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Objective: Intoxication is among the most common causes of emergency department (ED) visits. Activated charcoal is one of the useful treatments preventing poison absorption. However, nausea caused by using charcoal has made this substance less acceptable among patients. This study aims at investigating the influence of using cold charcoal on reducing the nausea among poisoned patients. Methods: This clinical experimental trial study approved by the Medical Ethics Committee of Regional School of Medicine of Mashhad University of Medical Sciences with the code 930106. Randomization was provided by Sealed Envelope. Accordingly, the experimental group received cold charcoal (4ᵒC), while the control group received room temperature charcoal (23ᵒC). We used the coding method in order to double blind the study. After half and one hour, nausea was checked in patients by visual numeric scale (VNS). Data were described by using descriptive and analytic test indices including frequency, mean ± standard deviation and suitable charts and tables. Results: The average age of participants was 25.83±7.05. The severity of nausea half an hour after consuming charcoal in cold charcoal group and experimental group was 1.3 and 2.73, respectively (P < 0.001). One hour after consuming charcoal, the severity of nausea in cold charcoal group and experimental group was 0.39 and 1.38 (P < 0.001). As indicated by the results of the study and after investigating the changing trend of nausea severity, nausea severity decreased in both groups by passing time from half to one hour (P < 0.001). Conclusion: Cold charcoal can reduce the rate of nausea and make it more acceptable among patients.

Objective: The exact link between COVID-19 pandemic and different adverse outcomes of pregnancy remains unclear. Plus, large-scale research is lacking. In the present study, we aimed to compare the maternal and fetal health outcomes during the COVID-19 pandemic with the same last year duration in Iran. Design: Two retrospective cohorts (pre-COVID-19 and during COVID-19) were studied. The pre-COVID-19 cohort include pregnant women who had given birth between January 1, 2019 and December 31, 2019. The COVID-19 cohort, who had given birth between January 1, 2020 and December 31, 2020. The characteristics of pregnant women before COVID-19 and during COVID-19 pandemic were compared with Fisher's exact test. Univariate and multivariate log-binomial regression models were used to determine the risk ratios of the impacts of the COVID-19 pandemic on adverse pregnancy outcomes. Results: Among 128968 women showed that women who had given birth during the pandemic were more likely to be of young age, lower rates of alcohol consumption and smoking, lower weight gain, and higher rates of using synthetic milk for feeding neonates (P

Background: Smoking is very important during pregnancy because of severe fetal and maternal complications. No community-based studies have been conducted on pregnant women in Iran. This study aimed to investigate the prevalence of smoking during pregnancy, as well as maternal and neonatal complications in Mashhad, Iran, during 2017.Methods: This cross-sectional study reviewed the information of 1140 and 92,225 smoking and non-smoking pregnant women during pregnancy, respectively, and 3-5 days after delivery using Sina Electronic Health Record System in Mashhad, Iran, during 2017. All data were extracted, encoded, and entered into SPSS software (version 16).Results: Out of the total of 93,365 pregnant women with a mean age of 22.36 years, the prevalence of smoking during pregnancy was significantly higher among those who live in the city (i.e., Mashhad), compared to individuals living in the suburbs or villages. The mean rates of stillbirth, prematurity, very-low-birth-weight, and low-birth-weight were higher in smoking pregnant mothers, compared to non-smoking ones (p

Cystic fibrosis-associated liver disease (CFLD) is an important aspect of cystic fibrosis (CF), which manifests with various signs and symptoms. Lack of specific examinations for CFLD have made the diagnostic process of the disease time-consuming, and the disease is often identified after severe progress. Finding the associations between the outcomes of various clinical, biochemical, and sonography examinations could help specialists identify the disease in a timely manner. This review study aimed to determine the correlations between the outcomes of various diagnostic approaches based on the current literature. According to the literature, some studies have reported correlations between various diagnostic approaches, while other studies have reported no associations in this regard. This discrepancy could be due to the various manifestations associated with CF.

Background: Globally, female sexual dysfunction is a serious concern based on negative family and social consequences, high side effects of medications and lack of effective treatment. Thus, the evaluation of treatment approach for this problem is an important priority for healthcare systems. Sexual life and its related disorders are considered the main aspects of a healthy lifestyle in traditional Persian medicine (TPM). Objective: The present study aimed to determine and compare the effects of food products containing Daucus carota, TPM-based training program, and a combination of these two interventions on the improvement of female sexual dysfunction. Methods: This randomized clinical trial was conducted on 96 women with sexual dysfunction based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5®), aged 18-35 years who referred to the Gynecology Clinic of Mashhad University of Medical Sciences, Mashhad, Iran, during 2016 and 2017. The patients were randomly divided into three groups (n=32) and received the intervention over an eight-week period. The first group was provided with TPM-based sexual health training, the second group received 30 g of a traditional food product (wild carrot halva: mixed Daucus carota and several herbs with honey) on a daily basis, and the third group received a combination of this traditional food product plus education. Data analysis was http://www.ephysician.ir Page 6578 performed using Chi square test, repeated measures ANOVA, two-way ANOVA, ANCOVA, post hoc Bonferroni, Friedman and Wilcoxon signed-rank test in SPSS version 11.5. Results: According to the results of this study, there was a significant difference in terms of sexual desire (p=0.002), lubrication (p=0.002), orgasm (p=0.004) and pain (p

Background: Specific language impairment (SLI) is one of the most common disorders of language development in children, which has been less addressed in Persian studies. The aim of this study was to evaluate the grammatical characteristics of Persian-speaking children with SLI using Photographic Expressive Persian Grammar Test (PEGT). Methods: This case-control, cross-sectional study was conducted on 16 children with SLI and 16 normal children aged 4-6 years, who were monolingual Persian speakers. The subjects in both groups were age- and gender-matched. After selecting each participant, PEGT was administered and results were recorded in an answer sheet and analyzed. To analyze the data, the mean total scores of the test and mean scores related to each syntactic structure of the PEGT were compared between the two groups using Mann–Whitney test. Results: In this study, a significant difference was observed in mean total scores of the test between the studied groups. In detail, the mean score of the normal group was significantly higher as compared with the SLI group (P

Introduction: This article aimed to review the literatures on visual impairments and ocular changes in premature infants with low birth weight and gestational age.Methods: Five electronic databases including: PubMed, Web of Science, Science direct, Ovid, and Scopus were searched. Original articles published until 2015 describing preterm infants were reviewed. Repetitive and derivative articles were excluded.Results: Out of 100 unique, potentially relevant articles, 42 studies that addressed and met the inclusion criteria were evaluated.Conclusion: Prematurity affects ocular structures (from anterior to posterior segment) and functions. Premature infants are at risk of myopization. Concerning the changes in premature infants, a significant increase is found in axial length, intraocular pressure, and central corneal thickness; moreover, high incidence of retinal changes is reported as a result of prematurity. On the other hand, visual acuity, tear, electroretinogram, and visual evoked potential responses decrease with prematurity. The most common ophthalmic disorders in preterm infants are myopia and retinopathy of prematurity, which could affect life quality due to reduced visual acuity.

Background and Objectives: Low Fruit/Vegetable (FV) diet seems to be a global public health problem. The trans-theoretical stages of change model have long been considered a useful interventional approach in lifestyle modification programs. The aim of this study was to find the most important intermediating factors of FV consumption in Mashhad, Iran. Materials and Methods: In this cross-sectional design, 777 participants were included with a convenient method from the general population in public places all around the Mashhad City, Iran in 2014. A standardized checklist about socio-demographic characteristics and possible related factors and stages of change questionnaire (6 stages: pre-contemplation, contemplation, preparing, action, maintenance, and termination) were used for data collection. Data were analyzed by SPSS 11.5 software using Chi-square test, Mann-Whitney U test, and Multiple Logistic Regression. Results: Totally, 254 (47.7%) and 299 (59.8%) of participants were in pre-action stages of FV, respectively. Smoking (OR=3.2, p=0.02) and believing that this is good for the body (OR=0.12, p=0.001) were predictors of the pre-contemplation stage for fruits. Being physically active (OR=2, p=0.008), low agreement with health benefits of vegetables (OR=8, p

Introduction: A limited number of risky behaviors cause most morbidity and mortality. The aim of this study was to determine the possible clustering of lifestyle behaviors, including transportation behaviors, diet, physical activity, and smoking in Shiraz, Iran. Methods: There were 776 representative Shirazi adults who participated in this cross-sectional study. The questionnaires were completed via person-to-person interviews. The datasets were searched for any clustering patterns. Cluster analysis was used for statistical analysis, and the data were analyzed using SPSS version 11.5. Results: Three distinct clusters were identified. Cluster 1 was named "Healthy," and it included non-smokers, safe drivers, appropriate or acceptable fruit, vegetable, and fast-food consumers, and physically-active people. Cluster 2, "Moderately Healthy," was relatively risky drivers who had appropriate behaviors on the rest of the health-related behaviors. Cluster 3, "Unhealthy," was smokers, risky drivers, inappropriate or unacceptable fruit, vegetable & fast-food consumers, and a sedentary lifestyle. Conclusions: It was obvious that health-related behaviors were clustered together and unhealthy behaviors were not established in isolation

BACKGROUND: Recently, the Iranian Ministry of Health estimated about 750,000 deaths are attributed smoking complications. The aim of this study was to apply the transtheoretical model (TTM) on general population of Mashhad city to evaluate the stages of change and possible cultural factors regarding smoking cessation. METHODS: This descriptive, cross-sectional population-based study was conducted in Mashhad, Iran. A total number of 562 participants selected by multistage sampling. They were asked about stages of change for smoking cessation for both hookah and cigarette smoking. Stages of change refer to an orderly sequence of changes in smoking behavior that people progress through according to the TTM. Its six stages are as follows: precontemplation (PC) (no intention to quit smoking within 6 months), contemplation (planning to quit smoking in the following 6 months), preparation (planning to stop smoking within 1 month), action (quit smoking for

Stroke is the leading cause of death and disability in the world after the cancer and cardiovascular diseases. Genetic factors have main significance to got stroke. Renin-angiotensin system contains candidate genes and polymorphisms for causing stroke. There are reported associations between stroke and angiotensin II type-1 receptor g. 1166A > C polymorphism (rs5186). Therefore in this study this association was investigated for the east Iranian population. This study is based on 201 stroke patients and 220 controls. To predict the genetic risk of stroke allele and genotype frequencies of angiotensin II type-1 receptor rs5186 were analyzed in this population according to stroke subtypes, gender, age, hypertension, diabetes mellitus, high and low density lipoprotein and triglycerides. According to statistical analysis no significant difference was found between case and control groups. But there were a significant relevance between total cholesterol and stroke (p = 0.037). In this population angiotensin II type-1 receptor g. 1166A > C polymorphism did not increase the risk of stroke. The main reason for this study is complex nature of gene-environment interactions in the pathophysiology of this disease.

Introduction: Patient satisfaction is an accurate assessment factor for evaluating the performance of health policies in the community. The purpose of this study is to assess patients' satisfaction with emergency department of Imam Reza hospital of Mashhad Iran. Materials and Methods: In this cross-sectional study, during six months period from April to October 2012, 420 patients were entered to study in morning, evening and night shifts before being discharged or transferred from emergency department. The Press Ganey questionnaire of patient satisfaction was completed. Results: 420[daneshgar1] patients in three work shifts of morning (140 patients) evening (140 patients) and night (140 patients) participated in our research. 226 (53.8%) of participants were male and 194(46.2%) were female. The average of patients’ time waiting for doctors' visit was 10.7±6.1 minutes. The mean score of satisfaction during attendance in Emergency Department (ED), during physicians' visit and overall satisfaction was 25.24±5.04, 25.32±5.42, 8.52±1.91 respectively. The highest level of satisfaction is related to speed of admission (81%), medical treatment (76%), nursing skills for doing medical orders (71.4%) and lowest level of satisfaction is related to comfort and pleasantness of the waiting area (45.9%), time the physician spent with the patient (56.5%) and length of wait before going to an exam room (62.8%). Conclusion: Attempt for reducing waiting time, providing comfort environment, increasing the time of visit with emergency physicians and enhance service quality based on patient needs can reduce the patient dissatisfaction.

Objective: In this trial, we intend to assess the effect of simulation-based education approach on advanced cardiovascular life support skills among medical students. Methods: Through convenient sampling method, 40 interns of Mashhad University of Medical Sciences in their emergency medicine rotation (from September to December 2012) participated in this study. Advanced Cardiovascular Life Support (ACLS) workshops with pretest and post-test exams were performed. Workshops and checklists for pretest and post-test exams were designed according to the latest American Heart Association (AHA) guidelines. Results: The total score of the students increased significantly after workshops (24.6 out of 100 to 78.6 out of 100). This demonstrates 53.9% improvement in the skills after the simulation-based education (P< 0.001). Also the mean score of each station had a significant improvement (P< 0.001). Conclusion: Pretests showed that interns had poor performance in practical clinical matters while their scientific knowledge, such as ECG interpretation was acceptable. The overall results of the study highlights that Simulation based-education approach is highly effective in Improving ACLS skills among medical students.

ABSTRACT Background: Acute respiratory infections (ARI) are the main cause for antibiotic (AB) use in all age groups specially the first two years of life. The local information about the pattern of AB prescription in ARI is a necessary part for any program which aims logical use of AB. The current study was designed to find the frequency and types of AB administration for ARI in young children (

Introduction: According to statistics, opioid addiction is quite common in Iran. Pathologic dilatation of the Common Bile Duct (CBD) may be caused by mechanical obstruction or opioid consumption; the latter is especially common among chronic opium abusers. The aim of this study was to assess the relationship between CBD diameter and addiction-related factors in opium users. Materials and Methods: This cross-sectional study was conducted in Imam Reza Hospital, Mashhad, Iran. A checklist, consisting of 18 items on demographic characteristics, type, administration route, and duration of opioid consumption, and type of biliary disease as indicated by Endoscopic Retrograde Cholangiopancreatography (ERCP), was prepared and completed via interview. The results of ERCP and abdominal ultrasonography of 40 addicted patients were gathered. Data were analyzed, using SPSS version 11.5. P-value less than 0.05 was considered statistically significant. Results: In total, 31 (62%) out of 50 patients were male, and the mean age of the subjects was 66±12.0 years. According to the findings, 46 (92%) cases were addicted to opium and four (8%) cases to laudanum (a solution prepared from opium). Among the addicted cases, 30 (75%) used opium through inhalation, while 10 (25%) cases used it orally. There was a significant relationship between the type of opioid and CBD diameter (P=0.03). However, no significant relationship was found between CBD diameter and the route of administration or opioid dose (P=0.6 and 0.06, respectively). Conclusion: Opium used by addicts has various degrees of impurity. It can be concluded that higher opium purity induces more CBD dilatation, although further investigations are highly recommended.

ABSTRACT Background: Acute respiratory infections (ARI) are the main cause for antibiotic (AB) use in all age groups specially the first two years of life. The local information about the pattern of AB prescription in ARI is a necessary part for any program which aims logical use of AB. The current study was designed to find the frequency and types of AB administration for ARI in young children (

Background: Physicians are one of the most important groups directly associated with public health and their health related lifestyle has a significant impact on their patient’s behaviors. Several studies showed that the majority of medical students did not have appropriate and healthy behaviors. The aim of this study was to determine the prevalence of risky lifestyle knowledge and behaviors among Shiraz medical students.Methods: This cross-sectional survey was conducted in 2011. Using a stratified random sampling method, 400 medical students were selected to fill in the questionnaires. The questionnaire contained 33 questions including demographic data, healthy lifestyle knowledge and behavior (including physical activity, fruit and vegetable consumption, water drinking, etc), perception of stress and student’s health information resource. The association between demographic factors and participants’ knowledge, practice and stress score was determined. The correlation between the participants’ knowledge and behavior scores was calculated.Results: The mean knowledge and attitude scores were 2.8 and 3.6, respectively. In 40% of knowledge and 80% of practice questions, the percentage of the correct answer was below 50%. There was a significant correlation between the participants’ knowledge and behavior scores (P

Background: Influenza disease is one of the oldest medical problems that can cause severe illness and high mortality rates, worldwide. In flu pandemics, medical and dental students′ knowledge, attitudes, and practices (KAP) is critical to save patients life. The aim of this study was to determine the score of KAP toward the Pandemic H1N1 and their predictor factors among the medical and dental residents and fellowships of Shiraz University of Medical Sciences, Iran. Methods: In 2009, 125 participants were recruited in a convenient sampling cross-sectional survey. Self-reported questionnaire were used and results were analyzed applying appropriate statistical tests. Results: The mean score of participants′ knowledge, attitude and practice were 22.6, 21.1 and 26.5 respectively. Participants practice had significant linear positive correlation with knowledge and attitude. Also, their age was significantly and directly correlated to knowledge and practice. The educational major, age, and sex were significant predictors of responder′s knowledge score and age was the only significant predictor of both attitude and practice scores. Conclusions: High knowledge is not sufficient lonely for improve attitude and practices.It seems that traditional educational models are not efficient and governments should emphasize to advanced and motivational education methods including health belief model and motivational interview at postgraduate levels. Perhaps younger students, dentists and males have less motivation to change their attitude and behavior, so we can focuses our interventions in these groups.

Background: The aim of this study was to determine the prevalence of tobacco use and effect of lifestyle factors on cigarette and hookah use among adult residents of Shiraz, Iran. Methods: In 2010, 1,000 participants were recruited in a multistage, random sampling cross-sectional population-based survey. Results: Response rate was 98%. Prevalence of cigarette smoking was 9.7%. Among cigarette users, 12.6% reported smoking 2 years. Almost half of those surveyed (48.9%) smoked 20 cpd. Almost a quarter (20.4%) of the cigarette smokers tried to quit in the past year. Being male, married, aged 37-54, having higher perceived levels of stress, a non-manual occupation, and sedentary lifestyle were positively associated with cigarette smoking. Manual labor occupations, housewife/jobless status, and going frequently to restaurants were positive predictors of hookah smoking. Conclusions: Compared to cigarettes, hookah smoking was more prevalent among Iranian adults. Approximately, the prevalence of hookah smoking in women is the same as men, whereas cigarette use was 31 times more common in men. Cigarette and hookah smoking were associated with less healthy lifestyle habits in both men and women.

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Background: The development of public transportation (PT) is a crucial issue in the modern societies. The aim of this study was to assess the status of PT usage among the population residing in Mashhad. Materials and Methods: In a cross-sectional design, 464 citizens of Mashhad filled a checklist about PT-use (i.e., bus, taxi, and metro) to find their supporting and opposing factors in 2014. Chi-square, Mann–Whitney, Student's t-test, and logistic regressions were used for inferential analysis in SPSS 11.5. Results: Mean age was 30.02 ± 11.24 years and 57% (263) were female. Bus (169, 50%) was the most popular PT means, followed by metro (98, 29%) and taxi (74, 21%). Most transportations were happened at morning (248, 35%) and evening (221, 31%). Increasing age (odds ratio [OR] =1.04, confidence interval [CI] 95% = 1.008–1.07), higher education (OR = 2.91, CI 95% = 1.14–7.38), being homemaker (OR = 2.97, CI 95% = 1.19–7.36), or student (OR = 2.91, CI 95% = 1.14–7.38) were predictors of PT-use. Conclusion: Individual preference between PT and driving is associated with social, economic, and cultural aspects of a population. Recognizing the influencing factors can help to design population-oriented services.