Background: Education of the patients with Coronavirus Disease 2019 (COVID-19) and their families is necessary to improve the quality of life. This study investigated the effect of person and family-centered training via telenursing on the quality of life in patients with COVID-19. Methods: This interventional study was performed on 88 patients with COVID-19 18--65 years and 44 family members referred to the Bank Melli Hospital, Tehran, Iran. The samples were randomly assigned into two groups person-centered and family centered. A cyberspace group including patients and their families was created. Four educational sessions planned (15--30-min-every day) and three sessions planned for completing the questionnaires via phone. The data were collected using demographic characteristics form and the 12-item Short-Form Health Survey version 2 before and 6 weeks after the intervention and were analyzed in SPSS 22 using Chi-square test, paired t-test, and independent t-test. Results: The mean scores of quality-of-life increased significantly in the person-centered group from 26.81 ± 5.15 to 34.4 ± 4.39 before and six weeks after intervention, respectively (p < 0.001). The means scores of quality-of-life increased significantly in the family-centered group from 28.11 ± 4.79 to 35.86 ± 3.85 before and 6 weeks after the intervention, respectively. (p < 0.001). Conclusions: The person and family centered methods increase the mean scores of quality-of-life of patients with COVID-19. The family centered method can be more effective to improve the quality of life of these patients.

Congenital hypothyroidism (CH) is one of the most treatable endocrine disorders in infants and children that can influence the function of many organs in the body. On-time diagnosis and treatment can prevent the adverse effects of thyroid hormone deficiency on the child's neurodevelopment. There are many challenges in screening, post-screening, diagnosis, and managing this disorder. Therefore, this article aimed to mention updated information on this issue. Although there are different approaches for the treatment of hypothyroidism, the authors decided to create a national approach based on the conditions of our country.

Background: Comprehensive assessment of health care quality is the first step in improving care and achieving health service goals. Therefore, this study aimed to conduct a systematic review and meta-analysis of health care quality in Iran based on the Comprehensive Quality Measurement in Health Care model. Methods: In this study, the databases of PubMed, Scopus, Web of Science, Iranian Scientific Information Database (SID), MagIran, and Google Scholar were searched using English and Iran keywords without time limit. STATA 16 software and a random effect model were used for conducting meta-analysis. Results: Of the 750 articles found, 20 were finally included; 13 of which were related to service quality, five to customer quality, and four to technical quality. Overall mean score of service quality was 7.79 [95% CI 7.43–8.15, df = 12, I² = 98.48, P value < 0.000] out of 10, and overall mean score of customer quality was 73.20 ± 4.56 [95% CI 65.18–81.22, df = 5, I² = 99.34, P value < 0.001] out of 100. Among the 12 dimensions of service quality, the confidentiality dimension (9.55 ± 0.12) had the highest mean score and the group support dimension (5.92 ± 0.901) had the lowest score. In general, from the viewpoint of service receivers, the technical quality is relatively favorable. Conclusions: According to the results of this study, the quality of health care in Iran is significantly far from ideal. Therefore, planning to improve providing health care is essential.

An epidemic of infectious diseases such as COVID-19 can affect mental health, which may be associated with suicidal behaviors. This study was conducted based on the systematic review and meta-analysis methods for evaluating the prevalence of suicide ideation during COVID-19. This study used Preferred Systematic Review Reporting System and Meta- Analysis guideline and valid keywords. The articles related to the prevalence of suicide ideation during COVID-19 pandemic were obtained by searching among different databases including Scopus, Web of science, PubMed, ISC, Google scholar, SID, and Magiran. All of the articles published from the beginning of January 2020 to the end of May 2021 were reviewed. Among 478 articles screened, 377 articles were related to the studied topic, among which 38 articles were selected after assessing the title and abstract of which for reviewing the full text and finally 18 studies were included in the meta-analysis. Based on the results, the prevalence of suicide ideation and attempt among all studies were equal to 13% (95% confidence interval = 0.11-0.15, I2 = 99.7%, P = 0.00) and 1% (95% confidence interval = 0.00-0.01, I2 = 95.5%, P = 0.00), respectively. Based on the results, the prevalence of suicide attempt and ideation is possible during the COVID-19 pandemic. Therefore, health officials should pay attention to mental health issues in addition to the protective measures for preventing or reducing the infection with COVID-19. The increase of psychological consequences is probably related to the effect of lifestyle changes which associates with the spread of the disease. In the current meta-analysis performed, the prevalence of suicidal ideation and suicidal attempt was examined during the COVID-19 pandemic period and compared to the previous period without COVID-19. The effect of COVID-19 on suicidal ideation and suicidal attempt has never been studied.

Background: Hearing loss is one of the most common congenital disorders. The Early Diagnosis and Intervention Process is designed for the early diagnosis and intervention of hearing loss in infants. The present study aimed to examine the results of Early Hearing Detection and Intervention (EHDI) in northeastern Iran from 2005 to 2019. Setting: Northeastern Iran. Methods: In most cases, the two-stage protocol (otoacoustic emissions [OAE] and automated auditory brainstem response [AABR]) has been used. Infant assessment methods included the use of OAE, ABR, auditory steady-state response, high-frequency tympanometry, and behavioral audiometry. Interventions included medical interventions, hearing rehabilitation, hearing aids, and cochlear implants. Results: 1,162,821 infants were screened. The screening coverage increased from less than 1% in 2005 to about 99% in 2018. The referral rate has been about 1%. 2.17 out of every 1000 infants are hearing impaired, and the most common cases are bilateral hearing loss and mild to moderate hearing loss. Conclusions: During 2005 to 2019 the coverage rate reached to more than 95% of live births. To improve the EHDI process in this population, better follow-up of diagnosed neonates and expansion of diagnostic and intervention services are needed.

Background: The household is considered as a private area that is untouched tobacco control policies in developing countries, especially in Indonesia, which has not ratified the Framework Convention on Tobacco Control (FCTC) treaty. Objectives: This study aims to identify smoking behavior and expenditure on cigarettes in the household, which are part of the initiation of a policy including a smoke-free home, so it assumes that the home is a public domain in Tegal Regency, Central Java Province, Indonesia. Methods: This research is an observational study with a quantitative descriptive design. A total of 225 subjects in the seven regions designated as smoke-free areas were all selected as samples in this study and were willing to be the subject of research. Results: The results found that 76.1% of smokers smoked with their nuclear family (wife/children/husband) present. Smoking behavior with the nuclear family inside the home (39.13%) and outside the home (36.96%) was more common than not smoking with the nuclear family. Expenditure for cigarettes per month was one-third of household revenue (IDR 607,521.74) based on the regency minimum wage (UMR) set by the local government. Conclusions: The study concludes that smokers who smoke with family still lack knowledge on smoking's impact on health and household economics. The smoke-free regulation that is initiated should include households as a parameter.

Background: The evolving COVID-19 outbreak requires a high level of population awareness and other measures to protect public health. Objectives: In this study, we aimed to identify knowledge, awareness, and fears of the Saudi population regarding COVID-19 during this pandemic. Methods: A cross-sectional survey study was conducted from April to May 2020 in different Saudi areas. Data were collected via online survey software (Google Forms), and the data collection tool was developed and validated by the study authors to fulfill the study objectives. Data were analyzed using SPSS version 21.0. Descriptive statistics and Chi-square tests were used for comparison between groups. The statistical significance was considered when the P value ≤0.05. Results: Study participants included 2982 people with 66.8% females. The average percentage of the awareness levels of the current study population was 68%. The vast majority (95.1%) did not know how the virus spread while 94.7% of the participants know the distance that a person should maintain from another person. Significantly higher percentages (70%) knew about and were aware of the prevention methods, including social distancing and hand hygiene, and 73.5% knew that elderly people with chronic diseases are the highest risk group to become infected. The highest significant fear of COVID-19 was from lack of treatment, which was reported by 77.5% of the participants with a P value of <0.05. Conclusions: Our study shows that the population has acceptable knowledge about COVID-19. Education and work-based awareness programs about COVID-19 are needed, especially for prevention and treatment aspects.

Background: Smoking is a public health problem that affects the adolescent population's health. This study aimed to investigate the relationship between extroversion (compared with introversion) and transition in cigarette and hookah smoking stages in high-school students to use the results in smoking prevention programs. Methods: A sample of 2312 students aged 15–16 years in Tabriz were included in the study. Demographic characteristics, cigarette, hookah smoking status, and Eysenck's extroversion questionnaires were completed by all students in the selected schools. Eight months later, cigarette and hookah smoking status were assessed again to determine transition in smoking stages. The marginal homogeneity (MH) test was used to compare the smoking status at the beginning and 8 months later. The generalized estimating equation (GEE) method with the ordinal link was applied to estimate the effect of extroversion on transition in smoking stages. Results: The mean (standard deviation) age of the students participating in the study was 15.5 (0.5) years. MH test results showed that, in general, transmission in the stages of both cigarette and hookah smoking in 8 months was significant in students (P-value < 0.0001). Extrovert personality had a significant positive effect on the transition from lower stages to higher cigarette and hookah smoking stages according to the GEE with ordinal link (P = 0.01). In cigarette and hookah smoking, extrovert persons transited to higher stages 1.64 and 1.55 times more than introvert persons. Conclusions: Being an extrovert person had a significant effect on the transitioning to higher stages of smoking cigarettes and hookah. In designing cognitive programs to prevent people from smoking or encourage them to quit smoking, considering this dimension of personality trait can be useful in the efficacy of the program.

Background: Disturbed biochemical factors have been observed in viral infections including SARS, Ebola virus, and now COVID-19. This study aimed to evaluate the association between Calcium axis' derangements and hospital duration, ICU admission, mechanical ventilation, and death in patients with COVID-19. Methods: 428 hospitalized patients with COVID-19 were included in this study. On the first day of admission, the patients were extensively evaluated for biochemical and hormonal factors and followed up until discharge/death. The association between hyperphosphatemia, hypoalbuminemia, and hypocalcemia and major outcomes, including hospital duration, ICU admission, mechanical ventilation, and death, was investigated by logistic regression analysis. Results: Hyperphosphatemia and hypoalbuminemia were present in 27 (6.3%) and 59 (13.8%) cases, respectively in the study population. The results of the present study reveal the relation of these factors with worse outcomes in COVID-19 patients; such as hospital duration, ICU admission, mechanical ventilation, and death. On the other hand, high frequency of hypocalcemia (59.1%, 253 subject) has no significant influence on the mentioned outcomes (All P values were greater than 0.05). Conclusions: Poor outcomes were associated with hyperphosphatemia and hypoalbuminemia. It seems that we should evaluate the patients for derangements of phosphate, albumin, and calcium and try to treat them for all COVID-19 patients.

Background: Kidney disorders are mainly diagnosed after a major decline in the renal function. Chronic kidney disease (CKD) is one of the most common disorders of the urinary system defined by gradual reduction of renal function. Considering the silent nature and late diagnosis of this problem, this study aims to investigate the prevalence of CKD and its association with Complete Blood Count (CBC) profile and liver function tests. Methods: Out of the total population enrolled in the Tabari cohort study, 5822 subjects without history of diabetes mellitus, hypertension, cardiac disease, renal failure, cancer, and pathologic obesity were selected. Glomerular filtration rate (GFR) was calculated using creatinine clearance as well as Modification of Diet in Renal Disease (MDRD) equation. CKD was defined as GFR decline less than 60 ml/min/1.73 m² regardless of its main cause. Results: Prevalence of CKD in total population as well as men and women was 20.2%, 16.8%, and 23.1%, respectively. Multivariate models showed the odds ratios for third and fourth quartiles of Mean corpuscular volume (MCV) and also for the fourth quartile of the lymphocyte count as of 0.78 (0.64, 0.95), 0.81 (0.67, 0.99), and 1.22 (1.01, 1.47), respectively. Corresponding odds ratios for the fourth, third, and second quartiles of Blood Urea Nitrogen (BUN) were 1.42 (1.14, 1.77), 1.76 (1.42, 2.19), and 2.79 (2.27, 3.43), respectively. Conclusions: This study showed a high prevalence of CKD among the normal residents (without major underlying diseases and excessive obesity) in the north of Iran, especially among women. In addition, low MCV, low lymphocyte, and high BUN were detected as predictors of this disorder.

Background: The present study aimed to investigate the effect of garlic supplementation on oxidative stress markers in patients with polycystic ovary syndrome (PCOS). Methods: Eighty patients with PCOS were randomized and instructed to consume either garlic supplementation (800 mg/day) or a placebo (starch) for 8 weeks. They were also asked to avoid intake of any other supplement during the study. Oxidative stress-related markers including total antioxidant capacity, catalase, glutathione, malondialdehyde concentrations, and anthropometric measures were assessed at baseline and end of the trial. Results: Garlic supplementation resulted in significant improvement in catalase concentration (1.82 ± 9.28 vs. –1.55 ± 8.66; P value: 0.03), glutathione levels (29.15 ± 57.53 vs. 2.42 ± 77.51; P value: 0.048) as well as weight (–0.64 ± 1.94 vs. 0.11 ± 0.82; P value: 0.04), body mass index (BMI; –0.25 ± 0.75 vs. 0.05 ± 0.61; P value: 0.04), and waist circumference (–0.21 ± 0.77 vs. 0.02 ± 0.65; P value: 0.01). However, we failed to detect any significant change in hip circumference, waist to hip circumference ratio, total antioxidant capacity, and malondialdehyde levels between the two groups. Conclusions: The present study indicates that garlic supplementation could be beneficial in improving oxidative stress and weight loss among PCOS women.