Introducing a new technique for limb prepping in orthopedic surgeries: Designing, construction, and evaluation of limb-lifting assistive device

Lifting and holding patients' limbs while preparing the skin for orthopedic surgeries may be a lengthy process causing work-related musculoskeletal disorders (MSDs) for preoperative team members. Studies reported weight limits for lifting and holding limbs; whenever this weight is greater than a specific amount, additional staff or assistive devices are needed because nurses and support staff working in orthopedic operating rooms (ORs) are at high risk of MSDs. The aim of this study was to demonstrate the design, construction, and effectiveness of a limb-lifting assistive device installed in the OR of 5 Azar Hospital affiliated with Golestan University of Medical Sciences and used during the surgical preparation process. Copyright © 2015 The Author(s)

Relationship between serum level of interleukin-2 in patients with systemic lupus erythematosus and disease activity in comparison with control group

Background: Despite the large number of surveys, there are not any validated biomarkers for SLE disease activity till now. This study aimed to evaluate the relationship between serum level of IL-2 in patients with SLE and disease activity in comparison with control group. Materials and Methods: In this case-control study, 73 patients with lupus and 73 healthy subjects referred to the rheumatology clinic of 5 Azar Hospital in Gorgan (North of Iran).They were studied via convenience sampling during 2011-2012. Blood samples were taken from both groups and serum levels of interleukin -2 measured by Avi Bion Human IL-2 ELISA kit. Serum Level of IL-2 greater than 15 pg/ml defined positive and lesser than this amount defined negative. Disease activity evaluated with SLE disease activity index. Score greater than or equal to three or four defined as active disease. Data analysis conducted by SPSS software (version 16) and by using descriptive statistics and statistical tests. Results: Serum level of IL-2 was positive in 45.2% of sample studied and negative in 54.8% in case group, while in control group, serum level of IL-2 only in 11% of sample studied was positive and in 89% was negative. Statistical analysis indicated a significant relationship between serum level of IL-2 and the SLE disease activity index (p=0.025). Conclusion: This study showed the relationship between serum levels of IL-2 and disease activity, so this biomarker can be used as a clinical indicator for assessing disease activity in patients with SLE

Physical Restraint and Associated Factors in Adult Patients in Intensive Care Units: A Cross-sectional Study in North of Iran

Background/aim: Patients in the intensive care units (ICUs) are at high risk of developing delirium and agitation. Physical restraint (PR) has increased to control these patients which accompanies by adverse consequences. The aim was to determine the PR use and associated factors in patients hospitalized at the ICUs in the North of Iran. Materials and methods: In this cross-sectional study, a total of 272 patients in 3 ICUs of 5 Azar referral hospital affiliated to Golestan University of Medical Sciences (Gorgan, Iran) in 2018 were included. Confusion assessment method for the ICU (CAM-ICU), Richmond Agitation-Sedation Scale (RASS), acute physiology and chronic health evaluation II (APACHE II), and Glasgow Coma Scale (GCS) were used to evaluate delirium, sedation level, disease severity, and level of consciousness, respectively. Analysis was done by STATA version 14.2 (StataCorp LP, College Station, Texas), univariate and multiple analyses. Results: Data from 272 patients were analyzed (mean age of 45.8 ± 21.3 years). PR was used for 74.5 of patients. Restrained patients had more severe disease mean of APACHE II score, 20.20 (7.5) vs 11.6 (7.1), longer length of stay mean of 10 (5.5) vs 5.5 (4.6) days, and lower level of consciousness mean of GCS score, 8.7 (3.5) vs 13.5 (3.3) than patients without it. CAM-ICU was positive in majority of patients (79.5 vs 10.4%) and agitation level of RASS score was higher in restrained patients (31.7 vs 3.0%). Associated factors in multiple analysis were use of sedative and psychoactive drugs odds ratio (OR), 2.85; 95% confidence interval (CI): 1.04�7.82, presence of delirium (OR, 15.13; 95% CI: 4.61�49.65), deep sedation (OR, 0.04; 95% CI: 0.00�0.45), and GCS score (OR, 0.69; 95% CI: 0.53�0.9). Conclusion: This study revealed the high use of PR in the ICUs, and use of sedative and psychoactive drugs, presence of delirium, deep sedation, and GCS score were such associated factors. © The Author(s). 2022

Prevalence of malnutrition among elderly people in Iran: Protocol for a systematic review and meta-analysis

Background: Malnutrition occurs following a decrease or an imbalance in the absorption of energy, protein, vitamins, and minerals because of numerous factors. Thus, it has serious and life-threatening consequences. To plan for this issue, we need information on the burden of this problem. Objective: The aim of this study is to determine the prevalence of malnutrition among elderly people in Iran. Methods: For the purpose of this study, papers, including original articles, theses, and conference proceedings on the prevalence of malnutrition among people aged 60 years and above, and have been published in national and international journals until September 2018 will be included without any language limitation. The following keywords along with their synonyms in Persian will be used in the literature search: malnutrition, elderly, and Iran. At first, the screening process will be conducted based on our inclusion and exclusion criteria. Then, the full text of the remaining articles will be read carefully, and eligible articles will be selected according to the objectives of the study. Next, the methodological quality of the selected papers will be reviewed, and the required information will be extracted from those with acceptable quality. Finally, a meta-analysis will be performed using the Stata software (version 14) when optimum criteria are met. It should be noted that all stages of screening, selection, quality assessment of primary studies, and data extraction will be performed by 2 reviewers independently. Results: This review is ongoing and will be completed at the end of 2019. Conclusions: This review aims to provide comprehensive evidence about the prevalence of malnutrition among elderly people in Iran. This can help Iranian health managers and policy makers make informed decisions for preventing malnutrition and promoting the health status of elderly people. © Homeira Khoddam, Sepideh Eshkevarlaji, Mahin Nomali, Mahnaz Modanloo, Abbas Ali Keshtkar

Rheumatologic manifestations in Iranian patients with autoimmune thyroid diseases

Background: Autoimmune thyroid diseases (ATDs) are the most common endocrine diseases which result in rheumatologic manifestations. Some studies have shown association between rheumatologic disorders and ATDs. Thus, the aim of this study was to assess the frequency of rheumatologic manifestations in patients with ATDs

Sleep problems in children with attention deficit and hyperactivity disorder

Background and Objective: Attention deficit and hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. 20-50% of ADHD affacted children have sleep disorders which can cause cognitive and behavioral disorders. This study was done to determine the sleep problems in children with ADHD. Method: In this case control study, 52 children with ADHD was considered as cases and 52 school age children without ADHD as a control group in Gorgan, northern Iran during 2013. Sleep habits (CSHQ) and DSM-IV questionnaires were filled for each child. Results: Sleep problems were observed in 45 (86.5%) and 36 (69.2%) of children in case and control group, respectively (P<0.05). The mean score of sleep problems in case and control group was 48.25±6.61 and 45.87±6.23, respectively (P<0.05). The score of resistance to sleep, anxious habits of sleep and waking during night in cases were more than controls (P<0.05). Conclusion: Sleep problems in children with ADHD are more frequent than children without ADHD

Associated malformations in newborns with imperforate anus in Gorgan, Iran (2006-10)

Background and Objective: Imperforate anus is a common anorectal malformation, which is associated with other anomalies. This study was done to determine the associated malformations in newborns with imperforate anus in northern Iran. Methods: This descriptive study was carried out on 40 hospitalized newborns (24 boys and 16 girls) with imperforate anus in Taleghani teaching hospital in Gorgan, northern Iran during 2006-10. Results: From 40 newborns with imperforate anus, 23 newborns (57.5%) had associated anomalies. The commonest associated anomalies was genitourinary (65.2%) followed by heart (47.8%), gastrointestinal (13%) and musculoskeletal anomalies (8.7%). Conclusion: Associated anomalies in newborns with imperforate anus in northern Iran have a high prevalence in comparison with other reports

Researchable clinical problems from the viewpoint of healthcare providers: A qualitative study

Background and purpose: There is lack of concordance between researchers' interests and clinical problems. This study aimed at explaining researchable clinical problems from the perspective of healthcare providers to provide a better understanding of the issues that could be solved by the health system. Materials and methods: This qualitative study was carried out in 27 healthcare providers in selected hospitals affiliated to Golestan University of Medical Sciences, 2017. The participants were selected by purposive sampling. Focused Group Discussion (FGD) was used to collect the data. The participants explained their experiences through three FGDs which began with a broad open-ended question and further probing questions were used. Interviews were recorded and transcribed verbatim. Data were analyzed using qualitative content analysis. Results: The participants aged 25-53 years old with 2-26 years of clinical experience, among whom 59 were males. The analysis of data led to the development of four main themes. The researchable clinical problems included clinical problems associated with health system structure, the status of healthcare providers, the status of service delivery in the health system and needs assessment, and problems associated with clinical processes. Conclusion: Current study suggests that after determining the priority of researchable problems regional issues should be addressed in designing and performing clinical researches. © 2019, Mazandaran University of Medical Sciences. All rights reserved

Self-monitoring by traffic light color coding versus usual care on outcomes of patients with heart failure reduced ejection fraction: Protocol for a randomized controlled trial

Background: Patients with heart failure (HF) reduced ejection fraction (HFrEF) have symptoms that are more severe and experience a higher rate of hospitalization compared with HF preserved ejection fraction (HFpEF) patients. However, symptom recognition cannot be made by patients based on current approaches. This problem is a barrier to effective self-care that needs to be improved by new self-monitoring instruments and strategies. Objective: This study describes a protocol for the self-monitoring daily diaries of weight and shortness of breath (SOB) based on the traffic light system (TLS). The primary objective is to compare the self-care between the intervention and control group. Comparison of HF knowledge, HF quality of life (HFQOL), and all-cause hospitalization between the 2 groups are the secondary objectives. Methods: A single-blind randomized controlled trial is being conducted at the HF clinic at Tehran Heart Center (Tehran, Iran). Sixty-eight adult patients of both genders will be enrolled during admission to HF clinic. Eligible subjects will be assigned to either the intervention or control group by a block balanced randomization method. Baseline surveys will be conducted before random allocation. Participants in the intervention group will receive an integrated package consisting of (1) HF self-care education by an Australian Heart Foundation booklet on HF, (2) regular home self-monitoring of weight and SOB, and (3) scheduled call follow-ups for 3 months. Patients in the control group will receive no intervention and they only complete monthly surveys. Results: This study is ongoing and is expected to be completed by the end of 2018. Conclusions: This is the first trial with new self-monitoring instruments in Iran as a low and middle-income country. If the findings show a positive effect, the package will be applied in different regions with the same health care status. ©Mahin Nomali, Ramin Mohammadrezaei, Abbas Ali Keshtkar, Gholamreza Roshandel, Shahrzad Ghiyasvandian, Kian Alipasandi, Masoumeh Zakerimoghadam