Iranian Red Crescent Medical Journal
Year:2022 | Volume:24 | Issue:12|Papers Count:9

Background: Self-care during Coronavirus Disease 2019 (COVID-19) helps people follow self-care strategies to reduce the spread of the virus. To control the disease, people need to engage in self-care behaviors, which should be investigated by a valid and reliable instrument to yield valid and credible results. Objectives: This study aimed to validate the Persian version of the Self-Care in COVID-19 Scale (SCOVID Scale). Methods: The sample included 582 participants from Tehran’, s general population, selected through convenience sampling in 2021. They were divided into two groups, one for exploratory factor analysis (EFA) and the other for confirmatory factor analysis (CFA). Cronbach’, s alpha coefficient and McDonald’, s omega were used to assess the internal consistency. Standard error of measurement and the interclass correlation coefficient were also employed to examine absolute and relative stability, respectively. Results: In the EFA, three factors, including Precaution, Routine Activities, and Lifestyle, were extracted, explaining 32. 31% of the total variance in COVID-19 self-care. Internal consistency of the whole scale using both Cronbach’, s alpha coefficient and McDonald’, s omega was above 0. 7. The goodness of fit indices of the second-order CFA were in the acceptable range (x2=262. 365, df=82, P<0. 001, RMSEA=0. 062, PCFI=0. 725, PNFI=0. 703, IFI=0. 930, and the CFI=0. 929). Conclusion: The Persian version of the SCOVID Scale is a valid and reliable instrument that can be used in studies on COVID-19.

Background: Coronavirus disease 2019 (COVID-19) involves multiple organs, including the gastrointestinal tract. It also causes frequent thromboembolic events because of its thrombogenicity. This study reports a COVID-19 case of extensive bowel necrosis despite using warfarin. Case Presentation: A 52-year-old homeless addict male was brought via Emergency Medical Services with a chief complaint of abdominal pain for two days and loss of consciousness since the day before. He had a history of cough and dyspnea for seven days and had been using warfarin after mitral valve replacement three years earlier. On admission, he had low oxygen saturation, tachycardia, and fever. Because of his respiratory signs and symptoms, a chest CT scan was performed, and evidence of COVID-19 infection was detected. He had nausea, and on abdominal examination, there was generalized tenderness, rebound tenderness, and guarding. Following physical examination and abnormal laboratory test results, he underwent an emergent laparotomy. Extensive necrosis made surgical intervention impossible, and he died shortly after the surgery. Conclusion: COVID-19-associated coagulopathy raises many challenges nowadays, and according to the present case, even using anticoagulants may not prevent it.

Background: Hazards have always been considered a threat to human life and preparedness to deal with risks for pre-hospital emergency as the first line of care and treatment is highly significant. Pre-hospital emergency (clinical) deals with different natural and man-made hazards which cause various harms. Preservation of disaster preparedness is one of the pre-hospital emergency concerns. In this regard. Objectives: The present study aimed to determine the priority of hazards and design preparedness programs based on health response. Methods: The present study was based on a descriptive-analytical study that was conducted in Rasht, Iran in 2019. The method used in this study was a combination of quantitative and qualitative methods. In a qualitative method, the major threats and potential hazards of pre-hospital emergency were identified by reviewing the texts and searching for relevant articles. Afterward, its effectiveness and the significance of its risk or threat were evaluated using a researcher-made checklist. In total, 19 crisis liaisons from the organizations involved in crisis management in Rasht were questioned, 18 of whom responded to the checklist. Results: The results obtained from the opinions of the experts showed that the risk of earthquakes (88. 8%) and seasonal flood (83. 3%), among all the risks investigated, have a higher priority than traffic accidents (77. 7%) and heavy snowfall (72. 2%) in the society. The prehospital emergency is closely related to many various risks, among which the earthquake risk was chosen as the priority by the community of experts participating in this research. For the emergency of the earthquake, preparedness plans were produced based on the response plan of the health sector and the additional comments of the expert community. Conclusion: Identification of high-priority risks and design of appropriate response plans will help those in charge to face and prepare in time and reduce damages.

Background: Anxiety is common among university students and previous research has highlighted the association between the COVID19 pandemic and higher anxiety scores in the public. Objectives: In this regard, this study aimed to evaluate the effect of the COVID-19 pandemic on the anxiety status of pharmacy students studying in Northern Cyprus and analyze the role of some parameters on the observed anxiety scores. Methods: Anxiety scores of 185 pharmacy students studying at two universities in Northern Cyprus were evaluated using Beck Anxiety Inventory (BAI) and Generalized Anxiety Disorder-7 (GAD-7) assessments. Additionally, the information of participants was recorded in terms of sociodemographic and educational characteristics, antidepressants and anxiolytic use, and consumption of vitamin-mineral supplements. The questionnaires were distributed during the COVID-19 pandemic from December 11, 2020, to January 4, 2021, online via the Microsoft Teams®,platform. It should be mentioned that responses were anonymous. Results: The mean BAI and GAD-7 scores of pharmacy students were 13. 1±, 11. 2 and 10±, 6. 7, respectively. Based on the results, 6% of the students (n=11) revealed potentially concerning levels of anxiety in their BAI responses. Moreover, 31. 9% of the pharmacy students (n=59) demonstrated severe anxiety scores on the GAD-7. Positive COVID-19 cases in the family led to statistically significant increases in anxiety on both instruments. Pharmacy students with five years of education (B. Pharm/M. Pharm) showed significantly higher anxiety scores on the BAI. Besides, age correlated negatively with anxiety scores on the GAD-7. Neither antidepressant and anxiolytic use nor vitamin/mineral supplement use were not related to the anxiety scores of participants. Conclusion: Results of this study demonstrated an alarming anxiety status among pharmacy students during the COVID-19 pandemic period. Diagnosis of a family member with COVID-19 was observed to be critical in triggering the anxiety of pharmacy students. Data from this study should raise awareness to take action plans for the mental well-being of pharmacy students during pandemics.

Background: Donor detection is the first step of organ procurement for transplantation, and about 50% of all potential donors are not detected. Objectives: The present study aimed to evaluate the facilitators and barriers to donor detection based on hospital characteristics and staff opinions. Methods: In this cross-sectional study, a 16-item questionnaire was prepared to clarify medical staff opinions about facilitators (10 items) and barriers (6 items) to potential donor detection. The questionnaire was distributed on social networks, and all medical staff members were invited to participate in the study. Results: A total of 230 medical staff participated in this study. From their point of view, the main facilitator was active detection via regular daily phone calls (150, 65. 2%), which had the most advocators among medical staff of public (64. 1%) and private hospitals (74. 5%). Detection by donor coordinators or inspectors tanked the second (103, 44. 8%). Moreover, private hospitals highly agreed with detection by donor coordinators and inspectors in 66. 7% and 60. 8% of cases, respectively. Donor detection by an in-hospital-coordinator was recommended by 42. 6% of all 230 participants, with most advocators among those affiliated with an organization (65. 4%). Staff opinions about donor selection and care to donor families were important barriers according to 53. 5% and 46. 1% of subjects, respectively. Conclusion: To identify all potential donors, different strategies are necessary according to hospital characteristics. In public hospitals, daily calls,in private ones, active visits,and in an-organization-related hospitals, in-hospital coordinators could be effective.

Background: Triage is used as one of the main concepts in emergency medicine to differentiate between critically ill patients and those in non-emergency situations. Mistriage (undertriage and overtriage) occurs when the prioritization of patients or injured is not performed correctly for any reason. Objectives: According to studies, the incidence of mistriage is high worldwide. Exercise is one of the ways to reduce the amount of mistriage. Methods: This two-group pretest post-test intervention study aimed to investigate the effect of drills on the mistriage of emergency medical service personnel. The follow-up period in this study was 14 days. The participants of the present study included 70 pre-hospital emergency personnel from the selected cities of Isfahan province. After the selection of two cities from Isfahan province by lottery method, all the personnel from these two cities who met the inclusion criteria were involved in the study by census method. The research instruments included: a demographic information form questionnaire, Triage Decision Making Inventory (TDMI), and designed START/jump START triage scenarios. After the collection of the required data, they were analyzed by appropriate parametric and nonparametric statistical tests. Results: Based on the results, the mistriage rate decreased from 4. 74±, 1. 55 out of 12 before the intervention to 1. 1±, 1. 4 after the intervention in the intervention group. Moreover, after the drill, the score of triage decision-making power increased from 121±, 15. 72 to 136±, 15. 11. Conclusion: The findings of the present study pointed out the effectiveness of this exercise method in the reduction of mistriage in participants. Therefore, this method shuld be used in emergency medical service personnel training and preparation programs.

Succinate dehydrogenase (SDH) is a multifaceted enzyme for the mitochondria of eukaryotes, which is responsible for converting succinate to fumarate as a component in the Krebs cycle. Its dysfunction occurs in several malignancies associated with endocrine and epithelial tumors. SDH is an enzymatic complex made of some subunits. Succinate is recognized as an oncometabolite,therefore, the discovery of SDH mutations can give a straight connection between the changes of succinate and tumorigenesis. Progresses in laboratory technologies made it possible to make profiles of and identify succinate accumulation in several types of cancer. In this study, we reviewed the potential roles of SDH mutation and alteration of succinate in tumorigenesis and as tumor markers for the early detection of malignancies.

Background: Pulmonary thromboembolism can be easily diagnosed with computed tomography (CT) and pulmonary angiography (CTPA). However, diagnosis is difficult since a contrast agent cannot be used. Several criteria are recommended for the diagnosis of pulmonary embolism (PE) with non-enhanced CT. Objectives: The aim of this study is to investigate the value of the increase in the pulmonary artery diameter (PA-D) and the ratio of the pulmonary artery diameter / ascending aorta diameter (Ao-D) ratio (PA-D/Ao-D) in the diagnosis of PE in the emergency department (ED). Methods: The CTPA of patients diagnosed with PE (n=88) and a control group (n=89) were examined retrospectively. The main PA (MPA), right MPA (RMPA), left MPA (LMPA), and Ao-D were measured. The ratio of PA-D and Ao-D was calculated. Results: Mean age of participants of this study was 67. 85±, 17. 03 (Min: 18, Max: 98) in the PE group and 67. 31±, 20. 17 (Min: 20, Max: 91) in the control group (P=0. 272). The PE diagnosis of RMPA, right segmental PA, and right subsegmental PA were found to be more than the left side. Moreover, the mean D-Dimer levels were found to be higher in the PE group (7. 31±, 3. 528 mcg/L), compared to the control group (1. 52±, 1. 042 mcg/L) (P=0. 000). In the PE group, the mean Ao-D (35. 14±, 4. 55 mm) was larger, compared to the control group (34. 97±, 5. 28 mm),however, it was not statistically significant (P=0, 828). In the PE group, the average MPA diameter (MPA-D) (30. 45±, 4. 77 mm) was larger than that of the control group (28. 35±, 3. 81 mm) and statistically significant (P=0, 001). In addition, in the PE group, the average MPA-D/Ao-D ratio (0. 87±, 0. 15) was higher in comparison to the control group (0. 82±, 0. 13) (P=0, 016). Conclusion: The increase in PA-D and PA-D/Ao-D ratio can be used in the diagnosis of PE when contrast agent cannot be given on CT or when thrombus cannot be seen on CT for the diagnosis of PE in the ED.

Background: Peripherally inserted central venous catheter (PICC) is a reliable and safe method of central venous catheterization. Objectives: This study aimed to investigate the operation techniques of PICC catheterization in special positions. Methods: From January 2015 to August 2020, 52 cases in special positions were successfully catheterized and divided into four types. The characteristics of body positions, the principle of position placement and sterile sheet laying, the position of the operator, the evaluation before the catheterization, the preparation of related equipment for the catheterization, and the technical points of the catheterization operation were analyzed among these four types. Results: By adopting different techniques (patient position placement, disinfection, sterile sheet laying, operator location, and operation key points) according to different patient positions, PICC catheters were successfully inserted in 52 patients. Conclusion: When PICC catheterization objects cannot be placed in conventional positions, an individualized analysis should be carried out. According to the characteristics of their positions, special evaluation, position placement, disinfection and draping, and the preparation of special equipment to assist individualized catheterization operations should be carried out.