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Background & Aims Caring for a patient undergoing hemodialysis is a stressful experience that causes a heavy care burden. With the outbreak of COVID-19, family caregivers of these patients had increased worry about the risk of infection in the dialysis centers. This fear can make their care burden heavier. This study aims to investigate the impact of coping skills training on the care burden experienced by family caregivers of patients undergoing hemodialysis. Materials & Methods This quasi-experimental study was conducted in 2020 on 60 family caregivers of patients undergoing hemodialysis at the Comprehensive Treatment Center for Special Diseases in Birjand, Iran. Participants were randomly assigned to intervention and control groups. The intervention group received coping skills training in six sessions. All participants completed the Zarit burden interview before, immediately after, and one month after the intervention. The data were analyzed in SPSSsoftware, version 19. Results The two groups were homogeneous regarding demographic information (P>0.05). Both groups had a moderate to severe care burden before the intervention. A significant difference was reported in the care burden score of the intervention group after training (P<0.001). Conclusion Coping skills training can reduce the care burden of the family caregivers of patients undergoing hemodialysis. Therefore, coping skills training can be used by nursing managers to reduce the care burden of family caregivers of patients with hemodialysis. [ABSTRACT FROM AUTHOR]

Background and Aim Fibromyalgia syndrome is a chronic disease that causes widespread musculoskeletal pain. It primarily affects women and negatively impacts many aspects of a person’s psychological and social life. This study aimed to compare the effectiveness of cognitive therapy based on mindfulness and compassion therapy on automatic negative thoughts, psychological symptoms, pain intensity, and quality of life in patients with fibromyalgia syndrome. Methods & Materials This research is a quasi-experimental study with a pre-test-post-test design with two experimental and one control group. The statistical study population consisted of all individuals with fibromyalgia syndrome referred to Mehregan Pain Clinic in Mirdamad (District 3), Seyed Khandan Clinic (District 4), and Taleghani Hospital Pain Clinic (District 1) in Tehran City, Iran. Of them, 30 patients were randomly selected and divided into three groups of experimental 1, experimental 2, and control; each group will include 10 people. The instruments used in this study included the World Health Organization quality of life questionnaire (WHOQOL BREF), pain intensity questionnaire (PIS), psychological symptoms questionnaire (Anxiety, Stress and Depression [DASS]), and automatic negative thoughts (QNS). Ethical Considerations This study was approved by the Research Ethics Committee of Arak Branch, Islamic Azad University (Code: IR.IAU.ARAK.REC.1400.005). Results The analysis of covariance showed the effectiveness of both cognitive therapies based on mindfulness and compassion therapy on four variables of pain intensity, psychological symptoms, automatic negative thoughts, and quality of life (P<0.05). Comparing the two intervention methods showed that both therapies had almost the same effect on pain intensity, psychological symptoms, and automatic negative thoughts (P<0.05) but the effectiveness of mindfulness intervention on the quality of life was significantly higher than compassion intervention (P<0.05). Conclusion The results indicate that cognitive therapy based on mindfulness and compassion therapy are suitable for people with fibromyalgia under appropriate treatment. [ABSTRACT FROM AUTHOR]

Background & Aims: From the beginning of the Covid-19 epidemic, a number of recommendations were made by health organizations, such as maintaining social distance, using masks, and hand hygiene. Hand washing with soap or alcohol-based disinfectants and high hygiene as a precautionary measure to prevent the spread of this emerging virus is widely promoted, and almost all people follow these recommendations. Although hand washing and hygiene are more serious than ever before, and is certainly helpful in preventing the spread of Covid-19, but there is the question of how this can affect different people who have not previously had obsessive-compulsive disorder, and also peoples with mild and sub-threshold symptoms (1,6). The Covid-19 epidemic in the late winter of 2019 / spring 2020 became a global crisis and spread widely and rapidly across borders and continues to this day (3). Covid19 disease may have different effects on people with different socioeconomic status, as shown in several studies (11,9,8,20,21,22). Very little is known about the impact of the emerging Covid-19 disease on the prevalence or development of mental disorders, and little research has been done in this area. The aim of this study was to evaluate the prevalence of obsessivecompulsive disorder in recovered hospitalized patients with Covid-19 six months after discharge from the hospital, evaluate the existence of a statistically significant relationship between the prevalence of obsessive-compulsive disorder, socioeconomic status and demographic variables such as gender, age, level of education and marital status. Methods: In this cross-sectional study, 479 patients with a history of definitive diagnosis of Covid-19 and subsequent hospitalization were studied. The participation of all sample members in this study was completely voluntary and the present study has been approved by the ethics committee of Kermanshah University of Medical Sciences, Iran. The sample members were selected using random number generation software and through a completely random selection from the list of hospitalized patients. After selecting the sample, they were invited to participate in the study by telephone. After initial satisfaction, research questionnaires were provided to the sample members face to face. In this study, Maudsley Obsessional Compulsive inventory (MOCI), Ghodrat Nama et al. Socio-Economic Status Questionnaire (GHSESQ) were used. The validity and reliability of these questionnaires have been studied in Iran and both of them are valid and reliable. Also, after completing the questionnaires, each member of the sample was examined through a short face-to-face supplementary interview (maximum 10 minutes) for the presence of DSM5 diagnostic criteria for obsessive-compulsive disorder and the results were recorded. After data collection, the overall point prevalence of obsessive-compulsive disorder was calculated. Also, the point prevalence of obsessive-compulsive disorder were obtained based on each of the classes of demographic variables in the study. Descriptive statistics, chi-square test, one-way analysis of variance and Tukey test were used in this study. SPSS 21 statistical software was used for data analysis. Results: After reviewing and analyzing the completed questionnaires and the results of the supplementary interview, 92 members of the sample were diagnosed with obsessivecompulsive disorder. The overall prevalence of obsessive-compulsive disorder in all samples was 19.20%. According to the results of statistical analysis, there was a significant relationship between gender and obsessive-compulsive disorder and this disorder was more common in women than men (χ2 = 5.3793; P-value = 0.020378; p≤0.05). There was a significant relationship between age variable and obsessive-compulsive disorder and the prevalence of this disorder was more common in other age groups of 38-58 and 18-38, respectively (χ2 = 10.3501; P-value = 0.015813 ; p≤0.05). There was no significant relationship between education and disorder (χ2 = 2.9693; P-value = 0.562976; p≤0.05). Finally, in the case of marital status, there was no significant relationship between marital status and obsessivecompulsive disorder (χ2 = 4.4587; P-value = 0.107601; p≤0.05). The prevalence of obsessivecompulsive disorder was 12.16% in very low socio-economic status, 15.16% in low socioeconomic status, 18.12% in medium socio-economic status, 35.84% in high socio-economic status and 40.00% in very high socio-economic status. The results of this study showed that there was a significant relationship between socioeconomic status and obsessive-compulsive disorder in recovered hospitalized patients with Covid-19 (χ2 = 20.7756; P-value = 0.000351; p≤0.05). The prevalence of obsessive-compulsive disorder has increased with increasing in level of socioeconomic status. The highest prevalence of disorders was in very high and high socio-economic status. One-way analysis of variance (one-way ANOVA) was performed to compare the mean scores of obsessive-compulsive disorder in different socioeconomic statuses and the value of F was 4.67467, Which shows that there is a significant difference in the mean scores of obsessive-compulsive disorder between socio-economic statuses. The results of Tukey test on the mean scores of obsessive-compulsive disorder in different socioeconomic statuses showed that the differences between very low and high socioeconomic status (p = 0.00597), very low and very high socioeconomic status (p = 0.00179), low and high socioeconomic status (p = 0.03153) were statistically significant. Conclusion: Evidence from research to date suggests that anxiety and fear of being infected by a person or family member, as well as fear of death and threat to life at the time of infection, especially in hospitalized cases, can lead to or the trigger for mental disorders such as obsessive-compulsive disorder. Hospitalized people who have experienced a severe illness and whose life and health are seriously threatened can be one of the groups with the highest rates of mental disorders caused by this epidemic. It is suggested that institutions and organizations related to the maintenance and promotion of mental health in the community take the necessary plans and measures to prevent the occurrence or exacerbation of mental disorders and reduce the psychological consequences of this epidemic in the general population and especially highrisk populations, like people who have experienced the intense and critical state of Covid-19. Considering that the prevalence of obsessive-compulsive disorder in recovered hospitalized patients with Covid-19 is much higher than the prevalence of this disorder in the general population, it can be concluded that covid-19 infection and subsequent hospitalization can lead to obsessive-compulsive disorder. prevalence of Covid-19 exacerbates obsessive-compulsive behaviors and thoughts related to cleanliness and avoidance of the virus. In addition to threatening people's physical health, Covid-19 also threatens their mental health. [ABSTRACT FROM AUTHOR]

Background and Objectives Non-alcoholic liver disease (NAFLD) is a spectrum of diseases, ranging from non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH) which can lead to liver cirrhosis and hepatocellular carcinoma. Nonalchololic fatty liver is the most prevalent hepatic disorder worldwide which can affect up to the one out of four adults. Little is known about the prevalence of nonalchololic fatty liver among regular donors of blood products. The current study shows the prevalence of nonalchololic fatty liver in regular plasma and blood donors with a discontinuous donor population. Materials and Methods In this case-control study, we non-randomly enrolled 400 volunteers of blood donors who met the blood donation criteria after signing the written informed consent. All patients underwent hepatobiliary ultrasonography to evaluate fatty liver. LFT (Liver Function Test) and demographic criteria had been submitted in data base. All data were described by central dispersion indices and analyzed by Mann-Whitney U test and chi-square. Results No difference was seen regarding gender and mean age between groups (p-value of 0.441 and 0.635, respectively). According to univariate analysis there was no significant difference between the two groups regarding the prevalence of fatty liver (p= 0.264) or its staging (p= 0.9). In addition, OR and RR were 1.17 and 1.11, respectively; both not being significant (p= 0.461). Conclusions The prevalence of NAFLD has no significant correlation with both regular blood donors and non-regular blood donors. [ABSTRACT FROM AUTHOR]

Background and Objectives Administering unnecessary blood can cause many complications in patients and add to medical costs. This study aimed to evaluate blood consumption pattern and its relation with causes of mortality in Geneal ICU Ward of Besat Educational Medical Center of Hamadan in 2018- 2019. Materials and Methods This cross-sectional study was performed retrospectively in 2018-2019 on all eligible patients. A checklist was developed to collect demographic and clinical data. Finally, the data were analyzed by Kruskal-Wallis Test, Spearman's Correlation Coefficient, Chi-square Test, Mann- Whitney U by SPSS version 22. Results 227 patients including 130 (57.3%) males and 97 females (42.7%) with the mean age of 39.02 ± 12.83 years were studied. The mean blood unit administered to each patient was 1.68 ± 1.02 and the mean hospital stay period was 8.43 ± 6.03 days. 19.4% of the patients died and the most common cause of death (8.4%) was attributed to brain and nervous system diseases/ damages. The most common type of blood products used was packed red blood cells (70%). The most common indication for blood prescription was surgery (75.3%) followed by bleeding (7.5%). There was a direct and significant relationship between the number blood units and final outcome of the disease (p < 0.001). Conclusions Since the most common type of administered blood products was packed RBCs and there was a direct relationship between the number of prescribed blood units and the incidence of death, it is recommended to avoid unnecessary administration of packed RBCs. [ABSTRACT FROM AUTHOR]

Background and Objectives Use of kits with high sensitivity and specificity to determine the prevalence of antibodies against hepatitis B virus (anti-HBc) core antigen is important. The aim of this study was to determine the prevalence of hepatitis B virus antibody in HBsAg negative blood donors using two anti-HBc enzyme immunoassay kits (DIA.PRO and SIEMENS). Materials and Methods In this Cross-sectional study, a number of 4313 samples of HBsAg negative blood donors were collected. All samples were tested for the detection of anti-HBc (Total, IgM & IgG) by ELISA using Diapro and Siemens kits. Anti-HBc assay was performed by both kits in duplicate. Statistical analysis of data was performed using SPSS Ver. 22.0; chi-square tests were also performed. Results The study population consisted of 227 (5.3%) women and 4086 (94.7%) men. 498 (11.5%) and 384 (8.9%) samples reacted with Diapro and Siemens kits for Anti-HBc, respectively. All positive samples of both kits in duplicate test showed the same results as the previously reported results. 114 cases of reactive kits of DIA.PRO kit were negative in re-testing with SIEMENS kit. Significant differences were observed between the reactive results of the two kits (p = 0.00005). The kappa coefficient for the reactive results of the two kits was 85%. Conclusions Considering the significant difference between the results of the two kits, it is recommended to perform anti-HBc testing with anti-HBs and /or anti-HBe to determine the prevalence of anti- HBc in blood donors with past HBV infection. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular diseases (CVDs) are known as a health-threatening factors and the most important cause of mortality worldwide and also in Iran. Thus, it seems necessary to intervene in order to increase public awareness of the risk factors and to enhance their motivation for reducing those factors via the theory-based education Objective: This study aimed to determine the effect of educational intervention based on health belief model on nutritional behavior of patients with myocardial infarction admitted to the hospitals in Guilan province during 1395-96( 2017-2018). Materials and Methods: This study is a randomized controlled experimental trial. Eighty-six patients with myocardial infarction were randomly assigned into two case (43) and control (43) groups. Data from both groups (demographic and health belief model and nutritional behavior) were collected using a researcher-made questionnaire before and a month after educational intervention. After fulfilling the requirements based on HBM, educational intervention took place in case group. Control group did not receive any kind of intervention, they just received the routine notes from hospital. Data were analyzed using SPSS version 21 using suitable statistical tests (chi-square test, Spearman coefficient and independent t-test). Results: In terms of demographic characteristics, no significant differences were seen between the groups. Before intervention, no significant differences were seen between mean scores of HBM constructs, awareness and nutritional behaviors in the groups, while after intervention there was a significant difference between them (p<0.001). Results also showed a significant difference in case group before and after receiving educational intervention (p<0.001). But there was no significant change in the control group before and after educational intervention (p<0.001). Conclusion: The present study showed that intervention based on HBM, emphasizing awareness and nutritional behavior of patients with myocardial infarction, could have a positive effect on the nutritional behavior of the patients and consequently their health status. [ABSTRACT FROM AUTHOR]

Introduction: Helicobacter Pylori (H. pylori) is a flagellated, spiral-shaped, microaerophilic gram-negative bacterium that colonizes stomach mucosa and causes upper gastrointestinal diseases, such as gastritis, chronic gastric ulcers and gastric carcinoma. IL-19, as an inflammatory cytokine, has been studied in different diseases including skin diseases, liver diseases, autoimmune diseases and infections. IL-19 gene at rs1028181,-513 T/C position is a polymorphic gene, which affects its expression. Materials and Methods: In this case-control study, blood samples of 100 patients and 100 healthy individuals were examined for gene polymorphism of IL-19 at rs1028181-513T/C position in patients with H. pylori infection. Genotypes of this polymorphism were determined by RFLP PCR method. Statistical data analysis of genomic and serum studies of patients was carried out by Chi-square test. Results: The relationship between T and C alleles at rs1028181-513T/C position revealed a significant relationship between allele C and H. pylori infection (p = 0.04 OR = 0.66 (CI; 0.45-0.96)). Conclusion: It appears that a direct relationship exists between H. Pylori infection and C allele at rs1028181-513T/C position. [ABSTRACT FROM AUTHOR]

Introduction: The seventh instruction of the Health System Reform Plan has been implemented since May 05, 2014 in order to promote natural delivery and reduce unnecessary cesarean rates. The present study aimed to investigate the cesarean section frequency and its causes and after the implementation of the Health System Reform Plan. Materials and Methods: The present descriptive study analyzed the existing data collected by questionnaires, checklists, and interviews. To this end, 1240 samples were systematically selected based on file number from May 05, 2014 to May 06, 2015. The data were analyzed using frequency, percentage, mean, Chi-square test, Pearson’s test, and Cramer test. Results: The cesarean section rate was 47.57% before implementing Health System Reform Plan, but it reduced to 38.70% after the implementation. Accordingly, there was a significant difference between the two groups (p=0.02). The two groups had a significant difference in the causes of elective cesarean section (p=0.01). However, there was no significant difference between the two groups regarding the causes of emergency cesarean section (p=0.08). After the implementation of the Health System Reform Plan, no case of elective cesarean section was performed (p=0.01). Conclusion: According to the results of the study (8.87% reduction in cesarean section), Health System Reform Plan succeeded in achieving its specific goal in the first year of its implementation. [ABSTRACT FROM AUTHOR]

Introduction: Till now multiple devices have been introduced in order to predict the "patients"' disability, function, muscle force and mortality in the acute phase of stroke. Objective: Determination the relationship between electroencephalography (EEG) findings and change of disability, functional status, functional independency, muscle force and mortality of the patients with ischemic stroke. Materials and Methods: This cross sectional study was performed on 47 patients in the range of 50-90 years old involved by ischemic stroke in the territory of middle cerebral artery, referred to Poursina Hospital in Guilan-Rasht in the north of Iran. At first, for all the patients a brain CT and after 48 hours a brain MRI or CT scan were done routinely to confirm the diagnosis. EEG accomplished during 48-72 hours after stroke, and the "patients" were grouped in 3, according to EEG abnormality: normal EEG, moderate and severe abnormal EEG. The patients disability, functional independency, functional status, and muscle force, respectively were assessed by Modified Rankin Disability, FIM, Bethel index and Medical Research Council scale(MRC) and their mortality in the first 48 hours, one week and three weeks afterstroke. The data were processed by software SPSS 20 using Chi square, independent T, Post Hoc Tukey, Kruskal-Wallis, Anova, Repeated Measure Anova and Sphericity. Results: A total of 47 patients (48.6% men, 53.2% women) with mean age of 73.09±9.01 years old participated in this study. Left middle cerebral artery involvement was evident in 46.8% of the patients and the others had right side involvement. First and second groups included 15 patients and third group17 patients and there wasn't any statistically significant difference between groups in age and sex. (P>0.05) No significant difference was found, either between groups in means and change of means of Rankin score, FIM, Barthel Index and MRC during the study period. (P>0.05) Conclusion: EEG findings can't determine prognostic value for functional outcome and mortality of patients. [ABSTRACT FROM AUTHOR]

Introduction: Cerebrovascular disease is the second leading cause of death worldwide. Data on epidemiology of stroke, its pattern and risk factors, are scarce. Seasonal variation in the incidence of stroke and role of meteorological factors in its occurrence, have been investigated in several studies. These studies show that there were different patterns in stroke incidence across different areas. Objective: To investigate the seasonal pattern of stroke incidence and the association between daily stroke occurrences and meteorological factors among the patients admitted to the Poursina Hospital, northern Iran, in (2012). Materials and Methods: This cross sectional study was conducted in the Poursina Hospital in Rasht. All the patients with acute onset of neurological symptoms during (2012), after performing imaging studies and confirmation of the diagnosis of stroke, were enrolled. Age, sex, history of diabetes and hypertension, and date of stroke occurrence were recorded for all patients. The number of stroke episodes, temperature and humidity were recorded on all days of the year. Distribution of stroke cases among seasons according to study variables, was analyzed using chi-square test. To compare the average number of strokes per day among different seasons, kruskal-wallis test was used. The relationship between the number of strokes per day and meteorological variables was analyzed using Spearman's correlation coefficient. Results: During the study period, 869 patients with diagnosis of stroke were admitted. Significant seasonal differences in the mean of ischemic stroke occurrence per day and mean of intracerebral hemorrhage occurrence per day, with peak rates in autumn, were observed. In the study of meteorological variables based on multiple linear regression with stepwise method, minimum temperature was inverse linear predictor of both overall stroke occurrence per day and ischemic stroke occurrence per day. For intracerebral hemorrhage occurrence per day, maximum temperature was inverse linear predictor and maximum humidity was direct linear predictor. Conclusion: This study suggests a seasonal pattern in the incidence of stroke and a possible role of meteorological factors in the incidence of stroke in this area. Attention to this seasonal pattern can be useful for medical centers to provide better services to their patients. [ABSTRACT FROM AUTHOR]