Iranian Red Crescent Medical Journal
Year:2022 | Volume:24 | Issue:8|Papers Count:10

Background: The Ottawa Decisional Conflict Scale (ODCS) is one of the initiatives developed to determine the information about the patient's decision and the factor that influence the decision made. Therefore, a systematic and structured process of decision-making can express the 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 researcher decided to make a transcultural adaptation and evaluate the decision-making of the Malaysia version of the ODCS, which seeks information about decision-making and 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.

Background: Breast cancer is extensively studied for its resistance to chemotherapy. Therefore, finding efficient therapeutic agents is vital to increasing the survival rate of patients. Objectives: Here, we conducted an in vitro study on the anti-tumor properties of Vinca herbacea extract on SKBR3 cells. Methods: Apoptotic and anti-invasive activity of V. herbacea extract 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-2 and BAX), as well as metastatic genes (MMP2 and MMP9) were studied using real-time polymerase chain reaction. Results: Vinca herbacea extract showed significant antiproliferative and cytotoxic effects on human breast cancer cells, compared to human embryonic kidney cells 293. Vinca herbacea extract had a great apoptosis-inducing potential in breast cancer cells by activating caspase-3 and increasing the BAX/Bcl-2 ratio. Vinca herbacea extract prevented cancer cell angiogenesis, marked by decreasing the expression level of angiogenesis-related genes, including VEGF, VEGFR-1, and VEGFR-2. In addition, V. herbacea extracts reduced cancer cell invasion and noticeably decreased the expression level of metastasis-associated genes, including MMP2 and MMP9. Conclusion: Vinca herbacea extracts exhibited vigorous cytotoxic effects on SKBR3 cells by the alteration of apoptosis, cell adhesion, invasion, and angiogenesis.

Background: Medical emergencies are unpredictable situations that can occur outside of the health facilities and when doctors are offduty. 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.

Dear Editor, After almost two years, the world is struggling with a deadly virus that is still infecting people daily across the world,moreover, successive mutations in the virus create new variants with higher spreading ability and new waves of disease (1-3). Coronavirus disease 2019 (COVID-19) claimed the lives of many defenseless people and medical staff on the front lines in the first months and years. In the fight against this deadly virus, the human being has shown that he has not retreated and has fought against it with all his might, and the production of various vaccines has increased the human defense against it (4). . .

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 their manifestation amongst men and women have been investigated. Objectives: This study aimed to compare the side effects of the Sinopharm vaccine among men and women 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 in women than in men. Moreover, women were significantly less able to perform daily routines than men.

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.

Cancer has always been a severe threat to health and life. Since patients with advanced cancer often have a limited survival time and high 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 of oncolytic bacteria and viruses, a revolutionary therapeutic technique for the treatment and potential cure of malignant tumors has emerged. Clostridium, Bifidobacteria, Salmonella typhimurium, Listeria monocytogenes, and Bacillus are all oncolytic bacteria. Adenoviruses, Vaccinia viruses, Reoviruses, Herpesviruses, and Coxsackieviruses are 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.

Venous thrombosis 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 "Prediction Models" 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, scoring method, evaluation method, and scope of application.

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 weight while fasting. There was no significant difference between the 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.

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 of literature 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 had average 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 study findings to discover the strengths and weaknesses of the e-Referral performance.