Hamadan Province Research Articles

The clinical manifestations and outcomes in neonates infected with COVID-19 in the West of Iran

Introduction: So far, no study has been conducted in Iran on the effect of COVID-19 on neonates. Therefore, the present cross-sectional study has been evaluated to determine the clinical manifestations and outcomes in neonates infected with COVID-19 in the west of Iran. Materials and Methods: The present cross-sectional study was conducted among neonates infected with COVID-19 in six provinces of Hamadan, Kermanshah, Kurdistan, Ilam, Zanjan and Lorestan, located in the west of Iran, from 1 March to 1 July 2020. In these neonates, the polymerase chain reaction test was positive. The data were collected by a checklist and were analysed using SPSS Statistics Software. Result: During the study period, 16 neonates infected with COVID-19 were identified including Kurdistan Province with five cases, Hamadan Province four cases, Kermanshah with three cases, and Lorestan and Zanjan provinces with two cases. Neonate gender of them had equal distribution. Two (15.38%) of them needed CPR after delivery. The delivery method for 9 (56.25%) was vaginal, and one of them died during the study period. The medical care used for these neonates was as follows: 87.5% were hospitalized in the intensive care unit and antibiotics were used for 68.75%. 12.5% underwent COVID-19-specific treatment, and for 25%, a ventilator was used. The laboratory findings in neonates infected with COVID-19 showed that in 18.75%, blood urea nitrogen has increased. 46.15% of neonates reported lymphocytopenia. The blood haematocrit and haemoglobin decreased by 31.35% and 56.25%, respectively. Conclusion: The coronavirus disease 2019 has occurred among neonates, but they seemed to have a milder disease course and better prognosis than adults. Findings showed that there is a possibility of vertical intrauterine transmission from pregnant mothers to newborns.

Esmail Hemati Azandaryani, Hossein Naseri Someeh, Mehrdad Malekzadeh, Hossein Torabzadeh, Michael Roaf. “Haji Khan: A Median Temple in Hamadan Province, Iran”

Esmail Hemati Azandaryani, Hossein Naseri Someeh, Mehrdad Malekzadeh, Hossein Torabzadeh, Michael Roaf. “Haji Khan: A Median Temple in Hamadan Province, Iran”

Presenting a Sustainable Production Model of Vegetable Products (Potato Case Study)

One of the most important key issues in the world economy is the issue of sustainable production management and waste control of agricultural products. In this study, considering the economic, social and environmental importance of potato product waste, relying on the concepts and opinions of farmers, experts and experts in this field, an explanation of potato waste reduction management and its sustainable production model has been tried in Bahar city of Hamadan province should be presented. The methodology of this research is qualitative, and in the discussion of the method, the basic theory method is used. Data was collected using semi-structured interviews, photos, videos, and documents, and the validity of the research was confirmed by agricultural experts. The highest amount of potato production waste is related to the harvesting and post-harvest stages. Also, the effective factors in the occurrence of potato waste in Bahar city can be listed in six major factors including economic, biological and natural, educational and skill, social, political and technical issues. The basic problems and challenges of potato waste in Bahar include three main categories that affect the economic, social and environmental sectors. The results showed that potato waste reduction management training is the most important common priority in all stages of sustainable potato production, because it leads to diversification of activities, reduction of agricultural risks, creation of new demand, generation of income and growth of industries. transformation and added value and increase of agricultural development opportunities. Two simple and logical models as the main framework for solving the problem, first for the farmers and then for the managers of the organizations, policy makers and planners in different stages of actions before, during cultivation, before harvesting, after harvesting and marketing.

Investigation of factors affecting rural drinking water consumption using intelligent hybrid models

Identifying the factors affecting drinking water consumption is essential to the rational management of water resources and effective environment protection. In this study, the effects of the factors on rural drinking water demand were studied using the adaptive neuro-fuzzy inference system (ANFIS) and hybrid models, such as the ANFIS–genetic algorithm (GA), ANFIS–particle swarm optimization (PSO), and support vector machine (SVM)–simulated annealing (SA). The rural areas of Hamadan Province in Iran were selected for the case study. Five drinking water consumption factors were selected for the assessment according to the literature, data availability, and the characteristics of the study area (such as precipitation, relative humidity, temperature, the number of subscribers, and water price). The results showed that the standard errors of ANFIS, ANFIS–GA, ANFIS–PSO, and SVM–SA were 0.669, 0.619, 0.705, and 0.578, respectively. Therefore, the hybrid model SVM–SA outperformed other models. The sensitivity analysis showed that of the parameters affecting drinking water consumption, the number of subscribers significantly affected the water consumption rate, while the average temperature was the least significant factor. Water price was a factor that could be easily controlled, but it was always one of the least effective parameters due to the low water fee.

Comparing the Perceptions of Operating Room Technicians and Nurses Regarding Futile Care: A Cross-Sectional Study

Background. The growing trend of useless care might lead to negative consequences for patients, staff, and the organization. The employees who care for patients in their last stages of life for a long time might not tend to pay enough attention to the patients' pain. As a result, the quality of care services might be negatively affected. This study aimed to compare the perceptions of operating room technicians and nurses regarding futile care in the selected hospitals in Hamadan province, Iran from October to December. Methods. Using available sampling method, the present descriptive cross-sectional study was performed on 200 health care workers (114 nurses and 86 operating room technicians). Data collection tools included a two-part demographic information questionnaire and the perception of futile care designed based on the Corley’s Moral Distress Questionnaire. The questionnaires were distributed in person and electronically. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 26. We used frequency, mean, and standard deviation for descriptive statistics and independent t-test and analysis of variance (ANOVA) for analytical statistics. Results. The mean score of nurses' perceptions regarding futile care was significantly higher (16.53±6.18) than that of operating room technicians. While the nurses' perceptions of futile care in both dimensions of intensity (66.71±13.72) and repetition (60.03 13 13.72) were at a high level, the perceptions operating room technicians in both dimensions of intensity (50.19±18.90) and repetition (52.43±18.8) were at an average level. Conclusion. Nurses seem to have a relatively better understanding of futile care compared to operating room technicians. This is probably due to frequent contacts with patients overlooking death, as well as direct contacts with their family and relatives. In this regard, it is essential to develop guidelines in Iran delimiting the standards for the staff’s provision of futile care.

The Effect of Provincial Policies on the COVID-19 Mortality Rate: Risk Analysis Study in Hamadan Province

The Effect of Provincial Policies on the COVID-19 Mortality Rate: Risk Analysis Study in Hamadan Province

COVID-19 Preventive Behaviors and Related Beliefs Among Diabetics: The Use of Protection Motivation Theory

Background: Recent data from coronavirus disease 2019 (COVID-19) confirm that diabetes, along with advanced age, is an important risk factor for adverse prognosis. Therefore, the present study aimed to determine the status of COVID-19 prevention behaviors and related beliefs among diabetic patients in Hamadan province using protection motivation theory (PMT). Methods: This cross-sectional descriptive study was conducted from April to September 2020. The research population included all diabetics, of whom 355 patients, who referred to an adult endocrinologist in Hamadan, were selected using the convenience sampling method. The data collection tool was a researcher-made questionnaire with demographic variables and PMT constructs. Data were analyzed by SPSS 22 using descriptive statistics, correlation, and logistic regression. Results: According to the result, the PMT construct explained 15% of the variance in the frequency of the intention to perform preventive behaviors. Perceived sensitivity (β=-0.128), perceived response efficiency (β=0.140), and perceived response cost (β=0.386) were the best significant predictors of behavior (P<0.05). There was a significant relationship between gender (P<0.001), marital status (P<0.001), and level of education (P=0.040) in observing preventive behaviors. Conclusion: It is necessary to enhance the levels of awareness and self-efficacy of diabetic patients to reduce fear in this at-risk group. Further, it is appropriate to use PMT to promote preventive behaviors.

Seroepidemiological Survey of Human Hydatidosis in Patients Referred to the Health Service Centers of Hamadan in 2019

Background and aims: According to evidence, a hydatid cyst is one of the most important health issues in most parts of the world. This study aimed to investigate the frequency of human hydatidosis in patients referred to health service centers in Hamadan province in 2019 using the enzyme-linked immunosorbent assay (ELISA)method. Methods: In this cross-sectional study, blood samples were collected from 300 patients referred to medical diagnostic laboratories in Hamadan and evaluated for the presence of immunoglobulin G antibodies against hydatid cysts by ELISA. The data were analyzed using SPSS software. Results: Out of 300 samples, 16 (5.3%) cases were positive, including 10 (5.6%) cases of the residents of urban areas and 6 (4.9 %) cases from those residing in rural areas. Moreover, of all the positive cases, 8 (50%) cases were males and 8 (50%) cases were females. The highest percentage of infection (45.5%) was observed in the age group 20-30 years. Conclusion: The findings indicated that human hydatidosis is a public health problem in this province. The implementation of control and prevention programs, as well as increasing the knowledge of people, can help in controlling and reducing infection in humans and livestock.

Epidemiologic and Clinical Characteristics of Guillain-Barré Syndrome in Patients Referred to Sina Hospital in Hamadan in 2018

Background and aims: Guillain-Barré syndrome (GBS) has several types, some of which damage myelin and some others cause axonal damage. Detecting the type of GBS is important in determining the type of treatment and its prognosis. This study was conducted to investigate the epidemiological characteristics of GBS and its variants in patients referred to Sina hospital in Hamadan, Iran, in 2018. Methods: In this cross-sectional study, 51 patients who were admitted to Sina hospital and diagnosed with GBS in 2018 were examined. Demographic data, GBS type, disease outcomes, and pre-clinical and clinical findings of patients were collected. Data were then analyzed using the Stata software version 12, and P value<0.05 was considered statistically significant. Results: Of the 51 investigated patients, 34 (66.66%) were male. The most common variant type was acute inflammatory demyelinating polyneuropathy (AIDP) with 27.45% of cases followed by acute motor axonal neuropathy (AMAN) with 19.61% of cases. Further, the highest average hospitalization days (11.1±11.7 days) were for chronic inflammatory demyelinating polyneuropathy (CIDP) patients, while the lowest (6.85±1.91 days) was for AIDP patients (P<0.001). All CIDP cases occurred in spring, and 71.43% of AIDP cases occurred in summer. Moreover, all 7 cases with acute motor and sensory axonal neuropathy (AMSAN) syndrome and the only case with the miller-fisher syndrome (MFS) occurred in fall (P<0.001). Conclusion: According to the results of this study, most variants of GBS in Hamadan province were AIDP in demyelinating form and AMAN variant in the axonal deterioration form. However, studies with a larger sample size are recommended in the west of Iran to better understand the epidemiology and to ensure common types of GBS.

Foot Care Performance and Foot Self-Care Behaviors in Iranian Patients with Type 2 Diabetes: A Cross-Sectional Study

Objective: A diabetic foot ulcer is one of the preventable complications of diabetes that can lead to amputation, morbidity, and mortality and increase treatment costs. This study aimed to investigate the relationship between self-care behaviors, demographic-clinical variables and, foot care performance in patients with diabetes. Materials and methods: This descriptive-analytical study was performed on 191 patients with type 2 diabetes in Asadabad (Hamadan province) in 2021. The demographic-clinical information form, the diabetic foot care performance scale, and the diabetic foot self-care behavior scale were used to collect data. The data were analyzed using descriptive and inferential statistics (multiple linear regression). Data analysis was performed using R software version 4.1.0. Results: The mean age of the subjects was 50.58 ± 11.87 years, and the duration of diabetes was 8.55 ± 9.07 years. There was a significant relationship between foot self-care behavior and age (p = 0.027), primary and secondary education compared to university education (p=0.042), insulin use compared to use of oral agents and insulin (p = 0.014), the logarithm of the duration of diabetes (p = 0.0001), foot care performance (p = 0.010). Conclusions: The status of self-care behaviors in patients with diabetes is unfavorable, and it is necessary to provide the necessary training to these patients to improve self-care and foot care.

Examining the Causes of Maternal Mortality in Pregnant Women Since the Beginning of the COVID-19 Pandemic in Hamadan Province, Western Iran: A Research Article

Background: Maternal mortality prevention and delivering optimal outcomes for both mother and fetus is the utmost concern of health systems in any country. Objective: This study aimed to examine maternal mortality in pregnant women since the beginning of the COVID-19 pandemic in Hamadan province, western Iran. Examining the causes of maternal mortality can be valuable in identifying mortality factors in line with prospective strategic plans. Methods: This case series study introduces the data of seven deceased pregnant women, the deaths of whom occurred since the beginning of the COVID-19 pandemic (December 2019 – March 2021) in the hospitals of cities within Hamadan province. All data were reported at the time of death or at least 14 days after hospital admission. In this study, epidemiological features and pregnancy history, background diseases, clinical symptoms, initial vital signs, medications in use, clinical laboratory values, delivery type, and neonatal outcome were assessed, respectively. Results: In the seven maternal mortality cases reported in this study, three women succumbed to pregnancy- related causes (two cases of preeclampsia and one case of antiphospholipid syndrome), and four women to severe coronavirus disease. All deceased mothers had been admitted to the intensive care unit as a result of severe illness. Four cases concerned a background condition as well, which included thromboembolic disorders, epilepsy, and lupus. In mortality cases, two women displayed a BMI score over 30. One maternal death had occurred 42 days postpartum, while five deaths had occurred prior to 37 weeks of gestation, and one past 37 weeks of gestation. Conclusion: This report provided valuable information on maternal mortality factors. Maternal mortality necessitates a careful acquisition of monitoring data, but in the prevailing pandemic circumstances, caution necessitates raising awareness of the maternal mortality potential in women with COVID-19 diagnosis in the second or third trimester. Pregnancy care programs must focus on recognizing high-risk groups of mothers-to-be with background conditions and risk factors for pregnancy, given that early diagnosis and prompt referral are invaluable in the immediate treatment and relief of pregnant mothers-to-be.

Determination of Oseltamivir Resistance Level by an H275Y Genotyping Assay among Influenza A (H1N1) Viruses in Hamadan Province, Iran

Determination of Oseltamivir Resistance Level by an H275Y Genotyping Assay among Influenza A (H1N1) Viruses in Hamadan Province, Iran

Use of LCA indicators to assess Iranian sugar production systems: case study — Hamadan Province

Use of LCA indicators to assess Iranian sugar production systems: case study — Hamadan Province

Elevated Levels of Anti-SARS-Cov2 IgG Antibody in Health Care Workers in Hospitals From Hamadan Province, Iran: A Prospective Study

Aim: Seroprevalence among health care workers (HCWs) has been estimated in different studies in various regions and countries. This study aimed to screen the immunoglobulin M (IgM) and IgG seroprevalences and to assess the durability of IgG seropositivity, as well as the incidence of subsequent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a group of Iranian HCWs. Methods: This voluntary serological screening was prospectively performed on 800 HCWs (492 females and 308 males) in Hamadan between November 2020 and February 2021. Anti-SARS-CoV-2 IgG and IgM antibodies were assessed by the enzyme-linked immunosorbent assay method at two-time intervals. Results: Overall, 243 out of 800 (30.38%) and 66 (8.25%) cases were IgG and IgM seropositive at their first antibody assessment, respectively. The male staff had a higher seroprevalence than females (31.49% vs. 29.67% for IgG, P=0.59 and 10.39% vs. 6.91% for IgM, P=0.08). Higher prevalences for both antibodies were found in the age group of 30-39.9 years (P=0.12 and P=0.05, respectively). In the second antibody screening, 81 (56.6%) cases were IgG seropositive. The mean titer of the first IgG antibody assessment in seropositive cases was lower than that of the second titer (2.95±2.07 vs. 5.08±4.01 cut-off index (COI) , P=1.4×10-5 ). Moreover, the comparison of the first and second IgG titers among 81 seropositive cases demonstrated a significantly increased level of anti-SARS-CoV-2 antibody (5.08±4.01 vs. 3.49±2.41 COI, P=0.002). Conclusions: Our findings revealed that the mean level of the anti-SARS-CoV-2 IgG antibody was significantly increased in the seropositive individuals after 2 months of follow-up.

Investigating factors associated with the number of rehospitalizations among patients with schizophrenia disorder using penalized count regression models

BackgroundSchizophrenia is a chronic, severe, and debilitating mental disorder always considered one of the recurrent psychiatric diseases. This study aimed to use penalized count regression models to determine factors associated with the number of rehospitalizations of schizophrenia disorder.MethodsThis retrospective cohort study was performed on 413 schizophrenic patients who had been referred to the Sina (Farshchian) Educational and Medical Center in Hamadan, Iran, between March 2011 and March 2019. The penalized count regression models were fitted using R.3.5.2.ResultsAbout 73% of the patients were male. The mean (SD) of age and the number of rehospitalizations were 36.16 (11.18) years and 1.21 (2.18), respectively. According to the results, longer duration of illness (P < 0.001), having a positive family history of psychiatric illness (P = 0.017), having at least three children (P = 0.013), unemployment, disability, and retirement (P = 0.025), residence in other Hamadan province townships (P = 0.003) and having a history of arrest/prison (P = 0.022) were significantly associated with an increase in the number of rehospitalizations.ConclusionTo reduce the number of rehospitalizations among schizophrenic patients, it is recommended to provide special medical services for patients who do not have access to specialized medical centers and to create the necessary infrastructure for the employment of patients.

A comparative of modeling techniques and life cycle assessment for prediction of output energy, economic profit, and global warming potential for wheat farms

Uncertainty about the energy use efficiency, lack of knowledge about economic outcomes, and its environmental consequences have always take risks in changing cultivation patterns and moving towards the optimal path. Accordingly, this study provided mathematical, artificial neural networks (ANNs), adaptive neuro-fuzzy inference system (ANFIS) methods to predict output energy, economic profit, and global warming potential (GWP) of wheat production. For this purpose, 75 wheat farms located in the central area of Hamadan province, Iran, were selected randomly, and data were gathered through oral interviews. After collecting input and output energies data, the averages of inputs and outputs energies were obtained about 43055 MJ ha−1 and 117407 MJ ha−1, respectively. Economic analysis has performed in the next step. Its results revealed that the benefit-to-cost ratio and net return were computed about 2.33 and 488.29 $ per ha for wheat production. Then, life cycle assessment (LCA) was utilized to specify the environmental effects of wheat cultivation, and its results demonstrated that GWP is the most important environmental impact which caused 624.29 kg CO2eq. during 1 ton of wheat production. Modeling results illustrated R2 was varied between 0.264 and 0.978 in the linear regression, 0.313 and 954 in the best structure of ANN with two hidden layers, and 0.520 and 0.962 in the ANFIS with three-level structure. Modeling comparison indicated that generally, ANFIS model with considering all uncertainty items can be offered better prediction models among all and after that ANN with considering non-linear parameters is in the next rank.

Metabolic Risk Factors in Infants and Children with Kidney Stones

Background and Objective: In spite of adult renal stones, in pediatric renal stones, most cases have a hereditary background. The evaluation of metabolic risk factors in children with renal stone disease is the basis of medical treatment aimed at preventing recurrent stone events and the growth of preexisting calculi. Therefore, this study was conducted to investigate metabolic risk factors among infants and children with kidney stones in Hamadan Province, Iran, so that it can be the basis for further studies to suggest the elimination of unnecessary diagnostic tests. Materials and Methods: A total of 270 children diagnosed with urinary stones were entered into the study. After recording demographic information, laboratory tests of patients' serum for calcium, phosphorus, sodium, potassium, bicarbonate, uric acid, magnesium, creatinine, and alkaline phosphatase were performed. Moreover, patients' urine was measured for the excretion of random morning samples, such as calcium, oxalate, magnesium, sodium, and uric acid. Results: It was revealed that the male gender had a significant relationship with hypercalciuria and hyperoxaluria. Furthermore, there was a significant relationship of stone size with impaired urine analysis and positive urine culture. Conclusion: Based on the results of this study, urinary metabolic risk factors were widely present in children with urinary stones, and hypercalciuria was the most commonly found disorder. It is recommended that in the evaluation of kidney stones in children, after ruling out the urinary tract abnormalities and infections, metabolic examination of urine be performed, including random measurement of calcium to creatinine in the morning urine, in order to reduce the economic consequences of extensive testing.

Application of random survival forest for competing risks in prediction of cumulative incidence function for progression to AIDS

Objective: There has remained a need to better understanding of prognostic factors that affect the survival or risk in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), particularly in developing countries. The aim of the present study aimed to identify the prognostic factors influencing AIDS progression in HIV positive patients in Hamadan province of Iran, using random survival forest in the presence of competing risks (death from causes not related to AIDS). This method considers all interactions between variables and their nonlinear effects.&#x0D; Method(s): A data set of 585 HIV-infected patients extracted from 1997 to 2011 was utilized. The effect of several prognostic factors on cumulative incidence function (probability) of AIDS progression and death were investigated.&#x0D; Result: The used model indicated that using antiretroviral therapy tuberculosis co-infection are two top most important variables in predicting cumulative incidence function for AIDS progression in the presence of competing risks, respectively. The patients with tuberculosis had much higher predicted cumulative incidence probability. Predicted cumulative incidence probability of AIDS progression was also higher for mother to child mode of HIV transmission. Moreover, transmission type and gender were two top most important variables for the competing event. Men and those patients with IDUS transmission mode had higher predicted risk compared to others.&#x0D; Conclusion: Considering nonlinear effects and interaction between variables, confection with tuberculosis was the most important variable in prediction of cumulative incidence probability of AIDS progression.

Predictors of COVID-19 Mortality in Hemodialysis Patients, Hamadan Province, Iran.

Background: Identification of the predictors of coronavirus disease 2019 (COVID-19)-related death in hemodialysis patients plays a key role in the management of these patients. In this regard, the present study aimed to evaluate the predictors of death among COVID-19 infected hemodialysis patients in Hamadan province, Iran. Study design: A cross-sectional study. Methods: This cross-sectional study investigated 50 COVID-19 infected hemodialysis patients who were confirmed by polymerase chain reaction (PCR) test and referred to hemodialysis wards of hospitals located in Hamadan province, Iran, from March 2019 and January 2020. In order to compare the demographic characteristics and clinical variables between survived and deceased patients, the independent student t test and chi-square test were applied. Results: Out of 50 confirmed COVID-19 hemodialysis patients, 27 (54%) cases were male, 38 (76%) subjects were urban residents, and 4 (8%) individuals were smokers. A significant relationship was observed between patients’ gender, age, acute respiratory distress syndrome (ARDS) status, and body mass index (BMI) with the treatment outcome (P<0.05). A significantly higher level of serum albumin was observed in the survived patients (3.49±0.37 vs. 3.17±0.42, P = 0.030). Moreover, in terms of lactate dehydrogenase (LDH) level, a significantly higher level of LDH was observed in the patients who died (1471.1±1484.89 vs. 670.86±268.85, P = 0.005). Conclusions: It can be concluded that some demographic characteristics of the patients, including age, gender, ARDS status, BMI, co-morbidities, and laboratory signs and symptoms are associated with disease outcomes in COVID-19 infected hemodialysis patients. Therefore, awareness about the predictors of death in these patients can help make better and direct clinical decisions and inform health officials about the risk of COVID-19 mortality among hemodialysis patients.

Epidemiological and Maternal Features of Maternal Mortality in the West of Iran: Hamadan, 2011-2019

Background: Maternal mortality is an important public health problem that is perceived as a sensitive indicator of the socioeconomic status and healthcare services. Objective: This study aims to describe the epidemiological features of maternal mortality in Hamadan province in western Iran. Methods: In this cross-sectional study, 50 maternal deaths that occurred in all hospitals and delivery places in the Hamadan province from March 2011 to January 2019 were studied for epidemiological features and history of pregnancy care of maternal death. Finally, the extracted data were analyzed using descriptive statistics in Stata software version 14. Results: Our findings show that the mortality due to pregnancy and childbirth was 18.07 per 100,000 live birth. The majority of maternal death occurred in women aged 20-34 years living in urban areas who were mostly housewives. Kabudrahang and Razan towns had the highest maternal rate. Conclusions: The present study revealed that maternal mortality is higher among women aged 20-34 years (mainly housewives) living in urban areas. Cesarean delivery, having a history of abortion, and gestational age under 37 weeks were other factors associated with maternal death. Therefore, it is suggested to direct the focus of pregnancy care and training programs on these high-risk groups.