The Prevalence of Restless Legs Syndrome in Patients Undergoing Hemodialysis: A Systematic Review and Meta-analysis Study

Introduction: Restless legs syndrome is a sensory-motor disorder that causes sleep disorder. The syndrome in patients undergoing hemodialysis associates with depression, sleep deprivation, performance disorder, day fatigue, excessive daytime sleepiness, stress, anxiety, and higher risk of cardiovascular diseases. The objective of this systematic meta-analysis study was to estimate prevalence of restless legs syndrome in patients undergoing hemodialysis. Methods: Twenty-six relevant articles published between 2000 and 2015 indexed in Iranian (MagIran and IranMedex) and international databases (SID, Google Scholar, ScienceDirect, PubMed, Pre Quest, and Scopus) were selected. Data analysis was carried out through metaanalysis (random effect model) and heterogeneity of the studies was determined using I2 index. The obtained data were analyzed in STAT (11.2). Results: Prevalence of the syndrome according to the found articles was 50 (95 CI: 38-61) in Iranian and 30 (95 CI: 23-37) in international databases. There was an ascending trend of prevalence of the syndrome corresponding to the publication year of the articles (P= 0.419), while the trend based on age of the patients was descending (P= 0.604). However, the variations were not significant. Conclusion: Given the high prevalence and considerable effects of restless legs syndrome on patients undergoing hemodialysis, it is recommended that these patients be screened for the syndrome

Relationship between Obstructive Sleep Apnea (OSA) and Difficult Intubation

BACKGROUND AND OBJECTIVE: One of the challenges of patients who are candidates for anesthesia is difficult intubation, which leads to severe complications and even death after anesthesia. The aim of this study is to investigate the relationship between obstructive sleep apnea and difficult intubation through systematic review and meta-analysis. METHODS: In this review article, observational articles about the relationship between obstructive sleep apnea and difficult intubation were extracted without time limit by searching national and international databases and the keywords were: difficult intubation, problematic intubation, Intra tracheal-endotracheal, difficult airway OSA, OSAS, obstructive sleep apnea, sleep breathing disorder, anesthesia, and their Persian equivalents. Data were analyzed using meta-analysis and fixed effects model. In order to study the heterogeneity and contradictions in the studies, Q Cochrane and I2 indices were used, respectively. FINDINGS: Of the 72 found articles, 9 articles with a sample size of 1,126 and an average of 125 subjects were included in the study. The results of this study showed that the relationship between obstructive sleep apnea and difficult intubation is significant (OR = 3.88, CI95% = 2.69 – 5.61). In addition, the results of the analysis based on country showed that the highest and lowest odds ratios were observed in studies conducted in France and Canada, respectively. CONCLUSION: The results of this study showed that there is a correlation between obstructive sleep apnea and difficult intubation

Prevalence of needlestick and sharps injuries in the healthcare workers of Iranian hospitals: An updated meta-analysis

Background: Needlestick and sharps injuries (NSIs) are critical occupational risk among health care workers (HCWs), which is extremely worrying due to the potential risk of transmitting bloodborn pathogens (BBPs). This study was carried out to evaluate the prevalence of NSIs among Iranian HCWs. Methods: In this systematic review and meta-analysis, the key terms percu*injur*, needle*stick injur*, needlestick*injur*, or sharp*injur*were searched in the Scientific Information Database (SID), MagIran, IranMedex, Google Scholar, Science Direct, PubMed, and Scopus. A prefabricated checklist, including variables: first author, publication year, study population, sample size, gender, total prevalence of needlestick in each gender, type of questionnaire, region, and type of hospitals, was used to extract data from the selected articles included which were published between 2003 and 2016. Results: The analysis showed that the prevalence of NSIs in the Iranian HCWs was 42.5 (95 CI 37-48). Moreover, the prevalence of NSIs was more in women (47; 95 CI 36-58) compared to men (42; 95 CI 26-58). Conclusion: Given the high prevalence of NSIs, it is necessary to supply safe needles and instruments, hold training programs focused on new methods of using sharp objects safely, observe safety principles and standards, reinforce the practical skills of personnel, and pay more attention to reporting and improving occupational behaviors like avoiding needle recapping in order to reduce the prevalence of NSIs and consequently reduce potential risk of transmission of BBPs. © 2018 The Author(s)

Prevalence of depression among Iranian patients under hemodialysis: A systematic review and meta-analysis

Context: Depression is a highly prevalent and debilitating mental disorder, particularly among patients under hemodialysis, who are more susceptible to depression due to their complex treatment regimens, dietary limitations, side effects of medications and fear of disease outcomes. This systematic review and meta-analysis explored the prevalence of depression in Iranian hemodialysis patients. Evidence Acquisitions: In this systematic review and meta-analysis, search was done in national and international databases, including SID, MagIran, Google Scholar, Web of Science, Medline (via PubMed), and Scopus from inception to March 2018. Key search terms included hemodialysis, renal replacement therapy, dialysis, end-stage renal disease, renal failure, depression and Iran along with all their possible combinations. Data were combined for meta-analysis using random effects model. Heterogeneity between studies was analyzed by I2 test, and data were analyzed by STATA (version 12) software. Results: The included 24 articles had a sample size of 2941 participants; the overall prevalence of depression in hemodialysis patients in Iran was 56.8 (95 CI: 50.5-63). The results of the univariate meta-regression analysis showed no significant correlation between prevalence of depression and methodological quality of articles (P = 0.524), duration of hemodialysis (P = 0.885), publication year (P = 0.116), mean age of participants (P = 0.224) and sample size (P = 0.194). Conclusions: More than half of the hemodialysis patients in Iran suffer from depression. Given the overlap of depression symptoms with uremia in this group of patients, it is necessary to identify depression in these patients for early management and interventions. © 2018 The Author(s)

Psychometric features of the persian version of self-efficacy tool for patients with hypertension

Background: Hypertension is one of the causes of mortality that can be prevented. Self-efficacy with regard to patients� performance predicts their abilities to change high-risk behaviors. Positive self-efficacy in patients with hypertension predicts compliance, adherence to medications, diet and exercise regimens, and behavioral self-management. Objectives: This study aimed to examine the psychometric features of self-efficacy questionnaire in patients with hypertension. Patients and Methods: In this cross-sectional study, 260 patients with hypertension were selected by multistage cluster sampling in Tehran�s public places to complete the Persian version of hypertension self-efficacy questionnaire. Then, face validity, content, and structure of the questionnaire were evaluated. To determine the reliability of the questionnaire, test-retest method with a two-week interval and Cronbach�s alpha coefficient were used. All data analyses were performed using the SPSS statistical software, version 18.0. Results: According to the results of Content Validity Ratio (CVR), three items were eliminated. The results of exploratory and confirmatory analyses identified three factors, including diet regimen, disease management, and adherence to treatment. The goodness of fit of the three-factor self-efficacy model in patients with hypertension was confirmed based on standard indices (RMSEA = 0.082, NNFI = 0.90, CFI = 0.91, IFI = 0.91, and X2/df = 328.35). Besides, internal consistency of diet regimen, disease management, and adherence to treatment based on Cronbach�s alpha was 0.849, 0.471, and 0.572, respectively. Conclusions: The three-factor structure of the self-efficacy questionnaire showed appropriate validity and reliability in patients with hypertension. Thus, this tool can help caregivers and health service providers assess self-efficacy of hypertensive patients and plan and implement educational and clinical interventions. © 2018, Iranian Cardiovascular Research Journal. All rights reserved

Relationship between using cell phone and the risk of accident with motor vehicles: An analytical cross-sectional study

Purpose: Traffic accidents are one of the major health problems in the world, being the first cause of burden of illness and the second leading cause of death in Iran. The Sistan-Baluchestan province is one of the most accidental provinces of Iran with the highest rate of accidents-caused deaths. This study was conducted to determine the risk factors associated with traffic accidents in Zahedan through 2013 to 2016. Methods: This analytical cross-sectional study was carried out on 223 drivers from Zahedan who were traumatized by traffic accident and sent to Zahedan hospitals. The data were obtained through interviews taken by the trained interviewers via refereeing to the medical records and collected in the researcher-made checklist. Census was obtained from the study subjects. For data analysis, independent t-test, one-way ANOVA, Chi-square and logistic regression were used with the Stata software version 11.0. Results: In this study, 223 male subjects with the mean age of (32.54 ± 12.95) years, 39.8 single and 60.2 married, entered for investigation. Most accidents (38.8) occurred between 12:00 to 17:59. While driving, 47.1 of the study subjects were using cell phones, 89.1 had manual use of mobile phones, 21.9 had a habit of sending short message service (SMS) and 23.4 had sent SMS within 10 min before the accident. The one way analysis of variance showed that the mean age of individuals with marital status, driving experience, education and accident with motorcycle were significantly different (p < 0.05). Also, the multivariate logistic regression test indicated a significant relationship of smoking, ethnicity, insurance and SMS typing while driving with motorcycle accident (p < 0.05). Conclusion: In this study, SMS and smoking while driving had the highest risk among the variables studied in the motorcycle accidents. Therefore, effective education attempting to enhance people's awareness about the consequences of using cell phone and smoking during driving to reduce traffic accidents seems necessary. © 2020 Chinese Medical Associatio

Identification of the Range of Nursing Skills Used to Provide Social Support for Mothers of Preterm Infants in Neonatal Intensive Care

Background. Hospitalization of preterm infants in neonatal intensive care units (NICUs) is a stressful experience for parents. Iranian NICUs do not have specified levels of care, nor do they integrate supportive methods of parent support such as family-centered care approaches. This study investigated the range and types of neonatal nursing support, as perceived by mothers of preterm infants, and its association with mothers’ satisfaction with infant care in the NICU. Methods. This is a descriptive, correlational study of mothers of preterm infants who were hospitalized in three different NICUs in Iran. A convenience sampling method was used. Data were collected using three questionnaires that identified (i) demographic information; (ii) social support available; and (iii) parent satisfaction with infant care. Results. Mothers (N = 110) generally rated the support from nurses as being moderate. Correlation analysis identified a moderate association of neonatal nurse social support domains for affirmational (r = 0.44) and concrete aid (r = 0.41), a moderately strong association for affectional support (r = 0.64), and total social support (r = 0.60) with mothers’ satisfaction. Conclusion. There were positive associations between social support from nurses and mothers’ satisfaction with the care of their infants. Therefore, planning to promote and create opportunities for neonatal nurses to support mothers in NICU is important to promote increased maternal satisfaction in infant care

The Effect of Foot Serial Casting Along with Botulinum Toxin Type-A Injection on Spasticity in Children with Cerebral Palsy

Abstract: Background & Aims: The goal of this study was to determine the effect of foot serial casting along with botulinum toxin type-A injection on spasticity in children with cerebral palsy. Methods: This study was a randomized clinical trial performed as a pre-post, double blind study. It was performed on 25 children with hemiplegia and diplegia (2-8 years) in Tehran city, who were referred to valiasr rehabilitation foundation. Participants were chosen by simple randomized sampling and were matched for age, Gross Motor Function Classification System (GMFCS) and type. They were randomly divided into two groups. The first group (n=13) underwent BTX-A injection alone and the second group (n=12) had BTX-A injection and foot serial casting after the injection. Clinical assessments were done using the GMFCS and Modified Ashworth Scale before and at 1, 3, 6 and 12 months after the interventions. Data were analyzed by Wilcoxon signed rank test and mann-whitney U. Results: Comparison of two groups in regard to the right and left knee spasticity at, 1, 3, 6 and 12 months after injection showed no significant difference in comparison to those before interventions. Furthermore, comparison of right and left ankle spasticity before injection with that at 1, and 3 months follow ups did not show statistically significant difference, but significant differences were found when compared with 6 and 12 month follow-ups (P<0.05) Conclusion: It seems, one of the proper approaches to reduce spasticity in children with cerebral palsy is foot serial casting along with botulinum toxin type-A injection and it can decrease the muscle tone when applied more than six months. Keywords: Cerebral palsy, Botulinum toxin type A, Muscle spasticity, Casts, Occupational therap

Resilience of Patients With Chronic Physical Diseases: A Systematic Review and Meta-Analysis

Context: Resilience can be seen as an adaption to stress, such as that caused by health problems or disease, that attenuates the negative effects of stress. The present research performed a systematic review and meta-analysis to study resilience scores among adults diagnosed with chronic physical diseases. Evidence Acquisition: Electronic databases, including Persian language (scientific information database SID, IranMedex, Magiran, IranDoc, and Medlib) and English language (Google Scholar, Science Direct, PubMed, Pre-Quest, and Scopus), were searched. Fifteen articles were found using the keywords disease or chronic disease, resilience or resiliency, and illness, either alone or in combination, both in Persian and English languages. Data analysis was carried out through meta-analysis (random-effects model), and heterogeneity was investigated by subgroup and meta-regression analyses. The data were analyzed in STAT software (12.0). Results: The mean resilience score of the chronic disease patients (n = 3369) was 74.6 (95% CI: 51.8-97.4). In terms of diseases, the mean resilience score of cancer patients was 79.6 (95% CI: 48.3-111.1), whereas it was 79.6 for cardiovascular disease patients (95% CI: 45.8-113.3) and 64.6 for patients with other diseases (95% CI: 6.6-122.7). There was no relationship between the resilience of chronic disease patients and the year of the study (P = 0.711) and the sample size in the studies (P = 0.351). Conclusions: The mean resilience score of the patients was less than that of healthy individuals. As resilience can be acquired at any stage of life, irrespective of age and disease status, there is a need for training to improve resilience among patients through educational programs