Researcher-made Checklist Research Articles

Designing and evaluating an educational mobile application for prevention of foreign body aspiration and measure to open airways of children

BackgroundForeign bodies aspiration (FBA) in children is one life-threatening event. Education using smartphone applications is an attractive method for reduction of risk and increasing public awareness. The purpose of this study was to design and evaluate an educational smartphone application for parents' education in pre-school age children. Design and Methods.In this descriptive-developmental study, 25 mothers of pre-school-age children were recruited through cluster random sampling from kindergartens in …. city. Design and evaluation of the application was done in three phases including educational analysis and developing educational content, designing and evaluating the initial algorithms, and designing the final shape. One researcher-made checklist was used to collect the viewpoint of the users. The experts’ suggestions were received either by an open ended questionnaire . The viewpoints of users and experts during the design and evaluation process caused some changes in the application. ResultsThe findings showed a high level of satisfaction among users (4/240 ± 0/96). This application was designed based on the users’ needs and based on the feasibility of its usage and the experts’ viewpoints about the scientific content, the design and the evaluation stages. ConclusionThe current application can be introduced to the community as an available scientific and user-friendly source which would create a continuous education for public health.

Explaining a Model of Human Resource Development and Empowerment Using the Service Provision Approach

INTRODUCTION: Health and healthcare services are of paramount importance in every society and are regarded as the essential needs of people. The present study aimed to assess, describe, and explore the model of human resource development and empowerment adopting a service provision approach in Ilam University of Medical Sciences and Health Services in 2019. METHODS: In the current study, theoretical sources were collected using systematic and library studies, and expertschr('39') opinions were collected through open-ended interviews. Thereafter, these sources were analyzed using grounded theory and structural modeling. In this qualitative study, a researcher-made checklist was provided to experts to identify the internal relationship among the components of each variable. The exploratory approach was used in the current study since the focus was on the use of qualitative methods. To identify the dimensions of the model and its associated factors, the indicators were firstly extracted using library studies. The Delphi method was then performed in three steps to monitor the indicators and obtain the final dimensions of the model. The statistical population of the study included all managers and experts of the human resources unit with more than 15 years of work experience in the studied university. MAXQDA software was used to record and manage the codes, and finally, the concept model was designed. FINDINGS: After analyzing the studies and conducting interviews with experts, "employee development and empowerment" was selected as the main category. It encompasses such issues as training and productivity of human resources, development of personnel capabilities, sustainable development of human capital, highlighting the importance of strategic human resource management by the management system, senior managerschr('39') support from human resources, and the independence of human resources unit. The relationship of other classes with the central class can be realized in five ways: causal conditions, control system, motivation, and appropriate counseling lead to the development and empowerment of employees. CONCLUSION: Healthcare organizations assume more importance since their human resources are mostly experts in charge of specialized activities. As evidenced by qualitative and library studies, as well as the conducted interviews, the development and empowerment of human resources in Ilam University of Medical Sciences and Health Services is positively correlated with the service provision approach and exerts a significant impact on it.

Survival Percentile and Predictors of Difference in Survival among Hemodialysis Patients and Their Additive Interaction Using Laplace Regression.

Background: Identifying survival modifiable factors and additive interaction between them could help in prioritizing the clinical care of Hemodialysis (HD) patients. We aimed to examine the survival rate and its predictors in HD patients; and explore the additive interaction between survival modifiable factors. Study design: A retrospective cohort study. Methods: The present study was performed on 1142 HD patients in Hamadan Province, western Iran from 2007 to 2017. Data were collected through a researcher-made checklist on hospital records. Laplace regression was used to evaluate differences in 40 th survival percentiles in different levels of predictors as well as exploring the pairwise additive interactions between variables. Results: We observed significantly higher survival in nonsmoker patients (40 th percentile difference = 5.34 months, 95% CI: 2.06, 8.61). Survival was shorter by more than 3 years in CRP positive patients (40 th percentile difference=36.9 months, 95% CI: 32.37, 41.42). Patients with normal albumin (40 th percentile difference =24.92, 95% CI: 18.04, 31.80) and hemoglobin (40 th percentile difference = 18.65, 95% CI: 12.43, 24.86) had significantly higher survival ( P <0.001). There was superadditive interaction between being CRP negative and nonsmoker (β 3 = 9.42 months, 95% CI: 3.35, 15.49 ( P =0.002)). Conclusions: High CRP and low serum albumin and hemoglobin were associated with the increased risk of death in HD patients. The results of this study support the presence of super-additive interaction between CRP status with serum hemoglobin and also CRP status with smoking, resulting in excess survival in HD patients.

Survival Percentile and Predictors of Difference in Survival among Hemodialysis Patients and Their Additive Interaction Using Laplace Regression

Background: Identifying survival modifiable factors and additive interaction between them could help in prioritizing the clinical care of Hemodialysis (HD) patients. We aimed to examine the survival rate and its predictors in HD patients; and explore the additive interaction between survival modifiable factors. Study design: A retrospective cohort study. Methods: The present study was performed on 1142 HD patients in Hamadan Province, western Iran from 2007 to 2017. Data were collected through a researcher-made checklist on hospital records. Laplace regression was used to evaluate differences in 40th survival percentiles in different levels of predictors as well as exploring the pairwise additive interactions between variables. Results: We observed significantly higher survival in nonsmoker patients (40th percentile difference = 5.34 months, 95% CI: 2.06, 8.61). Survival was shorter by more than 3 years in CRP positive patients (40th percentile difference=36.9 months, 95% CI: 32.37, 41.42). Patients with normal albumin (40th percentile difference =24.92, 95% CI: 18.04, 31.80) and hemoglobin (40th percentile difference = 18.65, 95% CI: 12.43, 24.86) had significantly higher survival (P<0.001). There was super-additive interaction between being CRP negative and nonsmoker (β3 = 9.42 months, 95% CI: 3.35, 15.49 (P=0.002)). Conclusion: High CRP and low serum albumin and hemoglobin were associated with the increased risk of death in HD patients. The results of this study support the presence of super-additive interaction between CRP status with serum hemoglobin and also CRP status with smoking, resulting in excess survival in HD patients.

The Clinical Skills of Emergency Medical Service (EMS) Personnel Regarding Spinal Immobilization of Trauma Victims; a Cross Sectional Study

Introduction:Spinal immobilization is the most important measure the Emergency Medical Service (EMS) has to take when facing the victims of traumatic events, especially those with confirmed or suspected traumatic spinal cord injury (TSCI). The aim of this study was to investigate the clinical skills of EMS personnel regarding the spinal immobilization of trauma victims.Methods:This cross-sectional study was conducted to examine the clinical skills of EMS personnel, regarding spinal immobilization of trauma victims during a 1-year period in 2019. EMS personnel were selected via convenience sampling method. Data collection tools were a demographic questionnaire and a researcher-made checklist to assess clinical skills. The face and content validity of the tool was reviewed and approved by 10 experts. Also, the overall reliability coefficient for the skills was 0.98. Data were collected by the researcher through observing the skills performed, and filling out the clinical skills checklist accordingly. Results:The mean overall score of the clinical skills of the 120 participants regarding spinal immobilization of trauma victims in supine, prone, and sitting positions were 0.60 ± 1.44, 0.58 ± 1.42 and 0.65 ± 1.62, respectively. Most of the studied personnel had moderate clinical skills in spinal immobilization, and they had poor clinical skills required to correctly pull the trauma victims in the longitudinal axis of the body to put them on a long backboard and immobilize their torso, legs, and head using the Kendrick Extrication Device (KED).Conclusion:The studied EMS personnel had moderate clinical skills regarding the spinal immobilization of trauma victims. It is recommended that the EMS training programs focus more on the practical aspects of clinical skills in addition to theoretical aspects.

The Rate and Pattern of Disclosing Medical Errors in Iranian Physicians and Healthcare Staff

Background: Ethics is of great significance in the medical community, i.e., because of the importance of this profession. How a physician manages a medical error, regardless of its cause, is among the major issues of medical ethics. Given the nature of the medical profession, medical malpractice may occur at any time during treatment. Medical malpractice is frequent in Iran and other countries. Methods: The present cross-sectional study was conducted using a researcher-made checklist. The study participants attended legal medicine training and refresher courses in Mashhad and Sabzevar Cities, Iran, from June 2012 to June 2017.Results: During five years, 1537 cases were enrolled in the study. Most of the study participants were female (n=832, 52.89%), with a Mean±SD age of 32.3±3.4 years. All study participants, except for 25 (1.58%) subjects answered “I do not disclose the malpractice” to the question “would you disclose your medical malpractice with treatable harm to the patient, while he/she gets hurt by not revealing the malpractice?”; the rest [1463 (92.94%) individuals] answered “I disclose the malpractice, but I do not mention that the harm is due to malpractice, and 85 (5.40%) participants answered, “I disclose the malpractice to the patient and mention that the harm is due to malpractice and it could be cured.” Conclusion: The study findings suggested that the majority of study participants did not tend to disclose their malpractice to patients and their families.

Assessing the Status of Yazd Province Medical Emergency and Accident Management Center in Terms of Necessary Standards for Air Emergencies

Background: Air emergency medical services provide advanced medical care to patients and critically injured as soon as possible to reduce injuries and casualties. In this study, the status of the Medical Emergency and Accident Management Center in Yazd Province in terms of the necessary standards for air emergencies was investigated and compared with existing standards. Materials and Methods: The present research was a cross-sectional descriptive study. Using a researcher-made checklist, the required data, such as human resource requirements, physical and environmental space, time, communication equipment, medical equipment, equipment for traffic detection and management, and equipment for technical and safety services, were collected by asking relevant officials and experts. Finally, data analysis was performed using tables and descriptive statistics. Results: The study findings showed that in total, 2 items in the field of human resource requirements, 7 items in physical space and environmental requirements, 2 items regarding time requirements, 4 items regarding communication equipment requirements, 43 items regarding equipment and medicine requirements, including patient cabin equipment, emergency resuscitation kit and Cardiopulmonary Resuscitation (CPR), medicine and jump bag equipment, delivery set, triage bag, dressing equipment and technical and safety service equipment requirements were in accordance with the existing standards. Conclusion: Based on the existing standards, the air emergency in Yazd Province in most areas was satisfactory. Because of the importance of the issue, authorities must take the necessary measures to address the deficiencies and limitations so that the emergency missions be carried out in the best conditions.

Performance of Nurses in Neonatal Intensive Care Unit Regarding Transfusion of Blood and Blood Products

Background: Critically ill neonates receiving blood products are at risk of transfusion-related complications. The quality of nursing care in this regard can be enhanced through continuous evaluations. Aim: This study aimed to assess the performance of nurses in a neonatal intensive care unit (NICU) regarding the transfusion of blood and blood products. Method: This descriptive cross-sectional study was carried out on the nurses working in an NICU in Tehran, Iran, during 2017. The performance of nurses was investigated for 550 blood transfusion procedures by structured observation through a researcher-made checklist with 40 items in three steps. The data were analyzed using SPSS software (version 22) using descriptive statistics and a generalized estimating equation. Results: The highest frequency (66.2%; n=365) of transfusions was observed for fresh frozen plasma. In the pre-transfusion phase, no case out of 550 transfusion procedures, ensuring the openness of the vein with normal saline injections run (100%), the carriage of blood products from the blood bank to the ward by the box Specific (76.2%), assess blood and blood products sensitivity (34.1%) and control of blood tests for blood count and coagulation factors (20.5%). In the transfusion phase, slow shaking the blood bag during injection (68.6%) and venous line washing with saline solution (45%) were not according to guidelines. After the transfusion phase, the volume of infused products, blood types, post-transfusion reactions and vital signs, and status of product labeling were recorded in 100% of the nursing reports. Implications for Practice: The performance of nurses was poor in many cases during the transfusion stage which can affect the health of the neonates. Therefore, it is recommended to provide continuous and persistent training for the staff.

Assessment of Disaster Preparedness of Hospital in Mamasani, Iran

Background: Iran is among the top ten disaster-prone countries in the world because of its size, geographical location, and climatic diversity. Practically, the healthcare sector is an active part in disaster management and an integral part of the national health plan. This study aimed to determine the preparedness of the personnel to cope with natural disasters in Valiasr Hospital of Mamasani, Iran. Methods: This cross-sectional study was conducted in Valiasr Hospital, which has 100 beds. Data were collected using a 210-item researcher-made checklist. For each target, six domains of equipment, human resources, structure, physical space, protocol, and performance charts were considered. Face and content validities were used to confirm the validity and reliability of the questionnaire. Results: The results of this study showed that the support unit scored the highest (69.45 %), followed by the command and management (66.16%) and education units (66%), respectively. Security units (51%), transportation (41.47%), and evacuation (40%) received the lowest score, respectively. Conclusion: The findings showed that the hospital under the study was in moderate level in preparedness for disaster. Improving the preparedness of hospitals for disasters will be possible with proper management of available resources and the use of update technologies.

Is there a relationship between gestational diabetes and postpartum depression?

Background: The relationship between gestational diabetes and postpartum depression (PPD) is poorly understood and seldom studied. Objective: In an effort to explore this issue, the present study investigated the relationship between gestational diabetes and PPD. Methods: The present cross-sectional study was performed with 342 women who were referred to four urban health centers of Hamadan city, west of Iran. We used convenience sampling as a method to recruit women in each health center. We used a researcher-made checklist for gathering data on socio-demographic characteristics and potential risk factors of PPD. The Persian validated version of the Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Univariate and multivariable binary logistic regression was applied to estimate the odds ratio (OR) (95% confidence interval [CI]). Results: Gestational diabetes was identified as the most important risk factor for PPD with OR (95% CI) of 2.19 (1.11, 4.31); P-value=0.02 after adjusting for other variables. Moreover, the adjusted odds ratio showed that PPD among lesseducated women (primary school) was 3.5 times higher compared to women with a university education (OR=3.54, 95% CI: 1.27, 9.84; P-value=0.01). Conclusion: Our findings suggested that PPD is more likely among women with gestational diabetes and those who were less educated. Interventional and educational activities for reducing the risk of PPD can be targeted for use with this population.

Assessing the effect of arrival time of physician and cardiopulmonary resuscitation (CPR) team on the outcome of CPR.

IntroductionNegligence of proper time and poor performance of resuscitation team can lead to more mortality and negative consequences of cardiac arrest, as well as less survival. This study was conducted with objective of determining the arrival time of physician and resuscitation team to survive the victims of cardiopulmonary arrest.Materials and methodsIn this prospective and descriptive-analytic study, the resuscitation performance and the arrival time of resuscitation team in 143 inpatients who had been diagnosed with witnessed cardiopulmonary arrest were examined using a researcher-made checklist. Data analysis was performed using parametric and non-parametric statistical tests and SPSS.ResultsInitial survival rate was 26.6%. In general, the mean time of physician’s presence after the code announcement in minutes and seconds was 02:31 ± 01:22. It was also 02:24 ± 01:15 in successful cases and 02:34 ± 01:25 in unsuccessful cases. Independent t-test did not show a significant difference between the physician’s presence time and the rate of initial successful resuscitation (p = 0.504). The time of first shock after observing ventricular fibrillation/tachycardia (in minutes and seconds) was 01:30 ± 00:47. According to independent t-test, the aforementioned time was less than the mean time (02:31 ± 01:22) of physician’s presence (p < 0.001).ConclusionsIn this study, the initial survival rate in comparison to other regions in the country was almost more favorable and it was similar to global norms. In this study, the starting time of resuscitation was within the acceptable range. There was no relationship between the presence of physician and the initial survival rate of patients, as well as the use of defibrillator (by physician compared to other team members) and intubation with the initial survival rate. This could indicate the adequate performance of resuscitation team in the absence of physician on the condition of having sufficient knowledge and skill.

Survey of Medical Ethics Research with the Science Drawing Method

The advancement of human knowledge in the field of medical science has brought activists to the field with new ethical issues. addressing medical ethical issues is one of the essential requirements in the health system. at present, the evaluation of science production can provide a clear picture of the growth, progress and important issues of a scientific field. in this study, we aimed to identify important areas of research in the field of medical ethics through a scientometric study. This is a scientometrics research using one of the most important techniques of this method, namely, the drawing of science. the statistical population of the study consisted of 3333 scientific papers indexed in the WOS database by the end of 2019. a researcher-made checklist was used for data collection and Ravar-matrix and ucinet6 software were used for data analysis. The results showed that the amount of scientific output in the field of medical ethics is 3333, starting with 1946 with two documents and reaching 2019 with 104 documents. the average annual growth rate is 21.03%. the world of medical ethics consists of 9 clusters worldwide and the concepts of bioethics, ethical counseling, education, medical education and autonomy have been the most commonly used keywords in medical ethics research, respectively. Iranian products in this field also consist of 6 clusters which are the key concepts in medical ethics, bioethics, ethics committee, strategic planning and medical education.

The Prevalence of Vitamin D Deficiency and Its Related Factors Among Female Staff of Gonabad University of Medical Sciences, Gonabad City, Iran, in 2019

Background: Vitamin D (VitD) plays a significant role in human health, survival, and fertility. It is necessary for calcium absorption and bone growth and the regulation of the immune system. This study aims to determine the prevalence of VitD deficiency and the factors affecting it in women working in the campus of Gonabad University of Medical Sciences, Gonabad City, Iran. Methods: In this cross-sectional analytical study, 70 women working on the campus of Gonabad University of Medical Sciences in 2019 were selected by the census method. After obtaining their consent forms, the researcher-made checklist was completed by the participants. The serum levels of 25-hydroxycholecalciferol (25-OH D3) were the index for measuring VitD. The significance level is set below 0.05. Results: The Mean±SD level of VitD in the research units was 13.67±22.5 ng/mL. About 12.85% of the samples had severe deficiency (less than 10 ng/mL), 32.85% had moderate deficiency (10-20 ng/mL) and 31.42% had mild deficiency (20-30 ng/mL). The prevalence of VitD deficiency was lower in people with a history of physical activity, and those with a history of taking supplements. Also, the highest VitD deficiency was observed in the age group of older than 40 years. Conclusion: According to the results, the prevalence of VitD deficiency in the study population was high because 45.7% of the subjects had severe and moderate VitD deficiency.

Relationship between using cell phone and the risk of accident with motor vehicles: An analytical cross-sectional study

PurposeTraffic accidents are one of the major health problems in the world, being the first cause of burden of illness and the second leading cause of death in Iran. The Sistan-Baluchestan province is one of the most accidental provinces of Iran with the highest rate of accidents-caused deaths. This study was conducted to determine the risk factors associated with traffic accidents in Zahedan through 2013 to 2016. MethodsThis analytical cross-sectional study was carried out on 223 drivers from Zahedan who were traumatized by traffic accident and sent to Zahedan hospitals. The data were obtained through interviews taken by the trained interviewers via refereeing to the medical records and collected in the researcher-made checklist. Census was obtained from the study subjects. For data analysis, independent t-test, one-way ANOVA, Chi-square and logistic regression were used with the Stata software version 11.0. ResultsIn this study, 223 male subjects with the mean age of (32.54 ± 12.95) years, 39.8% single and 60.2% married, entered for investigation. Most accidents (38.8%) occurred between 12:00 to 17:59. While driving, 47.1% of the study subjects were using cell phones, 89.1% had manual use of mobile phones, 21.9% had a habit of sending short message service (SMS) and 23.4% had sent SMS within 10 min before the accident. The one way analysis of variance showed that the mean age of individuals with marital status, driving experience, education and accident with motorcycle were significantly different (p < 0.05). Also, the multivariate logistic regression test indicated a significant relationship of smoking, ethnicity, insurance and SMS typing while driving with motorcycle accident (p < 0.05). ConclusionIn this study, SMS and smoking while driving had the highest risk among the variables studied in the motorcycle accidents. Therefore, effective education attempting to enhance people's awareness about the consequences of using cell phone and smoking during driving to reduce traffic accidents seems necessary.

Evaluation of demographic, clinical and paraclinical characteristics of children with acute disseminated encephalomyelitis

Introduction: Acute disseminated encephalomyelitis (ADEM) is an immunologically mediated inflammatory demyelinating disorder that commonly occurs following a viral infection or vaccination. Objectives: This study aimed to evaluate the demographic, clinical and paraclinical characteristics of children with ADEM. Patients and Methods: In a retrospective study, all children who had a definite diagnosis of ADEM were included in the study. Demographic information (including age and gender), epidemiological features (season of onset, history of previous vaccination and previous infection), clinical signs of ADEM, paraclinical features and also clinical outcomes were extracted from patients’ records and entered into a researcher-made checklist. All data were collected, classified and entered into SPSS version 21 for statistical analysis. Results: A total of 27 patients with ADEM were studied out of which, 16 (59.3%) were male and 11 (40.7%) were female. The mean age of patients was 5.21 ± 4.37 years, the youngest of which was three months and the oldest patient had 13 years old. The highest incidence (33.3%) was observed in autumn and 66.7% of patients had a history of recent infection. Electroencephalographic (EEG) findings were abnormal in 55.6% of patients. The most common clinical finding of abnormal EEG was motor disorders (51.8%). Among those who conducted MRI, 71.4% of them had cortical lesions in the brain. In the majority of cases (51.9%), the treatment achieved with intravenous immunoglobulin (IVIG) alone and complete recovery. Conclusion: The ADEM in this region has relatively similar epidemiological features to those studied worldwide and the favorable treatment of our cases has led to a satisfactory percentage of complete clinical recovery.

Https://www.ioer-imrj.com/wp-content/uploads/2020/05/Readiness-of-Science-Laboratory-Facilities-of-the-Public-Junior-High-in-Lanao-Del-Sur-Philippines.pdf

The Philippine K to 12 science curriculum is a learner-centered and inquiry-based discipline that requires learners to utilize learning materials and learning spaces needed for a meaningful understanding of the scientific concepts and for developing their scientific literacy. This is anchored to the constructivism theory that supports ‘learning by doing.’ A laboratory is an essential place for active learning and science teaching that would provide students with opportunities to think creatively and critically to solve real-world problems. This study assessed the current status of the science laboratory facilities in two public junior high schools in the province of Lanao del Sur. This is to assess the current condition and availability of laboratory facilities and to identify the challenges faced by science teachers. This study employed descriptive case study method, in which the participants were from two selected schools in Lanao del Sur. A researcher-made checklist of laboratory facilities and semi-structured interviews were used to gather the data. Frequency was used as a statistical tool for quantifying the number of available laboratory facilities and equipment. Based on the findings, both schools have inadequate laboratory facilities that hinder the performance of the activities in the science module designed by the Department of Education. The lack of a laboratory room, the inadequacy of laboratory facilities and science equipment, defective laboratory equipment, the inadequacy of learning materials, lack of water supply, lack of electricity are common issues in both schools. Teacherrespondents of this study have difficulty in teaching some science concepts and are not fully equipped on how to use some science equipment. Addressing the identified challenges is recommended to achieve quality education for all.

Relationship between the Time of Intrauterine Insemination and Pregnancy Outcome, Based on Islamic Recommendations

Background and ObjectivesIntrauterine insemination (IUI) is one of the methods of infertility treatment. When is the best time to do this assisted reproduction procedure? There are many Islamic narrations about the appropriate time for fertilization in order to give birth to a physically, mentally, and spiritually healthy child. Therefore, this study examined the relationship between the time of IUI performance and its consequences according to Islamic narrations.MethodsThe present historical cohort study was conducted at an Infertility Center affiliated with the Academic Center for Education, Culture, and Research of Qom, Iran using the medical records of patients who underwent sex selection IUI procedure from 2011 to 2015. The data were collected using a researcher-made checklist consisting of demographic characteristics, factors affecting the pregnancy outcome in terms of medicine and narrations, as well as the pregnancy outcome. The collected data were analyzed in SPSS software (version 20).ResultsThe findings indicated that the time of IUI performance based on Islamic recommendations and the pregnancy test result had a significant relationship (P=0.003). Moreover, the time of IUI based on Islamic recommendations had a significant relationship with pregnancy outcomes (P=0.023). The highest number of abortions and neonatal disorders were observed in pregnancies that had happened at the disapproved times according to the narrations (e.g., the end of the lunar month and when the moon is in Scorpio). Besides, the highest number of births of healthy infants happened when the insemination had happened at the recommended times (e.g., Thursday noon).ConclusionDue to the relationship between the time of IUI based on Islamic recommendations and the pregnancy outcome, it is recommended that IUI be performed based on Islamic recommendations and at times other than the disapproved times so that better results will be achieved in pregnancy. However, further studies are needed in this regard.

The association between serum vitamin D level and sperm parameters; A pilot study in a subset of Iranian infertile males

Introduction: Male-factor infertility affects about 7% of males in the general population. Vitamin D deficiency has been reported as an important public health issue all around the world and plays an important role in male fertility. Objectives: The aim of the present study was to investigate the association between serum levels of vitamin D and sperm parameters. Patient and Methods: We conducted this pilot cross-sectional study among infertile males who referred to Khanevadeh Specialty Hospital, Isfahan, Iran. A researcher-made checklist was used to collect data on basic characteristics of patients. Serum vitamin D level as well as sperm parameters (comprising sperm concentration, volume, vitality, total motility, progressive motility and abnormal morphology), DNA fragmentation and chromatin maturity were assessed according to standard protocols. Subjects with a serum vitamin D level of ≥30 ng/mL and 20-29 ng/mL were categorized as vitamin D sufficient and insufficient groups respectively. Results: According to our results, sperm parameters except for sperm volume were significantly different between two groups (P&lt;0.05). There was a positive significant correlation between sperm concentration, vitality, progressive motility and total motility with serum levels of vitamin D (P&lt;0.05). A negative significant correlation was observed between sperm abnormal morphology, DNA fragmentation and chromatin immaturity with serum levels of vitamin D (P&lt;0.05). We did not find any significant correlation between sperm volume and serum levels of vitamin D among infertile males (P&gt;0.05). Conclusion: The results of the current study showed that low vitamin D levels can be considered as a potential risk factor for male infertility among the Iranian population. Further large-scale studies are warranted to determine the association between male infertility with serum vitamin D level and underlying mechanisms.

Injury- and Non-Injury-Related Factors Associated with Under Five Mortality in Iran: A Multilevel Study

Background: Unintentional and intentional injuries are the most important factors that cause disability and death among children throughout the world, especially in Iran. Objectives: This study aimed to assess injury- and non-injury-related factors associated with under five mortality (U5M) at individual and community levels in Iran. Methods: This population-based case-control study recruited a total of 2,228 mothers in Iran in 2017. Subjects were divided into three groups (428 as the case group, 664 as the control group 1, and 1,136 as the control group 2). Data were extracted from health records of mothers and interviews through a researcher-made checklist in the health center of eight provinces of Iran. The multilevel logistic regression model was used to evaluate risk factors of under-five mortality at individual and community levels. Data were analyzed using R V. 3.5.0 software. Results: Analysis showed gestational age (post-term and pre-term) (OR = 4.20, CI: 3.14 - 5.61 , P < 0.001), pregnancy interval (between 1 to 3 years) (OR = 3.05, CI: 2.15 - 4.13, P < 0.001), history of mother’s diseases (OR = 3.14, CI: 2.41 - 4.10, P < 0.001), living in urban area (OR = 1.51, CI: 1.16 - 1.97, P < 0.01) and worst life events among mothers (OR = 1.91, CI: 1.46 - 2.49, P < 0.001) were risk factors associated with under-five injury-related mortality. Moreover, women’s literacy (OR = 0.72, CI: 0.54 - 0.97, P < 0.05), mothers being housewife (OR = 0.76, CI: 0.61 - 0.93, P < 0.01) were protective factor at the community level (P < 0.05). Conclusions: This study revealed factors related to under-five mortality at individual and community levels, which most of them are preventable. Therefore, child mortality can be controlled by improving family health, mothers’ education, as well as conducting interventions at the community level.

Epidemiological study of self-immolated patients referring to Velayat burn and reconstructive surgery center of Rasht

Introduction: Self-immolation is a deadly and painful issue that incurs high costs socially and individually. People who self-immolatearehardly cured and they will undergo serious mental and physical complications. This study aimed to determine the epidemiological distribution of self-immolated patients referring to Velayat Burn and Reconstructive Surgery Center in Rasht, Iran. Methods: This study was conducted based on a descriptive and cross-sectional design in Velayat Hospital in Rasht, Guilan province. The sample included all cases of self-immolation referring to Velayat Hospital from the beginning of April 2009 to the end of March 2017.The total number of self-immolated patients referred to hospital and registered was 96 individuals. Data were extracted from patients’ records using a researcher-made checklist. Descriptive statistics, such as mean, standard deviation, and analytical tests such as Poisson and multivariate logistic regression have been used for data analysis. Data were completely analyzed using STATA-SE software (version 13.1). Results: According to the results, 51% of the patients were female, and 67% of the cases were married; moreover, 43% of the females were housewives, and 42 % of the patients had a history of mental illness. It is worth mentioning that91% of the cases had no history of self-immolation. The most common reasons for self-immolation has been mental disorders (38.5%) and family problems (37.5%). The frequency of the rate of self-immolation has been almost equal in urban and rural areas, whereas the majority of the cases were observed in Rasht, Talesh, and Lahijan. In total, 60% of the patients died. The mean±SD age, total body surface area (TBSA), and hospitalization period were 37.5±1.5 years, 61.3±2.8, and 9.3±8 days, respectively. Analysis of regressions shows that the mortality rate has a direct and significant relationship with age and TBSA. Moreover, hospitalization time has a direct relationship with gender (i.e., male), TBSA, history of mental disease, previous records of suicide, and marital status (i.e., being married). However, it has a negative relationship with age and education. Conclusions: The level of burns is high in patients who are self-immolating, and mental disorders and familial problems have been the main reason for it. Therefore, although the frequency of self-immolation rate is lower, compared to other suicide methods, thesesmall groups of patients need special care due to the high rate of mortality.