Factors Affecting the Use of Physical Restraints by Nurses for Patients in Intensive Care Units.

How to cite this article: Shakeri B, Vatandost S, Nouri B, Valiee S. Factors Affecting the Use of Physical Restraints by Nurses for Patients in Intensive Care Units. Indian J Crit Care Med 2023;27(5):372-373.

Serum Circ-FAF1/Circ-ELP3: A novel potential biomarker for breast cancer diagnosis.

BACKGROUND: Recently, measurement of serum circular RNAs (circRNAs) as a non-invasive tumor marker has been considered more. We designed the present study to investigate the diagnostic efficiency of serum Circ-ELP3 and Circ-FAF1, separately and simultaneously, for diagnosis of patients with breast cancer. METHODS: Seventy-eight female patients diagnosed as primary breast cancer participated in this study. We measured the level of circRNAs in serum specimens of the studied subjects. A receiver operating characteristic (ROC) curve was plotted and the diagnostic efficiency for both circRNAs was determined. RESULTS: Compared to non-cancerous controls, Circ-ELP3 was upregulated in breast cancer patients (p-value = 0.004). On the other hand, serum Circ-FAF1 was seen to be decreased in breast cancer patients than controls (p-value = 0.001). According to ROC curve results, the area under the curve (AUC) for Circ-ELP3 and Circ-FAF1 was 0.733 and 0.787, respectively. Furthermore, the calculated sensitivity and specificity for Circ-ELP3 and Circ-FAF1 were 65, 64% and 77, 74%, respectively. Merging both circRNAs increased the diagnostic efficiency, with a better AUC, sensitivity and specificity values of 0.891, 96 and 62%, respectively. CONCLUSION: Briefly, our results revealed the high diagnostic value for combined circRNAs panel, including Circ-ELP3 and Circ-FAF1 as a non-invasive marker, in detection of breast carcinomas.

Effect of Interventional Educational Programs on Intensive Care Nurses' Perception, Knowledge, Attitude, and Practice About Physical Restraints: A Pre-/Postclinical Trial.

The article reports results of an educational program designed to modify negative attitudes of intensive care nurses regarding the use of physical restraints. Findings revealed that increased knowledge about appropriate utilization of various types of restraints positively impacted perceptions, attitudes, and patient care practices. Authors also explore restraint use in several countries and identify variations in use of restraining methods.

Iranian hospital efficiency: a systematic review and meta-analysis.

PURPOSE: The purpose of this paper (systematic review and meta-analysis) is to synthesize and analyze studies that assessed Iranian hospital efficiency. DESIGN/METHODOLOGY/APPROACH: A systematic literature search was conducted using both international (the Institute for Scientific Information, Scopus and PubMed) and Iranian scientific (Magiran, IranMedex and Scientific Information Database) databases. The review included original studies that used the Pabon Lasso Model to examine Iranian hospital performance, published in Persian or English. A self-administered checklist was used to collect data. In total, 12 questions were used for quality assessment. FINDINGS: In total, 34 studies met our inclusion criteria. The fixed-effects meta-analysis indicated that 19.2 percent (95% confidence interval (CI): 15.6-23.2 percent) of hospitals were in Zone 1 (poor performance: low bed turnover rate (BTR) and bed occupancy rate (BOR) and high average hospital stay (ALoS)), 23.7 percent (95% CI: 20.1-27.8 percent) were in Zone 2, 31.7 percent (95% CI: 27.7-36 percent) in Zone 3 (good performance: high BTR and BOR and low ALoS) and 25.4 percent (95% CI: 21.7-29.5 percent) in Zone 4. PRACTICAL IMPLICATIONS: Results help Iranian health policymakers to understand hospital performance, which, in turn, may lead to promoting greater awareness and policy attention to improve Iranian hospital efficiency. ORIGINALITY/VALUE: This study indicated that most Iranian hospitals had sub-optimal performance. Further studies are required to understand factors that explain the country's hospital inefficiency.

Prevalence and risk factors for HBV and HCV in prisoners in Iran: a national bio-behavioural surveillance survey in 2015.

OBJECTIVES: To provide more accurate estimates of the prevalence of Hepatitis B (HBV) and Hepatitis C (HCV) and their contributing factors among prisoners in Iran. METHODS: Cross-sectional study of 6200 Iranian prisoners in 2015. Data were collected through questionnaires and interviews. HBV infection and HCV exposure status of the participants was determined by HBsAg and HCV antibodies blood tests using enzyme-linked immunosorbent assay (ELISA). Data were analysed in STATA-12. RESULT: Prevalence of HCV exposure was 9.48% (95% CI: 8.73-10.27), and prevalence of HBV was 2.48% (95% CI: 2.07-2.89) in the general prison population. In multivariate analysis, the most important risk factor for HBV was a history of drug use in lifetime (adjusted odds ratio, AOR: 1.8, 95% CI: 1.17-3.02). The main risk factors for HCV exposure were a history of drug use in lifetime (AOR: 4.08, CI: 2.56-6.27), age over 30 (AOR: 2.68, CI: 2.01-3.56), and having tattoos (AOR = 1.67, CI: 1.35-2.07). CONCLUSION: Although vaccination is used to control HBV among prisoners, prevalence of HCV exposure is alarming in the prison population of Iran, especially among people who inject drugs. Eliminating viral hepatitis in Iran by 2030 requires a national commitment and rapid measures for targeting this high-risk group. Given the increased efficiency of HCV treatment in recent years, prisons provide an opportunity to access patients for treatment.

Period prevalence and reporting rate of medication errors among nurses in Iran: A systematic review and meta-analysis.

AIMS: To estimate the 1-year period prevalence of medication errors and the reporting rate to nurse managers among nurses working in hospitals in Iran. BACKGROUND: Medication errors are one of the main factors affecting the quality of hospital services and reducing patient safety in health care systems. METHOD: A literature search from Iranian and international scientific databases was developed to find relevant studies. Meta-regression was used to identify which characteristics may have a confounding effect on the pooled prevalence estimates. RESULTS: Based on the final 22 studies with 3556 samples, the overall estimated 1-year period prevalence of medication errors and its reporting rate to nurse managers among nurses were 53% (95% confidence interval, 41%-60%) and 36% (95% confidence interval, 23%-50%), respectively. The meta-regression analyses indicated that the sex (female/male) ratio was a statistically significant predictor of the prevalence of medication errors (p < .05), but not of the prevalence of reporting medication errors to nurse managers. CONCLUSION: The period prevalence of medication errors among nurses working in hospitals was high in Iran, whereas its reporting rate to nurse managers was low. IMPLICATIONS FOR NURSING MANAGEMENT: Continuous training programmes are required to reduce and prevent medication errors among nursing staff and to improve the reporting rate to nurse managers in in Iran.

Service quality in Iranian hospitals: A systematic review and meta-analysis.

Background: This study aimed to explore service quality in Iranian hospitals by a systematic review and meta-analysis of the existing literature. Methods: The literature search in the international (PubMed, Scopus, and the ISI) and Iranian (SID, Iranmedex, and Magiran) scientific databases was conducted to identify studies (published in English and Persian) used the service quality gap (SERVQUAL) model to examine service quality in Iranian hospitals between 2000 and 2016. The databases were searched using a combination of the following keywords: "hospital service quality", or "healthcare service quality", and "SERVQUAL model", or "gap model", and "Iran". A random-effects meta-analysis model was used to investigate the quality of hospital care in Iran. Results: A total of 13 articles with 4,217 patients were included in the study. Results indicate that there are negative gap values between patients' expectations and perceptions in six SERVQUAL dimensions namely. tangibility, reliability, responsiveness, assurance, empathy, and access. The overall mean score of patients' expectations and perceptions of quality of hospital care in Iran were estimated 4.59 and 3.69, respectively (i.e., quality score gap= -0.9). The highest and lowest quality score gap values were related to the reliability and responsiveness dimensions, correspondingly. Conclusion: The study found that expectations of patients from hospital care have not been met in Iran. Thus, improving service quality in Iranian hospitals warrants further attention by health professionals, health policy-makers, and hospital managers.

Period Prevalence and Reporting Rate of Needlestick Injuries to Nurses in Iran: A Systematic Review and Meta-Analysis.

The purpose of this systematic review and meta-analysis was to provide a precise estimate of the period prevalence of needlestick injuries (NSI) among nurses working in hospitals in Iran and the reporting rate of NSI to nurse managers. We searched both international (PubMed, Scopus and the Institute for Scientific Information) and Iranian (Scientific Information Database, Iranmedex and Magiran) scientific databases to find studies published from 2000 to 2016 of NSI among Iranian nurses. The following keywords in Persian and English were used: "needle-stick" or "needle stick" or "needlestick," with and without "injury" or "injuries," "prevalence" or "frequency," "nurses" or "nursing staff," and "Iran." In a sample of 21 articles with 6,480 participants, we estimated that the overall 1-year period prevalence of NSI was 44% (95% confidence interval [CI], 35-53%) among Iranian nurses. The overall 1-year period prevalence of reporting NSI to nurse managers was 42% (95% CI, 33-52%). In meta-regression analysis, sample size, mean age, years of experience, and gender ratio were not associated with prevalence of NSI or reporting rate. The year of data collection was positively associated with period prevalence of NSI (p < .05), but not with the period prevalence of reporting NSI to nurse managers. Results indicated a high NSI period prevalence and low NSI reporting rate among nurses in Iran. Thus, effective interventions are required in hospitals in Iran to reduce the prevalence and increase the reporting rate of NSI. © 2017 Wiley Periodicals, Inc.

Evaluation of screen time activities and their relationship with physical activity, overweight and socioeconomic status in children 10-12 years of age in Sanandaj, Iran: A cross-sectional study in 2015.

Background: Screen time (ST), including watching television and playing electronic games are the leading cause of a growing obesity epidemic. This study aimed to evaluate ST and its association with physical activity, overweight and socioeconomic status (SES) in children 10 to 12 years of age in Sanandaj. Methods: This study was designed as a cross-sectional study, which was conducted in Sanandaj in 2015. ST and physical activity data were collected using the Modifiable Activity Questionnaire (MAQ). Overweight indices are defined based on BMI age- and gender-specific percentiles, as proposed by WHO criteria. Considering household assets data, SES was calculated using principal component analysis (PCA). The relationship between ST and different determinants was assessed using logistic regression analysis. Results: Based on the results obtained in our study, 47.28% (95% CI: 45.33-49.24) of the participants spent more than two hours a day on television and video watching and electronic games playing. People who spend greater time on ST activities, independent of their physical activities, are more susceptible to overweight and obesity (p=0.002). People in higher socioeconomic groups spent more time on watching TV and video and playing electronic games (p=0.001). There was a direct relationship between the residential area and ST (P=0.052). ST in male was found to be greater (p=0.033). In addition, ST was also lower in school-aged children whose mothers had a greater education (p=0.56). Conclusion: Based on the results of this study, it is recommended to increase the education level and knowledge of mothers and design interventions consistent with children gender and residential location so that to reduce ST and its associated outcomes in children.

Comparative efficacy of methylphenidate and atomoxetine in the treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review and meta-analysis.

BACKGROUND: The aim of this study was to directly compare efficacy of atomoxetine and methylphenidate in treatment of children and adolescents 6- 18 years. METHODS: All published, randomized, open label or double blind trials, comparing the efficacy of methylphenidate with atomoxetine in treatment of children diagnosed with ADHD, using DSM-IV criteria were included in this study; ADHD Rating Scale-IV-Parent Version: Investigator Administered and Scored (ADHDRS) scores was used. The standardized mean difference (SMD) was used as a measure of effect size. RESULTS: Eleven studies were included with a total of 2,772 participants. The meta-analysis did not find a significant difference in the efficacy between methylphenidate and atomoxetine (SMD= 0.09, 95% CI -0.06, 0.25) (Z= 1.18, p= 0.24). Sub group analysis showed a significant standardized mean difference favoring OROS methylphenidate (SMD= 0.31, 95% CI 0.16, 0.47 (Z= 3.91, p< 0.0001); immediate release methylphenidate was not superior to atomoxetine (SMD= -0.05, 95% CI -0.20, 0.10) (Z= 0.68, p= 0.49). Open label trials did not make a difference in the standardized mean difference (SMD= 0.10, 95% CI -0.02, 0.23) (Z= 1.17, p= 0.09). There was significant heterogeneity among the studies (p= 0.003, I2= 63%). Subgroup analysis demonstrated that heterogeneity was because of the open label trials (p= 0.009, I2= 79%). CONCLUSION: Atomoxetine and methylphenidate showed comparable efficacy in the treatment of children and adolescents with ADHD. However, Osmotic (Controlled) Release Oral (Delivery) System (OROS) methylphenidate is more effective than atomoxetine in treatment of ADHD in children and adolescents that is suggested as a first-line treatment in ADHD. Moreover, comparing the immediate release (IR) methylphenidate to atomoxetine did not lead to the benefit of IR methylphenidate.

Relationship between Vaginal Bacterial Infections and Pregnancy Outcomes: A Systematic Review and Meta-Analysis.

Background: Bacterial infections are among the most serious infections worldwide. They can cause miscarriage, premature birth, stillbirth, and ectopic pregnancy in pregnant women. The aim of this study was to investigate the relationship between bacterial infections and pregnancy outcomes through a systematic review and meta-analysis. Materials and Methods: PubMed, Scopus, Web of Science, and Embase databases were searched from January 2000 to December 2018 using appropriate keywords to identify related articles. The final related studies were selected and evaluated using the Newcastle-Ottawa Scale (NOS). Results: Results of this meta-analysis based on combining case-control studies showed that the presence of bacterial infections could lead increase in the odds of all pregnancy outcomes like premature infant birth (odd ratio [OR]: 1.50; 95% Confidence Interval [CI], 1.39-1.61), preterm delivery (OR: 1.54; 95% CI, 1.39-1.70), abortion (OR: 1.16; 95% CI, 1.04-1.29), stillbirth (OR, 1.29; 95% CI, 1.12-1.49), and ectopic pregnancy (OR: 1.12; 95% CI, 1.05--1.19). The results showed that the Risk Ratio (RR) of preterm delivery in pregnant women with vaginal infections was 1.57 (95% CI, 1.46-1.67), whereas the RR of abortion was 2.02 (95% CI, 1.72-2.38). Conclusions: Based on the results of this meta-analysis, the presence of bacterial infections in pregnant women can lead increase in the risk of pregnancy outcomes especially, preterm delivery, abortion, stillbirth, and ectopic pregnancy. Therefore, it is necessary for obstetricians and gynecologists to pay attention to the diagnosis of these infections in women before pregnancy and during pregnancy in order to prevent the consequences of these infections.

Socioeconomic inequalities in metabolic syndrome and its components in a sample of Iranian Kurdish adults.

OBJECTIVES: The worldwide incidence of metabolic syndrome (MetS) has increased in recent decades. In this study, we investigated the socioeconomic inequalities associated with MetS and its components in a sample of the Iranian Kurdish population. METHODS: We used data from 3,996 participants, aged 35 years to 70 years, from the baseline phase of the Dehgolan Prospective Cohort Study (February 2018 to March 2019). The concentration index and concentration curve were used to measure inequality and the Blinder-Oaxaca decomposition method was used to examine the contribution of various determinants to the observed socioeconomic inequality in MetS and its components. RESULTS: The prevalence of MetS was 34.44% (95% confidence interval [CI], 32.97 to 35.93). The prevalence of MetS was 26.18% for those in the highest socioeconomic status (SES), compared with 40.51% for participants in the lowest SES. There was a significant negative concentration index for MetS (C=-0.13; 95% CI, -0.16 to -0.09), indicating a concentration of MetS among participants with a lower SES. The most prevalent component was abdominal obesity (59.14%) with a significant negative concentration index (C=-0.21; 95% CI, -0.25 to -0.18). According to decomposition analysis, age, gender, and education were the highest contributing factors to inequality in MetS and its components. CONCLUSIONS: This study showed socioeconomic inequality in MetS. People with a low SES were more likely to have MetS. Therefore, policymakers and health managers need to develop appropriate strategies to reduce these inequalities in MetS across age groups, genders, and education levels, especially among women and the elderly.

The relationship between microbial contaminations of embryo transfer catheters with pregnancy outcome after embryo transfer.

Background: Different stages of assisted reproductive technologies are susceptible to contamination by various microorganisms. Objective: The aim of the study was to investigate the relationship between microbial contamination of embryo transfer catheters and the pregnancy outcome after embryo transfer. Methods: This cohort study was conducted on 60 patients candied for in vitro fertilization and embryo transfer cycles from 2021 to 2022. All embryos were transferred using a sterile syringe. The catheter contamination was checked by the microbial culture method, and in the case of microbial culture that were negative, polymerase chain reaction was done to confirm the result. The data analyzed using STATA 17 to determine the impact of catheter contamination on the clinical pregnancy rate. Results: The average age of peoples whose microbial culture was positive was lower than that of people whose microbial culture was negative (P<0.05). Also the results showed that people who live in villages have more positive microbial cultures than people who live in cities (P<0.05). Also there is no difference between the number of successful implantations and the pregnancy outcome between people whose microbial culture results were positive or negative. Conclusion: The results of the current study showed that the contamination of the embryo transfer catheter with microorganisms under our investigation did not affect the pregnancy outcome.

ptk2 and mt2a Genes Expression in Gastritis and Gastric Cancer Patients with Helicobacter pylori Infection.

Background: ptk2 and mt2a genes contribute to the cell cycle during proliferation and apoptosis, respectively. Designing a case-control study including gastric adenocarcinoma and gastritis patients with and without Helicobacter pylori infection would lead to determinate of the correlations between ptk2 and mt2a genes expression with H. pylori infection in gastric antral epithelial cells. Methods: Overall, 50 and 30 gastric antral biopsy samples of gastric cancer (case group) and gastritis (control group) patients were included into study, respectively. All biopsy samples were collected considering the exclusion criteria including patients with a history of consumption of tobacco, alcohol, and anti-H. pylori drugs. Each patient group is divided into with and without H. pylori infection to detect cDNA fold changes of ptk2 and mt2a genes by using Real Time RT PCR. Furthermore, the presence of H. pylori virulence genes was detected directly by using specific primers and simple PCR on cDNA synthesized from total RNA of gastric antral biopsy samples. Results: A negative correlation was revealed between age and clinical manifestations with the ΔCt value of the ptk2 gene (P < 0.05). The H. pylori iceA1/2 and cagE genes revealed positive and negative correlations with the ΔCt value of the ptk2 gene (P < 0.05), respectively. Furthermore, a weak correlation was detectable between H. pylori babA2/B, oipA, and cagY genes and the ΔCt value of the mt2a gene in gastric antral epithelial cells of patients (P < 0.1). Conclusions: The results of the current study opened a view for more investigation on the stunning roles of H. pylori infection in clinical outcomes through mt2a and ptk2 gene expression in gastric antral epithelial cells.

The association between methamphetamine use and number of sexual partners in men who have sex with men: a systematic review and meta-analysis.

BACKGROUND: Methamphetamine use in men who have sex with men population is significantly higher than that in the general population. Meth use can cause high-risk sexual behaviors, such as having sex with a variety of sexual partners. The aim of this study was to determine the association between meth use and the number of sexual partners in MSM. METHODS: Searching international databases (PubMed (Medline), Scopus, Web of Sciences, Embase (Elsevier), PsycInfo (Ovid), Cochrane CENTRAL (Ovid)) until March 2021 was performed in this meta-analysis using appropriate keywords terms to identify related articles. After retrieving articles in these databases, screening was performed based on the title, abstract and full text of the articles, and the final related studies were selected and evaluated using the Newcastle Ottawa scale checklist. RESULTS: The sample size consisted 18,455 people in this study, including four cohort studies with a sample size of 15,026 MSM and four case-control studies with a sample size of 3429 MSM. The results of meta-analysis showed that meth use increased the number of sexual partners in MSM (RR: 3.70; % 95 CI: 2.04-6.70). The results of subgroup analyze based on the number of sexual partners showed that in MSM taking meth, the risks of having one to three, four to five, and six or more than six sexual partners were respectively 2.82, 2.98 and 5.89 times higher than those in MSM who did not take meth. CONCLUSION: The results showed that meth uses in MSM increased the number of their sexual partners. Due to the fact that increasing the number of sexual partners and high-risk sexual behaviors increase the risk of contracting sexually transmitted diseases such as HIV, it is necessary to adopt control programs to prevent meth use by this group, or to implement programs of reduction in the risk of STIs for this group.

Comparing the Effect of Ondansetron-dexamethasone and Metoclopramide-dexamethasone on Postoperative Nausea and Vomiting after Gynecological Laparoscopy: A Randomized Double-blind Clinical Trial.

Background: Nausea and vomiting is a common complication after gynecological surgeries, especially laparoscopy, which can lead to discomfort and restlessness in the patients. The aim of the study was to compare the effect of ondansetron-dexamethasone and metoclopramide-dexamethasone on postoperative nausea and vomiting following gynecological laparoscopy. Materials and Methods: In this double-blind clinical trial, 68 females scheduled for gynecological laparoscopy and age range of 18-40 years were randomly divided into two groups. Group OD received ondansetron 4 mg plus dexamethasone 8 mg and group MD received metoclopramide 10 mg plus dexamethasone 8 mg, 15 min before the end of surgery. The incidence of nausea and vomiting and need for rescue medication was assessed during the recovery period, as well as at 2, 4, 6, 12, and 24 h after surgery. The data were analyzed using STATA software version 12 and a significance level of <0.05 was considered in this research. Results: The incidence of nausea in ondansetron and metoclopramide groups was 23.3% and 33.3%, respectively, and the frequency of vomiting was 10% and 16.6%, respectively, which showed no significant difference (P > 0.05). The highest incidence of nausea and vomiting in patients belonged to the metoclopramide group inside 4-6 h after surgery. Conclusion: Our study showed that no significant difference was observed in the incidence of nausea and vomiting between ondansetron-dexamethasone and metoclopramide-dexamethasone groups following laparoscopic gynecological surgery; however, the number of patients with nausea and vomiting was lower in the ondansetron-dexamethasone group.

Effect of calcium hydroxide on morphology and physicochemical properties of Enterococcus faecalis biofilm.

Calcium hydroxide Ca(OH)2 has been used as an intracanal medicament to targets microbial biofilms and avert secondary infection in the root canal system. This study evaluated the effects of this material on the morphology and physicochemical properties of an established in-vitro biofilm of Enterococcus faecalis. A biofilm of E. faecalis was grown in multichannel plates. The chemicals including Ca2+, OH-, and saturated Ca(OH)2 (ie 21.6 mM) were prepared in order to evaluate which component eradicated or amplified biofilm structure. Various biochemical and microscopic methods were used to investigate the properties of the biofilm. Biofilms treated with Ca(OH)2 absorbed more Ca2+ because of the alkaline pH of the environment and the ions affected the physicochemical properties of the E. faecalis biofilm. A denser biofilm with more cavities and a granular surface was observed in the presence of Ca2+ ions. This resulted in a decrease in the surface-to-biofilm ratio with increases in its biomass, thickness, colony size, and volume. Calcium hydroxide did not destroy E. faecalis biofilms but rather contributed to the biofilm structure. This in-vitro study sheds light on a missing link in the formation of E. faecalis biofilm in which the Ca2+ in Ca(OH)2.

Effect of Multimodal Intervention on Nursing Students' Adherence to Hand Hygiene: An Experimental Study.

BACKGROUND: Hand hygiene adherence is highly important in clinical practice and is influenced by various factors. AIMS: This study investigated the effect of multimodal intervention on nursing students' adherence to hand hygiene in clinical practice. METHODS: Internship nursing students were randomized into control (n = 20) and intervention (n = 26) groups. Adherence to hand hygiene was measured by self-report questionnaire and by observation. The intervention group received multimodal interventions for 1 week. FINDINGS: Results showed significant effects of multimodal intervention on adherence to hand hygiene in "before contact with the patient," "before and after contact with the patient" situations, and at the beginning of medication administration, catheterization, vital sign measurement, and blood sugar testing. CONCLUSION: The multimodal intervention improved adherence to hand hygiene in the intervention group. Given the importance of hand hygiene adherence by nursing students in all situations, designing and implementing context-based multimodal interventions are recommended as part of nursing students' educational programs.

Investigating patients' attitudes toward receiving care from an opposite-gender nurse.

BACKGROUND: The imbalance in nurse-to-patient ratio and limited physical space may lead to care provision by a nurse of the opposite gender. On the other hand, the relationship with the opposite gender in Iran is limited due to cultural and religious beliefs. The aim of this study was to investigate patients' attitudes toward receiving care from the opposite gender nurse. MATERIAL AND METHOD: This descriptive cross-sectional study was carried out on 200 patients admitted to different hospital wards. The patients were recruited using convenience sampling. Data collection tools comprised of a demographic questionnaire and a researcher-made questionnaire. Data were analyzed using SPSS (version 16) and running descriptive statistics (i.e., χ2 , independent t test, and linear regression analysis). RESULTS: Male and female patients had 31.8% and 42.6% negative attitudes toward receiving care from the opposite gender, respectively, indicating a statistically significant difference (p = .05). Patients' attitudes had a significant and positive relationship with age, level of education, and experience of receiving care from a nurse of the opposite gender. CONCLUSION: A significant percentage of patients had a negative attitude toward receiving care from the opposite-gender nurse. Since people's attitudes affect their relationships, it is necessary to provide conditions for assigning the same gender nurse for patients and improving patients' attitudes toward nurses of the opposite gender.

Comparison of the effect of oral pregabalin with intravenous ketamine on reducing acute pain after abdominal hysterectomy: A randomized double-blind clinical trial.

BACKGROUND: The aim of this study was to compare the analgesic effects of pregabalin and ketamine on reducing pain after abdominal hysterectomy. METHODS: In this double-blind clinical trial, one hundred forty ASA I and II patients of age range 30-60 years scheduled for abdominal hysterectomy undergoing general anesthesia in 2018, were randomly divided into 4 equal groups. Pregabalin group received 300 mg oral pregabalin, ketamine group received 0.3 mg/kg of intravenous ketamine, and pregabalin- ketamine group received the combination of the two-above medication, and placebo group received the placebo and saline. Patients were evaluated for pain intensity according to the visual analogue scale (VAS) at 2, 4, 6, 12, 18, and 24 hours after surgery. Also, the need for analgesic drugs and the frequency of repetitions were also recorded. Statistical analysis was performed using STATA, Version 14. A p- value less than 0.05 was considered statistically significant. RESULTS: In the pregabalin and pregabalin-ketamine groups, pain in the first 6 hours after the end of operation was significantly less than the other two groups (p<0.05), but there was no significant difference between the 4 groups at 18 and 24 hours after surgery. The need for analgesic medications in the pregabalin group was lower than in other groups (p<0.05). CONCLUSION: The results of this study show that the administration of oral pregabalin with and without intravenous ketamine before abdominal hysterectomy can decrease postoperative pain and reduce the need for analgesia.