Effect of Convalescent Plasma Therapy on Clinical Improvement of COVID-19 Patients: A Randomized Clinical Trial.

Background: Due to the critical condition of COVID-19, it is necessary to evaluate the efficacy of administrating convalescent plasma to COVID-19 patients. Therefore, we decided to design a clinical trial to investigate the effect of convalescent plasma of patients recovered from COVID-19 on the treatment outcome of COVID-19-infected patients. Materials and Methods: In this parallel randomized controlled clinical trial, patients in the intervention group received standard treatment plus convalescent plasma of patients recovered from COVID-19. We allocated 60 patients to each treatment group through balanced block randomization. Then, COVID-19 outcomes, vital signs, and biochemical parameters were compared between the two treatment groups by the independent t test and ANCOVA. Results: The mean age (SD) of the patients in the intervention and standard treatment groups was 52.84 (15.77) and 55.15 (14.34) years, respectively. Although patients in the intervention group reported more hospitalization days (11.45±5.86 vs. 10.42±6.79), death rates (26.67% vs. 18.13%), ICU admission (45 vs. 41.67%), and ARDS (11.67% vs. 3.33%), these differences were not statistically significant (P>0.05). Moreover, the two groups were homogenous in vital signs and biochemical parameters before and after treatment (P>0.05). Conclusion: The present study indicated that convalescent plasma therapy has no significant effect on the survival, hospitalization, and ICU admission of COVID-19 patients.

Fall-related hospitalization of patients in Iran.

PURPOSE: Trauma has been called the neglected disease of modern society. According to WHO, fall is the second major cause of trauma or deaths resulting from unintentional accidents. The aim of this study was to investigate the different types of fall according to International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) in hospitalized patients visiting specialized accident and trauma hospitals of Mashhad, Iran. METHODS: This was a cross sectional retrospective study performed between March 20, 2013 and March 20, 2014. The research population consisted of all medical records of patients for fall injuries in three specialized accident and trauma hospitals. ICD-10 was adopted to categorize all types of falls (w00-w19). The results obtained were analyzed by SPSS 16. RESULTS: Altogether 7,448 cases were included. The codes w18 (fall on same level) and w09 (fall involving playground equipment) with the frequencies of 1,856 and 1,303, respectively in both genders had the maximum number of falls. The maximum percentage of mortality has been related to "fall on and from ladder"," fall from cliff "and "fall on same level involving ice and snow". CONCLUSION: As falls can cause irrecoverable injuries including mortality of people, thus health authorities and policymakers should take preventive measures given the causes of falls and the root of this type of injuries, so that the costs resulting from this cause and its injuries can be reduced.

A survey of perceptions, attitudes and practices regarding the antibiotic prescription among Iranian physicians.

Background: Over-prescription and overuse of antibiotics are a major cause of concern in terms of healthcare and economic implications, as well as the emergence of microbial resistance worldwide. So far, efforts have been administered by many countries to regulate the consumption of antibiotics and overcome the rapid emergence of resistant bacteria. Assessment of the perspectives and behavior of physicians can play a major role in achieving this objective. Objectives: The objective of the present study was to assess the perspectives on the antibiotic prescription practice of physicians and evaluate their tendency to receive feedback on their performance in outpatient settings. Materials and methods: Attitudes and practices of 330 physicians on antibiotics prescription were evaluated using a validated questionnaire in 2014 in Mashhad, Iran. Results: 94% of physicians asserted that the prescription rate of antibiotics in Iran is higher than the global average. Physicians noted that "patients' tendency to prescribe antibiotics" is the primary reason of excessive prescription of antibiotics. Approximately, 84% of physicians were keen on receiving performance feedback. More than 71% of participants specified Short Message Service (SMS) notification as their preferred medium for receiving feedback. Conclusions: The dominant viewpoint of physicians was that the rate of antibiotics prescription in Iran is larger than the global average, which can lead to adverse economic and bacterial resistance consequences. Interventions such as 'performance feedback' have the potential to reduce antibiotics over-prescription.

Concerns and hopes about outsourcing decisions regarding health information management services at two teaching hospitals in Semnan, Iran.

BACKGROUND: Changes in health programs in Iran have led to an increase in administrative costs. One cost-saving option available to hospital administrators is to outsource administrative services. OBJECTIVE: This study aimed to explore the attitudes of hospital staff towards outsourcing health information management services in advance of a decision being taken, to assist healthcare organisations to assess the potential benefits and challenges of outsourcing such services. METHOD: Six hundred and four clinical and allied health employees in two hospitals in Iran, who had had prior experience with outsourcing hospital services, responded to a survey designed to measure staff attitudes towards outsourcing health information management services, based on their perceptions of potential costs and benefits for the organisation and their own employment prospects. A 16-item attitude scale, developed by the researchers, was used in the study and demographic data were also collected. RESULTS: Summary statistics showed that approximately one third of the sample (34.53%) had a negative view of outsourcing, one third (35.16%) had a positive view, and 30.31% were neutral. An exploratory factor analysis of items on the attitude scale identified three underlying constructs, labelled: data security and management; workplace environment; and staff and customer satisfaction. One item (concern about the impact of outsourcing on staffing levels) did not load on any of the factors. A separate analysis of this single item showed a significant relationship between the sex of participants and their views on the impact of outsourcing on the number of hospital staff employed (p<0.05). CONCLUSION: While results of this study indicated that staff in hospitals surveyed held both positive and negative views of outsourcing, a large number of staff in these hospitals (a third of the total sample) had reservations about the skills of outside providers to securely manage hospital data, and did not consider that outsourcing health information management services would be positive for the organisation, their working environment or for staff and patient satisfaction. These findings have important implications for healthcare organisations planning to outsource health information services. Further research that focuses on communication skills of senior managers and their ability to provide team leadership is needed, as is research into the impact of geographical location and current market forces that impact on outsourcing tasks.