Erratum: Determinants of health volunteer training in natural hazard management in Iran.

[This corrects the article DOI: 10.4102/jamba.v15i1.1384.].

Determinants of health volunteer training in natural hazard management in Iran.

Both natural and man-made dangers cause bodily harm, as well as social, economic and environmental harm. In order to minimise the complications of these threats, proper training and preparedness are crucial. The purpose of this study was to look at the factors that affect how well-trained healthcare volunteers are for natural hazards in Iran. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, a systematic review of literature on the factors influencing the training of healthcare volunteers in natural hazard published between 2010 and 2020 was conducted. The Google Scholar search engine, PubMed (Medline and Central), Science Direct and Web of Science databases were searched using both individual and combined key phrases. The Strengthening the Reporting of Observational studies in Epidemiology checklist was used to select and evaluate 592 observational and quasi-experimental articles. Finally, the study comprised 24 papers that satisfied the research criteria and made good use of good technique, sample size and adequate tools for validity and reliability. The most useful variables for disaster preparedness were job self-efficacy, strategic decision-making and quality of work-life, job performance, job motivation, knowledge, awareness and health literacy. Contribution: To avoid calamity, a thorough training program is required. Therefore, the most crucial objectives for health education specialists are to identify the factors that determine disaster preparedness, train volunteers and provide fundamental techniques to reduce natural dangers.

Diseases Led to Refer Iranian Pilgrims From Hajj in 2012.

BACKGROUND: Some Iranian pilgrims are referred to Iran because of catching a new disease or exacerbation of their disease during the Hajj ceremony. These diseases need prolonged and specialized treatments. Investigation of the reasons led to their return to Iran is useful and effective in policy-making and planning of preventive health services. OBJECTIVES: This study aimed to investigate the causes of referring Iranian patients to Iran during Hajj in 2010. PATIENTS AND METHODS: In this cross-sectional study, all Iranian pilgrim cases in Hajj (2012) who referred to Iran were studied, and data analysis was performed. Demographic data and the causes of return to Iran during and after Hajj rituals were analyzed. RESULTS: A total of 106 cases were referred Iran during Hajj 2012. Psychiatric problems, with 26.4% allocated the highest rate of return to Iran during Hajj days, and significant difference was observed in the reasons before and after performing Hajj rituals (P = 0.001). CONCLUSIONS: Psychiatric, neurological, gastrointestinal, and respiratory diseases are the most frequent reasons of referring patients to Iran. More accuracy in screening and care of patients are recommended before Hajj in order to prevent references to Iran and its complications.

Health knowledge, attitude and practice among Iranian pilgrims.

BACKGROUND: Iran has the highest number of Umrah pilgrims among Islamic countries. Health care plays a major role in fulfilling the Umrah rites. Pilgrims' health situation depends on their health knowledge, attitude, and practice (KAP). OBJECTIVES: In this study, we aimed to determine the health KAP among Iranian Umrah pilgrims. PATIENTS AND METHODS: In this cross-sectional study, 157 Iranian Umrah pilgrims were randomly selected in Mecca, Saudi Arabia in June 2011. Data were collected using a questionnaire. The questionnaire consisted of demographic information (sex, age, degree of education, and resource of health knowledge), health knowledge (5 questions), health attitude (5 questions) and health practice (10 questions). RESULTS: Level of knowledge were very low in 12.1%, low in 25.2%, average in 38.1%, good in 20.4% and very good in 4.2% of respondents. Mean and standard deviation of attitude score was 18.58 ± 2.20 out of 25 (ranged between 13.00 and 25.00). The pilgrims were given 74.2 % out of total score. The Mean and standard deviation of practice score was 8.19 ± 1.32 out of 10 (ranged between 3 and 10). Although the old and low educated pilgrims had little knowledge of health tips, they had a good health attitude and practice. CONCLUSIONS: Educational strategy to improve knowledge regarding health-related problems and to develop health practices among pilgrims is needed.

The efficacy of systemic corticosteroids in treatment of respiratory tract infections during hajj 2012.

BACKGROUND: Diagnosis and treatment of respiratory tract infections (RTI) in a mass-gathering situation such as hajj is a medical challenge that requires quick decision-making and considerable knowledge about its etiology and treatment methods. High prevalence of RTI during Hajj and tendency of caravan physicians to treat of patients quickly in such situation lead to prescription of parenteral steroids. Nonetheless, no study has focused on the short-term and long-term effects of systemic steroids in Hajj pilgrims with RTI. OBJECTIVES: This study focuses on efficacy of systemic consumption of corticosteroids in alleviating symptoms of RTI. PATIENTS AND METHODS: This clinical trial was included 1671 pilgrims in Hajj 2012 who had symptoms of RTI based on caravan physician's findings. The patients were divided to two groups to receive either parenteral corticosteroid or other drugs. Patients who received antibiotics for bacterial infections were excluded. This survey concentrated on general symptoms of RTI during Hajj such as fever, musculoskeletal pain, coryza, sore throat, cough, dyspnea, and hoarseness before, 24 hours after, and five days after drug consumption. For classification and analysis of data, SPSS 17 was used. Descriptive statistical and Chi square test were used to compare variables. RESULTS: In comparison to corticosteroid injection, treatment without systemic corticosteroids could reduce the fever more significantly within five days (P < 0.05), while it had no effect after 48 hours (P > 0.05). Although corticosteroids alleviated the symptoms during the first 48 hours (P > 0.05), they had no more effect after five days of consumption (P > 0.05). Treatment with medications other than corticosteroid had less effect on reducing coryza (P > 0.05) while corticosteroids had significant alleviating effect on coryza, cough, and musculoskeletal pain (P < 0.05). CONCLUSIONS: There is a need to conduct more comprehensive studies on effect of combination therapy with corticosteroids and antibiotics as well as their short-term and long-term adverse effects on the immune system. While injecting corticosteroids is commonly administered in patients with RTI, they are not recommended due to the lack of data on their long-term therapeutic and adverse effects.

Glutathione and malondialdehyde levels in late pulmonary complications of sulfur mustard intoxication.

It has been hypothesized that antioxidant and oxidant capacities may be related to the severity of obstructive lung impairment in patients with sulfur mustard (SM)-induced lung injuries. Our study was designed to measure the level of glutathione (GSH) and malondialdehyde (MDA) activities in patients intoxicated with SM and to evaluate the relationship between their activity and the severity of pulmonary dysfunction. A total of 250 patients with a history of exposure to a single high dose of SM gas and also 60 healthy nonsmoking individuals with no history of exposure to SM were selected. All patients underwent spirometry; based on its indices they were divided into two groups: mild (n = 140) and moderate-to-severe (n = 110) pulmonary dysfunction. Also, serum GSH and MDA concentration measurements were performed for all patients and controls. The mean GSH level in controls was 29.85 +/- 3.26 micromol/ml, which was significantly higher than in patients with mild and moderate-to-severe pulmonary dysfunction (19.02 +/- 2.36 and 17.89 +/- 2.16 micromol/ml, respectively). Also, the mean MDA level in controls was 0.69 +/- 0.09 micromol/ml, which was significantly lower than in patients with mild and moderate-to-severe pulmonary dysfunction (0.74 +/- 0.05 and 0.75 +/- 0.05 micromol/ml, respectively). There was a weak linear correlation between GSH level and some of the pulmonary function indices. On the other hand, there was no significant relationship between the MDA level and pulmonary indices. Our study confirmed important alterations in the oxidative-antioxidative system in patients suffering from SM-induced lung injuries, as shown by a decreased serum level of GSH and an increased level of MDA. Individuals with moderate-to-severe SM-induced lung injuries show a greater tendency for a decreased level of GSH and an increased level of MDA than those with mild injuries; however, there is only minimal association between pulmonary function parameters and the serum level of MDA and GSH. These findings encourage us to examine therapeutic measures to correct such imbalances in future studies.

Evaluation of activity and phenotype of alpha1-antitrypsin in a civil population with respiratory complications following exposure to sulfur mustard 20 years ago.

BACKGROUND AND AIMS: The reduced alpha1-antitrypsin (AAT) activities of some phenotypes have been suggested as contributing to the development of respiratory diseases. MATERIALS AND METHODS: One hundred patients with respiratory disease following exposure to sulfur mustard were divided into two groups of 50 based on their respiratory symptoms and compared with a healthy control group. AAT phenotypes were determined in the plasma of all patient and control subjects by isoelectric focusing (IEF). RESULTS: Mean AAT activities in patient and control groups were 3.4 +/- 0.3 and 4.2 +/- 0.1 micromol min(-1) ml(-1), respectively (p < 0.001). No phenotypic alterations were detected. CONCLUSIONS: The difference in the clinical pulmonary symptoms of the two groups was attributed to reduced AAT activity, but this was not manifested as phenotypic changes identifiable by IEF.

Effect of depression on health care utilization in patients with end-stage renal disease treated with hemodialysis.

BACKGROUND AND OBJECTIVES: Depression is regarded as the most common psychiatric abnormality in patients on hemodialysis (HD) for end-stage renal disease (ESRD). Although several studies have demonstrated a relationship between depression and utilization of health care in ESRD and other chronic illnesses in developing countries, such evidence from hemodialysis patients is lacking in Iran. This study aims to investigate the effect of depression on health care utilization among Iranian hemodialysis patients. DESIGN: A longitudinal study. SETTING: Baqiyatallah Hospital (Tehran, Iran) between 2005 and 2006. PATIENTS: Of the 70 enrolled hemodialysis patients, 68 finished the study including 19 depressed and 49 non-depressed ones according to the Hospital Anxiety and Depression Scale (HADS). MEASUREMENTS: The subjects' health care utilization in a six-month period was prospectively assessed by recording the hospital admission and home nurse visits, outpatient physician visits, and patients' emergency department visits for any medical reason. The results were subsequently compared between the study groups. RESULTS: A higher hospital admission rate (94.7% vs. 55.1%, p=.002; Pearson's chi-square test) as well as a higher likelihood of emergency department visits (73.7% vs. 40.8%, p=0.002; Pearson's chi-square test) was seen in depressed patients. The frequencies of the other types of health care utilization were not statistically different between the two groups (p>0.05, Pearson's chi-square test). CONCLUSION: Depression in hemodialysis patients is associated with higher rate of hospital admission, and prospective studies should be conducted to assess whether treatment of depression will decrease health care utilization in these patients.

Prophylactic ophthalmic bethametazone for sulfur mustard-induced ocular injury.

BACKGROUND: The present study sought to evaluate the prophylactic effect of bethametazone on sulfur mustard (SM)-induced ocular morphometric damage in the rabbit eye. METHODS: Twenty five healthy New Zealand white rabbits were divided into 4 groups of normal (not exposed to SM or solution), solution (exposed to solution), SM (exposed to SM), and prophylactic bethametazone (received eye solution of bethametazone then exposed to SM solution; then treated for 2 weeks). On the day 14 after exposure, five-micron sections were stained with haematoxylin and eosin for light microscopy evaluation. The ocular morphometric characteristics in the study groups were compared to determine the prophylactic effects of the bethametazone. RESULTS: Bethamethazone could protect eyes from SM effect by means of decrease in changes in number of Keratocyte in 10000 µm(2), thickness of cornea (µm), thickness of corneal epithelium (µm), number of meibomian gland's cells in 2500 µm(2), thickness of palpebral conjuctival epithelium (µm), thickness of epithelial of palpebral skin (µm), number of epithelial layers of palpebral skin, and number of goblet cells in conjunctival sac in 1000 µm. CONCLUSIONS: Bethametazone may have a prophylactic effect on the early lesions of the eye of the rabbit due to SM exposure.

Activity and function in lung injuries due to sulphur mustard.

AIM: Pulmonary complications are known to occur in over half the patients exposed to sulphur mustard. Many studies have focused on the clinical complications, often ignoring the pathogenesis of sulphur mustard. Also, the reasons for the variable severity of lung injuries caused by sulphur mustard are unclear. Hence, the current study was performed to evaluate the correlation between superoxide dismutase (SOD) and catalase (CAT) activity and pulmonary function in patients exposed to sulphur mustard. METHODS: Our study was a comparative cross-sectional survey. Two hundred and fifty incident survivors were selected from the Sardasht population who were exposed to sulphur mustard in 1987. A control group from non-exposed civilians was also selected. We used a pulmonary function test, and SOD and CAT activity was measured in these groups. RESULTS: The mean SOD activity in the healthy control group (70.5+/-10.8 U ml(-1)) was higher than in the moderate-to-severe group (67.0+/-6.1 U ml(-1)) (p <0.001, one-tail ANOVA, least significant difference (LSD) post hoc). The mean activity in the mild group (72.5+/-6.9 U ml(-1)) was no higher than in the healthy control group (70.5+/-10.8 U ml(-1)) (p=0.095 one-tail ANOVA, LSD post hoc). The mean CAT activity in the healthy control group (4.9+/-1.5 U ml(-1)) was lower than in the moderate-to-severe group (8.0+/-1.8 U ml(-1)) (p <0.001, one-tail ANOVA, LSD post hoc) and in the mild group (7.5+/-1.5 U ml(-1)) (p=0.012 one-tail ANOVA, LSD post hoc). CONCLUSION: According to our findings, it is reasonable to hypothesize that re-establishment of the activation-inactivation or oxidant-antioxidant balance in favour of the activation and antioxidant balances would be useful as a therapeutic strategy to suppress pathological mechanisms underlying lung injuries.