مجله دانشکده پزشکی اصفهان
پیاپی 641 (هفته اول آذر 1400)

When transferring patients admitted to hospitals due to coronavirus disease 2019 (COVID-19), it is necessary to take appropriate measures to maintain the safety of patients and staff. The aim of this study was to design a checklist and evaluate in-hospital transfer status of patients with COVID-19 disease in emergency departments.

In this cross-sectional study, a checklist for evaluation of in-hospital transfer of patients with COVID-19 in the emergency department was designed, and then assessed. The initial in-hospital transfer checklist was prepared based on data from guidelines and published articles regarding patients with COVID-19. Its validity was confirmed using face validity (by 20 emergency nurses). Then, the items were evaluated in terms of content validity in both quantitative and qualitative methods. To evaluate the content validity in a quantitative way, the content validity ratio (CVR) coefficient and the content validity index (CVI) were used. Waltz and Basel methods were used to determine CVR from the panel of experts and for CVI, respectively. Using the final checklist, the transfer status of patients with COVID-19 in three stages (before, during, and after transfer) by three samplers, from May to September 2020, in the emergency departments of selected hospitals in Qazvin City, Iran.

In this study, the modes of transmission of 167 patients during 501 observations were investigated. Errors occurred in 50.9% of transfers, especially during transfer (32.9%), the most important cases of which included reduction of arterial blood oxygen saturation, decrease and increase in blood pressure, and incompliance with transfer protocols including non-disinfection of transmission routes (73.7%), lack of hand hygiene (74.6%), and non-replacement of personal protective equipment (60.5%).

The results of the study showed that the most accidents were reduction of arterial blood oxygen saturation and hypotension, respectively, which occurred in terms of time, mainly during patient transfer.

Pain and nausea after surgery under general anesthesia are common complications, that if not controlled, can lead to increased postoperative complications. </em>The aim of this study was to compare the effects of intravenous and subcutaneous injection of metoclopramide on pain and nausea after lower abdominal surgery.

This study was performed as a double-blind randomized clinical trial on 75 patients aged 18 to 65 years, class 1 and 2 in American Society of Anesthesiologists (ASA) scale, candidates for elective lower abdominal surgery under general anesthesia. Patients were divided into three groups of 25 patients receiving 0.15 mg/kg metoclopramide intravenously (group 1), subcutaneously (group 2), and normal saline (control, group 3). Intensity of pain and nausea, patient satisfaction, hemodynamic parameters, drug side effects, and rescue analgesic and antiemetic use were compared in three groups.

</em>Intensity of the pain and nausea were significantly lower in the intravenous group than in the placebo and subcutaneous groups. Moreover, patients' satisfaction in the intravenous and subcutaneous groups were significantly higher than the placebo group. The mean arterial blood pressure and abdominal cramps were significantly lower in the intravenous group than in the other two groups; but flushing frequency in the intravenous group was significantly higher than the two other groups.Conclusion: Intravenous injection of metoclopramide had better effects in controlling pain and nausea in comparison with subcutaneous injection and placebo in patients undergoing lower abdominal surgery.

The biological response of cells that are not directly exposed to radiation, but are in the vicinity or the environment of irradiated cells, is known as the radiation bystander effect. In previous studies, the existence and mechanism of the bystander effect induced by ionizing radiation have been investigated. Recently, ultrasound therapy was inducted as a new method for treating some cancers. Therefore, it seems necessary to evaluate the ultrasound-induced bystander effect.

To investigate the ultrasound-induced bystander effect, A375 and MCF-7 cell lines were cultured in the target and bystander plates. The target plates included four groups of control (without intervention), ultrasound, gold nanoparticles, and simultaneous ultrasound treatment and gold nanoparticles. The four bystander groups received the culture medium of the target groups, respectively. MTT and colony forming units assays were </em>performed to investigate the ultrasound induced bystander effect.

The percentage of colonization in bystander groups receiving ultrasound without and with gold nanoparticles were significantly lower compared with the control group. However, the amount of colonization for the MCF-7 cell line was more than A375.

The results showed that the ultrasound-induced bystander effect was intensified in the presence of gold nanoparticles due to.