Bacillus Calmette-Guerin Vaccine-Associated Lymphadenitis in Children

Background: Tuberculosis (TB) is one of the most important infectious diseases worldwide. Bacillus Calmette-Guerin (BCG) is a live attenuated vaccine, entered into the childhood immunization program by the World Health Organization (WHO) in 1974 to prevent TB. One of the relatively common complications of BCG vaccination is regional lymphadenitis. Objectives: This study aimed to determine the lymphadenitis incidence in BCG-vaccinated children in southwest Iran. Methods: In a prospective descriptive study, infants born from March to June 2017 were evaluated for BCG vaccine complications at two, four, six, nine, and 12 months of age in Ahvaz, southwestern Iran. Results: The study enrolled 1,506 infants (794 males and 712 females). Among the vaccinated infants, four (0.26%) had injection site reactions, and 106 (7.03%) presented lymphadenitis (66 males and 40 females). The lymphadenitis rate was significantly higher in males than in females (P = 0.024). The mean age at presentation was 4.28 ± 0.79 months. Suppurative lymphadenitis was seen in 53 (50%) cases and nonsuppurative lymphadenitis in 53 (50%) cases. About 80% of nonsuppurative lymphadenitis resolved entirely or partially after a one-year follow-up. Of 53 cases with suppurative lymphadenitis, 46 (43.4%) developed spontaneous drainage, and seven (6.6%) were drained by needle aspiration. No significant relationship was found between the BCG inoculation site and lymphadenitis rate. No other complications such as osteomyelitis or disseminated BCG infection were observed after one year of follow-up. Conclusions: The relatively high incidence of BCG lymphadenitis in this study may be due to the vaccine strain, young vaccinees, and improper vaccination techniques. In most cases, nonsuppurative lymphadenitis regressed spontaneously, and suppurative lymphadenitis was drained spontaneously or by needle aspiration.

Explaining the Status of Clinical Nursing Education: A Qualitative Research in Iran

Background: Challenges and problems of clinical nursing education are the most important factor in determining the quality of nursing students' education. Frequent assessment of the quality of nursing education without considering the existing challenges is an ineffective activity in analyzing the situation of nursing education. Objectives: This study aimed to explain the status of clinical nursing education at Jahrom University of Medical Sciences in Iran. Methods: This qualitative study based on the conventional content analysis approach was conducted at Jahrom University of Medical Sciences in 2018 - 2019. Data were collected through holding 10 semi-structured face-to-face focus group discussions (FGDs) with 110 nurses, head nurses, instructors, and students. Purposeful sampling was used and the interviews were analyzed by Graneheim and Lundman method by MAXQDA Software. Results: We obtained 626 in-vivo codes, 46 primary codes, eight subcategories (lack of attention to the evaluation process, non-participative evaluation, low staff educational cooperation, ineffective instructors, non-educational clinical space, student educational deficits, students' confusion in the clinical setting, and non-participatory planning), and three main categories (planning challenges, implementing challenges, and evaluation challenges). Conclusions: Educational leaders are recommended to shift to three areas, including democratic planning, wise implementation with frequent monitoring, and the use of modern clinical evaluation methods based on the participation of learners and other stakeholders.

Knowledge, Attitude, and Practice on Health Behaviors Regarding Air Pollution from Burning Waste: A Cross-sectional Study Among Villagers in the North of Iran in 2020

Background: Incineration is a waste disposal technique employed to reduce the volume of waste, resulting in air pollution. Objectives: This study aimed to determine the knowledge, attitude, and practice on health behaviors among Rasht villagers regarding air pollution from burning waste. Methods: The present descriptive cross-sectional study was conducted among 260 rural households in Rasht. Data were collected using a questionnaire by interviewing participants. The participants were randomly selected and entered the study. Data were analyzed by SPSS version 16 using the t-test, one-way ANOVA, and Pearson correlation at a 95% confidence interval. the content validity index (CVI) and content validity ratio (CVR) were used to assess the instrument's validity. Cronbach's alpha coefficient was calculated to evaluate the questionnaire reliability. Results: The findings confirmed the optimal validity and reliability of the instrument used in the study. The participants' age range was 19 to 78, with a mean age of 43.87 ± 12.66 years. The practice had a significant positive correlation with knowledge (r = 0.216). The correlation between practice and attitude was positive but not statistically significant. Education and information on burning wastes had a substantial relationship with knowledge. Participants received 80%, 29.3%, and 66.7% of the maximum achievable scores for knowledge, attitude, and practice components in the questionnaire, respectively. Conclusions: The villagers' attitude in performing health behaviors regarding air pollution was not favorable, and there is a need to provide educational and behavioral interventions in this regard.

Depression Severity and Sexual Satisfaction in Fertile and Infertile Women in Iran: A Population-Based Case-Control Study

Background: Depression and sexual dissatisfaction are among the most common psychological factors caused by infertility. Infertility is an essential topic in the Iranian culture, and many studies have already investigated it. Objectives: This study aimed to compare the depression severity and sexual dissatisfaction between fertile and infertile women in Iran. Methods: This case-control study enrolled 180 infertile women and 540 fertile women in 2019. The participants were selected through multistage stratified and cluster sampling methods. For each infertile woman, three fertile women were randomly selected. The data collection instruments consisted of a demographic form, the Depression Inventory Scale (Second Edition), and the Linda Berg Sexual Satisfaction Questionnaire. The multivariate marginal model and SPSS version 21 were used for data analysis at a significance level of 0.05. Results: After adjustment for confounding variables, the marginal model showed that the odds of depression increased by approximately 21.305 times among cases compared to controls (OR = 21.305, 95% CI = 14.75 - 32.021, P < 0.001). This model also found that by moderating the effects of confounding variables, infertility increased the odds of low sexual satisfaction by approximately 15.560 times (OR = 15.560, 95% CI = 5.089 - 47.571, P < 0.001). The chi-square test showed a significant relationship between infertility treatment and depression severity in infertile women (P = 0.001). Conclusions: The overall depression severity and sexual dissatisfaction were higher in the infertile group than in the fertile one. Most cases of severe depression were observed in IVF clinics with higher depression levels. The study may help reveal infertility's psychological and social aspects in Iran.

Comparison of the Effectiveness of Mindfulness-based Stress Reduction Therapy and Emotion Regulation Training on the Distress Tolerance of Adolescent Girls with a Drug-Dependent Parent

Background: The undesirable conditions resulting from addiction can be mitigated with timely diagnosis and effective interventions. Distress tolerance can be promoted in adolescents with a drug-dependent parent. Objectives: The present study aimed to investigate the effectiveness of mindfulness-based stress reduction (MBSR) therapy and emotion regulation training (ERT) on the distress tolerance of adolescent girls with a drug-dependent parent in Ahvaz, Iran. Methods: This clinical trial was performed on the experimental and control groups as the pretest-posttest design with follow-up. The statistical population included all the adolescent girl students with a drug-dependent parent in Ahvaz. The sample consisted of 45 adolescents with a drug-dependent parent selected by cluster sampling. The participants were randomly divided into two experimental groups of MBSR (eight 60-min sessions) and ERT (eight 45-min sessions) and a control group (n = 15 per group). All three groups were followed up after 45 days. The research instrument was the Distress Tolerance Scale (DTS), and data were analyzed using the analysis of covariance. Results: MBSR and ERT enhanced distress tolerance in adolescent girls with a drug-dependent parent (P < 0.001). The effects of the two interventions were not significantly different, and this result persisted in the follow-up stage. Conclusions: MBSR and ERT increased distress tolerance in adolescent girls with a drug-dependent parent. Therefore, these two interventions can be administered to enhance the mental health of adolescents.

Effects of Hospital Information System on the Performance of Management Units in Public Hospitals Analysis in Southwestern Iran

: The current study examines the effects of a hospital information system (HIS) on the performance of management units in Ahvaz public hospitals, Iran. The HIS supports hospital activities at practical, tactical, and strategic levels. In other words, this system establishes a connection between patient care and administrative information in all hospital activities. This descriptive-analytic research was an applied study with a correlational method. The hypotheses were tested by correlation model, structural equation modeling, one-sample t-test, one-way analysis of variance, and one-sample Kolmogorov-Smirnov test using the SPSS software version 20 and LISREL. The findings of this study indicated that an automated HIS can be a powerful tool helping managers with the process of hospital management and decision-making, leading to significantly improved hospital performance. Therefore, continuous training courses are beneficial in enhancing information quality and modern technology usage, which in turn improve the quality of services offered to patients and clients and make them less time-consuming. As a result, an effective step is taken in improving health services. The present study showed that the characteristics of HIS, including user-friendliness, speed, quality, being up-to-date, conformity with working conditions, and proficiency, have positive and significant impacts on the performance of management units.

Classification of High-Resolution Computed Tomography Manifestations for COVID-19 Patients: A Systematic Review

Context: The early detection of COVID-19 is of paramount importance for the disease treatment and control. As real-time reverse-transcription polymerase chain reaction indicates a low sensitivity, the computed tomography of patients' chest can play an effective role in the diagnosis of COVID-19, particularly for patients with false-negative RT-PCR tests. It is also effective in monitoring the clinical trends and assessing the severity of the disease. Objectives: Accordingly, this study aimed to review the different manifestations of the COVID-19 infections in High-Resolution Computed Tomography images of patients' chests and analyze the distribution of the disease in the lungs. The results can contribute to providing a comprehensive and concise reference on the appearance of various types of involvement and lung lesions and the extent of these lesions in the COVID-19 patients. Data Sources: We systematically searched four major indexing databases (namely PubMed, Science Direct, Google Scholar, and Cochrane Central) for articles published by May 2021 using the following keywords: High-Resolution Computed Tomography (HRCT), COVID-19, and Manifestations. Results: Overall, 29 studies addressing the role of HRCT in detecting and evaluating the manifestations of the COVID-19 infection in patients' lungs as Ground Glass Opacification (GGO), Consolidation, Irregular Solid Nodules, Fibrous Stripes, Crazy Paving Pattern, Air Bronchogram Sign, etc. were reviewed. Conclusions: GGO was the most common finding, as reported in 96.6% of the reviewed articles, followed by Consolidations (65.5%) and Irregular Solid Nodules (55.2%). Most patients revealed the disease process as a bilateral distribution in the peripheral areas of the lung.

Evaluation of Radiographers’ Knowledge, Attitudes, and Performance Regarding Gonadal Shielding in Diagnostic Radiology Examinations: Southern Khorasan Province Hospitals of Iran

Background: Nowadays, ionizing radiation is increasingly used in medicine. One of the most frequent X-ray examinations is pelvic radiography. Gonads are susceptible in the pelvic area. Gonadal shielding (GS) is a useful method to reduce the received dose by gonads. Despite the benefits of using gonadal shielding, it is rarely used by radiographers. Methods: This cross-sectional study was carried out in ten governmental hospitals with 300 radiographs. Results: The radiographers’ knowledge of using GS had a value equal to 59.1%. However, the radiographers did not have enough information on the subject, although their awareness about the significance of GS was acceptable. Conclusions: Although the radiographers believed in the necessity of using GS for pelvic, abdominal, and spine examinations, they used no shields.

Correlation Between Gender Differences and Anthropometric Indicators with Body Image Dissatisfaction Among Adults in Ardabil City

Background: Body image dissatisfaction has been rising in recent years. Despite the large body of evidence on body image, few studies have directed gender comparisons of body image in Iran. Objectives: This study aimed to investigate body image dissatisfaction and its correlation with anthropometric indicators and body composition in men and women. Methods: Following a cross-sectional design, 95 females and 95 males (age range: 18 - 50 years and body mass index: 18.5 - 40.0 kg/m2) who attended a nutrition clinic in Ardabil city were recruited using a convenience sampling method. Anthropometric measurements were achieved while participants were lightly clothed with no shoes. The body fat percentage, visceral fat level, and visceral fat area were measured using a bioelectrical impedance analysis. The body image was evaluated using the Multidimensional Body Self-Relation Questionnaire (MBSRQ). Data analysis was administered using SPSS, and a two-tailed P-value less than 0.05 was considered statistically significant. Results: The appearance orientation (females: 4.04 ± 0.57 vs. males: 3.72 ± 0.49, P-value < 0.001) and illness orientation (females: 3.70 ± 0.74 vs. males: 3.41 ± 0.83, P-value = 0. 01) subscales scores were higher in women than men. A negative association was observed between appearance orientation subscale score with anthropometric indicators and body composition. In contrast, the subjective weight, overweight preoccupation, and health evaluation subscales scores were positively correlated with anthropometric measurement and body composition. Conclusions: This study investigated body image dissatisfaction in a small sample of Iranians. Gender was an important factor in determining body image subscales. Thus, health interventions should be specially designed.

Assessment of Knowledge, Attitude, and Performance of Women Referring to Kashan and Aran-O-Bidgol Comprehensive Health Centers Toward Symptoms and Risk Factors for Breast Cancer in 2020

Background: Breast cancer (BC) is one of the most common cancers in women. Among factors reducing BC mortality, referring to health centers for early diagnosis is important. The level of knowledge, attitude, and performance of women toward BC risk factors has a major contribution in deciding to refer to a health center for early diagnosis. Objectives: The present study aimed to assess the level of knowledge, attitude, and performance of women referring to Kashan and Aran-O-Bidgol comprehensive health centers toward breast cancer risk factors. Methods: This cross-sectional study was conducted on 820 women aged 30 years and above in 2020 using a standard questionnaire, including sections of sociodemographic and existence risk factors, 20 items for women's awareness of the signs and symptoms of BC, risk factors, and breast self-examination, 10 items for attitude measurement, and 5 items for performance measurement. Data analysis was administered by SPSS using relative frequency and Chi-square tests. Results: Data of 776 (94.6%) participants were included in the analysis. The majority of participants had a moderate level of knowledge (66.4%) and attitude (76.6%) towards BC. For performance, about 44% of the participants had no breast self-examination during the last year. The results showed a significant association between marital status and education level with knowledge and attitude; employment with knowledge; age and income with attitude and performance (P < 0.05). Conclusions: Given the low level of knowledge, attitude, and performance of old aged and low educated women, as well as the increased risk of the disease in the elderly, it is necessary to provide educational interventions to this high-risk group.