Designing and Psychometric Evaluation of the Competency Inventory for Postgraduate Students of Intensive Care Nursing

Background: Today, the role of expert clinical nurses is highlighted because their presence is necessary for guaranteeing the quality of nursing care provided for the patients. However, there are no proper instruments for measuring the clinical competence of postgraduate students in intensive care nursing. Objectives: The present study aimed at development and psychometric evaluation of the clinical-competence inventory for postgraduate students of intensive care nursing. Patients and Methods: A methodological study was conducted at state nursing schools of Iran. The participants were postgraduate students of intensive care nursing, who were being trained at 16 nursing schools throughout Iran, during year 2014. After examining some relevant texts, the first draft of the inventory was designed with 60 items. In order to confirm its face and content validity, a panel of experts and students examined the inventory. The final draft, which contained 44 items, was distributed among postgraduate students of intensive care nursing, and 217 students answered the inventory. The construct validity was verified using exploratory factor analysis. The reliability of the inventory was verified using consistency tests. Results: Firstly an instrument with 60 items was developed. Next, the face and content validity of the instrument was assessed by 15 students and 11 experts. Overall, 16 items were removed through validity assessment and 44 items remained in the final draft. The content validity index of the final draft was 0.90. Moreover, the content validity ration of 44 items ranged between 0.75 and 1. The Cronbach’s alpha coefficient of the inventory was 0.95 and the intraclass correlation coefficient (ICC) of the test-retest results was 0.96. To examine the construct validity of the final draft, it was administered for 217 postgraduate students of intensive care nursing and five factors, with Eigenvalues above one and loading level equal to or above 0.4, were extracted through exploratory factor analysis. Conclusions: The inventory developed in this study is a suitable index for evaluating the efficacy of postgraduate students in the field of intensive care nursing

A systematic review of the use of telemedicine in the military forces worldwide

Context: Considering the pivotal role of telemedicine in providing healthcare services for remote areas, some of the military medical centers, especially in developed countries, use different types of telemedicine programs. Objectives: The present study aimed at identifying the implemented telemedicine projects in military medicine worldwide and introducing their features. Evidence Acquisition: The current systematic review was performed in 2018. PubMed, Scopus, Embase, and Web of Science databases were searched for articles published from 2014 to 2018 by a combination of related keywords, and the related original articles were then selected based on the inclusion and exclusion criteria. Data were collected by a data extraction form, and then the data were summarized and reported based on the study objectives. Results: Of the 173 articles retrieved from the first round of search, 12 were included in the study; five (41.66) studies had used the synchronous (real-time telemedicine) method. The United States, with nine studies, had the highest number of projects in military telemedicine. Most studies (n = 7) were performed on tele-psychology and the application of telemedicine in psychology. All selected studies reported the positive effects of telemedicine on providing healthcare for military forces. Conclusions: The proper utilization of telemedicine equipment is effective in saving time for both patients and healthcare providers, reducing costs, supporting in natural disasters, and satisfying patients with military medicine. To achieve telemedicine program objectives, they should be set precisely. Considering the importance of timely healthcare services, it is suggested to utilize synchronous methods and tools such as video conferencing. © 2020, Author(s)

Tinea pedis caused by Trichosporon asahii: case report

Background: Trichosporon species are commonly known as causative agents of skin infections and also responsive in some other systemic and disseminated diseases, especially in immunocompromised patients and those with leukemia or lymphoma. Chronic cutaneous infections with Trichosporon have been reported in non-immunocompromised patients, too. Case Presentation: This study is a case report of tinea pedis caused by Trichosporon asahii in an immunocompetent 39-year-old man who was a member of the military force with continuous wearing of army boots during his daytime work. In April of 2019, after visiting a dermatologist, he was referred to the Ghaem medical mycology laboratory of the Department of Health, Rescue and Treatment of Iran Police Force in Tehran. Clinical symptoms were scaling and erythematous patches on his left foot with intensive itching for four-months. In the laboratory, macroscopic and microscopic examination using direct 15 KOH wet mount was carried out as well as culture methods on fungal media (Sabouraud's dextrose agar with and without cycloheximide and chloramphenicol). According to microscopic observation and appearance of culture media colonies, the diagnosis was Trichosporon genus as the fungal agent of disorder. Molecular method analysis (polymerase chain reaction, (PCR) using amplification of ITS region with universal primers (ITS1 and ITS4) and sequencing identified Trichosporon asahii as a causative species of the disease. The patient was treated with topical clotrimazole (twice/day) and oral fluconazole (150 mg/day) for four weeks, and recovered. Conclusion: The conditions that cause the feet to be exposed to excessive sweating, moisture and darkness for a long time (wearing shoes and army boots for a long time); increase the risk of skin fungal infection. Therefore, full respect for an individual healthy manner seems to be essential. © 2021 Tehran University of Medical Sciences. All rights reserved

Seroepidemiological study of novel coronavirus disease (Covid-19) in Tehran, Iran

Backgrounds: A novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has now spread to all countries of the world, including Iran. Although anti-SARS-CoV-2 antibodies may be identified in patients using immunological methods with sufficient sensitivity and specificity, the conclusive diagnosis of the disease is made using the molecular RT-PCR method. A population-based seroepidemiological survey was conducted to quantify the proportion of the exposed population with SARS-CoV-2 antibodies and evaluate whether the antibodies are a marker of total or partial immunity compared to the population that remains susceptible to the virus. Material & Methods: This cross-sectional study was conducted to investigate the seroprevalence of COVID-19 in Valiasr, Sajad, and Ghaem hospitals in Tehran, the capital of Iran, from April to the end of October 2020. Clotted and heparinized blood specimens (2mL) were collected from the patients. The serum and plasma were separated and stored at −80 °C until use. Anti-SARS-CoV-2 IgG and IgM antibodies were examined in the serum samples of 1375 in-patients admitted to the hospitals using ELISA kits. The obtained data were analyzed using SPSS software Ver.22.0 by employing statistical tests such as Chi-square and Fisher’s exact tests. A p-value <.05 was considered as significant. Findings: In total, 1375 participants were enrolled in this study, and SARS‐CoV‐2 antibodies were detected in 291 patients using IgM‐IgG antibody assay. Among the seropositive patients studied, 187 were male (64.3), and 104 were female (35.7) (p<.05). The mean age of the patients was 49±8.4 years; the majority of whom (27) were in the age group of 31-40 years. Also, the lowest frequency of infected cases was related to the age group of 1-10 years (p <.05). The seroprevalence of SARS‐CoV‐2 IgM or IgG antibodies was determined to be 21.2. Diabetes mellitus was the most common underlying disease among SARS‐CoV‐2 patients p=.05; Odd Ratio=1.61(0.90-2.91). Conclusion: The use of conventional serological assays, such as the enzyme-linked immunoassay (ELISA), for detecting specific IgM and IgG antibodies in SARS‐CoV‐2 patients has a high-throughput advantage while minimizing false-negative results obtained using the RT-PCR method. In this study, the seroprevalence of SARS-CoV-2 antibodies was determined to be 21%. Control of diabetes, among other influential factors, plays an important role in the management and control of COVID-19. © 2021, TMU Press

Onychomycosis Caused by Rhodotorula mucilaginosa in a Young Immunocompetent Woman in Iran: A Case Report

Background and Aim: Rhodotorula mucilaginosa (R. mucilaginosa) has emerged as a potential pathogen in immunosuppressed hosts. This fungal agent rarely causes onychomycosis in immunocompetent hosts. In this study, onychomycosis caused by this strain on different fingernails and toenails in an Immunocompetent young adult is reported. Case Report: The patient was an 18-year-old woman with clinical symptoms of powdery, hyperkeratosis brief around erythema in the distal part of a toenail and deformity with a groove on surface of a fingernail who was referred to the Medical Mycology Laboratory of Hazrat Ghaem therapeutic center. After diagnostic procedures, he was treated with oral itraconazole 200 mg/day for 2 months along with topical clotrimazole and sulfacetamide ointment and was cured. The nails responded satisfactorily to the treatment. After two months of stopping the drug, the absence of fungus elements in the clinical samples was confirmed. Diagnosis and identification of the fungus was confirmed by morphological characteristics, culture, and DNA molecular method, and R. mucilaginosa was reported as the etiological agent of onychomycosis. Antifungal drug susceptibility was determined in laboratory using the disk diffusion method according to CLSI guidelines. Conclusion: The isolated species was reported as an unusual species of onychomycosis, which needs to be considered by mycology laboratory and clinical specialists for its sensitivity to ketoconazole, itraconazole, and econazole and its resistance to amphotericin B and nystatin. © 2023 Baqiyatallah University of Medical Sciences. All rights reserved