Golestan University of Medical Sciences

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    Resilience as the predictor of quality of life in the infertile couples as the most neglected and silent minorities

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    Background: It has been demonstrated that infertility can affect quality of life (QoL) in infertile couples. Resilience is considered a protective factor against the distress caused by infertility and the quality of life status. There is a new definition for Fertility Quality of Life that evaluates particularly the impact of infertility on various aspects of life. Material and methods: In this couple-based study, the main objective was investigating the quality of life based on the gender and resilience of infertile couples. Measurement tools were three questionnaires including a demographic one, a quality of life of infertile couples questionnaire and the Connor�Davidson Resilience Scale. Data analysis was done through paired t-test and linear multiple regressions test. Results: Overall the difference of mean score for QoL is statistically significant (P > 0.001) between men and women (69.48 vs 58.87), which means that QoL status was positive in men and neutral in women. In addition, the mean score of male resilience was more than female resilience (P = 0.009). The results showed there was a significant and positive correlation between the QoL status and resilience score (P = 0.008, r = 0.13) (P < 0.1), and resilience (β = 0.04 and P = 0.04) had a significant protective effect on the quality of life. Conclusion: Low resilience status in infertile couples is better to be considered as a risk factor compromising the quality of life and infertility consolers should keep in mind this issue and provide a comprehensive and holistic approach for a better outcome of infertility treatment. Abbreviations: QoLICQ: Quality of Life in Infertile Couple Questionnaire; CD-RISC: Connor�Davidson Resilience Scale; IVF: in vitro fertilisation; ART: assisted reproductive technique; PTSD: posttraumatic stress disorder; IUI: intrauterine insemination; ICSI: intracytoplasmic sperm injection. ©, Society for Reproductive and Infant Psychology

    Determinants of Subjective Loneliness and Quality of Life among Community-Dwelling Older Adults in Gorgan, Iran

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    Abstract: The purpose of this study was to identify the determinants of, and relationship between, subjective loneliness, general health and quality of life (QoL) among lonely community-dwelling older adults. A cross-sectional study was carried out among a sample of lonely (i.e. live alone without any assistance) older adults living in Gorgan city, Iran. The older adults were invited through a census sampling technique to complete six questionnaires, namely a 20-item UCLA loneliness scale, a six-item Lubben Social Network Scale, a 12-item Multidimensional Scale of Perceived Social Support, a 17-item Self-care Ability Scale for the Elderly (SASE), a General Health Questionnaire-12, and a Control, Autonomy, Self-Realization and Pleasure (CASP-19) questionnaire. Hierarchical multiple linear regressions were done with subjective loneliness and QoL as outcome variables. In total, 213 (91 females) lonely older adults (mean age: 68.2 ± 6.2) participated. Hierarchical multiple linear regressions yield socio-demographic characteristics (p < 0.001), predictor group 1 (p < 0.001), predictor group 2 (p < 0.001) explained 12.5, 13.5 and 46.6 of the observed variance in loneliness, respectively. Moreover, socio-demographic characteristics (p < 0.001), predictor group 1 (p < 0.001), predictor group 2 (p < 0.001) and feeling of loneliness (p < 0.001) accounted for 16.9, 21.1, 48.6 and 55.3 of the observed variance in quality of life, respectively. Both subjective loneliness and QoL were moderate in our sample. We suggest the presence of a probable causal inference between subjective loneliness, general health, and QoL; implying the need of population strategies for correcting subjective loneliness for its own sake as well as to help have an improved general health and QoL among older adults. Beside several non-modifiable factors (such as age, ethnic groups), we suggest that corrective measures should be based on social support and networking, self-care behavior, leisure activities, adapted for age, literacy and racial specifications. Given its population health relevance, there should be increased research and intervention on loneliness among older adults. © 2022, Pleiades Publishing, Ltd

    Double Aortic Arch as a Rare Condition in a 10-year-old Boy with Recurrent Pneumonia: A Case Report Study

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    Introduction: A double aortic arch (DAA) is a congenital anomaly of the aortic arch, which is also the most common type of complete vascular ring. This vascular ring can compress the trachea and esophagus, as well as cause respiratory, gastrointestinal, and cardiac symptoms. Case Presentation: In the present case report, a 10-year-old boy with recurrent cough, fever, shortness of breath, chest pain, and a history of recurrent respiratory infections was examined. According to the results of bronchoscopic evaluation, he was found to have a localized tracheomalacia. DAA and dextrocardia condition were also confirmed for this patient by performing a computed tomography angiography of the thorax and the three-dimensional reconstruction of CT angiography. Conclusions: The diagnosis of double aortic arch may be confused with upper respiratory tract infections or foreign body aspiration. Therefore, it was recommended that a particular attention should be paid to the double aortic arch when evaluating cases of stridor in children with unknown causes or recurrent respiratory infections. CT angiography and cardiac MRI were the diagnostic methods of choice for examining vascular rings. © 2022, Author(s)

    Study on antibiotic resistance and phylogenetic comparison of avian-pathogenic Escherichia coli (APEC) and uropathogenic Escherichia coli (UPEC) isolates

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    Avian pathogenic Escherichia coli (APEC) and uropathogenic E. coli (UPEC) can cause vast infections in humans and poultry. The present study was conducted to compare the isolates of the APEC and UPEC pathotypes on the basis phenotypic and genotypic features of antibiotic resistance and phylogenetic differences. Total number of 70 identified E. coli strains, including 35 APEC and 35 UPEC isolates, were isolated from avian colibacillosis and human urinary tract infection (UTI), and were subjected to the antimicrobial susceptibility testing, polymerase chain reaction (PCR) detection of the resistance genes, phylogenetic grouping and DNA fingerprinting with enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) to survey the variability of the isolates. The most resistance rates among all E. coli isolates were, respectively, obtained for Ampicillin (84.20) and sulfamethoxazole-trimethoprim (65.70). The APEC and UPEC isolates showed the most susceptibility to imipenem and gentamycin, respectively. Among 70 APEC and UPEC isolates 34.20, 32.80, 20.00, and 12.80 belonged to the A, B2, D, and B1 phylogenetic groups, respectively. Analysis of the DNA fingerprinting phylogenetic tree showed 10 specific clusters of APEC and UPEC isolates. According to the results, the most effective antibiotics and the phenotypic and genotypic predominant resistance patterns of the APEC and UPEC isolates were different. Moreover, APECs and UPECs showed various dominant phylogenetic groups. With all descriptions, the APEC isolates still are potential candidates for carrying important resistance genes and can be one of the possible strains related to human infections. © 2022 Urmia University. All rights reserved

    National, sub-national, and risk-attributed burden of thyroid cancer in Iran from 1990 to 2019

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    An updated exploration of the burden of thyroid cancer across a country is always required for making correct decisions. The objective of this study is to present the thyroid cancer burden and attributed burden to the high Body Mass Index (BMI) in Iran at national and sub-national levels from 1990 to 2019. The data was obtained from the GBD 2019 study estimates. To explain the pattern of changes in incidence from 1990 to 2019, decomposition analysis was conducted. Besides, the attribution of high BMI in the thyroid cancer DALYs and deaths were obtained. The age-standardized incidence rate of thyroid cancer was 1.57 (95 UI: 1.33�1.86) in 1990 and increased 131 (53�191) until 2019. The age-standardized prevalence rate of thyroid cancer was 30.19 (18.75�34.55) in 2019 which increased 164 (77�246) from 11.44 (9.38�13.85) in 1990. In 2019, the death rate, and Disability-adjusted life years of thyroid cancer was 0.49 (0.36�0.53), and 13.16 (8.93�14.62), respectively. These numbers also increased since 1990. The DALYs and deaths attributable to high BMI was 1.91 (0.95�3.11) and 0.07 (0.04�0.11), respectively. The thyroid cancer burden and high BMI attributed burden has increased from 1990 to 2019 in Iran. This study and similar studies� results can be used for accurate resource allocation for efficient management and all potential risks� modification for thyroid cancer with a cost-conscious view. © 2022, The Author(s)

    A knowledge implementation model in health system management based on the PARIHS model

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    Background: The gap between knowledge and practice, along with postponing or not implementing research findings in practice and policy-making, is one of the reasons for low-quality services. Hence, this study aimed at presenting a model of knowledge implementation in health system management in Iran. Methods: The present two-phase study was first performed qualitatively using a directive content analysis approach based on the Promoting Action on Research Implementation in Health Services (PARIHS) model. The researchers extracted the barriers and facilitators by conducting semi-structured individual interviews. Then, in a three-stage Delphi study, 25 health experts determined the barrier removal strategies. Data were analysed using MAXQDA10 software. Results: The content analysis of the interviews led to the emergence of 1212 codes under three categories of evidence, context and facilitation. The findings indicate that health managers make fewer decisions based on research findings. Instead, they make decisions regarding the experiences of service providers and organization data. In addition to the subcategories in the PARIHS model, the researchers extracted political, social and administrative factors under the context category. The relationships between the features of evidence, context, facilitation, barriers and strategies were presented in the final model. Conclusion: The presented model comprehensively emphasizes the evidence resources, context preparation, and facilitation of the knowledge implementation process. © 2022, The Author(s)

    Research Note: Effect of corn silage and alfalfa meal as alternative induced molt methods to improving Salmonella Enteritidis resistance in laying hens

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    This experiment was conducted to evaluate diets containing a high level of corn silage and alfalfa meal in inducing molt and reducing susceptibility to Salmonella Enteritidis (SE) colonization in laying hens. Thirty-two healthy hens were examined by cloacal swab samples to be free of Salmonella. Then they were weighed individually and distributed to 4 experimental groups containing 8 hens each, including Full-fed (control, FF); total feed withdrawal (positive control for molt induction, FW); 80 corn silage (CS) + 20 layer diet (CS80), and 80 alfalfa meal (AM) + 20 layer diet (AM80). The molting program was initiated at 71 wk of age. On d 4 of the experiment, all hens were inoculated with SE by oral gavage. All hens were first weighed at the ending molting period on d 10 and then euthanized by CO2 gas. The internal organs including the ovary, oviduct, liver, and spleen, were excised aseptically and weighed. Cloacal swab and feed samples at the beginning and organ samples (liver, ovary, spleen, and cecum) were collected from each hen at the end of the experiment and examined for SE colonies. Molted birds lost roughly 14 to 27t of their body weight and had significantly lower organ weight and egg production compared to FF group (P < 0.05). No significant difference was observed in the number of days to zero egg production between molted treatments. The SE positive organs did not significantly differ between CS80 and AM80 with FF treatment. Treatment CS80 had the lowest crop pH and differed substantially from treatment FW. In conclusion, results indicate that using corn silage and alfalfa meal, can improve resistance to salmonella Enteritidis during molt inducing compared to traditional feed withdrawal. © 2022 The Author

    Comparison of outcomes and complications in conventional versus ultrasound-accelerated catheter directed thrombolysis for treatment of pulmonary embolism: A systematic review and meta-analysis

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    Background: Acute submassive a massive pulmonary embolism are known as leading causes of cardiovascular morbidity and mortality in emergency departments. Choosing the optimal type of catheter directed thrombolysis (CDT) for treatment of pulmonary embolism presents a quandary to the practitioners. To the best of our knowledge, there is no meta-analysis comparing superiority of conventional CDT and ultrasound-accelerated catheter directed thrombolysis (USACDT). Therefore, in this meta-analysis, we aimed to compare conventional CDT with USACDT regarding clinical outcomes and safety profile. Methods: A systematic literature search of previous published studies comparing conventional CDT with USACDT regarding clinical outcomes and safety profile was carried out in the electronic databases including MEDLINE, Scopus, EBSCO, Google Scholar, Web of Science, and Cochrane from inception to December 2021. Data were analyzed by comprehensive meta-analysis software (CMA, version 3). Results: The meta-analysis included nine studies with a total of 705 patients. Our meta-analysis showed that there is no significant difference between two groups with respect to pulmonary arterial systolic pressure (SMD: �0.084; 95 CI: �0.287 to 0.12; p: 0.41), RV/LV (SMD: �0.003; 95 CI: �0.277 to 0.270; p: 0.98), and Miller score (SMD: �0.345; 95 CI: �1.376 to 0.686; p: 0.51). Similarly, we found no statistically significant differences between two groups regarding major and minor bleeding (p >.05). Conclusion: Our meta-analysis showed that when compared with USACDT, conventional CDT provides similar clinical and hemodynamic outcomes or safety for treatment of pulmonary embolism without the need for very expensive technologies. However, randomized clinical trials are required to further investigate cost-effectiveness of USACDT in comparison with conventional CDT. © The Author(s) 2022

    A Large Retrospective Study of Epidemiological Characteristics of COVID-19 Patients in the North of Iran: Association between SARS-CoV-2 RT-PCR Ct Values with Demographic Data

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    Objectives: To avoid worsening from mild, moderate, and severe diseases and to reduce mortality, it is necessary to identify the subpopulation that is more vulnerable to the development of COVID-19 unfavorable consequences. This study aims to investigate the demographic information, prevalence rates of common comorbidities among negative and positive real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) patients, and the association between SARS-CoV-2 cycle threshold (Ct) at hospital admission, demographic data, and outcomes of the patients in a large population in Northern Iran. Methods: This large retrospective cross-sectional study was performed from 7 March to 20 December 2020. Demographic data, including gender, age, underlying diseases, clinical outcomes, and Ct values, were obtained from 8,318 cases suspected of COVID-19, who were admitted to four teaching hospitals affiliated to Babol University of Medical Sciences (MUBABOL), in the north of Iran. Results: Since 7 March 2020, the data were collected from 8,318 cases suspected of COVID-19 (48.5 female and 51.5 male) with a mean age of 53�±�25.3 years. Among 8,318 suspected COVID-19 patients, 3,250 (39.1) had a positive rRT-PCR result; 1,632 (50.2) patients were male and 335 (10.3) patients died during their hospital stay. The distribution of positive rRT-PCR revealed that most patients (464 (75.7)) had a Ct between 21 and 30 (Group B). Conclusion: Elderly patients, lower Ct, patients having at least one comorbidity, and male cases were significantly associated with increased risk for COVID-19-related mortality. Moreover, mortality was significantly higher in patients with diabetes, kidney disease, and respiratory disease. Copyright © 2022 Farzin Sadeghi et al

    Impact of SNPs, off-targets, and passive permeability on efficacy of BCL6 degrading drugs assigned by virtual screening and 3D-QSAR approach

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    B-cell lymphoma 6 (BCL6) regulates various genes and is reported to be overexpressed in lymphomas and other malignancies. Thus, BCL6 inhibition or its tagging for degradation would be an amenable therapeutic approach. A library of 2500 approved drugs was employed to find BCL6 inhibitory molecules via virtual screening. Moreover, the 3D core structure of 170 BCL6 inhibitors was used to build a 3D QSAR model and predict the biological activity. The SNP database was analyzed to study the impact on the destabilization of BCL6/drug interactions. Structural similarity search and molecular docking analyses were used to assess the interaction between possible off-targets and BCL6 inhibitors. The tendency of drugs for passive membrane permeability was also analyzed. Lifitegrast (DB11611) had favorable binding properties and biological activity compared to the BI-3802. Missense SNPs were located at the essential interaction sites of the BCL6. Structural similarity search resulted in five BTB-domain containing off-target proteins. BI-3802 and Lifitegrast had similar chemical behavior and binding properties against off-target candidates. More interestingly, the binding affinity of BI-3802 (against off-targets) was higher than Lifitegrast. Energetically, Lifitegrast was less favorable for passive membrane permeability. The interaction between BCL6 and BI-3802 is more prone to SNP-derived variations. On the other hand, higher nonspecific binding of BI-3802 to off-target proteins could bring about higher undesirable properties. It should also be noted that energetically less desirable passive membrane translocation of Lifitegrast would demand drug delivery vehicles. However, further empirical evaluation of Lifitegrast would unveil its true potential. © 2022, The Author(s)

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