Adopting Clinical Guidelines for Admission Criteria of Intensive Care Unit: A Measure to Manage Queues of Patients Waiting for This Section

Background: Due to the need of patients to the intensive care unit (ICU) for receiving medical and nursing services, these services should be provided in a timely manner. This study aimed to develop the clinical guidelines for admission criteria of intensive care unit.Materials and Methods: This study was observational type study was conducted for nine months in 2015 based on a three-step process of adoption of clinical guidelines including planning, adoption and finalization. After conducting systematic searches, the quality of retrieved clinical guidelines was evaluated by experts from policy makers in the admission of patients in the ICU. Finally, the ultimate version of the guideline was developed after reviewing and organizing expert panel sessions.Results: The criteria for accepting patients were presented in form of seven clauses based on the neurological status, cardiovascular status, respiratory status, water and electrolyte disorders, gastrointestinal disturbances, endocrine disorders, surgery and postoperative care.Conclusion: One of the most important factors of creating demand inducing to the patients is the lack of clinical guidelines. It is recommended that departmental doctors should apply the mentioned clinical guidelines in order to make the resources of the intensive care unit more effective

Prevalence of obsessive-compulsive disorder in Iran

BACKGROUND: Estimates of the annual prevalence for Obsessive Compulsive Disorder (OCD) were consistent across the international sites range, 1.9% – 2.5%. The nine population surveys, which used Diagnostic Interview Schedule, estimated a six-month prevalence of OCD ranging from 0.7% to 2.1%. This study performed in order to determine the prevalence of OCD in a population-based study among Iranian adults aged 18 and older and to study the association of them with factors such as sex, marital status, education, type of occupation and residential area. METHODS: A cross-sectional nationwide epidemiological study of the Iranian population aged 18 and older was designed to estimate the prevalence of psychiatric disorders and their association with the above mentioned factors. 25180 individuals were selected and interviewed through a randomized systematic and cluster sampling method from all Iranian households. Schedule for Affective Disorders and Schizophrenia (SADS) and Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria were used in diagnosis of OCD. 250 clinical psychologists interviewed the selected subjects face to face at their homes. RESULTS: The prevalence of OCD in Iran is 1.8% (0.7% and 2.8% in males and females; respectively). 50.3% of the survey sample were men, 49.9% women, 29.1% single, 67.45% married, 0.4% separated or divorced, 2.5% widow/widower and 4% undetermined. All of the above-mentioned factors were examined in the univariate and multivariate logistic regression models. Although the data did not fit the models well, but in univariate models, sex, the category "single" of marital status, age, the categories "business" and "housewife" and residential areas showed significant effect adjusting for the factors, but the models didn't fit the data properly. CONCLUSION: The study suggests that the prevalence of OCD is not rare in the community of Iran and is within the range of other countries. Similar to prior studies in other communities, OCD is more common in females than males

Pneumothorax after Mechanical Ventilation in Newborns

Objective: Air leak syndromes including pneumothorax, pneumomediastinum and pulmonary interstitial emphysema are frequent in neonatal period. Mechanical ventilation with positive pressure is one of the most common causes of these syndromes. The aim of this study was to evaluate predisposing factors and incidence of pneumothorax in newborns under mechanical ventilation. Methods: This descriptive cross sectional study was performed in 400 newborns under mechanical ventilation in intensive care unit of a teaching hospital in Iran from April 2004 to December 2008. Predisposing factors leading to ventilation and incidence of air leak syndromes were studied. Sex, gestational age, birth weight, type of delivery, history of surfactant replacement therapy, ventilator settings and mortality rate were recorded. Statistical analysis was done using SPSS software. Univariate analysis and regression analysis were considered. Findings: Among 400 patients under mechanical ventilation, 102 neonates developed pneumothorax (26%). Fifty six (54.9%) of them were boys and 46 (45.1%) girls. 54.9% of newborns with pneumothorax were preterm and 45.1% term. Birth weight less than 2500g was recorded in 59.8%. Fifty two percent of these neonates were born by cesarean section vs. 32% of newborns without pneumothorax. The most common type (62.7%) of ventilation leading to pneumothorax was Inspiratory Positive Pressure Ventilation (IPPV). Surfactant replacement therapy was recorded in 32.4% of cases with pneumothorax compared to 60.4% of neonates under ventilation without pneumothorax, which was significantly different (P= 0.017). Conclusion: In newborns surfactant replacement therapy can reduce the risk of pneumothorax caused by mechanical ventilation

One pot synthesis of PMMA/silver nanoparticles and its antibacterial properties

Silver, Ag nanoparticles were prepared via one-pot reduction method with two different reducing agents of aniline and NaBH4 whereby the effect of different factors such as the order of mixing the reactants, presence of a stabilizer and time on stability, size and concentration of the silver nanoparticles were studied using UV-Vis. The resulted colloidal Ag was then incorporated into poly(methyl methacrylate), PMMA nanoparticles through miniemulsion. The obtained products were characterized with UV-Vis DR and TEM to investigate the presence of Ag in the samples and study its morphology. The occurrence of the polymerization was analyzed with FTIR and 1HNMR and the antibacterial activity of the samples was tested via Kirby-Bauer method. Results confirmed the successful synthesis of PMMA/Ag nanoparticles and measurements of the clear zone of inhibition from antimicrobial tests showed that by increasing the concentration of the Ag nanoparticles in the samples, the antibacterial activity was increased

BIO Treatment Protects Rat Marrow-Derived Mesenchymal Stem Cell Culture Against the TNF-α Induced Apoptosis

Objective: This study is an attempt to examine the anti apoptotic effects of BIO on ratMSC culture.Materials and Methods: Rat marrow primary cell culture was established and exposuregroups were defined; cultures with 0.01, 0.1, 1 μM BIO. Cells cultured without BIOtreatment were used as controls. During culture expantion, the average doubling time,as an index of the rate of cell growth, were determined and compared. To examinewhether or not BIO is able to protect MSCs against apoptosis, the passaged-3 cellsfrom each group were induced to undergo apoptosis with the addition of TNF-α (Tumornecrotic factor-α). Three days after, the cultures were quantified in terms of the percentagesof apoptotic cells using either the Tunnel or Annexin V staining method.Results: Marrow cells cultivated with 0.1 and 1 μM BIO appeared to expand at a significantlymore rapid rate than the 0.01 μM BIO and the control cultures (p<0.05). Tunnelstaining indicated that in 1 μM BIO-treated groups, there were lower percentagesof apoptotic nuclei than in groups with other concentrations of BIO (p<0.05). The BIOprotective effect appeared to be dose-dependent in that the cultures with high BIO contentpossessed less apoptotic nuclei. The results obtained by Annexin staining were inagreement with the results of Tunnel staining. The Annexin method additionally takesinto account the early apoptotic cells which are not detectable by the Tunnel method.Conclusion: Taken together, it seems that cultivation with BIO could both increase thegrowth rate of marrow cells and protect MSCs against induced apoptosis