7973 research outputs found
Sort by
Personalized Patient Education: Patient's Perspective
No full textIntroduction: Evidence indicates that many patients are discharged from healthcare settings without addressing their healthcare needs. To enhance patient satisfaction, outcomes, and overall quality of life, it is crucial to adopt a patient-centered approach to education that considers individuals' unique needs and expectations. By thoroughly understanding patients' requirements and preferences, healthcare providers can customize educational initiatives to effectively meet those needs, resulting in improved patient experiences and better overall outcomes. Methods and Materials: This prospective cross-sectional study investigated patients admitted to the internal wards of two educational hospitals in Shahrekord, Iran, between the winter and spring of 2020 and 2021. Two hundred inpatients aged 12-80 years, hospitalized for less than a week with a specific disease, were conveniently sampled. Exclusions were made for patients who declined consent, had cognitive impairments, or lacked an accessible companion. Data collection involved an online questionnaire administered one week after discharge, focusing on various aspects of pre-discharge training and patient education needs. The questionnaire included five categories addressing personal information, disease knowledge, healthcare team communication, education comprehension, and patient satisfaction. The items were ranked on a Likert scale, and the questionnaire demonstrated acceptable validity and reliability. Statistical analysis using SPSS-25 involved calculating mean values, standard deviation, and percentage distributions to assess training characteristics. The Chi-square test was used to analyze individual and disease-related education and responses. Results: In this study, 52.5 of patients were satisfied with their dedicated time, and 19 described the training as vivid. Demographics and pre-hospitalization knowledge affected patient education and contentment about time, vividness, and comprehensibility (p = 0.05). Efficiency of training on drugs, diet, post-discharge medical care, and limitations were related to demographic variables and the trainer (p = 0.05). Demographic considerations and the trainer's position also affected satisfaction with the training and anxiety (p = 0.05). Conclusion and Discussion: This study adds to the growing literature on personalized medicine. The novel idea is that providing appropriate patient education could increase satisfaction, reduce anxiety, improve outcomes, and minimize the probability of readmission and adverse events. The study's results have implications for patient trainers and addressing patients' demands
In Vitro Antileishmanial and Immune Modulation of Trigonelline Against Leishmania major
No full textThe mechanistic study of new pharmaceutical compounds is crucial for evaluating their efficacy, identifying potential side effects, and optimising drug formulations. This study aimed to investigate the mechanism of action of trigonelline on the promastigote and amastigote stages of Leishmania major (MRHO/IR/75/ER). An initial in silico study was conducted to examine the pharmacological effects of trigonelline using molecular docking to evaluate the potential binding affinity of trigonelline with nitrate, a crucial molecule in the macrophage immune response against Leishmania. In this experimental study, the inhibitory mechanism of trigonelline on promastigotes was evaluated by measuring metacaspase expression levels. In the amastigote stage of L. major, the expression levels of inducible nitric oxide synthase (iNOS), interleukin 12 (IL-12), interferon-gamma (IFN-γ), tumour necrosis factor alpha (TNF-α), transforming growth factor-β (TGF-β) and interleukin 10 (IL-10) genes were assessed using Real-time PCR. Trigonelline demonstrated a high-binding affinity to the iNOS molecule in computer modelling. In macrophages treated with various concentrations of trigonelline, glucantime and their combination, the expression levels of metacaspase, IL-12, TNF-α, IFN-γ and iNOS genes significantly increased compared to the control group (p < 0.05), whereas IL-10 and TGF-β gene expression levels significantly decreased (p < 0.05). Trigonelline exerts its antileishmanial effects through its high antioxidant properties, non-cytotoxicity to macrophages, and its ability to enhance apoptosis and cell cycle arrest in promastigotes of L. major
Investigating the Association Between Traffic-related Air Pollution (PM2.5 and Benzene) and the Risk of Asthma: A Systematic Review and Meta-analysis
No full textBackground and aims: Asthma is a chronic disease that causes respiratory system inflammation. Recently, traffic-related air pollution (TRAP), especially particulate matter (PM2.5) and benzene, has been considered a factor that may increase the risk of asthma. This study investigated the association between TRAP (PM2.5 and benzene) and asthma risk. Methods: In this systematic review and meta-analysis, the relevant published data were collected by searching the Cochrane Library, Web of Science, ScienceDirect, Scopus, PubMed, and Google Scholar databases up to November 2022. The study quality was evaluated using the Newcastle-Ottawa Scale checklist. The data were analyzed using Stata software (version 14), and the significance level in this meta-analysis study was considered to be < 0.05. Results: In the first search, 4,909 and 4,825 studies were extracted for PM2.5 and benzene, respectively. After evaluating and considering the search criteria, 25 and 4 studies remained for PM2.5 and benzene, respectively. For PM2.5, the odds ratio (OR) for developing asthma in the TRAP-exposed group compared to the unexposed group was 1.11 (95% confidence interval [CI]: 1.04-1.19, P = 0.002). For benzene, the OR of developing asthma in the exposed group was 1.19 when compared to the unexposed group (95% CI: 1.10-1.29, P < 0.001). Conclusion: Based on this review study, there was a positive association between TRAP exposure and the development of asthma. The results confirmed that PM2.5 and benzene increase the risk of asthm
Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
No full textBackground: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021. Methods: We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6–7·8] deaths; 10·7% [9·8–11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8–171·6] DALYs; 5·6% [5·0–6·1] of all DALYs). In 2021, there were 93·8 million (89·0–99·3) prevalent and 11·9 million (10·7–13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4–67·7), intracerebral haemorrhage constituted 28·8% (28·3–28·8), and subarachnoid haemorrhage constituted 5·8% (5·7–6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4–117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7–38·1]), diet high in sugar-sweetened beverages (23·4% [12·7–35·7]), low physical activity (11·3% [1·8–34·9]), high systolic blood pressure (6·7% [2·5–11·6]), lead exposure (6·5% [4·5–11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5–10·5]). Interpretation: Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. Funding: Bill & Melinda Gates Foundation
Fixed versus flexible gonadotropin releasing hormone antagonist protocol in women with polycystic ovary syndrome undergoing in vitro fertilization: An RCT
No full textBackground: Despite the extensive use of the gonadotropin-releasing hormone (GnRH) antagonist protocol in treating infertile women, particularly those with polycystic ovary syndrome (PCOS), there have not been sufficient evidence to compare the flexible and fixed variants in in vitro fertilization (IVF) cycles. Objective: This study aims to assess the treatment outcomes of flexible and fixed types of GnRH-antagonist protocol for IVF in women with PCOS. Materials and Methods: In this randomized clinical trial, 150 infertile women with PCOS, who were candidates for IVF, and referred to the Yazd Research and Clinical Center for Infertility, Yazd, Iran between October 2023 and February 2024 were included. Participants were divided into 2 groups (n = 75/each) based on the type of antagonist protocol (fixed or flexible). GnRH antagonist administration started on the 5th day of gonadotropin treatment in the fixed group. In the flexible group when there was at least one follicle 12–14 mm, GnRH antagonist was started. Finally, the number of metaphase II oocyte, the quality of embryos, the duration of the stimulation cycle, the dose of gonadotropin, the number of GnRH-antagonist, and the rate of ovarian hyperstimulation syndrome were evaluated. Results: No statistically significant difference was observed in terms of cycle length and the total dose of gonadotropin between groups. Nevertheless, a notable distinction was observed in the total number of oocytes (17.84 vs. 15.5, p = 0.023) and mature oocytes (13.64 vs. 11.83, p = 0.019) in the flexible group compared to the fixed group. Conclusion: In conclusion, the IVF outcomes are more favorable in women with PCOS undergoing the flexible GnRH-antagonist protocol compared to the fixed protocol
The Effect of an Online Self-Care Training Program on Perceived Stress in COVID-19 Patients: A Randomized Control Trial
No full textBackground: The coronavirus disease 2019 (COVID-19) caused many adverse effects, including increased stress in patients. Aim: The present study was conducted with aim to determine the effect of an online self-care training program on perceived stress in COVID-19 patients. Method: This randomized control trial study was fulfilled by recruiting 132 COVID-19 patients, referred to two hospitals in Isfahan, Iran, 2021. The patients were selected using the purposive sampling method and were then randomly allocated into experimental and control groups (n=63 in each group). The online self-care training program was presented to the experimental group in six 30-minute sessions over two weeks. The data were collected through an individual characteristic form and the Perceived Stress Scale (PSS) at three stages before, immediately, and one month after the intervention. P<0.05 was considered statistically significant. Results: The mean scores of perceived stress before, immediately, and one month after the intervention in the experimental group were 30.51±6.31, 24.59±4.66, and 26.57±3.82, respectively and in the control group were 29.78±4.81, 29.4±4.57, and 29.11±4.73, respectively. Moreover, no significant difference was observed between the two groups at the pre-intervention stage (p=0.467), while the mean scores of perceived stress in the experimental group were lower compared with the control group immediately (p<0.001) and one month after the intervention (p=0.001). Implications for Practice: The online self-care training program led to a reduction in perceived stress in COVID-19 patients. Thus, implementing this self-directed program may be considered as a safe and useful method to relieve perceived stress in similar conditions
Safety Integrity Level (SIL) Determination and Verification for Gas Turbine and Generator in a Combined Cycle Power Plant
No full textIntroduction: One of the ways to produce electricity in power plants is to use gas turbines and generators. Due to the use of methane gas as the fuel of the burners and the high rotation speed, this equipment has a high DOW index level, therefore, if the hazardous conditions in the gas turbine are not controlled by the safety instrumented system and the process is not directed to a safe state, Catastrophic events will occur such as fire and explosion and damage to property and people as well as interruption of the power generation process will happen in the long term, so gas turbine safety instrumentation systems can be considered as “critical safety systems”. Therefore, the reliability and availability of their function should be evaluated. The purpose of this research is to determine and verify the safety integrity level (SIL) related to the safety instrumented function (SIF) of the gas turbine and generator in a combined cycle power plant. Material and Methods: In this study, the safety integrity level was determined by using two methods, Calibrated Risk Graph (CRG) and Independent Protection Layer Analysis (LOPA), and to verify the safety integrity level, the requirements related to random hardware failure, hardware failure tolerance, and systematic capability are considered according to IEC 61511 and IEC 61508 standards. Results: The results of a case study in gas turbine and generator showed that the LOPA method is more quantitative than CRG and provides more details of independent protective layers, so it is a more suitable method for determining SIL. The SIL verification results show the SIL2 level, closer to the LOPA results. Conclusion: The obtained results show that the function of the studied gas turbine safety instrumentation system has a suitable level of reliability and availability and is well responsive to risky conditions and possible deviations. The present approach helps safety engineers and instrumentation engineers to calculate the reliability and availability of the Function of the safety instrumentation systems of their process equipment and ensure its acceptability or not. © 2024 The Authors
Explaining the Parenting Styles of Epileptic Children: A Content Analysis
No full textObjectives Understanding the parenting practices of parents of children with epilepsy can be a practical guide for care and education planners to prevent mental disorders in these children. This study aimed to explain the parenting practices of parents of children with epilepsy in Shahrekord. Materials & Methods This study is a qualitative study with conventional content analysis. Participants in the study consisted of 20 mothers with epileptic children in Shahrekord, who were included in the study by purposive sampling method with maximum variance in terms of child age, number of family children, and child sex. The data collection method was a semi-structured interview using the interview guide. Data analysis was performed using a conventional content analysis at the same time as data collection. Interviews continued until data saturation was reached. Results The present study revealed five main themes in discipline methods, including over-support / over-protection, forcing to support, rejecting, parental conflict in discipline methods, and using harmful discipline methods. Conclusion In conclusion, the experiences of mothers in the present study show that using inappropriate discipline methods can have adverse effects on the mental-emotional and social health of the child in the future and raise the need to design educational interventions to empower parents of epileptic children in coping with parenting stress effectively
The Role of Innate and Adaptive Immune System in the Pathogenesis of Schizophrenia
No full textSchizophrenia is one of the most severely debilitating mental disorders that affects 1.1% of the world's population. The exact cause of the disease is not known, but genetics, environmental factors (such as infectious agents, season and region of birth, exposure to viruses, low birth weight, advanced paternal age, and tobacco), and immune system dysfunction can all contribute to the development of schizophrenia. Recently, the role of the immune system in schizophrenia has received much attention. Both acquired and innate immune systems are involved in the pathogenesis of schizophrenia and facilitate the disease's progression. Almost all cells of the immune system including microglia, B cells, and T cells play an important role in the blood-brain barrier damage, inflammation, and in the progression of this disease. In schizophrenia, the integrity of the blood-brain barrier is reduced and then the immune cells are recruited into the endothelium following an increase in the expression of cell adhesion molecules. The entry of immune cells and cytokines leads to inflammation and antibody production in the brain. Accordingly, the results of this study strengthen the hypothesis that the innate and acquired immune systems are involved in the pathogenesis of schizophrenia
Synthesis, docking, pharmacokinetic prediction, and acetylcholinesterase inhibitory evaluation of N-(2-(piperidine-1-yl)ethyl)benzamide derivatives as potential anti-Alzheimer agents
No full textBackground and purpose: Alzheimer's disease is the most common form of dementia and the sixth most common cause of death in the US according to the Alzheimer's Association. As regards, to date, no effective treatments are available because of the multifactorial nature of the disease, therefore, a large body of recent research has been allocated to the design and development of multi-target-directed ligands that can become effective drug candidates. Experimental approach: A novel series of benzamide derivatives (5a-5l) containing piperidine core were synthesized in the current work. After identification of the chemical structures of the members of this series using 1H NMR, IR, and MS spectra, their anti-acetylcholinesterase activity was assessed by the Ellmans test. Docking studies were also performed to investigate the binding mode and determine the interacting amino acids with the corresponding ligands. Finally, the pharmacokinetic (ADME parameters) of the most potent derivative (5d) was predicted and compared with donepezil. Findings/Results: Compound 5d possessing the fluorine atom substitution at position ortho was the most active compound in these series (IC50 = 13 ± 2.1 nM). This compound demonstrated superior activity than the reference drug donepezil (IC50 = 0.6 ± 0.05 μM). Molecular docking showed a significant hydrogen bonding of the carbonyl group of compounds 5d with tyrosine 121 into the active site of acetylcholinesterase. Fortunately, this compound showed better promising ADME properties than donepezil. Conclusion and implication: The benzamide derivatives introduced in this paper could be proposed as potential anti-acetylcholinesteras