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

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

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

Statin therapy in chronic viral hepatitis: a systematic review and meta-analysis of nine studies with 195,602 participants

Background: Conflicting data suggest that statins could cause chronic liver disease in certain group of patients, while improving prognosis in those with chronic viral hepatitis (CVH). Purpose: To quantify the potential protective role of statins on some main liver-related health outcomes in clinical studies on CVH patients.Data Sources: The search strategy was explored by a medical librarian using bibliographic databases, from January 2015 to April 2020.Data synthesis: The results showed no significant difference in the risk of mortality between statin users and non-users in the overall analysis. However, the risk of mortality significantly reduced by 39% in statin users who were followed for more than three years. Moreover, the risk of HCC, fibrosis, and cirrhosis in those on statins decreased by 53%, 45% and 41%, respectively. Although ALT and AST reduced slightly following statin therapy, this reduction was not statistically significant. Limitations: A significant heterogeneity among studies was observed, resulting from differences in clinical characteristics between statin users and non-users, study designs, population samples, diseases stage, comorbidities, and confounding covariates. Conclusion: Not only long-term treatment with statins seems to be safe in patients affected by hepatitis, but also it significantly improves their prognosis

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

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)