Southeastern Iran Research Articles

Investigating stress, depression, and anxiety levels in students at medical universities in southeastern Iran during the covid-19 epidemic in 2020

Psychological problems in the general public and among students become common following the epidemic of infectious diseases such as Covid-19. This study investigated the rates of stress, anxiety, and depression and the factors affecting them during the epidemic of Covid-19 disease in students at medical universities in southeastern Iran. This cross-sectional study was conducted in 2020. A total of 390 students were selected through convenience sampling from medical universities in south-eastern Iran (Kerman, Bandar Abbas, Zahedan, and Birjand) as a sample size. The instrument used in this study was a DASS-21 questionnaire to measure depression, anxiety, and stress. Data were analyzed using SPSS16 software. The mean age of participants was 21.73±4.03. The mean scores for depression, anxiety, and stress were 13.95 ± 10.23, 11.38 ± 08.92, and 19.15 ± 09.67, respectively. Overall, 62.56% of students suffered from depression, 62.82% from anxiety, and 62.56% from stress. Among the demographic variables, age and education had a significant relationship with all three subscales (p <0.001), and marital status had a significant relationship with the levels of anxiety and stress. The Covid-19 epidemic was recognized as a reason for higher rates of depression, stress, and anxiety in students at medical universities in southeastern Iran. Appropriate planning during an epidemic of infectious diseases for prevention and treatment interventions in the field of mental health promotion for medical students seems necessary.

Source identification, spatial distribution and ozone formation potential of benzene, toluene, ethylbenzene, and xylene (BTEX) emissions in Zarand, an industrial city of southeastern Iran

Introduction: Benzene, Toluene, Ethylbenzene, and Xylene (BTEX) as the ozone precursors have been classified as the hazardous air pollutants because of their negative effects on humans. This article presents the results of the first assessment of source identification, spatial distribution and BTEX's Ozone- Forming Potential (OFP) in Zarand.
 Materials and methods: The current study was conducted at 30 geographically separated locations, in Zarand, Kerman, southeastern Iran, during the summer and winter of 2020. BTEX samples were collected using passive samplers and then analyzed using Gas Chromatography-Mass Spectrometry (GC-MS). Spatial variations were surveyed using the Kriging method in GIS.
 Results: Total BTEX levels (79.26±26.87 µg/m3) during the summer were greater than their levels in the winter (37.38±29.18 µg/m3). The ranking of BTEX level in all samples followed as: toluene>m,p-xylene>o- xylene>ethylbenzene>benzene. The overall OFP of 374.79±135.08 µg/m3 in the summer and 172.61±148.81 µg/m3 in the winter were more than 100 µg/m3 as recommended guideline defined by World Health Organization (WHO), with toluene having the highest potential.
 Conclusion: According to the results of the present study, BTEX relative abundances in all samples were toluene>m,p-xylene>o- xylene>ethylbenzene>benzene. Despite of concerns among inhabitants and workers, benzene concentration was lower than other studied species. Control measures such as management of fuel use in motor vehicles and industries and development of green space must be adopted to attenuate the level of toluene in the atmosphere in the studied area.

Probabilistic tsunami hazard analysis for western Makran coasts, south-east Iran

Makran subduction zone, along the southern coasts of Iran and Pakistan, has a wide potential seismogenic zone and may be capable of generating large magnitude (M ~ 9) tsunamigenic earthquakes. Considering ambiguities exist in tsunamigenic source characterization for subduction megathrusts like Makran, where detailed geologic, seismic, and geodetic data are insufficient, the probabilistic tsunami hazard analysis (PTHA) is the most prevalent approach to handle uncertainties and estimate more reliable tsunami hazard. Here, PTHA is performed for the coastal region of the western Makran, south-eastern Iran. Using the logic tree approach, we have considered the uncertainty of maximum seismic magnitude, earthquake occurrence model, continuity of seismic zone, seismic coupling coefficient, rupture depth, presence or absence of splay faults, fault locations, and fault slip distribution in PTHA calculation for the western Makran region. We have derived uniform tsunami hazard maps for two return periods of 475 and 2475 years for two confidence levels, the mean and the 84th percentile. Ground subsidence effects are also evaluated in a probabilistic manner. According to the PTHA results, Chabahar and Sirik towns are at the highest and lowest tsunami risk, respectively.

Explaining the educational challenges in the path of cultural competence: The experiences of Iranian nursing students.

Cultural care is necessary for healthcare settings due to the presence of culturally diverse clients. Nursing students face different challenges in the path of cultural competence. This study aimed to characterize nursing students' educational challenges in achieving cultural competence. Data were collected through interviews with 14 nursing students, 2 faculty members, and 2 nurses working in educational and clinical centers affiliated to Kerman University of Medical Sciences in southeastern Iran. The Graneheim and Lundman approach was used to conduct purposeful sampling and analyze data. Data analysis revealed the theme of nurses' educational challenges with cultural competence with four major categories: the neglect of cultural competence in educational approaches, the lack of importance of culturally congruent care in clinical settings, poor intercultural communication, and insufficient skill in cultural humility. The present study shows numerous barriers to nursing students' cultural competence, which impair their learning and care for culturally diverse patients.

Inequality in households’ access to primary health care (PHC): a case study in Kerman, southeast Iran

BackgroundFair access to health services is a vital issue in low-and middle-income countries. Therefore, the present study was conducted to evaluate the equity in access to primary health care (PHC) services in southeastern Iran.MethodsThis household-based survey was conducted on 1128 households in Kerman, southeastern Iran in 2019-20. A multistage probability method was used to select the samples. The online questionnaire was designed and its link was provided to the questioners. After receiving the training, the questioners went to the door according to the sampling guide. The collected data were analyzed at a significance level of 0.05, using the STATA software. The concentration index (CI) was also used to measure inequality in access to PHC services.ResultsThe results showed that there was a significant difference between gender and location in access to PHC services (P < 0.05). However, no significant difference was found between the access rates to PHC services and the variables of age, marital, education, health insurance, and Supplementary insurance (P > 0.05). The mean rate of access to PHC services was 3.51 ± 0.53. Cultural access (3.76 ± 0.54) and timely receipt of PHC services (2.51 ± 0.72) accounted for the highest and the lowest access rates, respectively. The concentration index for the distribution of PHC services among the income-adjusted population was 0.014 (CI 95%: -0.022 to 0.051), indicating pro-rich inequalities in access to PHC services.ConclusionThe results indicated that pro-rich inequality, but it was close to the equality line. Also, the access level was assessed as moderate to high. Therefore, planning and policy-making seems essential for reduce inequality, and development and promotion of access to PHC services, especially timely provision of services and organizational access.

Menopause symptoms in women and its relation with using complementary and alternative medicines: A survey in southeast Iran.

BackgroundPostmenopausal women are interested in using complementary and alternative medicine because of their menopausal symptoms and the side effects of chemical medications and hormone therapy. Therefore, this study aimed to investigate the relationship between the use of complementary medicine (CAM) and menopausal symptoms among postmenopausal women.MethodsThis cross-sectional study was conducted among 288 postmenopausal women who were referred to health centers in Kerman, southeastern Iran, from 2020 to 2021. Data were collected using a demographic questionnaire, the CAM questionnaire, and the Menopause Rating Scale (MRS).ResultsThe mean score for the menopausal symptoms of the participants was 8.73 ± 6.11. Only 28.8% of the participants had no/little symptoms. About 65.3% of the participants used at least one type of CAM in the previous year. The most commonly used types of CAM were nutritional supplements, prayer, and medicinal herbs. A significant association was found between the use of medicinal herbs, dry cupping, relaxation and meditation, prayer, and menopausal symptoms. Women experiencing menopausal symptoms used more CAM methods than those without menopausal symptoms (Odds ratio = 2.25, 95% confidence interval = 1.33–3.80).ConclusionThe study results indicated that the severity of menopausal symptoms and scores in somatic-vegetative and urogenital domains were higher in CAM users compared to non-CAM users. But there was no significant difference in the psychological domain between CAM and non-CAM users. Based on the results, it is suggested that more research be done in different communities with different healthcare systems to find out how complementary and alternative medicine affects menopausal symptoms in women.

The relationship between spiritual health and happiness in medical students during the COVID-19 outbreak: A survey in southeastern Iran.

It is necessary to study the various dimensions of health and their affecting factors during the coronavirus disease-19 (COVID-19) pandemic to identify the necessary interventions. The study aims to determine the relationship between spiritual health and happiness in medical students during the COVID-19 outbreak. In this analytical cross-sectional design study, 409 medical students were examined for the state of happiness and spiritual health and the relationship between them. Student information was collected through Web-based sampling by using standard tools from 20 April to 20 June 2020. Medical students completed the demographic questionnaire as well as Oxford Happiness Questionnaire (OHQ) and Paloutzian and Ellison spiritual health questionnaire. The results showed that while the score of spiritual health and happiness was related to factors such as marriage, interest in a field of study, and socioeconomic status, the relationship between spiritual health and happiness was significant (r = 0.72). This study showed that students’ happiness scores were not optimal during the COVID-19 pandemic. Due to the strong relationship between spiritual health and happiness scores, spiritual health promotion, in conjunction with other interventions, can be used to improve happiness in this group.

Psychological consequences and the related factors among COVID-19 survivors in southeastern Iran.

IntroductionCoronavirus disease‐2019 (COVID‐19) is a new viral disease that has spread rapidly worldwide since December 2019 and there is no effective treatment for it. The current study aimed to investigate the psychological consequences and related factors among COVID‐19 survivors.MethodsThis descriptive analytical study was conducted on 152 patients with COVID‐19 referred to referral hospitals in southeastern Iran in 2020. Data collection tools were three questionnaires of demographic and background information, Depression Anxiety stress Scale (DASS‐21) and Impact of Events Scale‐Revised (IESR). Descriptive and inferential statistics and SPSS25 were used to analyze the data.ResultsThe mean age of patients was 39.52 ± 13.16 years. The patients were mostly female (63.8%). Seventy‐three percent of the patients had severe posttraumatic stress disorder, 26.3% had moderate depression and 26.3% had severe anxiety. The mean scores of posttraumatic stress, depression, and anxiety among patients with COVID‐19 were 41.59 ± 17.28, 12.13 ± 9.16, and 12.45 ± 10.71, respectively. Intensive care unit (ICU) admission, divorce, illiteracy, and retirement were all associated with higher psychological load among patients.Discussion and ConclusionThe results showed that patients with COVID‐19 had different levels of anxiety, depression, and posttraumatic stress. These results may direct the attention of the medical staff to the mental health of COVID‐19 patients, necessitating timely psychological care and intervention during an epidemic.

Inappropriate hospital admission rates after the implementation of the health system transformation plan: A cross-sectional study in southeastern Iran

Inappropriate hospital admission rates after the implementation of the health system transformation plan: A cross-sectional study in southeastern Iran

The Prevalence and 5-Year Incidence Rate of Cigarette Smoking and Water-Pipe Tobacco Smoking and Their Associated Factors among 15 to 80 Years Old Urban Population in Southeast Iran: Results from KERCADR Study.

Cigarette and tobacco smoking are closely associated with chronic cardiovascular disease and lung cancer. We aimed to assess the prevalence and 5-year incidence rate (IR) of these two risk factors for cardiovascular diseases in Kerman, southeastern of Iran. 10015 individuals aged 15-80 were recruited to the study between 2014 and 2018 (Kerman coronary artery disease (CAD) risk factors study, KERCADRS) of which 2820 had also participated in the first phase (5 years earlier). We took fasting blood samples and collected demographic information and data on cigarette and water-pipe tobacco smoking (WPTS) through interviews. The overall prevalence of cigarette smoking increased from 8.1% in phase1 to 8.8% in phase 2. During the same period, the prevalence of WPTS increased from 10% to 14%, especially in the age groups of 15-45 years. The prevalence of opium dependance was higher among cigarette smokers compared to WPT users. The overall 5-year IR of cigarette and WPTS was 3.6 and 4.65 per 1000 person-years respectively. The highest IRs of cigarette smoking and WPTS were reported in the age group of 15-39 years, and IR of WPTS was higher among women. Obesity, diabetes, and hypertension associated with a reduced IRs of cigarette and WPTS. Over the past five years, the prevalence of cigarette smoking has increased slightly, but WPTS has increased more rapidly, especially among women. The highest prevalence of cigarette and WPT smoking was in the age groups of 15-39 years. Smoking is shifting from cigarette smoking to WPTS. Age- and gender-oriented interventions would help correct the unhealthy life style in the community and prevent further smoking-related morbidities and mortalities.

An update on spotted fever group serology in Kerman Province, Iran

Rickettsia conorii is the causative agent of Mediterranean spotted fever (MSF) and reports of its geographical distribution are spreading every day. Recently, some cases of the MSF have been reported from Iran. However, little information is available about the MSF epidemiology in Iran. The aim of the current study was to investigate anti-R. conorii IgG seroprevalence among farmers living in the rural regions of Kerman province (in southeastern Iran). In this study, 281 blood samples were collected from farmers in Zarand and Jiroft counties and tested for detection of anti-R. conorii IgG antibodies using the ELISA method. Among the 281 samples, 14 farmers (4.98%, CI 95%; 2.45–7.55%) had anti-R. conorii IgG antibodies. Seroprevalence of MSF in Zarand and Jiroft counties were 4.58% and 5.33%, respectively. The serological evidence of this study indicates the seroprevalence of R. conorii in rural areas of the Kerman province of Iran. So, it is recommended that the Iranian health care system pay attention to the MSF.

Evaluation of Salivary Lipid Peroxidation in Paan Users

Background: One known risk factor for oral cancer is chewing smokeless tobacco, which is common in southeastern Iran. Smokeless tobacco-related oral complications can be evaluated by assessing parameters of oxidative stress. Objectives: This study evaluated salivary malondialdehyde (MDA) levels in paan users and compared them with nonusers. Patients and Methods: In this study, saliva was collected from 50 paan users and 50 nonusers referred to the Zahedan Dental School in Zahedan, Iran. Salivary MDA was assessed based on standard biochemical methods, and the data were analyzed using t-test, chi-squared tests and analysis of variance. Results: In the paan users and the controls, the mean MDA was 2.19 ± 1.05 and 1.24 ± 0.62 (nmol/mL), respectively, and both groups showed significant differences (P &lt; 0.001). The daily consumption and duration were significantly related with the MDA concentration (P &lt; 0.001). Conclusions: In paan users, salivary MDA concentrations were higher. The concentration of salivary MDA increased with the consumption of paan in more quantities and for a more extended time.

Monitoring of water resources and vegetation in the Helmand Basin using satellite image time-series and border hydro-political challenges

Abstract Helmand is the most important river in Afghanistan and an indispensable water resource for southeastern Iran. Recent water depletions in the river, however, have caused environmental issues in the region with further repercussions on long-term hydro-political debates between the countries of Iran and Afghanistan. The primary reasons underlying depletions in the river's water levels remain, however, unclear, and are the main objective of this study.Therefore, this study proposes a hydro-political analysis of the Helmand Basin by analyzing precipitation through Global Precipitation Measurement (GPM) data, Gravity Recovery and Climate Experiment (GRACE) land data for groundwater analysis, and Landsat 5 and 8 Images from 1991 to 2020 to classify vegetation and waterbodies using a Support Vector Machine classifier and identify the prime cause of downstream water depletions. Despite severe droughts, the preliminary findings indicated increases in rainfall, groundwater sources, water bodies, and vegetation in the river upstream, which conveys the inconsequential share of droughts to the overall water shortage as opposed to human interventions and water usage which have also shown to increase in the river upstream. Further findings suggest that the severe downstream water depletions are primarily on account of upstream water consumptions that have triggered environmental degradations and are a threat to human habitations.

Short-term celecoxib (celebrex) adjuvant therapy: a clinical trial study on COVID-19 patients.

BackgroundIt is known that severe acute respiratory coronavirus 2 (SARS-CoV-2) is the viral strain responsible for the recent coronavirus disease 2019 (COVID-19) pandemic. Current documents have demonstrated that the virus causes a PGE2 storm in a substantial proportion of patients via upregulating cyclooxygenase-2 (COX-2) and downregulating prostaglandin E2 (PGE2)-degrading enzymes within the host cell.AimHerein, we aimed to study how short-term treatment with celecoxib (Celebrex), a selective COX-2 inhibitor, affects demographic features, early symptoms, O2 saturation, and hematological indices of cases with COVID-19.MethodsA total of 67 confirmed COVID-19 cases with a mild or moderate disease, who had been referred to an institutional hospital in south-eastern Iran from October 2020 to September 2021, were enrolled. Demographic characteristics, symptoms, and hematological indices of the patients were recorded within different time periods. One-way ANOVA or Kruskal–Wallis tests were used to determine differences between data sets based on normal data distribution.ResultsO2 saturation was statistically different between the control group and patients receiving celecoxib (p = 0.039). There was no marked difference between the groups in terms of the symptoms they experienced (p > 0.05). On the first days following Celebrex therapy, analysis of complete blood counts showed that white blood cell (WBC) counts were markedly lower in patients treated with a high dose of celecoxib (0.4 g/day) than in controls (p = 0.026). However, mean lymphocyte levels in patients receiving a high dose of celecoxib (0.4 g/day) were markedly higher than in patients receiving celecoxib with half of the dose (0.2 g/day) for one week or the untreated subjects (p = 0.004). Changes in platelet count also followed the WBC alteration pattern.ConclusionCelecoxib is a relatively safe, inexpensive, and widely available drug with non-steroidal anti-inflammatory properties. The therapeutic efficacy of celecoxib depends on the administrated dose. Celecoxib might improve disease-free survival in patients with COVID-19.

Trends in the Prevalence and Incidence of Opium Abuse and its Association with Coronary Artery Risk Factors in Adult Population in Iran: Findings from Kerman Coronary Artery Disease Risk Factors Study.

Background: The prevalence of opium addiction in Iran is high probably due to the belief that opium has preventive effects against cardiovascular diseases. In the second phase of Kerman coronary artery disease risk factors study, the prevalence, incidence rate, and the association between opium use and other coronary artery disease risk factors (CADRFs) were assessed.Methods: In a cross-sectional study (2014-2018), 9996 inhabitants of Kerman, southeastern Iran, aged 15-80 years were recruited to the study. After taking fasting blood samples, the participants were examined or interviewed for demographic data and CADRFs, including opium use. The participants were categorized into “never”, “occasional”, and “dependent” users. The association between opium use and CADRFs was assessed with adjusted regression analysis (Stata v.11 software).Results: The overall prevalence of opium consumption was lower than that of five years earlier (P<0.01). The prevalence was currently higher in men than women and decreased in men between the two phases (P<0.001). There was a positive correlation between opium use and depression (P<0.001), anxiety (P<0.05), and a negative association with the level of physical activity (P<0.001). The five-year incident rate of dependent and occasional opium use was 4.2 and 3.9 persons/100 person-years, respectively. The incidence of opium use was higher in diabetic, hypertensive, depressed, anxious, and obese subjects.Conclusion: The study did not demonstrate any protective effects of opium on CADRFs. Considering the higher rate of opium use in subjects with hypertension, diabetes, obesity, and psychological disorders, the health authorities should implement educational programs to warn and correct the unsafe belief.

Prevalence of Bladder Cancer in the Kerman Province, Southeastern Iran, using the Complete Prevalence Method

Prevalence of Bladder Cancer in the Kerman Province, Southeastern Iran, using the Complete Prevalence Method

A COMPARATIVE ASSESSMENT OF MACHINE LEARNING MODELS FOR PREDICTING WIND SPEED

Renewable energy is one of the most critical issues of continuously increasing electricity consumption which is becoming a desirable alternative to traditional methods of electricity generation such as coal or fossil fuels. This study aimed to develop, evaluate, and compare the performance of Linear multiple regression (MLR), support vector regression (SVR), Bagging and random forest (R.F.), and decision tree (CART) models in predicting wind speed in Southeastern Iran. The data used in this research is related to the statistics of 10 minutes of wind speed in 10-meter, 30-meter, and 40-meter wind turbines, the standard deviation of wind speed, air temperature, humidity, and amount of the Sun's radiation. The bagging and random forest model with an RMSE error of 0.0086 perform better than others in this dataset, while the MLR model with an RMSE error of 0.0407 has the worst.

Les premiers villages agricoles de l’est du plateau Iranien à la vallée de l’Indus : état de la question

The birth of agriculture east of the Fertile Crescent, between the Iranian plateau, Central Asia and South Asia, is poorly known. This area is vast and the archaeological data relating to this period, the Neolithic, is extremely limited. Most researchers agree that plants and animals’ domestication was introduced in this area from south-west Asia, similarly to what happened in Europe. In this scenario, agriculture emerged in the Fertile Crescent, between the Levant, Anatolia and the Zagros, 12.000 to 11.000 years ago, and then spread to other regions further east, across the Iranian plateau to Central Asia and the north-western part of the Indian subcontinent, beginning between the 8th and 7th millennia BCE. This article summarizes the main available data relating to this topic with a focus on the Indo-Iranian Borderlands, between southeastern Iran and Pakistan. Currently available paleoclimatic, paleogenetic and archaeological records are presented. A synthesis and discussion is then provided in the conclusion as well as reconstructions based on these records. Issues or challenges relating to the research on the earliest farming villages are mentioned while directions for future research are evoked.

Analysis of movement and relationships between morphometric components of sand dunes (barchans) in the south-eastern of Iran

Morphology of barchan dunes plays a key role in the rate of movement of barchan dunes and accordingly, the areas that are in the path of barchan dunes can be identified. In this study, morphological parameters of eight barchan dunes in west Lut and movement were investigated. For this purpose, 8 parameters of windward slope length, back-to-wind slope length, right arm length, left arm length, length, width, right width and left width were measured in each barchan dune and Pearson correlation was calculated by SPSS software. In order to better understand the shape of barchan dunes, satellite images were extracted separately from google earth. The results of morphometry showed that barchan dune 6 was in the first place in terms of all morphometric factors. The right arm length to the width had the highest correlation (0.993). The back-to-wind slope length to the right arm length had the lowest correlation (0.815). The right arm length to the width had the highest coefficient of determination (0.9845). The movement during 2005–2019 was extracted from satellite images. It was found that until 2015, the highest movement belonged to barchan dune 3 (225.55 m) and during 2017–2019, the lowest movement belonged to barchan dune 6 (137.49 and 184.66 m). The highest movement during 2017–2019 was 288.24 and 307.67 m for barchan dune 5, respectively.

Histomorphological And Scanning Electron Microscopic Study of Explanatum (Digenea) In Native Cattle of Kerman Province, Iran

Amphistomiasis is caused by different species of trematodes in the family paramphistomatidae and is one of the neglected parasitic diseases of livestock. Amphistomiasis has a wide geographic distribution, especially in subtropical and tropical regions. Although adult stage of most of the amphistomes are seen in the rumen and reticulum of ruminants, but sometimes can be seen in bile ducts too. A few parasites were collected from the bile ducts of a native cattle from the Kerman slaughterhouse, Kerman Province, southeastern Iran, and samples were studied by histomorphological as well as, Scanning Electron Microscopy. The worms were identified as Explanatum explanatum using identification keys and SEM. This trematode has been identified in livestock from only two other provinces of Iran but this is the first report of it in Kerman Province. Specific epidemiological studies with exact slaughter inspections are needed to recognize the extent of the parasite prevalence in native animals of Iran.