RESUMEN
Background: Since 1990, the maternal mortality significantly decreased at global scale as well as the North Africa and Middle East. However, estimates for mortality and morbidity by cause and age at national scale in this region are not available. Method(s): This study is part of the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Here we report maternal mortality and morbidity by age and cause across 21 countries in the region from 1990 to 2019. Result(s): Between 1990 and 2019, maternal mortality ratio (MMR) dropped from 148.8 (129.6-171.2) to 94.3 (73.4-121.1) per 100 000 live births in North Africa and Middle East. In 1990, MMR ranged from 6.0 (5.3-6.8) in Kuwait to 502.9 (375.2-655.3) per 100 000 live births in Afghanistan. Respective figures for 2019 were 5.1 (4.0-6.4) in Kuwait to 269.9 (195.8-368.6) in Afghanistan. Percentages of deaths under 25 years was 26.0% in 1990 and 23.8% in 2019. Maternal hemorrhage, indirect maternal deaths, and other maternal disorders rank 1st to 3rd in the entire region. Ultimately, there was an evident decrease in MMR along with increase in socio-demographic index from 1990 to 2019 in all countries in the region and an evident convergence across nations. Conclusion(s): MMR has significantly declined in the region since 1990 and only five countries (Afghanistan, Sudan, Yemen, Morocco, and Algeria) out of 21 nations didn't achieve the Sustainable Development Goal (SDG) target of 70 deaths per 100 000 live births in 2019. Despite the convergence in trends, there are still disparities across countries.Copyright © 2022 Academy of Medical Sciences of I.R. Iran. All rights reserved.
RESUMEN
Background: To tackle the 2019 coronavirus infection (COVID-19) disease pandemic, effective antiviral therapy is critical. We assessed the efficacy of sofosbuvir and daclatasvir for treating patients with COVID-19. Methods: This was a randomized controlled trial in adults with moderate-to-severe COVID-19 disease admitted to Razi Teaching Hospital in Ahvaz, Khuzestan Province, Iran. Patients were randomly assigned to the sofosbuvir and daclatasvir group (n=35, intervention group) and control group (n=35, standard care). The primary endpoint of this study was the length of hospital stay, clinical improvement, mechanical ventilation, mortality, and side effect. Results: We found that the combination of Daclatasvir and Sofosbuvir (DCV+SOF) did not make a statistically significant difference in terms of mortality. There was no significant difference in the duration of hospitalization between the two groups. The two groups did not differ significantly in terms of the frequency of side effects. There were 2 cases of intubation and death in both groups. Conclusion: The medications used in this study, i.e, the combination of daclatasvir and sofosbuvir, failed to show a significant effect in patients, and despite promising laboratory studies, there were no improvements observed in vital signs and the indicators studied, including clinical signs. Hospitalization days, ventilator requirements and mortality did not make a significant difference. To confirm the results of this study, conducting researches with a larger sample size are needed. © 2022 Seventh Sense Research Group®
RESUMEN
Introduction: This study was conducted to explore the lived experience of hospitalized patientsin critical care units (CCUs) who witnessed an unsuccessful resuscitation. Methods: The participants in this interpretive phenomenology study were ten hospitalized patients in CCUs selected through purposive sampling. The data were collected through unstructured interviews and analyzed using van Manen's approach. Results: Two main themeswere identified along with the subthemes including (1) deathanxiety (perception of the shadow of death, thinking about mourning and sympathize thinking about death);and (2) death awareness (mind-meditation self-discourse, spiritual-religious dialectic with God, and avoiding the consequences of thinking about death). Conclusion: Witnessingan unsuccessful resuscitation acted as a boundary situation and stressor for the fellow patients and led to mortality salience as well as the experience of death anxiety.Understanding how patients manage and reduce this death anxiety is necessary in order to provide appropriate clinical support during medical decision-making.
RESUMEN
Background. In the event of accidents and disasters, the presence of volunteers, if not organized, can sometimes worsen the situation instead of improving it. Objectives. This research was aimed at the ways of organizing volunteers in the healthcare system during the COVID-19 pandemic in the southwest of Iran. Material and method. This questionnaire-based descriptive study was conducted on 140 volunteer health workers either active in providing services to COVID-19 patients or on the waiting list. The participants were selected using convenience sampling. They completed the information form, which was analyzed after collection using SPSS version 22. Results. The 140 volunteers' mean age was 32.5 with a standard deviation of 7.5. Of these volunteers, 62.1% had volunteered to serve since the first days of the outbreak. According to the participants of this study, the management of volunteers was spontaneous under the supervision of the official and state system, and the vast majority of them considered the official healthcare system's reception of volunteers as positive but saw the bureaucracy as a major obstacle to recruiting volunteers, especially nursing and midwifery graduates. Finally, the participants' motive for volunteering was found to be a sense of personal responsibility and human duty. Conclusions. Proper planning, organization and management of volunteers in an epidemic situation should be taken into account by healthcare officials in order to receive the highest efficiency in times of crises such as the COVID-19 pandemic.
RESUMEN
Background and purpose: In the time of emerging infectious diseases, quarantine is one of the necessary preventive measures to maintain public health. This study aimed at reviewing the determinants of quarantine compliance in epidemics in synchrony with the coronavirus disease 2019 (COVID-19). Materials and methods: A systematic scoping review of studies (2000-2020) on quarantine determinants was done in both Persian and English. PubMed, Embase ProQuest, Science Direct, Google Scholar, MagIran, SID, Iran Doc, and Element were searched using the following keywords: quarantine, social distancing, home quarantine, infectious epidemic, compliance, acceptance, adherence, and noncompliance in both Persian and English. Results: A total of 13,755 articles were found of which 10 eligible studies were included in this review. The main factors inhibiting adherence to the COVID-19 quarantine were financial problems following job loss, lack of adequate education and awareness, low levels of education, psychological pressures, difficulty of the quarantine period, lack of trust, and low supervision. Factors influencing adherence to quarantine included awareness, creating voluntary conditions, clear communication, offering assurance about jobs, moral commitments, high levels of education, and living in urban areas. Economic incentives and effective informative and training campaigns could increase public compliance with quarantine. Conclusion: There is paucity of information about compliance with quarantine during COVID- 19 pandemic, therefore, further studies on this issue are needed in Iran and other countries.