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Background and Aim: Provision of timely healthcare for children under 5 years of age specially children with congenital hypothyroidism and also regular monitoring of growth through measuring weight, height and head circumference have been of great importance. The aim of this study was to make a comparison between healthy children and children with congenital hypothyroidism in regard to health-care coverage in Iran. Materials and Methods: This study was conducted in five provinces in different geographical areas of Iran in 2015. 240 children with congenital hypothyroidism and 240 healthy children were entered into the study. Children with congenital hypothyroidism were selected randomly from the national registere database. The children in the control group were matched with the children with hypothyroidism in regard to age, gender and place of residence. Anthropometric indices including weight, height and head circumference of the children of less than 3 years of age were recorded as the health care indices. STATA software version 13 was used for data analysis. Results: The mean percentage of measurement and record of weight, height and head circumference in children below 3 years of age with congenital hypothyroidism were 82.1, 78.7 and 55.4%, respectively. The mean percentage of measurement and record of weight, height and head circumference in healthy children (control group) below 3 years of age were 82.2%, 80.9 and 55.1%, respectively. There was a statistically significant difference between the two groups in relation to the percentage of height measurement (P =0.02). Conclusion: According to the results of this study, percentage of measurement and record of the anthropometric indices in Iranian children of less than 3 years of age is low. More attention to the measurement and record of these physical growth indices in children of less than 3 years of age specially children with congenital hypothyroidism who need regular follow up, is essential.

Background and Objective: Acquired immunodeficiency syndrome (AIDS) is a definition of dysfunction of immune system in human that is induced by infection with a virus named human immunodeficiency virus (HIV). The most high risk group in HIV infected people are intravenous drug users (IDUs) with unsafe sex. This study was conducted to evaluate knowledge and attitude of IDUs with unsafe sex about AIDS and relation with socioeconomic levels in Golestan province in North of Iran. Materials and Methods: This Cross-Sectional study was conducted on 134 IDUs in Golestan province during 2007. Samples were chosen by a random systematic method. Data was collected with interview by standard questionnaire. Data was analyzed by SPSS-16 and One-way ANOVA,T-test student, Kruskal-wallis, Mann-Whitney U and Kendall tests. Results: This study showed that 36.6% of samples had moderate knowledge about AIDS and 49.3% of them had negative attitude about AIDS. 67% of subjects had education between 6-12 years, 44.8% were married and 53% were jobless and without income. Level of knowledge had a significant relation with age (P

BACKGROUND: Neonates are too vulnerable that low birth weight (LBW) and preterm birth can easily threaten their lives. Demographic, social and environmental factors as well as health care are contributing factors for LBW. The study was conducted in 10 provinces of Iran to investigate the association between LBW and mother's diseases. METHODS: A case-control study was conducted in 10 provinces of Iran on 2580 mothers (712 cases and 1868 controls) referred to public health care centers. We used a questionnaire to collect data. For univariate analysis we used chi-square test and for multivariable analysis we used logistic regression model. RESULTS: LBW was significantly associated with living in rural area (OR = 1.4 CI: 1.14–1.71), having body mass index (BMI)<18 (OR = 1.48 CI: 1.14–1.92), being a housewife (OR = 1.65 CI: 1.07–2.53), having high blood pressure (OR = 1.91 CI: 1.26–2.88), and having pregnancy without testing for diabetes (OR = 1.91 CI: 1.44–2.54). Minor thalassemia, hypothyroidism, oral health care and headache were not significant predictors for LBW. CONCLUSION: In this study, we observed that place of residence, BMI before pregnancy, mother's occupation and gestational diabetes were significant predictors of LBW. It is necessary to improve women's awareness about prenatal health care before pregnancy to avoid LBW. [ABSTRACT FROM AUTHOR]

Background and Aim: AIDS is a lethal disease, for which there is no treatment or any vaccine to prevent it. The injection-drug use and unprotected sexual behavior are two factors important in HIV transmission. This study was conducted to determine changes in high-risk sexual and injection-drug use behaviors associated with HIV among drug users referring to Methadone Maintenance Treatment centers in Shiraz, Iran. Materials and Methods: This before-after interventional study with no control group included drug-users (n=694) referring to all the 7 MMT centers in Shiraz, Iran in 2009. The data were collected by interviewing patients and using a questionnaire. The software used for data analysis was SPSS 15, the statistical test being the Wilcoxon test. Results: The average age of the clients was 36.5 ± 9.5 years. Most of them were males (% 92.1) and single (% 43.1). 37.3 % of them being injection-drug users. The proportion of the injectiondrug users having had at least one shared injection one week before referring to an MMT center was 23.3%, which decreased to 9.2% after one week. Analysis of the data also showed that 25.2% of the addicts had had at least one unprotected sexual contact during the previous month; the proportion decreased to 21.0% one month after referring to an MMT center. The reductions in the mean numbers of both shared injections and unprotected sexual contacts were statistically significant (p <0.001). Conclusion: Considering the effectiveness of the MMT centers in reducing risky behaviors of injection-drug users, it is essential to expand these centers at both the national and regional levels quantitatively and qualitatively and encourage drug-users to refer to them and seek help. This will help greatly in the prevention of HIV. [ABSTRACT FROM AUTHOR]

Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objective: Tuberculosis caused by Mycobacterium tuberculosis is one of the deadliest infectious diseases in the world. The amount of the bacilli in tuberculosis will reduce rapidly by starting effective antibiotic treatment and the remained bacilli in the sputum will be an important scale to respond to treatment. This study was conducted to evaluate the examin factors associated with the conversion of positive smear to negative one in tubercular-pulmonary patients in Golestan province, in northern Iran. Methods: This retrospective cohort study was carried out on 2093 patients with smear positive pulmonary tuberculosis registered in Golestan province, northern Iran from March 2009-14 referred to health centers. The outcome of this study was to determine the time of changing to negative of the first smear during the treatment and evaluating its relationship with demographic variables, the density of bacilli in the smear, culture, chest x-ray, diabetes and HIV. Results: 67.5% of patients among 2093 smear-positive pulmonary tuberculosis patients were conversion rate of smear at the end of the second months. Results of Cox model showed relationship between gender, age, weight, density bacillus smear and culture results at the start of treatment and negative smears(P<0.05). Old age, low weight, high density of bacillus in primary smear in the beginning of treatment and increasing of the number of colonies in culture of positive smear patients were considered as predictor factors in changing positive smear to negative one. Conclusion: This study revealed that Conversion rate and treatment success in Golestan province was less than what was expected. [ABSTRACT FROM AUTHOR]

Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Population-based data on myocardial infarction rates in the Islamic Republic of Iran have not been reported on a national or provincial scale. In a cross-sectional study, data were collected on 20 750 new cases of myocardial infarction (ICD10 codes I21-22) admitted to hospitals and registered by the Iranian Myocardial Infarction Registry in 2012. The crude and age-adjusted incidence for the 31 provinces and the whole country were directly calculated per 100 000 people using the WHO standard population. Overall, males comprised 72.4% of cases and had a significantly lower mean age at incidence than women [59.6 (SD 13.3) years versus 65.4 (SD 12.6) years]. The male:female incidence ratio was 2.63. The age-standardized myocardial infarction incidence rate was 73.3 per 100 000 in the whole country (95% CI: 72.3%-74.3%) and varied significantly from 24.5 to 152.5 per 100 000 across the 31 provinces. The study provides baseline data for monitoring and managing cardiovascular diseases in the country. [ABSTRACT FROM AUTHOR]

The growing demand for high-speed packet data services and multimedia applications over mobile personal communication networks has set new design requirements and objectives for the next generation of air interface protocols. The asymmetric and bursty nature of multimedia packet data traffic, and the variability of data rates, packet sizes, and quality of service requirements make conventional voice-oriented channelization and access protocols inefficient. New media access control and common channel messaging procedures need to be defined to efficiently support concurrent multiple packet- and circuit-switch-based services and their related signaling messages. Specifically, the role of common channels in support of frequent short packet data and signaling transactions is much more significant. This article presents the new enhanced random access and reservation schemes in CDMA2000 as well as related concepts considered in the design of the current and future releases of this air interface standard. The scheme is based on a variation of packet reservation multiple access combined with variable data rate, power control and soft handoff capabilities, formalized within wideband CDMA2000 framework [ABSTRACT FROM PUBLISHER]

Background: Undiagnosed hypertension (HTN) and diabetes mellitus (DM) are major public health challenges worldwide. We aimed to investigate the prevalence of undiagnosed HTN and DM, and their correlates, in a large-scale population-based cohort study. Methods: In this cross-sectional study, data collected during the enrollment phase of the Tabari Cohort study (TCS) were utilized. Data were collected in the TCS using a standard questionnaire, blood collection, and measurement of anthropometric indices and blood pressure. Data were analyzed using the chi-squared test and univariate and multivariate logistic regression analyses. Undiagnosed HTN included those who were not aware of HTN at the time of enrollment but had systolic and diastolic blood pressures ≥ 140 mm or ≥ 90 mmHg, respectively. Undiagnosed DM included participants who were unaware of their DM at the time of enrollment and had FBS levels ≥ 126 mg/dL. Results: The total prevalence of undiagnosed HTN and DM were 5% (508) and 4.7% (485), respectively. The findings of multivariable logistic regression analysis showed that young age (OR: 0.40, P < 0.001), residents of urban regions (OR: 0.70, P = 0.03), lower Body Mass Index kg/m2 (BMI) (OR: 0.51, P = 0.002), waist-to-hip ratio (WHR)(OR: 0.70, P = 0.023), total cholesterol (TC) ≥ 200 mg/dL (OR: 0.1.83, P < 0.001), lack of history of DM (OR: 0.38,P < 0.001), cardiovascular diseases (CVD)(OR: 0.12, P < 0.001), and lack of a positive family history of HTN in first-(OR: 0.39, P < 0.001) and second-degree(OR: 0.56, P = 0.009) relatives were the main predictors of undiagnosed HTN. Accordingly, male sex(OR: 0.52, P = 0.004), young age(OR: 0.28, P < 0.001), residence in urban regions(OR: 0.30, P < 0.001), BMI ≥ 30 (OR: 1.51, P = 0.044), low-density lipoprotein (LDL) ≥ 130 mg/dL (OR:1.93, P < 0.001), TC ≥ 200 mg/dL (95% CI, 1.47–2.51, P < 0.001), positive history of chronic kidney disease (OR:1.39, P = 0.010), and lack of family history of first-(OR: 0.38, P < 0.001) and second-degree (OR: 0.62, P < 0.015) DM were the main predictors of undiagnosed DM. Conclusion: Overall, younger participants, those residing in urban areas, those with TC ≥ 200 mg/dL, and those without a positive family history of HTN or DM were at a greater risk of undiagnosed HTN/DM. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Research & Health is the property of Negah Institute for Social Research & Scientific Communication and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To compare and find out the relationship between psychological distress, general health and life satisfaction among children with thalassemia and children undergoing dialysis. Method: The current study utilized cross sectional research design. A representative group of children with Thalassemia (n=60) and children undergoing dialysis (n=60) with ages ranging from 6-14 years were included in the sample. The sample was drawn from Children's Hospital and Sundas Foundation from February 2023 to August 2023 through a purposive sampling technique. Results: Psychological distress significantly correlates negatively with general health (-.34**) and life satisfaction (-.44**) in Children with Thalassemia. A significant negative relationship is also observed between psychological distress and general health (-.43**) and life satisfaction (-.54**) in Children undergoing Hemodialysis. Children undergoing hemodialysis experience more psychological distress whereas children with thalassemia have better general health. However, no significant difference was found in life satisfaction. The findings of the present study will be helpful for healthcare professionals and clinical psychologists to develop strategies and training programs which can increase resilience among patients. Training the patients and caregivers regarding how to fight chronic illnesses will lead to an improvement in their quality of life. Conclusion: Psychological distress is higher in children undergoing hemodialysis and general health is also not good but the level of satisfaction is almost equal between the two groups. This is justified that chronic illnesses do not preclude children from leading happy and satisfying lives. [ABSTRACT FROM AUTHOR]

Background: Transfusion-dependent β-thalassemia (TDT) is a severe inherited disorder. Without regular treatment, patients with TDT experience complications that can significantly shorten life expectancy and severely impact both their quality of life and that of their families. The condition has attracted significant attention in global health discussions. Due to the challenges of blood supply shortages, the high costs of iron chelation therapy, and hematopoietic stem cell transplantation (HSCT), TDT presents a serious health risk to patients and imposes a substantial burden on families and society. However, research on the health-related quality of life (HRQoL) of thalassemia patients in China remains limited. This study evaluated the factors affecting the HRQoL of these patients, with the goal of developing strategies to improve their quality of life. Methods: In this cross-sectional study, children with TDT were recruited from five treatment centers in Guangxi, a province with a high prevalence of thalassemia in China. Structured questionnaires were employed to gather relevant data on sociodemographic variables, disease characteristics, treatments, and associated costs. The HRQoL was assessed using the Transfusion-Dependent Quality of Life (TranQoL) questionnaire, with a proxy version for patients aged 0–11 years and a child version for those aged 12–18 years. Results: The study included 418 participants, yielding an overall TranQoL score of 60.6 ± 16.3 among thalassemia patients. Multiple linear regression analysis revealed a negative correlation (P < 0.05) between overall TranQoL scores and several factors: increasing patient age, the presence of multiple thalassemia patients within a family, and undergoing HSCT. Conversely, adherence to regular treatment was positively correlated with higher TranQoL scores (P < 0.05). Conclusion: The study demonstrates that HRQoL among Chinese patients with TDT is at a low level. Age, treatment adherence, family support, and socioeconomic status were identified as key determinants influencing HRQoL. It is essential to further enhance and optimize health insurance policies and medical services to support comprehensive treatment strategies for these patients. [ABSTRACT FROM AUTHOR]

Background: Nausea and vomiting during pregnancy (NVP) is one of the most common complication of pregnancy. The present study was aimed to determine the association between vomiting during pregnancy and adverse birth outcomes. Methods: A cross-sectional study was conducted on 3649 pregnant women across 11 provinces of Iran. Cluster sampling method was used to select samples and data collection was done using family record and face-to-face interviews. Data were analyzed by logistic regression, using STATA14.2 software. Results: The prevalence of vomiting during pregnancy was 9.7% (95% CI: 8.8, 10.7), with an increasing trend by birth cohort. After adjusting for other confounders, the prevalence of vomiting revealed a decreasing trend by body mass index (OR = 0.63, 95%CI: 0.53, 0.78, P-trend < 0.001). In addition, long inter-pregnancy interval (IPI) significantly increased the odds of NVP (ORIPI of 1−3 year=2.42, ORIPI of >3 year=1.63). Multivariate analyses showed that the odds of stillbirth (AOR = 1.61, 95% CI: 1.17, 2.19) and the odds of infant mortality (AOR = 1.78, 95% CI: 1.29, 2.45) were significantly increased in women with daily vomiting during pregnancy. The odds of vomiting during pregnancy was significantly shown to reduce the odds of abortion by 45%. Conclusion: The prevalence of NVP was shown to have an increasing trend in Iran. This complication is associated with many adverse health outcomes during pregnancy and negatively affect maternal and fetal health. Given the importance of pregnancy period, nutrition education and increase the awareness of pregnant women towards NVP, especially pre-pregnancy training is suggested. [ABSTRACT FROM AUTHOR]

Background: Disinfection has a fundamental role in the control of pathogens in the hospital environment. This study was designed to assess the efficacy and functional impact of disinfectants in reducing pathogens related to healthcare associated infections (HAIs) in hospitals. Methods: This observation study was conducted at three university hospitals in Gorgan, Iran, from May to Oct 2023. The data including used disinfectants and microbiological examination were obtained from the infection control unit of each hospital. Results: The results showed that a variety of disinfectants from intermediate to high levels were employed in accordance with the World Health Organization (WHO) protocols. The microbial result revealed that 31.6% (286 out of 906) of the sample had at least one microorganism. Among identified organisms, Bacillus spp. were the predominant species followed by Staphylococcus epidermis, fungus genera, Enterobacter spp., Enterococcus spp., Pseudomonas spp., Escherichia coli, Alcaligenes spp., Staphylococcus aureus, Citrobacter spp., Corynebacterium spp., Klebsiella spp., Acinetobacter spp., Micrococcus spp., Staphylococcus saprophyticus, and Serratias spp. The highest prevalence rates of microorganisms were observed in the wards of ICU, emergency, internal medicine, and women's ward. The chi-square test revealed a significant relationship between the presence of organisms and hospital wards (P < 0.05). Conclusion: The presence of pathogens indicates a defect in the disinfection process, probably due to both little attention to disinfection protocols and multidrug resistance. It is not yet possible to eliminate pathogens from the hospital environment, but it can be minimized by education intervention, standardizing disinfecting processes, and monitoring by the infection control committee. [ABSTRACT FROM AUTHOR]

Purpose: Provisions for the minimisation of human error are essential through governance structures such as recruitment, human resource allocation and education/training. As predictors of safety attitudes/behaviours, employees' personality traits (e.g. conscientiousness, sensation-seeking, agreeableness, etc.) have been examined in relation to human error and safety education. Design/methodology/approach: This review aimed to explore research activity on the safety attitudes of healthcare staff and their relationship with the different types of personalities, compared to other complex and highly regulated industries. A scoping review was conducted on five electronic databases on all industrial/work areas from 2001 to July 2023. A total of 60 studies were included in this review. Findings: Studies were categorised as driving/traffic and industrial to draw useful comparisons between healthcare. Certain employees' personality traits were matched to positive and negative relationships with safety attitudes/behaviours. Results are proposed to be used as a baseline when conducting further relevant research in healthcare. Research limitations/implications: Only two studies were identified in the healthcare sector. Originality/value: The necessity for additional research in healthcare and for comparisons to other complex and highly regulated industries has been established. Safety will be enhanced through healthcare governance through personality-based recruitment, human resource allocation and education/training. [ABSTRACT FROM AUTHOR]

The global prevalence of diabetes has increased significantly, leading to various complications and a negative impact on quality of life. Hyperglycemia hyperglycemic‐induced oxidative stress (OS) and inflammation are closely associated with the development and progression of type 2 diabetes mellitus (T2D) and its complications. This review explores the effect of T2D on target organ damage and potential treatments to minimize this damage. The paper examines the pathophysiology of T2D, focusing on low‐grade chronic inflammation and OS and on their impact on insulin resistance. The review discusses the role of inflammation and OS in the development of microvascular and macrovascular complications. The findings highlight the mechanisms by which inflammatory cytokines, stress kinases, and reactive oxygen species (ROS) interfere with insulin signaling pathways, leading to impaired glucose metabolism and organ dysfunction. Lifestyle interventions, including a balanced diet and exercise, can help reduce chronic inflammation and OS, thereby preventing and controlling T2D and its associated complications. Additionally, various antioxidants and anti‐inflammatory agents show potential in reducing OS and inflammation. Some anti‐diabetic drugs, like pioglitazone, metformin, and glucagon‐like peptide‐1 (GLP‐1) agonists, may also have anti‐inflammatory effects. Further research, including randomized controlled trials, is needed to evaluate the efficacy of these interventions. [ABSTRACT FROM AUTHOR]

Introduction: Reinfection with SARS-Cov-2 after recovery can occur that most of them don't require hospitalization. The aim of this study is estimation of out-patient COVID-19 reinfection and recurrence rates and its associated factors among Iranian patients with history of confirmed SARS-Cov-2 infection and hospitalization. Methods: This study is a retrospective cohort conducted from May 2021 to May 2022 in Iran. The national Medical Care Monitoring Center (MCMC) database, obtained from the Ministry of Health and Medical Education, includes all information about confirmed COVID-19 patients who are hospitalized and diagnosed during the pandemic. Using probability proportional to size sampling from 31 provinces, 1,532 patients over one years of age with a history of hospitalization in the MCMC data are randomly selected. After that, interviews by phone are performed with all of the selected patients using a researcher-made questionnaire about the occurrence of overall reinfection without considering the time of infection occurrence, reinfection occurring at least 90 days after the discharge and recurrence (occurring within 90 days after discharge). Univariate and multivariable Cox regression analyses are performed to assess the factors associated with each index. All of the analyses are performed using Stata software version 16. Results: In general, 1,532 phone calls are made, out of which 1,095 individuals are willing to participate in the study (response rate ≃ 71%). After assessing the 1,095 patients with a positive history of COVID-19, the rates of non-hospitalized overall SARS-Cov-2 reinfection, reinfection and recurrence are 122.64, 114.09, and 8.55 per 1,000 person-years, respectively. The age range of 19–64 years (aHR:3.93, 95%CI : 1.24–12.41) and COVID-19-related healthcare worker (aHR: 3.67, 95%CI: 1.77–7.61) are identified as risk factors for reinfection, while having comorbidity, being fully vaccinated, and having a partial pressure of oxygen (PaO2) ≥ 93 mmHg during the initial infection are identified as factors that reduce the risk of non-hospitalized reinfection. Conclusion: Reinfection due to COVID-19 is possible because of the weakened immune system for various reasons and the mutation of the virus. Vaccination, timely boosters, and adherence to preventive measures can help mitigate this risk. [ABSTRACT FROM AUTHOR]

Automatic and blind parameter estimation based on the inherent features of wireless signals is a major research area due to the fact that these techniques lead to the simplification of receivers, especially in terms of coarse synchronization, and more importantly reduce the signaling load at the control channels. Thus, in the literature, many techniques are proposed to estimate a vast set of parameters including modulation types and orders, data and chip rates, phase and frequency offsets, and so on. In this paper, a cyclostationary feature detection (CFD) based method is proposed to estimate the carrier numbers and carrier spacing of carrier-aggregated direct sequence spread spectrum (DSSS) cellular signals blindly. The particular chip rate of the signal is also estimated through the process jointly. The proposed CFD-based method unearths the inhered and hidden second-order periodicities of carrier-aggregated DSSS signals, particularly targeting repeated pseudorandom noise sequences of users over the carriers. Throughout the paper, after the proposed method is formulated, the measurement setup that is developed to collect the data for the validation of the method is introduced. The measurement results are post-processed for performance analysis purposes. To that end, the method is investigated in terms of signal-to-noise ratio (SNR) values, different channel conditions, and measurement durations. Furthermore, the performance of the proposed method is compared with that of energy detection. The measurement results indicate superior performance of the proposed method under significant wireless channel impairments and in low-SNR regions, e.g., for 0 dB the proposed method provides more than 0.9 detection performance for the case of 0.1 false alarm rate, while the performance of ED is 0.6 under the same wireless channel impairments. The raw outputs of the method can be utilized to train a convolutional neural network to eliminate the statistical estimation process in future work. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is one of the most common diseases globally that may have side effects on liver and renal function. Pharmacological treatments to reduce adverse liver and renal effects are still limited. It has been proposed that silymarin may possess hepatoprotective and anti-inflammatory properties. The present trial aims to assess the hepatorenal protective efficacy of silymarin supplementation in cancer patients receiving chemotherapy in an outpatient setting. Method: This is a randomized, placebo-controlled clinical trial that recruited female breast cancer patients. Participants were randomly assigned to one placebo group and two intervention groups. The control group received 140 mg of placebo daily, while the two intervention groups received 140 mg silymarin daily. Follow-up assessments were conducted at baseline, 3 weeks, and 6 weeks. At the beginning of the study, the patients were subjected to a computed tomography (CT) scan, and the liver and renal parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin, Blood urea nitrogen (BUN) and Creatinine (Cr) were examined through laboratory tests. Results: Despite two deaths and three dropouts, 100 patients completed the study. Silymarin showed significant effects on liver enzymes in the levels of ALP and bilirubin (P < 0.05), with no significant impact on renal function in the levels of Blood urea nitrogen (BUN) and Creatinine (Cr) (P > 0.05). The medication was well-tolerated, with minimal reported side effects (P > 0.05). Discussion: The study suggests that silymarin may have hepato-renal protective potential in breast cancer patients and improve patient tolerance to chemotherapy. The data presented on the efficacy and safety of silymarin may provide stronger foundation for further trials and for a possible use in clinical practice. Trial registration information: Registration Number: IRCT20201123049474N2, First Trial Registration: 16/08/2021, Access: https://www.irct.behdasht.gov.ir/trial/57641 [ABSTRACT FROM AUTHOR]

Background: The incidence of chronic diseases, which are significant contributors to maternal deaths and adverse new-born outcomes, is increasing among women of reproductive age in northern Ghana. This emerging health issue raises serious concerns about the potential exacerbation of adverse birth outcomes in this setting, given that it is one of the regions in the country with a high incidence of such outcomes. We investigated the risks of preterm birth (PTB), low birth weight (LBW), and concurrent PTB and LBW among women with preexisting chronic conditions prior to conception in the Tamale Metropolis of northern Ghana. Methods: A facility-based cross-sectional study was conducted among 420 postpartum women randomly selected from five public health facilities. Information was collected electronically on participants' self-reported experience of chronic conditions, namely, hypertension, diabetes, asthma, heart disease, and sickle cell disease, prior to their most recent pregnancy. Information on gestational age at delivery and birth weight was also collected. Regression modeling was used to quantify the risk of adverse newborn outcomes among women who reported preexisting chronic conditions prior to pregnancy. Results: Chronic diseases affected 31.2% of our sample. Of these, 28.6% had a single chronic condition, while 2.6% had comorbid chronic conditions. The prevalence of PTB was 24.0% (95% CI: 20.2, 28.4), 27.6% (95% CI: 23.5, 32.1) of the newborns were born LBW, and 17.4% (95% CI: 14.0, 21.3) of the pregnancies resulted in both PTB and LBW. Compared with those without chronic conditions, women with chronic conditions prior to conception had a greater risk of PTB (aOR = 6.78, 95% CI: 3.36, 13.68), LBW (aOR = 5.75, 95% CI: 2.96, 11.18), and the co-occurrence of PTB and LBW (aOR = 7.55, 95% CI: 3.32, 17.18). Conclusions: We observed significant rates of PTB, LBW, and the co-occurrence of PTB and LBW among women who were already aware that they had preexisting chronic conditions prior to conception. Our findings highlight a potential gap in the quality of prenatal care provided to these women before delivery. Preconception care may offer an opportunity to address preexisting chronic conditions in women before pregnancy and potentially improve maternal and newborn health outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Chronic Kidney Disease (CKD) is a long-standing metabolic disease manifested by renal impairment, high morbidity and mortality, and causing a huge financial burden. Systemic inflammation and local intrarenal inflammation are found to exacerbate this irreversible condition. White blood cells, platelets, and their derived indices may aid in the assessment of the progression of CKD. This study aimed to assess the alterations of complete blood count and their derived indices in the various stages of chronic kidney disease. Methods: The retrospective cross-sectional study was conducted in the Department of Biochemistry at a tertiary care hospital, Chennai, India. The data were collected from the Medical Records Department from July 2022 to June 2023. The study included chronic kidney disease patients aged 35 to 70 years of both genders. Children, pregnant women, and patients with heart and liver diseases were excluded. The data of the renal profile and complete blood count were collected. Statistical analysis was performed using SPSS software version 16. A p≤0.05 was considered statistically significant. Results: Among the study participants, 65% were male and were more than 50 years of age. All the derived in-flammation index parameters, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lympho- cyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI). were significantly increased in stage 5 of CKD. Also, SII and SIRI were found to be correlated with other inflammatory variables. Conclusion: Chronic inflammation is considered to be prevalent among CKD patients. Inflammatory markers such as SII and SIRI are simple and cost-effective parameters to routinely assess the staging of CKD and thus initiate appropriate management to improve the quality of life. [ABSTRACT FROM AUTHOR]

An extremely dangerous side effect of type I and type II diabetes is diabetic nephropathy (DN). From the early microproteinuria to end-stage renal failure, it progresses. About one in three diabetics in the US suffer from diabetic nephropathy. Chronic hyperglycemia is the primary cause of diabetic ketoacidosis. Hyperglycemia (HG) has the potential to cause humoral mediators and cytokines to be produced by both resident and non-resident renal cells. These substances may interfere with cell growth, alter renal cell and tissue phenotype and function, interact with proteins, produce advanced glycation end products (AGEs), damage tubules and glomeruli, and ultimately cause kidney disease. Poor blood glucose management is thus a significant risk factor for the onset of DN. An alternate course of treatment for DN may use extracts from herbal remedies. Medicinal plants' bioactive components stop DN from progressing. Attention has to be paid to the role that traditional herbs and medications play in the treatment of diabetic nephropathy, particularly in India where several fruits and herbs are believed to provide health benefits. Natural compounds influence the KEAP1/Nrf2/ARE and NFB pathways in addition to having antioxidant and anti-inflammatory properties. The efficacy of entire herbs, plants, or seeds, together with their active components, in treating diabetic nephropathy was investigated in preclinical research. Natural compounds are biologically active substances that come from natural sources and are beneficial for treating specific illnesses. Numerous natural substances, such as glycosides, polysaccharides, terpenoids, alkaloids, flavonoids, and polyphenols, have been shown to enhance DN. The exorbitant expenses associated with contemporary medications suggest that other approaches are necessary for improved DN treatment. Future research on herbal remedies may provide a natural key to open a pharmacy for diabetologists. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is a prevalent and escalating health issue in Taiwan. This nationwide study delves into the relationship between Human Papillomavirus (HPV) infection and CRC risk, employing population datasets from 2007 to 2017. Cox regression analyses revealed a statistically significant hazard ratio (HR) of 1.73 (95% CI: 1.63–1.83) for CRC in HPV-positive patients, indicating a considerably elevated risk compared to non-infected individuals. Further, stratification by sex showed males with HPV have a higher CRC risk (HR = 1.49, 95% CI: 1.40–1.58) compared to females. Age-related analysis uncovered a progressive increase in CRC risk with advancing age (HR = 34.69 for over 80 years). The study of specific CRC subtypes showed varying risks: HR = 1.74 for the colon, HR = 1.64 for the rectum, and a notably higher HR = 4.72 for the anus. Comorbid conditions such as hypertension (HR = 1.26), diabetes mellitus (HR = 1.32), and abnormal liver function (HR = 1.18) also correlate with significantly increased CRC risks. These findings suggest that HPV is a significant risk factor for CRC, with disparities in risk based on anatomical location, demographic characteristics, and comorbidities, highlighting the need for intervention strategies and targeted prevention. [ABSTRACT FROM AUTHOR]

The WHO suggests that different societies should investigate the causes of elder abuse in their culture. This study was conducted to investigate the risk factors for elder abuse in Iran using an ecological approach at the microsystem level. This qualitative research had a direct content analysis approach with 66 older adults and caregivers as participants. The data were collected using interviews. Analysis of data was conducted simultaneously with data collection, using the MAXQDA10 software, and results were reported based on Elo's recommendation. Two main categories of data analysis were obtained, Issues related to care recipients and care and caregiver's challenges. This study was unique owing to its extensiveness and attention to the underlying factors of abuse in the socio-cultural context of Iran. Results can help health policymakers design strategies to prevent elder abuse. [ABSTRACT FROM AUTHOR]

Background: We aimed to estimate the prevalence of physical inactivity in all districts of Iran and the disparities between subgroups defined by various measures. Methods: Small area estimation method was employed to estimate the prevalence of physical inactivity in districts based on the remaining districts in which data on the level of physical inactivity were available. Various comparisons on the estimations were done based on socioeconomic, sex, and geographical stratifications to determine the disparities of physical inactivity among districts of Iran. Results: All districts of Iran had a higher prevalence of physical inactivity compared with the world average. The estimated prevalence of physical inactivity among all men in all districts was 46.8% (95% uncertainty interval, 45.9%–47.7%). The highest and lowest estimated disparity ratio of physical inactivity were 1.95 and 1.14 in males, and 2.25 and 1.09 in females, respectively. Females significantly had a higher prevalence of 63.5% (62.7%–64.3%). Among both sexes, the poor population and urban residents significantly had higher prevalence of physical inactivity than rich population and rural residents, respectively. Conclusions: The high prevalence of physical inactivity among Iranian adult population suggests the urgent need to adopt population-wide action plans and policies to handle this major public health problem and avert the probable burden. [ABSTRACT FROM AUTHOR]

Background: Comprehensive molecular assessment of cancers could open up new horizons for novel therapies. Fibroblast growth factor receptor 1 (FGFR1) gene amplification has been previously demonstrated in non-small cell lung cancer (NSCLC) patients. The current study aimed to evaluate the prevalence of FGFR1 gene amplification and its association with clinical and demographic data in a group of NSCLC patients. Methods: The present study was performed on eighty-eight NSCLC patients who underwent bronchoscopy or surgery in Qaem Hospital, Mashhad, between 2010 and 2016. FGFR1 gene amplification was detected using real-time PCR assay on DNA extracted from paraffin-embedded tissue blocks of patients. Also, patients' clinical and demographic data, such as their survival, were evaluated. Statistical analysis was carried out using SPSS software. Results: Seventeen (19.31%) out of eighty-eight patients with NSCLC presented FGFR1 gene amplification. Besides, we found a significant association between FGFR1 amplification and cigarette smoking (p-value= 0.01; OR: 4.08). Although cases with squamous cell carcinoma (SCC) showed a higher prevalence of FGFR1 amplification compared to adenocarcinoma patients, the difference was not statistically significant (pvalue> 0.05). In addition, our findings showed no relationship between FGFR1 gene amplification and other clinical and demographic factors, including age, sex, grade, tumor operability, and survival. Conclusion: The frequency of FGFR1 amplification is estimated at 20% in the current study (26% in SCC versus 11% in adenocarcinoma; p-value= 0.07). Moreover, we found a direct association between FGFR1 amplification and cigarette smoking. However, no significant relationship with survival or other factors was observed. [ABSTRACT FROM AUTHOR]

As drug overdose mortality rises in the United States, healthcare visits present critical opportunities to mitigate this trend. This study examines changes in healthcare visits for substance use disorders (SUDs) and remission prior to and during the COVID-19 pandemic in the Great Plains, with a focus on identifying the characteristics of those served. Data were analyzed from 109,671 patient visits (mode = one visit per patient), encompassing diverse demographics, including sex, age, race, ethnicity, and geographic location. Visits analyzed included those for Alcohol Use Disorder (AUD), Opioid Use Disorder (OUD), or Stimulant Use Disorder (StUD) and those in remission of these disorders between March 2019 and March 2021. Patient demographic information and geographic factors, like rurality and Medicaid expansion status, were considered, and logistic regression was utilized. Visits were primarily by White (70.83%) and Native American (21.39%) patients, non-Hispanic (91.70%) patients, and males (54.16%). Various demographic, geographic, and temporal trends were observed. Findings indicated that males were more likely to receive an AUD diagnosis, while females were more likely to receive an OUD or StUD diagnosis. Metropolitan-residing patients were more likely to receive an AUD diagnosis, while non-metropolitan patients were more likely to receive an OUD diagnosis. Remission odds increased for StUD during the pandemic but decreased for AUD and OUD. These findings illuminate the demographic and geographic patterns of SUD-related healthcare visits, suggesting critical touchpoints for intervention. The results emphasize the urgent need for targeted healthcare strategies, especially in rural and underserved areas, to address persistent health disparities. [ABSTRACT FROM AUTHOR]

Background: Family and Community Health Nurses (FCHNs) are at a higher risk of experiencing emotional exhaustion and feelings of low personal accomplishment. Higher levels of professional identity may decrease these negative feelings. Its measurement could produce positive effects for FCHNs and the quality of care they offer. Aim: This study aims to evaluate the psychometric properties (validity and reliability) of the Nurses Professional Values Scale-Revised (NPVS-R) on FCHNs in Italy. Research design: A cross-sectional research design was used. Participants and research context: A convenience sample of FCHNs was recruited in an out-of-hospital setting from Italy. A total of 202 nurses were eligible (mean age of 41.11 ± 10.55 years; 78.2% female). Ethical considerations: The study was performed in accordance with the World Medical Association Declaration of Helsinki. Participants were asked for their consent and were guaranteed anonymity in the information collected. The study was approved by the internal review board of the university. Results: Confirmatory Factor Analysis (CFA) supported a unidimensional factorial structure of the NPVS-R with an adequate fit to the data. Internal consistency reliability was also supported. The construct validity was further reinforced by the concurrent validity results showing a positive and significant correlation of professional identity with job satisfaction. Conclusion: The NPVS-R is a valid and reliable instrument to measure professional identity among FCHNs. It can be used in clinical practice to improve FCHNs' psychological-emotional feelings and quality of care provided, in research to allow comprehensive understanding of professional identity, and in educational settings to monitor the professional identity levels of Family and Community Health Nursing students. [ABSTRACT FROM AUTHOR]

Background: Up to now several studies estimate the prevalence of HBV, HCV, and TB among people living with HIV (PLWH) in Iran; however, their results are inconsistent. This study aimed to estimate the overall prevalence of HBV, HVC, and TB among Iranian PLWH. Methods: In this systematic review and meta-analysis six databases including Medline, Web of Science, Scopus, MagIran, Scientific Information Database (SID), and Barakat Knowledge network system were searched up to October 2023 with no language restriction. All studies estimated the prevalence of HBV, HCV, and TB among PLWH in Iran were included. The random-effects model was used to report the study estimates. Results were reported at a 95% confidence interval (CI). Results: Out of 1050 retrieved references, 58 articles met the eligibility criteria. Overall among PLWH, HBV prevalence was 13.0% (95% CI: 11.0, 15.0), HCV prevalence was 54% (95% CI: 45.0, 64.0), and TB prevalence was 19% (95% CI: 13.0, 24.0). The results from multivariate meta-regression analysis showed no statistically significant association between HBV and TB prevalence with the year of study, quality of studies, age, gender, and persons who inject drugs (PWID). HCV prevalence was significantly associated with PWID. Conclusion: We found HBV, HCV, and TB infections are common among PLWH in Iran and required to be screened and treated with effective and timely services. Key messages: The prevalence of HBV, HCV, and TB was high among Iranian PLWH The prevalence was higher among at-risk groups such as PWIDs and homeless people The prevalence of HCV was more than HBV and TB among PLWH [ABSTRACT FROM AUTHOR]

Background: In recent years, the development of robotic neurosurgery has brought many benefits to patients, but there are few studies on the occurrence of surgical site infection (SSI) after robot-assisted stereoelectroencephalography (SEEG). The purpose of this study was to collect relevant data from robot-assisted SEEG over the past ten years and to analyze the influencing factors and economic burden of surgical site infection. Methods: Basic and surgical information was collected for all patients who underwent robot-assisted SEEG from January 2014 to December 2023. Logistic regression was used to analyze the factors influencing SSI according to different subgroups (radiofrequency thermocoagulation or epilepsy resection surgery). Results: A total of 242 subjects were included in this study. The risk of SSI in the epilepsy resection surgery group (18.1%) was 3.5 times greater than that in the radiofrequency thermocoagulation group (5.1%) (OR 3.49, 95% CI 1.39 to 9.05); this difference was statistically significant. SSI rates in the epilepsy resection surgery group were associated with shorter surgical intervals (≤ 9 days) and higher BMI (≥ 23 kg/m2) (6.1 and 5.2 times greater than those in the control group, respectively). Hypertension and admission to the intensive care unit (ICU) were risk factors for SSI in the radiofrequency thermocoagulation group. Patients with SSIs had $21,231 more total hospital costs, a 7-day longer hospital stay, and an 8-day longer postoperative hospital stay than patients without SSI. Conclusions: The incidence of SSI in patients undergoing epilepsy resection after stereoelectroencephalography was higher than that in patients undergoing radiofrequency thermocoagulation. For patients undergoing epilepsy resection surgery, prolonging the interval between stereoelectroencephalography and epilepsy resection surgery can reduce the risk of SSI; At the same time, for patients receiving radiofrequency thermocoagulation treatment, it is not recommended to enter the ICU for short-term observation if the condition permits. [ABSTRACT FROM AUTHOR]

Some respiratory viruses can cause a viral interference through the activation of the interferon (IFN) pathway that reduces the replication of another virus. Epidemiological studies of coinfections between SARS-CoV-2 and other respiratory viruses have been hampered by non-pharmacological measures applied to mitigate the spread of SARS-CoV-2 during the COVID-19 pandemic. With the ease of these interventions, SARS-CoV-2 and influenza A viruses can now co-circulate. It is thus of prime importance to characterize their interactions. In this work, we investigated viral interference effects between an Omicron variant and a contemporary influenza A/H3N2 strain, in comparison with an ancestral SARS-CoV-2 strain and the 2009 pandemic influenza A/H1N1 virus. We infected nasal human airway epitheliums with SARS-CoV-2 and influenza, either simultaneously or 24 h apart. Viral load was measured by RT-qPCR and IFN-α/β/λ1/λ2 proteins were quantified by immunoassay. Expression of four interferon-stimulated genes (ISGs; OAS1/IFITM3/ISG15/MxA) was also measured by RT-droplet digital PCR. Additionally, susceptibility of each virus to IFN-α/β/λ2 recombinant proteins was determined. Our results showed that influenza A, and especially A/H3N2, interfered with both SARS-CoV-2 viruses, but that SARS-CoV-2 did not significantly interfere with A/H3N2 or A/H1N1. Consistently with these results, influenza, and particularly the A/H3N2 strain, caused a higher production of IFN proteins and expression of ISGs than SARS-CoV-2. SARS-CoV-2 induced a marginal IFN production and reduced the IFN response during coinfections with influenza. All viruses were susceptible to exogenous IFNs, with the ancestral SARS-CoV-2 and Omicron being less susceptible to type I and type III IFNs, respectively. Thus, influenza A causes a viral interference towards SARS-CoV-2 most likely through an IFN response. The opposite is not necessarily true, and a concurrent infection with both viruses leads to a lower IFN response. Taken together, these results help us to understand how SARS-CoV-2 interacts with another major respiratory pathogen. Author summary: During the COVID-19 pandemic, non-pharmacological measures were able to reduce the spread of SARS-CoV-2 and most respiratory viruses. Since the ease of these measures, SARS-CoV-2 variants and other viruses, such as influenza A, have started to co-circulate and can now infect a same host and interact with each other. These interactions can lead to attenuated or aggravated infections and can affect the timing of epidemics. Therefore, it is very important to elucidate how the new SARS-CoV-2 interacts with other viruses to better predict their implications in human health and their epidemic activity. Our work contributes to better understand these interactions using viruses that have likely co-circulated after lifting mitigation interventions, i.e., SARS-CoV-2 Omicron variant and a contemporary influenza A/H3N2 strain. We studied how each virus may affect the other virus' growth and how these interactions were associated with the innate immune response of the host. We found that a prior infection with influenza A can decrease the growth of SARS-CoV-2 while the latter reduces the innate immune response. Our results help to understand the interplay between SARS-CoV-2 and influenza A in the host and may improve mathematical models predicting epidemics. [ABSTRACT FROM AUTHOR]

Background: The Coronavirus disease 2019 pandemic increased global psychological distress, emotional distress, and sleep disturbances, all known risk factors for compromised oral health. Despite this, there is limited understanding of the impacts of these psychological factors on oral health in certain populations, including Iranians. Thus, the present study investigates the associations between sociodemographic characteristics, emotional distress, sleep pattern changes, tooth brushing frequency, and oral ulcer reports in a sample of Iranian adults during the Coronavirus disease 2019 pandemic. Materials and methods: This cross-sectional, web-based study collected data from Iranian adults between July and September 2022 using respondent-driven sampling. The Mental Health and Wellness questionnaire was used to gather information on sociodemographic characteristics, emotional distress, sleep pattern changes, toothbrushing frequency, and oral ulcer reports. Simple and multiple logistic regression served for statistical analysis. Results: Among the 240 participants, comprising 164 females and 76 males, with a mean age of 35.3 years (±13.3), 28 individuals (11.7%) reported reduced tooth brushing frequency, and 35 individuals (14.6%) reported oral ulcers. Male gender (OR = 2.75, p = 0.016) and sleep patterns changes (OR = 2.93, p = 0.01) increased the likelihood of reduced tooth brushing frequency. Additionally, being younger than 30 (OR = 2.87, p = 0.025) and fearing coronavirus transmission (OR = 3.42, p = 0.009) increased the odds of oral ulcers. Conclusions: Male gender and sleep pattern changes were risk factors for reduced tooth brushing frequency among the present sample of Iranian adults during the Coronavirus disease 2019 pandemic. Additionally, being under 30 and fearing coronavirus transmission were identified as risk factors for oral ulcers in this population. To preserve and promote adults' oral health during public health crises, targeted educational initiatives, public health awareness campaigns, and integrated mental and oral healthcare approaches are encouraged. [ABSTRACT FROM AUTHOR]

Background: Individuals with transfusion-dependent β-thalassemia (TDT) experience symptoms and functional impacts that reduce their health-related quality of life. However, EQ-5D-derived health utility index scores in TDT often indicate good HRQoL, suggesting the EQ-5D may not adequately capture the impact of TDT. This study explored the disease and treatment burden of TDT and examined the appropriateness of the EQ-5D-5L descriptive system (DS) in measuring HRQoL in TDT. Methods: Adults with TDT in the United Kingdom, United States, and France completed a background questionnaire and EQ-5D-5L DS, followed by 60-minute semi-structured interviews on symptoms and HRQoL impacts of TDT (concept elicitation) and appropriateness of EQ-5D-5L DS (cognitive debrief). Transcribed interviews were analyzed using thematic and content analyses. The relationship between TDT symptoms and impacts were summarized in a conceptual model. EQ-5D-5L DS was mapped to concepts identified in the qualitative data to assess its capture of HRQoL concepts. Participants' EQ-5D-5L DS scores were compared to their qualitative descriptions for each dimension to assess their concordance. Results: Thirty participants in the United States (n = 14 [46.7%]), United Kingdom. (n = 12 [40.0%]), and France (n = 4 [13.3%]) completed the study (73.3% female; mean age = 28.4 years [standard deviation (SD) = 5.1]; mean annual red blood cell transfusion [RBCT] frequency = 18.4 [SD = 7.6]). Participants reported TDT symptoms and impacts on HRQoL, all fluctuating across the RBCT cycle. EQ-5D-5L DS did not fully capture 11 of 16 (68.8%) HRQoL concepts reported. Most participants (n = 20/27 [74.1%]) reported that EQ-5D-5L DS did not capture important aspects of living with TDT, and 42.9% (n = 12/28) reported negative/neutral overall impressions of EQ-5D-5L DS. The highest degree of discordance between participants' qualitative data and EQ-5D-5L DS dimension scores was observed with mobility (42.3%) and self-care (34.6%), where the qualitative descriptions relating to these dimensions were worse than their quantitative scores. Conclusion: Current findings suggest that EQ-5D-5L DS lacks content validity and the derived health utility index score may not fully represent the burden of disease in TDT. [ABSTRACT FROM AUTHOR]

Context: Advance Care Planning (ACP), as a process for expressing and recording patients' preferences about end-of-life care, has received increasing attention in recent years. However, implementing ACP has been challenging in Iran. Objectives: To assess the readiness for advance care planning and related factors in the general population of Iran. Methods: This cross-sectional study was conducted on the general population of Iran in 2022. The data was collected using demographic information questionnaire and The RACP Scale. The purpose and methodology of the research was explained to all participants, and upon their agreement an informed consent was obtained. Participants were invited to fill out the questionnaires wherever is more convenient for them, either alone or if needed, with the help of the researcher to protect their privacy. Chi-square, fisher exact test and multiple logistic Regression model were used to assess the effective factors on the RACP. The data were analyzed by SPSS software version 26. Results: A total of 641 people with an average age of 36.85 ± 12.05 years participated in this study. Of those, 377 (58.8%) had high RACP. The logistics model showed an association between the chance of readiness for receiving ACP with participants' education level, such that the chance of readiness in those with Master's or Ph.D. degrees was three times higher than those with a diploma (p = 0.00, OR:3.178(1.672, 6.043)). However, the chances of readiness in those with bachelor's degrees was not significantly different from those with a diploma (p = 0.936, OR: 0.984 (0.654, 1.479)). Moreover, the chance of readiness was 1.5 higher in participants over 40 years of age compared with participants under the age of 40 (P = 0.01, OR: 1.571(1.10, 2.23)). Conclusion: According to the findings of this study, it can be concluded that there is a relatively RACP among people in Iranian society. The readiness of individuals for ACP increases by their age and education level. Therefore, by holding appropriate training intervention, we can increase the readiness of the public for ACP to improve their end-of-life outcome. [ABSTRACT FROM AUTHOR]

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Background: Congenital malformations are among the most pressing health concerns globally. In Morocco, minimizing the morbidity and mortality associated with congenital malformations is a key health policy objective. In the Marrakech-Safi region, the prevalence and etiology of congenital malformations remain unclear. Objectives: This study seeks to ascertain the prevalence of clinically evident congenital malformations and identify the factors contributing to their incidence in the Marrakech-Safi region. Methods: A retrospective study was conducted in the maternity ward of the Mohamed VI University Hospital Center in Marrakech in 2022. An obstetric chart was utilized to gather sociodemographic, obstetrical, maternal, and neonatal data from the target population, including risk factors. The data were analyzed using SPSS 21 software. Results: Out of 17 250 files reviewed, 159 births with malformations were identified, resulting in a prevalence of 0.92% of births. Newborns with multiple malformations constituted 22.64% of all cases, with a prevalence of 2.08/1000 births. Neural tube defects were the most common, with a prevalence of 3.65/1000 births, followed by musculoskeletal defects and digestive tract defects. Chromosomal malformations, specifically trisomy 21, were the fifth most common, with a prevalence of 1.4/1000 births. Facial and urogenital malformations were the least frequent in this study. The occurrence of congenital malformations in this region is influenced by various risk factors, including maternal age, male sex, parity, medical history, and newborn weight at birth. Conclusions: In the Marrakech-Safi region, congenital malformations are influenced by a wide range of risk factors. Identifying these factors is crucial for healthcare providers to enhance surveillance among at-risk populations and develop effective preventive, diagnostic, and therapeutic strategies. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of ventricular tachycardia in patients with acute coronary syndrome (ACS) during the first 24 hours of admission Material And Methods: This descriptive study was conducted at the coronary care unit of Khyber Teaching Hospital Peshawar from July 2020 to January 2021. Using a non-probability consecutive sampling technique, 169 patients of either gender aged between 30 and 70 years with ACS were included. Patients were monitored for any arrhythmias e.g., Ventricular tachycardia by a monitor (Nihon Kohden) and on 12 lead ECG (Cardio flex II) when needed. All the data was noted in a proforma. Results: A total of 169 patients comprising of male 121 (71.6%) and 48 (28.4%) female patients were included in this study. The mean age was 57.45+7.69 years. Patients in the age group 30-50 years were 45 (26.6%) while 124 (73.4%) patients were in the age group 51-70 years. The mean duration of symptoms was 8.99 + 4.740 hours. Out of 169 patients, 48 (28.4%) patients presented with unstable angina, 91 (53.8%) patients had NSTEMI and 30 (17.8%) patients with STEMI. A total of 22 (13.0%) patients were found to have hypokalemia and 23 (13.6%) patients with hypoglycemia. Patients who were diagnosed to have ventricular tachycardia were 12 (7.1%). Conclusion: In our study, ventricular tachycardia occurred in 7% of patients in the first 24 hours of admission who presented with Acute Coronary Syndrome. [ABSTRACT FROM AUTHOR]