Shiraz E-Medical Journal
Year:2020 | Volume:21 | Issue:7|Papers Count:9

Background: Conflicting results have been obtained from the studies on the hypoglycemic effect of cinnamon in patients with diabetes mellitus type II (T2DM). Objectives: This research aimed at assessing the effect of applying the syndrome differentiation model based on traditional Persian medicine (TPM) to identify the patients who benefit more from cinnamon supplementation. Methods: This study was a randomized, triple-blind, placebo-controlled trial based on a parallel design. One hundred and forty eligible patients referring to the Diabetes Clinic of Yazd University of Medical Sciences, whowere diagnosed with T2DM, were randomly divided into the cinnamon and placebo groups. Then, 500-mg capsules of cinnamon bark powder or placebo were administered to them twice a day for three months. All the participants completed a standard questionnaire for syndrome diagnosis in traditional Persian medicine (TPM). Fasting plasma glucose (FPG), glycated hemoglobin (HbA1C), fasting insulin (FI), and insulin resistance (IR), calorie intake, and physical activity were measured before and after the interventions. The glycemic outcomes were analyzed according to the TPM syndrome. Results: There was no statistically significant difference between the patients’ demographic and clinical features in the two groups. Glycemic indices were improved in patients receiving cinnamon supplementation compared to placebo group (-13. 1 1. 7,-1. 7 1. 9, P < 0. 001 for change in FPG and-0. 27 0. 039 vs. 0. 001 0. 019, P < 0. 001 for change in HbA1C respectively). All the outcomes were more improved in the patients with wet syndrome compared to dry ones, which was compatible with Persian syndrome differentiation (P < 0. 05). Conclusions: Diabetic patients with wet syndrome based on TPM benefit more form cinnamon supplementation.

Background: Cesarean section is performed to save the lives of the mother and the fetus. According to theWorld Health Organization (WHO), the expected cesarean section rate in different countries should be 10%-15%, which is about 72. 1% in Iran. Objectives: Therefore, due to the high prevalence of cesarean section, the present study was conducted to determine the prevalence of cesarean section based on Robson’ s classification in selected hospitals of Shiraz University of Medical Sciences. Methods: This descriptive-prospective study was conducted among 1787 women who had undergone a cesarean section in Hazrat Zeinab and Hafez hospitals of Shiraz in 2018. The data were collected by the researcher from the data recorded in the two delivery centers, and all the women were classified into 10 Robson groups. Cesarean section was calculated for each group of Robson’ s classification. Data were analyzed using descriptive statistics (frequency and percentage) in SPSS, version 22. Results: Findings showed that 63. 4% of the deliveries were performed through cesarean section, and the highest frequency (46. 6%) was related to group 5, followed by group 2 (19. 5%). Conclusions: Given the high Prevalence of cesarean section observed in this study, it is recommended that the rate of cesarean section should be reduced in nulliparous women (group 2), and vaginal delivery should be increased after cesarean section (group 5).

Background: HIV-related stigma is a barrier to effective HIV responses among people living with HIV (PLHIV). Objectives: The current study aimed at measuring HIV-related stigma, and its associated factors among the general population in the Southeast of Iran. Methods: The current cross-sectional study was conducted on a convenience sample of 900 individuals in Kerman, Southeast of Iran, from July to September 2016. Data was collected using a self-administered questionnaire, including (I) demographic and background characteristics; (II) HIV-related stigma; and (III) HIV-related knowledge. Data were analyzed with SPSS version 20 using descriptive statistics, as well as bivariable and multivariable linear regressions. Results: Low, moderate, and high levels of stigmatizing attitudes toward PLHIV were reported by 39. 1%, 57. 8%, and 3. 1% of the participants, respectively. Female sex(beta = 0. 33, P value = 0. 01) and those not having a history of HIV testing (beta = 0. 45, P value < 0. 001) had, on average, higher levels of stigmatizing attitudes, while those with a higher level of education (beta =-0. 97, P value < 0. 001) had, on average, lower levels of stigmatizing attitudes. Conclusions: Gender-sensitive educational interventions need to be developed to reduce the negative attitude towards PLHIV in Iran.

Dear Editor, Gudi and Tiwari have recently outlined the challenges of the current SARS-CoV-2 coronavirus pandemic, suggesting that it is “ forcing the entire world to lockdown” (p. 108). Yes, there are ‘ stay at home’ policies to protect populations; however, manyemployees must continue to work during the coronavirus pandemic. Many jobs cannot be shut down, particularly for those who work at the hospitals, the care sectors, utility companies, and food transportation. Important manufacturing industries continue to operate, manyof which, in addition to coronavirus, pose risks that still need to be managed. It is understandable that the governments have made a determined effort to support people with Covid-19 and those who attempt to treat them; nevertheless, it is also the case that other work is necessary, and the business of risk assessment in those industries is important. There have always been harmful occupational factors in the workplace, such as noise, dust, vapors, and chemicals...

Background: Teaching medical ethics is currently one of the most essential parts of medical education. Objectives: The present study aimed to design a blended learning program based on a constructive approach to ethical reasoning and determine its effect on the students’ reflection and learning. Methods: This quasi-experimental, single-group, pretest-posttest study was conducted on 35 students who took the medical ethics course in a university of medical sciences. Case studies were presented to the students in a discussion forum, and the main concepts in question were then addressed through interactive lectures and group discussions. Data were collected using the Self-Reflection and Insight scale (SRIS) developed by Grant et al. to assess reflection, with 20 items in three domains. The students’ ethical reasoning was assessed using multiple-choice and open-ended questions and the Objective Structured Clinical examination (OSCE). The relationships between the tests were assessed by calculating the correlation between them. The results of the multiple-choice questions were compared with those of students in the previous year (with the same teacher and content), using the independent t-test. Results: Assessing the mean scores before and after the intervention showed a significant increase in the students’ reflection in all three domains, including the need for self-reflection, encouraging reflection, and insight after the intervention. The findings also showed a significant relationship between the students’ final scores and their virtual round and OSCE scores (P < 0. 05). In the final theoretical test, the students’ mean scores were significantly higher than those of students in the previous year (P < 0. 001). Conclusions: The proper use of technology with a blended learning approach can help improve the students’ quality of learning and reasoning.

Dear Editor, It was an honor to read “ Equity in the Distribution of Maternal and Child Care Providers at the Second Administrative Level: Evidence from Iran” in an earlier issue of Shiraz E-Medical Journal. In this article, the authors claimed that the distribution of pediatricians and gynecologists in Lorestan Province was relatively equitable; however, its distribution trend has declined during 2011-2015 in comparison to the country-wide. They concluded that this shortcoming could increase the mortality rates among mothers and babies. It was confirmed that women’ s health in different periods might be threatened by an unequal distribution of resources and facilities. During 2010-2012, in Iran, the trend showed the number of health workforces, including general practitioners (GPs), midwives, pediatricians, and gynecologists per 10, 000 populationwas increased for GPs and pediatricians and decreased for gynecologists and midwives...

Background: Transferring the patient to the operating room (OR) and back to the ward should be performed in the shortest time possible. Objectives: We aimed to identify and classify different delays at our center and the possible factors associated with them. Methods: We investigated 46 patients scheduled for elective orthopedic surgery at Taleghani Hospital, Tehran, from July 2017 to March 2018. Results: Studying the time points showed that the main gap times included: T1 (when the surgical team informed OR staff until the orthopedic ward staff was informed (median of 5 minutes), T2 (when the orthopedic ward staff was informed until the patient was transferred to OR), T3 (when the patient reached OR until the patient was laid on OR bed), T6 (when the patient was prepared until the surgery started), T8 (from the end of the procedure until the patient exited the OR and entered the recovery room), T9 (duration spent in the recovery room), each with a median of 10 minutes. Although T5 and T6 were shorter in women (P = 0. 005 and 0. 020, respectively), the type of surgery or anesthesia did not affect the gaps. Conclusions: This study showed a total of 75 minutes gap (delays in informing the ward and the time to transfer the patient to the ward), regardless of the duration of anesthesia, surgery, and preparations, which calls for the attention of the hospital’ s policymakers to design strategies for reducing these gaps.

Background: Infection with cytomegalovirus (CMV) is highly frequent during pregnancy in human beings, which mostly results in preterm birth. Objectives: The current study aimed at comparing serological and molecular methods to determine the frequency of CMVinfection in pregnant women admitted to hospitals in Golestan Province, Northern Iran. Methods: The study was conducted on 315 blood samples collected from pregnant women. After completion of the screening test questionnaire, CMV-IgG, CMV-IgM, and CMV-IgG avidity tests were performed to determine the seropositivity prevalence of CMV. Finally, after DNA extraction, the PCR technique was employed to detect the CMV genome in the samples. Results: Out of the studiedwomen, 81. 2% were positive for CMV-IgG and CMV-IgM, but only 8. 2% had positive results in the molecular detection of CMV, out of which 61. 9% had a history of abortion. In terms of the correlation between ethnicity and infection withCMV, 66. 7% of positive samples belonged to Fars ethnic group. The relationship between ethnicity and occupational status in terms of CMVinfection revealed that 85% of Fars and 29% of Turkmen housewives were positive forCMV. In terms of the relationship between ethnicity and age, 35% of pregnant women from Fars and 42% from Turkmen ethnic groups were over 30 years. Furthermore, the resultsshowedthat 71% of Farsand42% of Turkmenpregnantwomenwere infected withCMVduring the2ndtrimester of pregnancy. Amongall these variables, a significant relationship was observed only between the age of pregnantwomenand infection withCMV (P = 0. 045). Conclusions: The current study resultsshowedthat despite the increasing frequency of CMVinfection in pregnantwomen, seropositivity, and even higher titers of CMV-IgG have no predictive value for active CMV infection. Concerning the importance of rapid and definitive diagnosis of the disease before the emergence of manifestations, molecular techniques could be of great help as they are effective in the diagnosis of infection with smaller amounts of the pathogenic genome.

Background: Procrastination is prevalentamonguniversity students and it affects different aspects of their personal and academic life. Objectives: This study aimed to determine the prevalence of academic procrastination among medical students and its relationship with their academic achievement. Methods: This is a cross-sectional correlational study of 317 medical students at Shiraz University of Medical Sciences. To collect the data, we used Solomon and Rothblum academic procrastination questionnaire (1984). The questionnaire’ s validity and reliability were confirmed by experts. We used descriptive statistics and inferential statistics (Pearson correlation coefficient, Independent t-test, and one-way analysis of variance) to analyze the data by SPSS version 14. Results: The results showed that 29. 25% of the students had academic procrastination (nearly always or always). Moreover, 47. 9% of the students stated that academic procrastination at a moderate level had caused a lot of problems for them. There was a significant negative relationship between academic procrastination and academic achievement in medical students (P < 0. 01). Male students and those living in the dormitory had higher levels of procrastination than females and those living at home (P < 0. 01). Conclusions: The findings of the present study revealed that a considerable number of students had high levels of procrastination, leading to permanent problems and reduced academic achievement.