN, etc. These are among the most referred and cited databases., Results: Summarizing the data led to three distinguished sections: 1) drug supply reduction activities; 2) drug demand reduction activities; 3) harm reduction activities., Conclusions: As the results showed, the trend of activities was encouraging and some additional activities could be included to future programs relying on early-onset preventions.