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Background: COVID-19 has been announced as an international public health emergency since February 2020 by the WHO. Objectives: The present study aimed to identify clinical manifestations and laboratory findings of COVID-19 patients and their relationship with severe outcomes. Methods: This cross-sectional study with descriptive and analytical purposes was conducted on 470 patients suspected of having COVID-19 infection hospitalized at Ganjavian hospital, one of the Referral Hospitals for COVID-19 patients, in Dezful, Iran. Patients’ records were reviewed for demographics and clinical manifestations, and the results of laboratory tests and severe outcomes from April to June 2020 were reviewed. The admission criterion was a definitive Coronavirus infection diagnosis, and the exclusion criteria were the medical records of patients who underwent three follow-up test appointments for any reason. Data were analyzed using SPSS version 22.0. Results: The mean age of patients was 56.05. The most prevalent symptoms among COVID-19 patients were dry cough, fever, and respiratory complications. The most significant laboratory findings were between the first and third test appointments in WBC, MCV, MCHC, HB, PLT, CRP, ESR, BUN, CR, LDH, and SGPT (P < 0.001). Age, fever, nausea, chills, underlying disease, and some laboratory factors with severe COVID-19 outcomes (ICU admission and death) had a significant relationship. Conclusions: Considering the main clinical manifestation of COVID-19, such as dry cough, Fever, and Dyspnea (need for oxygen) also, results of laboratory tests such as Hb and RDW can have a key role in early detection to progress to severe outcomes, thus decreasing COVID-19 mortality rate.

Aim The present study aimed to determine the relationship between spiritual well‐being and hope through adherence to diet in haemodialysis patients referred to the dialysis centre. Design This research was a cross‐sectional study of a descriptive‐analytical type conducted on 120 patients undergoing haemodialysis in a haemodialysis centre of a hospital affiliated to Dezful University of Medical Sciences using the census method. Method The data were collected using a questionnaire and through the laboratory information included in the patient's records. The data collection tools were a demographic information questionnaire, the Ellison and Paloutzian spiritual well‐being scale (SWBS), the Hope‐Herth questionnaire and the objective laboratory criteria (phosphorus, potassium). This included the weight difference between the two dialysis sessions from the record to examine the adherence to the diet. Results The results indicate there to be a significant relationship between hope and spiritual well‐being with the objective criteria of the adherence to the diet in dialysis patients (p = .001).

Background: Clinical competency is the ability of nurses to play a professional role in a clinical environment, in terms of the quality of the services provided. Objectives: The present study aimed to compare the clinical competence of emergency department nurses using self-assessments and evaluations by head nurses. Methods: A descriptive-analytical study was conducted from July to September 2019. The census method was used to select 70 nurses working in the emergency departments of three hospitals. Data was collected by using self-assessment questionnaires and evaluations by head nurses. The instrument was a clinical competency questionnaire with questions related to seven functional fields and 73 skills. Results: The viewpoints of nurses and head nurses on the clinical competencies of nurses were assessed at a moderate level in the majority of domains. Nurses defined their clinical competencies at a significantly higher level than the head nurses (P < 0.05). Conclusions: Based on the results, it is assumed that using more than one method and simultaneously applying multiple methods in an assessment will provide more accurate results about nurses’ clinical competence.

Introduction: This study was conducted to determine the relation between exposure to particulate matter less than 10 microns (PM10) caused by dust storms and the risk of cardiovascular, respiratory and traffic accident missions carried out by Emergency Medical Services (EMS). Methods: This was a time-series study conducted in Dezful city, Iran. Daily information on the number of missions by the EMS due to cardiovascular, respiratory and crash problems and data on PM10 were inquired from March 2013 until March 2016. A generalized linear model (GLM) with distributed lag models (DLMs) was used to evaluate the relation between the number of EMS missions and the average daily PM10. The latent effects of PM10 were estimated in single and cumulative lags, up to 14 days. Results: In the adjusted model, for each IQR increase in the average daily PM10 concentration, the risk of EMS missions in the total population in single lags of 2 to 7 days, and the cumulative lags of 0-7 and 0-14 days after exposure had a 0.8, 0.8, 0.8, 0.8, 0.7, 0.6, 6.7 and 1.4% significant increase. Also, for each IQR increase in the daily mean concentration of PM10 in single 1 to 7, and cumulative lags of 0-2, 0-7, and 0-14 days after exposure, respectively, a 2.4, 2.7, 2.8, 2.9, 2.9, 2.7, 2.5, 7.4, 23.5 and 33. 3 % increase was observed in the risk of EMS cardiovascular missions. Conclusion: Increase in daily PM10 concentrations in Dezful is associated with an increase in the risk of EMS missions in lags up to two weeks after exposure.

Introduction: Triage is the process of determining the priority of patients’ treatments based on the severity of their conditions. The aim of the present study was to survey the effect of triage video podcasting on the knowledge and performance of pre-hospital students. Methods: Sixty pre-hospital students were randomly divided into two groups of a 30-subject control group and a 30-subject intervention group. A pre-test was administered among all students. Afterwards, for the first group, triage education was offered through lectures using PowerPoint, while for the second group, audio and video podcasts tailored for this training program were employed. Right after the training as well as one month later, post-tests were run for both groups, and the results were analysed using an independent t-test and covariance. Results: No significant difference was observed between the effects of both types of education on knowledge and performance, either immediately, or one month after training. Discussion: We suggest that video podcasts are ready to replace traditional teaching methods in triage. Keywords: Triage, Lecture, Podcast, Pre-hospital, Education, Emergency

Background: Palliative nursing care provides the best possible quality of life (QoL) for patients who face life-threatening conditions, such as breast cancer, and their families. It seems that coping with breast cancer can affect couples' QoL. Hence, this study aimed to assess the potential role of ways of coping (WOC) in QoL among husbands of women with breast cancer. Method: In this cross-sectional study, 150 men whose wives were affected by non-metastatic breast cancer and were at least 4 months post-diagnosis, were recruited. The Persian version of the WOC questionnaire (WOCQ) and the World Health Organization's QoL brief questionnaire (WHOQoL-BREF) were used to measure WOC and QoL. ThePearson correlation test was applied to assess bivariate correlation of the variables. Results: A significant direct correlation was found between the total WHOQoL-BREF score and all subscales of WOCQ, except escape-avoidance coping (r=−0.017, P=0.830). Most dimensions of the WHOQoL-BREF and WOCQ subscales were correlated significantly and directly. Nevertheless, escape-avoidance coping had a significant indirect correlation with the physical dimension of WHOQoL-BREF (r=−0.220, P=0.007). Conclusions: Findings indicated a need for coping-based interventions in palliative nursing to improve QoL in husbands of women with breast cancer.

Background: Clinical competency is the ability of nurses in playing a professional role in a clinical environment specially emergency department as the quality of the services provided. The present study aimed to compare the clinical competence of the emergency nurses using self-assessment and evaluation methods by head nurses. Method: The study was designed in a descriptive-analytical way, collecting self-assessment questionnaire and evaluation methods by head nurse’s data. 70 nurses working in Emergency Departments of 3 Hospitals were selected and studied for 3 months based on entry requirements to the census. The instrument was a clinical competency questionnaire with questions in 7 functional fields and 63 skills. The data obtained from descriptive and inferential statistics were analyzed by SPSS-16. Result: The viewpoints of nurses and head nurses on the clinical competencies of nurses were assessed at a moderate level in the majority of domains. Nurses defined their clinical competencies at a significantly higher level compared to the head nurses (P

Background: In Spring 2018, due to intense rainfalls in Iran, plenty of mushrooms had grown, some of which were poisonous and their consumption had induced poisoning in people of different provinces; 1151 mushroom poisoning cases were reported within 25 days from 12 May to 9 July 2018. Objectives: This study aimed to address this issue from the public health perspective. The study further aimed at reporting the mortality and morbidity associated with mushroom poisoning and ascertaining the reasons behind the increase in the numbers of the affected persons. Methods: This report was based on the review of official reports and a field assessment in the areas affected by mushroom poisoning in the western part of Iran. Results: There were 1151 mushroom poisoning cases, out of which 1133 (98.4%) were hospitalized, and unfortunately, 18 (1.56%) died. Kermanshah province had the highest rate of mushroom poisoning casualties, out which seven people died. A total of 12 provinces were affected. Conclusions: Lack of knowledge of local people about the types of mushroom and their inability to differentiate between the toxic and non-toxic mushrooms, as well as lack of a swift and convenient immediate warning system has caused this incident of massive mushroom poisoning. However, planning and proper management can help to resolve these problems.

Background Heart failure is one of the serious cardiovascular diseases, which poses a global pandemic and places a heavy burden on health care systems worldwide. The incidence of this disease in Iran is higher than in other Asian countries. To reduce patients' complications, readmission rates, and health care expenditures, it is necessary to design interventions, which are culturally appropriate and based on community needs. Methods In 2016, a randomized clinical trial (IRCT2017010731804N1) was initiated to compare tailored tele-monitoring intervention with usual care. In total, 80 patients completed the study after a follow-up period of 8 weeks. The primary end point was heart failure self-care, which was measured using the Iranian version of the European Heart Failure self-care questionnaire. Secondary end points were heart failure related readmission rates. Results The mean scores for self-care behaviors of the two groups showed significant difference at the baseline (p = 0.045). The results of the analysis of covariance that was used to control the differences in the pretest scores of self-care behaviors showed that the difference between both groups after the intervention was still significant (p Conclusion This study showed that tele-monitoring improved self-care behaviors in Iranian patients with heart failure but did not reduce their readmission rates.

Chemotherapy-induced phlebitis (CIP) is one of the most important and common complications in patients with cancer. Currently, the use of complementary methods to prevent or alleviate phlebitis symptoms has attracted great attention. In this study, we aimed to assess the effects of topical sesame oil in reducing the pain severity of CIP.This randomized clinical trial was conducted on 60 patients with colorectal cancer afflicted with CIP. Patients received, twice a day for seven consecutive days, a 5-min massage solely (as the control group) or with 10 drops of sesame oil (as the experimental group) within the 10 cm radius of the affected site. The pain severity was evaluated by the visual analog scale on the first, third, fifth, and seventh days of the intervention.Mean changes of the pain severity compared to the baseline were significant on the third (P = 0.009), fifth (P 0.001), and seventh (P 0.001) days of the intervention in favor of the experimental group. Also, a significant reduction in the pain severity both in the experimental and control groups was observed during the seven days (F = 720.66, PApplication of massage with sesame oil as a complementary method is effective in reducing the pain severity of patients with CIP.