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Academic burnout among paramedical students: Predictors and its association with perception of educational environment and academic self-efficacy
No full textBackground & Objective: Today, several well-known factors involved in the educational environment could influence students’ level of learning because of academic burnout. Academic self-efficacy, a factor affecting academic burnout, is likely to affect students’ performance levels. This study aimed to determine the relationship between the perception of the educational environment and academic self-efficacy with the academic burnout of paramedical students studying at the Ilam University of Medical Sciences, Ilam, Iran. Materials & Methods: The present study was a cross-sectional type in which 300 paramedical students participated as the study sample. Data collection tools included the Dundee Ready Educational Environment Measure (DREEM), College Academic Self-Efficacy (CASES), and Maslach Burnout Inventory (MBI). Pearson’s correlation test was used to examine the relationship between variables, and linear regression applied to model the correlation between multiple variables. Data analysis was performed by SPSS (version 26). Results: Mean scores of academic burnout, perception of the educational environment, and academic self-efficacy were 41.79±13.4, 112.34± 24.63, and 102.65±18.73, respectively. Through linear regression, the identified predictors of academic burnout were: perception of educational environment (β=-0.769, 95CI;-0.985,-0.553, P<0.001), academic self-efficacy (β=-0.366, 95CI;-.544,-0.188, P<0.001) and marital status (β=0.351, 95CI; 0.013, 0.688, P<0.05). Conclusion: The results found a negative correlation between academic burnout and students' perceptions of the educational environment (EE) and academic self-efficacy. Therefore, one could consider effective factors in the learning environment to create favorable conditions for student learning and reduce academic burnout. © 2021,Sara Mohammadi et al
Nosocomial infections and antimicrobial susceptibility patterns among patients admitted to intensive care unit of Imam Khomeini hospital in Ilam, Iran
No full textIntroductionNosocomial infections (NIs) are a major challenge worldwide. Identification of antibiotic resistance pattern extended spectrum beta-lactamases (ESBLs) and carbapenem-resistant Enterobacteriaceae (CRE) were the objectives of this study.MethodsIn this cross-sectional study, the antimicrobial susceptibility pattern of bacterial isolates collected from patients with NIs in ICU was determined. Overall, 42 Escherichia coli and Klebsiella pneumoniae isolates from different infection sites were used to determine phenotypic tests of ESBLs, Metallo-beta-lactamases (MBLs) and CRE. Detection of ESBLs, MBLs and CRE genes were performed by the polymerase chain reaction (PCR) method.ResultsFrom 71 patients with NIs, 103 different bacterial strains were isolated. The most frequently isolated bacteria were E. coli (n = 29; 28.16), Acinetobacter baumannii (n = 15; 14.56), and K. pneumoniae (n = 13; 12.26). Also, the rate of multidrug-resistant (MDR) isolates was 58.25 (60/103). Based on phenotypic confirmation tests, 32 (76.19) isolates of E. coli and K. pneumoniae produced ESBLs, and 6 (14.28) isolates were identified as CRE producers. PCR showed the high prevalence of the bla(CTX-M) (n = 29; 90.62) in ESBL genes. In addition, bla(NDM) was detected in 4 (66.66), bla(OXA-23) in 3 (50), and bla(OXA-48) gene in 1 (16.66) isolates. The bla(VIM), bla(KPC), and bla(IMP) genes were not detected in any of the isolates.ConclusionThe Gram-negative bacteria E. coli, A. baumannii, and K. pneumoniae with high resistance levels were the most common bacteria causing NIs in the ICU. This study for the first time identified bla(OXA-11), bla(OXA-23), and bla(NDM-1) genes in E. coli and K. pneumoniae in Ilam city of Iran
Efficient sonocatalytic degradation of orange II dye and real textile wastewater using peroxymonosulfate activated with a novel heterogeneous TiO2-FeZn bimetallic nanocatalyst
No full textTiO2-FeZn nanocatalyst combined with sonolysis were used to activate peroxymonosulfate (PMS) as a highly efficient advanced oxidation process (US/TiO2-FeZn/PMS) for the decoloration of orange II dye (OII) and real textile wastewater. The characterization of the as-synthesized NPs was performed by SEM, FTIR, EDX and XRD analyses. Optimal experimental conditions of operational parameters were obtained: pH = 3, 15 mg/L initial OII concentration, 0.2 g/L PMS, 0.7 g/L nanocatalyst dosing, and 300 W ultrasonic power. The decolorization was observed to increase with increasing the dose of nanocatalyst and the ultrasonic power, and with decreasing pH (under acidic conditions). Under optimal experimental conditions, decolorization and COD removal of textile wastewater were 99.9 and 74.6, respectively, at 40 min. The TiO2-FeZn/PMS/US as a novel process exhibited a higher removal of OII (95) than TiO2 NPs/PMS/US process (54). The OII removal efficiency by the different processes decreased in the following order: TiO2-FeZn/US/PMS > TiO2-FeZn/PMS > TiO2-FeZn/US > TiO2 /US/PMS > US/PMS > TiO2-FeZn > PMS > US. The recyclability study revealed that the process could be reused up to three consecutive cycles. The current US/nanocatalyst/PMS system was concluded to be an efficient, reusable and stable nanocatalyst for the oxidation of textile dyes
Application of a Finite Mixture Model to Assess the Role of CD4+ T Cell Count as a Predictor of Memory Loss in HIV+ Patients
No full textIntroduction: Memory impairment is one of the most important complications in patients with HIV infection. The syndrome is caused by reductions in brain volume and the count of circulating CD4+ lymphocytes. This study was conducted to evaluate the relationship between CD4+ lym-phocyte count and memory function in HIV+ patients. Methods: This descriptive-analytical study was conducted on 150 HIV+ patients referred to the Behavioral Disorders Counseling Center of Kermanshah City. Memory function in patients was measured using the Wechsler memory scale. The patients' CD4+ cell counts and demographic information were extracted from their medical files. The data were recorded in STATA version 16 software and analyzed using regression and finite mixture models. Results: The means +/- standard deviations of memory function in three classes of patients were 63.99 +/- 7.02, 75.01 +/- 14.72, and 85.14 +/- 6.43. The results showed that a decrease in CD4+ cell count increased the risk of memory loss in patients (P < 0.001). In addition, higher age (P < 0.001), female gender (P < 0.001), and a lower education level (P < 0.001) were significantly associ-ated with an increased risk of memory loss in HIV+ patients. Conclusion: The results of the present study confirmed the findings of previous studies noting memory impairment in HIV+ patients as a result of immune system suppression, including the depletion of CD4+ cells. Therefore, it is nec-essary to monitor cognitive function in these patients and to implement measures to strengthen their performance
Comparison of Pain Intensity, Fear of Movement, and Disability Before and After Lumbar Spine Surgery
No full textBackground: Lumbar spine surgery (LSS) is performed to manage patients with lumbar discs. These patients commonly experience pain, fear, and disability after LSS surgery.Objectives: Considering the importance of LSS surgery and its outcomes in these patients, the purpose of the present study was to compare pain intensity, fear of movement, and disability before and after LSS.Methods: In this descriptive and analytical research, the population under study included all patients undergoing LSS at the Imam Khomeini Hospital of Ilam City from October 2015 to October 2016. Demographic and clinical information questionnaires, pain catastrophizing scale (PCS), tampa scale for kinesiophobia (TSK), and Physical Disability Questionnaire (PDQ) were data collection tools, which were completed for the patients referring to our center and undergoing LSS according to diagnostic findings and clin-ical documents. The patient's condition was evaluated using the aforementioned questionnaires six months to one year after the study. The collected data were analyzed using SPSS software.Results: The mean (SD) score of PCS before surgery was equal to 51.17 (7.53) in men and 63.84 (4.72) in women (P = 0.004). Nine weeks after the surgery, the PCS score was 19.36 (4.94) in men and 23.31 (6.68) in women (P = 0.04). There were significant decreases in all variables, including the PCS score, Brief Pain Inventory score, and PDQ score after the intervention compared to pre-intervention (P < 0.05).Conclusions: Considering that LSS can effectively reduce patients' pain intensity, disability, and fear of movement, this intervention is recommended for patients who need surgery according to relevant diagnostic criteria and clinical examination findings
A systematic review and meta-analysis of prevalence of urinary tract infection in childhood
No full textIntroduction: Urinary tract infection (UTI) is considered as one of the most important causes of fever and hospitalization in children. The present study was conducted with the aim of investigating the prevalence of UTIs in children through meta-analysis.Methods: This meta-analysis study was conducted on individuals aged >18 years. In order to retrieve the studied, the following domestic and foreign databases were searched: PubMed, Scopus, Web of Science, and Cochrane. The obtained data were analyzed in STATA version 14 at the significance level of P<0.05.Results: In 36 studies with 78212 samples published between 2000 and 2021, the prevalence of UTIs in children was reported at 15 (95 CI: 13, 17). It was 16 in girls (95 CI: 12, 19) and 10 in boys (95 CI: 7, 13). The most common cause of UTI in children was Escherichia coli with 58 (95 CI: 46, 69). The least common prevalence was reported in the UK with 6 (95 CI: 5, 6) and the USA with 6 (95 CI: 5, 8) and the highest prevalence was reported in Iraq with 43 (95 CI 39, 48). Conclusion: Approximately one out of 10 people suffers UTI and this rate is increasing over time and the prevalence of UTIs in girls is about 1.5 times higher than that in boys.Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42021290886, https://www.crd.york.ac.uk/ prospero/displayrecord.php?ID=CRD42021290886)
COVID-19-associated pulmonary aspergillosis (CAPA) in Iranian patients admitted with severe COVID-19 pneumonia
No full textPurpose Bacterial or virus co-infections with SARS-CoV-2 have been reported in many studies; however, the knowledge on Aspergillus co-infection among patients with COVID-19 was limited. This study was conducted to identify and isolate fungal agents and to evaluate the prevalence of pulmonary aspergillosis (CAPA) as well as antifungal susceptibility patterns of Aspergillus species in patients with COVID-19 admitted to Shahid Beheshti Hospital, Kashan, Iran. Methods The study involved 119 patients with severe COVID-19 pneumonia referred to the Shahid Beheshti Hospital, Kashan, Iran. A total of 17 Aspergillus spp. that were isolated from COVID-19 patients suspected of CAPA were enrolled in the study. CAPA was defined using ECMM/ISHAM consensus criteria. The PCR amplification of the beta-tubulin gene was used to identify the species. The antifungal activities of fluconazole, itraconazole, voriconazole, amphotericin B against Aspergillus spp. were evaluated according to the Clinical and Laboratory Standards Institute manual (M38-A3). Results From the 119 patients with severe COVID-19 pneumonia, CAPA was confirmed in 17 cases (14.3). Of these, 12 (70.6) were males and 5 (29.4) were females; the mean age at presentation was 73.8 years (range: 45-88 years; median = 77; IQR = 18). Aspergillus fumigatus (9/17; 52.9), Aspergillus flavus (5/17; 29.4), Aspergillus oryzae (3/17, 17.6), were identified as etiologic agents of CAPA, using the molecular techniques. Voriconazole and amphotericin B showed more activity against all isolates. Moreover, the MIC of fluconazole, itraconazole varied with the tested isolates. For 3 clinical isolates of A. fumigatus, 2 isolate of A. flavus and 3 A. oryzae, the MIC of fluconazole and itraconazole were >= 16 mu g/mL. Conclusions We observed a high incidence (14.3) of probable aspergillosis in 119 patients with COVID-19, which might indicate the risk for developing IPA in COVID-19 patients. When comparing patients with and without CAPA regarding baseline characteristics, CAPA patients were older (p =0 .024), had received more frequent systemic corticosteroids (p = 0.024), and had a higher mortality rate (p = 0.018). The outcome of CAPA is usually poor, thus emphasis shall be given to screening and/or prophylaxis in COVID-19 patients with any risk of developing CAPA
Green synthesis of gold nanoparticles using potato starch as a phytochemical template, green reductant and stabilizing agent and investigating its cytotoxicity, antioxidant and anti-ovarian cancer effects
No full textHerein we have demonstrated a sustainable pathway for the Au nanoparticles synthesis using potato starch as a phytochemical template, green reductant and stabilizing agent. The reaction was initiated by ultrasound irradiation as a non-conventional source of energy. As-synthesized nanocomposite material (Starch/Au NPs) physicochemical characteristics was determined over several analytical techniques like TEM, UV-Vis, SEM, XRD and EDX. The in vitro cytotoxic and anti-ovarian potentials of biologically synthesized Starch/Au nanocomposite were assessed against OVCAR-3 and OVCAR-4 cancer cells. The anti-ovarian cancer activities of the Starch/Au nanocomposite were validated by the significant diminishing of OVCAR-3 and OVCAR-4 cancer cells. The IC50 of the Starch/Au nanocomposite were found as 285 and 189 & mu;g/mL respectively against the said cell lines. The outstanding results of this current research definitely could lead the biologically synthesized Starch/Au nancomposite as a potential adjuvant chemopreventive and chemotherapeutic agent to cure the ovarian cancer. The material also exhibited significant antioxidant properties. However, it necessitates in vivo animal studies to ascertain further evidences as anti-ovarian cancer agents
Latent Toxoplasmosis among Breast Cancer Patients in Jahrom, South of Iran
No full textObjective. Reactivation of latent toxoplasmosis is the main cause of severe infection among immunocompromised patients, including patients with cancer. Hence, this study is aimed at screening the status of Toxoplasma gondii infection among breast cancer patients by serological and molecular methods and determining their associated risk factors in Jahrom County, Fars Province, south of Iran. Methods. One hundred and seven women with breast cancer (aged 34 to 80 years) were screened for anti-T. gondii antibodies (IgG and IgM) during 2019-2020. A questionnaire regarding demographic factors was filled out by participants. Molecular detection was performed by polymerase chain reaction (PCR) using the primer pair targeting the repetitive element (RE) gene of T. gondii. The risk factors and demographic data were analyzed by SPSS software (ver. 20, Chicago, IL, USA) using the Chi-squared test. Results. Anti-T. gondii IgG was detected in 45.8 (49/107) of the patients, which indicates latent infection, but anti-T. gondii IgM and PCR were negative in all samples. Demographic factors revealed a statistically significant increased T. gondii seropositivity among nonmenopause cancer patients (P<0.0005), patients without previous breast cancer (P=0.0001), and human epidermal growth factor receptor 2- (HER2-) negative patients (P=0.00002). As such, patients with a history of previous abortions and who were at stages II, III, and IIII of cancer had higher seropositivity rates than patients without a history of previous abortions or who were at stage I cancer, but the statistical analysis was not significant. We did not find a statistically significant association between T. gondii seropositivity and other risk factors of toxoplasmosis (e.g., education level, type of water source, washing raw fruits and vegetables, consumption of raw or undercooked meat, and contact with soil, cats, and domestic animal). Conclusion. A high seroprevalence rate of latent T. gondii infection was detected among patients with breast cancer; hence, these patients may be at high risk for reactivation of latent infection. Screening of T. gondii infection is recommended to detect active infection among patients with malignancies
The effect of culturally appropriate self-care intervention on health literacy, health-related quality of life and glycemic control in Iranian patients with type 2 diabetes: A controlled randomized clinical trial
No full textBackground: Cultural and language differences are necessary factors for diabetes management and self-care education programs in patients suffering from diabetes. This study aims to investigate the effectiveness of culture-based self-care intervention on health literacy, quality of life, and glycemic parameters in patients with type 2 diabetes. Materials and Methods: This randomized clinical trial has been carried out in selected centers in Darreh Shahr, Iran; 80 participants were randomly assigned into intervention and control groups. The intervention group received an educational program for 6 sessions twice a week, but the control group only received routine services. Data were collected using health literacy and life quality scales for diabetic patients, which were completed by both groups before, immediately after, and 3 months after the intervention; hemoglobin A1C (HbA1c) was checked before and 3 months after the intervention. SPSS software was also analyzed data using ?(2), Fisher's exact, independent t, and repeated measures analysis of variance tests. Results: There were no significant differences between the 2 groups before the study (p >0.05) goes forward. But, mean scores of health literacy (F-2,F-40 = 5.61, p =0.007), quality of life (F-2, 40 = 4.09, p =0.01), and HbA1c levels (t, 39 = 6. 91, p <0.001) have shown significant differences between the 2 groups immediately and 3 months after the intervention have been applied. Conclusions: Culturally appropriate intervention should be offered as a part of the nurse' care program for diabetic to control HbA1c, and improve their life quality and health literacy