mohamad golitaleb

Cancer and associated treatment methods present numerous complications, including anorexia and disturbances in sleep patterns. Consequently, the purpose of this study is to examine the impact of reflexology on the symptoms of anorexia and sleep quality among individuals afflicted with cancer.

In this double‑blinded randomized clinical trial, a total of 60 patients undergoing chemotherapy at Khansari Hospital, Arak, Iran, were selected using convenience sampling and then assigned to two groups of control and experimental using blocked randomization (30 patients in each group). The sample intervention group received reflexology in an exceedingly 4‑week amount (two sessions a week), By contrast, the control group was administered a placebo treatment without exerting any pressure on the reflex points during the same time frame. Sleep quality and anorexia in patients were measured using a Pittsburgh questionnaire and visual analog scale before and right after the intervention. Eventually, the data were analyzed, and we used the tests of central tendency, dispersion, independent‑ and paired‑samples t</em>‑tests, and Chi‑square.

The findings of the study revealed a significant improvement in sleep quality and reduction in anorexia symptoms among patients who received reflexology treatment scores (p </em>< 0.001). Conversely, there was no significant difference in the control group before and after the intervention (without pressure effect on the foot points) (p </em>> 0.05).

According to the positive effects on sleep quality and the reduction of anorexia symptoms, it is recommended to incorporate this therapeutic modality along with conventional medication for the treatment of individuals with cancer.

Regarding the importance of nursing education promotion, there is a need to use methods to create nurses' knowledge and skills. This study aimed to compare two training methods on nurses' skills in using ventilators in medical-surgical (Med-Surge) department.

This quasi-experimental study was performed in the internal and surgical wards of Amir Al-Moemenin Hospital in ArakCity, Iran, in August 2019 to May 2020. The samples were 100 nurses who were selected through convenience sampling and were randomly divided into two groups of 50 samples. After the pretest administration, nurses in the control group were educated using face-to-face or usual method education; in the experimental group, they were trained using video-based education. After ten days, the post-test was completed. Finally, dataanalysis was done using SPSS software.

The mean total score of the performance was significantly different among the two groups after the intervention (P < 0.001), so that after the intervention, the mean of performance score in video-based education was higher than the usualmethod.

It seems that the use of video-based education enhanced the clinical skills of nurses. Therefore, it is recommended to use more video-based education to enhance clinical nurses' learning.

Among musculoskeletal disorders, low back pain causes the most common complaints among emergency medical services personnel worldwide. This study aimed to investigate the prevalence of low back pain among emergency medical services personnel.

We used the PRISMA guideline in the present systematic review and meta-analysis. The search was conducted in PubMed, Scopus, Web of Science, Cochrane, ProQuest, Science Direct, Google Scholar, and Embase using English keywords and SID, Irandoc, and Magiran data resources with equivalent Persian keywords. Studies were selected based on inclusion and exclusion criteria. The data were gathered without a time limit until the end of June 2021. The quality evaluation of the selected studies was performed using the Appraisal tool for Cross-Sectional Studies (AXIS) tool. The random-effects model was used for meta-analysis, applying the I2 index as a measure to estimate heterogeneity among studies.

In the present study, a total of 1038 articles were identified in the primary search, of which ten studies entered the final evaluation phase and meta-analysis after initial screening and removing duplicates. In these studies, 7499 emergency medical services personnel were examined; the prevalence of low back pain was 50.30% (95% CI: 37.98-62.62, I2= 99.1%).

Our results indicated a considerable prevalence of low back pain among emergency medical services personnel. Also, the heterogeneity between studies was very high. It is recommended to teach the correct methods of lifting the stretcher and equipment as well as redefining the duties of the staff with low back pain.

Hepatitis B virus (HBV) is one of the most dreadful viruses causing high mortality rates and serious damages to hepatocytes. The aim of this study was to assess the frequency, related causes/risk factors, and treatments of HBV infection in Iran by systematic review and meta‑analysis.

The data were obtained by a literature search in the PubMed, Scopus, SID, and Web of Sciences databases. Keywords included prevalence, risk factors, causes, treatment, and HBV. The Persian equivalents of these keywords were also searched. The time span included 2004 to2021. The Q and I2 statistics were used to check heterogeneity among studies. The data were analyzed using Stata (version 14).

The frequencies of HBV infection and its pharmaceutical therapy were P = 6% (95% confidence interval [CI]: 4–9, I2 = 95.2%, P < 0.001) and 19% (95% CI: 18%–30%, I2 = 98.9%, P < 0.001), respectively. The most common risk factors/causes of HBV were narcotic consumption, blood‑related factors, and transmission from infected individuals with the respective frequencies of 27% (95% CI: 16%–38%, I2 = 88.7%, P < 0.001), 32% (95% CI: 11%–53%, I2 = 99.8%, P < 0.001), 25% (95% CI: 10%–41%, I2 = 99.3%, P < 0.001), and 15% (95% CI: 7%–22%, I2 = 98.4%, P < 0.001), respectively.

The most important causes of HBV infection were transmission from infected people, narcotic consumption, and blood‑related factors. The main therapeutic intervention for HBV was pharmaceutical therapy.

The present study aimed to investigate the potential effects of the combined herbal capsule (CHC), as a nutritional supplement, on glycemic indices (GIs) and lipid profile (LP) of patients with type 2 diabetes mellitus (T2DM).

Following a randomized, single-blind, placebo-controlled clinical trial, the current study was conducted on 80 cases with T2DM who were randomly assigned into two groups of treatment (CHCs; n = 40) and control (placebo; n = 40). Both groups received the intervention (500 mg capsules) twice a day for three months, without changes in the previous dose of oral anti-hyperglycemic drugs. The GI and LP levels were measured before the intervention and three months later to investigate the potential efficacy of the interventions.

For those in the intervention group, the mean GI [i.e., fasting blood sugar, two hours postprandial (2hpp), and HbA1c] was significantly different after 3 months (P < 0.05). The GI- and LP-related outcomes (TG, LDL-C except for TC) were improved after 3-month of receiving the intervention compared to the control group; however, the observed improvement was no statistically significant (P > 0.05). The HDL-C level was also significantly improved in the intervention group compared to the control group (P < 0.05).

This study demonstrated that receiving CHCs could improve GI and LP levels (TG, LDL-C, and HDL-C, except for TC), which indicates its potential to control T2DM. Moreover, no significant side effect was observed in the intervention group. It can be argued that the use of CHCs, as adjuvant therapy, in combination with conventional hypoglycemic and lipid-lowering drugs, as well as following a modified lifestyle, not only can significantly enhance glycemic control but also may prevent T2DM complications.

Patient safety is an important and mandatory component of quality health services. Insecure health services, in addition to inflicting pain and suffering to patients, impose a high financial burden on the health system of every society. The present study was conducted to evaluate the critical standards of patient safety based on the Patient Safety Friendly Hospital Initiative (PSFHI) checklist in Iran.

The present systematic review and meta‑analysis were performed based on the PRISMA guideline. For this purpose, articles related to the critical standards of patient safety based on the PSFHI checklist were obtained by searching valid Persian and English keywords in SID, Magiran, PubMed, Scopus, Web of Science, and Google scholar data resource through the end of 2019. The studies were analyzed using the STATA (version 14) software.

In the initial search, 533 articles were extracted among which 7 were eligible and entered into the meta‑analysis process. Overall, 55 hospitals were surveyed, and the results of the meta‑analysis showed that the average critical standards of patient safety were 69.52% (95%, CI = 57.09–81.95, I2 = 69%, P = 0.004).

The results showed that a moderate level of critical standards of patient safety in hospitals in Iran. Since meta‑regression analysis revealed a decreasing trend in compliance rate, hospital managers should implement principals designated by the World Health Organization to achieve the required standards that are the basis and pillar of a patient‑friendly hospital. With proper management, hospitals should set goals and take steps based on a strategic plan toward achieving these goals.

The effects of peer education have been addressed in different populations, but this method of education has not been applied in the elderly population of Iran, and its effect has not been studied. The present study investigated the effects of peer group education on anxiety, stress, and depression of the older adults living in nursing homes.

This research is a quasi‑experimental study with an intervention and control group and it was conducted on 70 elderly citizens living in Qom nursing homes in July 2017. For the intervention group, a relaxation and stress reduction program was trained through the peer group. The control group received routine care. Data were collected using a Demographic information questionnaire and Depression Anxiety Stress Scale‑21 (DASS‑21). Data were collected at the beginning, 10 and 30 days after the intervention. Data analysis was performed using SPSS 19, descriptive statistics, and repeated measure analysis of variance.

The results of the study showed no significant difference between any of the demographic variables at the beginning of the study (p > 0.05). The statistical test showed that the effects of time (p < 0.001) and group (p < 0.011) were significant on anxiety, stress, and depression.

The results of this study showed that peer education could decrease anxiety, stress, and depression in the elderly. Therefore, this educational method can be used by nurses to promote various health education programs, e.g., to health promotion and prevent disease especially in the elderly community

Occupational burnout, as a reaction to persistent work pressures, reduces efficiency, wastes manpower, and causes physical and psychological complications. The aim of this study was to determine the frequency and intensity of occupational burnout among pre-hospital emergency staff in Iran.

This study was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data resources included Scientific Information Database (SID), Magiran, Islamic World Science Citation Center (ISC), Irandoc, PubMed, Scopus, Web of Science, and Google Scholar.

Initially, 178 articles were extracted, and then 13 articles were finally analyzed. Overall, 2034 pre-hospital emergency personnel were examined. Mean of occupational burnout in term of frequency, respectively for emotional exhaustion (16.78, 95% CI = 8.89-24.67, I 2 = 62.30%, p = 0.004), depersonalization (11.57, 95% CI = 6.97-16.18, I2 = 68.50%, p = 0.001) and the lack of personal accomplishment (16.11, 95% CI = 8.60 -23.62, I2 = 74.70%, p = 0 <001) were determined. Also, in term of intensity, respectively for emotional exhaustion (17.90, 95% CI = 8.24-27.57, I2 = 64.80, p = 0.004), depersonalization (11.20, 95% CI = 6.80-16.22, I2 = 49.60%, p = 0.044) and the lack of personal accomplishment (23.45, 95% CI = 13.41 -33.49, I 2 = 84.80%, p = 0 <001) were determined.

According to findings, depersonalization and lack of personal accomplishment had moderate and high-level, respectively. Therefore, it is necessary health policymakers pay special attention to identifying and resolving the causes of occupational burnout in this population.

Adherence of emergency medical technicians (EMTs) to a professional code of ethics is one of the most important aspects of their occupation. The purpose of this study was to determine the degree of adherence to the professional code of ethics from the perspective of EMTs and their patients. This was a cross-sectional study. The inclusion criteria for patients were age between 18-65 years, willingness to participate in the study, normal mental status, being medically stable and absence of any chronic mental or psychiatric disorder. The inclusion criteria for EMTs were willingness to participate in the study, having an associate or bachelor’s degree in the medical emergency, working at medical emergency departments and management centers. The exclusion criteria were refusal to continue the study and the necessity of therapeutic intervention while completing the questionnaire. The patients were recruited by cluster sampling. For this reason, first, two hospitals were randomly selected among six hospitals in Arak, Markazi province (Arak, Iran). Then, the list of missions at each shift was extracted by referring to the emergency departments of these hospitals. Afterward, one of the missions in each shift was randomly selected. In this study, a two-part questionnaire was used for data gathering. In this first part, the demographic information of the participants was collected. In the second part, a professional code of ethics for EMTs' questionnaire, including 26 statements in 5 dimensions was used. Finally, the questionnaires were given and completed by the pre-hospital emergency personnel and the transferred patients. A total of 105 EMTs and 109 patients were randomly selected as they transported patients to the studied hospitals. From the viewpoint of patients, adherence to the professional code of ethics was rated 2% as highly desirable, 39% as desirable, 58% as moderate, and 1% as undesirable. On the other hand, the EMTs rated themselves as 59.8% highly desirable, 37.1% as desirable, and 3.1% as moderate. There was a statistically significant difference between the average score of adherence to a professional code of ethics from the viewpoint of patients versus that of the EMTs (p <0.001). There was a statistically significant difference between the degrees of adherence to the professional code of ethics by EMTs from their own viewpoint versus that of the patients.

Firefighters are exposed to many different chemicals and physical hazards and experience a significant number of accidents and injuries. They are exposed to high-risk of posttraumatic stress disorder (PTSD).The purpose of this study was to determine the prevalence of PTSD among Iranian firefighters.

This was a systematic review and meta-analysis. Valid Persian and English keywords were searched in data resources, including SID, Magiran, Irandoc, Google Scholar, PubMed, Scopus, and Web of Science to retrieve articles on the prevalence of PTSD among Iranian firefighters. The STROBE checklist was used to assess the quality of the articles. Heterogeneity among the studies was assessed by I2 index. The data were analyzed using Stata14 software.

Of the 316 articles selected in the initial search, 3 articles the inclusion criteria and were used for the meta-analysis. A total of 274 firefighters were studied. The prevalence of PTSD was 23.17% among Iranian firefighters (I2 = 92.4%, 95% CI = 6.71-39.62, p < 0.001).

The prevalence of PTSD is among Iranian firefighters relatively high and has been on the rise over the recent years.

Non-steroidal anti-inflammatory drugs (NSAIDs) constitute a broad spectrum of cyclooxygenase (COX) inhibitors suppressing prostaglandin synthesis. NSAIDs are used for treating various conditions such as pain, rheumatoid arthritis, osteoarthritis, and musculoskeletal disorders (1). Ketorolac is an NSAID, which is used to alleviate renal colic due to its anti-contractile effects on the urethra. Considering the pain pathogenesis in renal colic, ketorolac is one of the best pain-relieving drugs in these patients (2). In intravenous form, this drug reaches its serum peak level within 1 to 3 minutes. Ketorolac is metabolized in the liver and excreted through the kidneys (2). Although ketorolac has an excellent safety profile, allergic reactions and anaphylaxis may occur following its administration. Even though these reactions, either acute or delayed, are uncommon and rare, they can be fatal (3). A number of studies have reported anaphylactic reactions after ketorolac administration. However, the incidence of these reactions is not predictable (4-6). Here, we present a case of anaphylaxis in a male patient admitted to the emergency department of Vali-e-Asr Hospital, Arak, Iran, following the injection of 30 mg ketorolac.

Pulmonary complications after cardiac surgery are a major source of morbidity and mortality, as well as increased lengths of hospital stay and resource utilization. Pleural effusion following coronary artery bypass graft surgery (CABG) has been reported in 65% to 89% of cases. The present study was designed to determine the prevalence of pleural effusion after open-heart surgery.

This study evaluated 600 patients who underwent open-heart surgery. The study population was divided into 3 groups: group A consisted of 200 patients who underwent CABG, group B comprised 200 patients who underwent aortic valve replacement (AVR) and mitral valve replacement (MVR), and group C encompassed 200 patients who underwent    valve surgery and CABG. Chest radiography was performed before surgery and afterward on the first, third, and seventh postoperative days.

The study population was comprised of 330 (55%) men and 270 (45%) women. The size of the pleural effusion was small in a large proportion of the patients (45%, n = 270). Additionally, 90 (15%) patients had moderate effusion, occupying between 20% and 40% of the hemithorax, and 84 (14%) patients had large effusion.

Pleural effusion was detected in 37% of the patients after CABG, 25% after valve surgery (MVR+AVR), and 20% after CABG and valve surgery. Most of the cases of effusion after cardiac surgery were left-sided. (Iranian Heart Journal 2020; 21(3): 48-54)

The endotracheal tube (ETT) cuff pressure must be kept within the range of 20 to 30 cmH2O in order to prevent tube displacement and air leakage, maintain the circulation of the tracheal capillaries, and prevent the aspiration of oral and gastric contents to the lower parts of the respiratory tract. This study aimed to determine the ETT cuff pressure and appropriate intervals for measuring it in patients admitted to intensive care units (ICUs).

This descriptive cross-sectional study was conducted on 100 patients after cardiac surgery with general anesthesia admitted to ICUs between May and November 2017. For each research unit, the ETT cuff pressure was measured twice at a 6-hour interval using a cuff pressure manometer. Descriptive (ie, mean, standard deviation, and frequency distribution) and inferential (ie, t-test, Pearson, and ANOVA) statistics were used to describe the data. All the ETT cuff pressure measurements were performed with a calibrated manometer. The data were analyzed using the SPSS software, version 22.0.

The mean ETT cuff pressure was 38.3 ± 24.9 cmH2O. In the first measurement, the ETT cuff pressure was normal in only 17% of the subjects, while this figure increased to 78% after the 6-hour control period and cuff-pressure correction. There was a significant relationship between the number of days of intubation and the ETT cuff pressure in both first (P = 0.003) and second (P = 0.01) measurements.

The ETT cuff pressure often exceeds the recommended normal range, which can serve as a reminder that it may be necessary to control it at shorter intervals to avoid complications caused by increases or decreases in the cuff pressure. (Iranian Heart Journal 2020; 21(3): 33-39)