Adult emergency department performance in the largest teaching hospital in southern Iran: a 1.5-year cross-sectional study

Background: Emergency department (ED) is one of the most important hospital departments, with significant effects on public health. The aim of this study was to evaluate the adult ED's performance of the largest teaching hospital in southern Iran. Methods: In this retrospective cross-sectional study (March 2017-August 2018), the registered data in the Hospital Information System (HIS) were collected, and the ED’s performance was assessed based on the Iranian emergency performance index. The slopes of the trend lines were calculated for each indicator. Moreover, 2 six-month periods were compared. Results: The data of 104,081 patients were analyzed. The mean (±standard deviation) of visited patients per-month was 5,782.28 (±1258.55). The slope of the trend line was negative for all indicators, except for discharge from ED with personal responsibility. The mean duration of waiting time for the first visit by physician in each triage level slightly decreased. Comparison of the two six-month periods showed a significant difference between the visited patient (P<0.0001). The percentage of patients disposed within six hours (P<0.0001), leaving ED within 12 hours (P<0.0001), as well as the percentage of successful cardiopulmonary resuscitation (P=0.014) in the six-month period of 2018 was significantly lower. The percentage of discharge with personal responsibility significantly increased (P=0.005). Conclusion: Although the number of patients visited in this ED decreased, all indicators had dropped. However, the percentage of discharge with personal responsibility was increased. Moreover, the mean duration of waiting time for the first visit by physician slightly decreased in each triage level

The Effect of Spiritual Skills Training on the Quality of Life of Family Caregivers of Hemodialysis Patients

Background and Objective: The responsibility and concerns of caregivers of hemodialysis patients can impair their quality of life. Since spirituality, as one of the dimensions of human existence, plays an important role in the ability to cope with stress, the present study aimed to determine the effect of spiritual training programs on the quality of life in the caregivers of hemodialysis patients. Materials and Methods: The design of this study was the comparison of outcomes before and after a planned intervention without the use of a control. It was conducted on 30 family caregivers of hemodialysis patients who were referred to the Dialysis Center of Tabas in 2019. The subjects were selected via the convenience sampling method. The intervention was spiritual skills training, which was conducted orally in seven sessions of 45 to 60 minutes once a week. Before and after the intervention, a valid and reliable questionnaire on caregivers' quality of life was completed by the caregivers. The data were analyzed in SPSS software (version 20) using descriptive and inferential statistical tests. Results: There was a statistically significant difference between the overall quality of life and mental concerns before and after the intervention (P0.05). Conclusion: Teaching spiritual skills exerted a positive effect on the quality of life among the caregivers of hemodialysis patients. Therefore, the development of spiritual skills training programs for caregivers can be of great help in improving their quality of life

Prognostic Factors of In-Hospital Mortality in Adult Patients With Aluminum Phosphide (ALP) Poisoning in Southern Iran (2014-2018): Prognostic factors of mortality in ALP poisoning

Background: The suicide with aluminum phosphide, known as rice tablet, has increased significantly. This study aimed to investigate the epidemiology of Aluminum Phosphide (ALP) poisoning and determine the in-hospital mortality prognostic factors in adult people referring to ALP poisoning to one of the main poisoning centers in southern Iran.Methods: This retrospective cross-sectional study (March 21, 2014, to March 21, 2018) was conducted on all adult patients (>16 years) with ALP poisoning who were referred to Ali-Asghar Hospital (affiliated with Shiraz University of Medical Sciences). All data were extracted from the patients’ medical files. The patients were categorized into two groups of survived and non-survived. Univariate and multivariate logistic regression analyses were conducted to determine prognostic factors for in-hospital mortality, and Odds Ratios (ORs) were reported.Results: Totally, 97 patients were enrolled in this study. The patients’ Mean±SD age was 29.3±12.2 years. Both study groups (survived and non-survived) were matched in most demographic and poisoning characteristics. Nausea (62.9%) and vomiting (49.5%) were the most symptoms at the time of admission. Castor oil (66%), N-acetyl cysteine (56.7%), and magnesium sulfate (52.6%) were the most frequent treatment in these patients. The multivariate analysis showed that age (OR=1.12, 95%CI: 1.03-1.22), body temperature (OR=0.02, 95%CI: 0.01-0.48), resistant acidosis (OR=77.10, 95%CI: 5.05-1176.86), and taking sodium bicarbonate (OR=12.35, 95%CI: 1.25-122.10) were the prognostic factors of in-hospital mortality.Conclusion: The in-hospital mortality rate in patients with ALP poisoning was 29.9%. Age, illiteracy, body temperature, resistant acidosis, and taking sodium bicarbonate were the prognostic factors of in-hospital mortality in these patients

Evaluation of oxidative stress, blood parameters, and neurocognitive status in cement factory workers

The current investigation was aimed to evaluate the oxidative stress (OS), blood factors, and neurocognitive state among cement factory workers who are exposed to dust during their work. Totally 41 cement exposed workers and 41 subjects as a control group were selected, and their OS, biochemical parameters, and a neurocognitive questionnaire were assessed. The results indicated that the levels of triglyceride, alanine aminotransferase, and alkaline phosphatase were higher among the exposed workers. The rate of lipid peroxidation and total antioxidant capacity were not significantly differenced among the workers while compared to the control groupsem informaçã