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The reported fatality rate of COVID-19 was significantly differ between different countries, provinces in a country, and hospitals in a province. It is important to find and analysed the source of variation in fatality rates to control future epidemics of infection disease. This study propose an approach to investigates the hospital quality of care and its impact on the in-hospital fatality rates of COVID-19 among over 30 years old patients in Iran. The study included 78,217 COVID-19 hospitalized patients over 30 years old from 34 hospitals in Razavi Khorasan province between January 20, 2020, and June 20, 2021. Attribute control charts were employed to evaluate the quality of care in hospitals during four peaks of COVID-19. To account for the impact of hospital quality on in-hospital fatality rates by adjusting on patient characteristics, two predictive models; Poisson and Binomial regression were utilized. The adjusted odds ratio of COVID-19 fatality in no quality confirmed (NQC) hospitals to the quality confirmed (QC) hospitals is 3.48 C.I.95% (2.38, 5.10) at the first peak among patients without other risk factors. The significant negative interactions with QC and peaks indicates that the provision of quality care serves to mitigate the risk of fatality in NQC hospitals during these peaks. The significant negative interaction between diabetes and QC demonstrated that the relative risk in NQC hospitals for no diabetes patient is higher than diabetic patients. There is no significant interaction between age, SaO2, and ARDS with QC; it means that the odds of fatality in NQC hospitals is not depends to these factors. The use of attribute control charts facilitated timely identification of trends and outliers, enabling proactive interventions to enhance patient care. This research underscores the critical role of hospital quality in managing patient outcomes during the COVID-19 pandemic and emphasizes the necessity for continuous monitoring and quality improvement initiatives in healthcare settings. The findings advocate for collaborative efforts among healthcare providers to implement best practices, particularly during surges in cases, to optimize resource allocation and improve overall quality of care. [ABSTRACT FROM AUTHOR]

Many studies have examined the impact of air pollution on cardiovascular hospitalization (CVH), but few have looked at the delayed effects of air pollution on CVH. Additionally, there has been no research on the spatial and temporal differences in how environmental pollutants affect CVH. This study seeks to identify spatial heteroscedasticity in the relation between PM2.5 and CVH by developing a Generalized Additive Distributed Lag (GADL) model. Data on hospitalization due to cardiovascular disease were collected from the Hospital Information System (HIS) of Mashhad University of Medical Science from 2017 to 2020. Air pollution data from 22 air quality monitoring (AQM) stations were obtained from the Environmental Pollution Monitoring Center of Mashhad administrates. Markov Random Field (MRF) smoother was utilized in the GADL model to account for spatial heteroscedasticity in the observations. This developed model is a Spatial Heteroscedastic Generalized Additive Distributed Lag (SHGADL) model. Our use of GADL allowed us to discover a significant relationship between PM2.5 exposures and the risk of CVH at lags 0 and 1 in all districts. Our results reveal heteroscedasticity in the Relative Risks (RR) of PM2.5 on CVH across different districts. After accounting for this spatial heteroscedasticity, we found that the RR of PM2.5 on CVH at lags 0 and 1 were 1.0102 (95% CI: 1.0034, 1.0170) and 1.0043 (95% CI: 1.0009, 1.0078) respectively. The central and southeastern districts showed higher RR for CVH. The developed SHGADL model provides evidence of a significant lagged effect of PM2.5 exposures on CVH, and identifies low- and high-risk districts for CVH in Mashhad. This finding can assist decision-makers in allocating resources and planning strategically, with a focus on local interventions to manage ambient air pollution and providing emergency care for CVH. [ABSTRACT FROM AUTHOR]

Background: Controlling the False Discovery Rate (FDR) in Multiple Comparison Procedures (MCPs) has widespread applications in many scientific fields. Previous studies show that the correlation structure between test statistics increases the variance and bias of FDR. The objective of this study is to modify the effect of correlation in MCPs based on the information theory. We proposed three modified procedures (M1, M2, and M3) under strong, moderate, and mild assumptions based on the conditional Fisher Information of the consecutive sorted test statistics for controlling the false discovery rate under arbitrary correlation structure. The performance of the proposed procedures was compared with the Benjamini–Hochberg (BH) and Benjamini–Yekutieli (BY) procedures in simulation study and real high-dimensional data of colorectal cancer gene expressions. In the simulation study, we generated 1000 differential multivariate Gaussian features with different levels of the correlation structure and screened the significance features by the FDR controlling procedures, with strong control on the Family Wise Error Rates. Results: When there was no correlation between 1000 simulated features, the performance of the BH procedure was similar to the three proposed procedures. In low to medium correlation structures the BY procedure is too conservative. The BH procedure is too liberal, and the mean number of screened features was constant at the different levels of the correlation between features. The mean number of screened features by proposed procedures was between BY and BH procedures and reduced when the correlations increased. Where the features are highly correlated the number of screened features by proposed procedures reached the Bonferroni (BF) procedure, as expected. In real data analysis the BY, BH, M1, M2, and M3 procedures were done to screen gene expressions of colorectal cancer. To fit a predictive model based on the screened features the Efficient Bayesian Logistic Regression (EBLR) model was used. The fitted EBLR models based on the screened features by M1 and M2 procedures have minimum entropies and are more efficient than BY and BH procedures. Conclusion: The modified proposed procedures based on information theory, are much more flexible than BH and BY procedures for the amount of correlation between test statistics. The modified procedures avoided screening the non-informative features and so the number of screened features reduced with the increase in the level of correlation. [ABSTRACT FROM AUTHOR]

Introduction: According to the World Health Organization (WHO), breastfeeding is the best way to feed infants. Adoption of some inappropriate nutritional patterns along with breast milk, especially in infants older than 6 months, may lead to a delay in the child's growth. Therefore, the present study was conducted to investigate the relationship between breastfeeding and weight gain in children aged 6–24 months. Materials and Methods: This case-control study was conducted on 120 infants aged 6–24 months and their mothers recruited from health centers of Ahvaz, southwest of Iran. The data collection tool in the present study included a questionnaire to record demographic information and information in the child's medical records in health centers. Statistical analysis of the data was done by SPSS 23 using the Chi-square test and t-test. Results: No significant difference was observed between the control and case groups in terms of the infant's age (P = 0.741) and gender (P = 0.564) and the mothers' age (P = 0.614), her educational attainment (P = 0.389), and socioeconomic status of the infant's family (P = 0.563). The type of delivery (P = 0.650), mothers' opinion (P = 0.133), and the interval between breastfeeding and complementary feeding (P = 0.144) had no significant relationship with the infant's growth disorder. On the other hand, duration of breastfeeding per meal (P = 0.007) and frequent breastfeeding (dependency on the mother's breast) (P = 0.049) had a significant relationship with children's developmental disorders.Conclusion: According to the results of the present study, growth disorders in infants in the case group could be attributed to their mothers' inappropriate breastfeeding patterns. [ABSTRACT FROM AUTHOR]

Abstract Background In this exploratory study, the contribution of delivery type to the weight gain pattern for full-term infants with exclusive breastfeeding in the first month of infancy was determined. In addition, breastfeeding success among cesarean section (C-section) delivery mothers based on their neonate's weight gain at the end of the first month of infancy was evaluated. Methods A cohort of 92 neonates born in Shiraz, from July 10 to August 10, 2007 was followed longitudinally. The data were collected during the first month postpartum at three occasions: 3 to 7 days postpartum, 10-21 days postpartum and 24-31 days postpartum. Results Among 92 mothers in this study, 35 (38%) were delivered by C-section. Generalized estimating equation (GEE) showed that delivery type (p < 0.01), receipt of advice about breastfeeding (p = 0.03) and neonate's age (p < 0.01) significantly affected weight gain. GEE estimated the values of the parameters under study and the testing contribution of each factor to weight gain, leading to the conclusion that gender, parities and maternal education did not contribute to weight gain. The neonate's weight gain pattern for C-section deliveries lies below that of normal vaginal deliveries until 25 days postpartum, when weight gain for C-section deliveries became higher than that for normal vaginal deliveries. Conclusions Type of delivery contributes strongly to the weight gain pattern in the first month of infancy. In spite of greater weight loss among C-section birth neonates in the first days of life, at the end of the first month neonates showed a similar weight gain. Consequently, mothers with C-section delivery can successfully exclusively breastfeed.

This aim of this study was to determine the effect of 1540-nm nonablative fractional erbium on macular amyloidosis. This phase-II clinical trial study has been performed with parallel group with blinding of the evaluator. The skin lesions of the patients (15 patients and 30 lesions) with cutaneous macular amyloidosis were randomly assigned into laser and no-treatment groups. In the laser group, treatment was performed by 1540-nm nonablative fractional erbium laser. Thereafter, the patients' lesions were compared in terms of pigmentation, rippling, thickness, and subjective response. The lesions of the intervention group significantly improved in the three-month follow-up compared to the control group (in the control and intervention group, improved pigmentation was observed in 20 and 53.3% with p =.02, improved rippling in 6.7 and 60% with p =.007, diminished lichenification in 0 and 53.1% with p =.007, and overall lesion improvement in 20 and 60% with p =.03, respectively). In investigating the subjective response through patient global assessment, the patients in the intervention group had a greater satisfaction (p =.01). There was a considerable improvement of pruritus in the intervention group (p =.001). Use of 1540-nm nonablative fractional erbium laser offered a suitable efficacy to treat macular amyloidosis without significant complications. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: The exact etiology of premature hair graying (PHG) remains unknown; however, oxidative stress is shown to be involved. Selenium, as an antioxidant, is widely known for its antiaging potentials. Moreover, PGH is more prevalent among addicts and because Lead is a common impurity found in illegal drug. Aims: We evaluated the serum levels of lead and selenium in patients with PHG and compared it with a control group. Patients/Methods: In this cross‐sectional study, 60 patients referred to Dermatology Clinic of Imam‐Reza Hospital of Mashhad, Iran in 2015 were evaluated in two groups with and without PHG. Demographic information and disease characteristics, skin phenotype, and family history of PHG were recorded. Furthermore, 5 mL of brachial blood was drawn for measuring selenium and lead levels. Results: The mean patients' age was 28.1 ± 4.8 years. Age, sex, occupation, and skin phenotype in individuals with and without PHG were not significantly different (P >.05) but family history of PHG was significantly higher in the patients with PHG (P =.001). Similarly, the number of white hairs was significantly higher (P <.001), and the age of onset of hair graying was significantly lower in patients with PHG (P <.001). Serum levels of selenium and lead were not significantly different between two groups (P <.05). However, the serum levels of lead in the patients with PHG were slightly higher. Conclusions: The results of this study showed that there was no significant difference in lead and selenium serum levels in patients with and without PHG. [ABSTRACT FROM AUTHOR]

Background: Sexual health is a state of physical, mental, and social well-being in relation to sexuality. Sexual assertiveness is a person's ability to meet sexual needs. Considering limited sexual information of women and the taboo nature of talking about sexual needs, the purpose of this study is to evaluate the effectiveness of the sexual assertiveness training on sexual health. Materials and Methods: This randomized clinical trial assignment parallel study with a control group was performed in September and October 2016 on 60 married women referred to Imam Reza Health Center in Mashhad. The sample size was estimated to be 30 subjects per group. Instruments included demographic characteristics, sexual assertiveness, and sexual health questionnaire. The pretest was completed in two groups at the beginning of the study and post-test was done for both groups 1 week after educating the experimental group. Descriptive statistic tests included Chi-square, t-test, and paired t-test, and one-way analysis of variance. A p value less than 0.05 was considered to be statistically significant. Results: The two intervention and control groups showed no significant difference in terms of sexual health level before starting the study (t58 = 0.854, p > 0.05). After the study, based on the independent t-test, the two groups showed significant differences (t58 = -4.077, p < 0.001). Conclusions: Sexual assertiveness training can improve women's sexual health. Considering the lack of research in this area and due to the effect of mutual understanding of couples on emotional and sexual issues, further research is necessary for this field. [ABSTRACT FROM AUTHOR]

Purpose: To report the short-term outcomes of modified deep sclerectomy (MDS) in the management of open angle glaucoma. Methods: This prospective, non-randomized, controlled study included 105 eyes (105 patients) with open angle glaucoma. Eyes were categorized as follows: trabeculectomy (30 eyes), MDS (27 eyes), phacotrabeculectomy (28 eyes), and phaco-MDS (20 eyes). The MDS technique involved removal of a third scleral flap to expose the suprachoroidal space and excision of a trabecular block. A two-site approach was used for combined surgeries. Main outcome measures included intraocular pressure (IOP), number of glaucoma medications, and complications. Treatment success was defined as an IOP of 6–15 mmHg and/or a 30% reduction in IOP. Results: All groups showed significant decrease in IOP and number of medications (both P s < 0.001). The MDS group had a higher IOP (13.9 ± 3.8 vs. 12.4 ± 2.5 mmHg, P = 0.080) and required more medications (P = 0.001) than the trabeculectomy group at 1 year. The MDS group had a higher baseline IOP than the trabeculectomy group (P = 0.004) and both the groups showed similar IOP reductions (33.3% vs. 25.7%, P = 0.391). The phaco-MDS and phacotrabeculectomy groups had comparable IOP (13.3 ± 3.1 vs. 12.4 ± 3.1 mmHg, P = 0.354), number of medications (P = 0.594), and IOP reduction (P = 0.509) at 1-year follow-up visit. The trabeculectomy and phacotrabeculectomy groups developed more wound leaks (P = 0.043) and required more bleb needling during the early postoperative period (P < 0.001). Conclusion: The MDS technique seems to be slightly inferior to trabeculectomy, but when combined with phacoemulsification, is safer and results in similar IOP outcomes. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) can be detected in most of cervical cancers. Due to antiviral, antimutagenic, and proapoptotic activities of myrtle, this study was designed to investigate the effect of a herbal suppository based on myrtle in cervicovaginal HPV infections. This study was performed as a double-blind randomized trial at the Clinic of Traditional Medicine in Mashhad University of Medical Sciences between 2016 and 2017. Sixty women, 18 to 50 years old, with cervicovaginal HPV infection, were included and randomly allocated to two groups. Sixty placebo or herbal vaginal suppositories were prescribed for 3 months (20 suppositories at each menstrual cycle). Each herbal vaginal suppository contained 10% of myrtle aqueous extract and 0.5% of myrtle essential oil. The HPV test and colposcopic findings were evaluated after treatment. There was no difference between two groups as regards lesion site, diagnosis time of disease, and HPV type before intervention (p ≥ 0.05). At the end of the study, the HPV test was negative in 92.6% and 62.6% of the intervention and placebo groups, respectively (p = 0.036). The change in cervical lesion size was 71.4% and 30.4% in the intervention and placebo groups, respectively, based on colposcopic findings (p = 0.015). It seems that herbal suppository can speed up virus clearance and can be effective in treating HPV infection. [ABSTRACT FROM AUTHOR]

Objectives: Hypertension is a global major health challenge and mechanisms related to the risk factors associated with it are poorly understood. Therefore, we used structural modeling to test a hypothesized model to identify factors associated with hypertension. Methods: A cross-sectional population based survey, was performed and the data related to a random representative sample of 9704 subjects of MASHAD study were used. Then, we determined the relationship between risk factors for hypertension using structural equation modeling technique. The data were analyzed using Amos V. 22. Results: The conceptual model was validated by Goodness of Fit Indexes (CFI=0.939, TLI=0.908, NFI=0.935, RMSEA=0.04, SRMR=0.037). Obesity and lack of physical activity had the greatest impact on blood pressure. Discussion: Findings show evidences to confirm the conceptual model considered in the risk factors for hypertension that can be helpful in policies for preventing hypertension and consequently, the disabilities that arise from it. [ABSTRACT FROM AUTHOR]

Background: Sesamin is one of the most abundant lignans in sesame and has multiple functions and high values such as antioxidative effect and promoting-immunity function. The aim of this study was to evaluate the effects of sesamin supplementation on glycemic status, serum levels of inflammatory markers and adiponectinin patients with type 2 diabetes mellitus. Material and Methods: Forty-eight patients with type 2 diabetes participated in this double-blind, randomized, placebo-controlled clinical trial. Subjects were randomly assigned to two groups: intervention group (sesamin capsules; 200 mg/day, n = 24) and control group (placebo capsules; 200 mg/day starch, n = 24). Anthropometric indices and serum levels of fasting blood sugar (FBS), glycated hemoglobin (HbA1c), insulin, tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and adiponectin were assessed at the baseline and after 8 weeks. Result: Sesamin supplementation caused a significant reduction in FBS, HbA1C and TNF-α levels compared with the placebo (p < 0.05). Waist circumference, hip circumference, body adiposity index (BAI), FBS, HbA1c, TNF-α, and IL-6 levels were decreased, and adiponectin levels were increased significantly in the intervention group at the end of study (p < 0.05). Conclusion: According to the beneficial effects of sesamin supplement on glycemic status and inflammatory factors, it may be considered as a supplementary therapeutic approach for diabetic patients. However, future investigations are needed in this field. [ABSTRACT FROM AUTHOR]

Reducing postprandial hyperglycemia is an efficient medical therapy to improve the health of diabetic patients. One of the main strategies to reduce postprandial hyperglycemia is reducing or inhibiting the digestion and absorption of carbohydrates through inhibiting carbohydrate digestive enzyme. This study aimed to investigate the the inhibitory effects of hydroalcoholic extracts of barberry (Berberis vulgaris), sour cherry (Prunus cerasus) and cornelian cherry (Cornus mas L.) fruit extracts against pancreatic a-amylase and intestinal a-glucosidase. The findings showed that barberry extract was the most potent inhibitor against the a-amylase with the IC50 values of 2.38 mg/ml. Cornelian cherry was also the most effective inhibitor of a-glucosidase with the IC50 values of 6.87 mg/ml. The results of the present study suggest that the extracts of barberry, cornelian cherry and sour cherry fruits can be useful in controlling postprandial hyperglycemia. However, their effects should be further investigated in controlled in vivo studies. [ABSTRACT FROM AUTHOR]

Background and Objective: The current challenge of diabetes mellitus is to prevent its complications. These complications are directly associated with hyperglycemia in diabetics. The HbA1c measurement is essential for long-term glycemic control. Synchronization of HbA1c measurement is important in order to avoid discrepancies between results reported by laboratories. This study aimed to evaluate the accuracy, precision and agreement of five HbA1c measurement methods with HPLC reference method. Methods: HbA1c levels of 55 samples were measured using six methods of microcapillary electrophoresis (Sepia), enzymatic method (Pishtaz Teb), immunoturbidometry (Pars Azmoon), boronate affinity (Nycocard), immunofluorescence (ichroma) and Tosoh G8 HPLC. Results: The five tested methods showed a good agreement with the HPLC method with correlation coefficient of less than 95%. Regression testing of HPLC method and other methods showed slope of 0.99 (P<0.05) for Sebia, 1.02 (P<0.05) for Pishtaz Teb, 0.79 (P<0.05) for Pars Azmoon, 0.82 (P<0.05) for Nycocard and 0.89 (P<0.05) for ichroma. Average inaccuracy for the Sebia, Pishtaz Teb, Pars Azmoon, Nycocard and ichroma in comparison with the HPLC reference method were -0.09, -0.004, -0.75, -0.79 and -0.78, respectively. Conclusion: The Sebia microcapillary method and Pishtaz teb enzymatic method have appropriate accuracy and precision. Therefore, these methods can be used as alternatives to the HPLC method for HbA1c measurement. Other methods such as Pars Azmoon, Nycocard and ichroma have significant shortcomings in terms of accuracy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Colesteryl ester transfer protein (CETP) plays a key role in the metabolism of lipoproteins; therefore, polymorphisms of its gene can affect susceptibility to coronary artery disease (CAD) in diabetes mellitus. The aim of the present study was to investigate association between I405V polymorphism of CETP gene and risk of CAD in patients with type 2 diabetes mellitus. METHODS: The current case-control study was conducted on 143 patients with type 2 diabetes and angiographically diagnosed CAD and 150 patients with type 2 diabetes and without CAD. Genotyping was performed through polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The presence of CAD was defined as higher than 50% reduction in coronary artery diameter. RESULTS: The genotype frequencies of I405V polymorphism were II (27.3% vs. 23.2%), IV (61.5% vs. 67.5%), and VV (11.2% vs. 9.3%) in diabetic with CAD compared to diabetic without CAD (χ² = 1.164) (P = 0.55). The I and V alleles were found at frequencies of 63.6% and 61.6% in the diabetic with CAD group and 36.4% and 38.4% in the diabetic without CAD group (χ² = 0.263) (P = 0.60). No significant difference was observed between two groups in terms of genotype and allele frequency. Moreover, no significant association was observed between II, IV, and VV genotypes and lipid profiles in both groups. However, a significant difference was observed between genotype distributions of I405V polymorphism in men according to the severity of CAD. CONCLUSION: It is speculated that I405V polymorphism may be associated with the severity of coronary artery stenosis only in men with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

The present study aimed to evaluate the relation between stress and different aspects of female sexual function and satisfaction. This cross-sectional study was conducted on 228 reproductive-age women who were referred to the public Health Centers in Ahvaz, Iran. All eligible participants were asked to complete a demographic questionnaire, the Female Sexual Function Index, and the Perceived Stress Scale. The data were analyzed using independentttest, Pearson correlation, and logistic regression. The mean score of stress was 32.9 (SD= 4.7) in the normal sexual function group and 33.3 (SD= 5.5) in the unfavorable sexual function group. There was a significant correlation between stress and sexual function score, sexual desire, arousal, orgasm, lubrication, sexual pain, and satisfaction (p<.001). Spouses’ education (OR = 0.15, CI [0.02, 0.97],p=.04) and frequency of sexual intercourse per week (OR = 1.8, CI [1.3, 2.5],p<.001) had a significant relation with stress. There is a significant relation between women's perceived stress and sexual function and satisfaction. Further analytical studies are needed to show the harmful effects of stress on women's sexual activity and satisfaction. [ABSTRACT FROM AUTHOR]

Well-designed lighting decreases accidents and diseases of eyes and can increase productivity and concentration. Increase of energy price and a high proportion of electric lighting energy consumption in buildings due to defects in designing and maintenance led to desirable lighting to be reduced. One of our challenges in providing health and quality of lighting is lack of economic justification of projects. Furthermore, evaluating the lighting systems is very important to improve these systems and maintaining lighting quality. In this study the performance of the various lighting systems has been evaluated. The health and quality conditions of lighting systems, energy loss and the difference between the lighting variables, based on room index and the designed required levels (normalized power density) in studied schools and education workrooms in Ahvaz Jundishapur University of Medical Sciences (south-west of Iran) have been evaluated. Results showed that the modern lighting systems had 58% more efficient than the traditional others. In other words, modern lighting systems increase illuminance to 58 percent without increasing the electrical energy power. The performance indices of lighting systems between workrooms that had modern systems and traditional was significant (p=0.000). In 77.4% of spaces of the school of Medicine, where that had new lighting systems, the satisfaction index of users was equal to one. Evaluation of lighting systems in order to decreasing the electrical energy power along with preserving the standards of illumination intensity is very important, and some appropriate solutions could be adopted by replacing the traditional systems with the new others. [ABSTRACT FROM AUTHOR]

Background and Objective: One of the most important applications of electrode physiological tests is early diagnosis of hearing loss and estimating of hearing threshold in neonate and children for early auditory intervention. Auditory Steady--State Response (ASSR) is modern technology for threshold detection in audiology. Measurement of Auditory brainstem response (ABR) is most common method of detection auditory threshold in neonates. The goal of this article was to correlate the results between thresholds obtained from ASSR and click-ABR. Subjects and Methods: In this descriptive-analytic design, 32 children with mild and moderate hearing loss, aged between birth to 7 years, were studied. All children were evaluated by both ASSR and C-ABR. Results: The correlation coefficients for frequencies of 0.5, 1, 2, 4, mean of 2-4, and mean of 1-4 kHz were between 0.40- 0.87 in mild hearing loss and 0.52-0.91 in moderate hearing loss(P<0.05). Conclusion: C-ABR and ASSR thresholds in mean frequencies had a greater correlation than single-frequency(P-Value< 0.001<0.002-0.015). This correlation was higher in greater degrees of hearing loss and higher frequencies. [ABSTRACT FROM AUTHOR]

Background: In this exploratory study, the contribution of delivery type to the weight gain pattern for full-term infants with exclusive breastfeeding in the first month of infancy was determined. In addition, breastfeeding success among cesarean section (C-section) delivery mothers based on their neonate's weight gain at the end of the first month of infancy was evaluated. Methods: A cohort of 92 neonates born in Shiraz, from July 10 to August 10, 2007 was followed longitudinally. The data were collected during the first month postpartum at three occasions: 3 to 7 days postpartum, 10-21 days postpartum and 24-31 days postpartum. Results: Among 92 mothers in this study, 35 (38%) were delivered by C-section. Generalized estimating equation (GEE) showed that delivery type (p < 0.01), receipt of advice about breastfeeding (p = 0.03) and neonate's age (p < 0.01) significantly affected weight gain. GEE estimated the values of the parameters under study and the testing contribution of each factor to weight gain, leading to the conclusion that gender, parities and maternal education did not contribute to weight gain. The neonate's weight gain pattern for C-section deliveries lies below that of normal vaginal deliveries until 25 days postpartum, when weight gain for C-section deliveries became higher than that for normal vaginal deliveries. Conclusions: Type of delivery contributes strongly to the weight gain pattern in the first month of infancy. In spite of greater weight loss among C-section birth neonates in the first days of life, at the end of the first month neonates showed a similar weight gain. Consequently, mothers with C-section delivery can successfully exclusively breastfeed. [ABSTRACT FROM AUTHOR]

Objectives: Many studies concerning herbal products and medicines in the treatment of adult diseases have been performed around the world. However, there are very limited studies on use of these drugs in children and especially neonates. According to reference books, the use of herbal medicines has several risks and their use is contraindicated in infants. This study aimed to determine the prevalence of herbal treatment in neonates and its related factors in Iranian families. Materials and Methods: This prospective cohort study was conducted on 287 infants. All babies were referred three times (3-5 days, 10-15 days and one month old) to health centers for treatment. In this study, mothers were asked about use of herbal medicines for the treatment of neonatal jaundice and demographic information was collected. Results: Among 287 subjects, about 93 infants (32.4%) had been given at least one herbal medicine during their first month after birth. According to the results of logistic regression, there was no significant relationship between the use of herbal medicines and education level and age of mother, family income, and birth rank. Also, the rates of herbal medicine use were 24.6% in female and 40.6% in male babies, which is statistically significant. Conclusion: The results of this study showed that treating neonates with herbal medicines is relatively prevalent, regardless of educational level and socio-economic status of the family. Therefore, herbal therapy is considered as a safe treatment method for the treatment of babies by the majority of Iranian families. [ABSTRACT FROM AUTHOR]

Background and purpose: Women who develop preeclampsia are prone to post-traumatic stress disorder (PTSD). The major role of spiritual health is well understood in health contexts. On the other hand, the effects of stress, anxiety, and depression are known to influence the treatment process in women with preeclampsia experiences. So, this study aimed at comparing spiritual health and perceived stress levels in women with preeclampsia, affected and unaffected by PTSD. Materials and methods: This descriptive-analytic study was done in 278 multipara women with preeclampsia at 36-40 weeks gestation admitted to public hospitals in Mashhad, Iran 2017. The Perinatal Posttraumatic Stress Questionnaire (PPQ), the Post Traumatic Disorder Checklist (PCL), Depression Anxiety and Stress Scales (DASS 21), and the Spiritual Well-Being Scale were administered. Data were analyzed using SPSS V16 applying independent T-test, Mann Whitney, and Spearman's rank correlation coefficient. Results: Among the patients 68 (26%) developed postpartum PTSD. Significant relationships were found between the two groups of affected and unaffected by postpartum PTSD in spiritual wellbeing (P= 0.030), depression (P= 0.001), stress (P= 0.000), and anxiety (P=0.000). Conclusion: Low levels of spiritual health and high levels of depression, anxiety, and stress in postpartum women are amongst the main causes of developing PTSD in women with history of preeclampsia.en [ABSTRACT FROM AUTHOR]