Background and Aim: The insertion of a peripheral intravenous catheter is one of the most common procedures in nursing, causing pain and anxiety in children. This study aimed to compare the effect of two methods of using toys made with medical devices and visual distraction on the intensity of pain and anxiety during venous catheter insertion in children aged 3-6. Materials and Methods: In this randomized clinical trial study,150 children aged 3-6 years who needed venous catheter insertion were assigned to 3 control groups(A), toys with medical devices(B), and visual distraction(C) by a random block allocation method. There was no intervention in group A. In group B, toys were provided to the child 5 minutes before the start of the catheter insertion, and the child could play with the toys until the end of the procedure. For group C, the cartoon started playing 5 minutes before the insertion of the venous catheter and continued until the end of the procedure. The Wang-Baker face comparison was used to assess pain intensity, and the child anxiety face tool was used to assess anxiety. Data were analyzed using the chi-square test, t-test, and one-way analysis of variance under STATA version 14 software. Results There was a statistically significant difference between the mean pain scores of the control group with visual thought deviation (P=0.008), but there was no statistically significant difference between the mean scores of the control group with toys with medical devices and visual scores deviation with toys with medical devices. There was a statistically significant difference between the mean anxiety scores of the medical device toy group with the control (P=0.001) and the medical device toy with visual thought deviation (P=0.001), but no significant statistical difference was found between the mean anxiety scores of the visual thought deviation group with the control. Conclusion: It is recommended to use large televisions in children's catheter insertion rooms to broadcast children's programs, as well as toys with medical devices, to reduce pain and anxiety during venous catheter insertion
Background and Aim: The use of lithium, a mood-stabilizing drug, is a common treatment for bipolar disorder. Discontinuing lithium during pregnancy can be dangerous, as it may cause manic or severe depression in the mother. Despite the positive effects of lithium, it is important to study the molecular effects of this drug on infants. This study aims to investigate the expression of the miR-132 gene in the neonates of rats whose mothers were exposed to lithium during pregnancy. Materials and Methods: In this study, experimental female mice received lithium carbonate at a concentration of 30mg/kg in their drinking water daily during pregnancy. The newborns were then divided into two control and experimental groups. When the neonates reached 60 days of age, their hippocampus and blood serum were isolated for molecular analysis. Total RNA was extracted from the blood and serum, followed by cDNA synthesis. The expression of miR-132 was evaluated using qRT-PCR and compared with the control group using the Pfaffl method. Results: The expression of miR-132 in the hippocampal tissue and serum samples of infants whose mothers received lithium during pregnancy showed a significant decrease compared to the control group. The down-regulation of miR-132 expression was observed to be more pronounced in serum samples compared to hippocampal tissue samples. Conclusion: The decreased expression of miR-132 in the hippocampus and blood serum of newborn rats exposed to lithium during pregnancy indicates the influence of lithium on gene expression. This miRNA showed potential as a valuable indicator for detecting the effects of drug exposure on offspring. However, identifying specific miRNA markers for bipolar disorder is a challenging quest, and further studies are required.
Background and Aim: The inflammatory bowel diseases (IBD) affect young people of reproductive age. There is little knowledge about complications from IBD during pregnancy and delivery. Here, we aimed to evaluate the possible IBD effects on Fertility and pregnancy. Materials and Methods: This observational study was conducted on female IBD patients aged between 15 and 50 years who were referred to the GI clinic of Shariati Hospital from 2013-2017. Details on disease activity, prenatal complications, delivery, and neonatal outcome were collected through the medical report. Results: Among 1156 enrolled patients, 87.2% had UC and 12.8% had CD. About 40.2% of women had children. There was a history of infertility in 54 (7.4%) of subjects. No significant relation was found between the type of inflammatory bowel disease and the fertility status (P=0.47). However, the infertility rate in patients with Crohn's disease (9.5%) was significantly higher than in patients with ulcerative colitis (4%) (P = 0.006). The low age of the diagnosis was associated with a reduction in fertility (having a child) (p<0.001, r = 0.30) and an increase in abortion (p<0.004, r = 0.80) in the study population. Conclusion: The rate of infertility in people with Crohn's disease is higher than in people with ulcerative colitis, and the younger the age of onset of inflammatory bowel disease, the lower the fertility rate and the higher the risk of pregnancy complications, including miscarriage.
Background and Aim: Chitosan nanoparticles are becoming a popular alternative to deliver nucleic acids to tissues for gene transfer. The present study was carried out to design a combined multi-epitope gene construct based on the pathogenic genes of Salmonella typhimurium and Escherichia coli strain O157:H7 and to transfer it to BALB/c mice with the help of chitosan nanoparticles. Materials and Methods: In this experimental study, pcDNA3.1(+) recombinant vector containing a multi-epitope gene construct was designed and synthesized. E. coli strain TOP10F was transformed with the mentioned vector. Using the plasmid extraction kit, the plasmid was extracted from the transformed bacteria and confirmed. In the next step, this recombinant vector was combined with chitosan nanoparticles, and the characteristics of the complex after production were investigated. Plasmid-containing complexes with or without nanoparticles were injected into the thigh muscle of animals at time intervals of 0, 7, and 14 days. The animal tissue was collected, and the expression of gene structure and cytokines (IFN-γ and IL-10) was analyzed by the reverse transcription method. The spleen tissue of the animals was also examined histopathologically. Results: The correctness of the synthesis and extraction of the recombinant vector was successfully confirmed. Chitosan nanoparticles and recombinant vector were combined in the ratio (1:1). In animals treated with the recombinant vector, compared to the control group, the expression of the gene construct was successfully confirmed. Examination of cytokines showed that the cellular immune response increased in the challenge groups compared to the control group. However, the structure of the spleen tissue in the group that was transferred with the recombinant vector carrying the gene construct along with chitosan nanoparticles was healthy and normal. Conclusion: The recombinant vector, after combining with chitosan nanoparticles, was correctly transferred and expressed in the animal tissue, and there was no damage to the spleen pulp. In the future, this multi-epitope gene structure can be used as a vaccine against Salmonella Typhimurium and Escherichia coli.
Background and Aim: Tuberculosis is an endemic disease in Kurdistan province. The aim of this study is to assess progress toward the first milestone and a comprehensive response in the next stage in Kurdistan Province during the years 2015-2019. Materials and Methods: This is a population-based study that was conducted in 2023. The TB and leprosy registration system was used for data, and the standard method in the World Health Organization, with Stata 14.2 and Excel 2013, was used to calculate the burden of disease. The difference of this study from other burden studies is that it used a registration system. Results: Like other parts of the world, in Kurdistan, this disease has impressed from COVID-19. The total incidence numbers and mortality numbers, respectively, are 853 and 8. DALYs, YLDs, YLLs in Kurdistan province are 98.4, 23.6, 25.3, respectively, in 2015 and 101.7, 21.8, 34.1 in 2019. DALYs, YLLs, and YLDs were higher in women than in men in all years of this study. The age-standardised incidence rate (ASIR) in women is higher than in men and has an increasing trend. The most DALYs in both sexes are related to the age group of 60-69 years. The incidence rate decreased to 0.4 in 2019 compared to 201,5, but the mortality rate has not changed. Conclusion: According to the finding of this study, TB’s burden in Kurdistan province has grown at a moderate rate, and a major review of the programs by politicians and health makers is necessary and will provide an opportunity to achieve the global elimination of tuberculosis. It is recommended that the DOTS strategy be fully implemented, and active case finding among the contacts of patients be seriously pursued.
Background and Aim: Fibrosis and irreversible kidney damage that occur with inflammation are defined as renal parenchymal scar. Kidney scar occurs in children with pyelonephritis, and it is one of the major complications of urinary tract infection. DMSA is an excellent method to examine the renal cortex. It is also useful in making treatment decisions for these patients. This study aimed to evaluate the diagnostic value of ultrasound in detecting renal scar compared with DMSA in children from 2 to 10 years in Sanandaj in 2020-2021. Materials and Methods: This descriptive study was performed on 70 patients from 2 to 10 years old with a history of vesicoureteral reflux or urinary tract infection who had a kidney scar on the DMSA scan. These patients underwent renal ultrasound. Then ultrasound results were compared with the DMSA results of each patient. All data were entered in STATA-14, then frequencies, percentages, and standard deviations were calculated. Results: The results of this study showed that 60 percent of the subjects were female and 40 percent male. All scars were detected in all patients with DMSA scan, while only 41/4% were diagnosed by ultrasonography. Conclusion: In this study, the sensitivity of ultrasound in detecting renal scar was reported to be low. This research showed that ultrasound could not be an appropriate alternative to DMSA for detecting kidney scars in children.
Background and Aim: Poisoning is one of the most important accidental injuries in childhood, which is associated with significant mortality and morbidity. This study was conducted to evaluate the level of two inflammatory factors, Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP), as well as Complete Blood Count (CBC) changes in various childhood poisonings. Materials and Methods: In this cross-sectional study, all children aged 1-14 years who were admitted to the emergency and poisoning departments between November 2020 and October were evaluated. A checklist including the patient's demographic information, clinical symptoms at the first visit, and paraclinical measures was completed for patients. After collecting the data, the results were analyzed in 4 groups Results: A total of 151 patients with an average age of 56/1±47/44 months were included in the study, of which 81 (53.6%) were male. The most common cause of poisoning in children studied was drugs (76/8 %). There was a significant difference between the time between poisoning and the appearance of symptoms and the time between poisoning and going to the emergency room between patients with different causes of poisoning (P=0.00) and children with drug poisoning were brought to the emergency room with a longer time interval. The level of CRP in patients poisoned with drugs was lower than its level in patients poisoned with chemicals and patients with bites (P=0/007). The number of White Blood Cells (WBCs) in patients poisoned with drugs was significantly lower than in patients poisoned with chemicals and patients with bites (P<0.001). But there was no significant difference in ESR level in poisoned patients with different causes (P=0.219). Conclusion: The results showed that the level of ESR and CRP in poisoned children did not increase significantly at the time of referral. However, leukocytosis was observed in most of the patients with bites and chemical poisoning.
Background and Aim: Cancer treatment using ionizing radiation is an effective modality for the management and control of various cancers. The presence of oxygen inside the cell causes various damages to the DNA molecule. The purpose of this study is to calculate the relative biological effectiveness (RBE) of low-energy X-rays during cancer treatment using intraoperative radiotherapy at different oxygen concentrations within the cell through a Monte Carlo (MC) simulation approach. Materials and Methods: To estimate the RBE values in this study, the secondary electron spectrum, which was emitted from 1 cm after the bare probe surface, was calculated with the Geant4-validated MC model of the INTRABEAM system. After the calculation of the secondary electron energy spectrum, the RBE values of the emitted low-energy X-rays from the INTRABEAM system at different cell oxygen concentrations were calculated by the MCDS MC code. Results: The results showed that the RBE values increase with the oxygen concentration increment in the cell. When the oxygen concentration increments from 0 to 100%, the RBESSB and RBEDSB values increase by about 1.6 and 2.3 times, respectively. Furthermore, in most of the studied oxygen concentrations, the RBEDSB values were greater than unity, which indicates the high relative biological effectiveness of the considered low-energy X-rays compared to high-energy photons. Conclusion: Accordingly, it can be concluded that cell oxygen level is one of the influential factors for RBE assessments relevant to the emitted X-rays from the INTRABEAM system, where the cell sensitivity to the ionizing radiation decreases at low-oxygen levels.
Background and Aim: This study investigates the effects of sodium nitrite (NaNO2) on folliculogenesis, reproductive disorders, and embryonic development. Sodium nitrite, used as a food preservative, is toxic when consumed in excess by humans and animals(1). This study aims to examine the impact of drinking water contaminated with sodium nitrite on reproductive processes. Materials and Methods: Thirty female mice were divided into three groups: a control group that consumed deionized water and two treatment groups that consumed deionized water containing 50 mg/L and 100 mg/L of sodium nitrite for 8 weeks. Folliculogenesis was assessed through histological examination in 5 mice from each group. Additionally, to study fertility, the remaining mice were mated, and the number and health of embryos were evaluated before the end of the pregnancy. Results: The control group had higher body weight and ovarian weight, whereas the treatment groups exhibited lower body weight and variable ovarian weight. Notably, the number of embryos in Treatment Group 1 was higher, while the number of healthy embryos decreased in Treatment Group 2. Statistical analyses demonstrated significant differences between the groups, indicating varied effects of the treatments on the mice’s weight, the number of embryos, and the number of live embryos. Conclusion: This study revealed that sodium nitrite significantly affects follicular growth and fertility in NMRI mice. Differences in the number of follicles and fertility parameters between the control and treatment groups highlight the detrimental effects of excessive sodium nitrite consumption on reproductive health. Further research is needed to understand the mechanisms behind these effects and to develop therapeutic approaches to improve reproductive health. Keywords: Sodium Nitrite, Folliculogenesis, Fertility, Mice
Background and Aim: This study was conducted with the aim of investigating the causes of women's tendency towards cohabitation in Tehran and analyzing different micro, mezzo, and macro levels of women's tendency towards this lifestyle. Materials and Methods: Using the qualitative method, 19 people were selected in 2023 through snowball sampling from women who live in the cohabitation style in Tehran, and at least one year has passed in their lives, and an in-depth and semi-structured interview was conducted with them. Thematic analysis was used to analyze the data, and the control method, peer review technique, participant review technique, triangulation, continuous observations by researchers, and gathering evidence from various sources were used for the validity and reliability of the research. Results: In this research, 29 sub-themes were obtained, and after theoretical analysis, eight main themes were classified into three micro, mezzo, and macro levels as the causes of women's tendency to cohabitation. Individual characteristics and lived experiences and moralistic liberalism representing micro-level factors; The change in family functions and the expansion of the communication network represent mezzo-level factors; And the impact of socio-cultural and economic issues on the spread of marriage problems, a critical approach to the social structures of marriage, preventing the phenomenon of divorce, the creation of socio-cultural changes and the rethinking of traditions represent the macro-level factors in women’s tendency towards cohabitation. Conclusion: All three levels, micro, mezzo and macro, should be examined in the analysis of the tendency towards cohabitation, and the results of this research show that the majority of the main themes identified at the social level indicate the extent of structural factors in women's tendency towards cohabitation, and it should be prevented from labelling people who live in the cohabitation style.
Background and Aim: Lungs are the main organs of respiration in the body, whose main function is the ventilation of respiratory air. Through oxygenation, the lungs convert venous blood into arterial blood so that oxygen is available to the cells as the main molecule of the metabolic cycle in the body (production of Adenosine Triphosphate (ATP)). In a healthy and normal person, the lungs occupy the lateral parts of the chest cavity. Case Presentation: During the dissection of the lungs, it was found that the posterior border of the right lung does not have a normal morphology. The posterior border of the right lung had a heart incisura, similar to which does not exist in normal conditions. Also, the left lung and its external surface had an accessory fissure and lacked normal structure. These conditions cause abnormal and unexpected divisions of pulmonary segments, which lack knowledge, cause diagnostic and surgical errors. Conclusion: Knowing the variation in the anatomical structure of the lungs is particularly important in the diagnosis and treatment of respiratory diseases. The existence of this report and its help in understanding the types of anatomical diversity of the lungs will lead to a greater understanding of the morphological diversity of the lungs in the field of diagnosis in radiology images, CT scan, magnetic resonance imaging (MRI), differentiation of pulmonary pathology, and segmental reconstructive surgeries.
Background and Aim: Preeclampsia is a hypertensive disorder of pregnancy that is one of the leading causes of maternal and neonatal mortality. Several risk factors have been stated for this complication, and the World Health Organization has drawn attention to psycho-social conditions. Therefore, the present study was conducted to determine the relationship between psychological and social factors with the incidence of preeclampsia in pregnant women. Materials and Methods: The present study was conducted as a case-control study on pregnant women who referred to the women's single specialty hospital in Ilam city in 1399. The research samples included a group of women with preeclampsia (53 people) and a control group (53 people). People were selected according to the study's inclusion criteria. The data of the study was collected using three demographic and midwifery information questionnaires, perceived stress and social support questionnaires, and then the data were entered into SPSS version 17 software and analyzed using descriptive and analytical statistical tests. Results: According to the results of the study, there was a significant difference between the amount of perceived stress and social support in the two groups; Persons with preeclampsia had more stress and less social support. According to the logistic regression test, for each unit increase in stress in pregnant women, the probability of preeclampsia increases by 0.23%, and for each unit increase in social support in pregnant women, the probability of preeclampsia decreases by 0.53%. Conclusion: People with preeclampsia had more stress and less social support; therefore, examining psychological aspects as a risk factor in this disorder is necessary. Also, more efforts are needed by health and treatment personnel for prevention, screening, blood pressure management, and reduction of psychological and social stress among pregnant women.
Background and Aim: Thyroid nodules are among common clinical problems and fine needle aspiration (FNA) sampling is the most important method to diagnose its pathological nature. The frozen section (FS) is also very important in making treatment decisions. The present study was conducted to compare the diagnostic value of these two methods based on pathology findings in the patients with thyroid nodules. Materials and Methods: This descriptive-analytical study included patients with thyroid nodule surgery between 2011 and 2019 in Babol City. Information was collected by file reading method. Data analysis was done using SPSS-26 software and a comparative survey of the diagnostic value of pathology methods, FNA biopsy, and FS examination, was performed by calculating the sensitivity, specificity, and positive and negative predictive value (p<0.05). Results: The majority of patients in this study were female (68.66%) and the patients did not have any family history (70.44%). In the final pathology findings, the rates of benign and malignant lesions were; 54.88% and 45.11%, and in FNA and FS, they were 67% and 88.57%, respectively. Sensitivity, specificity, positive and negative predictive values in FNA were; 0.9582, 0.9896, 0.9950, and 0.9697, respectively. Sensitivity, specificity, positive and negative predictive value in FS were 100%. The two mentioned methods were consistent in 58.8% of the cases in the diagnosis of malignant or benign thyroid nodules (p<0.001). Conclusions: FNA is a reliable method for detecting malignancy in thyroid nodules due to its high sensitivity and specificity. On the other hand, the FS is considered a precise method due to its high correlation with pathology.
Background and Aim: Uterine arteriovenous malformations (AVM) is a rare congenital or acquired condition, mostly seen in the multiparous and women of reproductive age. Acquired uterine arteriovenous malformations occurs following trauma, uterine instrumentation, infection, abortion or gestational trophoblastic disease. Treatment of uterine arteriovenous malformations is based on different clinical conditions of the patient and includes drug, blood transfusion, uterine artery embolization and hysterectomy. In this article we report uterine artery embolization in a woman with uterine arteriovenous malformations 6 weeks after spontaneous abortion. Case report: A 39-year-old woman, gravida 3 and para 2, referred to our clinic with complaint of bleeding. 173 days ago, the patient had history of spontaneous abortion at the 6th week of pregnancy. After sonography, uterine artery malformation was diagnosed. Due to repeated bleeding and also due to mother's desire to preserve fertility, uterine artery embolization was performed. Conclusion: In abnormal uterine bleeding after abortion, it is necessary to perform color doppler sonography to rule out uterine artery malformation and embolization is the first and best treatment option for the women who want to preserve fertility.
Background and Aim: Epilepsy is a central nervous system disorder in which the activity of nerve cells in the brain is disrupted and leads to seizures. Despite the variety of available anticonvulsant drugs, approximately 30% of patients are resistant to conventional therapies. Nowadays, attention to drugs of natural origin, especially plant sources, has increased. Due to the effects of quinic acid, including antioxidant, anti-inflammatory, hepatoprotective, and immune cell-enhancing properties, this study aimed to determine the anticonvulsant effect of quinic acid in pentylenetetrazole-induced seizures in mice by investigating the possible role of the oxidative stress pathway and nitric oxide. Materials and Methods: In this experimental study, 48 male mice were divided into 6 groups of 8. The first group received PTZ at a dose of 90 mg/kg, the second to fifth groups received quinic acid at doses of 5, 10, 20, and 40 mg/kg, and the sixth group received Diazepam at a dose of 10 mg/kg. One week after quinic acid administration, seizures were induced in all mice by intravenous injection of pentylenetetrazole. Results: Quinic acid at doses of 20 and 40 mg/kg significantly increased seizure threshold compared to the group treated with normal saline (P<0.001). Quinicic acid treatment reduced serum nitrite and malondialdehyde levels of brain tissue (P<0.001). Quinic acid treatment also increased serum and brain tissue antioxidant activity in mice. Quinic acid significantly reduced the expression of iNOS and nNOS genes compared to the normal saline group (P<0.01). Conclusion: Quinic acid seems to have potential anticonvulsant effects. Its mechanism of action is probably to inhibit neuroinflammation and act through the nitric oxide pathway
Background and Aim: Brown adipose tissue (BAT) is a specialized type of adipose tissue that dissipates energy as heat and plays a crucial role in body weight regulation. UCP-1 and PGC-1α are key players in the conversion of white adipose tissue (WAT) to BAT. This study aimed to investigate the effects of aerobic exercise performed at different times of the day on the expression of these genes in the adipose tissue of diabetic mice. Materials and Methods: In this experimental study, 30 adult male NMRI mice aged 8-10 weeks with an average weight of 26 ± 2.3 grams were randomly divided into six groups (five mice per group): two healthy control groups (light and dark phases), two diabetic control groups (light and dark phases), and two diabetic groups with exercise intervention (light and dark phases). The diabetic groups were fed a high-fat diet and injected with streptozotocin. Aerobic exercise was performed for eight weeks at a moderate intensity (50-60% of maximum running speed). At the end of the study, the expression of UCP-1 and PGC-1α genes in adipose tissue was measured using real-time PCR. Data were analyzed using GraphPad Prism 10 software and ANOVA with a significance level of 0.05 Conclusion: The findings of this study indicate that aerobic exercise performed in the evening significantly increased the expression of PGC-1α in diabetic mice. This increase in gene expression suggests the potential for improving metabolic status in this animal model.
Background and Aim: While providing adequate and healthy blood, governments should ensure that measures are taken to respect the right of blood donors to privacy and confidentiality of information and their right to informed consent, as well as to protect them from stigma and discrimination. Therefore, the present study aimed to explore the ethical challenges in blood donation from the perspective of policy makers, experts and stakeholders of blood transfusion. Materials and Methods: This qualitative content analysis study was conducted in the second half of 2019 (before the Covid-19 pandemic). The participants consisted of policy makers and experts from the Blood Transfusion Organization and the Deputy of Public Health, Ministry of Health and Medical Education and blood donors. Purposeful sampling and focus group discussion were used to collect data. Data analysis was performed by Graneheim and Lundman inductive content analysis. Results: In this study, four main themes emerged in relation to ethical challenges in blood donation: first, the relativity of confidentiality, which itself includes three sub-themes: donor privacy and mutual trust, public health preference, and low awareness about examples of confidentiality and disclosure of information; second, the occasional conflict between donation motivation and organizational policies; third, ambiguous informed consent; and fourth, the fear of social stigma and lack of alternatives to increase confidentiality. Conclusion: The findings indicated the need to evaluate the executive processes of registration and reporting, and devise alternative strategies to secure these processes, in order to ensure the confidentiality of information, while informing and building trust.
Background and Aim: Candidiasis is a common opportunistic infection in HIV/AIDS patients caused by different Candida species. The aim of this study was to do molecular identification and determine the antifungal susceptibility profile of Candida species, isolated from the mouths of AIDS patients by the disk diffusion method. Materials and Methods: This study included 50 samples collected from the oral cavity of 50 AIDS patients with oropharyngeal candidiasis (OPC) in Ahvaz City. After microscopic and macroscopic identification, these samples were finally identified by PCR RFLP method. For these 50 isolates, antifungal susceptibility testing was performed by the disk diffusion method, based on CLSI-M44-A standard protocol. Results: In this study, among 50 samples collected from the oral cavity of AIDS patients, we found Candida albicans in 36% (18), Candida glabrata in 30% (15), Candida tropicalis in 26% (13), Candida krusei in 6% (3) and Candida parapsilosis in 2 % (1) of the cases. Our results showed that clotrimazole, amphotericin B, ketoconazole, voriconazole and itraconazole had the highest antifungal effect on Candida species, respectively. While fluconazole showed less antifungal activity compared to the other antifungal drugs. Conclusion: Considering the better antifungal activity of voriconazole and itraconazole compared to fluconazole and the increasing resistance to fluconazole, which is the main antifungal used in the treatment of AIDS patients with OPC, itraconazole and voriconazole can be used as alternative oral antifungal drugs in the treatment of these patients.
Introduction: Discharge against Medical Advice (DAM) is a process during which the patient leaves the hospital without completing the course of treatment and with the consent of the doctor. This study investigated the frequency and causes of discharge against medical advice and its related factors in Ghods Psychiatric Hospital in Sanandaj during 2017. Method: This is a descriptive-analytical study. The study population was all patients admitted to Qhods Hospital during 2017. Demographic and hospital related information and reasons for discharge were collected and completed with a pre-designed checklist. Finally, the data were statistically analyzed using SPSS software version 20 and Chi-square test. Results: The rate of discharge against Medical Advice was 5.7%, 69.3% of the subjects were male, 55.3% were married, 51.5% were in the age range of 27 to 52 years,. 77.2% of hospitalizations were emergency, 63.4% of hospitalizations were the first time and mainly on holidays , evening and night shifts. Sex didn’t have a significant relation with the type of discharge(p=0.538). Day and shift of hospitalization(p=0.001), (p=0.002), age(p=0.001), number of previous hospitalizations(p=0.0001)., ward(p=0.0001).and marital status(p=0.022). had a significant relation with the type of discharge. Personal couses(80.2%) was the main reason for discharge and the patientchr('39')s insistence (36.6%) was the most personal reason for discharge against medical advice.The most discharge occur in first 10 day of admition. Conclusion: In general, the rate of discharge against medical advice in Qhods Psychiatric Hospital is lower than other similar psychiatric and non-psychiatric studies in Iran, but higher than the global statistics.The patientchr('39')s insistence was the main reason for discharge and The most discharge occur in first 10 day of admition .According to this results, it seems that more focus on patient education during hospitalization, especially in the first days plays a major role in reducing discharge against medical advice and consequently reduce the complications in health care system.
Background and Aim: In many countries of the world, Human Papilloma Virus is known as the most common sexually transmitted disease and the most common cause of cervical cancer. This study aimed to evaluate the intervention based on social marketing on the screening of the human papilloma virus. Materials and Methods: In this semi-experimental study, the design, implementation, and evaluation of social marketing-based intervention on HPV screening in women living in Mashhad using the SMART model in the years 2020-2022 were discussed. After carrying out the intervention's formative and design study, a semi-experimental study on 70 women aged 30 to 50 living in Mashhad was used to implement the intervention. A health center was chosen as the test center and another center, which was similar to the first center in terms of demographic characteristics, was chosen as the control center. The intervention was implemented for three weeks in the test group and three months after the end of the intervention. Results: The results showed that after the implementation of the intervention, changes in knowledge score and scores of perceived severity, perceived benefits and perceived barriers, self-efficacy and guidance for action immediately after and two months after the intervention in the test and control groups were significant (p<0.0001). The results of the implementation and evaluation of the intervention showed that after the intervention, 29 people in the test group (82.8%) referred to the center for the screening test. In the control group, no case of referral for HPV screening test was reported. Conclusion: According to the findings of the present study, using social marketing model and paying attention to the opinions and viewpoints of the target group and removing barriers and using facilitators can be used to encourage people to perform screening. HPV screening to make facilitators and to remove barriers is suggested.
