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Introduction: This study assessed the incidence and severity of side effects associated with coronavirus disease 2019 (COVID-19) vaccination among healthcare workers registered with the Medical Council of the Islamic Republic of Iran. Methodology: A retrospective cohort study was conducted on the healthcare workers focusing on the side-effects of COVID-19 vaccines from March to June 2021. Data were collected using online questionnaires. Multivariable logistic regression was used to assess the association between side effects of the vaccines and demographic variables, comorbidities, vaccine type, and history of COVID-19. Results: Out of 42,018 people who were included, 55.85% reported at least one side effect after receiving the first vaccine dose. 4.59% of those with side effects sought diagnostic intervention or were referred to treatment centers. Multivariable logistic regression indicated that being a woman, higher education, having a history of COVID-19 infection, and having comorbidities increased the risk of side effects. The AstraZeneca vaccine significantly increased the risk of side effects compared to the Sputnik vaccine, while the Sinopharm vaccine decreased this risk. The risk of developing a side effect decreased with age. The risk of moderate and severe side effects was significantly associated with gender, younger age, comorbidities, and a history of COVID-19 infection. Moderate and severe side effects were less reported by those who received the Sinopharm vaccine. Conclusions: Clinical complications after COVID-19 vaccination, directly or indirectly caused by the vaccines, are common. However, the benefits of COVID-19 vaccines greatly outweigh the risk of reversible side effects, especially among the high-risk population. [ABSTRACT FROM AUTHOR]

Introduction: Drug-drug interactions (DDIs) can reduce therapeutic efficacy and increase the duration and cost of hospitalization so that patients are sometimes exposed to significant complications and even death. Patients in the intensive care unit (ICU) are at higher risk of DDIs for a variety of reasons, including impaired absorption, decreased metabolism, and renal failure. The main objective of this study was to evaluate frequency, clinical ranking and risk factors of potential DDIs in the ICUs of 3 teaching hospitals in Ardabil. Methods : In this descriptive-analytical cross-sectional study, drug prescriptions 355 patients admitted to the ICUs were studied. Patient information including age, sex, diagnosis, number of prescribers, number of drugs, length of stay, and status of patients' discharge (recovery or death) were recorded and checked using the online software up to date and the book Drug Interaction Facts. Finally, the data were statistically analyzed using the SPSS software. Results : The number of patients studied was 355. The mean age of the patients were 51.88 ± 23.22 years, and on average, 8.45 drugs had been prescribed for each patient. The total number of DDIs was 1597 among which class X was 1.4%, class D was 26.2%, and class C was 67.7%. Four hundred ninety-seven unique pairs of DDIs were identified. Age, number of prescribed drugs and length of stay in ICU were associated with prevalence of DDIs. Age and number of drugs were also identified as the risk factors of patients' discharge caused by death. Conclusion : DDIs can complicate health state of patients in ICUs and may increase the length of hospital stay. Setting up computerized systems to alert drug interactions in hospital wards and pharmacotherapeutic intervention by clinical pharmacist can minimize DDIs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Increased fear and anxiety among the general public following the emergence of coronavirus 2019 (COVID-19) can lead to hypochondriasis as well as indiscriminate use of drugs, versus the disease. OBJECTIVE: The present study was conducted to identify the frequency and causes of self-medication and hypochondriasis among students. METHODS: This descriptive cross-sectional study was conducted among 241 students of different disciplines of Khalkhal University of Medical Sciences in northwestern Iran over a period of six months. SPSS 26 software, Chi-square and Fisher tests were used to analyze the data. RESULTS: The rate of self-medication was calculated 51%. The highest rate of self-medication was in the form of tablets (75.6%) and capsules (28.5%) and the highest type of medication was herbal medicine (59.3%) and multivitamins and complementary drugs (54.5%). The most common cause of self-medication was previous use and the effectiveness of the drug in the past (79.7%). The mean score of hypochondriasis was calculated at 21.52 (11.02) and the majority of students (49.8%) were in the healthy group. There was a statistically significant association between hypochondriasis and self-medication (p = 0.002). CONCLUSION: Based on the findings, more than half of the participants in the study had self-medication. About 20% of students also experienced mild to moderate hypochondriasis. Therefore, it is suggested that the necessary training and support be provided to deal with the side effects of these two phenomena. [ABSTRACT FROM AUTHOR]

Background: Sirolimus is a potent immunosuppressive in renal transplantation. However, its use is limited by some reported side effects. The objective of this study was to determine the side effect profile of sirolimus in renal transplant patients. Materials and Methods: In the present study, we retrospectively reviewed the medical records of 116 renal transplant patients treated with sirolimus alone or in combination with other immunosuppressive agents at private therapeutic centers in Isfahan, Iran, between March 2009 and February 2020. A checklist was used to collect data on demographic and clinical variables. Data were analyzed with independent samples t test and Chi squared test. Results: Our findings indicated that the most prevalent sirolimus related side effects were edema (42.3%), proteinuria (37.5%), cytopenia (26.9%), abnormal level of liver enzymes (11.7%), and pneumonitis (9.7%). Stratification of side effects by sirolimus dose (<2 mg and ≥2 mg) demonstrated their dose independent occurrence (P > 0.05). Pneumonitis was the most frequent reason for sirolimus cessation (58.7%). No significant differences were observed between males and females regarding the frequency of reasons for sirolimus cessation (P > 0.05). Conclusion: Edema, proteinuria, cytopenia, abnormal level of liver enzymes, and pneumonitis were the most prevalent sirolimus related side effects in renal transplant patients. Further prospective cohort studies are warranted to detect underlying mechanisms and determinants of these side effects in renal transplant patients treated with sirolimus. [ABSTRACT FROM AUTHOR]

Objective: Vaccination is one of the effective ways to fight against COVID-19 disease. Various vaccines have been designed during the coronavirus pandemic. Each of the used vaccines has beneficial effects as well as side effects. Healthcare workers were among the first vaccinated persons against COVID-19 in different countries. The current study aims to compare the side effects of AstraZeneca, Sinopharm, Bharat, and Sputnik V on healthcare workers in Iran. Methods: This descriptive study was conducted from July 2021 to January 2022 on 1639 healthcare workers who received the COVID-19 vaccines. Data were collected using a checklist that contained questions related to systemic, local, and severe side effects of the vaccine. The collected data were analyzed using the Kruskal-Wallis, Chi-square, and trend chi-square. P <.05 was regarded as a significant statistical difference. Results: The most commonly injected vaccines were Sinopharm (41.80%), Sputnik V (36.65%), AstraZeneca (17.75%), and Bharat (3.80%), respectively. At least 37.5% of participants reported one complication. The most common side effects after 72 hours of the first and second doses were as follows: injection site pain, fatigue, fever, myalgia, headache, and chill. Overall complication rates were reported as follows: AstraZeneca (91.4%), Sputnik V (65.9%), Sinopharm (56.8%), and Bharat (98.4%). Bharat showed the highest overall side effects, while Sinopharm had the lowest overall side effects. Also, our results indicated that individuals with a previous history of positive COVID-19 infection had a higher rate of overall complications. Conclusions: The majority of participants did not show life-threatening side effects after the injection of 1 of the 4 studied vaccines. Since it was well accepted and tolerable by the participants, it can be used widely and safely against SARS-CoV-2. [ABSTRACT FROM AUTHOR]

Aims The new coronavirus disease (COVID-19), as a second epidemic of the 21st century, causes severe acute respiratory syndrome in patients. This study was designed to determine the causes of not vaccinating against COVID-19 in the eligible population of Fars province. Instruments & Methods This cross-sectional study was carried out in December 2021 to March 2022 on unvaccinated people of Fars province, Iran. The data of 12889 individuals were added to the study. The data collection tool was a researcher-made checklist with closed-ended questions that were completed through a telephone interview. Data were analyzed using SPSS 22 software through descriptive statistics and a Chi-square test. Findings The largest age group was 25 to 35 years old (19.8%). The percentage of unvaccinated females was significantly higher than males (p<0.001). Homemakers and college and school students were the occupational groups with the highest frequency of not receiving the vaccine. The considerable reasons for not being vaccinated are the side effects anxiety, and lack of belief in the vaccine conspiracy. Conclusioi The women of reproductive age and college and school students are the most frequent unvaccinated groups. Having an underlying disease and the lack of follow-up by the healthcare staff are the most frequent reason for not being vaccinated. [ABSTRACT FROM AUTHOR]

Background and Objectives: Morbidity and mortality caused by sever acute respiratory syndrome 2 (SARS-CoV-2) can decrease with effective vaccination. The current study assessed relationships between the food intakes and nutritional habits before vaccination and the severity of vaccination-linked symptoms. Materials and Methods: Totally, 586 participants (377 cases with moderate to severe symptoms after COVID-19 vaccination and 209 controls with no clinical symptoms after vaccination) were investigated in a case-control study. Food frequency questionnaire was used to investigate dietary food group intakes during a year. Food habits were assessed using general questionnaires. Logistic regression models were used to estimate strength of the associations between the history of food intakes and the odds ratios (ORs) of side symptoms after vaccination. Results: After considering energy intake, gender, vaccine type, type of dairy products and BMI in the logistic regression models, consuming yogurt and cheese during the year before the vaccination significantly increased the occurrence of side effects after vaccination with COVID-19 vaccine (OR = 4.153; 95% confidence interval (CI) = 2.182-7.902; p < 0.001), (OR= 1.556; 95% CI = 1.007-2.404; p = 0.047), respectively. In the group with side effects after vaccination, more participants consumed low-fat dairy, compared to the control (p = 049). Conclusions: It seems that intake of yogurt and cheese can increase the odds of side effects after COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Objective One-third of epilepsy of children is refractory, and this study was conducted to evaluate the efficacy and adverse events of levetiracetam as add-on therapy in the treatment of refractory epilepsy of children. Materials & Methods In this quasi-experimental study, seizures frequency and side effects of 314 children aged 1-14 years with refractory epilepsy were referred to the Pediatric Neurology Clinic of Shahid Sadoughi Medical Sciences University, Yazd, Iran, and treated with levetiracetam for six months, were evaluated. Results We evaluated 142 girls and 172 boys with a mean age of 6.78±2.12 years. At the end of six months of treatment with levetiracetam, 20% became seizure-free, 28% had more than 50% decrease in seizure frequency, 38% did not have a notable change in seizure frequency, and 14% experienced an increase in seizure frequency. Good response (stopping of all seizures or more than 50% reduction in seizure frequency) was seen in 51% of mixed types, 61% of myoclonic seizures, 64% of generalized tonic-clonic seizures, 69 % of partial seizures, 100 % of tonic seizures, and in 40 % of atonic seizures. Levetiracetam was significantly more effective in partial seizures, idiopathic epilepsies, and children with normal developmental status and normal brain MRI. Twelve children discontinued the treatment due to severe drowsiness, restlessness, and exacerbation of seizures. Transient and mild side effects, including somnolence, anorexia, fatigue, headache, ataxia, and diplopia, were seen in 9% (N=28) of patients. Conclusion Levetiracetam could be considered an efficient and safe adjunct therapy in treating refractory epilepsy in children. Keywords: Levetiracetam; Refractory Epilepsy; Children; Side effects [ABSTRACT FROM AUTHOR]

Since the initiation of the COVID-19 vaccination effort, there has been widespread concern regarding vaccine efficacy and potential side effects. This study aimed to explore the short-term side effects of four available COVID-19 vaccines (Sputnik V, Sinopharm, Oxford-AstraZeneca, and Covaxin) among healthcare workers (HCWs) in Iran. The multicenter study involved 1575 HCWs, with the majority received Sputnik V (74.1%), followed by Covaxin (15.6%), Sinopharm (6.4%), and Oxford-AstraZeneca (3.8%). The prevalence of at least one side effect after the first and second dose COVID-19 vaccine was 84.6% and 72.9%, respectively. The common side effects (presented in > 50% of the study participants) after the first dose of the vaccine were injection site pain (61.7%), myalgia (51.8%), and muscle pain (50.9%). The most reported side effects after the second dose of the vaccine were injection site pain (26.8%), myalgia (15.8%), fever (10.3%), headache (9.9%), and chills (9.2%). In conclusion, according to the COVID-19 vaccine type, different side effects might occur following the first and second doses of vaccination. These findings assist in addressing the ongoing problems of vaccination hesitancy which has been driven by widespread worries about the vaccine safety profile., (© 2024. The Author(s).)

The COVID-19 disease is a newly emerging disease, and the COVID-19 vaccine is one of the necessities to prevent this disease. The present study aimed to investigate the side effects of COVID-19 vaccines in southern Iran. We used convenience sampling to conduct this cross-sectional study on 647 people living in cities under coverage in Kerman province, southern Iran. The data collection tool was a researcher-made questionnaire of vaccine symptoms and signs. The results were analyzed using ANOVA and Chi-squared tests by SPSS software (version 24). The mean age of the participants was 40.19±15.20. The results indicated that 431 people (66.6%) reported post-vaccination side effects, with 18.23% of them having severe side effects. We noticed the most severe side effects in AstraZeneca, Sinopharm, Sputnik, and Bharat. Fever, headache, and pain at the injection site were the most common side effects after vaccination in descending order, which had a statistically significant relationship with all types of vaccines ( P =0.001). The side effects differed in the types of vaccines, and most of the vaccines had mild to moderate side effects. People with the B blood type showed the most severe side effects, while those with the AB showed the lowest rate of side effects. Therefore, the injection of the AstraZeneca vaccine in blood group B should be done with more caution. More attention should also be paid to blood groups B and A in the injection of COVID-19 vaccines. Moreover, health officials and the government should plan appropriate educational strategies to increase public awareness of the importance of vaccines in eradicating viral infections., Competing Interests: The authors declare no conflict of interest in this study

BACKGROUND: Cancer treatment can be a great source of anxiety and depression for patients. Patients who experience anxiety and depression may be treated with a variety of nonpharmacologic treatments, such as guided imagery. OBJECTIVES: The purpose of this article is to determine the effect of guided imagery on patients' anxiety, depression, and other selected side effects prompted by chemotherapy. METHODS: This pre- and postintervention assessment randomly selected patients with various types of cancer who were undergoing chemotherapy to listen to a guided imagery audio file for 20 minutes per day for one week. Data collection included a demographic questionnaire, the Hospital Anxiety and Depression Scale, and the Symptom Distress Scale. FINDINGS: A significant decrease in anxiety and depression was noted in the intervention group compared to the control group. No reduction in the mean score for anxiety and depression was observed postintervention for the control group. In addition, patients in the intervention group showed improvement in all side effect categories. Patients in the intervention group reported the greatest rate of improvement in the items of pain, insomnia, appetite, and nausea. [ABSTRACT FROM AUTHOR]

• 83.1% of participants showed at least one side effect. • Oxford–AstraZeneca and Sputnik V had the most frequent side effects. • Injection site pain was the most common local side effect. • Body/muscle pain, fever, headache, and fatigue were the most common systemic side effects. • Among the first-dose recipients of the Sputnik V vaccine, the prevalence of SEs was higher in those aged ≤ 31 years than those aged > 31 years.. Misinformation about the prevalence of COVID-19 vaccines' side effects (SEs) has led to concerns about and mistrust of vaccine safety. Thus, this study aimed to evaluate the prevalence of COVID-19 vaccines' SEs. In a cross-sectional survey-based study on the healthcare workers (HCWs) of a tertiary hospital in Iran, the SEs of Sputnik V, Oxford–AstraZeneca, Sinopharm, and Covaxin were evaluated through a face-to-face interview by a researcher-made questionnaire. A total of 368 HCWs received at least one dose of a COVID-19 vaccine. The prevalence of people with at least one SE was higher among those who received the Oxford–AstraZeneca (95.8 %) and Sputnik V (92.1 %) vaccines than those who received Covaxin (70.5 %) or Sinopharm (66.7 %). Following the first and second doses, injection site pain (50.3 % and 58.2 %), body/muscle pain (53.5 % and 39.4 %), fever (54.5 % and 32.9 %), headache (41.3 % and 36.5 %), and fatigue (44.4 % and 32.4 %) were the most common SEs. Overall, SEs were often initiated within 12 h and subsided within 72 h of vaccination. The prevalence of SEs after the first dose of Sputnik V was higher among those aged ≤ 31 years (93.3 %) than those aged > 31 years (80.5 %). In the Sputnik V group, the number of SEs experienced after the first dose was higher in women with underlying diseases than those without such diseases. Furthermore, the body mass index of participants with SEs was lower than that of participants without SEs. Compared to Sinopharm or Covaxin, the Sputnik V and Oxford–AstraZeneca vaccines were associated with a higher prevalence of SEs, a greater number of SEs per individual, and more severe SEs. [ABSTRACT FROM AUTHOR]

Background: When family planning programmes offer a wide variety of contraceptives, contraceptive prevalence would be higher overall. Objective: To determine the acceptability of Cyclofem© and to evaluate its side effects and continuation rate in Iran. Materials and Methods: An introductory study of Cyclofem© was conducted in seven districts of Kerman Province, the largest province of Iran, in three phases. At first, 14394 women attending randomly selected urban and rural health centers representing different socioeconomic classes were invited to choose Cyclofem© after a standard schedule of counselling. At the second phase 418 of those who accepted Cyclofem© and 354 of those who refused to use the method were randomly selected to participate in an interview. At the third phase the first group was followed up for one year at regular one-month intervals. Results: Nearly 12.6% (n=1809) of 14394 women counselled to choose Cyclofem© accepted the contraceptive method. They had a mean (±SD) age of 28.5 (±6.5) years. Fear of side effects was the most common cause of refusal to use Cyclofem©. The one-year continuation rate was 21.2%. The three main side effects leading to early discontinuation of Cyclofem© were nausea (18%), prolonged menses (15.8%), and amenorrhea (14.7%), respectively. Conclusion: The one-year continuation rate of Cyclofem© use in Iran has been lower than other countries. Further research is necessary to improve continuation rates. [ABSTRACT FROM AUTHOR]

Objective: Reporting some biological side effects with special attention to reproductive points which were seen after different experiments in laboratories of the Plasma Physics & Nuclear Fusion in atomic energy organization of Iran. Materials and methods: Dosimeter analysis and interpretation of biological side effects of research studies in nuclear fusion laboratories. Results: In the last 3 decades, neglecting the principles of the radiation protection has been confirmed in laboratories of the plasma physics and nuclear fusion research school of Iran, especially on DAMAVAND and ALVAND Tokamaks and DENA Plasma Focus. Also a series of biological side effects such as alopecia and thyroid function disorders, oligospermia and stomach cancer have been seen in personnel working in related laboratories. Conclusion: As in our laboratories transportation of the peripheral components such to further distances from the main devices seems not to be cost effective. The level of the absorbed dose of the personnel must be decreased in other ways such as: lowering the number of attended shots for each person and proper shielding. [ABSTRACT FROM AUTHOR]

The present study evaluated adherence to antiemetic guidelines for prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) in four tertiary university teaching hospitals in Tehran. This prospective observational study enrolled 382 adult patients on chemotherapy at oncology centers affiliated to medical universities located in Tehran. Patients were followed up during their chemotherapy cycles. Risk factors related to CINV were evaluated, and information on antiemetic prescribing patterns was gathered using direct interview and patient medical records. Guideline adherence was found to be low; however, 81.3% of the patients experienced chemotherapy without CINV. Low frequency of adherence to the guidelines in prescription patterns does not mean that prescription patterns were very different. Indeed, some drugs were added to base guideline recommendation regiments, since in high and moderate emetogenic chemotherapy categories, some novel antiemetics recommended by international guidelines are not yet included in Iranian pharmacopeia. It was shown that two drug classes were added as a common practice, namely, H1/H2 antagonists and dopamine receptor antagonist (metoclopramide). Statistically significant differences were found between antiemetic prescribing patterns of physicians and chemotherapy regimen category (aspect of emetogenic potential) (p < 0.001). The most commonly prescribed regimen in the minimal-emetic-risk category and the low-emetic-risk category was reported to be the combination of corticosteroids, 5HT3, and H1/H2 antagonists, 33% and 66.1% respectively. Moreover, corticosteroids +5HT3 and H1/H2 antagonists + NK1 antagonist were found to be the most frequently prescribed regimen in the moderate-emetic-risk category (39.7%) and high-emetic-risk category (41.8%). Antiemetic prescribing patterns were not completely compatible with the guidelines in moderate and high emetogenic chemotherapy categories. Differences were detected in two states of over- and undertreatment. The present study confirmed low level of adherence of antiemetic prescribing patterns with international guidelines. However, it could not be proved that high levels of adherence with the guidelines result in reduction of CINV incidence. Complete success in CINV control cannot be achieved only by adherence to the established guidelines as novel antiemetics recommended by the guidelines have not been included in the Iranian pharmacopeia as yet. The authors do recommend implementation of strategies for increasing guideline-compliant prescriptions with the aim of improving patients' outcomes. We also suggest that policymakers in healthcare system point more critically to overprescribing as an issue of concern., (© 2020. American Association for Cancer Education.)

Intrduction: Tubal ligation is a safe method of contraception for women and men, yet like any other surgery it is not without its side effects. But in some cases, the side effects reported by patients to the health centers do not have any relation to surgery and only psychological aspects are involved. But the evidence reflects less demand for using these methods while people are tending to other unreliable mrthods. Obviously, increasing unwanted pregnancies may have adverse effects on the population along with the maternal risks involved. This study was established for investigated the effects attributable to tubal ligations and satisfaction with them among women in Jahrom in 2013. Materials and Methods: In this cross-sectional study 144 women were surveyed in Jahrom City. Information were collected through a three-part checklists, containing demographic information, assessment of adverse sffects experienced by women, and their satisfaction and willingness to choose this method. All effect included in the checklist were extracted from available books and articles and were approved by a panel five faculty members. The data were analyzed using SPSS 16.0. Results: The mean age of patients undergoing tubal ligation was 32.79 ± 6.86 years. On average, patients had undergone tubectomy 131.20 ± 81.90 before the time of study. 92.8% of participants were housewives, and 7.2% were employed. 91.5% of tubectomies had been performed via laparotomy procedure and 8.5% via laparoscopy. The mean score of satisfaction with this technique was 25.23±79.70, though 56.1% of participants would like to use this method if they were given a new chance. The mean time for resuming daily activities after the surgery was 20.05±23.77 days. Participants attributed experiences of postoperative bleeding (13.9%), fever after surgery (14.6%), weight gain (30.6%), muscle cramps(25.7%), heart disease(9.1%), the loss of liveliness and freshness (9.7%), back pain (45.8%), and hypotension (6.9%) to the tubectomy operation. Conclusion: Based on the results of other studies, over 90% of reported side effects following vasectomy and tubal ligation by people who have neurological and psychological aspects occur in patients who have not received correct family planning consultations before their surgeries. It should be noted that family planning counseling - if done properly - is no less important than the practical aspects of tubal ligation in women and men. [ABSTRACT FROM AUTHOR]

Intrduction: Anxiety is an unpleasant, ambiguous feeling with unknown sources. At times, anxiety is directed towards health, causing psychological disorders such as hypochondriasis which is caused by an incorrect interpretation of physical symptoms and its related information. Although family planning programs are needed in some communities, people who have this condition and use permanent contraceptive methods can exert evastating effects on country's population policies. Materials and Methods: This cross-sectional study aimed at investigating the prevalence of hypochondriasis in women with tubal ligation in 2013. 144 women were surveyed in Jahrom City. Simple random sampling was used. Available urban residents willing to participate during the period of study were used to collect relevant data. Data were collected via a two-part questionnaire including demographic data and Evans Syndrome Questionnaire containing 36 items. Based on the scores obtained by participants they were characterized as healthy (0-20), borderline (21-30), mild (31-40), medium (41-60) and severe (above 60) groups. The data were analyzed using the SPSS 16.0. Results: The mean age of participants was 44.03±8.05 and the age of tubal ligation was 32.79±6.68 years. In terms of education 36.4% of participants were below diploma and 7.1% had attended universities. 62.7% of women had vaginal deliveries and 15.5% had a history of both vaginal and cesarean. The mean score of hypochondriasis in all of participants were 25.69±9.49. 44 (30.6%) of the women were healthy but 8 (5.6%) women had sever hypochondriasis. 38.2% of these woman had hypochondriasis in borderline zone. There was a significant association between the age of tubal ligation, satisfaction with this method, and the score of hypochondriasis (p= 0.035). Conclusion: Psychological consultations before choosing a permanent method of contraception are essential for arriving at the desired outcomes and enhancing satisfaction with family planning. Although the return of these methods is trivial today, yet people's anxieties and obsessions can be effective on social and personal dissatisfactions with life, marital relationships, and transmission of this feeling to women who are medically required to undergo tubectomy. [ABSTRACT FROM AUTHOR]