Healthcare-associated infections in Iranian pediatric and adult intensive care units: A comprehensive review of risk factors, etiology, molecular epidemiology, antimicrobial sensitivity, and prevention strategies during the COVID-19 pandemic.

The current review article provides a comprehensive analysis of nosocomial infections in pediatric and adult intensive care units (ICUs) in Iran. We examine the risk factors and etiology of nosocomial infections, with a particular focus on molecular epidemiology and antimicrobial sensitivity. In this article, we explore a range of prevention strategies, including hand hygiene, personal protective equipment, environmental cleaning, antibiotic stewardship, education, and training. Moreover, we discuss the impact of the COVID-19 pandemic on infection control measures in ICUs and provide valuable insights for healthcare professionals and policymakers seeking to address this critical public health issue. In conclusion, this review article can serve as a valuable resource for those interested in understanding and improving infection control in ICUs and beyond.

The Importance of Evaluating Serum Levels of Tumor Markers M2-PK and Inhibin A in Patients Undergoing Colonoscopy.

Despite the use of colonoscopy to detect colon cancer due to its aggressiveness, high cost, and lack of patient compliance, the use of laboratory tests with high accuracy and sensitivity, such as tumor marker M2-PK and Inhibin A is recommended and can be effective for early diagnosis and screening of patients in the early stages. We studied 46 patients admitted it the gastrointestinal ward of Amir al Momenin Hospital and 45 normal (age and sex-matched) subjects as a control group (case-control and retrospective studies). Before the colonoscopy, the level of tumor marker M2-PK in the stool sample and the serum level of Inhibin A were evaluated in patients and the control group. The level of tumor marker M2-PK was significantly higher in the group with hyperplastic polyps and colon cancer (P < .001) than in the control group. At the same time, there was no significant difference in Inhibin A level (P = .054). In the hyperplastic polyps group 73% and in the colorectal cancer group 27% had a positive immunochemical fecal occult blood (IFOBT) result, significantly higher than the control group (P < .001). Evaluation of the level of tumor marker M2-PK in the stool sample in association with the three-time iFOBT test method may be suggested as a quick and noninvasive method for screening and diagnosis of polyps and early stages of colon cancer.

Do Medical Sciences Students Have the Proper Knowledge, Attitude, and Practice, Regarding the Complementary and Alternative Medicine in Iran?

Background: The increasing use of complementary and alternative medicine (CAM) has changed expectations of healthcare professionals concerning the knowledge, attitude, and practice of CAM. The present study aimed to investigate the knowledge, attitude, and practice of students of Arak University of Medical Sciences (Iran) in 2020 concerning CAM. Methods: The present descriptive cross-sectional study was conducted on 226 medical sciences students using targeted quota sampling. The data collection tool was a researcher-made questionnaire based on valid scientific articles and literature. The questionnaire was comprised of 92 items and assessed students' knowledge, attitude, and practice regarding CAM. Results: The study participants' mean CAM knowledge and attitude scores were 14.12±6.1 and 58.7±29.28, respectively. The primary information sources included mass media, the internet, and friends. Most participants (63.4%) were willing to use CAM methods. The most common CAM was herbal therapy (29.1%), and the most common reason for using, was gastrointestinal problems (39.2%). Conclusion: The participants indicated moderate knowledge and poor attitude regarding CAM. Thus, considering the extensive application of CAM methods among the participants and their insufficient knowledge and inappropriate attitude, that is recommended to include CAM methods be included besides the conventional medicine, in the academic curriculum of students of medical sciences.

Effect of stachys lavandulifolia on occupational stress in emergency medical technicians.

OBJECTIVE: According to studies, occupational stress is quite prevalent among Emergency Medical Technicians (EMTs). On the other hand, it has been shown that Stachys lavandulifolia, also known as the Mountain Tea in Iran, has anxiolytic properties. Considering the current increasing trend of using remedies based on alternative medicine for stress management, the present clinical trial intended to investigate the effect of Stachys lavandulifolia on occupational stress in EMTs METHODS: The present study included 60 EMTs working in Arak, Markazi province, Iran, who were randomly divided into study and control groups. The study group was treated with tea made of Stachys lavandulifolia (2 g daily) for 2 months, while the control group was treated with black tea. Moreover, the level of occupational stress in the study participants was assessed using the Hospital Stress Scale (HSS-35) before and after the intervention. Data analysis was performed using the SPSS software version 22. RESULTS: According to our results, the mean occupational stress score was significantly decreased in the study group after the intervention (p < 0.05). Moreover, the post-intervention scores were significantly lower in the study group compared to the control group (p < 0.05). However, there was no significant change in occupational stress in the control group after the intervention (p > 0.05). CONCLUSION: In combination with other stress-relieving options, the tea made of Stachys lavandulifolia can be used as a complementary therapy for alleviating occupational stress in EMTs.

Therapeutic effects of magnesium and vitamin B6 in alleviating the symptoms of restless legs syndrome: a randomized controlled clinical trial.

BACKGROUND AND OBJECTIVE: Restless legs syndrome/Willis-Ekbom Disease (RLS/WED) is one of the most prevalent sleep disorders. There are contradicting data about the effectiveness of magnesium and vitamin B6 in alleviating the symptoms of this condition. Therefore, this study aimed to assess the efficacy of magnesium and vitamin B6 in alleviating the symptoms of RLS/WED. METHODS: A single-blind study was conducted on individuals with this illness for at least three months. Randomly, 75 patients were assigned into three groups: magnesium, vitamin B6, and placebo. The experimental group received daily doses of 40 mg vitamin B6 or 250 mg magnesium oxide. While others in the control group merely received a placebo. Patients' disease severity and sleep quality were evaluated three times using standard questionnaires (at the beginning of the study, one and two months after therapy). Utilizing SPSS22 software and the ANOVA, t-test, and repeated measure tests, statistical analysis was conducted. RESULTS: The mean and standard deviation of sleep quality and disease severity at the beginning of the trial and throughout the first month following the intervention did not differ statistically between the three groups. In the second month following the intervention, the mean and standard deviation of sleep quality and disease severity were significantly different (P = 0.001). CONCLUSION: Taking magnesium and vitamin B6 supplements can reduce the severity of symptoms of RLS/WED patients and improve their sleep quality.

Gefitinib-loaded polydopamine-coated hollow mesoporous silica nanoparticle for gastric cancer application.

Gastric cancer is a common malignancy that is the second cancer-associated mortality worldwide. This study aimed to develop a pH-sensitive drug delivery system including hollow mesoporous silica nanoparticles (HMSNs) loaded with gefitinib (GB) and encapsulated with mussel-inspired polydopamine (PDA) (HMSNs-GB-PDA) for the treatment of gastric cancer; where the HMSNs mainly function as drug storage platforms, and GB interrupts signaling through the epidermal growth factor receptor (EGFR) in cancer cells. In addition, PDA was used as an anticancer factor, mucoadhesive enhancing agent, stimuli, and gatekeeper to mediate the GB release. The drug delivery kinetics (in vitro), mucoadhesive properties (ex vivo), and cytocompatibility in both healthy (HGF) and gastric cancer (AGS) cell lines of this formulation were also investigated. The results showed that HMSNs-GB-PDA not only selectively killed AGS cells but also had no toxic effect on HGF cells, in such a way that more than 70% of AGS cells were eliminated at a GB concentration of 150 ug/ml, whereas only about 15% of HGF cells were killed at the same concentration. In addition, the PDA coating served as a gatekeeper, inhibited burst release, and resulted in a sustained release that lasted for a long time. The ex vivo mucoadhesiveness evaluation revealed the high mucoadhesive property (93.88%) of PDA-coated nanocarriers. According to the results, the suggested HMSNs-GB-PDA could potentially be used to treat gastric cancer.

Social Support and Meaning of Life in Women with Breast Cancer.

Background: Social support is known as an affection-oriented coping mechanism when a person is involved with cancer. Therefore, this study was conducted to investigate the relationship between family social support and the meaning of life in women with breast cancer. Methods: In this cross-sectional study, 84 women with a mean age of 60 (SD = 5.7) years with breast cancer who were admitted to a teaching hospital participated. Data were collected using social support and meaning of life questionnaires. After collecting the completed questionnaires and entering the data into the computer, the analysis was performed using SPSS software and using t-test, ANOVA, and Pearson correlation test at a significant level of 0.01. Results: The mean score of their social support was 39.35 ± 9.51, respectively and the meaning of life was 29.5 ± 7.49. ANOVA results indicated that the social support score and meaning of life had no significant relationship with any of the demographic variables. Also, the findings suggest that there is a statistically significant correlation between social support and the meaning of life (r = 0.773, P < 0.001). Conclusion: It is proposed to increase the level of social support from the family to help improve the meaning of life in cancer patients.

Comparison of the Antimicrobial Effect of Zataria Multiflora Essence and Deconex Surface on Microbial Load of Emergency Ambulances.

This study aimed to compare the antimicrobial effect of Deconex Surface, a common disinfectant, and Zataria multiflora essence on microbial load of Emergency ambulance equipment in Iran. The samples were selected from all the ambulances through convenience sampling. Before the intervention, the cultures were obtained from the contact surfaces and the surfaces were then disinfected with Deconex and Zataria multiflora. Then, repeated cultures were obtained from the same surfaces. Next, the samples were immediately sent to a microbiology lab. The obtained data were entered into SPSS 2016 and analyzed using statistical tests. Results showed that disinfecting effect of Zataria multiflora is better than Deconex in eliminating certain bacterial species such as Staphylococcus and Bacillus. So Zataria multiflora essence can be used as a surface and hospital equipment disinfectant along with other disinfectant compounds.

Transcendence, the Most Important Spiritual Need of Muslim Older Adults: A Content Analysis Study.

Healthcare providers agree that promoting spirituality among older adults while caring for them increases their quality of life. However, there is little knowledge about the spiritual needs of the elderly, especially in the Muslim community. This qualitative study attempted to explore the spiritual needs of Muslim older adults. Fifteen non-hospitalized Muslim older adults from Hamadan City, Iran, were interviewed. The semi-structured interviews were analyzed using conventional content analysis. After identifying semantic units from the text, related codes were extracted and placed in subcategories and categories based on their similarities. Once the data were analyzed, one theme was formed. The study's findings showed that the spiritual needs of older adults fell into three main categories: religious needs, the need for transcendence, and the need for connection. Religious needs included subcategories of religious practices and beliefs, and the need for transcendence included the search for meaning and purpose in life, and the need for peace and stability and balance. Also, the need for connection included the need to connect with nature and connect with others. Healthcare professionals and family caregivers should be trained in the specific competence of recognizing older people's unmet spiritual needs and fulfilling them.

Spiritual Care in Hospitalized Patients in Iran: An Action Research Study.

Religious practices can raise the sense of merit and hope through overcoming the feeling of isolation. Studies conducted in this area have indicated that patients may desire to have their spiritual needs met. Nonetheless, sufficient attention has not been paid to these special needs. Therefore, this study aimed to identify the barriers to the provision of spiritual care for hospitalized patients. This is an action research study in which a total of 11 nurses and 76 hospitalized patients were recruited using purposive and convenience sampling, respectively. Data were collected using a combination of qualitative and quantitative methods. In the action cycles, the participants' concerns were examined, constructed, then evaluated, and re-constructed using reflective assessment. The qualitative and quantitative data were analyzed using the content analysis approach and the Mann-Whitney U, Chi-squared, and t-tests, respectively. At the first stage, the results of the content analysis showed the lack of professional knowledge and the existence of organizational barriers in the provision of spiritual care for patients. Reflection in the final stage led to the discovery of four concepts including (a) perceived advantages of change in performance, (b) being capable of providing spiritual care, (c) getting positive feedback, and (d) preparation for improving the provision of spiritual care. The results of the quantitative analysis indicated a significant increase in the mean score of patient satisfaction after the provision of spiritual care (p = .001). The results of this study led the authors to a deeper understanding of various dimensions of spiritual care among patients hospitalized in the cardiology ward and ultimately improved the patients and their families' level of satisfaction.

Spiritual Needs of the Muslim Elderly Living in Nursing Homes: A Qualitative Study.

Paying attention to and meeting the needs of people who are elderly helps to improve their health. Caring for the elderly includes addressing their spiritual needs which has been less investigated. This study aimed to examine the spiritual needs of the Muslim elderly living in nursing homes. A qualitative study was conducted using conventional content analysis. Seventeen elderly people (nine women and eight men) were selected from four nursing homes in Iran using purposive sampling. The subjects were asked to participate in semi-structured interviews. The interview transcripts were analyzed using content analysis. First, semantic units were identified and then related codes were extracted and classified into categories and subcategories based on their similarities. Finally, themes were extracted from the data. The elderly's spiritual needs were classified into three main themes: religious needs, existential needs, and communication needs. Religious needs were divided into religious beliefs, individual religious practices, and collective religious practices. Existential needs were categorized as meaning of life, purpose of life, and need for peace. Communication needs were conceptualized to include relationship with God and relationship with others. It is argued that caregivers of the elderly should recognize the elderly's spiritual needs, including religious, existential, and communication needs, and attempt to maintain and promote the elderly's spiritual health.

Exploring the Process of Spiritual Health of the Elderly Living in Nursing Homes: A Grounded Theory Study.

BACKGROUND: Spiritual health is one of the important dimensions of the elderly's health, which plays an important role in other dimensions of their health. This study aimed to explain the process of spiritual health of the elderly living in nursing homes. METHODS: This grounded theory study was conducted in 4 nursing homes in the city of Arak Iran between October 2019 and September 2020. The participants were 24 elderly people living in nursing homes, two health care providers, one nurse and one family member, first selected through purposive sampling and then, through theoretical sampling. The data were collected through semi-structured interviews and field notes. All the interviews were transcribed verbatim and analyzed based on Strauss and Corbin approach (2008). RESULTS: Six main categories were identified, including helplessness, inefficient supportive environment, spiritual distress, seeking support, relative improvement of spiritual health and factors affecting spiritual health, each of which explains a part of the whole process of spiritual health of the elderly living in nursing homes. CONCLUSION: Supporting the elderly living in nursing homes is necessary in order to meet their spiritual needs and preserve and promote their spiritual health.

Education based on the health belief model to improve the level of physical activity.

PURPOSE: This study aimed to investigate the effect of education based on the health belief model on the physical activity of the staff of the University of Medical Sciences. METHODS: This semi-experimental study was conducted on 130 university staff aged 25-50 years from the Hamadan University of Medical Sciences. Inclusion criteria were having at least 1 year of work experience, lack of acute and chronic physical and mental illnesses, and not using drugs that affect physical activity. The samples were randomly divided into two groups. The experimental group received three training sessions based on the health belief model. Before and 2 months after training, the control and experimental groups were evaluated via the following questionnaires: (1) demographic information questionnaire, (2) Health Belief Model Questionnaire, and (3) International Physical Activity Questionnaire. Finally, data were analyzed statistically. RESULTS: The training process resulted in a significant increase in the mean scores of the health belief model constructs in the experimental group, but changes in the control group were not significant. Self-efficacy was the strongest predictor of physical activity. CONCLUSION: The health belief model is a useful model for improving individuals' understanding of the benefits of physical activity.

Prevention and Treatment of COVID-19 Using Traditional and Folk Medicine: A Content Analysis Study.

Background: Coronavirus 2019 (COVID-19) is a respiratory disease with no specific and definitive drug treatment. With the COVID-19 outbreak, traditional and folk methods were used for its treatment. This study was conducted to explore people's experiences of using traditional and folk medicine for the prevention and treatment of COVID-19 in Iran. Methods: This qualitative study was conducted on 37 people in Arak (Iran) from May to November 2020 using a conventional content analysis approach. The participants were selected using cluster sampling and interviewed using semistructured telephone interviews. After transcribing the interviews, they were analyzed using content analysis. Accordingly, semantic units were identified, related codes were extracted and placed in subcategories and categories based on similarities, and themes were formed. The interviews continued until data saturation. Results: After analyzing the collected data, 116 different codes were extracted and classified into two subcategories of pharmacological and non-pharmacological methods. Then, each of the subcategories was classified into two categories: conventional medicine and traditional medicine. Finally, two main themes were obtained, including prevention methods and self-treatment methods for COVID-19. Conclusion: People use various traditional and folk methods for COVID-19 prevention and treatment. Such methods can be either useful or lack the necessary effectiveness and have side effects. Thus, necessary training should be provided to the public about using these methods and avoiding unapproved treatments.

The effect of novel simple saffron syrup on fatigue reduction in patients with multiple sclerosis.

Objectives Multiple sclerosis (MS) is a progressive and often debilitating neurological disorder. This chronic disease has a high prevalence in the world and also in Iran. Fatigue is a common symptom of the disease, which causes serious mental and psychological discomfort. Simple saffron syrup, contains some compounds that can be effective in relieving the symptom. The object of this study is to investigate the effect of simple saffron syrup on fatigue in patients with MS. Methods This study is a pre-post study which evaluates the fatigue rate of MS patients (30 participants) according to the FSS scale. The participants were given a saffron simple syrup to consume a tablespoon (7.5 cc) every 8 h for two months. After 60 days of prescribing, patients are assessed for fatigue based on fatigue severity scale (FSS) criteria. Results One-way ANOVA showed that there was a notable difference between the mean score of fatigue in MS patients before and after the intervention (p<0.001). So, the fatigue severity of the subjects after saffron syrup consumption dropped dramatically for two months. (p<00.01). Conclusions According to the outcomes of this study, simple saffron syrup can be effective as an adjunct therapy for fatigue reduction in patients with MS due to effectiveness besides no significant side effects.

Correction to: Effects of relaxation on self-esteem of patients with cancer: a randomized clinical trial.

Cancellation of Open Access.

Effects of relaxation on self-esteem of patients with cancer: a randomized clinical trial.

BACKGROUND AND OBJECTIVES: Cancer is usually associated with decreased self-esteem. Relaxation is one of the most effective methods to promote self-esteem of patients with chronic diseases. Hence, the present study aimed to investigate the effects of relaxation on self-esteem of patients with cancer. METHODS: This randomized clinical trial was conducted on 80 patients with cancer. The samples were selected by convenience sampling method and were randomly divided into experimental and control groups. In the experimental group, the patients implemented relaxation techniques once a day for 30 min during 60 consecutive days in addition to receiving routine care, while patients in the control group received only routine care. Before and after the intervention, the Persian version of the Coopersmith Self-Esteem Inventory (CSEI) was completed. RESULTS: After the interventions, significant differences were observed between groups in favor of the relaxation group in total score of CSEI and all its subscales (P = 0.0001). In the experimental group, a significant increase in total score and all subscales of CSEI was observed after the intervention (P = 0.001), whereas in the control group, a significant decrease was found in all dimensions (P = 0.001). CONCLUSION: The relaxation seems to be potentially effective in promoting self-esteem of patients with cancer. Further studies, particularly randomized clinical trials with higher sample size and more power, are needed to confirm the obtained findings.

Is Emergency Medical Services (EMS) in Islamic Republic of Iran Practical and Efficient in Facing Ebola?

OBJECTIVE: To evaluate the efficacy and preparedness of Emergency Medical Services (EMS) in Islamic Republic of Iran to face Ebola. METHODS: The present study is cross-sectional and somehow descriptive. We used a standard questionnaire that was designed by "center for disease control and prevention". This questionnaire was captioned "Emergency Medical Services (EMS) checklist for Ebola preparedness". We collected a lot of data by studying that questionnaire and every manager in every province of Iran were informed about that info in 2016. This data was analyzed by using SSPP software version 16. RESULTS: Findings have showed the average score related to preparation level of EMS in facing Ebola in Iran was 63.73±12.77 percent. There was no significant difference between the country regions regarding the preparedness of to detect (p=0.975), protect (p=0.275) and respond (p=0.344) to ebola outbreaks.The highest score had been achieved by region number 5 and the lowest score belonged to region number 7. CONCLUSION: Although the acquired average score in this study is higher than standards, considering the increased threat of breaking out biologic threats especially Ebola infection, using and practicing some measures in order to enhance preparation level of Emergency Medical Services counter this infection and similar infectious diseases is inevitable.

Is the Treatment of Constipation Can Relieve the Migraine Symptoms? A Randomized Clinical Trial Study.

BACKGROUND: Many patients presenting with migraine also complain of constipation. The relationship between these two symptoms has not been explored yet in detail. This study, therefore, was carried out to investigate the effect of treatment of constipation with lactulose on the improvement of migraine headache in patients who referred to neurology clinics in Arak. MATERIALS AND METHODS: A total of 50 patients with migraine were selected based on the Headache International Society (HIS) index and the Rome Foundation is an independent not for profit 501(c) 3 organization that provides support for activities designed to create scientific data and educational information to assist in the diagnosis and treatment of functional gastrointestinal disorders (FGIDs) (ROME III) scale so as to diagnose their migraine and constipation. The patients were randomly divided into an experimental group and a control group. A 15 cc daily of lactulose syrup was prescribed to the experimental group with the antimigraine drugs (10-mg nortriptyline and 10-mg propranonol daily). In contrast, only the standard treatment for migraine was prescribed for the control group. The severity of disability was assessed based on the severity of migraine-induced disability (MIDAS) questionnaire. Having collected the data, the data analysis was carried out using Statistical Package for the Social Sciences (SPSS) (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) statistical t-tests, and repeated measures test. RESULTS: The results of the independent sample t-test showed no significant difference between the control and intervention group's main variables of the research before the intervention (P < 0.05). On the contrary, the results of the repeated measures test indicated that the mean scores ­of the severity of disability and the severity of migraine pain between the measurement times were significantly different for the intervention and control groups, in a way that after one and/or two months of using lactulose syrup, the severity of disability and pain in the intervention group was lower than those of the control group (P < 0.001). CONCLUSION: Short-term follow-up of this study showed that lactulose syrup could remove the constipation with no significant side effects--can be used as an adjunct for the treatment of patients with migraine. However, future studies suggested for long-term consequences of constipation control.