Isfahan Research Articles

Integrating public perception and quantitative metrics for improved urban park planning in Isfahan, Iran

This study delves into the intricate realm of public perception regarding urban parks, aiming to uncover key factors influencing this perception and offer insights for urban planning and park management in Isfahan City, Central Iran. A comprehensive survey was conducted across 63 urban parks, gathering subjective feedback from park visitors on park size, vegetation, and exposure to external disturbances. Objective metrics were the area of the park, the mean and stdev of the Sentinel-2 NDVI as measures of vegetation density and diversity, respectively, distance to other parks and the park perimeter-to-area ratio. Linear and non-linear regression analysis between subjective feedback and objective metrics revealed that satisfaction peaks in parks with sizes of 15 ha or more. Higher vegetation density maximizes satisfaction. Parks with simpler, more regular shapes tend to offer a greater sense of freedom from external disruptions. According to the Generalized Additive Model model (R2= 0.737, explained deviance = 77.1 %), lush and healthy vegetation is often associated with attractive and inviting parks, especially in parks with simpler, more regular shapes that minimize the exposure to (noise and visual) disturbances. Such green and circular park designs can guide urban planners and managers in creating inviting and user-friendly parks, aligning with public expectations.

Beyond the First Child: Unveiling the Reasons Behind Stopping Childbearing in Iran.

The determinants of the intention to stop childbearing tend to differ over time and contexts. This allows the issue of families' childbearing intentions to continually remain on the research agenda. As societal context and temporal variability will matter for second childbearing intentions, this study aimed at uncovering the reasons behind the intentions to stop childbearing from one-child mothers' perspective. A qualitative descriptive study in Isfahan City, Iran, was used to scrutinize reasons behind the unwillingness to have a second pregnancy. A purposeful sampling with maximum variation was used to select one-child mothers. Until reaching saturation, 48 semistructured interviews were conducted. A thematic analysis was used to analyse the qualitative data. Five themes and 19 subthemes emerged from the data analysis as structural attributes (economic, social and political conditions), parental attributes (parental (dis)agreements, childrearing troubles, having impatience and being at the inappropriate age for childbearing), husband attributes (having the intention to stop parenting, financially and emotionally nonsupportive and being busy by working), maternal attributes (health-related problems, adverse experience during former pregnancy, being employed, self-compassion, the fear of parity progression and being pessimistic) and child attributes (having a naughty child and having the physical or mental distress of the first child). Overall, findings highlight the multifaceted nature of factors influencing second childbearing intentions. Structural reasons at macro level, intrafamily relationship, mothers' self-related factors and challenges of raising the first child all play distinct roles in discouraging mothers from a second child intention. Understanding these key reasons can help policymakers, researchers and individuals alike to comprehend the complexities involved in family planning and fertility decisions.

Association Between Dietary Magnesium Intake with Serum Brain-Derived Neurotrophic Factor (BDNF) and Adropin Levels and Metabolic Health Status in Iranian Adults.

Given the sparse conclusive findings regarding the association of magnesium intake with metabolic health status and limited evidence relating magnesium intake to metabolic biomarkers, our objective was to evaluate the association of metabolic health status, adropin, and brain-derived neurotrophic factor (BDNF) in relation to dietary magnesium intake. In this cross-sectional study, 527 male and female adults were investigated in Isfahan City. The data regarding usual dietary intakes were gathered using a valid and reliable 168-item food frequency questionnaire. Biochemical variables, anthropometric indices, and blood pressure were assessed following standard methods. The criteria suggested by Wildman et al. were used to classify participants as metabolically unhealthy (MU) and metabolically healthy (MH). Moderate magnesium intake was associated with 71% reduced odds of MU (OR T2 vs. T1 = 0.29; 95% CI: 0.12-0.70). In the stratified analysis, the inverse association between moderate intake of magnesium and MU was seen only in overweight/obese subjects but not in normal-weight ones. A significant difference was found in serum levels of adropin between the first and second tertile of dietary magnesium intake among overweight/obese subjects (62.74 ± 4.99 vs. 50.13 ± 2.54, P = 0.03). After adjustment for potential covariates, this association became attenuated (59.06 ± 3.47 vs. 50.02 ± 3.64, P = 0.20). No statistically significant link was obtained between dietary intake of magnesium and circulating BDNF levels. Moderate dietary intake of magnesium may exert beneficial effects on metabolic health and serum levels of adropin, especially in obese/overweight individuals. Further prospective studies will be required to approve our findings.

Estimating release of the antibiotic metronidazole into the environment from hospital effluents and assessment of the associated ecological risk: a case study in Isfahan, Iran (2023)

Hospital effluents are important sources for the release of pharmaceuticals into the environment. Metronidazole (MTZ) is one of the most popular antimicrobial agent, widely used in veterinary and human medicine. This study aims to determine the concentrations of MTZ in the effluent of hospitals and to evaluate ecotoxicological risk for aquatic organisms. Grab samples were taken from the effluents of 15 large hospitals in Isfahan City (Iran) and MTZ concentrations were analyzed using HPLC-UV. Average daily MTZ prescriptions for patients in each hospital was also determined. MTZ was detected in effluents of all 15 hospitals in the range of 0.3 to 9.5 µg/L (mean = 4.8 ± 6.4 µg/L). A significant correlation was observed between MTZ concentration in hospital effluent and MTZ prescription as well as the hospital beds. Ecological risk assessment showed MTZ contamination of hospital effluent from 7 of 15 hospitals had median risk (risk quotient of 0.1 to 1) for green algae (Chlorella sp.) while the effluent of all hospitals had minimal risk (risk quotient <0.1) for gram-negative bacteria (Vibrio fischeri) and aquatic crustaceans (Daphnia magna). It is necessary to develop efficient treatment methods for the removal of MTZ from the hospital effluents before discharging them into the municipal wastewater systems.

Sustaining tranquility in small urban green parks: A modeling approach to identify noise pollution contributors

Noise pollution poses a significant environmental challenge in Iranian urban areas, particularly within Small Urban Green Parks (SUGPs). This study investigates the extent of noise pollution in SUGPs and identifies key contributors to elevated noise levels. A total of 94 SUGPs, with a mean area of 1.86 ± 0.99 hectares, were selected in Isfahan City, Central Iran, and subjected to 30-m Equivalent Sound Level (Lq30) measurements at their central locations. Explanatory variables were classified into two categories based on road density, traffic volume, proximity to roads, park vegetation, and physical characteristics. The relationship between noise levels and each explanatory variable was observed to be non-linear and polynomial (R2 < 0.334) in certain instances. Our modeling results using the Multi-Layer Perceptron (MLP)-Artificial Neural Network (ANN) model (R2 = 0.936) indicate that average noise levels in these parks surpass international guidelines, averaging 65.97 ± 17.76 dB. Traffic volume and proximity to limited access roads were identified as primary factors influencing noise levels in SUGPs. It was observed that the design and layout of small urban parks may not effectively mitigate surrounding traffic noise, even with sufficient green barriers to absorb or block sound. Consequently, future efforts should prioritize strategic site selection for SUGPs to minimize exposure to major noise sources.

Predictors of glomerular IgA immunostaining patterns and disease progression in IgA nephropathy patients; a 13-year study of clinical and morphological features of renal biopsies

Introduction: IgA nephropathy (IgAN) is a common primary glomerulonephritis with highly heterogeneous clinical and histopathological features. The MEST-C scoring system has been developed to improve prognostic assessment but lacks elements related to immunostaining study. Objectives: This study aimed to investigate the association between the immunofluorescence (IF) deposits’ patterns of IgA (mesangiocapillary versus pure mesangial) with demographic, clinical, biochemical, and morphological parameters of MEST-C classification in IgAN patients. Patients and Methods: This retrospective, cross-sectional study was conducted on 268 biopsy-proven cases of IgAN from July 2009 to July 2022 at a single laboratory in Isfahan in Iran. The demographic, clinical, and laboratory data including age, gender, serum creatinine, and proteinuria were collected from the biopsy request forms. The morphological parameters of MEST-C classification and IF study patterns were collected from the biopsy reports. Results: The average age of all patients was 37.7 ± 13.47 years, with 67% being males. The mean serum creatinine and proteinuria levels were 1.43 mg/dL and 1730.94 mg/day, respectively. MEST-C score analysis revealed that 171 patients (63.8%) had mesangial expansion (M1), while 105 patients (39.2%) exhibited endocapillary hypercellularity (E1). Additionally, segmental glomerulosclerosis (S1) and tubular atrophy/interstitial fibrosis (T1 and T2) was observed in 160 biopsy samples (59.7%). Moreover, crescent (C) formation was noted in 76 (28.4%) of biopsies. Data analysis using univariate logistic regression demonstrated that E, T, and C on morphology, complement C3, IgG, IgM deposits on IF, and the total MEST score were all associated with an increased risk for mesangiocapillary deposits of IgA. However, using the multivariate method, the results indicated that only the total MEST score (OR: 2.4), presence of crescent (OR: 3.22), presence of endocapillary hypercellularity (OR: 4.86), tubular atrophy/interstitial fibrosis grade II (OR: 34.4), and IgG deposition (OR: 3.37) were independent risk factors for mesangiocapillary deposits of IgA. Conclusion: The total MEST score is significantly higher in mesangiocapillary patterns. Furthermore, the presence of E1, T2, and C1-2 morphological parameters of the updated Oxford classification in renal biopsies are independent risk factors for IgA mesangiocapillary deposits. Hyperactivation of immunoglobulins and the complement system appears to contribute to mesangial-capillary proliferation.

Comparison of the Effectiveness the Educational Package to Prevent Academic Procrastination and Treatment based on Acceptance and Commitment on Academic Motivation and Academic Performance of Procrastinating Students

Aim: Academic Performance is one of the issues raised in the field of education, which not only affects the academic future of students from various dimensions, but also determines their fate in various fields. Therefore, the current research was conducted with the aim of comparing the effectiveness of an educational package to prevent academic procrastination as well as treatment based on acceptance and commitment on academic motivation and performance of procrastinating students. Methods: The research method was semi-experimental with a pre-test, post-test and follow-up design with a control group. The statistical population included all secondary school students suffering from academic procrastination in city of Isfahan. Among them, 45 people were selected by purposive sampling and randomly divided into two experimental groups (educational package to prevent academic procrastination and treatment based on acceptance and commitment) and a control group (15 people in each group). Research tools included academic procrastination questionnaires (Solomon and Rothblum, 1984), academic motivation (Abdkhodaei et al., 2017) and academic performance (Pham and Taylor, 1999). In order to analyze the data, analysis of variance with repeated measurements was used. Results: The findings showed that the educational package of prevention of academic procrastination and treatment based on acceptance and commitment had a significant effect on the academic motivation and academic performance of procrastinating students (p&lt;0.001) and there is a significant difference between the two interventions, so that the educational package to prevent academic procrastination has been more effective. Conclusion: Those involved in the field of student education are recommended to use the educational package to prevent academic procrastination in order to solve students' academic problems, especially to improve academic motivation and academic performance.

The Role of Queen Šīšīnduxt in Strengthening Relations Between the Sasanian State and the Jews

This study describes the role of queen Shishindokht, the wife of King Yazhgverdi I, who was in a prominent Jewish family responsible for Russ Jalut, and was the reason for strengthening the relationship between the Sasanian state and the Jews. The queen's support has done a number of great achievements, which have influenced Jewish social relations, as well as the restoration and reconstruction of The City of Esfahan, which led to the settlement of many Jews in the city, resulting in peace. The queen's latter work was to solve the tax code and pay taxes, because in the eyes of the Jews، tax donations were not allowed except for Jews, but it was a crime, but because of the role of Shishindokht, the queens had been called (Queen) who was also a boy mother, she solved many issues, despite the many remains of the time, indicates that the Jews lived peacefully under the queen’s ruling during the rule of Yisgury I.

Children's experiences during their first dental visit: A qualitative study.

While the child's first dental visit can shape his/her attitude towards further treatments, little consideration has been given to exploring this experience from the child's perspective. Therefore, the aim of the study was to delineate the experiences of the first dental visit of children based on self-written stories in their own words. Qualitative study conducted as part of the oral health promoting school program in Isfahan city, Iran. Data collection was based on the responses to a question included in the programme's printed educational content. Schoolchildren were asked to explain about their experiences of their first dental visit in a story. Two researchers read the stories separately and identified concepts and themes. In a discussion panel gained consensus about the main themes. Then the researchers integrated and grouped together similar themes to new categories. Categories originating in the data provided insights into and explanations of factors that might influence the schoolchildren's experience in the dental office. Sampling continued until saturation, when no new codes appeared in the data. The childrens' stories were imported in the MAXQD software and analyzed to retrieve the main categories and themes. Factors that influenced experiences appeared to be idiosyncratic, but could be classified into three categories: the person accompanying the child, child and dentist-related factors. Two sub-categories of the person accompanying the child were the role of person in their treatment and the types of persons accompanying them. Dentist-related factors included three more sub-themes of applied behavioral management techniques, their role in oral health education, and organization of the office environment. The three sub-themes of children's related factors were experiencing fear, remembering the details of their experience, and type of care received. Although the method was limited to the qualitative written stories of children and there was no opportunity to explore more and consider the detailed opinions by face-to-face interviews, some noticeable elements were mentioned by children. The person accompanying the child, child and dentist-related factors were three main categories obtained from the data.

Investigation of Neuropsychological Dysfunction Among Recovered Nurses: The COVID-19.

This investigation aimed to compare the neuropsychological dysfunctions of coronavirus (COVID-19)-recovered nurses to those of healthy nurses. The present research method was descriptive and causal-comparative, in which the statistical population consisted of nurses with a history of COVID disease and working in the COVID department of public hospitals in Isfahan city. The available method selected 30 nurses with a history of illness and compared them with 30 other nurses from the same hospitals. We collected data using the "go/no go" test, the Wisconsin card sorting test (WCST), and direct and inverted word reading tests. We also analyzed the collected data using multivariate analysis of variance. The results showed a significant difference between nurses with a history of COVID disease and normal nurses in memory performance, the total error of the Wisconsin card sorting test, and the error of committing and inappropriately inhibiting the go/no go task (P < 0.01). However, there is no significant difference between the two groups in the number of classes, the error of perseveration in the Wisconsin test, or the reaction time of the go/no task (P < 0.05). Therefore, the present study's results indicate that nurses recovering from COVID-19 perform worse than normal nurses in memory functions, cognitive flexibility, and response inhibition within one to three months of recovery.

Evaluation of the physical-functional resilience of Isfahan City center using spatial statistics methods and ELECTRE*

ABSTRACT Human populations and social wealth are generally concentrated in urban areas-which may be vulnerable to natural or anthropic disasters. In recent decades, increase in the number of natural disasters has caused much economic damage and human loss. Therefore, special attention is needed to reduce vulnerability and increase the capacity and adaptability of urban systems by way of urban resilience in order to deal with natural disasters. The city of Isfahan, located in Iran, is a city with a long history. Isfahan’s location in a low-risk zone has led researchers and urban managers to believe that earthquakes will probably never occur in this city, while recent geological findings have proven the opposite. Therefore, for the first time, this study seeks to determine the physical-functional resilience in the center of Isfahan in terms of enduring a hypothetical earthquake. To achieve this goal, first the required information was collected using library and field methods and then it was analyzed by spatial statistical methods in ArcGIS software, as well as the Analytic Hierarchy Process (AHP) and the ELECTRE Multi Criteria Decision Making method. Based on the results of this study, it seems necessary to propose a special focus on increasing the physical-functional resilience of Naghsh-e Jahan, Khalja, and Shahshahan neighborhoods out of the 25 neighborhoods located in the central districts of Isfahan. Accordingly, the study can help urban science researchers, investors, city managers and local and national organizations to identify resilience districts and focus on addressing their major weaknesses, thus preventing the loss of humn, financial and various limited urban resources as a result of earthquake through increasing the resilience of the physical-functional system of the city.

Spatial modeling of micro‐scale carbon dioxide sources and sinks in urban environments: A novel approach to quantify urban impacts on global warming

AbstractUrban environments play a significant role in global carbon emissions and sequestration, necessitating a comprehensive understanding of their spatial distribution. This study presents a micro‐scale spatial modeling framework to elucidate the complex interplay between CO2 sources and sinks within urban settings. Utilizing advanced geospatial analysis, remote sensing data, and geographically weighted regression (GWR) modeling techniques, we provide a detailed characterization of emission patterns and identify the spatial distribution of carbon dioxide sequestration. Employing the bottom‐up method and geographic information system techniques, we quantified carbon dioxide emissions in Isfahan City, Iran, attributing 81.68% to stationary combustion sources (residential, commercial, industrial, and power plant sectors) and 18.32% to mobile combustion sources (road‐rail transportation, and non‐road transportation [agricultural machinery]). To model carbon sequestration, we calculated tree biomass using allometric equations and estimated carbon sequestration per tree unit. Subsequently, we employed GWR to map the spatial distribution of carbon deposition across the city. The results revealed an annual carbon sequestration capacity of 7,704 tons, equivalent to storing 28,275 tons of CO2. Our findings highlight the substantial contribution of urban areas to greenhouse gas emissions and the potential of urban green spaces to mitigate these emissions. The spatial modeling framework developed in this study provides a valuable tool for urban planners to optimize carbon management strategies and promote sustainable urban development. © 2024 Society of Chemical Industry and John Wiley &amp; Sons, Ltd.

Urban form and socioeconomic deprivation in Isfahan: An Urban MorphoMetric approach

Studies on urban deprivation date back to the 19th Century but remain important today due to rising levels of inequality and social segregation. However, while social causes of deprivation have been investigated, the role of the built environment remains neglected. Existing studies either provide broad coverage at the expense of detailed morphological descriptions or offer meticulous accounts of small-scale areas without capturing the broader context. This paper addresses such a gap by investigating the relationship between urban form, measured at the building level, and deprivation across the entire city of Isfahan, Iran. By doing so, we position this study in the tradition of urban morphology. Operationally, we, first, identify urban types (UTs), that is, distinctive patterns of urban form, by clustering 200+ morphological characters; second, we explore the relationship between proportion of buildings belonging to each UT, in each neighbourhood, and deprivation; third, we offer detailed descriptions of the UTs most strongly associated with deprivation, discuss possible drivers for the observed correlations, and link findings to relevant literature in the field. Twelve UTs are identified, with four showing the strongest impacts on predicting deprivation. This study brings novel insights on the morphology of deprivation of Isfahan, while contextualising them with respect to domain-specific studies, which have predominantly focused on Western cities. The proposed methodology can be replicated to explore morphologies of deprivation in different contexts, further our understanding of the topic, and potentially inform planning and policy making.

“Calculation and Comparison of The Total Price of Day bed and Patient Day in the Surgical Department of an Educational-Therapeutic Hospital in Isfahan City with the National Tariff in 2022”

“Calculation and Comparison of The Total Price of Day bed and Patient Day in the Surgical Department of an Educational-Therapeutic Hospital in Isfahan City with the National Tariff in 2022”

Evaluation of the Efficacy of Melatonin in Visual Disturbed Methanol-intoxicated Patients: A Randomized Clinical Trial

Background: This study evaluates the role of oral melatonin in improving vision in methanol toxicity since vision disorders are one of the side effects related to methanol toxicity and assumes the potential effects of melatonin in protecting neurons and optic nerves. Meanwhile, little attention has been paid by researchers to the effect of melatonin in these patients. Methods: A double-blind randomized controlled clinical trial study was conducted on 40 patients diagnosed with methanol toxicity who were referred to Khorshid Hospital of Isfahan City, Iran, from May 2022 to May 2023. These patients were randomly divided into two groups. In the first group (the intervention group), in addition to the usual treatment, the patients were prescribed orally 3 mg of melatonin every morning and 6 mg of melatonin every night for 10 days. In the second group (the control group), in addition to the usual treatment, a placebo was administered similar to the intervention group protocol. Then, the clinical and vision parameters of the patients were evaluated before, during, and after the intervention. Results: The mean pH, PCO2 and HCO3 increased significantly after the intervention compared to the pre-intervention in both groups (P&lt;0.05); however, no significant difference was found between the two groups in any of the two follow-up times (P&gt;0.05). The most common visual complication caused by methadone toxicity was blurred vision with 71.4% and 90% in the melatonin and non-melatonin groups, respectively. Visual complications improved significantly after the intervention compared to the pre-intervention; accordingly, the complete improvement of vision complications in the melatonin group (76.2%) was significantly more than the non-melatonin group (53.3%) (P=0.040). Conclusion: Melatonin improves blurred or snowfield vision in methanol poisoning. Therefore, the administration of melatonin plus routine treatment can be effective in improving vision disorders (blurred or snowfield vision) caused by methanol poisoning.

Quality Assessment of the Information Technology (IT) Unit Services in Three Selected Hospitals in Isfahan City Using the Unweighted SERVPERF Model

Introduction: Considering the crucial role of IT unit in maintaining, preserving, and enhancing information systems and providing timely information to various individuals, the services provided by this unit must be of high quality. In this regard, the present study aimed to evaluate the quality of services provided by the Information Technology unit in three selected hospitals in Isfahan city using the SERVPERF model. Method: This is a quantitative and applied study . The statistical population consisted of all the employees who received service from the information technology unit in the educational hospitals of Isfahan city. The sample size was 351 people based on the Morgan ’s table. The service quality of the information technology unit in the studied hospitals was investigated using the standard questionnaire of the SERVPERF model (non -weighted) in five areas. Results: The average of service quality of the information technology unit was 3.23, which had a statistically significant difference with the average value of 3 (P&lt;0.05). The highest average is related to reliability (3.28) and responsiveness (3.25), respectively. The lowest average is related to the physical and tangible dimensions (3.14 ). Conclusion: The results show a negative gap in the service quality of information technology units in hospitals. To improve the quality of services in the dimensions of empathy, responsiveness, satisfaction, humility, goodwill, and information updates, regular training classes should be held for the employees of the information technology unit.

Potential of Pinus eldarica Medw. tree bark for biomonitoring polycyclic aromatic hydrocarbons in ambient air

Urban trees' biomonitoring of pollutants such as polycyclic aromatic hydrocarbons (PAHs) yields pertinent and useful data for air pollution management. The aim of this study was to biomonitor PAHs in pine (Pinus eldarica Medw.) trees in the city of Isfahan and identify their sources. In total, 34 samples of outer bark of the trees were collected and their contents of 16 EPA PAHs were analyzed. With a median value of 136.3 ng/g, the total PAH contents in tree barks varied from 53.4 to 705.2 ng/g. The average values of the diagnostic ratios for Ant/(Ant + Phe), Flu/(Flu + Py), BaA/(BaA + Chr) and IP/(IP + BP) were 0.19, 0.49, 0.45 and 0.49, respectively, revealing the PAHs majority source of pyrogenic. Meanwhile, principal component analysis showed two major types of PAHs sources including pyrogenic (fossil fuel combustion and industrial activities) and petrogenic (uncombusted) sources. The average ratio An/(An + Phe) and Flu/(Flu + Py) in bark samples was close to their relevant ratios in ambient air which demonstrated the potential use of this approach for biomonitoring of PAHs.

The effect of 8 weeks of personalized exercises on some health indicators and fat profile of firefighters in Isfahan city

Introduction: Due to the nature of their job, firefighters are at high risk of physical and mental injuries; Therefore, maintaining their physical and mental health is of particular importance. Personalized exercise training can help improve the health of firefighters and reduce the risk of injury.&#x0D; Materials and Methods: This study was experimental and practical and was conducted on the firefighters of Isfahan city. Through invitation to cooperation, 70 people were randomly divided into two experimental groups (18 people) and (18 people control). Sports training was done for 8 weeks in three sessions per week. Physical fitness indicators were evaluated before and after the exercises, and blood samples were taken for evaluation before and 48 hours after the end of the intervention. Correlated T-test was used for intra-group comparisons and independent T-test was used for inter-group comparisons at a significance level of 05/0 and analyzes were performed using spss software.&#x0D; Results: The results showed that these exercises can have a positive effect on the health indicators of firefighters, including aerobic capacity (p=005/0), muscle strength (p=01/0) and flexibility (p=01/0) and some fat indicators, such as decreasing triglyceride (p=005/0) and decreasing LDL (p=01/0) and increasing (p=03/0) HDL.&#x0D; Conclusion: Personalized physical exercises can help improve muscle strength and flexibility and improve cardiovascular health.

Evaluation of severe adverse cutaneous drug reactions in patients admitted to tertiary care center: A cross-sectional study.

Adverse cutaneous drug reactions (ACDRs) are common and potentially life-threatening, while also hindering patient compliance to medications. Given the regional differences in patterns and prevalence of ACDRs, it is important to study the epidemiology, as well as the clinical and outcome patterns of patients with ACDRs in Iran. This cross-sectional study on ACDRs was conducted among hospitalized patients in a referral university hospital in the city of Isfahan, Iran. The patients' demographics, clinical information, and outcomes, including age, gender, past medical history, medication history, drug reaction with eosinophilia and systemic symptoms (DRESS) diagnosis, Steven-Johnson Syndrome (SJS) diagnosis, toxic epidermal necrosis (TEN) diagnosis, treatment regimen (steroids or intravenous immunoglobulin [IVIG]) and outcome information, including intensive care requirements, severe medical complications, or death, were obtained from medical records. A total of 195 patients with a mean age of 40 years and consisting of 61% females were included. Carbamazepine, lamotrigine, sodium valproate, and phenytoin are the most commonly reported medications. Rate of complications was 45% with DRESS, SJS, and TEN diagnosed in 26%, 47%, and 19%, respectively. Treatment was carried out with steroids and IVIG in 81% and 19%, respectively. Among patients, 15% required intensive care and 5% died. Diagnosis of TEN, older age, and baseline heart disease were predictors of mortality. Patients with SJS were younger and more likely to be males, and they were more likely to have eye complications. On the other hand, patients with the diagnosis of TEN were more likely to receive IVIG and intensive care, and had a higher mortality rate. Our study provides insight into the demographics and clinical patterns of Iranian patients with ACDRs. This will help in predicting rates of complications, treatments, and outcomes in patients and therefore make proper management decisions.

Tele-psychotherapy for individuals with obsessive-compulsive disorder during the COVID-19 outbreak: A qualitative study.

One way of delivering psychological services is tele-psychotherapy, which has attracted significant attention as a viable approach. This study aimed to identify important variables in the application of tele-counseling and psychotherapy for the treatment of patients with obsessive-compulsive disorder (OCD) in Isfahan, Iran. This research employed an exploratory qualitative methodology. The participants of this study consisted of all the clients with OCD and all the psychotherapists in the city of Isfahan. Purposive sampling was employed, and following a series of semi-structured interviews with 35 individuals with OCD and 11 counselors in this area, the sample size reached a saturation point. The data was analyzed by Braun and Clark's thematic analysis method. Based on the findings of Braun and Clark's analysis, three primary themes emerged concerning tele-counseling: opportunities, requirements, and challenges. According to the feedback received from therapists and clients, remote services could offer promising prospects to both groups by providing accessible locations and flexible time management. However, to get the full benefits of teletherapy, therapists should consider certain factors to enhance the therapeutic alliance. Moreover, there are challenges that need to be addressed.