Medicine
Is Maternal-fetal Attachment Education Effective in the Success of Breastfeeding? A Randomized Clinical Trial Study
Breastfeeding represents the most enduring investment in the physical cognitive and social development of children. Maternal-fetal attachment (MFA) is suggested to be a predictor of breastfeeding. The study aimed to evaluate the impact of a maternal-fetal attachment (MFA) training program on breastfeeding success among nulliparous women in Iran.
This clinical trial study was conducted on 70 pregnant women referred to two maternity clinics in Tehran Iran. Using the randomized sampling method two perinatal care services in the north of Tehran were selected for recruiting the subjects into control and intervention groups. The eligible women completed the demographic and reproductive and Cranley’s MFA questionnaire. Then the intervention group received two MFA education sessions while the control group received routine prenatal education. Cranley’s MFA questionnaire was filled up again one month after the educational intervention. The breastfeeding success questionnaire and the Breastfeeding practice-related questionnaire were also completed in the 8th week of postpartum. Data were analyzed by using SPSS 22 and parametric and non-parametric tests.
Seventy women aged 30.67 ± 3.69 years participated in the study. There was no significant difference in MFA scores between the intervention and control groups prior to the intervention (89.03 ± 7.83 vs 89.66 ± 11.3; p = 0.7 respectively). However a significant difference was observed between the intervention and control groups one month after the MFA education intervention (89.91 ± 8.23 vs 97.86 ± 9.72; p <0.001 respectively). The results also revealed a significant difference between the intervention and control groups in terms of breastfeeding success at eight weeks postpartum (64.71 ± 9.99 vs 71.11 ± 11.05; p <0.001 respectively).
Maternal-Fetal attachment education is effective on the success of breastfeeding. This finding could be used in breastfeeding promotion programs meaning that providing MFA education can help breastfeeding promotion among mothers.
MFA education not only improves maternal-fetal attachment behaviors but also increases the success of breastfeeding and so it is suggested to be integrated into the maternal-child health services.
IRCT20120122008801N22; Registration date: 05/03/2018
Back Pain Severity in Women with Sexually Transmitted Diseases: A Cross-Sectional Study
Back pain is one of the main causes of disability most of which is caused by non-specific factors. There is a relationship between infections and back pain. The present study was conducted to detect the association between the severity of back pain and sexually transmitted diseases (STDs) in women.
This cross-sectional descriptive study was conducted among women with STDs referred to the selected clinics in Shahrekord city in 2022. After confirming the STD by a gynecologist the questionnaire was completed by the clients in a private environment. The research tool consisted of a demographic questionnaire a checklist related to medical and fertility records and a disability questionnaire for low back pain. The pain intensity was categorized into four levels: no pain mild moderate and severe. Data were analyzed using SPSS software (version 25) and the chi-square test and analysis of variance. p<0.05 was considered statistically significant.
A total of 310 women were included in the study. The mean age of the women was 37.04 ± 7.88 years and the mean number of pregnancies was 2.43 ± 1.40. The overall prevalence of back pain was 71.9% with 28.1% reporting no pain 22.9% reporting mild pain 24.5% reporting moderate pain and 24.5% reporting severe pain. There was a statistically significant association between the severity of back pain and the type of delivery menstrual status menstrual complications history of medical illness history of drug use travel abroad by self or spouse alone previous history of sexually transmitted infections multiple sexual partners type of sexual activity the use of condoms the number of sexual partners of the spouse the history of sexually transmitted infection in the spouse and job risk (p < 0.05). Also significant associations were observed between the severity of back pain and the type of sexually transmitted disease suffering from cervicitis burning and frequent urination vaginal discharge unusual mass in the groin area abdominal pain pain during intercourse pain in the perineum and anal discharge (p < 0.05) while there was no significant association with post-coital bleeding genital ulcer or vulvovaginal itching (p > 0.05).
Health service providers should consider the examination and diagnosis of STDs when patients present with symptoms of back pain. In addition policymakers and health care providers should work to prevent STDs and their consequences including back pain by adopting educational and support policies thereby reducing the burden of disease on the health care system.
Cognitive Behavioral Therapy on Sexual Function in Women with Vaginismus Disorders: A Systematic Review
Vaginismus is characterized by involuntary tightening of the pelvic floor muscles around the vagina and requires appropriate management. This review systematically evaluates the effectiveness of cognitive behavioral therapy in treating sexual dysfunction in patients with vaginismus.
PRISMA guidelines were used to compile a systematic review. A search of the ScienceDirect PubMed ProQuest and Google Scholar databases was conducted to find English-language studies published between 2002-2023 that examined the effects of cognitive behavioral therapy and its effects on the sexual function of women with vaginismus. The included studies were assessed for quality using the Mixed Methods Appraisal Tools (MMAT) and data were analyzed narratively.
A total of 5 studies including a total of 288 women with vaginismus were included in the review. The majority of studies included women with vaginismus according to DSM-IV-TR diagnostic criteria. The duration of the treatment and outcome measurements varied.
Cognitive-behavioral therapy has an effect on sexual satisfaction sexual functions and marital adjustment as well as reducing levels of depression and anxiety symptoms in women with vaginismus. CBT is a helpful cost-effective and non-invasive interventional therapy.
The duration of therapy required for improvement as well as its possible association with the severity of vaginismus remains unclear.
Job Adjustment and Sick Leave during Pregnancy: An Integrative Review of the Literature
Pregnant employees have special needs and most of them require sick leaves during pregnancy. Pregnancy can lead to complex work adjustments and may affect women's well-being. Therefore this integrative review of the literature aims to assess studies on job adjustment and sick leaves availed during pregnancy.
Searches were performed using Scopus PubMed ProQuest ISI Web of Science and Cochrane databases using both relevant keywords and MeSH terms including “job adjustment” “pregnancy” and “sick leave” up to August 2023 (search updated in January 2024) with no geographical restrictions. Full-text articles published in English observational studies including cross-sectional longitudinal and qualitative studies including phenomenological content analysis and grounded theory were included. Studies published in the form of conference proceedings other study designs with an interventional study method and the articles for which full texts were not available were all excluded.
Twenty-one full-text articles were considered eligible. More job adjustments lead to few sick leaves and increased presenteeism during this period. Pregnant employees implement different kinds of adjustment strategies to reach job adjustment. The manager’s efforts to facilitate job adjustment and sick leave days during pregnancy should also involve professional care or guidance adjusting job tasks and work schedules.
This integrative review of the literature shows that job adjustment during pregnancy could reduce sick leave but it needs comprehensive support from families and organizations so that pregnant women can make appropriate changes. In addition implementing adjustment strategies should be improved in pregnant women to increase job adjustment.
Welcome to the EndoHood: A Scoping Review of Social Media Spaces for those with Endometriosis
Social media has a significant capacity to influence healthcare delivery. The development of online communities is well documented for conditions including asthma and stroke. Less is known about social media use amongst those with endometriosis. This review explores internet groups as an under-recognised supplement to healthcare prompting greater clinician engagement online.
This scoping review was conducted according to the methodology developed by Arksey & O’Malley. It is the first piece of work bringing together commentary on endometriosis-related social media use and existing frameworks used to analyse other online communities. Relevant studies were identified through searches of MEDLINE and EMBASE. As an exploratory piece there were no predetermined exclusion criteria provided articles were in English or translated into English. A total of 26 articles from 2004-2024 were included.
The literature on social media posts about chronic conditions typically explores the accuracy of medical content or offers sociological commentary. Nine articles assessed the evidence base of endometriosis posts across various platforms. All raised concerns about the reliability of information shared and called for expert engagement in the dissemination of educational materials online.
Three key themes emerged from the analysis of online communities. First online groups are perceived as an antidote to unmet needs in endometriosis patients accessing traditional healthcare including problem-solving and psychosocial support. Further such groups cultivate a sense of kinship amongst affected individuals. The exchange of experiences and peer validation of symptoms contributes to a collective narrative. Finally social media can facilitate open conversation around sensitive topics through anonymity within these communities.
Endometriosis is a condition with the potential for profound psychological and psychosexual impact. Social media communities create a space in which private suffering can become public and taboo subjects explored. Clinicians have a responsibility to engage both with factual content curation and in addressing unmet care needs expressed by patients online.
Drawing and Midwife-led Counseling for Reducing Fear of Childbirth and Distress in Late Pregnancy
Pregnancy and childbirth increase maternal fear and distress. Therefore this study aimed to compare the effectiveness of drawing combined with midwife-led counseling (MLC) with that of MLC alone in reducing fear of childbirth (FOC) and distress during the third trimester of pregnancy.
This quasi-experimental study was conducted on 100 pregnant women (28–32 weeks). The drawing and MLC group painted with free themes twice a week and received MLC once a week to address maternal fears and distress over a five-week period. In the MLC group only MLC was conducted. Data were collected through demographic information the Childbirth Attitudes Questionnaire (CAQ) and the Prenatal Distress Questionnaire before and after the intervention and were analyzed using analysis of covariance chi-square tests and independent t-tests.
The mean fear and distress scores of both groups decreased significantly after the intervention (P<0.001). However the difference in the mean fear score between the intervention group (33.5 ± 7.7) and the MLC group (34 ± 8.1) and the difference in the mean distress score between the intervention group (10.2 ± 3.8) and the MLC group (11 ± 4.9) were not statistically significant. There were also no significant differences in pregnancy outcomes between the two groups.
Compared with the MLC group the drawing and MLC group experienced greater although statistically insignificant reductions in fear of childbirth and distress. However further research is necessary to draw definitive conclusions. Furthermore the interventions in our study did not affect pregnancy outcomes including delivery method hypertension preterm delivery or gestational diabetes.
Quality of Life in Subjects with Chronic Diseases and Impact of the Medication Burden
Quality of life (QoL) in patients with chronic diseases is affected by physical emotional and social aspects including medication burden. This study evaluates the impact of chronic diseases and medication on quality of life emphasizing the importance of incorporating patient perception.
A cross-sectional study conducted in Ecuador focused on the adult population treated at the Rheumatology Department of the Homero Castanier Crespo Hospital in 2023. A sample of 161 individuals was selected based on specific criteria and the COOP-WONCA questionnaire was used to assess health-related quality of life. Statistical analysis was performed using SPSS® including descriptive statistics and bivariate analysis with Chi-square and Fisher’s exact tests to explore relationships between variables.
The study population was predominantly composed of women (95.1%) adults over 70 years of age (37.8%) and individuals from urban areas (60.4%). Regarding education the majority had completed primary education (62.2%) and a significant proportion were illiterate (18.3%). Additionally 39.6% of the sample had hypertension and 14% had diabetes. Quality of life was characterized by high satisfaction with social activities (84.1%) while perceptions of physical fitness and general health were more moderate. Quality of life was influenced by osteoporosis and hypertension in the domain of physical fitness (p < 0.05) and individuals with depression reported negative effects on their emotional well-being (p < 0.05).
The predominantly female and elderly population presents differences in quality of life related to chronic diseases and depression highlighting the impact of these conditions on physical and emotional well-being.
Analysis of Mother's Intention toward Iron-deficiency Anemia Prevention Behaviour based on the Theory of Planned Behavior
Iron deficiency anemia (IDA) is prevalent among under-five and school-aged children in Indonesia often attributed to maternal knowledge gaps and unsupportive behaviors. This study grounded in the theory of planned behavior explores maternal intentions toward preventing IDA in children.
A cross-sectional descriptive survey was conducted among 226 mothers of children aged 6 months to 12 years. Data were analyzed using SPSS version 22.0 employing descriptive statistics and Likert scale scoring (Cronbach’s alpha = 0.82).
The results showed that participants were predominantly housewives (64.2%) aged 31–35 years (39.8%) with secondary education (44.2%) and monthly incomes of Rp 1–3 million (approximately 60–180 USD). Strong positive intentions were found for balanced nutrition provision (93.7%) and iron-content monitoring (89.9%). While mothers showed positive attitudes towards nutrition (95.4% agreed on providing balanced diets) and supplement monitoring (93.5%) most (63.5%) did not perceive the need for IDA screening. Knowledge of IDA causes was high (88.5%) but implementation was hindered by economic constraints (40.7%) and limited nutritional information access (38.9%).
Despite strong knowledge and positive intentions toward IDA prevention mothers showed gaps between knowledge and practice particularly in screening behaviors. Findings suggest a need for targeted interventions focusing on screening awareness and addressing economic barriers to enhance IDA prevention effectiveness.
Combating Cholera in Syria: A Comprehensive Approach to Clean Water, Sanitation, and Vaccination
This study presents a comprehensive strategy for combating cholera in Syria with a focus on clean water initiatives treatment surveillance and vaccination and the critical role of clean water in halting disease transmission.
The review design has involved a thorough research and review of existing literature and data on cholera outbreaks in Syria. It has also included an analysis of vaccination and treatment options as well as an exploration of cholera surveillance systems and clean water initiatives.
Key findings have indicated that prioritizing access to clean water through community water management plans and water purification technologies is essential for cholera prevention. Case studies supported by epidemiological data up to September 2023 have underscored the importance of clean water in stopping cholera spread.
The study has highlighted the urgent need for a comprehensive strategy to protect millions in Syria through enhanced water sanitation and vaccination measures. It has advocated for improved cholera surveillance and response systems along with continued efforts to ensure clean water access for all.
Cleaning and Disinfection of Surfaces in a COVID-19 Respiratory Syndrome Unit: A Quasi-Experimental Study
This study aimed to assess the impact of an educational intervention on the cleaning and disinfection processes within a respiratory syndrome unit serving as a designated facility for COVID-19 patients.
A quasi-experimental design was employed incorporating a pre-intervention and post-intervention assessment. The evaluation of surfaces involved various monitoring techniques including Adenosine Triphosphate (ATP) testing colony-forming unit analysis and visual inspections. All statistical analyses were conducted at a significance level of 5% (p < 0.05).
Following the implementation of the educational intervention a notable reduction in surface contamination rates was observed. Significant improvements were noted for specific surfaces when utilizing the ATP testing method including benchtops (p = 0.030) mattresses (p = 0.014) doorknobs (p = 0.014) and armchairs (p = 0.014). Furthermore a decrease in the total count of aerobic bacteria was observed for benchtops (p = 0.014) mattresses (p = 0.014) and doorknobs (p = 0.014). Visual inspection results also indicated enhancements with approval rates for benchtops armchairs and mattresses rising from 0% before the intervention to 37.5% afterward.
The findings of this study demonstrate substantial improvements in approval rates following the implementation of the educational intervention. Additionally this research provides valuable insights for the development of ongoing educational initiatives for the healthcare team incorporating evaluation and feedback mechanisms as well as updates to cleaning and disinfection protocols.
Antimicrobial Susceptibility Profile of Bacteria Isolated from Hemocultures of Patients Attended in a Campaign Hospital During COVID-19 Pandemic
Primary bloodstream infections are most commonly related to health care and are associated with intravascular devices increasing patient mortality length of stay and health care costs. Among the complications of hospitalizations for COVID-19 bloodstream infection is one of the most prevalent requiring prevention and early treatment. Due to the contingency of hospital resources during the pandemic understanding the prevalence and incidence of antimicrobial agents that cause bloodstream infections and using exams judiciously are essential public health measures avoiding the misuse of antimicrobials and being able to establish treatment.
This study aimed to determine the antimicrobial susceptibility profile and the prevalence of etiological agents of bloodstream infections in patients with COVID-19 at the field hospital in the city of São Bernardo do Campo - SP.
A descriptive observational and retrospective cross-sectional study was carried out on the results of blood cultures already collected for diagnostic purposes from patients from May to August 2020 at the same hospital.
Of the 300 blood cultures analyzed 73.7% of the samples showed no bacterial growth. Among the others the main bacteria found were Klebsiella pneumoniae sensitive to tigecycline present in 30 (10%) followed by Staphylococcus sp. (coagulase-negative non-lugdunensis) sensitive only to doxycycline gentamicin tetracycline and vancomycin in only 2 (14.3%) samples.
In this study a low rate of laboratory-confirmed bacterial coinfection was identified in patients with COVID-19.
Effects of COVID-19 on Food Supply: A Systematic Review
The COVID-19 outbreak has had a significant influence on several critical industries including agriculture education and the economy. This essay investigates these processes with a focus on agriculture where the repercussions have been particularly harsh for poor groups dealing with unpredictable food supplies and food safety.
Along with a critical examination of the shift to digital education systems the report highlights the major obstacles that lie ahead for regions lacking adequate digital infrastructure and digital literacy. There have been notable disruptions in the economy as well. Manufacturing the financial markets and tourism have all seen major downturns.
The study emphasizes the crucial part that following safety measures and boosting immunization campaigns play in mitigating these negative consequences while supporting economic recovery. Also new technical solutions have emerged throughout this time. The application of drone technology to contactless food delivery is a notable illustration of how creativity can overcome the challenges posed by the pandemic.
Finally the report recommends the development of specific and rigorous methods to strengthen recovery efforts in these critical areas.
Evaluation of the Effect of Vaccination Status on Lung Involvement and Hospitalization in COVID-19 Patients
The spectrum of COVID-19 in adults ranges from asymptomatic infection to mild respiratory tract symptoms to severe pneumonia with acute respiratory distress syndrome (ARDS) and multiorgan dysfunction. In our study it was aimed to investigate the effects of COVID-19 vaccine on lung involvement and hospitalization.
Cases over the age of 18 who had a history of contact with cases infected with COVID-19 or had clinical findings suggestive of COVID-19 who applied to the emergency department and who were diagnosed with COVID-19 by reverse-transcriptase-polymerase chain reaction (RT-PCR) were included in the study. Age gender comorbid diseases hospitalization status thorax tomography findings and vaccination status in the last 3 months of the patients included in the study were obtained by examining the hospital information system and patient files.
Our study included 496 patients. One hundred eighty-three of the cases were vaccinated and 42.6% (n = 78) of the vaccinated patients were male. Of the 313 unvaccinated patients 36% (n = 113) were male. Comorbid disease was observed in 55.2% (n = 101) of the vaccinated patients and 38.7% (n = 121) of the unvaccinated patients. Of the 313 unvaccinated patients 72.2% (n = 226) were discharged from the emergency department 19.8% (n = 62) were admitted to the service and 8% (n = 25) were admitted to the intensive care unit. Of the 183 vaccinated patients 78.1% (n = 143) were discharged from the emergency department 16.4% (n = 30) were admitted to the service and 5.5% (n = 10) were admitted to the intensive care unit. In the vaccinated patient group both the service admission rate and the intensive care hospitalization rate were found to be significantly lower than the non-vaccinated patient group (p < 0.05). Thoracic tomography findings of 32.9% (n = 103) of 313 unvaccinated patients were reported as CORADS 1-2-3 and thoracic tomography of the remaining 210 patients was reported as CORADS 4-5. The number of patients whose thorax tomography report was CORADS 4-5 was found to be significantly higher in the unvaccinated group than in the vaccinated group (p < 0.05).
In our study it was found that vaccination significantly reduced hospitalization in COVID-19 patients. Although the mean age was higher in the vaccinated patient group both the service admission rate and the intensive care admission rate were found to be lower.
The XEC COVID-19 Variant: A Global Threat Demanding Immediate Action
The new XEC variant that has recently been described a recombinant strain originated from the Omicron sub-lineages KS1.1 and KP3.3 (also known as FLuQE; it is descended from the FLiRT lineage) has since early July 2024 been confirmed in more than 15 EU countries as well as North America and Asia. Currently the XEC variant is reported in 27 countries including America Britain and China with T22N and Q493E in the spike that gives it a transmission advantage meaning that it may be the dominant strain in this coming winter season. Like past COVID-19 strains XEC has caused flu-like signs including fever sore throat and body aches. Thus the high efficacy of vaccines in preventing severe disease and hospitalization cannot negate the necessity to pay attention to XEC increase public health measures and improve genomic surveillance due to the high transmissibility of the virus and slight advantage in transmission. This letter urges people worldwide to pay attention to how XEC is spreading and to act quickly to stop new cases from rising especially among the susceptible groups.
Revealing the Unseen: Post COVID-19 Biomarkers, Severity, and Outcome Mysteries
Although the COVID-19 pandemic has passed some patients still experience post-COVID-19 symptoms. It has been reported that COVID-19 symptoms can persist for more than three months after recovery.
This study aims to analyze biomarkers severity and outcome factors associated with post-COVID-19 symptoms.
This prospective cohort study involves hospitalised COVID-19 patients who were followed for up to 3 months after discharge. Clinical examinations and laboratory tests for MMP-9 TIMP-1 and IL-6 were conducted during hospitalisation and after three months.
We enrolled 76 COVID-19 patients with a mortality rate of 30.26%. Among them 55 individuals (30.91%) had no residual symptoms 54.5% had acute COVID-19 9.09% had ongoing COVID-19 and 5.45% had long-term COVID-19. Symptomatic post-COVID-19 had oxygen demand and respiratory rates higher than no-symptoms groups. Early IL-6 IL-10 MMP-9 and TIMP-1 were lower in symptomatic post-COVID-19 compared to dead and asymptomatic post-COVID-19 groups. IL-6 and MMP-9 decrease and TIMP-1 increases after cure. IL-6 significantly still increases in post-COVID-19 symptoms compared to no-symptoms (p=0.01). Patients more than 50 years old and critically ventilated patients are prone to have symptoms post-COVID-19.
More than half of patients suffer from post-COVID-19 symptoms with various related factors. Even though IL-6 decreases after recovery IL-6 levels are still higher in symptomatic post-COVID-19 patients.
Unraveling the Effects of SARS-CoV-2 on Dementia: A Comprehensive Study
Since late 2019 a pandemic caused by SARS-CoV-2 a highly contagious coronavirus has jeopardized human and public health. Neurodegeneration and structural brain diseases produce dementia which is developing rapidly. Strong evidence of COVID-19 brain abnormalities as neurotrophic viruses impair neurological systems. Neuron and glial cell degeneration can affect nerve transmission and brain function. Damage to these brain components raises dementia risk. Multiple studies linked SARS-CoV-2 to dementia. This manuscript contains selective data. This study aims to review the findings and suggest strategies to improve SARS-COVID dementia management. The study makes use of medical research databases like Google Scholar PubMed Medline and Embase. Furthermore information is also collected by recognized health organizations and government agencies. COVID-19 can produce neuropsychological deficits agitation confusion inattention and disorientation. Thus SARS can worsen dementia and neurodegeneration. This article summarizes COVID-19's effects on dementia patients from several sources. The focus on existing treatments for affected patients ties the two.
Mucormycosis: Current Perspectives on Treatment, Diagnosis, and Advancements
This review study examines mucormycosis treatment challenges gaps in medicines and COVID-19-related effects. This paper examines diagnostic and drug development advances while addressing safety and specificity.
This review study searches PubMed Web Science and Scopus for relevant material. Keywords associated with mucormycosis therapy diagnosis medication advancement and COVID-19 are used to identify pertinent articles. Data extraction summarizes therapeutic obstacles diagnostic advances and innovative drug options.
This review article covers mucormycosis therapy diagnostics and drug development. It reveals limitations in present medicines such as selectivity safety and resistance mechanisms. Diagnostic advances and mucormycosis in COVID-19 have also been explored.
This review emphasizes the need for more secure specific mucormycosis therapies. It discusses therapy obstacles diagnostic advances and new drug techniques. Overall this research emphasizes improving mucormycosis therapy to enhance patient outcomes.
Antibodies as Promising Molecules to Block Spike Glycoprotein from SARS-CoV-2
COVID-19 is caused by a new SARS-CoV-2 virus from the Coronaviridae family responsible for developing severe acute respiratory syndrome (SARS-CoV). Its emergence in 2019 presented several challenges to global health. The virus can infect host cells using the ACE2 receptor and after infection several clinical manifestations appear ranging from mild symptoms to death. One approach that has shown promising results is convalescent plasma since convalescent plasma (CP) consists of a concentrate of immunoglobulins in the blood of patients recently infected with the coronavirus for those currently infected. Therefore this therapy uses antibodies in the plasma to neutralize the virus. This literature review aims to evaluate the efficacy of CP therapy in symptomatic COVID-19 patients by analyzing clinical trials and studies published between 2020 and 2023. Therefore the search identified studies in which the majority reported the efficacy of using convalescent plasma to treat and alleviate the clinical condition of patients diagnosed with COVID-19. Important factors influence the efficacy of CP therapy such as the timing of administration and the severity of the disease. Early administration in mild and moderate cases has shown promise. Furthermore molecular docking analysis suggests that antibodies can cause conformational changes in the SARS-CoV-2 spike protein raising the hypothesis that using CP may interfere with viral entry into host cells.
Evaluation of Mental Health Status of Obstetrics and Gynecology Assistants during the COVID-19 Pandemic in Iran - A Cross-sectional Study
Some evidence shows that the COVID-19 pandemic has had negative effects on the mental health status of different sections of society including the medical staff.
The current study was conducted with the aim of investigating the mental health status of obstetrics and gynecology (OB-GYN) assistants during the COVID-19 pandemic in Iran.
The present cross-sectional study was conducted in 23 hospitals across Iran in 2021 (January-March). Four hundred OB-GYN assistants were randomly and voluntarily enrolled in the study. The instrument used in this study was the 28-item General Health Questionnaire (GHQ-28) which had four subscales including somatic symptoms anxiety/insomnia social dysfunction and severe depression. To collect data and to reach respondents in distant areas the questionnaires were provided to the OB-GYN assistants by the online platform.
The mean age of the OB-GYN assistants was 32.3±2.6 years and all were female. Of 400 OB-GYN assistants 132 (33%) had no distress and 268 (67%) had psychiatric distress. According to subscales scoring 72 (18%) 68 (17%) 92 (23%) and 64 (16%) had severe distress in somatic symptoms anxiety/insomnia social dysfunction and severe depression respectively.
Considering that more than half of the Iranian OB-GYN assistants had poor mental health it seems that the COVID-19 pandemic has had a negative and destructive effect on the mental health of OB-GYN assistants. In this situation they need psychological support and appropriate intervention.
Assessing the Efficacy and Challenges of Tofacitinib in the Management of COVID-19: A Systematic Review and Meta-analysis of Cohort Studies
Global healthcare faces challenges in combating COVID-19 with rising cases despite widespread vaccination. Severe COVID-19 cases marked by acute respiratory distress and cytokine release syndrome highlight the importance of managing cytokine storms. Janus kinase (JAK) inhibitors such as tofacitinib show promise in this regard. While tofacitinib is recommended for severe cases challenges include adverse effects conflicting studies and the need for further investigation of new virus strains. Overcoming these hurdles is crucial for developing an effective treatment protocol and reducing COVID-19 mortality.
This study conducted a comprehensive search across PubMed Scopus and ISI Web of Science for observational studies on tofacitinib treatment in human adults with COVID-19. The search covered a specified period up to 2024. Data extraction including study characteristics and quality assessment employed the Newcastle Ottawa Scale and a modified Cochrane tool. Statistical analysis conducted with Comprehensive Meta-Analysis Software assessed heterogeneity and significance levels.
The meta-analysis of the three studies showed a significant reduction in mortality (Risk Ratio: 0.372 95% CI: 0.213–0.649 p-value = 0.001) with low heterogeneity (Cochrane p-value = 0.793) while no significant reduction in the need for mechanical ventilation was observed (Cochrane p-value = 0.194).
Tofacitinib administration shows a significant reduction in COVID-19 mortality. However the limited studies on its efficacy highlight the need for cautious interpretation in clinical assessments.