Medical Journal of Tabriz University of Medical Sciences
Year:2023 | Volume:44 | Issue:6|Papers Count:8

Background. Chronic hepatitis B is associated with different long-term outcomes in various regions. One of the critical predictors of clinical outcomes is the genotype of Hepatitis B virus (HBV). The current study investigated the frequency of worldwide and Iranian national HBV genotypes. Methods. Electronic search was performed through Medline (via Ovid), Embase, Web of Science, and Persian databases. Furthermore, the references of eligible articles were manually checked. The quantitative synthesis was conducted using the 2nd version of comprehensive Meta-analysis software (CMA. 2). Results. In total, 5817 records were retrieved, and after removing duplicate studies, 3701 were screened at the title/abstract level. A total of 350 eligible studies were identified in the end. D genotype had the highest frequency (43. 50%,95% CI: 39. 60 to 47. 50), and the H genotype had the lowest frequency (1. 2%,95% CI: 0. 6 to 2. 7) globally. In 29 studies conducted in Iran (97. 0%), genotype D was identified. Genotype E was the most prevalent in the African Region, followed by A in the American Region, B and C in the South-East Asian Region, D in the European Region, and C in the Western Pacific Region. Conclusion. The most prevalent genotype of HCV worldwide and in Iran is D. Furthermore, HBV genotype frequencies vary according to WHO regions. A prediction of progression could be made based on these results. Practical Implications. 1. According to the results of the meta-analyses, the D genotype had the highest frequency (43. 50%,95% CI: 39. 60 to 47. 50) and the genotype H had the lowest frequency (1. 2%,95% CI: 0. 6 to 2. 7) globally. 2. In 29 studies conducted in Iran (97. 0%), genotype D was identified. 3. Genotype E was the most prevalent in the African Region, followed by A in the American Region, B and C in the South-East Asian Region, D in the European Region, and C in the Western Pacific Region.

Background. The current study was conducted to investigate the balance performance of 7-12-year-old Iranian children based on functional reach tests. Methods. This cross-sectional descriptive study was conducted on 483 male and female students from the first to sixth grades. After measuring the height, weight, and length of the upper and lower limbs, the functional reach test was evaluated with the dominant limb, and the initial amount of the functional reach test was recorded by the examiner, and subsequently, the same protocol was used for the non-dominant limb, as well as two limbs. The final amount of functional reach was recorded, and the difference between the two was recorded in the test sheet. This process was repeated three times, and the average of these three attempts was recorded as the final score. The obtained data were analyzed by SPSS software version 23, and its descriptive and inferential statistics were extracted. Pearson's correlation coefficient was also calculated to measure the correlation of anthropometric characteristics of height, weight, and body length. Results. In this study, 483 elementary school students with an average age of 9. 53 years (minimum of 7 years and maximum of 12 years) and the average height of 138. 217, as well as an average body mass index of 17. 43 in the first to sixth grades, were evaluated. The normative scores for right, left, and two-handed functional reach tests were 20. 45±, 7. 87 cm, 22. 46±, 8. 09 cm, and 18. 60±, 7. 89 cm, respectively. The right and left lateral reach test scores were 14. 68±, 6. 01 cm and 14. 90±, 6. 01 cm, respectively. These scores significantly correlated with each other (P<0. 001) and anthropometric characteristics. Conclusion. The results of the current study revealed that on 483 students from the first to the sixth-grade evaluation of functional reach and lateral reach, tests is vital for clinical use and assessing the balance of Iranian children. Due to the lower balance functional level of Iranian children than their peers in some other countries, there is a need for planning to increase physical activity and sports in school programs and at the community level. Practical Implications. The data obtained from functional reach tests in this study can be used to measure the balance performance of Iranian school-age children.

Background. During pregnancy, it is crucial to minimize maternal anxiety to maintain the mental and physical health of both the mother and fetus, especially in high-risk pregnancies. This study aimed to investigate the effect of family support on decreasing depressive and anxiety symptoms in women hospitalized with high-risk pregnancies in their third trimester. Methods. This randomized controlled clinical trial was performed on 70 high-risk pregnant women in their third trimester. Samples were randomly divided into intervention and control groups. The intervention group walked for five weeks, five days a week, with their spouse or a family member for half an hour a day in the hospital. The control group received routine care. Participants completed the Spielberger Anxiety and Beck Depression Inventory once before and once a week during the intervention. Data were analyzed using SPSS. 21 software using ANCOVA, independent t-test, and Mann-Whitney U. Results. Results showed that the subjects were homogeneous in terms of mean overall score of anxiety before the intervention, and there is no significant difference between the intervention group 43. 2 (±, 2. 93) and the control group 42. 63 (±, 3. 3) (P=0. 53). Statistical tests showed that, three weeks after the intervention, the mean anxiety score in the study group decreased significantly, and there was a significant difference in the mean anxiety score of women in the intervention 41. 3(±, 3. 07) and control 42. 12(±, 3. 6) groups (P=0. 032). On the other hand, the level of state anxiety in the study group decreased (P=0. 03). The results showed that the depression score after the intervention in the study group decreased significantly (P=0. 001). Conclusion. Anxiety level and depression score decreased after the intervention. Practical Implications. The current study's results showed that talking to a spouse or relatives during pregnancy can increase women's peace of mind, and social support during hospitalization can reduce the anxiety and depression of the pregnant mother. Therefore, using such methods will be beneficial for the pregnant mother.

Background. Caring for chronic psychiatric patients places a complex burden on patients' caregivers. Paying attention to the needs of caregivers based on the cultural conditions of the country in which they live is of particular importance to improve the quality of care. Methods. In this study, 30 caregivers of patients with schizophrenia who were treated for at least two months by a regular psychiatrist joined the study over six months. They contacted the psychiatrist via SMS when their patient was in remission. In total, 1581 text messages were sent during 3 years. All messages were evaluated by three faculty members through the qualitative content analysis method. Results. The results of this study were categorized into training, reporting, and the expression of feelings themes and several codes. Conclusion. Addressing the caregivers needs to take steps forward to improve the effective two-way treatment relationship and prevent the gap between patients, caregivers, and the health care staff. Practical Implications. Paying attention to different dimensions of caregivers' concerns while caring for patients with chronic psychiatric disorders such as schizophrenia can have a significant impact on controlling the disease and improving the quality of life of patients and their family members.

Background. Many studies have been performed to prevent nausea and vomiting after surgery with different drugs alone or in combination, but no definite answer has been given yet. This study was performed to evaluate the effect of an intranasal dose of dexamethasone on the prevention of nausea and vomiting after hysterectomy. Methods. In this clinical trial study, 70 patients undergone hysterectomy were randomly distributed into two groups of 35, and immediately after intubation, in the intervention group 0. 5 ml of dexamethasone in each nostril (total 4mg) and in the control group 0. 5 ml of distilled water was dripped in each nasal passage. Patients in the two groups were evaluated and compared during recovery and at 2, 12, and 24 hours after entering the ward for the incidence and severity of postoperative nausea and vomiting and receiving anti-emetic medication. Results. The incidence of nausea and vomiting in recovery and ward was not significantly different between the two groups so that 3 patients in the distilled water group and 1 patient in the dexamethasone group experienced nausea in recovery (9. 7% and 3. 2%, respectively). The incidence of vomiting in recovery was 3 cases, all 3 cases (9. 7%) were distilled water group. The severity of nausea in recovery (P= 0. 55), in the second hour of admission (P= 0. 12), in the next 12 hours (P= 0. 19), and 24 hours later (P= 0. 46) was not significantly different between the two groups. Conclusion. Intranasal dexamethasone (4 mg) is associated with an insignificant reduction in the incidence of PONV in post-hysterectomy pain. Practical Implications. Intranasal dexamethasone administration is a safe and effective method and can be associated with reduced incidence of nausea and vomiting and pain after hysterectomy.

Background. Multiple sclerosis is a chronic disease of the central nervous system and most often occurs in people between the ages of 20 to 50 years. Orem's self-care model is one of the models that have had a special approach to human and health care issues. The aim of this study was to review the effect of self-care training based on the Orem model on the burden on caregivers of patients. . Methods. The present quasi-experimental study was performed on 76 main members of the family caring for patients with multiple sclerosis in Bandar Abbas with a pre-test, post-test design and a control group. The study units were randomly selected and divided into two groups of control and intervention. The intervention group was trained according to the Orem training program in patients with amnesia during 6-8 sessions of 40 minutes. In order to assess the burden on caregivers, a 22-item "Zarit" questionnaire was used and a questionnaire was completed before and after the intervention in both groups. The results were analyzed with SPSS software version 26. Results. The difference between the mean of burden before the intervention (44. 6 13 13) and after the intervention (33. 7 10 10) in the intervention group was significant (P<0. 05), which indicated the positive effect of training on decrease in the burden. The increase in the age of the intervention group was associated with an increase in the burden on the caregivers (P<0. 05). There was a significant relationship between the burden on caregivers and the amount of income in the intervention group (P<0. 05). Conclusion. Educating the caregiver of these patients can play an important role in reducing the burden on the caregiver during the long period of care. Applying Orem self-care model enables people to play a more active role in their care and treatment, thereby improving self-care, reducing fear and dependence, increasing motivation and self-confidence, and a sense of independence. Practical Implications. Application of research findings in nursing practice, nursing service management and nursing training.

Background. Gestational diabetes is a metabolic disorder that occurs in more than 8% of all pregnancies. Hence, this study aims to investigate the relationship between gestational diabetes and the clinical outcomes of mothers and their infants in Ilam city. Methods. This study was conducted as a retrospective cohort. All diabetic pregnant mothers referring to obstetrics, gynecology clinics, and comprehensive health service centers were randomly selected. The clinical outcomes were analyzed using SPSS20. Results. In total, 332 pregnant women, including 166 diabetics and 166 non-diabetics with a mean age of 32. 3 years, participated. Of the diabetic mothers, 31 people had overt diabetes before pregnancy. The results of this study revealed that the relative risk of neonatal jaundice in diabetic mothers was about seven times higher than that of non-diabetic mothers (P=0. 001, RR=7). The relative risk of postpartum hemorrhage was about six times (P=0. 001, RR=5. 9), blood hypertension was two times (P=0. 013, RR=2. 4) and the need for cesarean delivery was two times (P=0. 009, RR=2. 6), preeclampsia was 1. 4 times (P= 0. 011, RR=1. 4) neonatal infection was twice (P=0. 002, RR=2. 1), respiratory distress was one-third (P=0. 012, RR=1. 3), compared to non-diabetic mothers. Furthermore, diabetes and other clinical outcomes studied in mothers and infants were not significant. Conclusion. The results showed that pregnant mothers with diabetes are more likely to suffer from postpartum hemorrhage and blood pressure as well as toxemia during pregnancy. In addition, their neonates have a higher risk of neonatal icterus. Health care providers and pregnant mothers should consider these risks in prenatal care. Practical Implications. Since diabetes is a dangerous complication during pregnancy and can have detrimental effects on the mother and fetus, therefore, it is crucial to study the factors affecting its occurrence so that by recognizing the risk factors and consequences, an effective step can be taken to control this disorder.

Background. One of the effective genes in the pathogenesis of the celiac disease is the Ets1 gene, which encodes the transcription factor Ets1 and is highly conserved during evolution. The Ets1 gene inhibits the differentiation of T helper 17 (Th17) cells and the production of interleukin-17A (IL-17A) by these cells and decreased expression of the Ets1 gene can lead to autoimmune disorders. The aim of this study is to evaluate the changes in Ets1 gene expression in the blood samples of patients with celiac disease compared with the control group. Methods. Blood samples were collected from twenty patients with celiac disease under a gluten-free diet and also from twenty healthy people. After RNA extraction and cDNA synthesis, a specific primer pair of the Ets1 gene was designed and its expression changes were examined by real-time PCR. Results. The expression of the Ets1 gene in patients with celiac disease on a gluten-free diet did not show a significant difference compared with healthy individuals (P-value= 0. 54). . Conclusion. Failure to observe a significant difference between the patient and the control group can be due to the effect of the duration of the gluten-free diet and also the inadvertent entry of gluten from hidden sources into the diet of patients under treatment. Practical Implications. According to the results observed in this study, it is possible that if the gluten-free diet is followed more strictly and over a longer period of time by patients with celiac disease, the expression of the Ets1 gene will proceed as we expected. This issue needs to be evaluated in future studies with a larger community.