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Background: Bleeding during nose surgery is very important, because it can cause a problem in the surgeon's field of view and lead to an increase in the probability of surgical complications. The aim of this study was to compare the local effects of tranexamic acid and phenylephrine on bleeding in rhinoplasty. Methods: The present study is a double-blind clinical trial in which 98 patients who were candidates for rhinoplasty Shiraz were randomly divided into 49 groups of phenylephrine and tranexamic acid. In the first group, 1 cc of phenylephrine and in the second group, 1 cc of tranexamic acid was used locally and then the variables in the two groups were compared. The current study was approved by the Iranian Clinical Trial Registration Center with code IRCT20201205049602N1. Results: The average blood pressure and heart rate in the phenylephrine group first increased and then decreased, but in the tranexamic acid group decreased from the beginning to 30 minutes. Based on the results of the test, there was a difference between the two groups in terms of the amount of bleeding, and a statistically significant relationship was observed. The average bleeding volume was lower in the phenylephrine group (p

Background: In recent years, with the rapid expansion of Internet use, Internet addiction has increased. Internet addiction will be considered as a disorder worldwide in the near future and it is very important to prevent it from becoming an acute problem in the new era. Objectives: The current study was planned to assess changes in the state of internet addiction, before and during the COVID-19 pandemic in 2021. Materials & Methods: The current cross-sectional study was done on university students (Medical Sciences and Islamic Azad) in southern Iran in October 2021. Standard Kimberly Young questionnaire was used to measure the status of internet addiction. A total of 379 students was selected through convenience sampling method. The link to the online questionnaire was provided to the study participants through the official educational programs, websites and official social networks of the universities. Paired t-tests, chi-square and ANOVA were used for analysis. Logistic regression model was used to measure predictive variables. Results: More than 65% of the people were women and 83.6% were single. Analysis of the standard internet addiction questionnaire showed that the average score of Internet addiction had increased from 34.44±14.10 to 48.47±17.72, which was significant (P

Abstract Background Type 2 diabetes mellitus (T2DM) is a significant risk factor for non-alcoholic fatty liver disease (NAFLD). Increased fasting blood sugar (FBS), fasting insulin (FI), and insulin resistance (HOMA-IR) are observed in patients with NAFLD. Gut microbial modulation using prebiotics, probiotics, and synbiotics has shown promise in NAFLD treatment. This meta-umbrella study aimed to investigate the effects of gut microbial modulation on glycemic indices in patients with NAFLD and discuss potential mechanisms of action. Methods A systematic search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library until March 2023 for meta-analyses evaluating the effects of probiotics, prebiotics, and synbiotics on patients with NAFLD. Random-effect models, sensitivity analysis, and subgroup analysis were employed. Results Gut microbial therapy significantly decreased HOMA-IR (ES: −0.41; 95%CI: −0.52, −0.31; P

Background: During the last decade, social media have affected people’s lives in an unprecedented way, today, different parts of people’s lives, from shopping to education, business, and electronic messages, are influenced by these media. In fact, social media have become an integral part of human life today, and in recent years this dependence has become even greater than before. Because following the spread of the COVID-19, people used social media more to work and study, to keep in touch with their loved ones, and to get information about Covid-19. The present study aimed to determine the positive and negative impact of social media in the Covid-19 pandemic.Methods: The present study was a brief review designed. From 01 to 10 January 2022, the researchers of this study examined 6 international databases: Medline/PubMed, ProQuest, Scopus, EMBASE, Google Scholar, and ISI Web of Science. After reviewing the titles and abstracts of the articles, 46 articles entered the next stage, in which the full text of the articles was reviewed.Results: Social media provides a space where health information is easily accessible to everyone. This capability is very efficient in global emergencies such as the outbreak of the Covid-19 pandemic so the use of social networks during the Covid-19 pandemic has increased significantly compared to previous data. In today’s world, social media has become a new field in business and marketing. With the involvement of social media in many aspects of life, we see its significant impact on various aspects of business, from brand development to guaranteeing buyer’s trust. Conclusion: Today, the role of social media in social communication, health, economy and other cultural fields is undeniable. However, it is important to consider the negative effects of these media. It seems that it is necessary that social media users be given the principal training before and during their use so that they do not become victims of its undesirable and unconscious effects.

Background and aims: Today, the role of coronavirus disease 19 (COVID-19) vaccines in preventing the disease and reducing the severity of the disease is undeniable; however, there is a possibility of serious adverse events following immunization (sAEFI) that might be life-threatening. The present study was designed to identify the frequency of the most common sAEFI in hospitalized people after receiving the COVID-19 vaccine in the south of Iran. Methods: This cross-sectional study was conducted in 2022. In total, since the start of the COVID-19 vaccination program in the city of Larestan, in the south of Iran, a total of 68 sick people have been hospitalized due to complications caused by the vaccine. The research tool of the present study was a standard checklist called the sAEFI of the COVID-19 vaccine. Results: A total of 68 hospital cases were reviewed. The mean age of the individuals with sAEFI was 59.78±12.70 years, and 21 (56.8%) of them were females. Acute respiratory distress syndrome (ARDS) was the most common 24 (64.9%) sAEFI. Based on the results, 2 (5.4%) had acute coronary syndrome (ACS), 2 (5.4%) had Guillain-Barré syndrome, and 2 (5.4%) had a stroke. Conclusion: It can be mentioned that there is always a possibility of sAEFI, but its frequency in the general population is extremely rare. However, the most common sAEFIs included adverse drug reactions, stroke, and Guillain-Barré syndrome. The readiness of health care staff for early detection of possible sAEFI can be effective in reducing the severity of the sAEFI.

Abstract Background and Aim Bowel preparation is a crucial factor affecting the diagnostic accuracy of colonoscopy, and few randomized control trials evaluated enhancement in bowel preparation. In this study, we aimed to evaluate the effectiveness of walking exercises on bowel preparation before a colonoscopy procedure. Methods The present study is a single-blind randomized controlled trial involving 262 patients scheduled for colonoscopy procedures. These patients were randomly assigned to two groups: an intervention group (n = 131) and a control group (n = 131). In the intervention group, participants followed a predetermined plan that included the consumption of specific liquids and foods, bisacodyl pills, polyethylene glycol powder, and a regimen of walking exercises in preparation for their colonoscopy. Conversely, individuals in the control group followed the same regimen but were not instructed to engage in walking exercises. On the day of the colonoscopy, both groups were assessed for their level of physical activity using a foot counter. Additionally, an experienced gastroenterologist evaluated and compared the bowel preparation between the two groups using the Boston Bowel Preparation Scale (BBPS). Results The number of footsteps recorded in the two groups exhibited a significant difference (P

Background: Hypertension (HTN) is one of the primary risk factors for heart disease and stroke worldwide. The present meta-analysis was aimed to systematically review and statistically estimate the prevalence rate of pre-hypertension (PHTN) and HTN in the Iranian child/adolescent and adult age groups. Methods: In this study, four International databases, including PubMed, Scopus, Web of Science, and Cochrane, as well as three Iranian databases, including SID, Magiran, and IranMedex, were separately investigated for articles published before December 2021. Also, we estimated the pooled effect size for the prevalence of PHTN and HTN in children/adolescent and adult age groups. Stata software (version 14.0) was used for all statistical analyses. Results: From a total of 1185 articles found in database searches, fifty-one were included in the meta-analysis. The prevalence of HTN in the Iranian adult population was 26.26% (25.11 % and 26.22 % for women and men, respectively). Meanwhile, the prevalence of PHTN and HTN in the child/adolescent age group was 8.97% (95% CI 7.33 - 10.61) and 8.98% (95% CI 7.59 - 10.36), respectively. Conclusions: This study provides information which can be used for various purposes, including study designing. Further nationwide surveys should be carried out to obtain accurate information on the HTN prevalence rate, particularly based on the American College of Cardiology /American Heart Association guidelines in the Iranian population.

BACKGROUND: Psychological distress, as a key indicator, describes a person’s emotional problems and psychological reactions to adapt to the environment. This study aimed to investigate the relationship between psychological distress and coping strategies used by individuals during the crisis caused by COVID-19. MATERIALS AND METHODS: The current research is an analytical cross-sectional study that was designed in 2021. The sampling area included the three cities of Lar, Gerash, and Evaz in the south of Fars province in the south of Iran. The study population was the residents of these three cities during the COVID-19 pandemic. The final sample size in the present study was 384 people. Individuals were selected through available sampling. By answering questions from the self-assessment system of COVID-19 disease, the Ministry of Health and Medical Education filled out the necessary information for individual screening and registration of the symptoms of COVID-19 disease. Then, they completed the Coping Methods Questionnaire and the Psychological Distress Questionnaire. RESULTS: The mean age of the participants was 40.90 years. One hundred sixty-seven (43.5%) participants were male, and 217 (56.5%) were female. The mean score of problem-oriented coping style was significantly different between the levels of education (P = 0.001). The mean score of problem-solving coping style for the participants suspected of being infected with COVID-19 was 6.18 scores lower than others, and the difference was statistically significant (P = 0.001). Multiple regression with a forward selection also showed that among the studied variables, age, problem-oriented, and emotion-oriented coping strategies were important variables affecting mental distress. CONCLUSION: People who were not suspected of having COVID-19 symptoms had a higher mean problem-oriented coping score than those who were suspected of having COVID-19. Therefore, early identification of suspects and the implementation of counseling and training programs can be very effective.

Background: People experience a lot of challenges during COVID-19 pandemic, and studies that have examined the effects of quarantining people exposed to COVID-19 in Iran are limited. Objectives: This study aimed to explore the people's experiences of psychological challenges of home-quarantine during the COVID-19 pandemic in southern in Iran. Methods: In this descriptive qualitative study, 44 individuals who were voluntarily quarantined at home for at least two weeks due to the COVID-19 pandemic were interviewed in depth from the beginning of January to March 2021. Purposive sampling method was used to select the participants, and the conventional content analysis approach was used to analyze the data. Qualitative data management was performed using MAXQDA 10 software. Results: Most participants were 31- 40 years old (29.5%), had diploma (38.6%), were married (75%), and were female (56.8%). The extracted data were classified into 3 main categories (Individual psychological issues, social psychological issues, and family psychological issues) and 15 subcategories. Conclusion: Due to the prevalence of COVID-19, measures such as home quarantine should be taken to control the infection, but it might have adverse psychological impacts on some people, as confirmed by the results of this study. Therefore, it is necessary to pay attention to the mental health of people during home quarantine, so that this method is more welcomed and successful.

Abstract Background Evidence suggests that menopause can be associated with a variety of negative psychological changes such as depression and anxiety, and improving the mental health status of women during menopause is one of the important priorities and challenges of the health system. The aim of this study was to determine the effect of saffron (Crocus sativus L., Iridaceae) herbal tea on happiness in postmenopausal women. Methods In this randomized clinical trial which was conducted in 2021, 72 postmenopausal women were enrolled and divided into intervention and control groups. The randomization blocks method was used for random allocation, and the Oxford Happiness Questionnaire was utilized to measure the scores. The intervention included the use of 30 mg of dried stigmas of the saffron plant, which was boiled once (in the morning, in 300 ml of boiling water for 10–15 min) and consumed with white rock candy as one cup of saffron tea daily. To compare the trend of changes and after removing the effect of other variables, generalized estimating equation (GEE) was used. Results There was no significant difference between the intervention and control groups in any of the quantitative and qualitative characteristics (p > 0.05). The results of paired samples t-test showed that the happiness mean score in the intervention group increased significantly (p

Background and aims: Since one of the most important methods of preventing the transmission of COVID-19 is wearing a mask, the present research was conducted to clarify the reasons for avoiding wearing a face mask by some people during the coronavirus outbreak. Methods: This is a qualitative content analysis study. In this study, 45 people from the cities of Evaz, Lar, and Gerash participated and were interviewed. The interview method was semi-structured, and the participants were selected based on purposive sampling. The collected data were analyzed by the conventional approach of the qualitative study. Results: The participants of this study consisted of 45 individuals. The mean age of the samples was 41.89±12.88 years. A total of 30 themes were extracted during the qualitative content analysis and then divided into 6 categories, including personal, social, cultural, environmental, economic, and physical factors. Conclusion: According to the findings of this study, the factors influencing the lack of tendency to wear masks by people in the COVID-19 epidemic period are numerous and interact with each other. Therefore, for encouraging people to perform such protective behavior during the coronavirus epidemic, it is necessary to consider individual, social, environmental, economic, and physical factors together.

Objective: To investigate the trend of animal bites in southern Iran from 2015 to 2019. Methods: This is a cross-sectional study of patients with animal bites who were referred to the Center for Disease Control in the three cities of Larestan, Evaz, and Khonj in Fars province, southern Iran from 2015 to 2019. The trend of animal bites incidence was analyzed using the Cochran-Armitage trend test. Results: In total, from 2015 to 2019, 1 944 cases of animal bites were reported. A total of 79.8% of the cases were men. The overall average incidence of animal bites was 142.93 per 100 000 people. The incidence of animal bites was significantly increased (Ptrend

Background: Since psychological well-being can predict the individuals’ suicidal ideation, therapeutic interventions such as reminiscence can be helpful for these persons. This study aimed to evaluate the effectiveness of reminiscence intervention on psychological well-being among individuals with a history of suicide attempt.Methods: This study was a randomized controlled trial. The population of this study consisted of individuals who had attempted suicide and referred to public hospitals in Shiraz. The sample size in each control and experimental group was estimated to be 20 people.Results: The comparison of the mean score of depression in the intervention and control groups showed that the two groups did not have a significant difference before the intervention (P=0.414), while immediately after the intervention (P

Background: On 30 January 2020, the WHO declared the outbreak of SARS-CoV-2 as a public health emergency. In the present study, we compared the preventative and therapeutic strategies and the success rates of Iran and Switzerland during the COVID-19 outbreak. Materials and Methods: This study was conducted using electronic databases such as PubMed, Scopus, and Web of Science. In addition, the official documents of developed countries and WHO from 1st February until 15th May 2020 were studied. Relevant documents were reviewed in detail, and vital data were extracted. Results: Both countries have restriction policies to reduce the infection rate in the prevention setting. These policies, such as the recommendation to all citizens to stay home unless necessary, army participation, and non-face-to-face counseling, were surveyed by similar techniques in both countries. Some policies were implemented in both countries with different protocols. These policies, including social distancing practices, smart distancing methods, business activities, border closures, border controls, and restrictions, travel restrictions, testing and screening for infection and fever, and decreased working hours, were performed in both countries. In the treatment setting, the therapeutic strategy used in Iran consisted of hydroxychloroquine or chloroquine phosphate and anti-viral drugs. Switzerland followed the guidelines of the European countries. The infection rate, recovery rate, and death rate were 0.139%, 78.73%, and 5.91% in Iran, while these rates were 0.352%, 88.81%, and 6.15% in Switzerland, respectively. Conclusion: Due to the lack of special treatment for the disease, prevention must be considered the most important factor in policymaking. Importantly, observing social distance is the most effective method among the preventative strategies. The capacity of the health care systems to provide optimal services and facilities is an important factor for patients recovery.

Background and aims: Today, with the outbreak of the coronavirus disease 19 (COVID-19) pandemic, we have witnessed many efforts by different countries to produce a vaccine for this disease. Each vaccine has been marketed with different efficiencies, thus this research was designed to determine the efficacy of different types of these vaccines in 2022. Methods: The present research was a systematic review. Researchers surveyed six international databases, including Medline/PubMed, ProQuest, Scopus, EMBASE, Google Scholar, and the ISI Web of Science, in January 2022. After reviewing the titles and abstracts of articles, 60 articles entered the final stage, and their full texts were reviewed based on the study purpose. All the vaccines included in the study were approved by the World Health Organization (WHO) or the Ministry of Health of the manufacturer country in the third phase of the clinical trial. Results: All current vaccination platforms provide adequate protection against severe acute respiratory syndrome coronavirus 2 (SARC-CoV-2) infection and significantly reduce the risk of serious infection. In addition, people who receive two vaccine doses have higher efficacy than those who only receive one dose of each vaccine. The results of the studies demonstrated that the effectiveness of vaccines is different in various groups and countries. According to the results of the reviewed studies, the Pfizer vaccine had an overall effect of 100% on the age group of 12-15 years. The overall effect of the Moderna vaccine varied from 78.6% to 97% in different groups. In general, the available vaccines for COVID-19 are less effective in the Omicron variant. On the other hand, it seems that the COVID-19 vaccines had better efficacy on the alpha variant. Conclusion: Overall, the vaccines used in the COVID-19 pandemic have acceptable efficacy. Although serious side effects caused by the injection of the vaccine have been rarely reported in some studies, it seems that the safety of these vaccines is acceptable in general.

Background: One of the treatments for depression and anxiety which has significantly increased in recent years in most countries is drinking lavender and chamomile herbal tea. The current study aimed to compare the result of these two types of herbal drinks on anxiety and depression in the postmenopausal women.Methods: The present study is a randomized clinical trial conducted in 2020. It was recorded with the code of IRCT20090304001742N6 in the Iranian Registry of Clinical Trials. The total sample size was 96 people. In the current study, the depression questionnaire (created by Beck) and anxiety questionnaire (created by Spielberger) were used to assess the contributors. Each intervention group received 2 g of dried lavender and chamomile leaves, which were cooked twice daily—once in the morning and once at night—in 300 ml of boiling water for 10 to 15 minutes—as part of the intervention. The data were analyzed using one-way ANOVA, paired t-tests, and chi-square. Results: The average score of depression in the lavender tea group was reduced from 21.00±4.10 to 18.56±3.24 (P

Background: Given the dramatic expansion of e-learning in the world and also its increasing use in Iranian universities and considering the fundamental role of students in educational systems, it is necessary to further study the structure of their knowledge and attitude in using e-learning method. The present study was designed to determine the level of satisfaction with virtual education among the students of Larestan University of Medical Sciences in 2021.Methods: The present study is a survey conducted in 2021 on students at Larestan University of Medical Sciences. The sample size was 132 people. Available (convenient) sampling method was used for sampling. A researcher-made questionnaire (Content Validity Ratio=0.99, Cronbach’s alpha reliability=0.82) was used to collect data on the students’ satisfaction with virtual learning. SPSS software version 25 and independent t-test and one-way analysis of variance were used for statistical analysis.Results: Out of 132 students participating in the present study, 88 (67.70%) were girls. The only correlation was between the students’ semester and the total satisfaction score, where the higher the student’s semester, the lower their satisfaction was (P=0.002). The overall mean score of satisfaction with virtual learning was 3.02±0.84.Conclusion: In general, due to the significant expansion of virtual education around the world, despite the short life of those efforts to improve the facilities and infrastructure of hardware and network ,paying attention to the diversity and appeal of training using diverse solutions, providing appropriate content based on the results of needs assessments, and more interactions between professors and students can lead to the development of this type of education and maximize student satisfaction.

Abstract Background Novel coronavirus disease-19 (COVID-19) was declared as a global pandemic in 2020. With the spread of the disease, a better understanding of patient outcomes associated with their symptoms in diverse geographic levels is vital. This study aimed to evaluate clinical outcomes of COVID-19 patients by disease symptoms in Ilam province, Iran. Methods This was a cross-sectional study. Data were collected from integrated health system records for all hospitals affiliated with the Ilam University of Medical Sciences between 26-Jan-2020 and 02-May-2020. All patients with a confirmed positive test were included in this study. Descriptive analyses, chi-square test, and binary logistic regression model were performed by using SPSS version 22. Results The mean age of participants was 46.47 ± 18.24 years. Of the 3608 patients, 3477 (96.1%) were discharged, and 129 (3.9%) died. 54.2% of the patients were male and were in the age group of 30–40 years. Cough, sore throat, shortness of breath or difficulty breathing, and fever or chills were the most common symptoms. Patients with symptoms of shortness of breath, abnormal radiographic findings of the chest, and chest pain and pressure were relatively more likely to die. According to binary logistic regression results, the probability of death in patients with shortness of breath, abnormal chest radiographic findings, and chest pain was 1.34, 1.24, and 1.32 times higher, respectively, than for those without. Conclusion Our study provides evidence that the presentation of some symptoms significantly impacts outcomes of patients infected with SARS-CoV-2. Early detection of symptoms and proper management of outcomes can reduce mortality in patients with COVID-19.

Background: Hematuria is one of the most common symptoms in nephrology and urology. Due to the lack of extensive meta-analysis studies on the epidemiology of hematuria in Iran, this study was conducted to determine the epidemiological status of hematuria in Iran. Methods: In Sep 2020, researchers studied six international databases such as PubMed, ISI/WOS, ProQuest, Embase, Scopus, and Google Scholar for English papers and Iranian databases (SID and MagIran) for Persian papers. Joanna Briggs Institute (JBI) checklist was used to review and control the quality of articles. Heterogeneity between studies was assessed by Cochran's test and its composition using I2 statistics. Results: After several screening phase, the number of 25 article included to the final analysis. The prevalence of hematuria in the general population and children, in Iran were estimated at 16.4% (95% CI, - 0.05-37.9) and 1.6% (95% CI, 0.9-2.3) respectively. The odds ratio (OR) of women to men in the prevalence of hematuria in the general population 1.74, 95% CI: 1.20-2.52, P=0.003, patients with beta-thalassemia major 2.02, 95% CI: 1.11-3.65, P=0.020, children 2.61, 95% CI: 1.19-5.71, P=0.016, the elderly 1.50, 95% CI: 1.15-1.94, P=0.002, and taxi drivers 3.73, 95% CI: 2.58-5.38, P

Background and aims: Today, with the increasing prevalence of COVID-19 in the world, the general population with excessive worry due to media reports has a higher level of psychological distress. Therefore, the present study aimed to determine the state of anxiety among Instagram users in 2020. Methods: This is a cross-sectional study that was conducted from June to July 2020 on 313 Instagram users. Coronavirus Anxiety Scale was used to measure anxiety caused by coronavirus in Iran. The subjects entered the study by availability sampling and filled out the questionnaire through the features of Instagram such as posts and stories. Chi-square test was used to analyze the relationship between independent and dependent variables according to the nature of the variable. The significance level was considered to be P < 0.05. Results: Out of 313 participants in the study, 218 (69.6%) were in the age range of 19-35 years. Additionally, 50.5% of them were male and the majority of the participants had academic education. Overall, 21.4% of the participants had moderate to severe anxiety. There was no significant relationship between the participants’ levels of anxiety and demographic variables (age groups, gender, and level of education) (P > 0.05). Conclusion: The results of chi-square test showed that no significant relationship was observed between the dimensions of anxiety based on the demographic characteristics of individuals such as age groups (P=0.256), gender (P=0.644), and level of education (P=0.415).

Background: In the last two decades, the number of people who have referred to mental health services due to concerns about gender identity has increased dramatically. The aim of this study was to present the most important and fundamental results of studies on transgender psychological and behavioral disordersand compare these results. Methods: This is a narrative review study. Search for articles related to common psychological and behavioral disorders in transgender people was done by two trained researchers between December 2019 and March 2020 in 5 Latin scientific databases (Google Scholar, PubMed / Medline, Scopus, ISI Web of Science and Embase). Results: Psychological and behavioral disorders were much higher in transgender people than in the general population. The most common disorders included anxiety and depression, suicidal attempt, drug abuse, self-injury without suicidal tendency, and HIV. Conclusion: Transgender people are constantly harassed and abused by friends, acquaintances, classmates and teachers, and even their families. Having multiple sexual partners increases the risk of HIV infection and other sexual misconduct. Therefore, governments need to implement their support programs through training centers and counseling for transgender individuals.

Background: The mental health of healthcare workers has been a concern during the outbreak of 2019 novel Coronavirus Disease (Covid-19). Therefore, the present study was designed to evaluate the anxiety of the healthcare workers during Covid-19 epidemic and to discover the factors affecting it. Methods:The present study was a cross-sectional descriptive-analytical study. In this study, the anxiety of 124 nurses, operating room staff, midwives and anesthetists working in different wards of Imam Reza Hospital in Lar in 2020 was assessed using the Corona Anxiety Scale Questionnaire. Results: The results showed that most of the samples were female, married, with a bachelor's degree and an average age of 33 years. 53 (42.8%) participants had mild anxiety and 34 (27.4%) had severe anxiety. Comparison of anxiety levels based on demographic variables of participants in the study showed that there was no significant relationship between anxiety levels with gender, marital status, education level, and field of study (P> 0.05). Conclusion:According to the results of the study and the worsening of the COVID-19 epidemic, there is a need to strengthen the awareness and address the issues related to mental health of healthcare workers.

Background and aims: Self-medication, as the most common method of self-care, is one of the major problems in treatment in many countries in the world. The present study was designed to determine the prevalence of self-medication and identify the factors associated with casual medication use among students of Larestan University of Medical Sciences in Iran in 2020. Methods: This is a cross-sectional descriptive-analytical study conducted in 2020. The study was conducted at Larestan University of Medical Sciences and 147 students entered the study through convenience sampling. The data collection tool was a researcher-made self-treatment questionnaire. After collecting the data, the SPSS software version 25.0 was used to analyze the data. Fisher’s exact test, independent t test, and chi-square test were used to investigate the relationship between the variables. A P value of less than 0.05 was considered statistically significant. Results: The prevalence of self-medication was 62.5%. The most common sources of self-medication were pharmacies and previous prescriptions. The most common illnesses treated with over-the-counter medications include colds, headaches, and digestive problems. The most important over-the-counter medications include painkillers, anti-colds, antibiotics, iron pills, calcium supplements, and antihistamines. A comparison of students’ attitudes towards medication showed that attitudes “I feel my problem has been treated with over-the-counter medications” and “I feel I have enough information about diseases and how to treat them” (the group who did have self-medication and the group who did not have self-medication) had a significant difference between the two groups (p

Background: Cervical cancer is one of the most common female genital cancers. It accounts for about half of the one million new cases and one-quarter of all cancer deaths in women. The present study was designed to comprehensively identify the risk factors of cervical cancer using the results of similar studies. Methods: The present study was an epidemiological review study. Searches related to the epidemiology and risk factors of cervical cancer between April 2020 and May 2020 were conducted by two researchers at four Latin scientific databases (Google Scholar, PubMed / Medline, Scopus, ISI Web of Science). The two researchers examined the extracted articles and included articles that referred to the epidemiology and risk factors of cervical cancer. Results: The most important risk factors for cervical cancer included human papillomavirus, viral, fungal and bacterial infections, sexual behavior, smoking, pregnancy and childbirth, and other factors (family history and menopause earlier than 45 years). Conclusion: It is recommended that health issues should be considered, especially during sexual intercourse, HPV screening in women, as well as periodic examinations for women.

Background and aims: Leishmaniasis is one of the most overlooked diseases in tropical areas, which can lead to many deaths and illnesses. The present study was designed to determine the trend of cutaneous leishmaniasis in the south of Fars Province (south of Iran) during 2007-2016. Methods: The population of this cross-sectional study consisted of all people with cutaneous leishmaniasis referring to the Center for Infectious Diseases in Larestan, Gerash, Evaz, and Khonj in the south of Fars Province during 2007-2016. The incidence of cutaneous leishmaniasis was analyzed using the Cochrane-Armitage trend test, and the significance level was considered 5%. Results: In general, 4602 cases of cutaneous leishmaniasis were reported from 2007 to 2016. The highest and lowest incidence rates (659.1 versus 88. 3 per 100000 people) were observed in 2008 and 2012, respectively. In addition, the incidence of the disease significantly reduced (P Trend=0.003). Finally, the 0-4 age group had the highest incidence of the disease (69.64 per 100000 people), and the hands were the most common organ affected by cutaneous leishmaniasis (37%). Conclusion: According to the research findings, the incidence rate of cutaneous leishmaniasis is declining although leishmaniasis is still one of the endemic diseases in the region. Therefore, preventive and controlling interventional programs can be effective in reducing new cases of the disease, including the education of individuals, especially children, environmental cleanup, and extermination and control of stray dogs and rodents in the suburbs.

Background: In December 2019, a series of pneumonia cases of unknown cause appeared in Wuhan, China, which was very similar to viral pneumonia. In late January 2020, the World Health Organization named this disease the sixth public health emergency of international concern due to an increase in the number of COVD-19 cases. This study was designed to determine different epidemiological and clinical aspects of COVID-19 worldwide. Methods: This is a review study. We searched for articles related to COVID-19 from December 20, 2019 to June 05, 2020. Two researchers performed the search separately, and finally articles containing information on coronavirus, its mortality and epidemiology and clinical characteristics of the patients were selected for review and extraction. Results: The results of various studies show that the most common symptoms of the disease include fever, cough and fatigue, and the most common respiratory symptom is Rhinorrhoea. Transmission occurs primarily when an infected person sneezes or coughs through respiratory droplets, such as the spread of influenza and other respiratory pathogens. Some studies have reported that the COVID-19 incubation period is an average of 4.6 days, ranging from 1.2 to 11.1 days and can potentially be asymptomatic. Conclusion: The significant increases in the morbidity and mortality necessitate prevention and control activities by educating people on important health issues such as staying at home, using clean masks and gloves, as well as performing proper and timely medical interventions.

Background: Suicide is a multi-factorial phenomenon whose patterns can vary even from one place to another in one country; the purpose of this study was to determine the causes of suicide attempt in a 6-year period in Larestan County in the period between 2012 and 2017. Methods: The present study was a descriptive-analytic cross-sectional study. In order to investigate the epidemiological condition of suicide attempters in Larestan, all files of suicide cases registered in the period between 2012 and 2017 in this city were investigated, and finally 723 cases were included in the study. For statistical analysis, independent t-test, chi-square and logistic regression models were used. A significance level of 5% was considered. Results: Of the total 723 suicide attempts recorded in the health network of Larestan, the mean age at suicide attempt was 26.08 ± 7.88 years and 3.73% of them had died as a result of suicide attempt. Drug abuse and poisoning were the most common methods of suicidal attempt. Based on the regression model, Increase in age, male sex, and physical problems were the most important factors in predicting suicide death (PConclusion: Various factors including age, male gender and physical problems contribute to suicide and deaths associated with it; therefore, the implementation of educational and counseling programs for these individuals, especially in adolescence and youth, and people with physical and psychological problems is essential.

Background: Thyroid cancer is the most common malignancy of the endocrine glands at any age and sex. The present study was designed to comprehensively identify the epidemiological status of thyroid cancer using the results of similar studies. Methods: The present study was an epidemiological review study. Studies on the epidemiology of thyroid cancer between March 2020 and April 2020 were searched by two researchers at four Latin scientific databases (Google Scholar, PubMed / Medline, Scopus, ISI Web of Science). Persian and Latin articles about the epidemiology of thyroid cancer were included in the study. Results: The incidence of thyroid cancer is increasing worldwide; however, this type of cancer has a good survival rate. The most important risk factors for thyroid cancer include Ionizing radiation, diet, female gender, age, genetic background and race and ethnicity. Conclusion: The incidence of thyroid cancer in the world is increasing. Therefore, preventive and protective measures to reduce the risk factors of this cancer are recommended to reduce the incidence of the disease.

Background: Teachers' motivation towards their jobs is one of the major challenges in educational systems. The purpose of this study was to investigate the motivation of teachers towards their job. Methods: This is a cross-sectional study. The participants consisted of all teachers of secondary school of Bandar Lengeh city in 2016. The sample size of the study was 45 for teachers. The teachers were recruited through census sampling. Data were collected using the Hackman and Oldham's Job Motivation Questionnaire. The data were analyzed by descriptive and inferential statistics using SPSS 25 software. Results: Of the 45 teachers, 41 (92%) were married and 4 (8%) were single; also, 29 subjects (64%) were males. The majority of teachers were (no:19, 43%) between the ages of 31 and 40 years. 64% of the teachers had a bachelor's degree. 18% of them had low job motivation, 44% had moderate and 38% had high job motivation. The results of the T-test did not show a statistically significant difference between the teachers of public and gifted students schools (p value>0.05). Conclusion: The results of the study show that the teachers' job motivation is important in their productivity. It is suggested that targeted and effective programs should be implemented to promote the mental health of this important group of society.

Abstract Background: Malaria has been considered by health systems as one of the most dangerous human infectious diseases. In Iran, the disease has caused great economic and social damage to the country. The present study was designed to identify the epidemiological situation of malaria during 2006 to 2018 in the southern region of Fars province, southern Iran. Methods: This is a cross-sectional study. The study population consisted of all people with malaria whose information was recorded at the Larestan Infectious Diseases Center from 2006 to 2018. To extract the data, a checklist was used that included information such as the total number of smears performed each year, the number of positive smears, age of the individual, sex, type of malaria species, and the month of the disease. Results: Out of a total of 85,201 smear tests performed to identify malaria in the region, 190 had positive smear tests. The majority of the positive cases were Afghan nationalities. Most cases of the disease were seen in 2017, 2008 and 2016, respectively. In all years, men were more likely than women to have malaria, and the highest prevalence was in the age group of 21-30 and 11-20 years, respectively. Conclusion: Despite the relative decrease in malaria cases in recent decades in Larestan city, in recent years, especially from 2014 to 2018, the increasing trend of the disease has been relatively shown again, so making active diagnosis, equipping health systems and doing more blood smears tests are necessary to reduce the prevalence of malaria in this region.

Objective (s): Since suicide attempt is a major challenge among adolescents, this study aimed to investigate the factors related to suicide attempt among adolescents. Methods: This study was a qualitative research using the content analysis method. The samples were 10 adolescents with a history of attempted suicide referred to welfare centers in Larestan, Iran, in 2018. Purposeful sampling was used. Data collection continued through in-depth semi-structured interviews until data saturation achieved. Results: Five themes emerged for m the analysis: failure in love, family involvement, family disruption, psychological problems, and ineffective coping strategies. Conclusion: According to the findings it seems that an appropriate support system focusing on prevention of risk factors might help to prevent suicide attempt in adolescents. Training on how to cope with stress and increasing adolescentschr('39') access to specialized counseling services also might be useful.

Introduction: Drug abuse problem is one of the four global crises and the most important social crisis in Iran. This study was conducted to investigate the importance of life skills training in preventing the recurrence of addiction among young people. Methods: The present article is a narrative review performed by two researchers between January and February 2020 by searching in scientific databases in articles published in Scopus, Pubmed, Google scholar and Google search engine including the terms “addiction”, “youth” , “Coping skills”, “adaptability skills”, “life skills training”, and “drug abuse”. Results: The results of various studiesindicate that the life skills training program increases the feeling of happiness, improves the quality of life of people, and increases the ability to control emotions. Conclusion: Due to the positive impact of life skills training and its applicability to all segments of society, planners and managers in the community's mental health sector can set up centers to continuously hold such classes and conduct life skills training even as in-service training program.

Background: Menopause is one of the female life stages affecting their mental health due to symptoms experienced by them during this period. This study aimed to investigate the relationships between severity of menopausal symptoms, depression and anxiety. Methods: This cross-sectional analytical study was performed on 120 females aged 45-65 years in the city of Larestan, Iran. Subjects were selected by convenience sampling. Data collection tools included a demographic questionnaire, Beck depression inventory, Spielberger anxiety scale, and the modified Kupperman menopausal complication index. Data analysis was performed using SPSS software (version 25) at 95% confidence level. Results: Out of 120 menopausal females, who participated in this study, 89.2% were married, and their mean age was 53.30±4.24 years. The majority of them (92.5%) were in their diploma level and below. According to the results of the Spearman correlation test, there was a significant relationship between depression score and severity of menopausal symptoms (r = 0.775, P P Conclusion: Considering the significant relationship between the severity of menopausal symptoms and the presence of anxiety and depression, the treatment of menopausal symptoms can prevent depression and anxiety in females during this sensitive period.

Objective: Fars province in south Iran is an endemic focus of Leishmaniosis. This study was designed to evaluate the epidemiological status of cutaneous Leishmaniasis in Fars province, South Iran, from 2007 to 2016. Methods: This study was a retrospective-analytical cross-sectional study. The study population consisted of all people with Leishmaniasis, who referred to the infectious disease center in four cities of Larestan, south Fars province, from 2007 to 2016. Chi-square test and ANOVA were used in data analysis. The significance level was considered as 5%. Results: In the period 2007-2016, 4599 cases of cutaneous Leishmaniosis were registered. The highest number of cases occurred in 2008. The mean age in 2007 and 2016 was 17.7±17.1 and 12.9±16.5, respectively. Women were the majority of cases, from 2007 to 2012. Hand ulcers were the most prevalent part of the body in all these years, except 2016. In terms of seasonal distribution, most of the cases occurred in winter and the least in summer. Afghan and Pakistani immigrants produced the majority of cases. Conclusion: The trend of cutaneous Leishmaniosis has declined in Larestan city from 2007 to 2016. However, Leishmaniosis is still a major public health problem. Since the majority of cases were related to Afghan and Pakistani immigrants, it is necessary to ward off these people

Background: Suicide and Suicidal attempt at the 1996 World Health Organization Summit was an important public health and anti-social behavioral issue. Suicide rates are one of the most important indicators of the community's mental health. The present study was designed to elucidate the factors affecting suicidal attempts among adolescents. Methods: This is a review study. Two researchers searched for suicide-related articles and related factors between October and November 2019 at five Latin scientific databases (Google Scholar, PubMed / Medline, Scopus, ISI Web of Science and Embase). Results: The most important factors in suicidal attempts in adolescents included individual factors, family factors, and social factors. Hormonal changes in puberty in adolescents, especially in girls, can affect the adolescents’ behavior. The breakdown of the family structure can have negative consequences for children and cause them to commit suicidal attempts. Conclusion: The available evidence indicates the influence of individual, family, and social factors at the beginning of the process of suicidal attempt among adolescents. Therefore, by focusing on preventing risk factors leading to suicidal behavior in adolescents, teaching how to deal with stress and increasing the adolescents' access to specialized counseling services and useful social networks, a suitable support system can be provided for these people.

Introduction: Elderly people face many challenges and these problems make them vulnerable to various types of mental disorders. The purpose of this study was to evaluate the level of anxiety and depression in the elderly people who referred to the health center of Larestan city in 2019. Methods: In this cross-sectional study, 109 elderly people were selected by convenience sampling from health center of Larestan city. Demographic information, Beck Depression Inventory and Spielberger Anxiety Questionnaire were completed by the samples. Finally, the collected data were analyzed using Spearman, Kruskal-Wallis and Mann-Whitney tests. In this study, a p-value of 0.05 was considered as statistically significant . Results: Out of 109 elderly people who participated in this study, 47 (43.1%) were male and 62 (56.9%) were female. The mean age of the men and women was 65.30±5.013 and 69.34±5.675 years, respectively. Most of the samples were married (79.80%) and illiterate (43.10%). The mean of depression, state and trait anxiety in men was 11.79±5.91, 33.02±11.56 and 34.19±13.50 respectively; also, the mean of depression, state and trait anxiety in women was 15.31±6.65, 40.68±12.44 and 40.82±12.29, respectively. The results of Mann-Whitney U test showed a statistically significant relationship between gender and the level of depression, state and trait anxiety (P value0.05). Conclusion: The findings of this study indicate the high prevalence of depression and anxiety among the elderly under the study, especially among the elderly women; therefore, interventions are needed to reduce the stressors of the elderly people's lives.

Background: Brucellosis is known in Iran as an endemic disease; however, its incidence is not the same in all provinces and is higher in some areas. Objective: The present study was designed to determine the epidemiological status and trend of brucellosis in the period from 2015 to 2020 in the south of Fars province, Southern Iran. Methods: This is a cross-sectional analytical study. This study included all patients with brucellosis in the period from 2015 to 2020 whose information had been registered in the Infectious Diseases Center of Larestan city. To collect the data, we used a checklist that included information such as age, gender, number of cases by year and month, occupation, and nationality of the patients with brucellosis. The rate of brucellosis incidence during these years was analyzed using the Cochran-Armitage trend test. P-value less than 0.05 was considered significant. Results: The average annual incidence of the disease was 8.94 per 100 000 population. It has decreased from 26.83 (per 100 000 people) in 2015 to 1.83 (per 100 000 people) in 2020. The results of Cochrane-Armitage process test showed that the reduction in the incidence of the disease from 2015 to 2020 was significant (PTrend = 0.001). The trend of the disease by month also showed that the majority of cases occurred between December and February, with the highest incidence of the disease in February (9.93 per 100 000 people) and the lowest in May (1.1 per 100 000 people) (P = 0.001). Conclusion: Although the results of the present study indicated a decrease in the incidence of the disease in the southern region of Fars province, due to the fact that the disease is common between humans and livestock, there is the possibility of scattered and irregular epidemics in each period.

Background: Adolescence can be a critical period during which individuals begin to cope with self-harm behaviors, and the increasing prevalence of suicide and suicidal attempts in this period is quite tangible in different communities. Given the lack of awareness concerning tolerance strategies in individuals with suicidal behavior, we investigated coping strategies in adolescents with suicidal thoughts. Methods: This qualitative research was conducted during January and February 2019 in which we used the method of qualitative content analysis. In this study, 17 adolescents with suicidal ideation referred to Larestan welfare centers, Fars province were interviewed. In addition, one psychologist and 17 parents of the adolescents participated in this research. Purposeful sampling was done. Data collection continued through semi-structured deep interviews until data saturation. Results: Two main themes, namely effective coping strategies with 16 sub-themes and ineffective coping strategies with 12 subthemes were extracted from the data. Conclusions: It was concluded that using appropriate plans to strengthen positive strategies in adolescents, providing them with new positive strategies, and omitting negative strategies can be conducive to preventing suicidal thoughts.

Coronavirus (COVID-19) was first developed in Wuhan, China in December 2019 and spread rapidly around the world (1, 2). In late January 2020, the disease was recognized as the sixth international public health emergency (3). The infection is transmitted from person to person through respiratory secretions and contact with surfaces or people (4). In general, infectious diseases constantly threaten human health; especially if they are new, because they are always a potential challenge for the healthcare system around the world (5). Health personnel, like other infectious diseases, are at the forefront of the fight against coronavirus. A high percentage of these personnel work night shifts with high workload (6). Work-related stress, lack of sleep, and shift work in health care personnel cause sleep disorders and poor sleep quality (7). Sleep is a specific behavior and each person is aware of its importance and its appropriate duration, and is rotated by waking up. Also, one of the most important parameters in assessing the quality of life and health status of each person is the quality of sleep (8). Sleep is a key factor in a person's physical health and related disorders including poor sleep quality, difficulty sleeping at night, waking up early, circadian rhythm disorders, parasomnia, sleep-related movement disorders, and sleep-related respiratory disorders (9). Sleep disorders are physical and mental conditions that cause adverse effects due to poor sleep quality (10). Sleep disorders have many negative effects on people's lives and lead to physical complications such as increased risk of obesity, diabetes, high blood pressure, increased heart rate, heart attack, and stroke (11). Therefore, during the COVID-19 epidemic and with the increase of work pressure in health care workers, there is a possibility of increasing sleep disorders and consequently increasing physical diseases. Healthcare personnel are the most important group in dealing with the COVID-19 epidemic; therefore, increasing the number of medical staff and reducing the number of work shifts can relieve fatigue and maintain energy levels in them and reduce physical complications in them. Among the treatment methods for insomnia, we can mention medication; however, because sedatives have side effects such as drowsiness and decreased accuracy, they are not recommended for people such as nurses who always need full alertness during their shift; instead, non-pharmacological therapies such as relaxation techniques can be used. Because relaxation is a relative state of relief from the mental and physical effects of stress which can improve the sleep quality by regulating the hypothalamus and reducing sympathetic and parasympathetic functions (12). The progressive muscle relaxation technique introduced and used by Jacobsen is an easy, cost-effective method without the need for special equipment; it is one of the best complementary therapies to reduce the effects of mental illness such as anxiety because people in this method, by contracting and relaxing a specific muscle, cause relaxation in different target muscles and increase concentration and pleasant emotions (13). In order to improve working conditions, it is also suggested that the chronobiological characteristics of individuals should be considered when planning work shifts and classifying individuals accordingly. This type of chronotype classification is a simple method and takes into account issues such as individual circadian differences, sleep habits and performance on a particular day, and ultimately helps to plan work shifts based on these chronobiological characteristics (14). Another suggestion that can be made in this regard is physical activity because physical activity promotes physical and mental health with the biological and biochemical changes that follow. As a result, they improve the quality of sleep. In addition, physical activity, if repeated frequently, reduces the risk of physical illnesses such as cardiovascular disease, cancer, diabetes, and hypertension by boosting the immune response in the body (15).

Background: Anxiety and low self-esteem can lead to feelings of vulnerability and being at risk, which can predict a suicide attempt. This study aimed to investigate stress and self-esteem of suicide attempters referring to hospitals affiliated to Shiraz University of Medical Sciences in 2018. Methods: This is a descriptive-analytical study. In this study, 74 patients were selected through convenience sampling from referring to hospitals affiliated to Shiraz University of Medical Sciences in 2018. Data were collected through demographic questionnaires, Spielberger anxiety questionnaire, and Rosenberg self-esteem questionnaire. After completing the surveys, the data were analyzed. Finally, by defining the scores of the questionnaires, statistical analysis was performed and the results obtained from the study. Results: Out of 74 suicide attempters, 62.2% were women, and the majority of them were married (70.30%). The state anxiety score showed that 24.3% and 21.6% were in medium to high and severe anxiety, respectively, and the trait anxiety score indicated that the majority of individuals were in moderate to the critical range. Self-esteem scores showed that 54.1% were in low self-esteem range. Conclusion: Anxiety and low self-esteem can be effective factors in a suicide attempt. Therefore, therapeutic interventions to reduce anxiety and improve self-esteem in such individuals can prevent a suicide attempt.

Objective: Type 2 diabetes is the most prevalent chronic disease in the world. Timely and appropriate control can significantly reduce the burdens and costs of this disease. Although insulin injection is the most efficient method to control type 2 diabetes, patients avoid this method for unknown reasons. The main aim of the present study is to determine the factors influential in non-adherence to insulin using tools and models that have not been applied in this field so far. Methods: The tendency to insulin injection in 457 patients with type 2 diabetes was investigated in this cross-sectional study using the classic logistic regression and new learning algorithms, including conditional tree, conditional forest, and random forest. Different fits were compared so that the best model can be determined to identify the factors in non-adherence to insulin. Results: Although random forest had the highest accuracy among the fitted models, all the methods had a relative consensus that having life insurance, academic education, and insulin injection experience in immediate family members increase the tendency to accept insulin therapy. Our results also showed that younger patients and those who were committed to a specific diet better approved insulin therapy. Conclusions: The reasons for non-adherence to insulin can be summarized in economic and psychological aspects. Therefore, the health system policies are recommended to address economic issues and also raise public awareness about this treatment method.

Objective (s): Suicide attempt is one of the major health problems for many countries. The purpose of this study was to investigate the demographic characteristics of adolescents with a history of suicide attempt in Larestan, Iran. Methods: This was a descriptive study. The statistical population of this study was all registered cases of adolescent with suicide attempt referred to the health and social emergency centers in the city of Larestan between 2012 to 2018. In this study,. Data were analyzed by using chi-square test. The significance level was considered at 0.05. Results: There were 184 adolescents with a history of suicide attempt. Of these 123 records were for females (66.8%); the mean age of the adolescents was 17.48 ±1.63 years, and 146 cases (79.3%) were single. In all 20 cases (10.9%) had a history of previous suicide attempts. Overall 5 cases died due to suicide. There was a statistically significant difference between suicide attempt and gender (p = 0.01). Also, the reason for suicide attempt had a significant relationship with marital status (p = 0.05). Conclusion: The findings suggest that the risk of suicide is higher among single and female adolescents.

Background: Job performance is one of the most important variables in industrial and organizational psychology and its importanceis clear to both individuals and organizations. The purpose of this study was to investigate the relationship between spiritual wellbeingand organizational virtuousness with the performance of high school teachers in Bandar Lengeh, Hormozgan Province.Methods: This was a cross sectional study conducted on all secondary teachers in Bandar Lengeh city, Hormozgan Province. 127 individuals were determined by using Morgan table. Measurement tools were 40-item Spiritual Well-being Questionnaire, 15-item of Organizational Virtuousness Questionnaire, and the 12-item Job Performance Questionnaire. Level of statistical significance was set at PResults: The majority of respondents (77%) were men. 71% (n=90) of the respondents had a bachelor’s degree. The findings of this study showed that there was a positive and significant relationship between spiritual well-being and its dimensions (relationship with God, self-relationship, relationship with others, and relationship with nature) with the performance of highschool teachers (PConclusion: Based on the findings of this study, it can be said that enhancing spiritual well-being and organizational virtuousness can enhance the performance of secondary school teachers.

Background: Since suicide attempt and its association with mental disorders such as depression in individuals is a major challenge in societies, this study aimed to investigate depression in suicide attempters referring to hospitals affiliated to Shiraz University of Medical Sciences in 2018. Methods: This was a cross-sectional descriptive-analytical study. The study population included all suicide attempters referring to hospitals affiliated to Shiraz University of Medical Sciences in 2018. Some 74 patients were selected by convenience sampling method. Data were collected through demographic questionnaires and second version of Beck Depression Inventory. Finally, by defining the scores of the questionnaires, statistical analysis was performed and the results obtained from the study. Mann-Whitney, Kruskal-Wallis and Spearman correlation tests were used to analyze the relationship between the variables. The significance level was considered 5%. Results: The mean age of the samples was 49.41±5 5.68 years. 28 (37.8%) of the samples were male, and the rest were female. The mean and standard deviation of depression were 30.38±11.52, which were in the category of severe depression. There was a meaningful relationship between marital status, education level, and depression (P-value Conclusion: Depression is one of the predictive variables of suicide attempts in individuals; therefore therapeutic and supportive interventions in such individuals can prevent a suicide attempt.

Abstract Water pipe tobacco smoking with biological, psychological and social dimensions is one of the problems of the present age. The purpose of this article was to investigate the factors affecting the use of hookah among women. This article is a review study conducted by searching the scientific databases using search engines in the articles published in Scopus, Pubmed, Google scholar databases as well as the general Google search engine using the keywords hookah, Shisha, water pipe, tobacco, women. A rapid literature search strategy was conducted for all theEnglish language literature published before January 2020. The findings of this study indicate the effect of multiple personal, social and family factors on the initiation and continuation of water pipe tobacco smoking among women. Therefore, it seems that with regard to these risk factors, appropriate programs and interventions for prevention of water pipe tobacco smoking use among women can be considered.

Background: Since the elderly are more susceptible to cognitive impairment than other age groups, this study aimed to investigate the assessment of cognitive status of the elderly living in nursing homes in Larestan city and the relationship between cognitive status of the elderly people and some demographic variables. Methods: This research was a cross-sectional study conducted on all the elderly living in a nursing home in Larestan city. Sampling was done by census method and 54 elderly people were selected according to the inclusion criteria. Demographic characteristics questionnaire was used to assess general information of the elderly, and standard mini mental state examination questionnaire was used to assess the elderly people’s cognitive status. Results: The mean age of the males was 69.44± 5.83 years with a range of 60-78. Mean and standard deviation of cognitive status were 25.28 ± 2.15 for males and 24.82 ± 2.54 for females, respectively. Also, 5 (9.30%) had moderate cognitive impairment, 24 (44.40%) had moderate cognitive impairment and 25 (46.30%) had normal cognitive status. There was a significant relationship between marital status and cognitive status in the elderly (p value = 0.012). The mean cognitive status of the married and single elderly was 24.10 ± 2.51 and 25.54 ± 2.13, respectively. Conclusion: Cognitive disorders are more prevalent among the elderly married couples, which can improve the adverse effects of these cognitive disorders by strengthening family relationships and caring.

Background: Many patients with type 2 diabetes are uncontrolled on maximum oral treatment. The early introduction of insulin can lower diabetes-related complications. This study aimed to evaluate type 2 diabetes patients’ demographic characteristics, clinical factors, and attitude toward insulin therapy initiation. Methods: In the present cross-sectional study, 457 patients were selected from 12 diabetes clinics in the southern Iranian city of Shiraz in 2017. Adult patients (>30 y) with type 2 diabetes indicated to use insulin for the first time (insulin-naive) were asked to complete a researcher-designed questionnaire. The data were analyzed using SPSS 19. The relationships between insulin and the tendency to use insulin, demographic characteristics, and clinical data were evaluated using the χ2 or t test and logistic regression. The significance level was considered at 0.05. Results: The mean age of the participants was 55.16±8.76 years and 67.4% were female. Despite physician recommendations, 60.2% of the patients were disinclined to use insulin. Those unwilling to initiate insulin therapy had more misconceptions. In the multivariate analysis, the chances of insulin noncompliance were increased by 4.63-fold among the patients without supplementary insurance (P

Objective: Testicular cancer (TC), although it is one of the most unusual cancers, seems to be increasing. There is no accurate information on the incidence of this cancer in Iran. The present study is conducted to evaluate the incidence rates of TC in Iran. Methods: A systematic search was conducted on all published studies of TC incidence using Medline/PubMed, Scopus, Embase, Web of Science, Google Scholar and four Iranian databases (Scientific Information Database, MagIran, IranMedex and IranDoc) until June 2018. This systematic review was done according to the preferred reporting items for systematic reviews and meta-analyses. Result: The database searching yielded 132 potentially relevant studies. A total of 11 studies were included in the study. The results of the random-effects model were demonstrated that the age-standardised rate (ASR) of TC was 1.13, 95% confidence interval (0.97–1.29) among Iranian males. Conclusion: ASR for TC in Iran is lower than the world average; however, it has a higher incidence than other Asian countries.

Background: Resiliency is considered as a coping method for nurses in dealing with work problems. Because different personality characteristics also cause different responses by nurses in coping with challenges, this study was conducted to investigate the relationship between personality traits and resilience in Nurses and Paramedical staff in Lar and Gerash hospitals. Methods: This is a cross-sectional study. The research sample consisted of 160 nurses and paramedical staff in Lar and Gerash hospitals that were selected by convenience sampling strategy. To measure the variables, NEO Personality Inventory (NEO- FEI) and Connor - Davidson Resiliency Scale (CD-RISC) were used. Data were analyzed using Pearson correlation coefficient in SPSS version 25 software. Results: Statistical analysis showed that extraversion personality traits (r=0.680, P P (r=0.635, P the resiliency variable, and it was only the trait of neuroticism (r=-0.749, P with the resiliency variable. Conclusion: In the nursing profession, resiliency is a key element in improving the mental health of nursing staff and helping them to cope better with their stress, challenges and difficulties. Therefore, awareness of the effect of the nurses’ personality traits leads to better management, and since resilience is an educable and changeable variable, problems with nurses who lack effective personality traits can be improved by increasing resiliency