7973 research outputs found
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Explaining the challenges of pre-hospital emergency healthcare workers in providing care at the scene
No full textBackground and Purpose: Pre-hospital emergency healthcare workers face various problems because of the complexities of providing care during emergencies. These challenges can affect their successful performance in achieving their professional goals. To identify these challenges, the present study was conducted to explain the challenges of pre-hospital emergency workers in providing care at the scene. Materials and Methods: The present qualitative study was conducted at Shahrekord University of Medical Sciences in 2022 using the contractual content analysis method. Twenty pre-hospital emergency workers were selected purposefully, and data were collected using individual in-depth semistructured interviews and analyzed using Granheim and Lundman’s approach. Results: The findings include three categories (systemic obstacles, society’s cultural ignorance, and religious obstacles) and seven subcategories (manpower-related obstacles, inappropriate and insufficient equipment, lack of attention and support, inconsistency between organizations, disruptive measures of care, wrong attitude and wrong belief, and gender-related barriers) of obstacles that cause emergency healthcare workers to face challenges in providing care at the scene. Conclusion: The factors that need consideration in strengthening pre-hospital emergency healthcare include improving the training process of students, planning for in-service training of employees, increasing their motivation levels, noticing their psychological issues, developing inter-organizational protocols and policies, and educating, training, and employing women in pre-hospital emergency car
Life story of Iranian parents of a child with phenylketonuria: a qualitative study
No full textParents of a child with phenylketonuria (PKU) face many challenges in childcare. It is crucial for health care workers to understand the situation of parents of a child with PKU and their needs. The purpose of this study was to explore the life story of parents with a child with PKU. This qualitative study has been done with a conventional content analysis approach. Twenty-four parents were selected purposefully. A semi-structured interview was conducted. Data analysis identified three main themes, which included parental reactions, consequences of a child with PKU in parents, and parents’ needs. Parents of children with PKU can be considered people at risk for mental health because of their feelings of isolation and their lonely struggle to manage the disease and its effects on their child. This study shows that mothers need more support due to the misconceptions in and attitudes of their social environment. Therefore, it is necessary to understand this group, their needs and lives, and provide further support and promote empathy in the health system for the parent
In silico design and immunoinformatics analysis of a universal multi-epitope vaccine against monkeypox virus
No full textMonkeypox virus (MPXV) outbreaks have been reported in various countries worldwide; however, there is no specific vaccine against MPXV. In this study, therefore, we employed computational approaches to design a multi-epitope vaccine against MPXV. Initially, cytotoxic T lymphocyte (CTL), helper T lymphocyte (HTL), linear B lymphocytes (LBL) epitopes were predicted from the cell surface-binding protein and envelope protein A28 homolog, both of which play essential roles in MPXV pathogenesis. All of the predicted epitopes were evaluated using key parameters. A total of 7 CTL, 4 HTL, and 5 LBL epitopes were chosen and combined with appropriate linkers and adjuvant to construct a multi-epitope vaccine. The CTL and HTL epitopes of the vaccine construct cover 95.57% of the worldwide population. The designed vaccine construct was found to be highly antigenic, non-allergenic, soluble, and to have acceptable physicochemical properties. The 3D structure of the vaccine and its potential interaction with Toll-Like receptor-4 (TLR4) were predicted. Molecular dynamics (MD) simulation confirmed the vaccine's high stability in complex with TLR4. Finally, codon adaptation and in silico cloning confirmed the high expression rate of the vaccine constructs in strain K12 of Escherichia coli (E. coli). These findings are very encouraging; however, in vitro and animal studies are needed to ensure the potency and safety of this vaccine candidate
Marginal Accuracy of CAD/CAM Frameworks Fabricated by Presintered Cobalt-Chromium Alloy: A Systematic Review and Meta-analysis
No full textPurpose: To evaluate the marginal accuracy of soft-milled cobalt-chromium (Co-Cr) compared to other construction methods/restorative materials in tooth/implant-supported restorations. Materials and Methods: PICO questions were defined, and a systematic search was conducted in six electronic databases. Titles and abstracts were collected and screened by two independent reviewers. After removing duplicate articles, the full texts of relevant articles were gathered, and the required information and data were extracted. Risk of bias was assessed and meta-analyses of the collected data were conducted using STATA software version 16. Results: A total of 1,914 experimental and clinical articles were reviewed, and 18 studies were selected for qualitative analysis. The 16 studies that were included in the meta-analysis showed no significant marginal gap differences between soft-milled Co-Cr and the following methods/materials: hard-milled Co-Cr (I2 = 92.9%, P =.86), casting wax (I2 = 90.9%, P =.42), laser-sintered Co-Cr (I2 = 93.3%, P =.46), and zirconia (I2 = 0.00%, P =.47). However, a significantly higher marginal accuracy of soft-milled Co-Cr was observed when compared to milled-wax castin
Antioxidants and cisplatin nephrotoxicity; an updated review on current knowledge
No full textCisplatin is a first-line antitumor drug which is applied in the therapeutic field of numerous kinds of cancers. The main dose-dependent adverse effect of cisplatin is nephrotoxicity in approximately one-third of patients, who received this drug during their treatment. Oxidative stress is one of the most significant mechanisms in cisplatin nephrotoxicity. Cisplatin-induced oxidative stress stimulates apoptosis, inflammation, mitochondrial damage within cells, and endoplasmic reticulum (ER) stress. The administration of an antioxidant in this context could be a suitable approach for preventing of cisplatin nephrotoxicity. Antioxidants are categorized into four classes: dietary antioxidants, free radical scavengers, thiol-containing compounds, and iron chelator
Relation of CAD/CAM zirconia dental implant abutments with periodontal health and final aesthetic aspects; A systematic review
No full textBackground: Using dental implants to replacing missing teeth and satisfy both functional and aesthetic needs is one of the mainstream dental treatments. New approaches including computer-aided design and computer-assisted manufacture (CAD/CAM) have been introduced to improve these elements. This systematic review aimed to compare CAD/CAM zirconia (Zr) implant abutments with other available abutments in terms of peri-implant health and aesthetics. Material and Methods: Five electronic databases (PubMed, Web of Science, Scopus, ProQuest, and Embase) were scoured for clinical studies evaluating Zr abutments reporting on the outcomes of interest including interproximal papilla stability (PS), papilla recession (REC), pink and white esthetic score (PES, WES), marginal bone level (MBL), color, and soft tissue contour. A hand searches in English language journals until September 2020 complemented the search. Two tools of Joanna Briggs Institute and Jaded Score calculation were used for the risk of bias assessment. No quantitative synthesis of the data was done due to high heterogeneity. Results: A total of six studies from the 412 ones obtained from the search were included. The study designs were either prospective cohort (n=3) or randomized clinical trial (n=3). Papilla fill, WES, PES, and the distance from the bone crest of adjacent teeth to the contact point (CPB) and inter-tooth–implant distance (ITD) was not significantly different between Zr CAD/CAM and Zr stock abutments. However, soft tissue stability and REC index were better in Zr CAD/CAM abutments. Conclusion: Higher soft tissue stability can be achieved for Zr compared to titanium abutments with either stock or CAD/CAM abutments
Pre-hospital Emergency Service Challenges in the Face of the COVID-19 Pandemic in Iran
No full textObjective: With the outbreak of coronavirus disease 2019 (COVID-19), the workload of the Iran's health-care system along with the Pre-hospital Emergency Service (PHES) increased significantly so that Iranian fledgling emergency system had never experienced such a crisis. With regard to the importance of the function of PHES as the front-line staff of Iran's health system and its role in controlling the recent epidemic crisis, this study was conducted to identify the challenges of PHES function in the face of COVID-19 pandemic. Methods: The study was conducted with qualitative approach through content analysis in 2021. Semi-structured interviews were used to collect data. Sampling was purposive and continued until data saturation. After 24 interviews, the data were saturated. The extracted codes were thoroughly prepared as a data pool. After encoding all available data, the related codes were categorized into a single theme. After extracting the themes, a network of themes, related to the research topic, was drawn, and then, the relationship between the themes was analyzed. Results: Data analysis undertaken for the qualitative study resulted in the identification of 4 main themes included: challenges related to facilities and equipment, living with uncertainty, professional and organizational capabilities, and burnout. Conclusions: PHES personnel have an important and key role in providing care to patients during COVID-19 epidemic period. Individual and systemic challenges were among the most important issues in the experiences of these personnel. These challenges require organizational planning and special attention of health policy-makers to maintain the staff's physical and mental health during the pandemic and the possible crises ahead
Chronic stress but not acute stress decreases the seizure threshold in PTZ-induced seizure in mice: role of inflammatory response and oxidative stress
No full textSeizure is paroxysmal abnormal electrical discharges in the cerebral cortex. Inflammatory pathways and oxidative stress are involved in the pathophysiology of seizures. Stress can induce an oxidative stress state and increase the production of inflammatory mediators in the brain. We investigated the effects of acute and chronic stresses on the seizure threshold in pentylenetetrazol (PTZ)-induced seizures in mice, considering oxidative stress and inflammatory mediators in the prefrontal cortex. In this study, 30 male Naval Medical Research Institute (NMRI) mice were divided into 3 groups, including acute stress, chronic stress, and control groups. PTZ was used for the induction of seizures. The gene expression of inflammatory markers (IL-1 beta, TNF-alpha, NLRP3, and iNOS), malondialdehyde (MDA) level, nitrite level, and total antioxidant capacity (TAC) were assessed in the prefrontal cortex and serum. Our results showed that stress could increase the expression of inflammatory cytokines genes and oxidative stress in the prefrontal cortex of the brain and serum following PTZ-induced seizures, which is associated with increased seizure sensitivity and decreased the seizure threshold. The effects of chronic stress were much more significant than acute stress. We concluded that the effects of chronic stress on seizure sensitivity and enhancement of neuroinflammation and oxidative stress are much greater than acute stress
Preparedness of Iranian nurses against COVID‐19: An analytical study
No full textBackground and Aims: The reasons for the unfavorable performance of hospitals in providing care to Coronavirus Disease 2019 (COVID-19) patients include the lack of preparation, knowledge, and relevant skills, making it necessary to evaluate the preparedness of nurses to respond to COVID-19. Therefore, the present study aimed to investigate the preparedness of hospitals affiliated with Shahrekord University of Medical Sciences during the COVID-19 pandemic in 2022. Methods: In this analytical study, data were collected from 350 randomly selected nurses who worked in three hospitals affiliated with Shahrekord University of Medical Sciences; demographic information tools and the preparation of nurses for COVID-19 patients were used to collect the data. We analyzed the data using SPSS software version 26. Results: The mean and standard deviation of the total preparation score was 118.85 ± 0.98. The lowest (6.80 ± 0.18) and highest (23.35 ± 0.19) average values belonged to risk assessment and management and COVID-19, respectively. The score of nurses' preparedness to deal with COVID-19 was not statistically correlated with age, work experience, and so on. The average preparation score was significantly different in different treatment departments (operating room and COVID-19). Conclusion: The preparation of nurses was low in dealing with COVID-19. Thus, managers of nursing services should design and implement educational programs to strengthen the nurses' weaknesses and ultimately increase their awareness and skills in dealing with disasters
Pneumomediastinum: A case report of baclofen toxicity
No full textIntroduction: Baclofen is a γ -aminobutyric acid (GABA) agonist used to treat spasticity; however, it may be toxic at dosages above 200 mg. The psychological, nervous, cardiovascular, gastrointestinal, musculoskeletal, and respiratory systems are all affected. This report represents a case with the rare respiratory complications brought on by baclofen toxicity: atelectasis and pneumomediastinum. Presentation of case: A 19-year-old female was admitted to the emergency department after attempting suicide by taking 20 baclofen tablets (500 mg). Imaging revealed pneumomediastinum, atelectasis, and a leftward displacement of mediastinal structures. Her therapy included a chest tube to relieve the pneumomediastinum and sodium valproate, promethazine, biperiden, and quetiapine for neurological symptoms. Four days after being admitted, she was successfully extubated without any complications. Discussion: Baclofen activates GABA-A and GABA-B receptors. High doses of baclofen may induce central nervous system and respiratory depression, requiring intensive care. GABA receptors may cause hallucinations, delusions, and agitation in baclofen overdose. High dosages of baclofen may cause bronchial and bronchiolar muscular spasms, leading to breathing problems and atelectasis. Recent animal studies on baclofen toxicity showed that increased alveolar pressure, circulatory abnormalities, edema, alveolar hemorrhages, and infiltration cause rupture and pneumomediastinum. Pneumomediastinum may need bed rest, oxygen, antitussives, and analgesics, but severe cases may necessitate a chest tube. Conclusion: A high index of suspicion is required for early diagnosis of acute baclofen poisoning, which could manifest as respiratory complications, including pneumomediastinum and atelectasis. Since most cases are benign, it is still crucial for clinicians to detect complications early for further management