Review Articles
Maiya Taushanova; Lyudmila Yermukhanova; Fatima Bagiyarova; Zhanna Zhussupova; Venera Baisugurova
Abstract
Background: This bibliometric study analyses the global output of glaucoma in primary healthcare from 1978 to 2024.Methods: The study surveyed trends in publications, leading research institutions, and principal contributors, utilizing data from the Web of Science (WoS) and Scopus databases. The analysis ...
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Background: This bibliometric study analyses the global output of glaucoma in primary healthcare from 1978 to 2024.Methods: The study surveyed trends in publications, leading research institutions, and principal contributors, utilizing data from the Web of Science (WoS) and Scopus databases. The analysis revealed an increase in scholarly articles focused on glaucoma within primary healthcare, reflecting an enhanced emphasis on early detection and management at the initial level of care. Relevant documents were identified using a reliable search strategy from the WoS and Scopus databases and were reviewed and evaluated using Microsoft Excel and the bibliometrix R-package.Results: The United States, Portugal, and Brazil were identified as leading countries in glaucoma research, demonstrating a broad commitment to addressing this eye condition. Research has focused on enhancing awareness among patients and healthcare providers, developing effective screening protocols, and improving the quality of life for those affected by glaucoma. The findings highlight the importance of an integrated approach that includes educating primary care providers, adopting advanced diagnostic technologies, and actively involving patients in their care and monitoring. Challenges such as limited access to proficient healthcare services and the incorporation of specialized ophthalmological services within primary care frameworks were also noted.Conclusion: This bibliometric analysis underscores the need for enhanced cross-disciplinary collaboration and worldwide knowledge exchange regarding early glaucoma detection and management in primary care settings. The insights gained could guide the development of strategies to improve access to glaucoma diagnosis and treatment while heightening public awareness of the condition.
Review Articles
Hamed Yarmohammadi; Mehdi Jahangiri; Moslem Ali Mohammadloo; Mojtaba Kamalinia
Abstract
Background: Accidents caused by human error often lead to severe incidents. Correctly understanding human errors is essential to prevent such occurrences. Therefore, the purpose of the present study was to conduct a scientometric analysis of human error research in various industries.Methods: This study ...
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Background: Accidents caused by human error often lead to severe incidents. Correctly understanding human errors is essential to prevent such occurrences. Therefore, the purpose of the present study was to conduct a scientometric analysis of human error research in various industries.Methods: This study was conducted using scientometric methods. It includes all articles published and indexed in the Web of Science (WoS) database. The study is a review that aims to synthesize and analyze the existing literature. In total, 845 articles were included in this study. VOSviewer and Bibliometrix, an R package, were used to perform the scientometric analysis of these articles.Results: Industrial human error research is generally related to marine safety and accidents, the aviation industry, nuclear power plants, oil and petrochemical industries, occupational accident analysis, occupational fatigue, ergonomic issues, safety analysis of process systems, and the construction industry. Concepts such as “Human error,” “Human reliability analysis,” and “Human reliability” (with frequencies of 196, 113, and 64, respectively) were identified as the most frequently used keywords in the field of human error research.Conclusion: The co-occurrence map of keywords in human error reveals that most studies focus on diagnosis and assessment rather than preventing human errors. Only a tiny percentage of studies address the prevention of human errors. Therefore, greater attention needs to be paid to prevention and protective measures.
Original Article
Reema Nair; Somu G; Srinivas Vinayak Shenoy; Laxmitha Shetty; Aparna Satish
Abstract
Background: Acute kidney injury (AKI) is a frequent complication among critically ill patients, contributing significantly to morbidity, mortality, and healthcare costs. Despite its impact, limited studies exist on the economic burden of AKI, particularly in the Indian healthcare context.Methods: From ...
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Background: Acute kidney injury (AKI) is a frequent complication among critically ill patients, contributing significantly to morbidity, mortality, and healthcare costs. Despite its impact, limited studies exist on the economic burden of AKI, particularly in the Indian healthcare context.Methods: From January to April 2021, we conducted a singlecenter, cross-sectional observational study at Kasturba Medical College, Manipal. The study included 132 patients directly admitted to the medical intensive care unit (ICU). Demographic and clinical data, including AKI etiology, healthcare costs, and insurance coverage, were collected and analyzed.Results: Of the 132 patients, 57.6% developed AKI, with sepsis identified as the leading cause (78%). Patients with AKI incurred significantly higher total healthcare costs (US$ 2452.4 vs. US$ 1556.8, P<0.001) and experienced longer ICU stays (8 days vs. 4 days, P<0.001) compared to those without AKI. Among AKI patients, 85.5% required hemodialysis. While 61% of patients had some form of health insurance, predominantly government-sponsored plans, coverage was limited, with a median reimbursement rate of 35.8%.Conclusion: AKI represents a substantial economic burden for critically ill patients, marked by higher costs and prolonged ICU stays. A deeper understanding of these financial implications is essential for guiding resource allocation and shaping healthcare policies to mitigate the economic impact of AKI.
Original Article
Maryam Akbari; Mohammad Hossein Kaveh; Rosanna Cousins; Hamidreza Mokarami; Mehdi Jahangiri; Changiz Rahimi Taghanaki
Abstract
Background: Psychological well-being is a protective factor against mental disorders. This study aimed to clarify the contribution of resilience and social capital as predictors of psychological well-being as a first step toward developing evidence-based interventions to improve psychological wellbeing ...
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Background: Psychological well-being is a protective factor against mental disorders. This study aimed to clarify the contribution of resilience and social capital as predictors of psychological well-being as a first step toward developing evidence-based interventions to improve psychological wellbeing in healthcare workers.Methods: This cross-sectional study was conducted on Iranian healthcare workers. Systematic random sampling was used to recruit 140 employees working in healthcare centers in Shiraz, Iran, in 2021. Data were collected using a survey that included Ryff’s Scale of Psychological Well-Being, the Social Capital at Work Scale, and the Resilience at Work Scale. Data analysis involved correlations and path analysis to clarify the relationship between predictor variables for psychological well-being in healthcare workers.Results: Significant relationships were found between psychological well-being and resilience (r=0.29, P<0.01), psychological wellbeing and social capital (r=0.31, P<0.01), and resilience and social capital (r=0.42, P<0.01). Path analysis revealed a significant and direct relationship between social capital and resilience (β=0.56, P=0.001) as well as resilience and psychological well-being (β=0.59, P=0.001). The direct path from social capital to psychological wellbeing was insignificant (β=0.00, P=0.93). The model explained 36% of the variance in psychological well-being.Conclusion: Resilience was the most influential predictor of psychological well-being. It was associated with psychological well-being both directly and indirectly through the contribution of social capital. Promoting individual empowerment and developing resilience skills should be considered an essential approach in designing and implementing intervention programs to improve the psychological well-being of healthcare workers.
Original Article
Zahra Hosseini Dastgerdi; Nasrin Gohari; Mobina Mehrabifard; Hasti Seifi; Bahare Khavarghazalani
Abstract
Background: Vestibular vertigo and decreased sleep quality are prevalent issues that significantly affect the life expectancy, quality of life, and mental health of the elderly. Evidence from human and animal studies suggests a link between sleep disorders and vertigo. However, this association has not ...
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Background: Vestibular vertigo and decreased sleep quality are prevalent issues that significantly affect the life expectancy, quality of life, and mental health of the elderly. Evidence from human and animal studies suggests a link between sleep disorders and vertigo. However, this association has not been sufficiently explored in the elderly population. The present study investigates the associations between vertigo-induced handicap and sleep quality in older people.Methods: This cross-sectional study included individuals aged 60–70 with vestibular vertigo. The participants completed two questionnaires—the Dizziness Handicap Inventory (DHI) and the Pittsburgh Sleep Quality Index (PSQI)—in the presence of one of the authors.Results: In this study, 96% of participants exhibited some degree of poor sleep quality. Correlation analysis revealed positive relationships between PSQI subcategory scores and specific domains of the DHI. Subjective sleep quality was significantly associated with DHI-Total (DHI-T), DHI-Emotional (DHI-E), and DHI-Functional (DHI-F) scores. Sleep disturbance showed significant links with the DHI-E and DHI-F domains. The use of sleeping medication was significantly correlated with DHI-T, DHI-E, and DHI-F scores, while daytime dysfunction was associated with DHI-T and DHI-F scores (P<0.05). However, the PSQI-Total (PSQI-T) score did not show significant correlations with DHI-T, DHI-P (Physical), DHI-E, or DHI-F scores (P>0.05).Conclusion: This study demonstrated that, in elderly individuals with vestibular vertigo, there is a correlation between the degree of vertigo-induced handicap and various dimensions of sleep quality. Specifically, as the handicap worsens, sleep quality deteriorates. These findings underscore the importance of assessing sleep quality when evaluating elderly patients with vestibular vertigo.
Original Article
Sara Tabanfar; Seyvan Sobhani; Ali Safari Variani; Sakineh Varmazyar
Abstract
Background: This study aimed to investigate the effect of exercise intervention on non-specific neck pain and head and neck angles among adult smartphone users.Methods: This interventional study was conducted among 84 adults divided into experimental and control groups. Data were collected using a demographic ...
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Background: This study aimed to investigate the effect of exercise intervention on non-specific neck pain and head and neck angles among adult smartphone users.Methods: This interventional study was conducted among 84 adults divided into experimental and control groups. Data were collected using a demographic questionnaire and the Visual Analogue Scale (VAS). Craniovertebral angle (CVA), head flexion angle (HFA), gaze angle (GA), and forward head position (FHP) were determined from photographs analyzed with Kinovea software. The corrective exercises included 10 exercises targeting the neck muscles, including flexors, deep flexors, scapulothoracic muscles, and stretching of both left and right neck muscles. The experimental group performed these exercises for 12 weeks, with five weekly sessions lasting 15 minutes each. Research variables were re-measured immediately after the intervention.Results: 45.3% of the experimental group reported moderate neck pain severity before the intervention. Following the intervention, 33.3% of the experimental group reported no neck pain. The severity of neck pain significantly improved in the experimental group after the intervention (t=8.08, P=0.004). The greatest angle improvement was observed in GA, with a mean increase of 20.44° in the experimental group after three months (t=12.49, P=0.003). HFA (t=6.52, P=0.009) and FHP (t=12.74, P=0.007) significantly decreased in the experimental group postintervention. Additionally, CVA showed a statistically significant increase in the experimental group (t=-11.75, P=0.004).Conclusion: Over half of the experimental group reported reduced neck pain severity after the exercise intervention. Three months of corrective exercises significantly decreased HFA and GA while increasing CVA in the experimental group by more than 10 degrees.
Original Article
Zeinab Alizadeh; Farzaneh Noroozi; Mohammad Hossein Kaveh; Rosanna Cousins; Leila Ghahremani
Abstract
Background: A woman’s first pregnancy is a significant life event, and anxieties related to pregnancy and childbirth arecommon during this time. This study aimed to evaluate the effect of a stress-management intervention based on self efficacy in primigravida women, as indicated by improvements ...
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Background: A woman’s first pregnancy is a significant life event, and anxieties related to pregnancy and childbirth arecommon during this time. This study aimed to evaluate the effect of a stress-management intervention based on self efficacy in primigravida women, as indicated by improvements in sleep quality, relationship quality, and marital satisfaction.Methods: A quasi-experimental design with a control group was used. Inclusion criteria included being at 14–18 weeks ofgestation, having no concomitant illness, and attending one of four healthcare centers in South Iran in 2022. Two centers were randomly allocated to the intervention group and the other two to the control group. Of the 128 eligible pregnant women consented to participate, 39 were randomly assigned to each condition. The intervention group completed eight weekly one-hour stress-management training sessions using a blended learning approach. Data were collected using a survey administered before and immediately after the intervention. The survey included demographic information and validated questionnaires measuring self-efficacy, marital satisfaction, relationship quality, and sleep quality. Data were analyzed using independent and paired t-tests to evaluate the efficacy of the intervention by comparing changes in mean scores between the two groups pre-and post-intervention.Results: There were no confounding differences between participants in the two groups at the pre-test. Self-efficacy, sleep quality, marital satisfaction, and relationship quality were significantly improved in the post-test in the intervention group (P<0.01). No meaningful changes were observed in the control group.Conclusion: T he r esults s uggest t hat i ntegrating s tressmanagement workshops into routine prenatal care may be beneficial. Providing facilities and support for such interventions could enhance maternal well-being during pregnancy.
Original Article
Masoumeh Amin; Hamideh Edalat; Hamidreza Basseri; Morteza Zaim; Kourosh Azizi; Mostafa Salehi- Vaziri; Sahar Khakifirouz; Mohsen Kalantari; Mozaffar Vahedi; Saideh Yousefi; Parisa Amin
Abstract
Background: Mosquitoes (Diptera: Culicidae) are significant vectors of mosquito-borne diseases prevalent across temperate and tropical regions. Understanding the abundance and distribution of these vectors is essential for studying the ecoepidemiology of mosquito-borne diseases.Methods: This cross-sectional ...
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Background: Mosquitoes (Diptera: Culicidae) are significant vectors of mosquito-borne diseases prevalent across temperate and tropical regions. Understanding the abundance and distribution of these vectors is essential for studying the ecoepidemiology of mosquito-borne diseases.Methods: This cross-sectional study aimed to identify mosquito populations (Culicidae) and conduct molecular analysis for Flavivirus infections, explicitly focusing on West Nile Virus (WNV) and Dengue Virus (DENV) in Fars Province, Southern Iran. Mosquitoes were collected from 23 stations across urban and rural areas and migratory bird habitats in five counties, using hand catch with manual aspirators, CDC light traps with CO2, and human and animal bait methods from April to December 2018. Molecular screening for Flavivirus RNA, including WNV and DENV, was performed using a specific PCR technique.Results: 8212 adult mosquitoes were collected, representing four genera and nine species. The most prevalent species were Culex pipiens (54.20%), Culiseta longiareolata (30.40%), and Culex sinaiticus (10.25%). Molecular screening was conducted on the 8212 mosquitoes grouped into 150 pools based on sex, species, and trapping location. None of the pools tested were positive for Flavivirus RNA.Conclusion: This study highlights the importance of monitoring mosquito species distribution and emphasizes the need for enhanced Flavivirus surveillance and long-term monitoring programs in the region to understand the risk of disease transmission better.
Original Article
Rozhan Khezri; Shaker Salarilak; Sepideh Jahanian
Abstract
Background: Preterm birth (PTB) is a significant global health issue, with the majority of preterm births occurring in low and middle-income countries (LMICs), including Iran. This study aimed to determine the prevalence of PTB and its associated factors in urban areas of Iran.Methods: Over one year, ...
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Background: Preterm birth (PTB) is a significant global health issue, with the majority of preterm births occurring in low and middle-income countries (LMICs), including Iran. This study aimed to determine the prevalence of PTB and its associated factors in urban areas of Iran.Methods: Over one year, this case-control study included 387 pregnant women (129 cases and 258 controls) in Sardashat, Iran. Data were extracted from medical records. Gestational age was estimated through ultrasound in the first trimester. Statistical analyses were performed using logistic regression.Results: The prevalence of PTB was 7.43%. Multivariable logistic regression analysis revealed a significant association between PTB and the following factors: education levels, antenatal care (ANC) visits [Adjusted Odds Ratio (AOR)=7.91 (95% CI: 2.43–25.71)], premature rupture of membranes (PROM) [AOR=5.25 (95% CI: 2.01–13.74)], gestational diabetes mellitus (GDM) [AOR=5.27 (95% CI: 1.49–18.58)], and preeclampsia [AOR=9.47 (95% CI: 3.02–29.73)].Conclusion: Identifying pregnant women at risk of preterm birth is crucial, and treatments are available to reduce the risk. Our research suggests that factors such as education level, ANC visits, PROM, GDM, and preeclampsia predispose pregnant women to preterm birth.
Original Article
Fateme Kooshki; Masoud Neghab; Fatemeh Rahimian; Fereshteh Aliasghari; Esmaeel Soleimani
Abstract
Background: Several epidemiological studies have reported associations between high levels of lead exposure and oxidative stress (OS). However, research on the effects of low-level lead exposure remains limited. This study aims to assess the relationship between OS parameters and exposure to low concentrations ...
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Background: Several epidemiological studies have reported associations between high levels of lead exposure and oxidative stress (OS). However, research on the effects of low-level lead exposure remains limited. This study aims to assess the relationship between OS parameters and exposure to low concentrations of lead dust in mine workers.Methods: This cross-sectional study evaluated 73 lead-exposed workers and 70 age- and sex-matched non-exposed individuals. Demographic data and occupational and medical history were collected through questionnaires. Workers’ exposure to lead dust was assessed by air monitoring, and blood lead levels (BLLs) were calculated based on inhalation exposure. Blood samples were collected to determine OS parameters. Data were analyzed using SPSS version 21.0.Results: The mean exposure of workers to lead dust was 24 μg/ m³ (range: 1.5 to 185 μg/m³), which complied with the OSHAPEL and ACGIH TLV-TWA standards for lead dust. The BLL in the exposed workers was found to be 45.47 μg/dL. A significant association was observed between the SOD/MDA ratio and exposure to lead dust. Additionally, a borderline negative association between lead exposure and superoxide dismutase (SOD) activity was found. A significant relationship was noted between workers’ BMI and OS biomarkers.Conclusion: This study’s findings suggest that chronic exposure to lead dust may affect OS biomarkers, even at concentrations below the current OSHA-PEL and ACGIH TLV-TWA.
Original Article
Khalil Taherzadeh Chenani; Somayeh Bolghanabadi; Zahra Zamanian; Mohammad Hashemi
Abstract
Background: Surgical practices are critical activities within healthcare systems, and when human error (HE) occurs, the consequences can be irreparable. However, the literature on HE quantification reveals significant gaps in both structural and methodological approaches. This study aimed to suggest ...
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Background: Surgical practices are critical activities within healthcare systems, and when human error (HE) occurs, the consequences can be irreparable. However, the literature on HE quantification reveals significant gaps in both structural and methodological approaches. This study aimed to suggest a new taxonomy of environmental influencing factors (EIFs) that impact surgeons’ technical performance.Methods: In this cross-sectional study, EIFs related to the operating room were selected by reviewing various literature. Structured expert judgment elicitation was used to validate the EIFs under consideration. The weight and negative impact rate of the EIFs during surgical processes on surgeons were quantified using the spherical fuzzy-SWARA (Step-wise Weight Assessment Ratio Analysis) method and an elevenpoint numerical scale, respectively. Questionnaires from expert surgeons were employed to quantify the weight and negative impact rate of the EIFs.Results: The taxonomy of nine EIFs was validated through individual interviews with surgeons from three regional hospitals. The ranking of the influence of EIFs showed some conflicts regarding weight and negative impact rate. Specifically, climate conditions and music received the highest and lowest grades in both weight and negative impact rates.Conclusion: The current study offers an original contribution to developing a new taxonomy based on domain-specific knowledge. The proposed EIFs taxonomy illustrates how surgeons’ reliability can be degraded qualitatively and quantitatively. Furthermore, the results could enhance patient safety programs in the operating room.
Original Article
Ali Shahryari; Amineh Zahed; Abdolhalim Rajabi; Maryam Shafipour; Niloufar Emrani; Hadi Rahimzadeh; Hamidreza Heidari
Abstract
Background: Waterlines in dental units can harbor various types of bacteria and microorganisms, including heterotrophic bacteria, which can pose a health risk to patients and dental personnel. This study aimed to investigate the extent of heterotrophic bacterial contamination in the waterlines of dental ...
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Background: Waterlines in dental units can harbor various types of bacteria and microorganisms, including heterotrophic bacteria, which can pose a health risk to patients and dental personnel. This study aimed to investigate the extent of heterotrophic bacterial contamination in the waterlines of dental units and evaluate its potential as a health risk factor for occupational and patient exposure.Methods: This cross-sectional study selected four active departments at the Faculty of Dentistry, Golestan University of Medical Sciences (Gorgan, Iran). Bacterial contamination in the waterlines, dental handpieces, and other water-related components of dental units was investigated and analyzed in terms of Colony-Forming Units per milliliter (CFU/ml). The data were analyzed using the Kruskal-Wallis and Wilcoxon signedrank tests using SPSS version 23.Results: The mean and standard deviation of bacterial contamination across all studied departments were significantly higher than the recommended limit of 500 CFU/ml (ranging from 10,250.00±8,924.28 CFU/ml for the inlet to the water tank in the pediatric department to 275,625.00±41,520.86 CFU/ml for the air-water syringe before flushing in the surgery department). No significant differences were observed between departments (P>0.05). Furthermore, there were no significant differences in bacterial contamination between different days and hours of sampling (P>0.05), although bacterial levels were higher on Saturdays and mornings. Flushing the waterlines for 30 seconds reduced bacterial contamination (P<0.05).Conclusion: Stagnation of water in dental unit waterlines, particularly over weekends or after working hours, using reserve water during dental procedures, and insufficient flushing of dental handpieces resulted in consistently high bacterial contamination levels. Therefore, using fresh water and performing proper flushing in dental handpieces is strongly recommended to mitigate the risks associated with bacterial contamination.
Original Article
Roya Sahebi; Hossein Dehghanian; Alireza Mirahmadizadeh; Leyla Sahebi; Reza Yousefi Farkhad; Simin Khayatzadeh-Safaie; Nazila Sattari; Leila Jahangiry; Hamid Sharifi
Abstract
Background: Poor diagnosis remains a significant barrier to effective HIV control in Iran. A web-based screening programcould provide a novel approach to address this challenge. This study aimed to evaluate the feasibility and acceptability of a web-based HIV screening program for identifying individuals ...
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Background: Poor diagnosis remains a significant barrier to effective HIV control in Iran. A web-based screening programcould provide a novel approach to address this challenge. This study aimed to evaluate the feasibility and acceptability of a web-based HIV screening program for identifying individuals with high-risk HIV behaviors in Iran.Methods: A cross-sectional study was conducted using an educational website where individuals could anonymously complete a risk assessment questionnaire. Those with a history of high-risk behaviors were invited to attend voluntary counseling and testing (VCT) centers for HIV testing. Various strategies, including text messages, Instagram posts, and advertisements on local health center websites, were employed to promote website visitation.Results: The website received 11,581 visits from 4,303 unique Internet Protocol (IP) addresses. Of these, 3,079 visitors (71.0%) accessed the questionnaire section, and 456 (14.8%) completed the questionnaire. Nine respondents (1.97%) were under 16 years old and were excluded. Among the remaining 447 participants, 254 (56.8%) were from Tabriz City. Of these, 180 (70.9%) reported engaging in high-risk sexual behaviors, drug use, or occupational exposure. Notably, this group’s five individuals (2.8%) reported visiting VCT centers after completing the questionnaire.Conclusion: Developing an educational website combined with targeted promotion appears to be a feasible and potentially effective strategy for increasing awareness of HIV and motivating individuals to seek testing. Incorporating online counseling and interactive educational materials managed by trained professionals may enhance the program’s impact. Further studies are recommended to comprehensively evaluate this approach’s feasibility and acceptability.
