parisa moradimajd

Pre-anesthetic evaluation is the initial stage of anesthesia procedures for patients. This evaluation involves elucidating the patient's medical history, determining patient readiness, screening for undisclosed disorders, and identifying risk factors. Safety measures help mitigate patient-related risks within medical environments. The aim of this study is to investigate the role of Pre-anesthetic evaluation in patient safety.

The present study was a review conducted in the year 2024. Databases including PubMed, Direct Science, MEDLINE, Proquest, SID, Scopus, Google Scholar, Magiran, and library resources were searched using keywords such as Pre-anesthetic evaluation, pre-anesthetic visit, anesthesia clinic, patient safety, and their English equivalents. A logical combination of these keywords was performed using "OR," "AND," and "NOT" operators. The search was conducted in relevant articles from the year 2000 to January 2024.

Initially, 22,000 articles were screened, and ultimately, 16 relevant articles were used for preparing this paper. In all the reviewed articles, pre-anesthetic evaluation played a key role in patient safety.

Studies indicate that pre-anesthetic evaluation is a key improver of surgical outcomes. These measures not only mitigate potential risks but also enhance surgical outcomes. Overall, pre-anesthetic evaluation has a direct correlation with patient safety, playing a significant role in postoperative improvement and elevating the quality of medical care.

The safety of the beating heart is a health service that means the absence of clinical errors during the implementation of health care. The period of anesthesia is identified as one of the most critical phases for patients requiring general anesthesia, carrying the potential for critical clinical errors that may have irreversible consequences. This study's main objective was to conduct a concise assessment of the anesthesia checklists utilized to enhance patient safety during general anesthesia procedures. To accomplish this, a comprehensive search was conducted using relevant keywords spanning from 1990 to 2023 across databases including PubMed, Springer, Google Scholar, Web of Science, Scopus, online libraries, and the Cochrane library. Initially, 188 studies were identified at the outset of the research, and among these, 13 studies that focused on the development of checklists for anesthesia safety were scrutinized. Included articles were reviewed separately and divided into 3 categories; Specific vs. Generalized Scope, Single-Stage vs. Multi-Stage, Single-Factor vs. Multi-Factor. According to the findings from these studies, the systematic and proper utilization of all available checklists can contribute to improved safety. However, due to the specialization of surgical procedures and the increasing emphasis on patient safety over the past decade, there has been a shift in the compilation of anesthesia checklists from being broad and general to becoming specific, transitioning from single-stage to multi-stage, and evolving from single-factor to multi-factor checklists.

Management of patients with high risk of bleeding during oral and dental procedures faces many challenges. The aim of this study was review strategies for facing high risk of bleeding patients taking dabigatran under dental procedure.

Articles and scientific texts will be searched in the six main databases, such as PubMed, Scopus, Web of Science, Science Direct, Google Scholar and Cochrane Library from 2007 to 2022, with keywords “dabigatran” AND “bleeding” AND “dental procedures” OR “dental care”. The inclusion criteria for articles included in the study were papers published about treatment patients with dabigatran and undergoing a dental procedure, English language and design of case reports, case series, quasi-experimental studies and clinical trials. This study was performed using PRISMA.

At first, 43 references included and finally 8 articles that met the inclusion criteria were select. CASP and STORBE checklists used for quality evaluation. Two reviewers checked eligibility of the selected articles, separately. Challenging Controversial results were found in selected studies. 4 studies demonstrated that Dabigatran should be interrupted at least 12 hours before invasive dental procedures. Some studies highlight that discontinuing Dabigatran depends on the patient's renal function. Also, it showed that deciding whether to stop Dabigatran or not by cardiologists determine based on elective or emergency high-risk patients.

Based on the results of the included studies, it is better to decide to stop or continue dabigatran before any dental treatment based on the type of intervention, the risk of bleeding and the patient's clinical situation. However, is preferred to discontinue taking this drug in high risk of bleeding dental procedures.

Patient safety is one of the main elements of the quality of health services. Our aim of this study was to compile a complete checklist for the three stages of anesthesia.

This research was a cross-sectional descriptive-analytical study. First, an internet search was conducted in databases to identify checklists related to safe Anesthesia. The WHO Safe Anesthesia Checklist was designated as the main checklist. Then, a brainstorming session was held with experts and according to the determined fields, the initial draft was compiled. Face and content validity were conducted. The reliability of the checklist was measured with Cronbach's alpha and intra class correlation index (ICC) methods.

The initial draft was compiled with 34 items. 29 items scored higher than 0.79 in terms of CVI (content validity index) The value of CVI of 5 items was less than the permissible limit and the edge of the border, which was revised and corrected by the research group. 2 items were returned to the research process according to the survey of experts and their necessity CVR (content validity ratio) (value >0/62) and 3 items were removed from the research process. Cronbach's alpha was calculated as 0.876 for the first evaluator and 0.870 for the second evaluator, and the percentage of agreement between the evaluators was 0.956 (P<0.001).

We developed and evaluated a checklist for the three stages of anesthesia through an evidence-based study. We hope this checklist can reduce and prevent clinical errors.

One of the basic principles in the safety of drug therapy for patients is the correct registration and labeling of anesthetic drugs, which can lead to the reduction of drug errors, the increase of drug and patient safety, the reduction of drug consumption and the environment, and the optimization of hospital costs.

This descriptive-analytical and cross-sectional research was conducted in February 2022 in the operating rooms of Iran University of Medical Sciences hospitals. The participants included 177 Anesthesia experts working in the hospitals’ operating rooms, who were included in the study by census method. The data was collected using the checklist for evaluating anesthetic drug registration and labeling guidelines and analyzed using SPSS software and one-way ANOVA, Fisher, and Pearson correlation coefficient statistical tests. The significance level was considered P value < 0.05.

The average compliance with the guidelines for registration and labeling of anesthetic drugs in all hospitals was 3.559 out of the total score of 16. The average adherence to guidelines in 8 hospitals was significantly different from each other (P < 0.001). Hazrat Ali Asghar Hospital had the highest compliance rate, averaging 10.333 out of 16. Firouzgar and Shahid Akbarabadi hospitals were in the next rank, averaging 10.11 and 6.65, respectively. There was a negative and significant correlation between the level of compliance with the guidelines and the average work experience and age of the experts (P=0/17); However, gender did not significantly correlate with the degree of adherence to the guidelines(P=0/596).

According to the obtained results, compliance with the guidelines for registration and labeling of anesthetic drugs in most hospitals was assessed as weak and at an unfavorable level. Considering the importance of this issue in reducing medication errors and increasing patient safety, it is necessary to use empowerment and retraining courses for Anesthesia experts according to the latest guidelines.

The correct registration and labeling of anesthetic drugs in the operating room are the basic and important principles in order to maintain patient safety, reduce the wastage of drugs and their subsequent costs, and reduce environmental pollution. Therefore, the present study was conducted with the aim of designing and psychometry of evaluation checklist for the registration and labeling guidelines of anesthetic drugs in the operating room.

This descriptive-analytical research was conducted in 2022 in the Iran University of Medical Sciences. In order to design the checklist, the latest and most reliable scientific sources in the field of anesthesia were examined and the opinions of experts of the university’s Department of Anesthesia were used. To determine the validity of the checklist, face and content validity (content validity index and content validity ratio) were calculated. In order to determine the reliability of the checklist, two methods of test-retest reliability and inter-rater reliability were used. The research results were analyzed using SPSS 22 software.

An initial checklist was designed with 19 items. In the face validity check, all the items remained on the checklist with the optimal level of 1.5. In the content validity check, three items with a content validity ratio of less than 0.62 and a content validity index of less than 0.79 were removed from the checklist. The intraclass correlation coefficient was calculated as 0.992 in reliability by the test-retest method and 0.987 in the inter-rater method, which indicates the good reliability of the checklist.

The research findings show the checklist’s face and content validity and good reliability. Therefore, it can be used to evaluate the level of observance of the guidelines for registering and labeling anesthetic drugs.

Training and improving the surgical team's awareness of radiation protection is necessary to prevent severe and irreparable damage. Therefore, the purpose of the present study was to compile and psychometrically evaluate (content and face validity) the educational booklet on the principles of radiation protection to promote the knowledge and culture of radiation safety of the operating room staff and prevent injuries.

 The current research is a methodology carried out in Iran University of Medical Sciences in 2022-2023 in three stages: first, the content of the educational booklet was selected based on the needs of the target audience, and the related articles and sources were reviewed. Then, the initial draft of the educational manual was designed and prepared. After that, expert judges in related fields as well as anesthesia and operating room technologists evaluated the formal and content validity of the manual. The content validity index at the item level (I-CVI) and the content validity index at the scale level (S-CVI) equal to or greater than 0.78 and 0.9, respectively, were considered as criteria for validity of the booklet. The binomial test was used to check the reliability of the content validity index of the items so that the significance level was 0.05 and the expected agreement ratio was 0.8. Data were analyzed using SPSS 26 software.

In this research, 22 experts in related fields and 22 anesthesia and operating room technologists with an average work experience of 13.8±4.3 years and 15.6±6.3 years participated, respectively. After sending and receiving the draft version of the booklet along with its evaluation scale, the specialists and experts participating in the study were given the minimum values of I-CVI and S-CVI values for the desired scale items to check the face validity and content of the booklet. According to experts, it was equal to 0.9 and 0.97, respectively. The minimum observed agreement ratio of the binomial test was 0.9, which was more than the expected agreement ratio (0.8). The values of I-CVI, S-CVI, and agreement ratio between anesthesia and operating room technologists were all equal to 1.

The present educational booklet has an acceptable form and content validity based on the research findings. Therefore, it can be used as a simple tool to promote radiation safety culture and prevent radiation damage in operating rooms.

Context:

 One of the most common cancers in men is prostate cancer, which can lead to death. Immune checkpoint inhibitors (ICIs) are drugs that have been proposed in recent years as proposed treatments for prostate cancer.

 The aim of this study was to review the efficacy and tolerability of ICIs in these patients.
Data Sources: From January 1, 1990, to January 1, 2022, using the keywords in checkpoint inhibitors, prostate cancer, efficacy, and tolerability, systematically reviewed databases such as PubMed, ClinicalTrial.gov, Web of Science, Scopus, Cochrane Library, ScienceDirect and Google Scholar based on the protocol registered in Prospero were identified as CRD42021252562.

 Out of 690 studies found, 43 studies were reviewed for evaluation in terms of inclusion criteria, and finally 6 studies were included in the design. In the analysis of selected studies, 1 800 patients were studied, and the range of sample size was from 23 to 799. According to the results of the meta-analysis, there was no significant difference in death risk compared to ICI + radiotherapy with radiotherapy + placebo (HR: 0.96, 95% CI: 0.74, 1.23, P = 0.74). Combined results from 2 clinical trials demonstrated that the risk of death in the radiotherapy + ICI group was less than in the group just treated with radiotherapy (HR: 0.69, 95% CI: 0.61, 0.77, (P < 0.001), 0.77, P < 0.001). To evaluate tolerability, the results showed a non-significant difference between the groups considering the overall prevalence of treatment-related side effects (RR: 1.59, 95% CI: 0.75, 3.39, I2 = 98%).

 The present meta-analysis showed that the use of safety checkpoint inhibitors has been associated with improved survival without progression, but their effect on increasing overall survival has not been confirmed.

The outbreak of the Corona disease in 2019 deeply affected the world community in all dimensions. Moreover, based on the recommendation of the World Health Organization, most countries decided to control the spread of Covid-19 by leading people to quarantine and regarding social distance. The main problem of this universal solution was the lack of attention to the mental health of people especially the elderly. The purpose of this article is to review and summarize the findings of studies that examine the impact of covid-19 on the social isolation of the elderly. Furthermore, this study provides strategies to reduce mental and physical harm and it improves the quality of life of the elderly.

Methods and Materials: 

The studies conducted in the field of the impact of social isolation caused by Corona virus pneumonia on the elderly using corona virus, social isolation, mental health, covid-19, epidemic and the elderly keywords in Pubmed, Science direct, Scopus, Google Scholar and Iranian databases such as SID, Iranmedax and Magiran.

The results show that the impact of Covid-19 on mental health is moderate to severe. On the other hand, social isolation in the elderly can lead to increased depression and tendency to suicide, decreased immune response to viral infections, and increased risk of stroke, cardiovascular diseases, and brain deterioration. Therefore, it is important to provide a systemic approach to improve the quality of communication in all individual and social dimensions. In addition, providing these solutions can reduce the stress and anxiety caused by social isolation in the elderly with social supports such as emotional and practical support. Furthermore, educational interventions, maintaining the dignity and respect of the elderly, encouraging the use of Virtual network, and sports are among other things that improve the mental and social health of the elderly in the era of Corona.

Although social isolation is one of the most important measures to deal with the Corona virus, paying attention to mental health and implementing quality and acceptable services in times of crisis is essential especially for the elderly. This issue requires an integrated and interdisciplinary assessment of geriatric specialists. , psychiatrists and physiotherapists in improving the conditions of the elderly.

The novel coronavirus disease (caused by SARS-CoV-2) has become a disaster all over the world. Based on available evidence, the main organ infected by this virus is the respiratory system; however, various other vital systems can also be affected by potential outcomes. One of the critical affected organs is the kidney.

This study aimed to report and reviewed Risk of Renal Stones in Patients With COVID-19 Infection.

In the present study, we reviewed literature about the renal stone in patients with COVID-19 in six databases, including PubMed, Scopus, Web of Science, Springer, Ovid, and Google Scholar. Then, we reported six adult COVID-19 patients with no history of kidney disease and new-onset renal stones. 

The rate of complicated ureteral stone disease significantly increased during the COVID-19 period. A few studies were available about renal stones, and mostly they were about the management of renal stones in patients infected with the coronavirus. However, in six patients, after being infected with COVID-19, the renal stone was recognized in patients. All the reported patients did not have a history of renal disease or other risk factors for renal stone formation.

Kidney injury is a possible complication of coronavirus, but based on our search, renal stone without history was not reported. However, observed cases highlighted the possible effects of COVID-19 infection on kidney function changes. On the other hand, although supplementation with vitamins C and D may be beneficial for the management of COVID-19, is associated with risks. These molecules should be used with caution, particularly in prior stone formers. Physicians should be responsible for understanding the impact of potential treatments for COVID-19 on common pathologies within their scope of practice.

In late December 2019, a kind of pneumonia caused by a novel coronavirus (SARS-CoV-2) emerged in Wuhan, Hubei Province, China. This virus rapidly spread worldwide and infected 195 countries and territories, including Iran. By March 22, 2020, the virus had affected more than 40000 people worldwide and caused more than 19000 deaths. Pregnant women are a vulnerable group to viral infections because partial immune suppression occurs during pregnancy. Therefore, the COVID-19 epidemic may cause a rising global concern about its consequences for pregnant women and fetuses. 

In this case study, we report the delivery of a pregnant woman after her COVID-19 confirmation.

We report a 44-year-old pregnant woman (32 weeks gestation) with COVID-19 who gave birth to a healthy baby with no evidence of COVID-19. We did not observe any worse clinical outcomes, such as maternal mortality, stillbirth, spontaneous abortion, and preterm delivery.

A preterm baby girl with 2500 g weight and Apgar scores at 5 minutes and 10 minutes were 9 and 10 was delivered. The preterm baby was normocephalic, had no icteric sclera, and the heart sounded normal without murmurs, Lung ventilation was normal. 

Viral pneumonia may severely be presented in pregnancy because of physiological and immunological changes and shift from cell-mediated to humoral-mediated immunity during the pregnancy period. Vertical transmission of COVID-19 from mother to child, short-term and long-term adverse effects on mother and newborn are still unclear and controversial.

Medical education has special features due to the need various areas of learning. The present study was conducted to provide a complete picture of the evaluation system in Iran University of Medical Sciences for improving the evaluation system and medical sciences examinations.

The research was cross‑sectional study that conducted through self‑reporting of educational departments, a comprehensive review of the student evaluation system in the affiliated faculties of Iran University of Medical Sciences from 2017 to 2018. Educational members and heads of nine faculties and 80 departments participated in this study. The research tool was a researcher‑made questionnaire, include two parts: (1) 10 general questions about the activities of the educational groups regarding the student evaluation system and (2) 20 questions about the types and quality of examinations.

From 80 questionnaires, 71 were completed by the managers of the departments. The results showed that 62% of the faculty members in the educational departments in the last 2 years did not participate in the workshop on the methods of evaluation and making tests. 56% of the faculties have a reference for continuous monitoring of students’ assessment and evaluation, and in 87% of the cases, the content is given in accordance with the objectives. The use of logbooks was more common (28%) than other methods to assess practical skills.

Empower faculty members on the use of various tools, strengthening the supervision of formative evaluation and use of medical education graduates to promote evaluation methods seems necessary

The biotechnology revolution and the emergence of new ways to change the genetic material of an organism have led to an increased risk of biological wars. Coping strategies against these threats is very important to improve the health of people. Therefore, due to the importance of this issue, this study is aimed to review the scope of using biotechnology and genetic engineering in wars and coping strategies in all over the world. In this review study, database includes of PubMed, Web of Science, Google Scholar, Scopus, and Science Direct were searched. The search was limited to reviewed articles in English published between 1990 and 2020. The primary search results generated 148 relevant references. After eliminating the duplicates and articles which were not related to the review of the abstract, 11 references were identified for inclusion in this review. Based on the results of these studies, the advances in genetic engineering can lead to the development of new weapons for other types of conflict and war scenarios, secret operations, and sabotage activities. Rapid developments in biotechnology and genetics have created environmental, ethical, political, and social challenges for many communities. Increasing awareness and sensitivity, monitoring, and building capacity for effective coping are essential. Biotechnology areas that will probably significantly contribute to countering biological weapons include recognizing the human genome, strengthening the immune system, identifying bacteria and viruses’ genome, equipment for biological identification, new vaccines, new antibiotics, and anti‑viral drugs must be monitored.

Iran always exposed many chemical events and threats. Although, chemical events not common, they cause widespread and severe casualties. Hospital preparedness for these events has an important role in reduced morbidity and mortality. This study has attempted to develop a comprehensive and operational model of hospital preparedness against chemical events and threats in order to address existing challenges in hospitals and to fill the gaps.

A qualitative approach was used to identify the dimensions and factors affecting hospital preparedness and through content analysis, 37 semi-structured face-to-face interviews with managers, experts and victims of chemical disasters were analyzed. In the third stage, the extracted components from the previous stage were presented as initial model and validated by Delphi method. Finally, after validation of the initial model, the final model was explained and presented.

Qualitative study findings included 9 themes: hospital risk assessment, management and organization, human resource empowerment, law, coordination and communication, documenting and recording, socio-cultural origins, hospital contamination, and challenges. Each of these themes had several categories and sub-categories. Following a Delphi step, all questions reached a percentage of agreement above 75%. Drawing the relationships of the final extracted themes formed the initial conceptual model of hospital preparedness against chemical events and threats.

The present study showed that a model-based preparedness plan should be designed based on hospital capacities, hospital preparing level, up to date knowledge, personal protective equipment and adequate decontamination. Avoiding Security chemical events and raising the risk perception of managers, officials, and people will provide the basis for hospital preparedness. Followed by reduced the various undesirable consequences of chemical accidents.

 Postoperative nausea and vomiting (PONV) is still a common complication that occurs frequently at the time of recovery from eye surgery.

 The present study aimed to compare the effect of oral Ondansetron and Ginger on the frequency and severity of postoperative nausea and vomiting in patients undergoing eye surgery.

 A total of 148 patients were randomly assigned to Ginger, Ondansetron, and placebo groups. Group A received a Ginger capsule (1,000 mg), group B Ondansetron capsule (16 mg), and group C placebo capsule with 30 ml water, one hour before surgery. The frequency of nausea and vomiting and the severity of nausea were recorded immediately after recovery, 1, 2, and 4 hours after recovery. Also, some side effects following prescription such as headache, stomach ache, dizziness, and cardiac arrhythmias were recorded.

 Of the 148 participants, 54% were men, and 46% were women. The average age was in group Ginger (36.14 ± 2.17), group Ondansetron (36.24 ± 2.49), and group placebo (36.24 ± 2.20). There was no significant difference in the frequency of vomiting between the three groups immediately after recovery (P = 0.19) and 4 hours after surgery (P = 0.18). However, the frequency of vomiting in Ginger and Ondansetron groups 1 and 2 hours after the surgery was significantly lower than that in the control group (P = 0.003). No significant difference was observed in the severity of nausea between the three groups at certain times (P > 0.05). There was no significant difference in terms of the need for injection antiemetic drugs after surgery (P = 0.2).

 Ginger and Ondansetron can reduce the frequency of vomiting. However, Ginger was more effective, safer, and less expensive than Ondansetron; therefore, it may be a better substitute for Ondansetron to prevent PONV.

The outbreak of (SARS-CoV-2) originated in Wuhan, China, and pneumonia induced by this virus is named coronavirus disease 2019 (Covid-19). By March 29, 2020, 737000 people were infected and 35000 died worldwide. To date, no effective medication is recommended to treat SARS-CoV-2 infection, and the drugs introduced are still in the clinical trial phase. Tocilizumab and Remdisivir are possible drugs to treat and improve the symptoms of the patients. We prescribed a combination of Remdisivir and Tocilizumab to treat three critical patients with Covid-19, and presented the results in this article. After the duration of treatment with this combination, one case was improved and discharged, but, unfortunately, two cases expired.

Acute stress response to heart surgery can cause major morbidity in patients. The trace of selenium is useful for preventing heart damage. Although the trend of selenium changes is of high importance for body balance, the usefulness of routine use and effectiveness of this element for patients under open-heart surgery is still unclear.

This study aimed at assessing serum selenium level before and after open-heart surgery and the relationship between selenium trace and patient outcome.

This prospective analytical study was performed on 100 patients undergoing open-heart surgery using cardiopulmonary bypass (CPB). In all patients, the serum level was measured at a predetermined time (before surgery and one and two days after surgery). Then, the relationship between serum selenium and patient outcome was assessed.

The mean serum selenium level in patients on admission was 72.90 ± 14.62 μg/L, one day after surgery was 71.20 ± 15.84 μg/L, and two days after surgery was 71.54 ± 15.97 μg/L. Serum selenium levels were inversely and significantly associated with age (r = -0.183; P = 0.034, 013) duration of surgery (r = -221 and P = 0.014), duration of intensive care unit stay (r = 0.204, P = 0.021), and duration of CPB (r = 0.223, P = 013).

Based on this study’s results, a low level of selenium can affect patients’ outcomes after open-heart surgery.

Postoperative nausea and vomiting (PONV) is considered a common complication of anesthesia, which, particularly in eye surgery, may exert pressure on stitches and open or leak the surgical wound, leading to bleeding.

We aimed to study the effect of ginger on PONV and changes in vital signs after eye surgery.

In this triple-blind randomized controlled trial, 120 candidate patients for eye surgery were divided into group A (n = 40) and group B (n = 40). Patients in group A received the capsules of ginger 1 g while patients in group B received a placebo one hour before the procedure with 30 mL water. The incidence of nausea and the frequency of vomiting were evaluated at 0, 15, 30 minutes, and 2 hours after the operation. Also, the vital signs of the participants were recorded at certain times.

The results demonstrated a statistically significant difference in the frequency of nausea between group A and group B (P < 0.05). The severity of nausea was lower in group A than in group B immediately and 2 hours after recovery (P < 0.05). The incidence of vomiting was significantly lower in group A than in group B (P < 0.05). The vital signs were not significantly different between group A and group B (P > 0.05).

Ginger was effective in the prevention of PONV after eye surgery but had no impact on vital signs. Hence, ginger is proposed to use as a low-cost, prophylactic measure for PONV reduction.

Disasters and emergencies have been increasing all over the world. Todays, with technological advancement, acquiring knowledge and its application in the realm of action is regarded as the only effective way for prevent disasters or reducing its effects. The present study aimed to review the importance of education and the effect of different methods of education on disaster risk reduction and preparedness in vulnerable people. To this aim, some articles indexed in Database of PubMed, Web of Science, Google Scholar, Scopus, Science Direct, and ProQuest were searched. The search was limited to reviewed articles in English published between 1990 and 2017. In addition, the selected articles were reviewed for relevant citations. The conducted studies were reviewed by two researchers independently. The primary search generated 128 relevant references. After eliminating the duplicates and articles which were not related to the review of the abstract, 41 references were identified for inclusion. After reviewing more, 31 references, which failed to meet inclusion index, were excluded from the study. Disaster education aims to provide knowledge among individuals and groups to take actions to reduce their vulnerability to disasters. During the last decades, the issue that trained people can be prepared for disasters and responding well has been extensively investigated. Based on the results, disaster education is a functional, operational, and cost‑effective tool for risk management. Based on some evidence, it is important for vulnerable people to learn about disasters. There are different methods to educate vulnerable people, but no method is better than others. Trained people can better protect themselves and others. In this regard, planning and designing comprehensive educational programs are necessary for people to face disasters.

One of the important duties of nurses is to protect patients against any injuries. In most cases, physical restraint is applied as one of the immunity tools. In cases that other actions are not possible, physical restraint seems to be one of the acceptable interventions to protect patients or personnel of the unit.
The current study aimed to assess the effectiveness of multifactorial intervention on observance of physical restraint standards of patients hospitalized in intensive care units.
Patients and In this clinical trial study, 240 patients under physical restraint and hospitalized in intensive care units of Hazrat Rasool Akram hospital were studied in two control and intervention groups with convenience sampling. Observance of the physical restraint standards was first recorded with observational checklist. Then, the multifactorial intervention (education through pamphlet, installation of poster in the unit and physical restraint datasheet) was executed for one month. After that, observance of standards was recorded and compared with that of the control group. The collected data were analyzed using SPSS v.16 software with independent t-test and Chi-square test.
The findings showed that observance of physical restraint standards in the control group was undesirable in more than half of the patients (56.7%) and relatively desirable in the intervention group for the majority of the patients (73.3%). Result of independent t-test showed statistically significant difference in observance of standards between the control and intervention groups (P value Considering the obtained results, multifactor intervention increased the observance rate of physical restraint standards for patients hospitalized in intensive care units. As a result, it is suggested to use multifactor intervention (education to personnel, recording restraint and installing poster) to improve immunity of patients and reduce the side effects of physical restraint in intensive care units.

Most patients hospitalized in intensive care units suffer from restlessness, confusion, and delirium. Physical restraint seems to be the only acceptable measure for ensuring patients’ own and others’ safety in certain cases in which other interventions are not applicable or useful. The aim of this study was “to evaluate the application of physical restraint standards in intensive care units”. This was a cross-sectional descriptive study. A convenient sample of 120 physically restrained patients was recruited from the intensive care units of selected hospitals of Tehran University of Medical Sciences, Tehran, Iran. The data collection tool was an observational checklist for physical restraint standards. The SPSS16 was used for calculating the measures of descriptive statistics and conducting statistical tests. Most of the participating patients were male (65.8%), aged 50–60 years (62.5%), and had a Glasgow Coma Scale score of less than 8. The Fisher’s exact test revealed a significant difference among the studied intensive care units and also among the three phases of using restraint (i.e. before, during, and after restraint use) regarding the rate of applying restraint standards (p≤0.001). Moreover, restraint standards were minimally applied in the study setting. Educating nurses—as the first decision makers for restraint use—and familiarizing them with restraint-related clinical guidelines are crucial.

Pulse oximetry is a frequently used and standard non-invasive method for moni- toring oxygen (O2)-saturation in blood. Many factors including dark skin and pigmentation may effect on rate of saturation of the blood oxygen absorbed by pulse oximetry. The effect of nail polish and/or henna color on blood oxygen has not been yet identified and the present study has been carried out by aiming at the review on impact of henna and nail polish on results of pulse oximetry.Methods & Materials: In the current investigation, clinical trial was studied on 60 resident young women at ages 20-40 by means of purposeful sampling method. Initially, 20 g of Iranian original henna was solved in 30 ml water and put on forefinger of non-dominant hand of the subjects. The other fingers of the same hand were stained by red, black, and white nail polish, respectively. The middle finger of the same hand was considered as the control variable. Then, blood O2-saturation was measured by two calibrated pulse oximetry devices simultaneously. The results indicated that henna (P = 0.020), red nail polish (P ≤ 0.001), and white nail polish (P = 0.020) have increased significantly the rate of O2-saturation absorbed by pulse oximetry. The impact of black nail polish (P = 0.100) on O2-saturation was not significant, but it has changed the mean rate of O2-saturation. Test result of ANOVA with iterative values of f = 10.385 and P ≤ 0.001 showed the significant statistical difference among mean values of O2-saturation (henna, red, black, white, and control nail polish). Henna and nail polish may effect on percent of O2-saturation that showed by pulse oximetry and this may lead to error in monitoring of the patient. As a result, it is recommended to use other areas of the hand to put pulse oximetry sensor if henna is utilized and nail polish to be removed before installing the given sensor.