Publications by authors named "Gholamreza Masoumi"

40 Publications

Identifying the Challenges of Simulating the Hospital Emergency Department in the Event of Emergencies and Providing Effective Solutions: A Qualitative Study.

Disaster Med Public Health Prep 2022 Jul 18:1-8. Epub 2022 Jul 18.

Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.

Introduction: Emergencies and disasters occur in any society, and it is the hospitals and their emergency department staff who must be prepared in such cases. Therefore, 1 of the effective methods of training medical care staff is the use of simulators. However, when introducing new simulation approaches, we face many challenges. The aim of this study was to identify challenges of the simulation of the hospital emergency department during disasters and provide effective solutions.

Methods: This conventional content, thematic, analysis study was conducted in 2021. Participants were selected from Iranian experts using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis.

Results: After analyzing the data, the challenges of simulating the hospital emergency department during disasters were identified in 2 main components and 6 perspectives, which included organizational components (inappropriate and aimless training methods, lack of interaction and cooperation, lack of funding, and inadequate physical space) and technological components (weak information management and lack of interdisciplinary cooperation). Solutions included management (resource support) and data sharing and exchange (infrastructures, cooperation and coordination).

Conclusion: The simulation technology can be used as a method for training and improving the quality of health care services in emergencies. Considering that most of these challenges can be solved and need the full support of managers and policy makers, by examining these issues, supporting staff of health care centers are advised to make a significant contribution to the advancement of education and problem reduction in the event of disasters.
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http://dx.doi.org/10.1017/dmp.2022.144DOI Listing
July 2022

Background and design of a 5-year ST Elevation Myocardial Infarction Cohort in Isfahan, Iran: SEMI-CI study.

ARYA Atheroscler 2021 May;17(3):1-7

Associate Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Cardiovascular disease (CVD) is one of the most important causes of mortality and morbidity in Iran. Secondary prevention of acute myocardial infarction (AMI) is necessary. The main aim of this cohort is evaluating clinical, paraclinical, management, and 5-year major events of the participants in Isfahan, Iran.

Methods: All consecutive patients with AMI hospitalized in Chamran Hospital, Isfahan, during 1 year from march 2015 were recruited and followed for 5 years. ST-Elevation Myocardial Infarction Cohort Study (SEMI-CI) has been initiated as a longitudinal study to evaluate course of patients with AMI in Iran, adherence to evidence-based secondary prevention drug, and five-year events such as death, re-myocardial infarction (REMI), re-hospitalization, congestive heart failure (CHF), and referring to another procedure [percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and resynchronization therapy].

Results: A total of 867 patients with ST-elevation myocardial infarction (STEMI) with mean age of 60.91 ± 12.76 years were recruited. 705 (81.3%) subjects were men with mean age of 59.63 ± 12.59 years. 470 (54.2%) patients had anterior AMI (ant-AMI) and the rest had other types of AMI. The ejection fraction (EF) mean was 37.80 ± 11.74 percent. A total of 30 (3.5%) cases of AMI had not received reperfusion. 445 (51.4%) had primary PCI and 392 (45.2%) had thrombolysis at first revascularization strategy. In-hospital death occurred in 72 participants (8.3%). Drug during hospital included: at discharge, 767 (88.5%) received aspirin, 787 (90.7%) statin, 697 (80.4%) beta-blocker, and 480 (55.4%) angiotensin-converting enzyme (ACE) inhibitor.

Conclusion: According to the best of our knowledge, it is among few cohorts in Eastern Mediterranean Region (EMR) in patients with AMI. This paper showed methodology of this study in patients with STEMI and its follow-up protocol. We can use this result in policy-making for improving secondary prevention strategies.
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http://dx.doi.org/10.22122/arya.v17i0.2375DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133708PMC
May 2021

Development and psychometric evaluation of the emergency nurses' professional resilience tool.

PLoS One 2022 7;17(6):e0269539. Epub 2022 Jun 7.

Behavioural Sciences Research Centre, Life style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Background: There is no specific tool for measuring the professional resilience of emergency nurses. Therefore, the present study aimed to design and psychometrically evaluate a new tool named the emergency nurses' professional resilience tool.

Method: This mixed-method sequential exploratory study was conducted in two phases: (1) item generation using literature review and evaluation of the results of a qualitative study and (2) psychometric evaluation of the developed scale. The face, content, and construct validity (exploratory and confirmatory factor analysis), reliability (internal consistency, relative, and absolute), and accountability were assessed in the population of Iranian nurses (N = 465) during March 2019-June 2020.

Results: The tool designed for assessing the professional resilience of Iranian nurses included 37 items. The average scale content validity index (S-CVI/Ave) was equal to 0.94. The exploratory factor analysis revealed five factors, including professional competencies, emotional-cognitive characteristics, external support, in addition to behavioral and cognitive strategies, and explained 75.59% of the whole variance. Cronbach's alpha and intraclass correlation were 0.915 and 0.888, respectively. Construct validity for five factors was established with acceptable model fit indices [Chi-square/df = 1336.56/619, p < .001]; [Comparative Fit Index [CFI] = 0.96]; [Non-Normed Fit Index [NNFI] = 0.96]; [Root Mean Square Error of Approximation (RMSEA) = 0.074 and 90 Percent Confidence Interval = (0.069; 0.080)]; and [SRMR = 0.095].

Conclusions: According to the findings of the current study, the emergency nurses' professional resilience tool can be used by healthcare managers as a valid and reliable scale to evaluate the professional resilience of nurses to designate them as nurses working in emergency and disaster situations.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0269539PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9173641PMC
June 2022

Setting research priorities to achieve long-term national road safety goals in Iran.

J Glob Health 2022 2;12:09002. Epub 2022 Apr 2.

Department of Operating Room and Anesthesia, School of Paramedic Sciences, Sabzevar University of Medical Sciences, Khorasan Razavi, Iran.

Background: Road traffic crashes (RTCs) and its associated injuries are one of the most important public health problems in the world. In Iran, RTCs rank second in terms of mortality. To address this issue, there is a need for research-based interventions. Prioritizing researches using a variety of approaches and frameworks to determine the most effective interventions is a key nodal point in the RTCs' research policy planning cycle. Thus, this study aims to generate and prioritize research questions in the field of RTCs in Iran.

Methods: By adapting the Child Health and Nutrition Research Initiative (CHNRI) method, this study engaged 25 prominent Iranian academic leaders having role in setting Iran's long-term road safety goals, a group of research funders, and policymakers. The experts' proposed research questions were independently scored on a set of criteria: feasibility, impact on health, impact on the economy, capacity building, and equity. Following the prioritization of Research Questions (RQs), they were all classified using the 5 Pillar frameworks.

Results: In total, 145 Research Questions were systematically scored by experts against five criteria. Iran's top 20 road traffic safety priorities were established. The RQs related to "road safety management" and "road and infrastructure" achieved a high frequency.

Conclusions: The top 20 research questions in the area of RTCs in Iran were determined by experts. The majority of these RQs were related to "road safety management". The results of this study may contribute to the optimal use of resources in achieving long-term goals in the prevention and control of road traffic crashes and its related injuries. Considering these RQs as research investment options will improve the current status of Road Traffic Injuries (RTIs) at a national level and further advance toward compliance with international goals. If these research priorities are addressed, and their findings are implemented, we can anticipate a significant reduction in the number of crashes, injuries, and deaths.
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http://dx.doi.org/10.7189/jogh.12.09002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8974318PMC
April 2022

Do any kinds of perceived stressors lead to hypertension? A longitudinal cohort study.

Hypertens Res 2022 06 4;45(6):1058-1066. Epub 2022 Apr 4.

Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Stress has been suggested as a contributing factor in the etiology and progression of hypertension in prior investigations. For a more comprehensive understanding of this concept, in this study, we aim to evaluate different domains of perceived stress and their possible contribution to the development of hypertension (HTN). This is a secondary analysis of the Isfahan Cohort Study (ICS). We used data from 2007 and 2013. The 12-item General Health Questionnaire (GHQ-12) and Stressful Life Events Questionnaire (SLEQ) were used to evaluate psychological distress and perceived stress in subjects, and a generalized linear mixed model (GLMM) was used to assess their association with HTN. Psychological distress had a significant positive relation with HTN that remained after full adjustment for other covariates. Individuals with high stress levels were 38% more likely to develop HTN (OR 1.38, 95% CI 1.18, 1.59). After full adjustment, total perceived stress was significantly associated with a 15% increase in HTN development (OR 1.15, 95% CI 1.01-1.29). Domains of perceived stress that were significantly associated with HTN independent of sociodemographic and lifestyle covariates were job conflict, job security, personal conflict, sexual life and daily life in both genders and financial problems in males (P < 0.01). The findings from this study underline the importance of identifying the effect of different sources of perceived stress to organize community-based strategies for the management of hypertension and help health professionals prioritize and efficiently allocate their resources for interventions.
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http://dx.doi.org/10.1038/s41440-022-00895-3DOI Listing
June 2022

An assessment on the use of infra-scanner for the diagnosis of the brain hematoma in head trauma.

Am J Emerg Med 2022 05 1;55:174-179. Epub 2021 Oct 1.

Department of Neurology, University of Cincinnati, Cincinnati, OH, USA.

Purpose: Timely identification and treatment of intracranial hematomas in patients with brain injury is essential for successful treatment. This study evaluates Infra-scanner as a handy medical screening tool for diagnosing, on-site, cerebral hematomas in patients with head injury.

Materials And Methods: Patients referred to the emergency department of university hospitals with mild to moderate brain trauma, up to 12 h from injury were included. NIR sensors of infra-scan device were placed on the right and left frontal, temporal, peritoneal and occipital parts of the head and light absorption was recorded. Positive or negative cerebral hemorrhage cases were compared with contrast-enhanced CT scan results as the gold standard. Diagnostic parameters of the device and cases related to bleeding were analyzed and reported.

Results: A total of 300 patients were studied. Sensitivity of the infrasound scanner in the Iranian study population was 94.8 (95% CI: 88% -100) and its specificity was 86.9 (95% CI: 79% -99% 99). Negative predictive value (NPV) was 90.3% and positive predictive value (PPV) was 92.9%. Sensitivity in men (95.7%) (95%CI, 90% -1) was more than women (95% CI, 81% -99%)90%. At the ages of less than 36 years, sensitivity (95.3%) and specificity (87.1%) were more than sensitivity (94.4%) and specificity (86.5%) over 36 years old. If the test had been performed in less than / equal to two hours from trauma, the sensitivity (94.9%) and the specificity (92%) were greater than the sensitivity (94.6%) and the specificity (75%) during when the scan had been performed in more than two hours from trauma. In general, in extra-axial bleeding including EDH, SAH, SDH, the sensitivity was 95.1% and the specificity was 84.5%, while in intra-axial bleeding, including ICH and IVH, the sensitivity was lower (93.9%) and the specificity was 91.7. The sensitivity of the device in detecting bleeding in the occipital lobe (95.8%) was higher than other brain lobes.

Conclusion: This study shows that Infra-scanner is useful in initial examination and screening of patients with head injury and can be used as an adjunct to a CT scan or when not available and may allow earlier treatment which reduce the secondary damage to the hematoma.
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http://dx.doi.org/10.1016/j.ajem.2021.09.074DOI Listing
May 2022

Benefits of simulation-based education in hospital emergency departments: A systematic review.

J Educ Health Promot 2022 31;11:40. Epub 2022 Jan 31.

Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.

Background: The emergency department is one of the most important parts of all hospitals. For this reason, many simulation programs are performed in this department to increase the knowledge, skills, and productivity of health-care workers. The purpose of this study was to identify the benefits of simulation in hospital emergency departments.

Materials And Methods: In the present systematic study, using "AND" and "OR" operators, we searched for the keywords "benefits," "simulation," and "hospital emergency department" in PubMed, Web of Science, Scopus, Google Scholar as well as Persian language databases such SID, Magiran, Irandoc, and Iran Medex. Then, a three-step screening process was used to select studies relevant to simulation and hospital emergency from 2005 to 2021 using the PRISMA checklist, and finally, the obtained data were analyzed.

Results: A total of three main groups, each with several subgroups, were extracted and identified as the benefits of using simulation in hospital emergency departments. They included improving the diagnosis of the disease (rapid prediction of the disease, rapid diagnosis, and patient triage), improving the treatment process (improvement of treatment results, anticipation of admission and discharge of patients, acceleration of interventions, and reduction of medical errors), and improving knowledge and skills (improvement of the speed of decision-making, staff's acquisition of knowledge and skills, simple, convenient, and low-cost training, improvement of staff's preparedness in crisis).

Conclusion: Based on the results of the present study, it is suggested to develop some training programs in order to help staff upgrade their knowledge and performance as well as acquire practical skills and also to improve the diagnosis and treatment process in hospital emergency departments. Virtual methods are also proposed to be applied as potential and cost-effective platforms for learning, teaching, and evaluating the staff of hospital emergency departments.
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http://dx.doi.org/10.4103/jehp.jehp_558_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8893067PMC
January 2022

Design and psychometric evaluation of sociocultural scale predicting the incidence of road traffic crashes in drivers.

J Inj Violence Res 2022 Mar 12;14(3). Epub 2022 Mar 12.

Workplace Health Promotion Research Center, Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Various factors are involved in the occurrence of Road Traffic Crashes (RTCs), one of the most important of these are human factors that can be greatly influenced by the specific sociocultural bases of the drivers. So far, there has not been a scale for measuring Sociocultural Factors (SCFs) predicting the occurrence of RTCs in Iranian drivers. Therefore, the present study was conducted to design and to do psychometric evaluation of a scale for measuring SCFs predicting the occurrence of RTCs in drivers.

Methods: This exploratory sequential mixed method was carried out in three phases. In phases 1 and 2, an initial items pool was created based on systematic literature review (phase1), and semi structured interviews (phase 2). In phase 3, the initial scales were validated using face and content validities. Then, principal component analysis and confirmatory factor analysis were performed to assess the construct validity. Finally, the reliability of the scale was evaluated by examining internal consistency and stability.

Results: The scale content validity index was 0.92. Principal component analysis showed seven factors with 27 items, which explain 55.56% of the total variance. In confirmatory factor analysis, model fit indices were satisfactory. Discriminant analysis was also able to distinguish between two groups of accident-involved drivers and accident-free drivers (P less than 0.0001). The reliability of the scale by Cronbach's alpha, Theta, Omega and intra-class correlation coefficients was 0.82, 0.96, 3.07, and 0.80, respectively.

Conclusions: This scale can be used as a valid and reliable scale to evaluate the SCFs predicting the occurrence of RTCs in drivers. Furthermore, the findings of this study will be useful in identifying and planning to reduce RTCs, especially in accident-prone drivers.
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http://dx.doi.org/10.5249/jivr.v14i3.1707DOI Listing
March 2022

Determining the diagnostic value of tracheal intubation by palpation and auscultation methods compared to the chest X-ray method in children.

Acute Crit Care 2022 May 3;37(2):224-229. Epub 2022 Feb 3.

Cardiac Rehabilitation Research Center, Chamran Hospital, Isfahan University of Medical Sciences.

Background: It is important to determine the proper location of tracheal tube for proper ventilation. In this study, we compared the diagnostic value of tracheal intubation with two methods of palpation and auscultation with chest X-ray (CXR) method in pediatric.

Methods: In this interventional study, 80 patients under 6 years of age were included. After tracheal intubation appropriate depth of tracheal tube was determined by auscultation and recorded, then by palpation depth of tracheal tube determined and tube was fixed. The length of the tube was calculated with the standard formula based on age. After surgery, CXR was taken and, according to the landmark, the distance from the end of the tube to the anterior lower tooth was recorded.

Results: Interclass correlation coefficient (ICC) between the palpation method and the standard method in the number of fixing tracheal intubation was 0.573, which shows the average and significant correlation between these two methods in determining the fixed number of tracheal intubation. ICC between the auscultation and the standard method in fixing tracheal intubation number was 0.430, which shows the average and significant agreement between these two methods in determining the fixed number of tracheal intubation. There is no significant relationship between sex and the average number of fixing tracheal intubation in all methods.

Conclusions: This study has shown that both palpation and auscultation methods are appropriate, but with a slightly higher palpation ICC, the palpation can be considered relatively better.
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http://dx.doi.org/10.4266/acc.2021.00787DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9184985PMC
May 2022

Anethum graveolens L. (Dill) Effect on Human Lipid Profile: An Updated Systematic Review.

Curr Probl Cardiol 2021 Nov 26:101072. Epub 2021 Nov 26.

Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Dill is an aromatic edible herb, belongs to the genus Anethum in the celery family (Apiaceae or Umbelliferae) with a long history of cultivation from ancient times and two closely related cultivated species, European dill (Anethum graveolens) and Indian dill (Anethum Sowa). We wanted to do this systematic review on the effect of Anethum graveolens intake on lipid profile because the outcomes of multiple research and meta-analyses in this regard were inconsistent. A systematic search for English published randomized controlled trials (RCTs) covering PubMed, EMBASE, Scopus, and Coherence library. The pooled weighted mean difference (MD) and its 95% confidence interval (CI) were calculated and pooled using a random-effects model. Pooled data of 6 RCTs involving 171 intervention cases indicated that dill supplementation was associated with a significant reduction in mean serum total cholesterol (MD 95% CI= -3.71(-5.71,-1.70); P < 0.001), low-density lipoprotein cholesterol (LDL-C) (MD 95% CI= -1.51(-2.65,-0.47); P = 0.005), TG (triglycerides) (MD 95% CI= -2.48(-3.98,-0.98); P = 0.001) and interestingly high-density lipoprotein cholesterol level (HDL-C) (MD 95% CI= -2.19(-3.58,-0.81); P = 0.002). Subgroup analysis showed that dill use was more effective in lowering triglyceride in both hyperlipidemic patients, MD 95% CI= -3.54(-6.49,-0.60); P = 0.02) and type 2 diabetes (MD 95% CI= -3.64(-5.69,-1.58); P = 0.001). Dill use reduced the LDL levels more effectively in patients with type 2 diabetes (MD 95% CI= -3.54(-6.49,-0.60); P = 0.03). Dill supplementation significantly improved LDL-C, TG, and Total cholesterol (TC) levels but not HDL-C. Further high quality controlled clinical trials on human is needed for more accurate and confirm conclusion.
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http://dx.doi.org/10.1016/j.cpcardiol.2021.101072DOI Listing
November 2021

Disaster preparedness in emergency medical service agencies: A systematic review.

J Educ Health Promot 2021 30;10:258. Epub 2021 Jul 30.

Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

The Emergency Medical Services (EMSs) are in the frontline between the health-care systems and people in emergencies and disasters. With the increase in the frequency of natural or man-made disasters around the world, the need for prepared EMS services is increasing. This study aimed to evaluate the current disaster preparedness status of the EMS agencies in the literature and exploring the key preparedness elements and the strategies to improve the EMS disaster preparedness. The electronic database such as PubMed, Web of Science, Scopus, and Google Scholar was searched from 2000 to 2019. The searching keywords included: "EMS," "Disaster," "Preparedness," "Emergency" "Preparedness," "Disaster Preparedness," "Readiness," and the terms related to "disaster types" were used in combination with Boolean operators OR and AND. Out of 1412 articles, 7 articles were included in the review. The most important elements of the EMS disaster preparedness include the size and scope of the incident, surge capacity, planning, communication, training and education, policymaking, financial support, coordination, safety and security, early warning system, disaster response experience, and legal considerations. This systematic review showed that the EMS agencies in the world generally are inadequately prepared for an effective response to major emergencies and disasters. This study provides valuable information to EMS educators, EMS administrators to adopt and perform appropriate activities to improve the EMS disaster preparedness.
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http://dx.doi.org/10.4103/jehp.jehp_1280_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396056PMC
July 2021

Could SARS-CoV-2 or COVID-19 Be a Biological Weapon?

Iran J Public Health 2020 Oct;49(Suppl 1):143-144

Department of Health in Emergencies and Disasters, School of Health Management and Information Services, Iran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.18502/ijph.v49iS1.3691DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266003PMC
October 2020

Effect of Beetroot Consumption on Serum Lipid Profile: A Systematic Review and Meta-Analysis.

Curr Probl Cardiol 2022 Jul 8;47(7):100887. Epub 2021 May 8.

Cardiac Rehabilitation Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Beetroot has recently become very popular among people as a medicinal superfood that decreases blood pressure and improves athletes' performance. The present meta-analysis aimed to investigate the effect of beetroot consumption on serum lipid profile. A literature search was conducted covering PubMed, ISI Web of Science, Scopus, and Google scholar of English human subject randomized clinical trials (RCT) up to December 2020. Pooled results showed that beetroot consumption had no significant effect on any of the variables. The mean difference (95% CI) between intervention and control groups for TC was 1.25 (-0.03, 2.53), for TG -0.47 (-1.16, 0.21), for HDL 0.54 (-0.13, 1.21) and for LDL was -0.48(-1.04, 0.09). Subgroup analysis by the health condition of subjects, the form of beetroot consumption, and type of intervention showed no significant differences. It can be concluded that beetroot cannot be categorized as an effective supplementation for adjustment of lipid profile.
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http://dx.doi.org/10.1016/j.cpcardiol.2021.100887DOI Listing
July 2022

Prevalence of Return to Work in Cardiovascular Patients After Cardiac Rehabilitation: A Systematic Review and Meta-analysis.

Curr Probl Cardiol 2022 Jul 17;47(7):100876. Epub 2021 Apr 17.

Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

The present systematic review and meta-analysis aimed to clarify the effects of cardiac rehabilitation (CR) on the prevalence of return to work (RTW) in cardiovascular diseases (CVDs) patients. CR plays a very important role in the management of CVDs and improves the patients' physical activity, quality of life, and a decrease in the cost of healthcare. RTW is the most important goal in the rehabilitation of CVD patients. PubMed, Web of Science, Scopus, and Google scholar were searched systematically from inception up to January 2021 for English published clinical trials and observational studies. In total, 16 studies were analyzed, of them, 8 were controlled studies. Pooled results showed that the mean age of patients was 52.30 (50.04, 54.57). The prevalence of RTW in the CR attending group was 66% (60%, 71%) and in the control group was 58% (47%, 68%). Subgroup analysis showed that the proportion of RTW was higher in white-collars 76% (73%-79%) compared to. blue-collars 63% (56%-70%). Out-patient CR with 72% (61%-81%) RTW was more effective compared to in-patient CR with 62% (44%- 78%) and usual care (control). It can be concluded that CR especially out-patient CR increases the prevalence of RTW but not much. Improved and appropriate CR programs related to each individual's disease and patient condition which follow the valid guidelines might help to increase the effectiveness of CR in terms of RTW.
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http://dx.doi.org/10.1016/j.cpcardiol.2021.100876DOI Listing
July 2022

Post-Hospital Discharge Strategy for COVID-19 Treatment and Control: Focus on Fangcang Hospitals.

Disaster Med Public Health Prep 2021 Mar 26:1-3. Epub 2021 Mar 26.

Department of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objective: One of the concerns of health managers in Iran in case COVID-19 reached a new peak is a shortage of hospital beds. In response, the country designed and created intermediate treatment centers, known as fangcang hospitals, which are prepared quickly at low cost and with high capacity. The aim of this study is to provide health managers with an effective post-hospital discharge strategy for COVID-19 patients.

Method: The study was conducted from April 2020 to June 2020, with a narrative case study design. Setting up a fangcang hospital was based on a narrative analysis of 2 in-depth interviews with 4 fangcang hospital managers in Iran, a field visit of these places, and a review of their protocols and guidelines.

Result: The patient flow for screening, treatment, and follow-up includes the following: Patients will be hospitalized if their symptoms are severe. If they are infected with mild symptoms, they will be referred to a fangcang hospital and admitted there if necessary, to prevent further spread of the disease. Patients will be monitored regularly and treated with routine health services. At the end of the 14-day quarantine period, patients approved for discharge are sent home.

Conclusion: Traditional hospitals and fangcang hospitals are working together under the supervision of the Iran University of Medical Sciences. Our experience can serve as guidance for other clinics and recovery shelters. Having guidelines in place assists health care workers and managers in responding quickly to patients' needs during times of a disaster.
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http://dx.doi.org/10.1017/dmp.2021.83DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193180PMC
March 2021

Evaluating the disaster preparedness of emergency medical service agencies in the world: A systematic literature review protocol.

J Educ Health Promot 2020 29;9:351. Epub 2020 Dec 29.

MD National Emergency Medical Organization, Tehran, Iran.

Introduction: Disasters occur almost everywhere in the world, and preparation is essential. Preparedness is an effective approach for disaster management, and it is crucial for the health systems, especially the Emergency Medical Service (EMS) agencies. This systematic review will be conducted to assess the preparedness levels of EMS agencies in the world for the response to disasters and explore the key dimensions and strategies to enhance it.

Methodology: This systematic literature review will be conducted to search comprehensively the articles published between 2000 and 2019 to explore the disaster preparedness of EMS Agencies. To this end, PubMed, Scopus, Web of Science, and Google Scholar will be thoroughly assessed. The following terms and expression will be used for searching the databases: "EMS" and other keywords "Disaster Preparedness," "Mass Casualty Incident," "Mass Gathering," "Terrorist incident," "Weapons of Mass Destruction," and CBRNE, Disaster, included: 'Emergency Preparedness, Preparedness, Readiness.

Discussion: To the best of our knowledge, no systematic review study has been conducted on disaster preparedness of EMS agencies in the world. This is the first study to address this gape. It will also explore the key dimensions of disaster preparedness in EMS services and the strategies to enhance their preparedness.

Conclusion: Identifying the key dimensions of disaster preparedness is the first step in designing valid assessment tools to evaluate disaster preparedness of EMS service. This study will provide valuable guides for EMS administrators and researchers in an attempt to enhance of preparedness of EMS systems in disasters.
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http://dx.doi.org/10.4103/jehp.jehp_416_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871916PMC
December 2020

Lessons Learned From a Chlorine Gas Leakage in Dezful City, Iran.

Disaster Med Public Health Prep 2022 Apr 9;16(2):818-824. Epub 2020 Dec 9.

Department of Nursing and Emergency Medicine, Dezful University of Medical Sciences, Dezful, Iran.

Dezful is the capital of Dezful County, a city in Khuzestan Province, Iran. On August 12, 2017, after a chlorine gas leakage in Dezful, more than 475 people were affected by chlorine gas, and they all suffered from respiratory complications. A lot of problems were encountered in the preparation of the relief forces and organization of the blueprint on how to respond to the incident, such as lack of knowledge on establishment of danger zone, lack of warning system, lack of proper triage and absence of decontamination plans, lack of special chemical safety outfit and respiratory equipment for rescuers, lack of instructions for proper handling, lack of knowledge in dealing with this type of disaster, and inappropriate evacuation skills and failure to cordon off and insure the location of the incident. Although the initial measures to arrest this crisis was performed based on the health system's instructions of the country with regard to all the possible risks, lack of a comprehensive inter-organizational program and prevention plans, lack of control plans, lack of adequate preparation and response to chemical poisoning, lack of foresight, lack of a risk plan, and lack of an intervention plan for these incidents were the reasons for the damages and problems encountered after the crisis.
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http://dx.doi.org/10.1017/dmp.2020.284DOI Listing
April 2022

Disaster Preparedness among Emergency Medical Service Providers: A Systematic Review Protocol.

Emerg Med Int 2020 26;2020:6102940. Epub 2020 Oct 26.

Health in Emergency and Disaster Research Center, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

. The emergency medical service (EMS) provides first-line medical care to people who require urgent medical care in emergency and disaster situations. Preparedness is the most effective approach for the management of disaster risks, and it is essential for the emergency medical service (EMS) providers, such as paramedics, emergency medical technicians (EMT), and other EMS personnel. This systematic review will explore evidence on the preparedness of emergency medical service providers in emergency and disaster situations by reviewing peer-reviewed journal articles. . This study will be conducted on peer-reviewed articles published between 2005 and 2019 to explore the preparedness of emergency medical service providers in emergencies and disasters. Scopus, Web of Science, PubMed, and Google Scholar will be thoroughly searched to identify published studies on emergency and disaster preparedness. The following keywords will be used for searching the databases: "Medical Technician," "Paramedic," "Emergency Paramedic," "Emergency Medicine Technician," "Emergency Medical Technician," "Emergency Prehospital Provider," "Emergency Preparedness," "Disaster Preparedness," "Hospital Preparedness," "Disaster management," "Disaster Competencies," "Disaster Readiness," "Disaster," "Disaster Role," "Readiness, Preparedness, Terrorist," "Mass Casualty Incident," "Major incidents," "Mass Casualty," "Mass Gathering," "CBRNE," "Weapons of Mass Destruction," and "Chemical, Biological, Radiological, Nuclear, and Explosive Event." . To the best of our knowledge, no comprehensive review study has been conducted on the preparedness of emergency medical service providers in disaster situations. This study is the first attempt to address this gap. It will also explore the key dimensions in disaster preparedness of EMS providers and the strategies to enhance their preparedness. Identifying the key dimensions of disaster preparedness is the first step in designing and developing valid instruments to evaluate EMS provider's disaster preparedness and as well as adopting appropriate strategies to improve the level of their preparedness (This systematic review is registred in PROSPERO with CRD42020149689).
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http://dx.doi.org/10.1155/2020/6102940DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7683168PMC
October 2020

A Systematic Review and Meta-analysis on the Prevalence of Smoking Cessation in Cardiovascular Patients After Participating in Cardiac Rehabilitation.

Curr Probl Cardiol 2021 Mar 24;46(3):100719. Epub 2020 Sep 24.

Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Smoking is the most important modifiable cardiovascular risk factor causes around approximately one of every 4 cardiovascular-related deaths worldwide. Cardiac rehabilitation (CR) is the standard way of management of heart diseases after myocardial infraction. This study aimed to determine the prevalence of cardiovascular patients' quit smoking after participation in CR. PubMed, EMBASE, Web of Science, Scopus, and google scholar were searched systematically. In total, 18 studies were analyzed. Results showed that the mean age of smokers' were 54.80 (52.06, 57.55), and of them 53 % (22%, 83%) quit smoking after participating in CR. Subgroup analysis showed that among type of CR the most effective one was the educational along with physical exercise (comprehensive CR) cause 99% (98%, 100%) smoking cessation (SC). Group-based methods with76% (57%, 94%) of quitters showed to be more effective than individual-based. It can be concluded that CR has been effective in terms of smoking cessation.
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http://dx.doi.org/10.1016/j.cpcardiol.2020.100719DOI Listing
March 2021

Hospital Preparedness Challenges in Biological Disasters: A Qualitative Study.

Disaster Med Public Health Prep 2020 Nov 5:1-5. Epub 2020 Nov 5.

Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Objective: Identification of hospital preparedness challenges against biological events such as coronavirus disease 2019 (COVID-19) is essential to improve dynamics, quality, and business continuity confidence in the health system. Accordingly, the purpose of the present study is to evaluate the challenges of hospital preparedness in biological events.

Methods: This study used a qualitative method using content analysis in which 20 health-care managers and experts who are experienced in biological events were selected through purposeful sampling. The data collection was done through semi-structured interviews, which continued until data saturation. The data were analyzed using qualitative content analysis as well as the Landman and Graneheim Approach.

Results: Six main concepts (training and practice, resource management, safety and health, patient management, risk communication, and laboratory and surveillance) and 14 subconcepts were extracted on hospital preparedness challenges in biological events through analyzing interviews.

Conclusions: The present study indicated that the health system of the country faces many challenges in response to biological events and threats. Moreover, study participants indicated that Iranian hospitals were not prepared for biological events. It is recommended to design preparedness plans of hospitals based on preparedness standards for biological events. In addition, comprehensive measures are required to enhance their capacity to respond to biological emergencies.
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http://dx.doi.org/10.1017/dmp.2020.434DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900656PMC
November 2020

Investigation of the relationship between end-tidal carbon dioxide and partial arterial carbon dioxide pressure in patients with respiratory distress.

Med J Islam Repub Iran 2020 24;34:67. Epub 2020 Jun 24.

Department of Internal Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences and Health Services, Tehran, Iran.

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http://dx.doi.org/10.34171/mjiri.34.67DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500426PMC
June 2020

Combination of liver enzymes, amylase and abdominal ultrasound tests have acceptable diagnostic values as an alternative test for abdominopelvic CT scan in blunt abdominal trauma.

Open Access Emerg Med 2019 22;11:205-210. Epub 2019 Aug 22.

Emergency Medicine Management Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Introduction: Abdominal trauma accounts for 15-20% of all-cause mortality of trauma. Abdominopelvic CT scan with intravenous contrast is considered the most accurate non-invasive diagnostic tool in detecting intra-abdominal injuries. In previous studies, rise in liver enzymes and amylase was associated with intra-abdominal injuries but the studies were not sufficient. Our aim was to assess the diagnostic values of liver enzymes and amylase for intra-abdominal injuries in blunt trauma patients.

Methods: We included blunt abdominal trauma patients who referred to three teaching hospitals in 2018. The patients who had 14 years old or more and Glasgow Coma Scale above 8 were enrolled the study if the treating physician had high index of suspicion for intra-abdominal injuries and sent the patients for abdominopelvic CT scan with intravenous contrast. Sensitivity, specificity, positive and negative predictive values are calculated for results of liver enzymes, amylase and abdominal ultrasound.

Results: Eventually, 300 patients with blunt abdominal trauma entered the study. Sensitivity, specificity, positive and negative predictive values of concurrent positive results of abdominal ultrasound, amylase and liver enzymes were 81.73 (95% CI, 73.2-88.1), 63.78 (95% CI, 65.36-70.61), 58.38 (95% CI, 56.36-70.61) and 84.89 (95% CI, 77.6-90.19), respectively.

Conclusion: Considering findings of the present study, the combination of liver enzymes, amylase and abdominal ultrasound results can be an alternative method for detecting intra-abdominal injuries in patients in whom treating physicians have limitations such as overweight, instability of hemodynamic and lack of CT scan facility.
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http://dx.doi.org/10.2147/OAEM.S207066DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709808PMC
August 2019

What structural factors influencing emergency and disaster medical response teams? A comparative review study.

J Educ Health Promot 2019 27;8:110. Epub 2019 Jun 27.

Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Introduction: An important indicator increasing the survival chances of patients and injured people immediately after emergency and disaster is the rapid access to medical services. The establishment of Emergency and Disaster Medical Response Teams (EDMRTs) is one of the main strategies to improve response capacity and capability in the field of EDMRT. This study aimed to probe the structural factors influencing of EDMRTs.

Methodology: In this study, a comparative review method was used. The current study was conducted between March 2017 and September 2018. For this, articles, books, formal reports, and information concerning the available websites regarding the structure of EDMRTs were analyzed. To access relevant scientific articles, an extensive search was carried out in several steps using divergent keywords in the Scopus, ProQuest, PubMed, ScienceDirect, and Google Scholar databases. After accessing the resources and documents, the process of analyzing and comparing different team structures was carried out using content analysis.

Results: Following the search of relevant databases and websites, the structure of EDMRTs in the United States, Australia, Japan, Turkey, New Zealand, Canada, and the World Health Organization were taken into consideration and compared. Two areas of "Organization and Management" as well as "Capacity and Capability Development" were explored along with multiple subsets.

Conclusion: The results of this study revealed that the model and structure of EDMRTs have direct relationship with such elements as the structure of the disaster risk management system, risk assessment, impact of the hazards and medical needs of the affected area, population distribution, level of team activity, and timing of the teams' presence after disasters. The research team recommends designing and conducting studies for determine the roles and responsibilities of the teams.
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http://dx.doi.org/10.4103/jehp.jehp_24_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615133PMC
June 2019

Are serial hematocrit measurements sensitive enough to predict intra-abdominal injuries in blunt abdominal trama?

Open Access Emerg Med 2019 7;11:9-13. Epub 2019 Jan 7.

Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran,

Objective: Routine serial hematocrit measurements are a component of the trauma evaluation for patients without serious injury identified on initial evaluation. We sought to determine whether serial hematocrit testing was useful in predicting the probable injuries in blunt abdominal trauma.

Materials And Method: We performed a prospective study of trauma patients admitted in our observation unit over a 12-month period. Patients routinely underwent serial hematocrit testing in 6-hour intervals (two hematocrit levels). We compared trauma patients with a hematocrit drop of 5 and 10 points or more to those without a significant hematocrit drop.

Results: Five hundred forty-two isolated blunt abdominal trauma patients were admitted to observation unit, and 468 patients (86.35%) had serial hematocrit during their 6-hour stay. Of these patients, 36.11% had a hematocrit drop of 5 or more and 12.61% a drop of 10 or more. Of patients with the hematocrit drop >10, 50.8% have had diagnostic manifestations of intra-abdominal injury in both ultrasonographic and computed tomography scanning (<0.001). There was no significant correlation between hematocrit drop >5 and positive imaging.

Conclusion: Although serial hematocrit testing may be useful in specific situations, routine use of serial hematocrit testing in trauma patients at a level I trauma center's observation unit did not significantly aid in the prediction of occult injuries.
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http://dx.doi.org/10.2147/OAEM.S180398DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327898PMC
January 2019

Effect of cardiac rehabilitation on inflammation: A systematic review and meta-analysis of controlled clinical trials.

ARYA Atheroscler 2018 Mar;14(2):85-94

Assistant Professor, Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: This systematic review and meta-analysis aimed to assess the effect of cardiac rehabilitation (CR) on serum C-reactive protein (CRP) as an indicator of the inflammatory state and predictor of recurrent cardiovascular events.

Methods: PubMed, SCOPUS, Cochrane library, and Google Scholar databases were searched up to January 2014 for original articles which investigated the effect of CR on CRP among adult patients with previous cardiovascular events. The random effects model was used to assess the overall effect of CR on the variation in serum CRP levels.

Results: In the present systematic review and meta-analysis, 15 studies were included. The analysis showed that CR might significantly reduce high-sensitivity CRP (hs-CRP) levels [Difference in means (DM) = -1.81 mg/l, 95% confidence interval (CI): -2.65, -0.98; P = 0.004). However, the heterogeneity between studies was significant (Cochran's Q test, P < 0.001, I-squared = 84.9%). To find the source of variation, the studies were categorized based on study design (quality) and duration. The negative effect was higher among studies which followed their participants for 3 weeks or less (DM = -2.75 mg/l, 95% CI: -3.86, -1.64; P < 0.001) compared to studies which investigated the effect of CR for 3-8 weeks (DM = -0.89 mg/l, 95% CI: -1.35, -0.44; P < 0.001) and those which lasted more than 8 weeks (DM = -1.71 mg/l, 95% CI: -2.53, -0.89; P < 0.001). There was no evidence of heterogeneity when the categorization was based on the follow-up period.

Conclusion: Both short- and long-term CR have resulted in improvement in serum hs-CRP levels. CR can be perceived as a beneficial tool to reduce inflammatory markers among patients with previous cardiac events.
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http://dx.doi.org/10.22122/arya.v14i2.1489DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6087630PMC
March 2018

Development and Psychometric Evaluation of the Pre-hospital Medical Emergencies Early Warning Scale.

Indian J Crit Care Med 2017 Apr;21(4):205-212

Department of School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.

Introduction: The number of requests for emergency medical services (EMSs) has increased during the past decade. However, most of the transports are not essential. Therefore, it seems crucial to develop an instrument to help EMS staff accurately identify patients who need pre-hospital care and transportation. The aim of this study was to develop and evaluate the psychometric properties of the Pre-hospital Medical Emergencies Early Warning Scale (Pre-MEWS).

Materials And Methods: This mixed-method study was conducted in two phases. In the first phase, a qualitative content analysis study was conducted to identify the predictors of medical patients' need for pre-hospital EMS and transportation. In the second phase, the face and the content validity as well as the internal consistency of the scale were evaluated. Finally, the items of the scale were scored and scoring system was presented.

Results: The final version of the scale contained 22 items and its total score ranged from 0 to 54.

Conclusions: Pre-MEWS helps EMS staffs properly understand medical patients' conditions in pre-hospital environments and accurately identify their need for EMS and transportation.
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http://dx.doi.org/10.4103/ijccm.IJCCM_49_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5416787PMC
April 2017

The effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery.

J Res Med Sci 2016 7;21:113. Epub 2016 Nov 7.

Department of Perfusion, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

Background: Cardiopulmonary bypass is associated with increased fluid accumulation around the heart which influences pulmonary and cardiac diastolic function. The aim of this study was to compare the effects of modified ultrafiltration (MUF) versus conventional ultrafiltration (CUF) on duration of mechanical ventilation and hemodynamic status in children undergoing congenital heart surgery.

Materials And Methods: A randomized clinical trial was conducted on 46 pediatric patients undergoing cardiopulmonary bypass throughout their congenital heart surgery. Arteriovenous MUF plus CUF was performed in 23 patients (intervention group) and sole CUF was performed for other 23 patients (control group). In MUF group, arterial cannula was linked to the filter inlet through the arterial line, and for 10 min, 10 ml/kg/min of blood was filtered and returned via cardioplegia line to the right atrium. Different parameters including hemodynamic variables, length of mechanical ventilation, Intensive Care Unit (ICU) stay, and inotrope requirement were compared between the two groups.

Results: At immediate post-MUF phase, there was a statistically significant increase in the mean arterial pressure, systolic blood pressure, and diastolic blood pressure ( < 0.05) only in the study group. Furthermore, there was a significant difference in time of mechanical ventilation ( = 0.004) and ICU stay ( = 0.007) between the two groups. Inotropes including milrinone ( = 0.04), epinephrine ( = 0.001), and dobutamine ( = 0.002) were used significantly less frequently for patients in the intervention than the control group.

Conclusion: Administration of MUF following surgery improves hemodynamic status of patients and also significantly decreases the duration of mechanical ventilation and inotrope requirement within 48 h after surgery.
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http://dx.doi.org/10.4103/1735-1995.193504DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331766PMC
November 2016

Heparinized and Saline Solutions in the Maintenance of Arterial and Central Venous Catheters After Cardiac Surgery.

Anesth Pain Med 2015 Aug 22;5(4):e28056. Epub 2015 Aug 22.

Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

Background: Heparinized saline solution is used to prevent occlusion in the arterial catheters and central venous pressure monitoring catheters. Even at low dose, heparin administration can be associated with serious complications. Normal saline solution can maintain patency of arterial catheters and central venous pressure monitoring catheters.

Objectives: The current study aimed to compare the efficacy of normal saline with that of heparinized one to maintain patency of arterial and central venous catheters after cardiac surgery.

Patients And Methods: In the current randomized controlled trial, 100 patients, with an age range of 18 - 65 years of valve and coronary artery surgery were studied in Rajaie heart center, Tehran, Iran. Patients were randomized to receive either heparinized saline (n = 50) or normal saline flush solutions (n = 50). In the study, arterial catheters and central venous pressure monitoring catheters were daily checked for any signs of occlusion in three postoperative days as primary end-point of the study.

Results: According to the information obtained from the study, four (8%) arterial catheters in the saline group (P value: 0.135) and three (6%) arterial catheters in the heparin group (P value = 0.097) were obstructed. Statistical analysis showed that the incidence of obstruction and changes in all other parameters between the two groups during the three-day follow-up was not significant (all P values > 0.05).

Conclusions: It seems that there is no difference in the use of heparinized and normal saline solutions to prevent catheter occlusion of arterial and central venous pressure.
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http://dx.doi.org/10.5812/aapm28056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604422PMC
August 2015

Traffic accidents in Iran, a decade of progress but still challenges ahead.

Med J Islam Repub Iran 2014 16;28:96. Epub 2014 Sep 16.

11. MD, Assistant Professor of Emergency Medicine, Injury Control Research Center, Shohada-e-haft Tir hospital , Iran University of Medical Sciences, Iran.

Iran has had incremental incidence of traffic accident mortality since introduction of mechanization about a century ago. But the newest data from Iran show decrease in the absolute number of deaths, death per 10,000 vehicles and death per 100, 000 populations. Despite its huge impact on health and economy, research in the field of traffic crashes is still scant and there are still deficiencies in problem oriented research on traffic accidents. Actual cooperation of policy makers, executive bodies and academician could build platform for intersectoral discussion of different aspects of traffic accidents and could reduce burden of traffic accidents.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301220PMC
February 2015

Insulin infusion on postoperative complications of coronary artery bypass graft in patients with diabetes mellitus.

Res Cardiovasc Med 2014 May 1;3(2):e17861. Epub 2014 Apr 1.

Department of Anesthesiology, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

Background: Cardiovascular events are common in patients with diabetes mellitus (DM), which make coronary artery bypass graft (CABG) a highly demanded surgery in this population. Tight control of blood glucose in patients with DM is beneficial in reducing postoperative complications; however, the adequate range has not been determined yet.

Objectives: This study aimed to investigate the effect of semi-tight (moderate) control of DM on complications and serum glucose levels during and after CABG.

Patients And Methods: In this prospective clinical trial, 18 and 31 patients with and without DM, respectively, who were referred to Shahid Chamran Hospital, Isfahan, Iran, for elective CABG surgery, were enrolled. For DM group, patients with controlled DM (i.e. glycosylated hemoglobin levels [HgA1C] ≤ 7%) were recruited. Blood glucose level (blood sugar, BS) was measured after anesthesia, during pumping, warming, off pumping, six and 12 hours after Intensive Care Unit (ICU) admission, and at discharging from the hospital. The hemodynamic state of the patients, bleeding, need of blood transfusion, infection, and duration of hospitalization were also monitored and recorded.

Results: None of the BS measurements (FBS, after anesthesia, on-pump, warming, off pump, six and 12 hours after ICU admission, and at discharge) were significantly different between study groups (P > 0.05). Frequency of surgery site bleeding and blood transfusion need were not significantly different between these groups (P > 0.05).

Conclusions: Semi-tight control of DM with insulin infusion during operation did not led to any difference in the type and rate of CABG complications between patients with well-controlled and those without DM; however, BS levels in patients with well-controlled DM could be more easily controlled.
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http://dx.doi.org/10.5812/cardiovascmed.17861DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253788PMC
May 2014
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