Prevalence of burnout among nurses in Iran: a systematic review and meta-analysis.

AIM: This study aimed to summarize the available information in the literature to make an accurate estimate of the prevalence of burnout among Iranian nurses. BACKGROUND AND INTRODUCTION: Burnout is a work-related stress syndrome that has negative impact on healthcare providers, patients and healthcare delivery systems. METHOD: A comprehensive search of literature using international [PubMed, Scopus and the Institute for Scientific Information (ISI)] and Iranian scientific data bases [Scientific Information Database (SID), IranMedex and Magiran] was conducted to identify English and Persian language studies, published between 2000 and 2016, that examined the prevalence of burnout among nurses in Iran. The I-squared test and Chi-squared-based Q-test suggested heterogeneity of reported prevalence among the qualified studies; thus, a random-effects model was applied to estimate the overall prevalence of burnout among nurses in Iran. RESULTS: Based on 21 selected articles with 4180 participants, the overall prevalence of burnout among Iranian nurses was estimated to be 36% [95% confidence interval (CI), 20-53%] in Iran. Meta-regression indicated that sample size and year of data collection, mean age of samples, female to male ratio and geographic regions were not statistically significantly associated with the prevalence of burnout. Also, based on Egger's test and funnel plot, there is no publication bias among studies included in the analysis. CONCLUSION: Professional burnout affects more than one-third of nursing staff in Iran; thus, effective interventions and strategies are required to reduce and prevent burnout among nurses. IMPLICATION FOR NURSING AND HEALTH POLICY: Due to the negative consequences of burnout on patients, nurses and organizations, nursing and healthcare managers should intervene to prevent and reduce burnout among nurses in Iran. Policy attention should focus on developing effective interventions to prevent and minimize the burden of burnout among nurses in Iran. Nurses' involvement in the policy-making process is crucial in the implementation of effective programs and initiatives tailored to address the higher prevalence of burnout among Iranian nurses.

Long-term outcome of total hip arthroplasty in patients with haemophilia.

INTRODUCTION: Besides the target joints (elbow, knee and ankle), the hip is one of the commonly affected joints in haemophilic arthropathy. Hip arthroplasty is the therapy of choice after failure of conservative treatment. There are only limited data on long-term results after primary total hip arthroplasty (THA). AIM: The aim of this retrospective study was to analyse clinical outcome and complication rate after total hip replacement in patients with severe haemophilic arthropathy. METHODS: Forty-three patients with haemophilia (PWH), one patient with von Willebrand disease and one patient with a Factor-VII-deficiency undergoing 49 total hip arthroplasties, were evaluated in a retrospective study. Harris hip score (HHS), range of motion (ROM), pain status (visual analogue scale, VAS) complication rate and patient satisfaction were assessed at a mean follow-up of 11.5 years (range: 3-32). RESULTS: HSS, ROM and VAS improved significantly combined with high patient satisfaction. In total, three (6.1%) periprosthetic infections and five (10.2%) aseptic implant loosenings occurred after THA leading to revision arthroplasty. In two (4.1%) cases, a pseudotumour and one (2.0%) periarticular ossification had to be resected after THA. CONCLUSION: Total hip replacement in PWH leads to a significant increase of function, reduction of pain and a high satisfaction. Due to the relatively high complication rate (infections and aseptic loosening) compared to patients without haemophilia, an individual assessment of the risk-benefit ratio from surgical and haemostaseological point of view is needed.

Effects of an specific methodology (I Pass the Baton) on quality of handoff information among Nurses: A comparative study.

AIM: The aim of this study was to investigate the effect of applying I Pass the Baton (IPB) on the quality of handoff among nurses. METHOD: The present study was a quasi-experimental study. All nurses of the internal wards of Sanandaj educational hospitals, Kurdistan Province, Iran were selected by census method and randomly assigned to intervention (n=34) and control (n=31) groups. Handoff quality was measured by self-report and observation methods. The intervention included a face-to-face training session, training on how to use the IPB, inserting the IPB chart into the patient file, training leaflet, and installing a poster in the ward. The Situation, Background, Assessment, Recommendation (SBAR) was used according to routine practice in the control group. Descriptive and inferential tests were applied to analyze the data using SPSS-16. RESULTS: The mean score of handoff quality was 82.61±12.77 and 107.11±7.97 before and after the intervention in the intervention group (p<0.05) and 89.00±0.34 and 85.64±19.19 before and after the intervention in the control group, respectively (p=0.91). There was a statistically significant difference between the two groups after the intervention (p<0.05). Implementation of the training program and the IPB tool improved the handoff quality in terms of interaction and support, patient involvement, information quality, and efficiency. CONCLUSIONS: The IPB has various indicators of patient participation and includes the criteria needed for patient evaluation. Therefore, it can be used to handoff a wide range of patients in the internal ward.

Design, Synthesis and Biological Evaluation of Some Triazole Schiff's Base Derivatives as Potential Antitubercular Agents.

BACKGROUND: Tuberculosis (TB) is the second important cause of death worldwide caused by a bacterium called Mycobacterium tuberculosis. There is a need to find and develop new Anti-TB medications that are effective, inexpensive and suitable with human immunodeficiency virus and other anti-TB drugs used in many countries and mainly the developing countries where the disease is widespread. These drugs must be designed to shorten treatment time and to be active against resistant forms of the mycobacteria that will help to increase the patients compliance. A key compound which could be used as a lead to meet these requirements, is the thiolactomycin (TLM). This antibiotic which is naturally available has an ability to treat M. tuberculosis by inhibiting condensing enzymes called FAS II (mtFabH, KasA and KasB) which are related to biosynthesis of mycolic acid. METHODS: Our main aims are to design and synthesize analogues of TLM as new lead molecules which could be a possible anti-TB candidate. To overcome the synthetic challenges associated with preparing the chiral TLM analogues; we synthesized and investigated a series of triazole analogues as inhibitors of KasA enzyme and the whole cell Mycobacteria. A series of twelve compounds were synthesized, purified and fully characterized using several spectroscopic techniques. Molecular modelling studies for our synthesised compounds were achieved by using a modelling program called AutoDock 4.2 utilising rigid docking. RESULTS: Our results indicate that analogues of TLM show a good activity as compared to TLM. CONCLUSION: The activity obtained for the synthesized compounds against Mycobacteria tuberculosis indicate that the synthesised compounds 1, 2, 6 and 9 are pharmacologically active as they restrained the growth of the Mycobacteria bacteria.

Specific determination of cyanide in blood by headspace gas chromatography.

An improved method has been developed for the quantitative determination of cyanide in human blood by headspace gas chromatography with electron-capture detection. In this novel method, cyanide was detected after conversion of hydrogen cyanide into cyanogen chloride by a reaction with chloramine T. The advantage of this new procedure lies in the fact that hydrogen cyanide formation and chlorination are carried out in a single step and in the same reaction medium. This method is simple, rapid, and specific for cyanide and does not suffer from any interference by cyanate and thiocyanate. The detection limit is 5 micrograms/L. The detection response is linear from 5 to 1000 micrograms/L, and the within-run coefficient of variation in this range is 8% or less. This method is particularly useful for routine diagnostic analysis of biological samples in case of acute cyanide poisoning.

Design, synthesis, molecular modeling, and biological evaluation of sulfanilamide-imines derivatives as potential anticancer agents.

A series of sulfanilamide Schiff base derivatives (1 to 15) have been designed as potential antitubulin agents depending on the chemical structures of combretastatine A-4 and isoquinoline sulfamate (antimitotic agents under investigation). The designed compounds were synthesized by microwave chemical synthesis, their purity was confirmed by melting point and HPLC and chemical structures were determined by FT-IR, UV, and 1H and 13C-NMR spectroscopic techniques. The synthesized compounds have been docked in the colchicine binding site of ß-tubulin using molecular modeling programs and the antitumor activities were screened on human breast and lung cancer cells by cell counting assay. Some tested compounds showed potent and selective activity against breast cancer (MCF-7) with IC50 range of 90 to 166 µM. With regarding broad-spectrum activity, compounds 4, 8, and 13 have shown potent antitumor activity against human breast and human lung cells with IC50 range of 96 to 140 µM. The obtained results suggest that the sulfanilamide Schiff base derivatives might potentially constitute an interesting novel class of anticancer agents, which deserve further studies.

Capillary gas chromatographic determination with electron capture detector of beta-propiolactone in biological materials.

A method has been developed for the determination of beta-propiolactone by derivatizing it to the volatile N-hexyl-3-heptafluorobutanoyloxypropanamide, which can be separated and identified by a capillary CP-Sil 8 column, and detected by an electron capture detector (ECD). First, beta-propiolactone is reacted with N-hexylamine to yield N-hexyl-3-hydroxypropanamide. The fluorobutanoyl ester derivative is next prepared by using heptafluorobutyric acid anhydride in the presence of trimethylamine. The method is very sensitive, simple, and specific, and can be used to detect and quantitate residual beta-propiolactone in lyophilized biological materials. The limit of detection is 0.2 ppm beta-propiolactone in a 50 mg sample; however, because of variability at low levels, the limit of quantitation is 1 ppm. Detector response was linear for 2-500 mg beta-propiolactone. Recoveries were 98% or greater from lyophilized vaccines spiked at the 2-20 ppm level. No side products or interference peaks were observed in the derivatization reaction.