Concept of Spirituality: A Conventional Content Analysis

Introduction: Health is a holistic concept that incorporates physical, social, cultural, emotional, spiritual, mental, mystical, intrinsic, communicative, and cognitive dimensions. However, spirituality is the least understood and most challenged dimension of health. The purpose of this study was to explore the concept of spirituality. Method: In a conventional content analysis, 10 participants of the Quran and Medicine Congress were recruited. Data was collected with semi-structured interviews and narrative approach. Results: We recognized one theme, i.e. multidimensional concept of spirituality and its aspects, and two main subthemes, namely different perceptions of people about the concept of spirituality and various aspects of spirituality. Conclusion: Although this study provided a definition of spirituality and its dimensions, these concepts are ambiguous and have unclear domains. Therefore, further investigations are necessary to differentiate between aspects of spirituality. Keywords: Spirituality, Concept, Content analysi

The effect of 2 nitroglycerin ointment application on the phlebitis intensity, induced by intravenous catheter

چکیده: زمینه و هدف: شیوع بالای عارضه فلبیت یکی از مسایل مهم در رابطه با تزریقات وریدی می باشد. در بیمارستان هایی که میزان عوارض ناشی از تزریقات وریدی کمتر بوده، مدت اقامت بیماران در بیمارستان و همچنین موارد مرگ و میر کاهش چشمگیری داشته است. این مطالعه با هدف بررسی تاثیر کاربرد پماد نیتروگلیسرین 2 بر شدت فلبیت ناشی از کاتتر وریدی انجام شده است. روش بررسی: در این مطالعه کارآزمایی بالینی یک سو کور 300 نفر از بیماران بستری در بخش قلب و سی سی یو بیمارستان قائم شهر مشهد به روش مبتنی بر هدف انتخاب و به صورت تصادفی در دو گروه شاهد و آزمون قرار گرفتند. در گروه آزمون پس از جایگذاری کاتتر وریدی در قسمت دیستال کاتتر پماد نیتروگلیسرین 2 به میزان 5/0 اینچ گذاشته و پانسمان می‌شد و در گروه شاهد جایگذاری کاتتر وریدی بدون استفاده از پماد نیتروگلیسرین انجام شد. پس از جایگذاری کاتتر هر 12 ساعت محل کاتتر از نظر وجود علایم فلبیت بررسی و در گروه آزمون پانسمان پماد نیتـــروگلیسرین تعـویض می‌شد. داده های به دست آمده به کمک آزمون های آماری t مستقل، کای دو و آزمون دقیق فیشر تجزیه و تحلیل شد. یافته ها: شدت فلبیت در گروه آزمون کمتر از گروه شاهد بود (001/0

Using Data Mining Algorithm for Assigning Family-Centered Empowerment Model as to Improve the Quality of Life in Cardiac Infarction Patients

Introduction: Today, cardiovascular disease is a major threat to advanced human societies, and is acting as a major cause of disability in many aspects of a patient and family members' lives, including their quality of life. Therefore, the aim of the present study is to provide models for classifying and determining the factors influencing the allocation of family-centered empowerment model to further improve the psychological quality of life of these patients.  Materials and Methods: In this study, data from a clinical trial study were used in which 70 patients with myocardial infarction who randomly received a family-centered empowerment pattern and control group. A model of linear mixed effects and then learning algorithms were used to predict the success or failure of the empowerment model. Results: In this study, the decision tree model was able to accurately predict more than 96% of patients (Kappa=0.828, ROC=0.96).  Physical functions, walking status, creatinine level, EF level, employment status, gender, stress level and body mass index were identified as the effective factors in assigning a family-centered empowerment pattern (P value <0.05). This process was done through software of SPSS24, SAS9.1 and WEKA 3.6.9 Conclusion: The decision tree model was able to correctly classify more than 96% of patients; if a family-centered empowerment model was assigned, this model would improve the psychological dimension of their quality of life. &nbsp

Effect of COVID-19 on Mortality of Pregnant and Postpartum Women: A Systematic Review and Meta-Analysis

Background. Based on what is known at this time, pregnant women are at an increased risk of severe illness from COVID-19 compared to nonpregnant women. Additionally, pregnant women with COVID-19 might have an increased risk of adverse pregnancy outcomes. To investigate the effects of coronavirus disease 2019 (COVID-19) on mortality of pregnant and postpartum women, we performed a systematic review of available published literature on pregnancies affected by COVID-19. Methods. Web of Science, SCOPUS, and MEDLINE- databases were searched for original studies concerning the effect of COVID-19 on mortality of pregnant and postpartum women published by July 10, 2020. Meta-analyses of proportions were used to combine data and report pooled proportions. Results. 117 studies with a total of 11758 pregnant women were included. The age ranged between 15 and 48 years. Most subjects were infected with SARS-CoV-2 in the third trimester. Disease severity was not reported in 1125 subjects. Maternal mortality was 1.3%. In 100% of fatal cases with adequate data, fever alone or with cough was one of the presenting symptoms. Also, dyspnea (58.3%) and myalgia (50%) were the most common symptoms. Sore throat (8.3%) and gastrointestinal symptoms (anorexia, nausea) (8.3%) were rare. The rate of comorbidities was 20% among COVID-19 deaths. The majority of COVID-19-infected women who died had cesarean section (58.3%), 25% had a vaginal delivery, and 16.7% of patients were not full term. Conclusion. COVID-19 infection in pregnant women was associated with higher rates (and pooled proportions) of cesarean section and mortality. Because new data are continuously being generated and published, the findings of this study can be complete and updated with new researches. The results of this study can guide and improve prenatal counseling of COVID-19-infected pregnant women

Age and the Length of Hospital Stay in Patients With Sepsis at the ICU Admission can Prolong the Duration of Endotracheal Intubation

Background: Endotracheal intubation (EI) associated with mechanical ventilation (MV) is frequently performed in critically ill patients admitted to intensive care unit (ICU) with sepsis. Objectives: This study aimed to assess the impact of important factors on the duration of tracheal intubation in patients with sepsis at the ICU admission. Methods: Adult patients admitted to the mixed medical–surgical ICUs with sepsis at the ICU admission who needs prolonged mechanical ventilation (PMV) (≥ 21 days) were included in this retrospective secondary analysis study. The primary outcome was ICU mortality. Baseline demographic and clinical characteristics of all patients were assessed as risk factors associated with the duration of MV by univariate and multivariate Binary logistic regression. Results: Eighty-five patients required more than 21 days of MV. Out of the 85 patients, 52 (61.2%) patients were intubated within 30 to 34.50 days and 33 (38.8%) patients had intubation within 34.51 to 65 days, and categorized as PMV and very prolonged MV groups, respectively. Two parameters were significantly associated with very prolonged MV which are as follows: older age 1.229 (95% CI: 1.002-1.507, P = 0.048) and long hospital stay (LOS) 2.996 (95% CI: 1.676-5.356, P < 0.001). No significant survival difference was observed between the two groups of study. (33.3% vs. 25%, P = 0.406). Conclusion: Our observations showed that the older age and LOS as pre-ICU stay in patients with positive sepsis at the ICU admission can prolong the duration of intubation. In addition, no significant survival difference was observed between patients with PMV and very prolonged MV

Effects of Iranian herbal Zofa® syrup for the management of clinical symptoms in patients with COVID-19: A randomized clinical trial

Objective: The objective of this study was to determine the role of Iranian herbal Zofa® syrup in improving the clinical symptoms of patients with COVID-19. Materials and Methods: This randomized clinical trial was conducted on 105 patients with COVID-19. Patients were randomly assigned to the intervention (n=35) group (received 10 ml of Zofa® syrup every 8 hours/seven days plus standard treatment) or the control (n=70) group (received only standard treatment). Assessments were performed before and after treatment. Results: The groups were comparable regarding age (p=0.980), gender (p=0.584), comorbidities (p=0.318), or drug history (p=0.771). There was no difference between patients' recovery status at the time of discharge (p=0.327) or two weeks post-discharge (p=0.165) in the intervention and control groups. No patient was hospitalized to the intensive care unit (ICU) for supplemental oxygen therapy and no patient died in the intervention group. However, in the control group, three (4.5%) patients were transferred to the ICU, and two (3.03%) patients died. Conclusion: Considering the better recovery status of the patients at the time of discharge and the absence of patient deaths in the intervention group, more additional studies are needed to confirm these findings and elucidate the role of Zofa® in COVID-19

Is the Ratio of Retracted Iranian Papers Compatible With Their Research Growth Rate? An International Database Survey

Background: Retraction of articles occurs as a result of scientific misconducts or honest errors. Objectives: This study aimed to identify the frequency of retracted Iranian publications, compared to those of other countries and adjust them with influential parameters. Methods: All publications that were indexed on the Scopus database from 2008 to 2017 and then retracted, due to scientific misconduct were extracted through the Retraction Watch database and selected as the research community. To calculate the growth of retraction for each proposed country (or region), first, the rate of an absolute number of retracted papers for the years 2013-2017 was divided by the similar number for years 2008-2012, then this rate was adjusted to the retracted rate which is similarly computed for the total retracted statistics of the world. Results: Overall, 545 Iranian retracted publications from 2008 to 2017 were identified, of which 240 and 305 retracted articles were related to the first five years and the second five years of the study, respectively. The results showed that less than 1% (0.82) of all scientific articles published by Iranian researchers were retracted. However, the rate of retracted scientific articles in Iran compared to this rate in the world was significantly higher. Conclusion: Although retracted Iranian publications make up a small percentage of all Iranian publications, the number of retracted publications is increasing. It is important to recognize the reasons for scientific misconducts and to provide researchers with proper education

Integration of Palliative Care into the Primary Health Care of Iran: A Document Analysis

Background: Providing palliative care (PC) is increasing by the increase in the number of people with life-threatening diseases and determined the benefits of these services in the community. Access to palliative care is a patient’s rights and ethical responsibility. Thus it is necessary to integrate into all level of the health system, including the primary health care. This study was conducted to assess the requirements for the integration of PC into the primary health care. Method: It was a document analysis, carried out through conventional content analysis and 10 national documents on PC, released by governmental organizations from 2010. The 4-step Scott method was used for the data validity and the coding process was done utilizing MAXQDA 10 software. Results: Base on the data analysis, we identified the “requirements of the integration of PC into the primary health care”, was of 4 main categories and 12 sub-categories. The categories include “principles and basics”, “legislation and policy-making”, “the establishment of PC system” and “the need for civil support”, which were extracted by reviewing the documents. Conclusion: PC is believed to be in its early stages in the Iranian health system. Therefore, universal access to these services requires their provision at the community level. Thus, it is recommended that the principles and basics of PC in the country be explained and then, the necessary infrastructures of this integration be provided with the cooperation of governmental organizations, NGOs, and charities, through proper policy making

A systematic review and meta-analysis on the effects of statins on pregnancy outcomes.

Abstract Background and aims Statins are contraindicated in pregnancy, due to their potential teratogenicity. However, data are still inconsistent and some even suggest a potential benefit of statin use against pregnancy complications. We aimed to investigate the effects of statins on pregnancy outcomes, including stillbirth, fetal abortion, and preterm delivery, through a systematic review of the literature and a meta-analysis of the available clinical studies. Methods A literature search was performed through PubMed, Scopus, and Web of Science up to 16 May 2020. Data were extracted from 18 clinical studies (7 cohort studies, 2 clinical trials, 3 case reports, and 6 case series). Random effect meta-analyses were conducted using the restricted maximum likelihood method. The common effect sizes were calculated as odds ratios (ORs) and their 95% confidence interval (CI) for each main outcome. Results Finally, nine studies were included in the meta-analysis. There was no significant association between statin therapy and stillbirth [OR (95% CI) = 1.30 (0.56, 3.02), p=0.54; I2 = 0%]. While statin exposure was significantly associated with increased rates of spontaneous abortion [OR (95% CI) = 1.36 (1.10–1.68), p=0.004, I2 = 0%], it was non-significantly associated with increased rates of induced abortion [OR (95% CI) = 2.08 (0.81, 5.36), p=0.129, I2 = 17.33%] and elective abortion [OR (95% CI) = 1.37 (0.68, 2.76), p=0.378, I2 = 62.46%]. A non-significant numerically reduced rate of preterm delivery was observed in statin users [OR (95% CI) = 0.47 (0.06, 3.70), p=0.47, I2 = 76.35%]. Conclusions Statin therapy seems to be safe as it was not associated with stillbirth or induced and elective abortion rates. Significant increase after statin therapy was, however, observed for spontaneous abortion. These results need to be confirmed and validated in future studies

Prevalence of depression among Iranian patients with rheumatoid arthritis : a systematic review and meta-analysis

Patients with rheumatoid arthritis (RA) are prone to depression due to several factors related to their RA, including chronic and persistent pain, functional disability, economic constraints, and the side effects of RA medication. Previous Iranian studies showed conflicting and inconclusive findings regarding the prevalence of depression among RA patients. Therefore, this systematic review and meta-analysis was conducted to estimate the true prevalence of depression in Iranian patients with RA. Search for eligible articles was performed using the keywords of depression, depressive disorder, dysthymic disorder, major depressive disorder, RA, and Iran, and their possible combinations in the following databases: Scientific Information Database, MagIran, Web of Science/ISI, PubMed, and Scopus. The search was restricted to articles published in Persian and English languages. The meta-analysis was performed using the random effects model, and the data were analyzed using the STATA software version 12. Overall, six articles were selected; the overall prevalence of depression among the Iranian patients with RA was 65.58% (95% CI: 56.53%-74.62%). There were no significant relationships between the prevalence of depression and articles' methodological quality and year of publication, participants' age, sample size, and duration of disease. More than half of RA patients suffer from depression. The overlap between the physical symptoms of RA and depression in this group of patients makes it difficult to correctly diagnose depression; therefore, initiative and efforts are required to improve the identification of early depression symptoms in RA patients in order to effectively manage their depression