Efficacy of Momiai in Tibia Fracture Repair: A Randomized Double-Blinded Placebo-Controlled Clinical Trial.

Objectives: Momiai ( shilajit, mummy, mumie, or mineral pitch) has been used traditionally in different medical systems for the treatment of a variety of ailments since hundreds of years ago. It is a natural substance found in different rocky parts of the world, formed by plants, mineral, and animal remains gradually. There is also worthwhile evidence supporting its oral use for bone repair in Persian medicine. The aim of this study was to evaluate the efficacy and safety of momiai in tibia fracture healing. Design: This study is a randomized double-blinded controlled trial. Settings/Location: Three different hospitals in Tehran, Iran. Subjects: Patients with age range of 18-60 years admitted due to new tibia fracture were enrolled after meeting the inclusion criteria. Interventions: The patients were divided into two groups randomly and received two 500 mg capsules of momiai or placebo for 28 days. Outcome measures: The process of bone healing was assessed by frequent X-ray radiographies and adverse effects were recorded. Results: Totally, 160 patients participated in the study either in two equal intervention or placebo groups. There was no significant difference between groups in terms of demographic and descriptive data. At the end of the study, the mean time of tibial bone union was 129 days in the experimental group, while it was 153 days in the placebo group (p < 0.049). There was no significant difference in the reported adverse effects between the two groups (p = 0.839). Conclusions: The current study showed that oral consumption of momiai after tibial shaft fracture surgery could be a promising option to reduce the healing time.

Efficacy of Half-length vs. Standard-sized Short Arm splint in Soft Tissue Injuries of the Hand and Wrist: a Randomized Controlled Trial.

INTRODUCTION: Hand and wrist soft tissue injuries are common orthopedic problems that are traditionally treated with short arm splint, which covers the forearm to 1 cm distal to the elbow crease. OBJECTIVE: The present study was conducted to compare the treatment efficacy of traditional standard-size splint with half-length short arm splint. METHOD: In this randomized, controlled, clinical trial, patients with hand and wrist soft tissue injuries were randomly assigned to two groups. Group one received standard-sized short arm splints and the other group received half-length short arm splints. The swelling and pain scores were compared between the groups by the end of weeks one, two and three. RESULTS: A total of 256 patients with a mean age of 36.96 ± 12.27 years were enrolled in this study, and 71.9% of them were male. No statistically significant differences were observed in terms of swelling between the two groups after one and two weeks (P=0.41, P=0.18). None of the patients had swelling after three weeks. No statistically significant differences were observed between the two groups in terms of the pain score after one, two and three weeks (P=0.47, P=0.29, P=0.92). CONCLUSION: In this study, half-length short arm splints were found to be as effective as standard short arm splints.

Job Burnout, Stress, and Satisfaction among Emergency Nursing Staff after Health System Transformation Plan in Iran.

INTRODUCTION: Job burnout, stress, and satisfaction are linked to quality of care, patient outcomes and retention of staff. This study was conducted to determine the mentioned issues among emergency nurses. METHODS: This cross-sectional study was conducted on all nurses working in the emergency departments of 10 hospitals in Tehran, Iran, in 2017. Standard questionnaires were used for gathering the data of participants regarding job burnout, stress, and satisfaction. RESULTS: 709 (90%) participants returned the completed questionnaires (58.9% female). The mean age of the nurses was 33 (SD = 7) years. The level of job burnout was moderate in 76.1%, low in 22.5%, and high in 1.4% of the nurses. The level of burnout in the married nursing staff was lower than single nurses (3.78 ± 0.98 versus 4.14 ± 0.58, p = 0.049). The level of job satisfaction was moderate in 61.1%, low in 22.2%, and high in 16.7%. There was a significant correlation between age and job satisfaction (p = 0.027, r = 0.3). Job burnout was directly correlated with job stress (p ≤0.001, r = 0.57) and job burnout was negatively correlated with job satisfaction (p = 0.001, r = -0.41). CONCLUSION: More than 60% of the studied emergency nurses had moderate levels of job burnout, stress, and satisfaction. Job burnout had a direct correlation with job stress and indirect correlation with job satisfaction. Planning to reduce burnout of the emergency nursing staff seems to be necessary.

A Survey of Current Practice of Informed Consent in Iranian Hospitals.

BACKGROUND: Informed consent is legal and ethical process which is considered as important issue in quality of patient's treatment. The aim of the current study was to assess current informed consent of patients admitted in Iranian selected Hospitals, 2016. MATERIALS AND METHODS: This cross-sectional study was conducted on 2150 patients admitted in 11 public Hospitals. Data was collected using a dichotomous questionnaire with 30 questions. Statistical analysis was done using SPSS software (version 18). RESULTS: The results shown that 46% of patients had medium perception about informed consent, 44% believed to get insufficient information and 66% claimed to have active participation in treatment process. The significant associations were found between some dimensions and important parameters: Understanding of information dimension and education level (p = 0.008), Participation (in decision-making) dimension and type of hospitalization (p = 0.01), and level of patients' information dimension with resident address (p = 0.027) and medical specialty (p < 0.001). CONCLUSION: In our study the current informed consent of patients wasn't in desirable condition. The Necessary measures are required to achieve a level that the patients' informed consent convert to informed choices. Hospital healthcare team need to take proper actions such as give proper information, patient training, sufficient information and etc.

Evaluation of Appropriate and Inappropriate Admission and Hospitalization Days According to Appropriateness Evaluation Protocol (AEP).

BACKGROUND: Inappropriate admission and hospitalization days are the factors that impose more costs to hospitals. By considering current condition of hospitals, it is vital to have an insight into the data on inappropriate admission and hospitalization days in order to eliminate obstacles to the proper and appropriate hospitalization. METHODS: In this study, 198 patients who were admitted to receive surgical or non-surgical treatment in Sina public hospital were selected. An appropriateness Evaluation Protocol (AEP) was used for data collection. The validity of AEP is well established by the preceding studies. In order to achieve the study objectives, binary logistic regression test was used. RESULTS: According to our findings, 39.4% of hospitalization days and 16.2% of admissions are inappropriate. In this study, inappropriate admission was observed among married patients eight times more than among single ones. Inappropriate hospitalization days were 12 times more prevalent among patients from provinces than among those from Tehran. With increasing age of the patient the probability of inappropriate admission decreases slightly, i.e. the probability of inappropriate admission decreases 10% as the age increases one year. The number of hospitalization days was significantly correlated to the following parameters: type of admission, patient's city of residence, type of treatment, and length of stay (P < 0.05). CONCLUSION: Regarding the results of this study, a large number of admissions and specially hospitalization days are inappropriate. According to other studies, with suitable programming many inappropriate admissions and hospitalization days are preventable.