Mostafa Ghanei; Seyed Hassan Saadat; Alireza Najimi-Varzaneh; Mohammad Gholami Fesharaki
Volume 26, Issue 1 , 2024
Abstract
Context: The prevalence of in-hospital death due to COVID-19 hospital is one of the qualitative indexes, which can be used to assess the quality of care, as well as the mortality patterns in COVID-19 pandemic.Objectives: Therefore, this study has been done with the goal of estimating overall prevalence ...
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Context: The prevalence of in-hospital death due to COVID-19 hospital is one of the qualitative indexes, which can be used to assess the quality of care, as well as the mortality patterns in COVID-19 pandemic.Objectives: Therefore, this study has been done with the goal of estimating overall prevalence in-hospital death due to COVID-19 disease in iranian patients.Evidence Acquisition: Articles were identified through iranian searching databases including Health.barakatkns, IranDoc, SID, Civilica and MagIran and international searching databases including Scopus, Web of Science, PubMed and Elsevier . Additional search was also done by Google Scholar search engine. We reviewed systematically all studies reporting the prevalence of in-hospital death due to COVID-19 disease. In this study meta-analysis method with random effect model has been used to estimate the pooled in-hospital death.Results: 118 records were identified by the electronic search, of which 43 studies were identified as relevant documents that were meta-analyzed for the pooled in-hospital death due to COVID-19 prevalence. Overall, prevalence of death were 12.16% (95% CI: 10.72%-13.61%). The highest and lowest death prevalence has been reported in Northern Provinces (Gilan, 27.27% (95% CI: 8.66%-45.88%) and Mazandaran, 21.27% (95% CI: 18.14%-24.40%)) and Turkish-speaking provinces (Azerbaijan, East, 3.29% (95% CI: 2.11%-4.47%) and Zanjan, 3.42% (95% CI: 1.82%-5.02%)) respectively.Conclusions: Considering the death rate obtained in this study and its comparison with other countries, it can be said that the performance of the Iranian medical system in COVID-19 pandemic is acceptable.
Alireza Molaei; Mohammad Gholami Fesharaki
Volume 23, Issue 11 , 2021
Abstract
Background: COVID-19 has raised a worldwide trajectory since it emerged in Wuhan, China in December 2019. The direct and indirect mortalities in the world and as well as in Iran have increased significantly after the occurrence of this pandemic.
Objectives: In this study, Excess Mortality Rate (EMR) ...
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Background: COVID-19 has raised a worldwide trajectory since it emerged in Wuhan, China in December 2019. The direct and indirect mortalities in the world and as well as in Iran have increased significantly after the occurrence of this pandemic.
Objectives: In this study, Excess Mortality Rate (EMR) was estimated by multilevel poison regression method and then this estimation was compared to the historical trends to obtain total deaths related to COVID-19. Additionally, the geographic distribution of EMR has also been presented for Iran.
Methods: All-cause mortality rates of each province of Iran from March 21, 2013 to September 22, 2021 was downloaded from National Organization for Civil Registration (NOCR). The data of COVID-19 pandemic period (spring 1399 SH (Mar 20, 2020) to summer 1400 SH (Sep 22, 2021)) was removed from the data and then the multilevel poison model was applied to estimate all-cause mortality in this period. Then, EMR= (real deaths-expected death)/(real deaths) ratio was calculated.
Results: The results of this study showed that Irans EMR in COVID-19 pandemic was 36% (Male=35%, Female=36%, P-value=0.798). Our findings also revealed four category of EMR including low (EMR?30%, n=9), moderate (30 %< EMR?35%, n=8), high (35 %< EMR?40%, n=10) and very high (40 %< EMR, n=4) in different provinces.
Conclusion: Due to the diverse EMR in different provinces of Iran, the type of disease management of provinces with low and moderate EMR can be used as an appropriate model to control EMR in provinces with high and very high EMR.
Amir Hosein Ghazale; Ali Ghazvini; Mostafa Ghanei; Ensieh Vahedi; Abolfazl Mozafari; Shideh Omidian; Mohammad Rezapour; Nafiseh Rastgoo; Fatemeh Movaseghi; Fateme Mansouri; Mohammad Ali Zohal; Maryam Gheraati; Seyed Hassan Saadat; Hassan Goodarzi; Mohammad Gholami Fesharaki; Amir Mohammad Dehghan Banadkooki; Shahrzad Saloo; Hesamodin Salou
Volume 23, Issue 6 , 2021
Abstract
Background:
COVID-19 is a new disease for which a definitive treatment has not yet been proposed. Therefore, the present study aimed to investigate the effect of combination therapy on the treatment of COVID-19 due to the importance of finding an appropriate treatment for this epidemic disease.
Materials ...
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Background:
COVID-19 is a new disease for which a definitive treatment has not yet been proposed. Therefore, the present study aimed to investigate the effect of combination therapy on the treatment of COVID-19 due to the importance of finding an appropriate treatment for this epidemic disease.
Materials and Methods:
This two-center cohort study included 175 confirmed COVID-19 inpatients at two medical centers designated for the treatment of COVID-19 patients in Qom and Qazvin, Iran. In this study, four different groups of drug regimens were studied which included G1 (azithromycin, prednisolone, and naproxen), G2 (lopinavir/ritonavir, azithromycin, naproxen, and prednisolone), G3 (hydroxychloroquine, azithromycin, naproxen, and prednisolone), and G4 (levofloxacin, vancomycin, hydroxychloroquine, and oseltamivir). It should be noted that G1, G2, G3, and G4 treatment regimens were used on 48, 39,30, and 77 patients, respectively.
Results:
The study participants included 175 confirmed COVID-19 patients with mean±SD age of 58.9 ±15.1 years, out of whom 80 (46%) patients were male and the rest were females. The results indicated that the hospital stay period was significantly shorter in the G1 compared to other groups (G1:5.9±2.4, G2:8.1±4.2, G3: 6.3±1.7, and G4: 6.4±2.9; [P-value=0.008]). It should be noted that pulse rate, oxygen saturation, hemoglobin, and platelet count (PLT) changed significantly during the study in four treatment groups; however, a significant change in temperature, creatinine, and white blood cell (WBC) was observed only in G3, G4, and G1 groups, respectively. The number of ICU admissions and deaths were not statistically significant among the patients who received the four treatment regimens (P=0.785). Based on the results, the history of ischemic heart disease, baseline oxygen saturation, WBC, neutrophil, lymphocyte count, and C-reactive protein (CRP) are the risk factors for the prolonged hospital stay in COVID-19 patients.
Conclusion:
The obtained results in this study indicated that the combination of azithromycin, prednisolone, and naproxen is the most effective regimen for the treatment of COVID-19, compared to three other combination treatment regimens.
Abolfazl Nikpour; Mohammad Gholami Fesharaki
Volume 22, Issue 9 , 2020
Abstract
Background: There have been a limited number of studies on the relationships between time and occupational and demographical variables with the mean changes of low-frequency hearing (LFH) and high-frequency hearing (HFH).
Objectives: This study investigated the rate of occupational noise-induced ...
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Background: There have been a limited number of studies on the relationships between time and occupational and demographical variables with the mean changes of low-frequency hearing (LFH) and high-frequency hearing (HFH).
Objectives: This study investigated the rate of occupational noise-induced hearing loss (NIHL) due to working in the steel industry and associated effective factors.
Materials and Methods: This historical cohort study was conducted within 2000 to 2010. Two LFH and HFH definitions of NIHL were used in this study. The average changes of LFH and HFL were considered the response variables. In addition, time and occupational (i.e., shift work and work experience) and demographic (i.e., age and educational level) variables were regarded as the independent variables. For data analysis, Bayesian multivariate multilevel modeling using skew distribution and OpenBUGS (version 3.2.2) and R (version 2.13.2) software were used in this study.
Results: The present study was performed on 1,959 male workers with a mean age of 36.64±3.92 years. Among these subjects, 913 (46.6%), 134 (6.8%), and 912 (46.6%) participants were day workers, weekly-rotating shift workers, and routinely-rotating shift workers, respectively. The obtained results showed that age, work experience, educational level, and shift work had significant relationships with the changes of LFH and HFH.
Conclusions: Overall, the findings of this 10-year historical cohort study demonstrated a relationship between time and demographic and occupational variables with the changes of LFH and HFL. Therefore, it is recommended to design preventive measures to reduce the deleterious effects of such variables on LFH and HFL.
Zahra Zanjani; Hamid Yaghubi; Mohammad Reza Shaeiri; Ladan Fata; Mohammad Gholami Fesharaki
Volume 20, Issue 11 , 2018, Pages 1-6
Abstract
Background: Early studies showed that disgust contributes to developing the contamination obsessive-compulsive disorder (C- OCD) and fear of contamination. Despite considering disgust to explain the fear of contamination as a symptom of C-OCD, there are few studies on the mediating role of information ...
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Background: Early studies showed that disgust contributes to developing the contamination obsessive-compulsive disorder (C- OCD) and fear of contamination. Despite considering disgust to explain the fear of contamination as a symptom of C-OCD, there are few studies on the mediating role of information processing bias (IPB) in the relationship between disgust propensity (DP) and the fear of contamination. Objectives: The current study aimed at exploring the mediating role of IPB between DP and fear of contamination. Methods: The current descriptive-analytical study was conducted on 386 students selected by cluster sampling method. The em- ployed tools were disgust propensity and sensitivity scale-revised (DPSS-R), the Padua inventory (PI), obsessive beliefs questionnaire(OBQ), and spatial cueing task. Data were analyzed with Amos-22 software. Bootstrap methods were used to analyze the mediating role. Results: Results of the structural equation modeling (SEM) indicated that the proposed model had a good fitness [GFI (goodness of fit index), TLI (the Tucker-Lewis index), and CFI (comparative fit index) > 0.95 and RMSEA (root mean square error of approximation) = 0.03]. The results showed that the relationship between DP and fear of contamination was mediated by IPB. Conclusions: Results indicated the impact of disgust propensity on fear of contamination through information processing. These findings emphasized that information processing is essential to explain C-OCD.
Alireza Najimi-Varzaneh; Mohammad Gholami Fesharaki
Volume 20, Issue 10 , 2018, Pages 1-10
Abstract
Context: One of the major causes of death in Iran is the injuries caused by accidents. Information regarding the distribution of injuries caused by accidents can lead to appropriate decision making in the management of Red Crescent, emergency, and police forces. Objectives: The current study is carried ...
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Context: One of the major causes of death in Iran is the injuries caused by accidents. Information regarding the distribution of injuries caused by accidents can lead to appropriate decision making in the management of Red Crescent, emergency, and police forces. Objectives: The current study is carried out with the aim of studying the prevalence of road traffic accident in Iran using the GIS and meta-analysis study. Evidence Acquisition: Articles were identified through international searching databases including Pub Med, Scopus, Elsevier, Google Scholar, and Web of Science as well as Iranian Scientific Information Database (SID), Health barakatkns, MagIran, and Iran Medex. We systematically reviewed all studies reporting the prevalence of accident trauma in Iran. Results: A total of 2200 relevant records were identified by the electronic search, of which a total of 60 studies were identified as eligible papers, which were meta-analyzed for the pooled road traffic accidents in Iran. Overall, the prevalence of road traffic accidents in Iran was estimated as 51.50% (95% CI = 50.6% - 52.3%). The highest pooled road traffic accidents rate was related to theGuilan province (79.80% [95% CI = 79.1% - 80.5%]), while the lowest pooled road traffic accidents rate was in the Fars province, with the rates of 27.50% (95% CI = 26.3% - 28.8%). A descending of prevalence trend rate was observed during the year 2000 until 2010 (53.30% → 46.90%), however, after the year 2010 this trend increased (46.90% → 52.50%).Conclusions: The result showed the prevalence of the road traffic accidents decreased from North to South of Iran. In addition, more results showed an increasing trend of the rate of road traffic accidents in Iran, therefore, design safety strategy, according to the province and time trend, can be helpful.
Shokofeh Maleki; Mohammad Gholami Fesharaki; Mohsen Rowzati
Volume 20, Issue 9 , 2018, Pages 1-5
Abstract
Background: Previous studies have reported conflicting results concerning the association between shift work and variables such as blood pressure and lipid profile. Objectives: The present study aimed to examine the moderating effect of shift work on lipid profile and blood pressure. Methods: This cross-sectional ...
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Background: Previous studies have reported conflicting results concerning the association between shift work and variables such as blood pressure and lipid profile. Objectives: The present study aimed to examine the moderating effect of shift work on lipid profile and blood pressure. Methods: This cross-sectional study was done on steelworkers who worked in Esfahan’s Mobarakeh Steel Company (EMSC) in the year 2017. In this study, workers were selected using random cluster sampling to investigate the moderating effect of shift work on lipid profile using the path analysis model in AMOS software. Results: A total of 1549 workers (including 926 (60%) shift workers and 623 (40%) day workers) with a mean age of 24.17 ± 6.11 years participated in this study. The path analysis model showed a good fit index (RMSEA = 0.012, P = 0.010). The path analysis results revealed that shift work moderating effect caused a decrease in the relationship between Triglyceride (TG) and Low-Density Lipopro- tein (LDL) and between TG and LDL but increased the relationship between TG and Diastolic Blood Pressure. Conclusions: Our findings showed a new evidence that shift work could have a moderating effect on blood pressure and lipid profile.
Amir Hamta; Anoshirvan Kazemnejad; Mohammad Gholami Fesharaki; Roya Farhadi
Volume 19, Issue 5 , May 2017, , Pages 1-6
Abstract
Background: The effectiveness of cervical cerclage (CC) in mothers suffering cervical incompetence (CI) for preventing preterm birth (PTB) in twin gestations remains controversial. Some studies show that it plays a preventive role in the occurrence of PTB, while others suggest it is ineffective.Objectives: ...
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Background: The effectiveness of cervical cerclage (CC) in mothers suffering cervical incompetence (CI) for preventing preterm birth (PTB) in twin gestations remains controversial. Some studies show that it plays a preventive role in the occurrence of PTB, while others suggest it is ineffective.Objectives: Our aim was to evaluate the effectiveness of CC in preventing PTB and negative neonatal outcome (e.g., respiratory distress syndrome (RDS) and birth weight) based on a new statistical framework: multilevel analysis and propensity score matching (PSM) in twin pregnancies.Methods: A cross-sectional study was conducted in the maternity wards of three general and teaching hospitals in Tehran, Iran, during January 2014 to February 2015. Using stratified random sampling with the proportional allocation method, twin pregnancieswere randomly selected from the medical files list. Of 431 eligible individuals, 31 patients underwent CC as a result of CI, and the others had healthy cervixes and no CC. Next, variables that confound the relationships between CC and PTB (e.g., assisted reproductive technology (ART), preterm rupture of membrane (PROM), nulliparous, history of abortion, and mother’s age) by applying 1:2 PSM were matched in both groups. The CC group was considered the case group and, based on PSM, 61 patients, whose characteristics were similar to the CC group, were selected from 400 healthy mothers as a control group. For considering twins dependencies, multilevel modeling was used, and prevalence of PTB, LBW, and RDS, as well as mean gestational age in the two groups, were compared.Results: The standardized mean difference (SMD) shows that the distribution of confounding variables in the propensity-matched data is the same in both groups. Results revealed that, although gestational age in the case group was significantly less than the control group, the prevalence of PTB in case and control was not significantly different (P = 0.190). The prevalence of neonatal outcome of RDS and LBW in the case and control groups was not significant (P > 0.05).Conclusions: It appears that CC has an effective role in prevention of PTB, LBW, and RDS, because their prevalence in both groups was the same. However, drawing a clear conclusion regarding its role requires more research with a random clinical trial (RCT) design.
Hesam Akbari; Mojtaba Satkin; Masoume Gangi; Hamed Akbari; Mohammad Gholami Fesharaki
Volume 19, Issue 3 , March 2017, , Pages 1-8
Abstract
Background: Job stress has recently been regarded as a risk factor for some diseases.Objectives: In this study, we standardized the Persian version of the HSE management standards indicator tool and studied the psychological properties of the tool.Methods: In this cross-sectional study, the Persian version ...
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Background: Job stress has recently been regarded as a risk factor for some diseases.Objectives: In this study, we standardized the Persian version of the HSE management standards indicator tool and studied the psychological properties of the tool.Methods: In this cross-sectional study, the Persian version of the HSE questionnaire was submitted to 429 participants who were randomly drawn from five occupational groups in Isfahan, Iran in 2014. Internal consistency, reliability, discriminative validity, and construct validity were evaluated. Predictive validity was explored with respect to the beck depression inventory (BDI). discriminant validity was explored with respect to type of occupational groups.Results: Cronbach’s alpha for the all subscales ranged between 0.53 and 0.74. In addition, the intraclass correlations for the domains ranged from 0.52 to 0.73 with a median of 0.7. The confirmatory factor analysis showed that the Persian version of the HSE questionnaire had adequate construct validity. The root mean square error of approximation, incremental fit index, and comparative fit index were 0.064, 0.9, and 0.9, respectively; moreover, other indexes were satisfactory. An analysis of variance highlighted the differences between the stress of the occupational groups (P = 0.012). A lower score on the HSE questionnaire was significantly related to a higher BDI score (r = -0.46, P < 0.001).Conclusions: The analysis of the reliability and validity of the Persian version of the HSE questionnaire showed that it is a useful and reliable measure to analyze work-related stress.
Hamed Akbari; Hesam Akbari; Majid Bagheri Hossein Abadi; Mohammad Gholami Fesharaki; Mohammad Ghasemi
Volume 19, Issue 2 , February 2017, , Pages 1-8
Abstract
Background: Manual handling of patients without using proper devices built for this purpose is the most important risk factor causing musculoskeletal disorders (MSDs) among nursing staff.Objectives: The aim of the present study was to determine the prevalence of MSDs, assess the risk of manual handling ...
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Background: Manual handling of patients without using proper devices built for this purpose is the most important risk factor causing musculoskeletal disorders (MSDs) among nursing staff.Objectives: The aim of the present study was to determine the prevalence of MSDs, assess the risk of manual handling of patients, and identify the risk factors related to the development of such disorders among nursing staff.Methods: This cross-sectional study was conducted in 2015 and included 220 nurses from 24 wards who were working in Baqiyatallah hospital, Tehran, Iran; their duties mainly involved patient handling. The participants were selected based on the random stratified samplingmethod. In this study, the Nordicmusculoskeletal questionnaire, demographic questionnaire,movimentazione and assistenza di pazienti ospedalizzati (MAPO), and patient transfer assessment instrument (PTAI) methods were applied as data collection tools. In addition, Spearman correlation coefficients and binary and multiple logistic regressions were used to determine the possible relationships between the variables.Results: The prevalence of MSDs among the participants over the past 12months was found to be 79.5%. The results for the risk factors showed that the lower back, neck, shoulders, and upper back were the most affected areas of the body. According to the MAPO and PTAI, 60% and 40% of the wards, respectively, are at risk of MSDs. A significant relationship between MAPO and PTAI was found, with a coefficient correlation of 0.252. Based on the statistical analysis, positively significant relationships were found between body mass index, gender, nurse-to-bed ratio, final PTAI and MAPO indices, and MSDs.Conclusions: The prevalence of MSDs among the nurses was high, and the occurrence of such disorders was found to be related to the scores of MAPO and PTAI indices. Based on the results, these two indices can be used as appropriate tools to assess the risk of MSDs in patient handling by nursing staff. The risk of developing MSDs can be lowered through interventional programs, such as providing and equipping hospitals with the tools required for patient handling and educating staff on how to properly use such devices. In addition, increasing the nurse-to-bed ratio will lower the burden for the nurses in patient handling.
Mehdi Habibi; Mohammad Gholami Fesharaki; Hossein Samadinia; Maryam Mohamadian; Somayesadat Anvari
Volume 19, Issue 1 , January 2017, , Pages 1-5
Abstract
Background: Sufficient evidence is lacking about patient safety culture in Iran. It is only by focusing on the culture of safety within healthcare and treatment institutes that improvements may be made in patient care services.Objectives: The present study aimed to examine patient safety culture and ...
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Background: Sufficient evidence is lacking about patient safety culture in Iran. It is only by focusing on the culture of safety within healthcare and treatment institutes that improvements may be made in patient care services.Objectives: The present study aimed to examine patient safety culture and factors that affect that culture in two hospitals in Tehran city.Patients and Methods: A cross-sectional study was conducted in two government teaching hospitals (135- and 650-bed hospitals) in Tehran city in February of 2013 using a proportional stratified sampling method. The participants completed questionnaires with questions concerning their demographics and patient safety culture.Results: Overall, the study participants rated patient safety culture within their healthcare institutions at 64.7%. The highest and lowest patient safety culture subscales were 73.8% and 50.1% for “teamwork within units” and “staffing,” respectively. According to the findings, hospital size (P < 0.001) and hospital area (P < 0.001) had a significant relationship with patient safety culture.Conclusions: Given that “Staffing” was the lowest rated element in patient safety culture, improving this element could help to increase patient safety culture in hospitals in Tehran.
Roya Farzanegan; Maryam Alehashem; Behrooz Farzanegan; Sharareh R Niakan Kalhori; Mohammad Gholami Fesharaki; Farshid Rahimi Bashar; Behjat Barari; Mahdi Zangi; Mohammad Behgam Shadmehr
Volume 19, Issue 1 , January 2017, , Pages 1-11
Abstract
Background: Tracheal stenosis is one of the worst complications of endotracheal intubation, but timely diagnosis can change its natural history. Management of these patients places a great burden on the health care system and the well-being of the patients and their families. Therefore, discharged intensive-care-unit ...
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Background: Tracheal stenosis is one of the worst complications of endotracheal intubation, but timely diagnosis can change its natural history. Management of these patients places a great burden on the health care system and the well-being of the patients and their families. Therefore, discharged intensive-care-unit (ICU) patients who underwent more than 24 hours of intubation should be actively followed-up 3 months after extubation and screened for post-intubation tracheal stenosis. The present study was aimed at assessing the impact of post-discharge follow-up call interviews on increasing successful screening for post-intubation tracheal stenosis.Objectives: To determine the effect of post-discharge call interviews on improving screening of post-intubation tracheal stenosis.Methods: This experimental study was conducted in Iran in September 2014. Using the simple randomization method, 140 patients who had undergone than 24 hours of endotracheal intubation and had received oral and written educational materials upon discharge from the ICU were equally assigned to an intervention and a control groups (received a call interview before or after the follow-up due date, respectively). The needed sample size was calculated to be 70 participants in each group (considering α = 5%, the statistical power of 90%, and effect size = 0.4).Results: There was a significant difference in follow-up rates at the due date between the intervention group (50.7%, 34of 67 participants) and the control group (17.5%, 11 of 63 participants) (OR = 4.871, 95% CI = 2.172 to 10.924, P < 0.0001). In the control group, the call interviews significantly increased the follow-up rate from 17.5% to 66.7 % (42 of 63 participants) (P < 0.0001), although followup occurred after the due date. The results of the logistic regression model showed that the patients who had attempted suicide completed follow-up more than those who had not (P = 0.017), that interviews with patients and their parents were more effect than interviews with others (P < 0.05), and that phone call interviews after the follow-up due date were more effective than those before the follow-up due date (OR = 2.653, 95%CI = 1.079 to 6.526, P = 0.034).Conclusions: We highly recommend making call interviews, along with distributing the oral and written educational materials, to increase the follow-up rate among discharged ICU patients.
