Iranian Red Crescent Medical Journal
Year:2021 | Volume:23 | Issue:1|Papers Count:10

Background: Testicular self-examination (TSE) is one of the most effective ways for the early detection of testicular cancer. The Medical Association and American Urological Association recommend raising the awareness of TSE and educating the public in this regard for early diagnosis. Objectives: The present study aimed to evaluate the effect of the training given to nursing students for testicular cancer and TSE on the knowledge levels of the students. Methods: The current single-group pretest-posttest quasi-experimental study was carried out on the students continuing their education and training in the Faculty of Health Sciences of a university in Turkey within 2018 and 2019 (n=83). No sample selection was made for the determination of the study subjects (n=56). The research data were collected using a questionnaire. The data were evaluated by appropriate statistical methods, and a p-value of less than 0. 05 was considered statistically significant. Results: The students participating in the study were within the age range of 20-26 years. In addition, 51. 8% of the study subjects were male. Moreover, 58. 9% of the students in the study stated that they did not receive any training for testicular cancer and TSE. Furthermore, 80. 4% of the male students did not perform TSE 43. 6% of whom reported that they did not know how to do it. However, the mean test scores of the participants for testicular cancer and TSE were reported as 12. 84 and 15. 73 prior to and after the training, respectively, with a statistically significant difference (P<0. 01). Nevertheless, the rate of TSE among the students was previously reported as 19. 6% and increased to 100% after the training. Conclusion: In this study, it was concluded that the participants, even with an ordinary awareness-raising campaign, could be informed about testicular cancer and TSE. It is recommended to raise the awareness of society in this regard through well-planned educational activities.

Background: Patients with mechanical heart valve replacement surgery (MHVRS) should be followed up in terms of prosthetic valverelated and open heart surgery complications. Objectives: This study aimed to determine the anticoagulant complications in long term in patients with MHVRS. Methods: This retrospective and descriptive study was conducted in a university hospital, Izmir, Turkey. The data were collected from July to December 2019. In total, 73 patients referring for regular check-ups to the hospital with intervals not exceeded more than 90 days, and those who had international normalized ratio (INR) measurements for January-April-July-October 2018 were included in this study. Results: The mean age of the patients was obtained at 58. 98± 12. 89 years, and 53. 4% (n=39) of the cases were male. Moreover, the mean follow-up period was estimated at 65. 98± 28. 47 months. According to the results, complications developed in 60 patients (82. 2%). The first hospitalized unit was the emergency department. The factors affecting the development of complications after MHVRS were evaluated, and a difference was found regarding gender (X 2 =6. 18, P=0. 013), comorbidities (X 2 =25. 58, P=0. 018), and monthly referral for regular check-ups to the hospital (X 2 =5. 20, P=0. 023). There was no relationship between the INR levels and the development of complications. Furthermore, the results of evaluating the factors affecting the number of hospitalizations after MHVRS revealed that monthly referral to hospital for check-ups (t=3. 18, P=0. 002) and history of previous valve surgery (Z=201. 00, P=0. 03) affected the number of hospitalizations. Conclusion: It was observed that patients frequently refer to the emergency department and struggled with various complications. Moreover, it was found that the patients had frequent bleeding and refer to the emergency service repeatedly. Accordingly, there is a need for interventional studies to reduce postoperative complications and provide the therapeutic INR level.

Background: Infective endocarditis (IE) is a relatively rare disease but with significant rates of morbidity and mortality. Vancomycin and teicoplanin are bacteriostatic glycopeptide antibiotics used for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. Objectives: The current study aimed to compare the efficacy and adverse effects of vancomycin and teicoplanin in the treatment of patients with MRSA-IE. Methods: This parallel, randomized, and controlled trial study was carried out on the efficacy and safety of teicoplanin versus vancomycin in the treatment of MRSA endocarditis within August 2012 and April 2017. The present study recruited adult patients with a definite or possible diagnosis of IE based on the Modified Duke Criteria. Vancomycin was intravenously administered at a dose of 30 mg/kg/day in two doses. Teicoplanin was administered at a loading dose of 6-12 mg/kg every 12 h in four doses and then continued once a day. Results: Out of 86 patients with suspected IE, 66 patients were randomly assigned to the vancomycin (n=33) and teicoplanin (n=33) groups. The mean age values of the study subjects were 41± 11. 8 and 39± 13. 1 years in the vancomycin and teicoplanin groups, respectively. In addition, 27 patients (81. 8%) in the vancomycin group met the criteria for microbiological cure, compared to 25 subjects (89. 3%) in the teicoplanin group. In this regard, the observed difference was not statistically significant (P=0. 41). Overall, the patients in the vancomycin group experienced more adverse events in comparison to those of the teicoplanin group (P=0. 04). The rate of acute kidney injury over time, especially in the first week of therapy, was higher in the vancomycin group than that reported for the teicoplanin group (P=0. 05). Conclusion: It was concluded that the administration of vancomycin or teicoplanin does not significantly change the outcome of patients undergoing empirical treatment for MRSA-IE.

Background: Diabetic neuropathy is a complication of diabetes causing damage to the nerves. Objectives: Considering the neuroprotective anti-inflammatory antioxidant characteristics of statins, the current study aimed at determining the effects of atorvastatin on diabetic neuropathy through assessing the involvement of the N-methyl-D-aspartic acid (NMDA) receptor, factors of oxidative stress, and inflammatory cytokines in rats with diabetes. Methods: Male rats were randomly assigned into six groups of saline-and atorvastatin-treated controls, streptozotocin-induced diabetic animals treated with vehicle, diabetic animals treated with morphine (5 mg/kg), and rats treated with atorvastatin (10 mg/kg/day for 10 weeks) alone or in combination with NMDA receptor agonist. The hot plate and formalin tests were carried out on the rats. Moreover, malondialdehyde level, catalase and superoxide dismutase activities, and levels of interleukin 1 beta (IL-1β ), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α ) in the dorsal root ganglia (DRG) of the animals were measured. Finally, the expression of the NMDA receptor in DRG was investigated in the current study. Results: According to the findings, diabetes resulted in analgesia in all the tests, and pretreatment with atorvastatin exacerbated diabetes-induced analgesic effects in the hot plate test and early phase of the formalin test (P≤ 0. 01 and P≤ 0. 05 in comparison to those reported for the diabetic vehicle-treated group, respectively). The injection of NMDA could reverse the atorvastatin-induced analgesia in the hot plate test (P≤ 0. 05). Diabetes caused an increase in the levels of IL-1β , IL-6, and TNF-α in DRG in comparison to those reported for the control group (P≤ 0. 05). Furthermore, the pretreatment of rats using atorvastatin could significantly reverse the increase in TNF-α level (P≤ 0. 05). Conclusion: Atorvastatin showed analgesic properties, which might be acting through NMDA receptors and reduction of inflammatory cytokines.

Background: No studies have investigated the results of ossicular chain reconstruction using mastoid cortical bone ossiculoplasty (MCBO) and titanium total ossicular replacement prosthesis (TiTORP) in Austin-Kartush Group D cholesteatoma patients with severe middle ear risk index (MERI). Objectives: The present study aimed to compare the hearing results of MCBO and TiTORP in Austin-Kartush Group D cholesteatoma patients with severe MERI who underwent ossicular chain reconstruction during primary surgery. Methods: The hearing results of 28 adult cholesteatoma patients who underwent tympanomastoidectomy and ossicular chain reconstruction with MCBO (n=15) or TiTORP (n=13) were analyzed in the current study. The postoperative hearing was tested 12 months after the surgery. The hearing-related functional success rate was determined in accordance with the American Academy of Otolaryngology-Head and Neck Surgery Foundation criteria. Results: When all patients were taken into account, the mean preoperative and postoperative air-bone gaps (ABG) were reported as 32. 2 decibel (dB) and 17. 6 dB, respectively, (P<0. 001). In 57. 1% of the patients, the mean postoperative ABG was ≤ 20 dB. The mean preoperative and postoperative ABGs of the MCBO group were obtained at 29. 9 and 16. 2 dB, while these values were reported as 35. 0 and 19. 3 dB in the TiTORP group (P=0. 001 and P<0. 001, respectively). Hearing-related functional success rates were calculated at 60. 0% and 53. 8% in MCBO and TiTORP groups, respectively, without any significant difference between the groups (P= 0. 743). Conclusion: As evidenced by the obtained results, MCBO and TiTORP can provide similar and successful hearing results in Austin-Kartush Group D patients with cholesteatoma; nonetheless, MCBO is a more cost-effective option in this regard.

Background: Iran is a disaster-prone country, which is subjected to various hazards, such as floods, earthquakes, fire, and trafficaccidents. Objectives: This study aimed to determine the priority and risk of various hazards threatening the public in different provinces ofIran in 2019. Methods: This cross-sectional study was carried out from March to September 2019 using data related to 31 provinces of Iran. The assessment was conducted using hazard assessment tools presented by the Iranian Ministry of Health. A total of 70 natural, man-madeand complex hazards were analyzed in this study. The data were collected by holding sessions and conducting individual and groupinterviews with the officials of provincial Red Crescent Societies as well as reviewing the databases of the Red Crescent Society and theDisaster Management Organization. The participants consisted of operation analysis experts. Results: In terms of the frequency of occurrence, earthquake (12: 38. 7%), traffic accidents (7: 22. 6%), and flood (6: 19. 4%) obtained thehighest priority in different provinces in descending order. Furthermore, regarding the total scores of hazards in all provinces, flood(78. 6), earthquake (75. 3), traffic accidents (71. 9), drought (60. 1), and building collapse (58. 1) had the highest priority in descendingorder. Conclusion: Given the extreme vulnerability of Iran to various disasters, authorities should develop strategic plans to reduce the risksassociated with high-priority disasters. In addition, crisis and disaster management policymakers must develop separate detailed disasterresponse plans for each hazard in order to increase the preparedness at organizational and community levels. Public training can alsoraise awareness among the public and help people cope better with various hazards.

Background: The health transformation plan was implemented in Iran with eight service packages in 2014. However, it has faced various problems and barriers since no pilot programs were launched. Objectives: The present study aimed to investigate the challenges of the out of pocket payment in the health system of Iran. Methods: The required data for this applied qualitative study were collected through semi-structured interviews with 30 policymakers and planners of the health system of Iran in 2020. It must be noted that the participants were selected using th e purposeful sampling method. The obtained data were entered into MAXQDA software (version 10) and analyzed through the content analysis approach. Results: The data analysis resulted in five themes: 1) weakness in the structure of health expenditure management, 2) weakness in the structure of policy and plan development, 3) low effectiveness and efficiency of the health system, 4) lack of opportunities to identify the challenges facing the Ministry of Health, 5) consequences of the program. They were categorized into 12 concepts and 79 sub-themes, and the challenges were extracted from them. Conclusion: By identification of the opportunities and challenges of the out-of-pocket payment, the results of this study can provide a suitable framework for observation and evaluation of the payment reduction program in the health system of Iran. Moreover, the findings offer good suggestions for policymakers and planners in different stages of the program.

Background: Organophosphorus pesticides (OPPs) have a wide application throughout the world and exert adverse effects on human health. Moreover, these chemical compounds are responsible for thousands of deaths per year worldwide. Kinetic and mathematical models could be used to optimize the application of pesticides on fruits and vegetables and monitor their residues. Objectives: The present study aimed to model the dissipation of diazinon and chlorpyrifos in different conditions, such as household conditions (e. g., storage at room and refrigerator temperatures, as well as cooking) and field condition for greenhouse tomatoes. Methods: A multi-residue analysis of diazinon, chlorpyrifos, and their oxon derivatives was established by gas chromatography-tandem mass spectrometry. The limit of quantification (LOQ), recovery, precision, linearity, and the limit of detection (LOD) were evaluated to ensure that the method was able to effectively determine the studied pesticides in the tomato samples. The linear and nonlinear kinetic models were presented for chlorpyrifos and diazinon residues in tomato using zero-order, first-order, and second-order equations. Results: Based on the best fitting models for diazinon in the case of laboratory treatment at the refrigerator, room, and boiling temperatures, the half-lives were calculated as 18. 79 days, 11. 41 days, and 45. 39 min, respectively. The half-life of diazinon was lower than that of chlorpyrifos in both field and laboratory treatments. Conclusion: Modeling the removal of the pesticides indicated that the nonlinear first-and second-order models were the best fitted models for the dissipation of both pesticides in field and post-harvest conditions.

Background: The global incidence rate of frailty syndrome among older adults aged 60 years and over has been estimated to be 43. 4 cases per 1000 persons/years. Objectives: This study aimed to determine the prevalence of pre-frailty and frailty syndromes in community-dwelling older adults and assess the correlated sociodemographic factors. Methods: All elderly people recruited in the second phase of the Amirkola Health and Ageing Cohort Project, including 2135 older adults aged ≥ 60 years living in Amirkola, North of Iran, were invited to participate in this study using the census method. The standard "FRAIL" scale was used to assess the frailty syndrome. The individuals who obtained a score of three or more and one or two were classified as frail and pre-frail cases, respectively. Results: Totally, 2010 older adults with a mean age of 70. 41± 7. 65 years were included in this study. Out of them, 672 (33. 4%; 95% CI: 31. 37-35. 50%) cases met the criteria for frailty syndrome, and 874 (43. 5%) individuals were regarded as pre-frail. The prevalence of frailty was significantly higher in females (50. 8%; 95% CI: 47. 58-54. 05%), compared to males (18. 7%; 95% CI: 16. 41-21. 05%). Multivariate logistic regression analysis revealed that age ≥ 85 (OR=7. 27; 95% CI: 4. 12-24. 46) and female gender (OR=2. 67; 95% CI: 2. 309. 95) had the highest effect on frailty in older adults. Conclusion: One out of every three elderly people (aged ≥ 60) in Amirkola, North of Iran, had frailty syndrome. Older age, female gender, lower education level, low level of satisfaction with income, marital status (single), living alone, and unemployment increased the risk of frailty in older adults.

Background: Colorectal cancer (CRC) has already been considered the fourth leading cause of mortality worldwide as the genes involved in apoptotic pathways and alterations of reversible epigenetic have an important role in the progression of CRC. Objectives: The current study aimed to evaluate the effect of sodium butyrate as a histone deacetylase inhibitor on the alterations of the gene expression of FAS, Fas ligand (FASL), Death receptor 4 (DR4), Death receptor 5 (DR5), and tumor necrosis factor-related apoptosisinducing ligand (TRAIL) in HCT-116 CRC cell line. Methods: HCT-116 cell line was cultured in Dulbeccoʼ s Modified Eagle Medium. The cytotoxicity effect of sodium butyrate on HCT-116 was evaluated using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay for three incubation times (i. e., 24, 48, and 72 h). The half-maximal inhibitory concentration (IC50) values were determined. The optimum concentration was within the range of 6. 25200 mM. The cellular ribonucleic acid was extracted, and complementary deoxyribonucleic acid was synthesized. Finally, the alterations of the gene expression of FAS, FASL, DR4, DR5, and TRAIL were assessed by real-time polymerase chain reaction (PCR). Results: The IC50 levels for three incubation times were 50, 12. 5, and 6. 25 mM, respectively. The obtained results of real-time PCR demonstrated a significant increase in the gene expression of TRAIL, DR5, and FAS in comparison to that of the untreated cells as the control group at the three incubation times. The DR4 gene expression significantly increased in comparison to that reported for the control group at 48 and 72 h of incubation. In addition, FASL gene expression remarkably decreased at the three incubation times. Conclusion: Sodium butyrate could show cytotoxicity effect on CRC cell lines through the induction of death receptors in the extrinsic apoptotic pathway. The obtained results of this study revealed that the optimum effect of sodium butyrate is an incubation timedependent and concentration-dependent manner.