A BSTRACT Medical education is socially responsible for a global educational movement that transforms the development and presentation of medical schools in higher education. Therefore, in the present systematic review, we aimed to evaluate the impact of socially accountable health professional education. Published research articles were reviewed by searching the relevant terms invalid databases. In the initial search, 2340 records were obtained. At this stage, 1482 records were deleted due to duplication, and 773 records were removed due to indirect connection with the subject. Then, 85 articles were retrieved for full-text review. Finally, the complete review led to the selection of nine studies that met all inclusion criteria. Based on the results of the present systematic review, among the nine reviewed articles, four studies (44.44%) evaluated the effectiveness of social accountability on increasing the sense of empowerment, self-confidence, competencies such as teamwork, communication skills, and readiness for work. Three studies (33.333%) assessed the effectiveness of social accountability on providing further and better medical services and reducing infant mortality. Also, in two articles (22.22%), students’ lack of knowledge about social accountability was studied. Social accountability can help cultivate a healthy and skilled medical workforce and be effective in improving health services provided to the people. On the other hand, there are different perceptions and views on what social responsibility really is and how its effectiveness can be measured. Also, it is highly important to provide awareness in this regard for students.
Introduction: Elder abuse is a major public health concern worldwide. Considering the high prevalence of misbehavior towards the elderly, this study investigated the prevalence of elder abuse and its related factors among the elderly people in Yasouj, Iran in 2021. Methods: Using a convenience sampling method, this cross-sectional study included 299 older adults aged over 60 years referring to the Social Security Outpatient Clinic in Yasouj. To collect data, we used the Domestic Elder Abuse Questionnaire. To analyze the data, chi-square and multiple logistic regression statistical tests were used. Results: Of the participants, 55.2 % reported at least one type of misbehavior. While psychological misbehavior had the highest prevalence (41.8 %), rejection had the lowest prevalence (10.7 %). Multiple regression analysis showed that elder abuse was statistically associated with higher educational status (p = 0.002), lower economic status (p = 0.002), and single people reported a higher rate of elder abuse (p = 0.001). Conclusion: According to our results, more than half of the participants reported at least one type of elder abuse, and psychological abuse was the most common type of abuse experienced by the elderly. Since elder abuse can have serious effects on the health and well-being of the elderly, it is critical to identify the related risk factors. Furthermore, it is essential to implement screening programs to increase the awareness of the elderly and caregivers.
We report a 74-year-old male with a recent history of COVID-19 pneumonia who was admitted with acute periumbilical and left lower quadrant pain and respiratory distress. Laboratory data showed pre-renal azotemia and microscopic hematuria. An abdominopelvic computerized tomography (CT) scan with intravenous contrast was conducted, showing signs of right renal vein thrombosis (RVT) with extension to inferior vena cava (IVC), without any evidence of renal ischemia. The patient did not have any risk factors for thrombosis except for probable hypercoagulopathy due to COVID-19 and diabetes mellitus. He was not an appropriate candidate for surgical or radiologic thrombectomy, thus received heparin infusion accordingly. Unfortunately, he died after the cardiopulmonary arrest on the second day of admission. Considering his respiratory distress, we suspect pulmonary embolism as the most probable cause of death.
Introduction: Apart from the direct effect of COVID-19 on the incidence of ischemic heart disease, the pandemic effect of this infection on the control of ischemic heart disease and on the clinical consequences of these patients and also their hospital admission is also significant. Objectives: The present review attempted to assess the admission rate, treatment protocols, and outcome changes in patients suffering ST-segment elevation myocardial infarction (STEMI) in the COVID-19 outbreak. Materials and Methods: The included studies were identified through electronically reviewing the manuscripts databases of MEDLINE, EMBASE, Web of knowledge, and Google Scholar from inception to September 2020. The titles and abstracts of the manuscripts were screened by two blinded reviewers followed by an in-depth assessment of the full texts for assigning the inclusion appropriateness. Results: Eighteen articles (including 6225 STEMI patients hospitalized within the COVID-19 pandemic duration and 55711 STEMI patients in pre-COVID-19 periods) were desirable for the final analysis. A longer delay among symptom onset and first medical contact (FMC) in the COVID-19 lockdown period than before the COVID-19 pandemic was revealed. Comparing STEMI-related death in the COVID-19 period compared to the pre-COVID-19 duration showed a significantly higher death rate and a higher rate of thrombolytic therapy. The examined pre-COVID-19 and COVID-19 periods showed a reduction in STEMI patients’ admissions reached 30.9%. Additionally, entering the COVID-19 period resulted in a significant 44.4% reduction in the number of primary percutaneous coronary intervention. Conclusion: During the COVID-19 pandemic, the management of STEMI has undergone significant changes, including reduced hospital admissions, reduced invasive and semi-invasive treatment interventions, increased STEMI-related mortality, increased thrombolytic therapy, and delayed patients’ referral to the hospitals.
Objectives: The use of herbal medicine is one of the most widely used methods of complementary medicine around the world. Studies have shown that the elderly use a variety of herbal medicines and believe that these products are harmless due to being natural. This study aims to evaluate the amount of herbal medicines prescribed by physicians for the elderly in Iran. Methods & Materials: This is a secondary analysis study with a cross-sectional design. The study population consist of the paper prescriptions for all older adults in Tehran, Iran in 2020. Of these, 1591 paper prescriptions for older people aged >60 years referred to pharmacies in Tehran were selected by a cluster random sampling method. The data were analyzed using descriptive statistics (Mean, No. [%]) and inferential statistics (Chi-square test, independent t-test) in SPSS software, version 24. Results: Out of 1591 prescriptions, 79(5%) contained herbal medicines. Laxatives, ginkgo, and ginseng were the most prescribed medicines. Chi-square test results showed the statistically significant relationship of the educational level of the elderly (P=0.018), having insurance (P=0.004) and polypharmacy (P=0.000) with the prescription of herbal medicines, but the gender and marital status of the elderly and the gender, age and work experience of the physicians had no significant relationship with the prescription of herbal medicines. The rate of herbal medicine prescription by general practitioners was 5.7% and by specialized physicians was 4.7%, but no significant relationship was found between them. Among the specialized physicians, infectious disease specialists prescribed the most herbal medicines (14%) followed by physical medicine specialists (12%) and orthopedics (9.2%). Chi-square test results showed a significant relationship between the expertise of physicians and prescription of herbal medicines (P=0.042). Conclusion: The rate of herbal medicine prescription in Tehran city is low, but due to the interest of the elderly in herbal medicines, producing various herbal medicines with suitable forms and dosages and increasing the knowledge of physicians about these medicines can help increase the prescription of herbal medicines.
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