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The outbreak of the COVID-19 pandemic has affected the safety and well-being of healthcare workers. A scoping review was conducted to highlight the impact of COVID-19 on the safety, health, and well-being of healthcare workers and to shed light on the concerns about their perceived safety and support systems. A literature search was conducted in three different databases from December 1, 2019, through July 20, 2022, to find publications that meet the aim of this review. Using search engines, 3087 articles were identified, and after a rigorous assessment by two reviewers, 30 articles were chosen for further analysis. Two themes emerged during the analysis: safety and health and well-being. The primary safety concern of the staff was mostly about contracting COVID- 19, infecting family members, and caring for patients with COVID-19. During the pandemic, the health care workers appeared to have anxiety, stress, uncertainty, burnout, and a lack of sleep. Additionally, the review focused on the suggestions of health care providers to improve the safety and well-being of workers through fair organizational policies and practices and timely, individualized mental health care. [ABSTRACT FROM AUTHOR]

Health care workers (HCWs) are exposed to needle needles daily. Despite individual studies, there is no statistics on the prevalence of unreported needle stick injuries (NSIs) have been reported. This study was performed to determine the prevalence and causes of unreported NSIs among HCWs. In present systematic review and meta-analysis study, three international databases (Web of Science, Scopus, PubMed) were searched from January 1, 2000 to December 31, 2018. The random model was used to determine the prevalence of unreported needle stick among HCWs. Forty-one studies performed on 19,635 health care workers entered the final stage. Based-on random effect model, pooled prevalence of unreported needle stick injuries was 59.9% (95% CI: 52.0, 67.7; I2=98.9%). The most common cause of unreported NSIs was: They were not worried about NSIs (n=12). The high prevalence of unreported needle sticks injuries indicates the urgency and necessity of paying attention to strategies to improve reporting among health workers. [ABSTRACT FROM AUTHOR]

One important part of a nurse’s job is to create and help maintain a safe work environment. Evidence shows that negative behaviors such as incivility are not uncommon in the nursing profession. This systematic review and meta-analysis aimed to examine the prevalence of incivility toward nurses. For this purpose, all observational studies that primarily investigated the rate of incivility toward nurses were selected. The electronic databases PubMed, Embase, Web of Sciences, Magiran, IranDoc, and Scopus were searched for studies published during the period of January 1, 1996 to December 31, 2019. The quality of studies was assessed using Hoy’s Critical Assessment Checklist. The study was undertaken using the random effects model, and data were analyzed using STATA14. Data on 60 articles, including data on 30801 individuals, published between 1997 and 2019, entered the study. The findings showed the prevalence of incivility to be 55.10% (95%, CI: 48.05, 62.06). Due to the high prevalence of uncivil behavior, especially of the verbal type, nursing managers should identify risk factors in the workplace. Planners should develop programs to increase workplace safety, especially in centers that are most exposed to these behaviors. It is also recommended that future studies focus on implementation of effective evidence-based interventions based on organizational culture. [ABSTRACT FROM AUTHOR]

This study was done with the purpose of clarifying the concept of patient perceived quality of nursing care in hemodialysis. In this meta-synthesis study, qualitative studies was searched in the four interntional databases from January 1st, 2000 to December 30th, 2019. The keywords used were: nursing care quality, and hemodialysis. Studies which had been done with the purpose of understanding the patient perceived quality of nursing care concept aomg hemodialysis patients were included. Two researchers were evaluate the quality of included studies separately using JBI tool, required information were extracted using the designed table. The main themes in the structure dimension include Sufficient Human resource, quality of equipment, financial support from patient and quality of the patient care environment. Process dimension consisted of continuous monitoring of the syndromes, effective patient education, efficient care, effective therapeutic relationship, and patient's empowerment and participation in the process, and in the outcome dimension included high dialysis adequecy, patient burnout reduction, and increased patient satisfaction from services. The results of the study indicated a comprehensive, deep and interactive dimensions about the concept of nursing quality of care. [ABSTRACT FROM AUTHOR]

This study was done with the purpose of clarifying the concept of patient perceived quality of nursing care in hemodialysis. In this meta-synthesis study, qualitative studies was searched in the four interntional databases from January 1st, 2000 to December 30th, 2019. The keywords used were: nursing care quality, and hemodialysis. Studies which had been done with the purpose of understanding the patient perceived quality of nursing care concept aomg hemodialysis patients were included. Two researchers were evaluate the quality of included studies separately using JBI tool, required information were extracted using the designed table. The main themes in the structure dimension include Sufficient Human resource, quality of equipment, financial support from patient and quality of the patient care environment. Process dimension consisted of continuous monitoring of the syndromes, effective patient education, efficient care, effective therapeutic relationship, and patient's empowerment and participation in the process, and in the outcome dimension included high dialysis adequecy, patient burnout reduction, and increased patient satisfaction from services. The results of the study indicated a comprehensive, deep and interactive dimensions about the concept of nursing quality of care. [ABSTRACT FROM AUTHOR]

Background: Surgical site infections (SSIs) are the most common and costly type of hospital-acquired infections (HAIs) worldwide. Despite individual studies, there is also no clear statistics on the SSI prevalence rate in the East Mediterranean region. The aim of this study was to investigate the prevalence of SSI in the Eastern Mediterranean region. Methods: This systematic review and meta-analysis were performed by searching three international databases (Web of Science, PubMed and Scopus) from 1 January 2001 to 31 December 2018. The keywords used included 'Prevalence' OR 'incidence' OR 'surgical site infection' OR 'wound infection' OR 'Postoperative Wound Infections' and 'Middle east'. The Hoy et al.'s tool was used to evaluate the quality of the articles. Result: Out of 889 initial studies, 40 studies from 12 countries of the Eastern Mediterranean region were included in the final stage of the study. Based on the results of random effect method, the overall prevalence of SSI in 137,452 patients was 7.9% (95% Confidence Interval (CI): 7.1, 8.8; I2=96.7%). The prevalence of SSI in cardiac surgery and general surgery wards was 10 and 9.2%, respectively. The prevalence of SSI was lower in women than in males, although this difference was related to caesarean section. Conclusions: Considering the high prevalence of SSI in the Eastern Mediterranean region, timely diagnosis, proper prevention and postoperative control are necessary in the region using the same international guides in all countries. [ABSTRACT FROM AUTHOR]

The current study evaluated the oncology nurse's knowledge, attitude, related factors of cancer-related pain management (CPM), and clinical recommendations for improving knowledge and attitude. In this systematic review, international databases (PubMed, EMBASE, Web of science (WOS), Science Direct, and Scopus) were searched for relevant studies published in English language from March 30, 2000 to March 30, 2018. The quality of the studies was evaluated using the Hoy instrument. Out of 888 initial studies, 12 studies performed on 3574 participants were included in the final stage of the review. Based on the results, most studies indicated that nurses had a poor (n = 4) or moderate (n = 4) knowledge of CPM. The lowest and the highest knowledge levels were 28.5% and 75%, respectively. According to most studies, nurses had a fair (average) (n = 4) or negative (n = 3) attitude toward CPM. The important factors related to the nurses' knowledge of CPM included previous pain-related education programs (n = 7) and having work experience with cancer patients (n = 4). The most important barrier was the deficit in staff's knowledge of pain (n = 2). The important clinical recommendations for improving nurses' levels of knowledge included the implementation of educational programs (n = 9), training programs (n = 3) on CPM and including CPM topics in nursing curricula (n = 5). This systematic review showed that most nurses had poor knowledge of CPM and a fair attitude toward CPM, indicating the importance of considering the barriers to knowledge, strengthening the positive relevant factors, and using clinical recommendations based on clinical guidelines such as including CPM topics in nursing curricula and implementing educational programs on CPM to improve the knowledge, attitude, and skills of oncology nurses. The results of the present study could be used by policymakers to provide care for cancer patients and manage their pain. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the prevalence of CKD in the Iranian general population. In this systematic review and meta‐analysis study, international (PubMed, Web of Science, Scopus, and Google scholar) and national databases (SID, Magiran) were searched until December 30, 2017. The quality of the studies was evaluated using the Hoy instrument. Out of 1170 initial studies, 9 studies with a total of 70 605 participants were included in the final stage of this study. Based on the results of the random effect method (95% CI), the overall prevalence of chronic kidney disease in 70 605 people was 15.14% (I2 = 99.77%). The prevalence of CKD in female patients (18.80%) was 1.7 times higher than in male patients (10.83). The results of the present study indicate a higher than the global average prevalence of CKD in Iran and the need for additional attention of policy makers on better planning for control and implementation of screening programs in high‐risk populations, such as patients with hypertension and diabetes. [ABSTRACT FROM AUTHOR]

Introduction: Urinary Tract Infections (UTIs) are the most common infections in children worldwide, however, data from Iran is not very well studied. Aim: The aim of the present study was to evaluate the prevalence of UTIs in Iranian children. Materials and Methods: From the beginning of databases to November 2017, International {PubMed, Web of Science (WOS) and Google scholar} and National {Scientific Information Database (SID), Magiran} databases were searched for related observational studies that were conducted in Iran including only on Iranian children and published in English and Persian languages. The quality of the articles was evaluated using the Hoy D tool. Results: Out of 515 initial studies, 14 and 6 studies were included in systematic review and meta-analysis, respectively. The overall prevalence of UTI in 3926 children was 4.92% (95% CI:2.32, 7.52; I2=93.58%). The prevalence of UTI in male and female children was 2.59% and 4.78%, and the difference was non-significant. Conclusion: Considering the prevalence of UTIs in Iranian children, it is recommended that studies should be conducted in the field of research at the national level to determine the precise incidence and risk factors for UTIs in children. [ABSTRACT FROM AUTHOR]

Purpose: Quality of life is the most important psychological factor affecting breast cancer patients. This study aimed to examine the health related quality of life of breast cancer patients in Iran.Methods: International (PubMed, Web of science, Scopus and Google scholar) and national (SID, Magiran) databases were searched for related studies to September 2017. The quality of the articles was evaluated using the Hoy tool.Results: Out of 232 initial studies, 18 studies performed on 2263 people were included in the final stage of the study. Based on the EORTC-QLQ-C30 and random effect method, the pooled mean score of quality of life in 1073 people was 57.88 (95% CI 48.26-67.41, I2 = 97.90%) and the pooled mean score of quality of life based on WHOQOL-BREF in 357 people was 66.79 (95% CI 45.96-87.62, I2 = 99.50%).Conclusion: According to the results of the study, a moderate level of quality of life in women with breast cancer was indicated. Therefore, the use of multidimensional approaches can improve their quality of life. [ABSTRACT FROM AUTHOR]

PURPOSE: Cataract is the leading cause of blindness and the second cause of low vision in the world. In the world, Asia has the highest number of blind population. The aim of the present systematic review and meta-analysis was to assess the frequency of clinical cataracts in Iran. MATERIALS AND METHODS: The frequency of clinical cataract was defined based on the international criteria and the measured outcome of the disease. Study selection, data extraction, and quality assessment were performed by two independent reviewers. We explored PubMed, Google Scholar, ISI Web of Science, and national databases (scientific information database, Magiran) to evaluate the clinical cataract of cataract in the Iranian populations from 1995 to July 2017. Statistical analysis was performed using STATA 14.0 software. RESULTS: Of 283 studies, 27 studies utilized meta-analysis. In 2017, the pooled overall frequency of clinical cataract in 59668 people was 9.27% (95% confidence interval [CI]: 8.09, 10.45, I2 = 98.82%). Based on subgroup analysis, in the random effect method, the frequency of clinical cataract in males and females were 8.03% (CI: 6.78, 9.28) and 8.32% (CI: 7.08, 9.55), respectively. CONCLUSION: Regarding the high frequency of clinical cataract in Iran, it seems that paying attention to the results of the current study and the application of international policy plans may contribute to better cataract control in Iran. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of oral capsule of saffron (a herbal medicine) on anxiety and quality of sleep of diabetic patients of a tertiary healthcare facility in Zabol, Iran in 2016. Methods: This was a quasi-experimental study on 50 diabetics of Zabol who met the inclusion criteria. Participants were randomly split into two groups (control and test). Anxiety and quality of sleep were evaluated by Spielberger Anxiety Inventory and Pittsburgh Sleep Quality Index (PSQI). Participants in the intervention group received a daily (between 12 noon and 2 pm) intake of 300 mg saffron capsule after lunch while those in the control group received a placebo daily for a similar duration. After a week, anxiety and sleep quality were assessed. Results: A significant difference in anxiety and quality of sleep prior to and after saffron oral capsule intake (p = 0.001) was observed. In the control group, anxiety and quality of sleep did not show any significant difference before and after intervention (p = 0.001). Conclusion: The results show that saffron capsule intake is effective in reducing anxiety and improving the quality of sleep among diabetic patients. Further studies are required to enhance saffron capsule formulation. [ABSTRACT FROM AUTHOR]

Background and Objectives: Multiple sclerosis (MS) is a major cause of disability worldwide that causes many complications and problems for patients and leads to disability. Therefore, the use of self-care strategies for these patients is important. This study aimed to determine the effect of Orem model-based self-care training program on complications of the disease in patients with MS. Materials and Method: In this quasi-experimental before and after study, 88 patients with multiple sclerosis who were a member of Zahedan MS association in 2014 were selected through the convenience sampling method and were randomly divided into two groups of intervention and control, each with 44 subjects. Nine training program sessions were designed and conducted based on the patients' needs. The effectiveness of the program was evaluated by patients using a check list. Before and 3 months after the intervention, patients' needs assessment forms were evaluated. Data was analyzed using independent t-test, paired t-test, and chisquare using SPSS 16. Results: The mean age of the intervention group was 34.1±8.2, while the mean age of the control group was 35.6±8.4 years. Self-care program resulted in a significant reduction in complications such as muscle cramps, fatigue, constipation and self-esteem (P=0.001). Conclusion: According to the results, implementation of Orem self-care program can improve the complications in MS patients. Given the limitations of this study, more research in this regard is recommended. [ABSTRACT FROM AUTHOR]

Background and Objective: Patient education is among the basic rights of patients. There are so many barriers to the implementation of patient education such as anxiety, pain, and unawareness of its benefits, the patient's lack of cooperation, lack of manpower and time, lack of knowledge, nurses' lack of skill and lack of interest in patient education as well as managerial factors. Due to the specific conditions and status of patients who are often in critical situations and given that saving lives is a priority, patient education in the emergency department is unique and very important. Thus, this study was conducted to determine the barriers to patient education from the viewpoint of nurses in the emergency department. Materials and Method: This descriptive study was conducted on 62 nurses working in the emergency department in the hospitals affiliated with Zahedan Medical Sciences University in 2015 and through census method. Nurses completed demographic information form and the questionnaire of barriers to patient education. Then, data were analyzed by SPSS V16 using independent t-test and multivariate analysis of variance (MANOVA). Results: Most participants (35.5%) in the age range 25-30 years were women (79%), married (80.6%) and contract employees (41.9%). Most of them (37.1%) had a work experience between 1 and 5 years and held a BA degree (96.1%). Among the four aspects under investigation, the aspect of managerial barriers to education had the highest average score (14.5±3.7) and skill-related barriers had the lowest score (10.5±2.7), respectively. Conclusion: According to the study results, the barriers to patient education in the emergency department included managerial barriers including lack of motivation for patient education, lack of control and supervision on the patient education process, lack of evaluation of patient education process and lack of declaration of patient education as one of the nurses' duties. [ABSTRACT FROM AUTHOR]

Background: Although new hemodialysis methods are not efficient enough, statistics indicate inadequacy of dialysis. Inadequacy of dialysis is a cause of reduced quality of life, frequent hospitalization and increased mortality rates in these patients. High dialysis blood flow can be effective in improving dialysis adequacy. On the other hand, this method has many benefits alongside few complications. The present study aimed to examine the effect of increased dialysis blood flow on adequacy and complication in dialysis simultaneously. Method: this was a single-group semi-experimental before- and after-intervention trial. All 22 patients who underwent hemodialysis in the past six months 3 times a week. Preliminary examinations were performed using a checklist in each session. The complications were evaluated during every hemodialysis session using a checklist. Adequacy of dialysis was measured for each patient in the fourth intervention sessions. Results: a significant difference was found between the two methods in terms of mean systolic blood pressure before and at the beginning of dialysis. No significant difference was found between the two methods in terms of incidence of hypotension, nausea, vomiting and muscular cramps. Mean score of dialysis adequacy was as 0.83 %#177; 0.22 in the routine sessions as 1.19 %#177; 0.45 in the intervention sessions (increased dialysis blood flow). Paired-sample t-test results showed a significant difference between these two figures (p = 0.000). Conclusion: findings of this study suggested that although higher blood flow was used in this study compared to previous studies conducted in Iran, a considerable increase was observed in adequacy of dialysis. [ABSTRACT FROM AUTHOR]

Introduction: Cancer is the disease of cells and the cancer pain may be tangible from the very beginning stage of the disease in some of its types such as bone cancer or testicular cancer. However, pain is often a complication of advanced cancer. Aim: The present study aims to compare coping strategies and pain intensity between cancer patients undergoing chemotherapy and healthy subjects. Methods: The present research was a descriptive-analytic study. The statistical population included all cancer patients undergoing chemotherapy in Imam Ali Hospital of Zahedan, Sistan and Baluchestan Province and healthy people. Using the simple random sampling, 50 cancer patients undergoing chemotherapy and 50 healthy people (with equalization) were selected as the sample. The subjects were asked to fill out two questionnaires on coping strategy and pain intensity. Results: The results showed that there is a significant difference between cancer patients and healthy subjects in terms of pain intensity and avoidant, cognitive, emotion-focused, and problem-focused coping strategies (P<0.001). Conclusion: The study results revealed the importance and necessity of identifying the risk factors and ways of coping with them and timely prevention, diagnosis, and treatment of cancer. [ABSTRACT FROM AUTHOR]

Introduction: One of the most effective strategies in the prevention of addiction is increasing awareness among young people, towards the tendency for taking drugs their physical, mental and social side effects. Storytelling is effective for increasing characteristics of happiness and resilience. This study uses storytelling, a common and popular method to increase awareness among adolescents. Aim: To examine the effect of storytelling-based education on the prevention of drug abuse, based on a readiness to addiction index. Materials and Methods: This quasi-experimental study was conducted on 136 high school students (grade one), selected by a cluster sampling procedure from May 2014 to February 2015 in Zabol, Iran. The instrument for gathering data was a readiness to addiction questionnaire. This questionnaire included 41 items for which the scoring of each item followed the Likerts format. The data gathered was analysed using SPSS version 21 with descriptive statistics and inferential statistics. Results: The results revealed that the mean of the readiness to addiction index in the case group fell from 75.66 ±19.99 to 69.57 ±21.83 (paired t-test; p =0.02); in the control group the same index changed from 103.01 ±21.88 to 93.98 ±27.70 (paired t-test, p = 0.775). That is, the index decreased for both groups, but the reduction was statistically significant only for the case group (p =0.02). Conclusion: This suggests that the narrative method is effective in reducing adolescents readiness to addiction. Storytelling is an effective way to raise awareness among young people about addiction and its detrimental impacts on health. Therefore, such a technique can be taken into consideration in teaching principles of prevention. [ABSTRACT FROM AUTHOR]

Introduction: Occupational stress is a major factor in hindering the performance of nurses and midwives and developing physical and mental complications in them. Given that these two groups are in direct contact with patients more than other medical staff and stress management training can be effective in the reduction of occupational stress among the nurses and midwives. Aim: This study was set out to compare the effect of a PRECEDEPROCEED based stress management training program on the occupational stress of the nurses and midwives. Materials and Methods: This quasi-experimental study was conducted on the aforementioned nurses and midwives. Data collection instruments included the Nursing Stress Scale (NSS). The training program was held in two 4-hour-long sessions for three months from 1st January to 31st March 2013. Results: The results showed a significant increase in the PRECEDE scores of both groups by the end of the program, as compared to the baseline. A significant decrease was also observed in the stress scores of both groups. There was no difference between groups in these regards. Conclusion: The PRECEDE-based stress management training is effective in the reduction of occupational stress among the nurses and midwives. [ABSTRACT FROM AUTHOR]

Introduction: Maternal mortality is one of the threatening factors of human life and the overall status index of women's health in any society. Death of a mother causes irreversible damage to a family and a society. This study aims at examining the causes of maternal mortality in urban and rural areas. Aim: The purpose of this study was to determine the frequney and causes of maternal mortality in urban and rural areas in southeast of Iran in 2009-2013. Materials and Methods: This was a retrospective descriptive study and its research population includes the entire pregnant woman who died in Iranshahr County between April 2009 and March 2013. An eight-section questionnaire was used for collecting data. The first section was based on the hospital records of pregnant woman including mother's demographic data and the following sections were completed based on their health records. Results: The frequency of maternal mortality during birth in the study period was 34 (of 4857). The study individuals were between 13 and 40-year-old with the mean age of 30±6.4. Maximum maternal mortality occurred in 2012. Haemorrhage was the most common cause of maternal death (38.2%). Conclusion: As haemorrhage was the most common cause of death of pregnant women in this study, it seems necessary to improve care for woman and reduce haemorrhage and its complications during pregnancy period. [ABSTRACT FROM AUTHOR]

Introduction: The Evidence-Based Practices (EBP), have gained considerable ground in treatment and care, increases the quality of nurses' clinical care. Yet EBP is less frequently employed despite its efficiency and importance. Pain management is an important component of nursing care and sufficient pain control has still remained as a challenge despite routine nursing practices that are already provided. Aim: The present study intended to define the impact of evidence-based nursing practices on postoperative pain in patients undergoing gastrointestinal surgery. Materials and Methods: The present study was a single group quasi-experimental study with before/after design. The study was conducted in the General Surgery Departments of the Amiralmomenin Hospital in Zabol during 2014-2015. A purposive sampling method was used to study 55 patients undergoing abdominal surgery. The data collection tool was a questionnaire. The patients pain severity was defined before and after implementing evidence-based practices. The collected data were analysed in SPSS using descriptive statistics and inferential statistics. results: The results showed that 61.8% of patients experienced severe postoperative pain. The mean perceived pain ratings in women and men were 7.88±1.78 and 9.42±0.81, respectively. The mean pain intensity was 8.48±1.66 before the intervention and reached 7.16±1.71 after the intervention, which was significant based on Kruskal-Wallis test (p=0.003). The mean postoperative pain experienced by the patients (p<0.01) and pain-relief following the intervention (p=0.002) was significant for gender. conclusion: This study suggests that a high percentage of patients experienced acute postoperative pain despite routine nursing care, while evidence-based nursing practices could significantly alleviate pain. [ABSTRACT FROM AUTHOR]

Introduction: One of the factors influencing the burnout of nurses is their difficult and complicated relations with patients and other members of the medical team. Therefore, it is necessary that nurses to be trained on communication skills. Aim: The present research aims to study the effect of communication skills training on the burnout of nurses. Materials and Methods: The present research was an experimental study using pretest-posttest method. The subjects included 60 nurses working in Khatamolanbia Hospital in Iranshahr, Sistan and Baluchestan Province, Iran. The subjects were randomly divided into two groups. The required data and information were collected using Jackson and Maslach Burnout Inventory which was filled out by subjects in three steps including before the intervention, at the end of the second session, and one month after the intervention. The intervention included training on communication skills which was carried out for the intervention group as a 2-day workshop for 8 hours within a week. Results: The findings showed that the mean score of frequency and intensity of burnout in the intervention group before the intervention, at the end of the intervention, and one month after the intervention was 39.3±6.2 and 61.1±8.0, 37.5±4.6 and 58.8±7.6, and 34.2±4.4 and 54.6±7.0, respectively. These changes suggest a significant decreasing trend (p=0.01). On the other hand, mean scores of burnout in the control group showed no significant difference in three steps (p<0.05). Conclusion: Since communication skills training is an effective and inexpensive way for reducing the burnout among nurses, it is recommended that this approach to be taken into account by managers in order to reduce the burnout among nurses and improve the quality of healthcare services provided by them. [ABSTRACT FROM AUTHOR]

Introduction: Haemodialysis is one of the most conventional treatments of chronic renal failure. The risk of clot formation is high during haemodialysis due to regular contact of blood with the surfaces of foreign objects such as catheters, dialyzers' membrane, and other materials used for dialysis. Therefore, to prevent clot formation during haemodialysis, the dialysis system requires anticoagulation; this is usually done by heparin. Aim: The present study aimed to compare two heparinization methods and determine the proper impacts of these methods. Materials and Methods: In this quasi-experimental study, 80 haemodialysis patients covered by the dialysis center of Amir-al-momenin Hospital of Zabol were studied in two 40-member groups of heparin therapy methods of bolus injection and continuous infusion. PT and PTT were measured in blood samples collected from all patients before starting haemodialysis. The first group received 3000 units of heparin once the haemodialysis machine started to work and 2000 units of heparin two hours later as bolus injection. In the second group, 1500 units of heparin was injected at the start of dialysis after then, 5000 units of heparin (one mL) were mixed with 11 mL of distilled water and infused using a heparin injection pump up to half an hour before the end of dialysis. At 30 minutes after starting dialysis and at the end of 4 hours of haemodialysis, PT and PTT were measured and compared between the two groups. Results: According to the results, the mean partial thromboplastin time in the bolus and continuous heparin-receiving group was 41.75±6.29 and 37.90±4.77, respectively, which was statistically significant (p=0.036). But PT was 14.45±1.82 in the bolus heparin group and 13.95±1.39 in the continuous heparin group, which was not significant according to the results of independent t-test (p=0.336). Conclusion: The results indicated a statistically significant difference between the bolus heparin injection and the continuous heparin infusion groups in terms of coagulation tests in haemodialysis patients (p=0.036). Therefore, given the effects of heparin on coagulation, it was more effective in the bolus heparin group than the continuous infusion group. It is recommended to use the bolus method for heparin therapy during haemodialysis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although Marfan's syndrome is a disease with various phenotypes, but the major mechanism of death is cardiovascular complication. Aortic dissection is a major cause of death in Marfan syndrome. CASE REPORT: A 30-year-old man with severe refractory chest and left flank pain and history of previously surgically repaired Type A aortic dissection was referred to the hospital. His typical manifestations of Marfan's syndrome were identified. Cardiovascular imaging showed an acute spiral dissection in the descending aorta extending to the left renal and femoral arteries with no evidence of thrombosis in its huge false lumen (8 cm). By the diagnosis of acute, expanded, spiral, Type B aortic dissection, he underwent the stent grafting of dissected aorta. He discharged without any complication. On follow-up cardiovascular imaging, thrombosed false lumen in stented aorta from descending aorta to the proximal abdominal aorta was seen. CONCLUSION: Endovascular treatment of Type B dissection is an effective treatment in Type B dissection, even in patients with Marfan syndrome. [ABSTRACT FROM AUTHOR]

Introduction: The needlestick injuries can cause the transmission of infectious diseases. Compared to other members of the community of health care nurses are at great risk of needle stick injury because of their frequent performance with vein punctures and taking care of patients suffering from different infectious diseases. Aim: The main aim of this study was to assess Prevalence, causes and preventive of Needle Sticks injuries among nurses in Kerman (south of Iran). Materials and Methods: This cross-sectional study was conducted from December 2014 to March 2015 on 240 nurses employed in two hospitals of Kerman. Sampling was performed through simple random sampling. Data gathered through a researcher made questioner. Data analysed by use descriptive analytical testes. Results: From the nurses' perspective the main physical and human causes of needlestick injuries were syringe needles (82) and crowded wards (74). The majority of the nurses believed the most effective method to prevent needlestick were training (82). Conclusion: Due to the high prevalence of injuries caused by sharp objects in nurses, needlestick injuries are suggested to be recorded in special forms and their causes to be checked by the Infection Control Committee. Since syringe needle heads and angiocatheter are the main causes of needlestick injuries, providing safe medical equipment should also be emphasized. [ABSTRACT FROM AUTHOR]

BACKGROUND: Endovascular coil embolization is an approved treatment for pulmonary arteriovenous malformation (AVM) but it brings high rate of thromboembolic complications with subsequent morbidity and mortality. Hereby, we report two cases of AVM coil embolization and management of their compilations. CASE REPORT: The first case was a 57-year-old male with five implanted coils in the lower lobe of right lung in which two of them were migrated soon after implantation. On exploration, a large atrial septal defect was detected and then repaired successfully. The next day, he was transferred for fluoroscopy. Two embolized coils were found at the site of the left iliac artery which was extracted via snare through sheath implanted in the left femoral artery. Coil migration to the left atrium and subsequently to the left iliac artery is reported for the first time. The second case was a 45-year-old male with central cyanosis and clubbing of upper and lower extremities from childhood. On computed tomography angiography (CTA), a vascular lesion was found. The patient underwent coil embolization for closure of AVM. The patient was still symptomatic after successful closure of AVM. On CTA, two feeding arteries were detected. He underwent second coil embolization procedure. CONCLUSION: AVM coil embolization is a temptative procedure, which should be performed on its real indications by an expert centers who can handle complications of this procedure. The performance of CTA seems beneficial in some cases to confirm complete embolization of AVM. [ABSTRACT FROM AUTHOR]

Pityriasis Rosea (PR) is a common skin disease and characterized by generalized scaly eruptions typically on the trunk and proximal extremities. Atypical presentations of PR are common and can be a diagnostic challenge for clinicians. Here we present a case of a 26-year-old female who presented with a sudden onset of several asymptomatic, erythematous and scaly plaques on her trunk. Plaques sized 0.5-1cm in diameter that were distributed unilaterally (right side) on her chest, back and axilla. Atypical cases of PR are fairly common and less readily recognized. Careful history, clinical evaluation and follow-up are important to avoid misdiagnosis of PR and physicians should be aware of PR variants so that appropriate management and reassurance can be offered. For atypical eruptions without a definite diagnosis, it is safer to consider lesional skin biopsy. [ABSTRACT FROM AUTHOR]

Background: Assessment of quality and cost of medical care has become a core health policy concern. We conducted a nationwide survey to assess these measures in Iran as a developing country. To present the protocol for the Iran Quality of Care in Medicine Program (IQCAMP) study, which estimates the quality, cost, and utilization of health services for seven diseases in Iran. Methods: We selected eight provinces for this nationally representative short longitudinal survey. Interviewers from each province were trained comprehensively. The standard definition of seven high-burden conditions (acute myocardial infarction [MI], heart failure [HF], diabetes mellitus [DM], stroke, chronic obstructive pulmonary (COPD) disease, major depression, and end-stage renal disease [ESRD]) helped customize a protocol for disease identification. With a 3-month follow-up window, the participants answered pre-specified questions four times. The expert panels developed a questionnaire in four modules (demographics, health status, utilization, cost, and quality). The expert panel chose an inclusive set of quality indicators from the current literature for each condition. The design team specified the necessary elements in the survey to calculate the cost of care for each condition. The utilization assessment included various services, including hospital admissions, outpatient visits, and medication. Results: Totally, 156 specialists and 78 trained nurses assisted with patient identification, recruitment, and interviewing. A total of 1666 patients participated in the study, and 1291 patients completed all four visits. Conclusion: The IQCAMP study was the first healthcare utilization, cost, and quality survey in Iran with a longitudinal data collection to represent the pattern, quantity, and quality of medical care provided for high-burden conditions. [ABSTRACT FROM AUTHOR]

Background: Some studies show that a low level of emotional intelligence (EI) is associated with self-destructive behaviors such as deviant behavior or smoking. Objective: The current study aimed at determining the effects of EI on the illicit drug use potential among nurses. Methods: The current quasi-experimental study was conducted in 2015 on 70 hospital nurses. Samples were randomly selected and divided into 2 groups (35 nurses in each group). Then, the experimental group subjects attended EI training sessions. Results: Illicit drug use potential in the experimental grouphadsignificant negative changes in comparison with that of the control group (P < 0.001) after the completion of the training sessions. Conclusions: Given the importance of EI to help nurses to avoid risky behaviors, holding training sessions on EI for nurses and nursing students appears necessary. [ABSTRACT FROM AUTHOR]

Objectives: Health care workers (HCWs) are exposed to needle needles daily. Despite individual studies, there is no statistics on the prevalence of unreported needle stick injuries (NSIs) have been reported. This study was performed to determine the prevalence and causes of unreported NSIs among HCWs., Content: In present systematic review and meta-analysis study, three international databases (Web of Science, Scopus, PubMed) were searched from January 1, 2000 to December 31, 2018. The random model was used to determine the prevalence of unreported needle stick among HCWs., Summary and Outlook: Forty-one studies performed on 19,635 health care workers entered the final stage. Based-on random effect model, pooled prevalence of unreported needle stick injuries was 59.9% (95% CI: 52.0, 67.7; I2=98.9%). The most common cause of unreported NSIs was: They were not worried about NSIs (n=12). The high prevalence of unreported needle sticks injuries indicates the urgency and necessity of paying attention to strategies to improve reporting among health workers., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

One important part of a nurse's job is to create and help maintain a safe work environment. Evidence shows that negative behaviors such as incivility are not uncommon in the nursing profession. This systematic review and meta-analysis aimed to examine the prevalence of incivility toward nurses. For this purpose, all observational studies that primarily investigated the rate of incivility toward nurses were selected. The electronic databases PubMed, Embase, Web of Sciences, Magiran, IranDoc, and Scopus were searched for studies published during the period of January 1, 1996 to December 31, 2019. The quality of studies was assessed using Hoy's Critical Assessment Checklist. The study was undertaken using the random effects model, and data were analyzed using STATA14. Data on 60 articles, including data on 30801 individuals, published between 1997 and 2019, entered the study. The findings showed the prevalence of incivility to be 55.10% (95%, CI: 48.05, 62.06). Due to the high prevalence of uncivil behavior, especially of the verbal type, nursing managers should identify risk factors in the workplace. Planners should develop programs to increase workplace safety, especially in centers that are most exposed to these behaviors. It is also recommended that future studies focus on implementation of effective evidence-based interventions based on organizational culture., (Copyright © 2021 Tehran University of Medical Sciences.)