Prevalence of headaches in healthcare workers while using personal protective equipment during the COVID-19 pandemic: a systematic review and meta-analysis.

OBJECTIVES: During the COVID-19 pandemic, healthcare workers (HCWs) are at a serious risk of contracting this virus. Therefore, they should use personal protective equipment (PPE) to protect themselves. Long-term use of these devices has led to many side effects, including headaches. This study investigated the prevalence of headaches related to using PPE in HCWs during the COVID-19 pandemic. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Embase, PubMed, Scopus and Web of Science databases were searched from December 2019 to February 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: All cross-sectional studies that investigated the prevalence of headache complications caused by PPE were included. DATA EXTRACTION AND SYNTHESIS: Two researchers reviewed the articles separately and independently. The Appraisal Tool for Cross-Sectional Studies was used to address study design quality and the risk of bias in cross-sectional studies. The heterogeneity of the studies was checked with the I2 statistic, and due to the high heterogeneity, the random effects model was used for synthesis. Data were analysed using Comprehensive Meta-Analysis software V.3.3.70. RESULTS: Out of 3218 articles retrieved for all side effects, 40 were eligible for this meta-analysis. The prevalence of headaches related to the use of PPE in these 40 studies, with a sample size of 19 229 people, was 43.8% (95% CI 43.1% to 44.6%, I2=98.6%, p<0.001). Based on the meta-regression results, no significant relationship was observed between the prevalence of headaches and variables such as year of publication, study location, sample size and quality of studies. CONCLUSION: Headache is one of the common side effects of PPE, which can interfere with HCWs' performance. It is suggested that manufacturers improve the quality of their equipment while healthcare managers should equip and train staff adequately to minimise side effects, ensuring health and enhanced service delivery. PROSPERO REGISTRATION NUMBER: CRD42021264874.

Design and psychometric properties of the acute care quality in trauma emergency units scale.

BACKGROUND: Systematic trauma care scale could be designed and used by nurses to completely and adequately fulfill a complex care to improve trauma care quality. The purpose of this study was to design and evaluate the psychometric property of the Nursing Care Quality in Trauma Emergency Units and trauma care promotion. METHODS: This methodological study was conducted in 2022. The process of designing and psychometric assessment of the scale was performed in two steps such as Generating an Item Pool and Validity and Reliability evaluation (Item reduction). The construct validity was determined using the experimental intervention; for determining the reliability of the scale and internal consistency, we measured the inter-rater reliability (IRR). Data were analyzed using the SPSS software, version 22. RESULTS: Based on our findings, the CVI and CVR of the scale were 1 and 0.83-1, respectively. A significant difference between the pre- and post-intervention scores in group 1 supports the inference that the construct has been appropriately represented, and the instrument has construct validity (p < 0.001). We found that there was a significant difference in the scores of Patient assessment, Planning and Implementations, and Evaluation of the care plan. The inter-rater reliability method allows the optimal reliability assessment of observational instruments, which was used in this study, and the results confirmed excellent reliability of the instrument. CONCLUSIONS: The validity and reliability of the Nursing Care Quality in Trauma Emergency Units Scale were confirmed. The instrument could successfully assess the process of nursing care in the trauma emergency ward. The use of this checklist is recommended as a valid observational tool for other researchers. STUDY TYPE: Therapeutic/care management.

Validation and psychometric properties of the Persian version of the MISSCARE survey.

AIM: To conduct, translate, and psychometric evaluation of the MISSCARE-Persian Survey. DESIGN: A cross-sectional study was conducted in Iran in February-June 2021. METHODS: The translation of the MISSCARE Survey was accomplished according to World Health Organization (WHO) guidelines. Construct validity was performed by (N = 300) exploratory factor analysis and confirmation. To assess the reliability, internal consistency was assessed using Cronbach's alpha coefficient, and relative stability was assessed using the interclass correlation coefficient (ICC). The study adhered to COSMIN guidelines. RESULTS: The exploratory factor analysis, which resulted in the identification of three factors in the second part of the tool, explained 79.6% of the total variance. Confirmatory factor analysis indicated the model's good fit of information. The reliability of the first and second parts of the tool was 0.912 and 0.901, respectively. Additionally, the ICC was found to be 0.687 for the first and 0.706 for the second part of the tool.

Eco-friendly preparation, characterization, evaluation of anti-melanogenesis/antioxidant effect and in vitro/in vivo safety profile of kojic acid loaded niosome as skin lightener preparation.

In the current study, an ultrasonic approach (as green method) was utilized to prepared kojic acid niosome (kojisome) which aimed to increase the dermal delivery and improving anti-melanogenesis properties. The study's findings demonstrated that increasing cholesterol enhanced the mean particle size from 68.333 ± 5.686 nm to 325.000 ± 15.099 nm and entrapment efficiency 0% to 39.341 ± 4.126% of the kojisome. Cholesterol may enhance the number and rigidity of bilayers that induced a size enhancement and entrapment efficiency. The skin permeability test revealed that kojisome gel had more kojic acid in dermal layers (437.563 ± 29.857 µg/cm2 or 16.624 ± 1.379%) than kojic acid plain gel (161.290 ± 14.812 µg/cm2 or 6.128 ± 0.672%). The niosome's lipophilicity allowed for gradual penetration, possibly due to better contact with the skin layers. Also, the extended-release behavior of improved kojisome exhibited high safety profile and low side effect in In vitro cytotoxicity assay, dermal irritation test, and Histo-pathological evaluation. Furthermore, optimum kojisome inhibited melanin formation (53.093 ± 2.985% at 1000 µM) higher than free kojic acid (62.383 ± 1.958%) significantly (p < 0.05). In addition, Kojisome 6 inhibited L-dopa auto-oxidation greater extent (94.806 ± 2.411%) than pure kojic acid solution (72.953 ± 2.728%). Kojisome by delivering and targeting large amount of kojic acid on specific site causes high efficacy in inhibition of melanin synthesis. The observations of this study revealed that the produced kojisome might be used as a potential nano-vehicle for kojic acid dermal administration, thereby opening up innovative options for the treatment of hyperpigmentation problems.

Evaluation of the Therapeutic Effect of the Traditional Herbal Medicine Atrifil and Oshagh Gum on Testosterone-Induced Benign Prostatic Hyperplasia in Wistar Rats.

Benign prostatic hyperplasia (BPH) is a common disease that affects elderly men with various complications. This study evaluates the effects of an Iranian traditional herbal medicine "Atrifil and Oshagh gum" on BPH in male Wistar rats. Atrifil is a combination of three medicinal plants: Emblica officinalis Gaertn, Terminalia chebula Retz, and Terminalia bellerica Retz" extracts, and Oshagh gum is Dorema ammoniacum D. Dono gum. In this study, 30 male Wistar rats were divided into five groups: normal control, disease, finasteride, and extract with 300 and 600 mg/kg groups. The extract is a combination of hydroalcoholic Atrifil extract and Oshagh gum. All groups received intramuscular testosterone enanthate to induce BPH except the normal control group. On the twenty-eighth day, prostate glands were separated. Histopathological changes were observed. Furthermore, the prostate-specific antigen (PSA) and prostate weights were measured. The binding propensities of finasteride, equol, and flavonoids present in this extract such as quercetin, rutin, and kaempferol for 5α-reductase, estrogen receptor alpha and beta, and estrogen-related receptor gamma were assessed using in silico docking approach. Histopathological evaluation, biochemical parameter, and PSA level results indicated significant inhibition of accruing and progression of BPH in groups treated with 600 mg/kg extract (p < 0.01). Furthermore, molecular docking showed that rutin had a high affinity to bind the receptors 5α-reductase, estrogen receptor beta, and estrogen-related receptor gamma even more than finasteride, and on average, quercetin had a higher affinity to all these receptors. In the end, it can be concluded that Atrifil and Oshagh gum is effective in preventing BPH.

Novel Molecular Targets and Mechanisms for Neuroprotective Modulation in Neurodegenerative Disorders.

BACKGROUND: Neuronal death underlies the symptoms of several human neurological disorders, including Alzheimer's, Parkinson's and Huntington's diseases, and amyotrophic lateral sclerosis and their precise pathophysiology have not yet been elucidated. According to various studies, the prohibition is the best therapy with neuroprotective approaches, which are advanced and safe methods. METHODS: This review summarizes some of the already-known and newly emerged neuroprotective targets and strategies and their experimental effects have also been reported. Accordingly, literature was studied from 2000 to 2021, and appropriate articles were searched in Google Scholar and Scopus with the keywords given in the keywords section of the current review. RESULTS: Lewy bodies are the histopathologic characteristics of neurodegenerative disorders and are protein-rich intracellular deposits in which Alpha-synuclein is its major protein. Alphasynuclein's toxic potential provides a compelling rationale for therapeutic strategies aimed at decreasing its burden in neuronal cells through numerous pathways, including ubiquitin-proteasome system and autophagy-lysosome pathway, proteolytic breakdown via cathepsin D, kallikrein-6 (neurosin), calpain-1 or MMP9, heat shock proteins, and proteolysis targeting chimera which consists of a target protein-ligand and an E3 ubiquitin ligase (E3) followed by target protein ubiquitination (PROTACs). Other targets that have been noticed recently are the mutant huntingtin, tau proteins and glycogen synthase kinase 3ß; their accumulation proceeds extensive neuronal damage and up to the minute approach such as proteolysis targeting chimera promotes its degradation in cells. Various studies demonstrated that Mendelian gene mutations can result in neurodegenerative diseases. An additional target that has gained much interest is epigenetics, such as mutation, phosphodiesterase, RNA binding proteins and Nuclear respiratory factor 1. CONCLUSION: The novel molecular targets and new strategies compiled and introduced here can be used by scientists to design and discover more efficient small molecule drugs against neurodegenerative diseases. And also, the genes in which their mutations can lead to the α-synuclein aggregation or accumulation have been discussed and considered a valuable information on epigenetics in dementia.

Patient Representatives' Perspectives on Healthcare at the Time of COVID-19 and Suggestions for Care Redesign After the Pandemic: A Qualitative Study in Twenty-Four Countries.

OBJECTIVE: Several comments and recommendations called to embed better the patients' and public voice in healthcare policymaking. Still, no studies captured patients' bottom-up perspectives regarding healthcare at the time of COVID-19 at a micro-level in a range of different countries. We, therefore, explored the perspectives of patient representatives in all six World Health Organisation (WHO) regions and extracted suggestions for care redesign after the pandemic. METHODS: We conducted semi-structured interviews with patient representatives until saturation. Thematic analysis followed a modified form of meaning condensation. We established rigour by transcript checking, inter-coder agreement, quote variation and standardised reporting. RESULTS: Disadvantaged people experienced an unprecedented inequity in healthcare from limited access to physical violence. The narratives revealed the extent of this inequity, but also opportunities for health workers to act and improve. Stigmatisation from COVID-19 differed between cultures and countries and ranged from none to feeling "ashamed" and "totally bashed". While experienced as indispensable in the future, patients refused telehealth when they were given "bad news", such as having an eye removed because of melanoma, and in end-of-life care. Patient representatives redefined their role and became indispensable influencers throughout the pandemic and beyond. CONCLUSION: We reached out to patient representatives with diverse perspectives, including those who represent minorities and marginalised patient populations. Since preferences and personal meanings drive behaviour and could be foundations for targeted interventions, they must be considered in all groups of people to increase society's resilience as a whole. Future healthcare should tackle inequity, address stigmatisation and consider patients' narratives to optimize telemedicine.

Innovative topical niosomal gel formulation containing diclofenac sodium (niofenac).

The purpose of this research was to enhance the transdermal delivery of diclofenac sodium niosomal formulations. To characterise the obtained niosomes, SEM, XRPD, DSC and ATR-FTIR were employed. The size of the niosomes increased from 158.00 ± 6.17 to 400.87 ± 4.99 nm when cholesterol was incorporated into the formulations. It was observed that the zeta potential of niofenac varies from -25.40 ± 1.352 to -43.13 ± 1.171 mV when the cholesterol percentage decreased from 2% to 0.2%. The higher entrapment efficiency percentage (63.70 ± 0.18%) was obtained for the formulations with larger particle sizes and higher cholesterol content. The optimised niofenac formulation showed a controlled release fashion where 61.71 ± 0.59% of the drug released within 24 h. The results showed that the value of permeated diclofenac sodium through the skin layers was higher for the niofenac gel formulation (242.3 ± 31.11 µg/cm2) compared to simple gel formulation (127.40 ± 27.80 µg/cm2). Besides, niofenac formulation outperformed the anti-inflammatory activities in the formalin test compared to the control and diclofenac simple gel group. The licking time was significantly lower in both early (40.2 ± 7.3 s) and late stages (432.4 ± 31.7 s) for niofenac compared to conventional formulation (early stage 130.4 ± 8.73 s and late stage 660.6 ± 123.73 s). This study indicates that niosomal formulations can improve drug therapeutic effects by increasing drug delivery to specific sites.

Development of a novel nanoemulgel formulation containing cumin essential oil as skin permeation enhancer.

Essential oils have been proposed as promising non-toxic transdermal permeation enhancers. Their use is limited because of their low water solubility. The use of nanotechnology-based strategies is one of the ways to overcome this limitation. This study aimed to explore the transdermal permeation enhancing capability of cumin essential oil in nanoemulgel systems containing diclofenac sodium. Cumin essential oil nanoemulsion was produced by high-pressure homogenization technique. The formulation was optimized by changing HLB values in a range of 9.65-16.7 using different surfactant mixtures, namely, Tween 20, Tween 80, and Span 80. Preparations were characterized by polydispersity index, droplet size, and zeta potential. Nanoemulsion with concentrations of 2 and 4% essential oil was incorporated into 0.75% Carbopol gel matrix to make nanoemulgel formulation, and its permeation enhancing effect was performed through Franz diffusion cells. Antinociceptive activities of the formulations were measured in thermal (tail-flick) and chemical (formalin) models of nociception in mice. Characterization exhibited that at HLB value of 9.65, the smallest particle size (82.20 ± 5.82 nm) was formed. By increasing the essential oil percentage in the nanoemulgel from 1 to 2%, the permeation of diclofenac increased from 28.39 ± 1.23 to 34.75 ± 1.07 µg/cm2 at 24 h. The value of permeation from the simple gel (21.18 ± 2.51 µg/cm2) and the marketed product (22.97 ± 1.92 µg/cm2) was lower than the formulations containing essential oil. Nanoemulgel of diclofenac containing essential oil showed stronger antinociceptive effects in formalin and tail-flick tests than simple diclofenac gel and marketed formulation. In conclusion, the study proved that nanoemulgel formulation containing cumin essential oil could be considered as a promising skin enhancer to enhance the therapeutic effect of drugs.

Evaluation of in-situ gel-forming eye drop containing bacteriophage against Pseudomonas aeruginosa keratoconjunctivitis in vivo.

Introduction: Eradication of Pseudomonas aeruginosa has become increasingly difficult due to its remarkable capacity to resist antibiotics. Bacteriophages have been suggested as an alternative treatment for bacterial infections. Methods: In-situ gel-forming eye drop containing phage against P. aeruginosa keratoconjunctivitis was prepared. The Cystoviridae phage was formulated as in-situ gel-forming formulation which is a solution formulation but turns into gel when it contacts the eye. Therapeutic effectiveness of the in-situ gel forming formulation was evaluated by histological examination on day 12 post-infection. Results: The viscosity of selected formulation increased when it was instilled into the eye. The histological results showed edema, abscesses, and destruction of the stromal structure of cornea in groups where no in-situ gel-forming formulation was used. In the group where in-situ gel forming formulation was used, re-epithelialization and normal corneal structure were observed. Conclusion: In-situ gel-forming ophthalmic formulation containing phage can be effective in the treatment of P. aeruginosa keratoconjunctivitis.

Yoga Effects on Anthropometric Indices and Polycystic Ovary Syndrome Symptoms in Women Undergoing Infertility Treatment: A Randomized Controlled Clinical Trial.

The aim of this study was to investigate the effects of yoga exercises on anthropometric parameter and clinical sign of PCOS among women undergoing infertility treatment. This clinical trial study was performed on 61 women with PCOS who have undergone infertility treatment at Sarem Hospital in Tehran, Iran. The patients were first selecting based on purposeful and then randomly assigning to the intervention and control groups. In the intervention group, yoga exercises were performed for 6 weeks and the patients in the control group only received routine care. Anthropometric parameters and clinical signs were performed and recorded. After the intervention, here was a significant reduction in hirsutism, abdominal circumference, and hip circumference scores in the intervention group compared to the control group (P < 0.05). Given the effects of yoga exercises on the improvement of hirsutism, abdominal circumference, and hip circumference, it is suggested to use yoga as a treatment strategy in women with PCOS.

The methodological quality is insufficient in clinical practice guidelines in the context of COVID-19: systematic review.

OBJECTIVES: The number of published clinical practice guidelines related to COVID-19 has rapidly increased. This study explored if basic methodological standards of guideline development have been met in the published clinical practice guidelines related to COVID-19. STUDY DESIGN AND SETTING: Rapid systematic review from February 1 until April 27, 2020 using MEDLINE [PubMed], CINAHL [Ebsco], Trip and manual search, including all types of healthcare workers providing any kind of healthcare to any patient population in any setting. RESULTS: There were 1342 titles screened and 188 guidelines included. The highest average AGREE II domain score was 89% for scope and purpose, the lowest for rigor of development (25%). Only eight guidelines (4%) were based on a systematic literature search and a structured consensus process by representative experts (classified as the highest methodological quality). The majority (156; 83%) was solely built on an informal expert consensus. A process for regular updates was described in 27 guidelines (14%). Patients were included in the development of only one guideline. CONCLUSION: Despite clear scope, most publications fell short of basic methodological standards of guideline development. Clinicians should use guidelines that include up-to-date information, were informed by stakeholder involvement, and employed rigorous methodologies.

Psychometric properties of the Persian version of Instrument of Professional Attitude for Student Nurses (IPASN).

AIM: To evaluate nursing students' professionalism attitude, it is necessary to use a validated and reliable instrument. DESIGN: This study aimed to develop the Persian version of the eight-dimensional professionalism attitude questionnaire for student nurses (Instrument of Professional Attitude for Student Nurses). METHODS: In this cross-sectional study during March to April 2017, after being translated into Persian and receiving experts' comments face, content, and construct validity of the questionnaire were sought among nursing students. Internal consistency reliability was examined by estimating the Cronbach's alpha coefficient and stability was estimated by calculating intraclass correlation coefficinet. RESULTS: A total of 750 students with an average age of 24.15 (SD = 1.32) years participated in the study. Both exploratory and confirmatory factor analyses confirmed the construct of the questionnaire. Cronbach's alpha coefficient for the entire instrument was 0.89 and more than 0.70 for all dimensions. Also the intraclass correlation coefficient for the questionnaire was found to be 0.92, well above acceptable threshold. The findings approved that the Iranian version of Instrument of Professional Attitude for Student Nurses is a reliable and valid questionnaire. Hence, using this questionnaire to conduct studies is recommended.

Factors Affecting the Implementation of Early Rehabilitation Care in Patients with Traumatic Brain Injury: A Multidisciplinary Perspective.

Background: Traumatic brain injury is now regarded as the silent epidemic. This disease can cause some physical, cognitive, and psychological impairments that require proper and early rehabilitation interventions. Therefore, the aim of this study was to explore the factors affecting early rehabilitation care in patients with traumatic brain injury based on the experiences of the rehabilitation team. Methods: This qualitative study was conducted as a conventional content analysis from September 2019 to August 2020. For this purpose and given the maximum diversity, 22 members of the rehabilitation team, patients, and their caregivers in trauma level 1 hospitals affiliated with Tehran University of Medical Sciences were selected based on a purposeful sampling method. The data were also collected using semi-structured interviews until data saturation is obtained. Graneheim and Lundman's content analysis method was performed to analyze the data. Results: The data analysis results eventually led to the introduction of three main themes and eight categories. The main themes were associated with early rehabilitation barriers, which included cultural factors and rehabilitation infrastructures. Rehabilitation management was regarded as the main theme regarding the early rehabilitation facilitator. Conclusion: Early rehabilitation is considered a vital rehabilitation stage for patients with traumatic brain injury. Hence, accurate identification of the influential factors on early rehabilitation can help the rehabilitation team promote early rehabilitation care among these patients; it can lead to the revival of the patients' abilities and the improvement of their quality of life.

Auriculotherapy as a means of managing nausea and vomiting in pregnancy: A double-blind randomized controlled clinical trial.

INTRODUCTION: This study was aimed to assess the effectiveness of auriculotherapy on managing nausea and vomiting during pregnancy. METHODS: In this randomized clinical trial, 128 pregnant women suffering from nausea and vomiting were selected and assigned to study groups. The data were collected using demographic information and Rhodes' questionnaires and analyzed in SPSS v.22. RESULTS: After intervention, the average nausea score of the Rhodes index declined significantly in patients in the intervention group (p < 0.001).However, there was no significant (p = 0.305) difference between the two groups regarding vomiting. The results of the repeated measures showed that interventions had a significant effect on the total score of the questionnaire and also the scores regarding nausea (p < 0.04). CONCLUSION: The appropriate use of effective points on ears to control nausea and vomiting as a non-medicine and complementary treatment can alleviate nausea among pregnant women.

The effect of music therapy on physiological parameters of patients with traumatic brain injury: A triple-blind randomized controlled clinical trial.

OBJECTIVE: This study aims to investigate the effect of music therapy integrated with family recollection on physiological parameters of patients with traumatic brain injury who are admitted to Intensive Care Units. METHODS: Sixty patients were selected through convenience sampling and were then randomly assigned to the intervention group and control group. In the intervention group and for 6 consecutive days, the patients received a combination of music and auditory stimulation twice a day for 15 minutes. The patients' physiological parameters were measured before the intervention, and then 10 minutes and finally 30 minutes after the intervention. The data were analyzed using multilevel modeling method through MLwiN version 2.27. RESULTS: The results showed that there was no significant difference between the two groups in terms of demographic factors and the duration of coma. However, the results of the two-level multiple linear models which were performed for 6 consecutive days indicated a significant decrease in systolic blood pressure, diastolic blood pressure, respiratory rate and heart rate for the patients in the intervention group as compared to the patients in the control group (P < 0.0001). Nevertheless, no significant difference was observed in temperature and oxygen saturation (P > 0.05). CONCLUSION: Integration of music therapy with family recollection can moderate physiological parameters. Therefore, it is recommended to use this cost-effective treatment along with the routine treatments, especially for patients with traumatic brain injury.

Psychometric assessment of the Persian version of short clinical scale to measure chemotherapy-induced nausea and vomiting: the MASCC antiemetic tool.

INTRODUCTION AND OBJECTIVE: Managing chemotherapy-induced nausea and vomiting (CINV) in patients with cancer is still a challenge for the patients and also the clinicians. The Multinational Association of Supportive Care in Cancer (MASCC) has developed a scale for better measurement and management of CINV. Thus, this paper aims at translating the scale into Persian and assessing the psychometric properties of the proposed translated version of MASCC Antiemesis Tool (MAT). METHODS: Having received the necessary permissions and complying with the Forward-Backward translation protocol, we conducted a qualitative assessment of the face validity through cognitive interviewing and content validity assess with 5 experts in Persian Literature. Internal consistency using Cronbach's Alpha Coefficient was applied to determine the scale reliability. In order to determine the construct validity, the three methods of exploratory factor analysis, known group analysis, and convergent validity (assessment of the correlation between Rhodes Index of Nausea, Vomiting and Retching (INVR) scale and the Persian version of MAT scale) were conducted on 300 participants. RESULTS: About 300 patients with a mean age of 50.73 ± 0.81 participated in the study. The results showed a significant difference in the index of nausea and vomiting between the patients who are below 50 years old and those who are above 50 (P = 0.0001). The Cronbach's Alpha Coefficient was reported 0.88 for the whole MAT questionnaire. Due to the low factor load (fewer than 0.5) for question 1, it was removed in the factor analysis. Besides, exploratory factor analysis (EFA) led to the exploration of the two factors of nausea and vomiting. CONCLUSION: According to the results of the study, the Persian version of the MAT questionnaire is considered as a highly reliable and valid tool, in order to efficiently and accurately measure chemotherapy-induced nausea and vomiting and to better manage this side effect.

The effect of auricular acupressure on nausea and vomiting caused by chemotherapy among breast cancer patients.

OBJECTIVE: The aim of this study was to determine the effect of auricular acupressure in relieving nausea and vomiting among the women who received chemotherapy. METHODS: 48 women suffering from Breast Cancer and receiving chemotherapy were recruited for the study. The patients were randomly assigned into two groups of experiment and control. In the initial phase of chemotherapy, the experimental group received standard medications to control nausea and vomiting and auricular acupressure for five days. Meanwhile, the control group received only the standard medications. RESULTS: The use of auricular acupressure led to the decrease in the number and intensity of nausea and vomiting in both the acute and delayed phases in experimental group which were significantly lower than the control group (P = 0/001). CONCLUSIONS: It is suggested that nurses use this pressure technique as a complementary treatment, non - pharmacological, inexpensive, non-invasive approach for the relief of chemotherapy-induced nausea and vomiting.