Effect of body change positions on endotracheal tube cuff pressure in patients with head injury treated with mechanical ventilation

Background: Maintaining endotracheal tube cuff pressure in the normal range of 25-30 cmH2o plays an important role in the prevention of related complications. Objective: The present study aimed to determine the effect of body change position on level of endotracheal tube cuff pressure in patients with head trauma under mechanical ventilation admitted in ICUs. Methods: This quasi-experimental study was implemented on 30 patients with head injury under mechanical ventilation who admitted in ICUs in 2014. Available method was used for sampling. The mean of endotracheal cuff pressure was measured in 6 different body positions in the two-hour intervals using standard manometer, immediately before, immediately after, 15 minutes and 2 hours after the change positions. Data was analyzed using Chi-square, t and Bonferroni tests. Findings: The mean of endotracheal cuff pressure in the left and right lateral position with an angle of 30 degrees and head to the body (Respectively 31.5±0.68 and 34.1±0.68 cmH2o) and also the left and right lateral and a 45-degree angle to the body at the end of the period of 15 minutes and 2 hours after change positions was higher than the normal range (Respectively 31.9±0.92 and 30.4±1.5 cmH2o). In all cases, the mean of pressure differences were statistically significant (p<0.001) Conclusion: According to the unnatural changes in endotracheal tube cuff pressure due to body change positions, it is suggested that after changing position of the patient, measure the cuff pressure and correct it if it’s necessary. Keywords: Head Injury, Mechanical Ventilation, Body Position, Endotracheal Tube Cuff Pressur

Hand hygiene compliance before and after wearing gloves among intensive care unit nurses in Iran

Nosocomial infections are considered a major risk factor in hospital wards, and hand hygiene is the first step in their control. An observational study was conducted in 2015 with 200 nurses working in intensive care units in teaching hospitals of Tabriz, Iran. Data were collected by using the Hand Hygiene Observation Tool questionnaire. The researchers monitored nurses’ opportunities for hand hygiene during the 8-week period from February 3-April 4, 2015. A total of 1,067 opportunities occurred for hand hygiene before and after wearing gloves. The results show that hand hygiene compliance before wearing gloves is poor among nurses who work in intensive care units (14.8%). Therefore it is necessary to conduct effective interventions through continuing education programs to improve hand hygiene compliance. © 2016 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc

Cigarette and hookah smoking and their relationship with self-esteem and communication skills among high school students

Background: Tobacco smoking is one of the most important public health problems that may be prevented. There is limited information about its relationship with communication skills. Findings on the relationships between self-esteem and cigarette/hookah smoking are inconsistent. The aim of this study was to investigate the relationships between cigarette and hookah smoking,self-esteem and communication skills among a representative sample of high school students. Methods: In this cross-sectional study, a sample of 1321 tenth-grade students (14-17 years) was selected through multi-stage proportionally cluster sampling in Tabriz, 2017. The participants completed a self–administered multiple choice questionnaire including questions about cigarette smoking, hookah smoking, self-esteem, and communication skills. Results: After controlling for potential confounders, the results demonstrated that higher score of self-esteem protects students against being in advanced stages of cigarette smoking (odds ratio [OR] = 0.95, 95% CI: 0.92-0.99, P=0.012). However, there was no significant association between self-esteem score and the hookah smoking. Also, there was no significant association between communication skills score and cigarette and hookah smoking. Conclusion: According to our findings, self-esteem was associated with cigarette smoking,but not with hookah smoking. Furthermore, there was no statistically significant association between communication skills score and cigarette and hookah smoking

Clinical and Laboratory Findings in Iranian Children with Cyclic Neutropenia

Cyclic neutropenia is a rare immunodeficiency syndrome, characterized by regular periodic oscillations in the circulating neutrophil count from normal to neutropenic levels through 3 weeks period, and lasting for 3-6 days. In order to determine the clinical features of cyclic neutropenia, this study was performed. Seven patients with cyclic neutropenia (3 males and 4 females), who experienced neutropenic periods every 3 weeks (5 with severe and 2 with moderate neutropenia), were investigated in this study. They had been referred to Iranian Primary Immunodeficiency Registry during 23 years (1980-2003). The range of patients' ages was from 7 to 13 years (median 11 years). The median age at the onset of the disease was 12 months (1 month- 2 years) and the median age of diagnosis was 2 (1.5-5) years, with a median diagnosis delay of 1 year (2 months- 5 years). Neutropenia was associated with leukopenia (3 patients), anemia (3 patients), and thrombocytopenia (1 patient). Patients were asymptomatic in healthy phase, but during the episode of neutropenia suffered from aphthous ulcers, abscesses and overwhelming infections. The most commonly occurred manifestations were: otitis media (6 cases), oral ulcers (5 cases), abscesses (4 cases), pneumonia (3 cases), diarrhea (3 cases), oral candidiasis (3 cases), cutaneous infections (2 cases), and periodontitis (2 cases). One of these patients subsequently died because of recurrent infections. Unusual, persistent or severe infections should be the initiating factors to search for an immune deficiency syndrome such as cyclic neutropenia, because a delay in diagnosis may result in chronic infection, irretrievable end-organ damage or even death of the patient

Vaccine-associated Paralytic Poliomyelitis in Immunodeficient Children, Iran, 1995–2008

To determine the prevalence of vaccine-associated paralytic poliomyelitis (VAPP) in immunodeficient infants, we reviewed all documented cases caused by immunodeficiency-associated vaccine-derived polioviruses in Iran from 1995 through 2008. Changing to an inactivated polio vaccine vaccination schedule and introduction of screening of neonates for immunodeficiencies could reduce the risk for VAPP infection

Application of acoustic agglomeration for removing sulfuric acid mist from air stream

The application of acoustic fields at high sound pressure levels (SPLs) for removing sulfuric acid mists from the air stream was studied. An acoustic agglomeration chamber was used to conduct the experiments. The studied SPLs ranged from 115 to 165 decibel (dB), with three inlet concentrations of acid mist at 5â10, 15â20, and 25â30 ppm. The air flow rates for conducting experiments were 20, 30, and 40 L minâ1. The concentration of sulfuric acid mist was measured using US Environmental Protection Agency Method 8 at inlet and outlet of the chamber. The resonance frequencies for experiments were found to be 852, 1410, and 3530 Hz. The maximum acoustic agglomeration efficiency of 86% was obtained at optimum frequency of 852 Hz. The analysis of variance test revealed significant differences between agglomeration efficiency at three resonance frequencies (p-value < 0.001). The maximum acoustic agglomeration efficiency was obtained at SPL level of 165 dB. High initial concentrations of acid mists and lower air flow rates enhance the acoustic agglomeration of mists. High removal efficiency of acid mists from air stream could be achieved by the application of acoustic agglomeration method with appropriate range of frequencies and SPLs. Keywords: Sulfuric acid, Mist, Acoustic agglomeration, SP

The relationship between feeling of loneliness, source of control, and intolerance of ambiguity with death anxiety in the elderly during the COVID-19 era

Background. Coronavirus disease 2019 (COVID-19), as a global epidemic, can cause widespread and irreparable disorders in the personal and social health. Although elderly people are more at risk, they receive less attention in this regard. This epidemic can affect the elderly in different ways, including the fear of contracting the virus and fear of death. This study aimed to determine the relationship between loneliness, locus of control, and intolerance of ambiguity with death anxiety in the elderly during the COVID-19 era. Methods. Using cluster random sampling, this cross-sectional and analytical study included 309 elderly people in Islamabad-e Gharb, Iran in 2022. Data was collected using questionnaires on demographic variables, loneliness, locus of control, intolerance of ambiguity, and death anxiety. The collected data were statistically analyzed using logistic regression. Results. The mean age of participants was 70.69±6.28 years. The prevalence of death anxiety was 71.20% and it was statistically related to gender. The results of regression analysis showed that loneliness, external source of control, high uncertainty intolerance and gender could significantly predict death in the elderly. Conclusion. According to our findings, more than half of the elderly experienced death anxiety. Loneliness, source of control, and intolerance of ambiguity play an important role in death anxiety of the elderly. Death anxiety among this population can be improved by designing psychological interventions based on the feeling of loneliness, source of control from external to internal, and intolerance of ambiguity from top to bottom. Practical Implications. Since death anxiety is a multi-dimensional structure affecting many aspects of the elderly's life and it is one of the most common mental health issues of the elderly, it is essential to investigate the related factors. This can help to take effective steps and improve the mental health of the elderly

ursing Students’ and Instructors’ Viewpoints Regarding Professional Abilities of Students in Internship Program at Tabriz University of Medical Science

Introduction: Most of previous studies have focused on factors affecting learning during nursing educational program, and a few researches have been conducted on students’ achievements. The present research aimed to determine nursing students’ and instructors’ viewpoints regarding the level of skills gained by students during internship in Tabriz University of Medical Sciences. Methods: In this descriptive study conducted in 2003, 74 bachelor nursing students attending internship program and 33 instructors were selected using census method of sampling. A researcher made questionn-aire with five point Likert scale and including 96 questions was distributed as self-administered. The questionnaire covered a variety of dimensions such as providing services for patients, patient care, patient safety, management skills, quality improvement, and patient education. The data was analyzed by SPSS software using frequency distribution, and Chi2. Results: The achieved professional abilities in all dimensions were not satisfactory. There was a significant difference between students’ and instructors’ viewpoints, on the level of professional skills in patients’ services, patient care, management skills, quality improvement, and patient education. Conclusion: Students’ professional abilities during internship program were not optimum. The gap is probably due to the absence of good, supportive and incentive environment, or due to the lack of appropriate stewardship and management mechanisms