IntroductionThe uptake of Pap smear among Iranian women is low, resulting in a high rate of casualties from cervical cancer in Iran. The present study used the Health Belief Model (HBM) and the Stages of Change theory as theoretical frameworks for understanding the predictors of the behaviour of Iranian Women Health Volunteers (WHVs) with respect to cervical cancer screening.MethodsData from the 1,253 WHVs were analyzed using path analysis to assess the effects of cognitive factors (including knowledge, perceived susceptibility to cervical cancer, perceived severity of cervical cancer, Pap smear benefits, Pap smear barriers, and Pap smear self-efficacy) on the stages of change for Pap-smear behaviour.ResultsThe majority of the respondents (71.5%) reported that they had not taken previous Pap smear tests; only 3% had received a regular Pap test. The perceived benefits to cervical cancer screening, the perceived barriers to cervical cancer screening, and the perceived self-efficacy to perform cervical cancer screening emerged as the predictors of cervical cancer screening’s stages of change; perceived threat to cervical cancer, however, did not.DiscussionUptake of regular cervical screening for Iranian WHVs was very low. Different interventions, such as media campaigns and educational interventions could provide an opportunity to improve women's knowledge on cervical cancer and Pap test benefits, address any misconceptions or fears about the procedure of the Pap test, and finally increase the cervical screening uptake by Iranian women.

Background Coronavirus Disease 2019 (Covid-19) is expanding worldwide. The characteristics of this infection in patients varies from country to country. To move forward, clinical data on infected patients are needed. Here, we report a comparison between fatalities and recovery of patients with severe Covid-19, based on demographic and clinical characteristics. Methods Between 5 March and 12 May 2020 in Mashhad, Iran, 1278 of 4000 suspected Covid-19 patients were confirmed positive by real-time reverse-transcriptase–polymerase-chain-reaction assay of upper respiratory specimens. We compared the demographic, exposure history and clinical symptoms of 925 survivors and 353 fatal cases with confirmed disease. Results Mean (SD) age for all confirmed patients was 56.9 (18.7) years, 67.1 (15.9) years in fatal cases and 53.0 (18.3) years in survivors. Multivariate logistic regression analysis showed that the outcome of patients was associated with age (odds ratio = 1.049, P = 0.0001, 95% CI = 1.040–1.057). Despite a high burden of Covid-19 infections in the 30–39 and 40–49 year age groups, most of these (89.6 and 87.2%, respectively) recovered. The median (IQR) duration of hospitalization was 9.0 (6.0–14.0) days. The most prevalent co-morbidities were cardiovascular disorders (21%) and diabetes (16.3%). Dyspnoea (72.7%), cough (68.1%) and fever (63.8%) were the most frequent clinical symptoms. Healthcare workers, of whom two (3%) died, comprised 5.2% of infected cases. Combination antiviral and antibiotic therapy was used in 43.0% of cases. Conclusions The characteristics of severe Covid-19 varied substantially between fatal cases and survivors, with diabetes and cardiovascular disorders the most prevalent co-morbidities. In contrast to other studies, there were a higher number of fatalities in younger patients in our setting.

Coronavirus disease 2019 (COVID-19) can present with a variety of symptoms. Severity of the disease may be associated with several factors. Here, we review clinical features of COVID-19 inpatients with different severities. This cross-sectional study was performed in Imam Reza hospital, Mashhad, Iran, during February–April 2020. COVID-19 patients with typical computed tomography (CT) patterns and/or positive reverse-transcriptase polymerase chain reaction (RT-PCR) were included. The patients were classified into three groups of moderate, severe, and critical based on disease severity. Demographic, clinical, laboratory, and radiologic findings were collected and compared. P < 0.05 was considered statistically significant. Overall, 200 patients with mean age of 69.75 ± 6.39 years, of whom 82 (41%) were female were studied. Disease was severe/critical in the majority of patients (167, 83.5%). Disease severity was significantly associated with age, malignant comorbidities, dyspnea, nausea/vomiting, confusion, respiratory rate, pulse rate, O2 saturation, extent of CT involvement, serum C-reactive protein (CRP), pH, pO2, and aspartate transaminase (P < 0.05). Moreover, complications including shock, coagulopathy, acidosis, sepsis, acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission, and intubation were significantly higher in patients with higher severities (P < 0.05). O2 saturation, nausea/vomiting, and extent of lung CT involvement were independent predictors of severe/critical COVID-19 (OR 0.342, 45.93, and 25.48, respectively; P < 0.05). Our results indicate O2 saturation, nausea/vomiting, and extent of lung CT involvement as independent predictors of severe COVID-19 conditions. Serum CRP levels and pO2 were also considerably higher patients with higher severity and can be used along with other factors to predict severe disease in COVID-19 patients.

Background: Quality of life is one of the most important health-related outcomes that can be affected by mobile phone addiction. This study was conducted to determine the prevalence of mobile phone addiction and its relationship with quality of life in students of Birjand University of Medical Sciences (BUMS). Methods: This cross-sectional study was conducted on 360 students in BUMS in 2018. The sample was randomly selected from each faculty using proportional stratified sampling. To collect data, a questionnaire containing the demographic variables, the PMPAS questionnaire for mobile addiction and SF-12 for quality of life were used. Data were analyzed by independent t-test and Pearson correlation coefficient in SPSS (V.18). Results: The mean age of the students was 25.1 ± 6.3 years that 75.5% were female. In terms of marital status, 60.6% were single. Nearly 75% of students were with moderate or severe mobile phone addiction. The score of mobile phone addiction was higher in single and younger students (p < 0.001). The mean score of quality of life for the students in two aspects of the physical and mental component were 50.81 and 42.86 respectively. Based on the results, there was a significant inverse relationship between scores of mental function and mobile phone addiction (r = −0.35, p < 0.001), this relation was not significant for physical function (r = −0.60, p = 0.25). Conclusions: According to the results, the prevalence of mobile phone addiction among students was high and mobile phone addiction has a negative effect on the quality of life of students, which has a negative effect on psychological performance.

Background: Understanding people, physicians, and healthcare workers' knowledge, attitude, and practices (KAPs) can help to achieve the outcomes of planned behavior. The aim of this study was to investigate and synthesize the current evidence on KAPs regarding COVID-19. Methods: We conducted a systematic search on PubMed/LitCovid, Scopus, and Web of Sciences databases for papers in the English language only, up to 1 Jul 2020. We used the Joanna Briggs Institute (JBI) checklist developed for cross-sectional studies to appraise the quality of the included studies. All stages of the review conducted by two independent reviewers and potential discrepancies solved with a consultation with a third reviewer. We reported the result as number and percentage. PROSPERO registration code: (CRD42020186755). Results: Fifty-two studies encompassing 49786 participants were included in this review. 45.76% of the participants were male. The mean age of the participants was 32.6 years. 44.2% of the included studies were scored as good quality, 46.2% as fair quality, and remaining (9.6%) as low quality. 30.76% examined all three components of the KAPs model. The knowledge component was reported as good, fair, and poor in 59%, 34%, and 7%, respectively. Of the studies that examined the attitude component, 82% reported a positive attitude, 11% a fairly positive attitude, and 7% a negative attitude. For the practice component, 52% reported good practice, 44% fair practice, and 4% poor practice. Conclusion: This systematic review showed that the overall KAP components in the included studies were at an acceptable level. In general, knowledge was at a good level, the attitude was positive and practice was at a fairly good level. Using an integrated international system can help better evaluate these components and compare them between countries.