فهرست مطالب

Iranian Red Crescent Medical Journal
Volume:24 Issue: 8, Aug 2022

  • تاریخ انتشار: 1401/09/14
  • تعداد عناوین: 10
|
  • Sarah AlSaif, Saad Alsaad Page 1
    Background

    Medical emergencies are unpredictable situations that can occur outside of the health facilities and when doctors are off-duty. Limited studies, to the best of our knowledge, have explored factors that contribute to physicians’ responses to such situations in Riyadh, Saudi Arabia.

    Objectives

    The present study aimed to investigate physicians working in a teaching hospital by responding to multiple hypothetical scenarios that can occur outside of routine clinical care and the contributing factors which lead to the physicians’ responses.

    Methods

    The present cross-sectional study was conducted among physicians working in King Saud University Medical City (KSUMC) Riyadh, Saudi Arabia from February to October 2020. The Participants were selected using the convenience sampling method. The calculated sample was 384 individuals. An online survey tool was designed using a validated questionnaire to assess the opportunities for interventions, responses to hypothetical emergency scenarios, or willingness to provide different levels of care. In addition, the hindrances to providing care, including fear of legal ramifications were assessed.

    Results

    A total of 360 physicians completed the survey. Moreover, 57.2% of physicians reported having intervened at least once in the past. No significant difference was found between specialties. Gender, experience, and nationality significantly affect the willingness to intervene. Fear of potential litigation was the most common reason for hesitancy in dealing with an emergency.

    Conclusion

    Local physicians are less inclined to offer assistance in an emergency. Fear of litigation and perceived lack of training were among the most notable reasons for hesitancy in emergencies. Continuous education on local regulations may encourage physicians to intervene in an emergency.

    Keywords: Cross-sectional studies, Emergencies, Physicians, Saudi arabia
  • Hasan Erdem, Mehmet Gençtürk, Abdullah Şişik, MuhammedSaid Dalkılıç, Selim Sozen Page 2
    Background

    Demands for fasting occasionally arise in patients undergoing bariatric surgery, depending on their beliefs.

    Objectives

    In the present study, patients who had undergone laparoscopic sleeve gastrectomy (LSG) and experienced fasting at different postoperative times were examined, and the effects of fasting in Ramadan were evaluated.

    Methods

    A total of 206 patients who underwent LSG were included in the study. All participants were asked to complete three separate questionnaires. The first questionnaire consisted of 15 items on general eating habits and fasting. The second questionnaire comprised 7 items, scores on a 10-point scale, assessing the feeling of hunger while fasting and the desire to get food. The third questionnaire included a total of 9 items asked to determine the psychological state.

    Results

    The first fasting was observed 13.6±9.1 months (1-36)after the operation. The mean hunger/food cravings score was 26.1±9.6, and the mean psychological disturbance index score was 6.9±3.8. A total of 42.6% of the patients stated that they lost weightwhile fasting. There was no significant difference betweenthe genders in terms of food consumption habits. There was no difference between the groups in terms of weight and energy level changes after the initiation of fasting.

    Conclusion

    One year after LSG, most people begin fasting, and women begin their fasting earlier than men. Fasting becomes more difficult after surgery as time passes.

    Keywords: Bariatric surgery, Fasting, Laparoscopic sleeve gastrectomy
  • Kuah Lee Peng, Li Yoong Tang, Ng Chin Jerk, Samira Mohajer, Mohammad Namazi Nia Page 3
    Background

    The Ottawa Decisional Conflict Scale (ODCS) is one of the initiativesdeveloped to determine the information about the patient's decision and the factorthat influence the decision made. Therefore, a systematic and structured process of decision-making can expressthe difficult action to be taken by patients.

    Objectives

    This study aimed to evaluate the psychometric properties of the Malaysian version of ODCS among cardiovascular patients undergoing major surgery.

    Methods

    This study used the forward-backward translation method to develop an instrument that enabled Malaysians to know about this variable. Therefore, the researcherdecided to make a transcultural adaptation and evaluate the decision-making of the Malaysia version of the ODCS, which seeks information about decision-makingand the factors that influence the choices made. This study was conducted from January 2015 to July 2016 through a convincing sampling of 520 cardiovascular patients who need to undergo major surgery with a focus on decision-making regarding the diseases.

    Results

    The results obtained on the reliability tests showed good internal consistency for all items (Cronbach α=0.914-0.917). From the analysis,the Kaiser-Meyer-Olkin Measure of Sampling Adequacy was 0.886, while the significant value of Bartlett's Test of Sphericity was P<0.001. Therefore, the analysis concluded that the data were appropriate for principal component analysis.

    Conclusion

    The psychometric properties of the Malaysian version of the ODCS are considered appropriate to be administered to patients who need to undergo cardiac surgery. Patients' provision of information was able to decrease decisional conflict among them with cardiovascular disease.

    Keywords: Cardiovascular patients, Confirmatory factor analysis, Ottawa decisional conflict scale, Patient decision making, Validation study
  • Fatemeh Tajari, Ghahraman Mahmoudi, Fatemeh Dabbaghi, Jamshid Yazdani-Charati Page 4
    Background

    Electronic referral system (e-Referral system) in Iran was launched to increase access to care and improve interaction.

    Objectives

    The present study aimed to design an appropriate model for evaluating the performance of the e-Referral system in Iran.

    Methods

    This study was conducted in three stages: 1) review ofliterature related to electronic referral systems, 2) qualitative phase, and 3) quantitative phase. Participants in the qualitative phase included 42 managers, policymakers of the Ministry of Health, medical universities, service providers, and recipients who were purposively selected for this study.Data were analyzed through content analysis. In the quantitative phase, the target group consisted of 604 staff of medical universities implementing the e-Referral system. Data were analyzed using the EQS (version 6.3) and SPSS (version 20) software. Chi-square test, degree of freedom, the goodness of fit index, root mean square error, adjusted goodness of fit index, and the Friedman test were used to investigate the suitability of the model.

    Results

    Fourteen main themes were identified and classified for the model design Based on the results of the present study. The components of developing rules and regulations, stakeholder advocacy, economic evaluation, and quality of health services hadaverage ratings of 13.99, 13.00, and 11.35, respectively, regarding their role in designing the evaluation model for the e-Referral system in Iran.

    Conclusion

    The results of structural equation modeling showed that the components play an essential role in designing the performance evaluation model of e-Referral in the Iranian health system.This study addressed various aspects affecting the e-Referral and provided the possibility of performance evaluation in the health sector in a principled and systematic format. Health managers and policymakers can use the present studyfindings to discover the strengths and weaknesses of the e-Referral performance.

    Keywords: Delivery of health care, Electronic health records, Electronic humans, Iran, Physician-patient relations, Referral, consultation
  • Ali Hosseinzadeh, Abbas Tavakolian, Vahid Kia, Hossein Ebrahimi, Hossein Sheibani, Ehsan Binesh, Majid Rahmati, Maryam Yarmohammadi, Nazanin Aghayan, Seyed Mohammad Mirrezaie, Moslem Jafarisani, Reza Jafari Page 5
    Background

    Coronavirus pandemic has affected a large population worldwide. Currently, the standard care for individuals who are exposed is supportive care, symptomatic management, and isolation.

    Objectives

    This study aimed to evaluate the effects of the combined use of ethanol and dimethyl sulfoxide (DMSO) as a nasal spray in preventing Coronavirus disease 2019 (COVID-19).

    Methods

    This randomized controlled trial was conducted on volunteer healthcare workers of medical centers who were at the forefront of the fight against COVID-19 in Shahroud, Iran.In total, 232 participants were randomly assigned to intervention and control groups to receive DMSO/ethanol or routine care, respectively. The subjects were followed for four weeks to determine the incidence of COVID-19 infection in each group based on the RT-PCR test. Finally, absolute risk difference and relative risk were calculated to evaluate the effect of DMSO on COVID-19 prevention.

    Results

    The results showed that the incidence rates of COVID-19 were 0.07 and 0.008 in the control and intervention groups, respectively. The relative risk was obtained at 0.12 (0.02-0.97) according to the incidence rate in the two groups.

    Conclusion

    Combined administration of DMSO and ethanol by healthcare providers can considerably prevent COVID-19.

    Keywords: COVID-19, DMSO, Ethanol, Healthcare workers, RCT
  • Amirsaleh Abdollahi, Iman Naseh, MohammadHassan Kazemi Galougahi, Fatemeh Kalroozi, Maryam Nezamzadeh, Nazanin Khajevand, Mohana Mazandarani, Mojtaba Yousefi zoshk Page 6
    Background

    Since the outbreak of COVID-19, vaccination has been considered as an important measure against it. Side effects have always been an inseparable component of vaccination, which in this study, Sinopharm vaccine, its side effects and the differences of theirmanifestation amongst men and women have been investigated.

    Objectives

    This study aimed to compare the side effects of the Sinopharm vaccine among men andwomen working in some medical centers in Tehran, Iran.

    Methods

    This cross-sectional descriptive-analytical study on 890 healthcare workers of 7 medical centers in Tehran within 2 months, from late June to late August 2021. The samples were selected by the complete enumeration method, and the required data were collected using a questionnaire. Only those who received the Sinopharm vaccine at least 10 days before the study were included.

    Results

    Of 890 participants, 22.96% and 77.30% were women and men, respectively, and 65.8% of women and 78.1% of men were in the age range of 20-29 years. It was revealed that 74.75% of women and 26.16% of men had at least one side effect. The incidence of at least one side effect was significantly higher in women than in men (P<0.001). It was also found that 12 side effects were significantly higher in women than in men. Most men and women had side effects within the first 24 h after vaccination. There was no significant difference in taking therapeutic measures to reduce or minimize the post-vaccination complications between men and women; however, 9.4% of men and 27.2% of women reported a decline in their ability to perform daily activities as they were unable to do their everyday tasks the day after vaccination which was significantly different between the two groups (P<0.001).

    Conclusion

    The results showed that the occurrence rate of side effects after receiving the Sinopharm vaccine was significantly higher inwomen than in men. Moreover, women were significantly less able to perform daily routines than men.

    Keywords: Adverse effects, COVID-19 vaccines, Gender
  • Somayeh Dehghanipour, Sara Saadatmand, Nasim Hayati Roodbari, Mahdi Mahdavi Page 7
    Background

    Breast cancer is extensively studied for its resistanceto chemotherapy. Therefore, finding efficient therapeutic agents is vital to increasing the survival rate of patients.

    Objectives

    Here, we conducted an in vitrostudy on the anti-tumor properties of Vinca herbacea extract on SKBR3 cells.

    Methods

    Apoptotic and anti-invasive activity of V. herbaceaextract was studied using Annexin FITC-V kit and Matrigel invasive assay, respectively. The expression of angiogenesis genes (VEGFR-1, VEGFR-2, and VEGF-A), apoptotic-related genes (Bcl-2and BAX), as well as metastatic genes (MMP2and MMP9) were studied using real-timepolymerase chain reaction.

    Results

    Vinca herbaceaextractshowed significant antiproliferative and cytotoxic effects on human breast cancer cells, compared to human embryonic kidney cells 293. Vinca herbaceaextract had a great apoptosis-inducing potential in breast cancer cells by activating caspase-3 and increasing the BAX/Bcl-2ratio. Vinca herbaceaextract prevented cancer cell angiogenesis, marked by decreasing the expression level of angiogenesis-relatedgenes, including VEGF, VEGFR-1, andVEGFR-2. In addition, V. herbaceaextracts reduced cancer cell invasion and noticeably decreased the expression level of metastasis-associated genes, including MMP2and MMP9.

    Conclusion

    Vinca herbaceaextracts exhibited vigorous cytotoxic effects on SKBR3 cells by the alteration of apoptosis, cell adhesion, invasion, and angiogenesis.

    Keywords: Angiogenesis, Anti-tumor, Apoptosis, Breast cancer, Metastasis, V. herbaceaextract
  • Majdedin Ghalavand, Fatemeh Parandin, Ehsan Lutfi, Hadi Lotfi, Nafiseh Shourideh Yazdi, Ruhollah Dorostkar, Mahdieh Farzanehpour, Hadi Esmaeili Gouvarchin Ghaleh Page 8

    Cancer has always been a severe threat to health and life. Since patients with advanced cancer often have a limited survival time andhigh treatment expenditures, routine therapies, such as surgery, radiation, and chemotherapy may help them live longer. However, the majority of these individuals cannot afford the excessive cost of care and have short life duration. With the introduction ofoncolytic bacteria and viruses, a revolutionary therapeutic technique for the treatment and potential cure of malignant tumors has emerged. Clostridium, Bifidobacteria, Salmonella typhimurium, Listeria monocytogenes, andBacillusare all oncolytic bacteria. Adenoviruses, Vaccinia viruses, Reoviruses, Herpesviruses, andCoxsackievirusesare all oncolytic viruses. This study aimed to review the current studies on the therapeutic potential of oncolytic bacteria and viruses as an alternate method for cancer prevention and therapy, including both experimental and clinical trials.

    Keywords: Carcinogenesis, Human microbiota, Oncolytic bacteria, virus, Probiotics, Tumor therapy
  • Zhoupeng Wu, Yukui Ma Page 9

    Venousthrombosis has a great impact on patients' quality of life after relapse. The present study summarizes the prediction model of recurrent venous thrombosis published in recent years regarding the applicable population, evaluation index, and predictive performance. It aims to provide a reference for the construction of a more reasonable predictive model and application of venous thrombosis recurrence. A query was conducted on EBSCO, Ovid, PubMed, Wanfang, and CNKI databases using the keywords "Venous Thromboembolism", "Recurrence", and "PredictionModels" to assess the prediction model of recurrent venous thrombosis. A total of five major models related to the recurrence of venous thrombosis were included. The models differed in reliability, validity, scoringmethod, evaluation method, and scope of application.

    Keywords: Prognostic models, Recurrence, Venous thromboembolism