Relationship between Vaginal Bacterial Infections and Pregnancy Outcomes: A Systematic Review and Meta-Analysis.

Background: Bacterial infections are among the most serious infections worldwide. They can cause miscarriage, premature birth, stillbirth, and ectopic pregnancy in pregnant women. The aim of this study was to investigate the relationship between bacterial infections and pregnancy outcomes through a systematic review and meta-analysis. Materials and Methods: PubMed, Scopus, Web of Science, and Embase databases were searched from January 2000 to December 2018 using appropriate keywords to identify related articles. The final related studies were selected and evaluated using the Newcastle-Ottawa Scale (NOS). Results: Results of this meta-analysis based on combining case-control studies showed that the presence of bacterial infections could lead increase in the odds of all pregnancy outcomes like premature infant birth (odd ratio [OR]: 1.50; 95% Confidence Interval [CI], 1.39-1.61), preterm delivery (OR: 1.54; 95% CI, 1.39-1.70), abortion (OR: 1.16; 95% CI, 1.04-1.29), stillbirth (OR, 1.29; 95% CI, 1.12-1.49), and ectopic pregnancy (OR: 1.12; 95% CI, 1.05--1.19). The results showed that the Risk Ratio (RR) of preterm delivery in pregnant women with vaginal infections was 1.57 (95% CI, 1.46-1.67), whereas the RR of abortion was 2.02 (95% CI, 1.72-2.38). Conclusions: Based on the results of this meta-analysis, the presence of bacterial infections in pregnant women can lead increase in the risk of pregnancy outcomes especially, preterm delivery, abortion, stillbirth, and ectopic pregnancy. Therefore, it is necessary for obstetricians and gynecologists to pay attention to the diagnosis of these infections in women before pregnancy and during pregnancy in order to prevent the consequences of these infections.

The relationship between microbial contaminations of embryo transfer catheters with pregnancy outcome after embryo transfer.

Background: Different stages of assisted reproductive technologies are susceptible to contamination by various microorganisms. Objective: The aim of the study was to investigate the relationship between microbial contamination of embryo transfer catheters and the pregnancy outcome after embryo transfer. Methods: This cohort study was conducted on 60 patients candied for in vitro fertilization and embryo transfer cycles from 2021 to 2022. All embryos were transferred using a sterile syringe. The catheter contamination was checked by the microbial culture method, and in the case of microbial culture that were negative, polymerase chain reaction was done to confirm the result. The data analyzed using STATA 17 to determine the impact of catheter contamination on the clinical pregnancy rate. Results: The average age of peoples whose microbial culture was positive was lower than that of people whose microbial culture was negative (P<0.05). Also the results showed that people who live in villages have more positive microbial cultures than people who live in cities (P<0.05). Also there is no difference between the number of successful implantations and the pregnancy outcome between people whose microbial culture results were positive or negative. Conclusion: The results of the current study showed that the contamination of the embryo transfer catheter with microorganisms under our investigation did not affect the pregnancy outcome.

Socioeconomic inequalities in metabolic syndrome and its components in a sample of Iranian Kurdish adults.

OBJECTIVES: The worldwide incidence of metabolic syndrome (MetS) has increased in recent decades. In this study, we investigated the socioeconomic inequalities associated with MetS and its components in a sample of the Iranian Kurdish population. METHODS: We used data from 3,996 participants, aged 35 years to 70 years, from the baseline phase of the Dehgolan Prospective Cohort Study (February 2018 to March 2019). The concentration index and concentration curve were used to measure inequality and the Blinder-Oaxaca decomposition method was used to examine the contribution of various determinants to the observed socioeconomic inequality in MetS and its components. RESULTS: The prevalence of MetS was 34.44% (95% confidence interval [CI], 32.97 to 35.93). The prevalence of MetS was 26.18% for those in the highest socioeconomic status (SES), compared with 40.51% for participants in the lowest SES. There was a significant negative concentration index for MetS (C=-0.13; 95% CI, -0.16 to -0.09), indicating a concentration of MetS among participants with a lower SES. The most prevalent component was abdominal obesity (59.14%) with a significant negative concentration index (C=-0.21; 95% CI, -0.25 to -0.18). According to decomposition analysis, age, gender, and education were the highest contributing factors to inequality in MetS and its components. CONCLUSIONS: This study showed socioeconomic inequality in MetS. People with a low SES were more likely to have MetS. Therefore, policymakers and health managers need to develop appropriate strategies to reduce these inequalities in MetS across age groups, genders, and education levels, especially among women and the elderly.

Factors Affecting the Use of Physical Restraints by Nurses for Patients in Intensive Care Units.

How to cite this article: Shakeri B, Vatandost S, Nouri B, Valiee S. Factors Affecting the Use of Physical Restraints by Nurses for Patients in Intensive Care Units. Indian J Crit Care Med 2023;27(5):372-373.

ptk2 and mt2a Genes Expression in Gastritis and Gastric Cancer Patients with Helicobacter pylori Infection.

Background: ptk2 and mt2a genes contribute to the cell cycle during proliferation and apoptosis, respectively. Designing a case-control study including gastric adenocarcinoma and gastritis patients with and without Helicobacter pylori infection would lead to determinate of the correlations between ptk2 and mt2a genes expression with H. pylori infection in gastric antral epithelial cells. Methods: Overall, 50 and 30 gastric antral biopsy samples of gastric cancer (case group) and gastritis (control group) patients were included into study, respectively. All biopsy samples were collected considering the exclusion criteria including patients with a history of consumption of tobacco, alcohol, and anti-H. pylori drugs. Each patient group is divided into with and without H. pylori infection to detect cDNA fold changes of ptk2 and mt2a genes by using Real Time RT PCR. Furthermore, the presence of H. pylori virulence genes was detected directly by using specific primers and simple PCR on cDNA synthesized from total RNA of gastric antral biopsy samples. Results: A negative correlation was revealed between age and clinical manifestations with the ΔCt value of the ptk2 gene (P < 0.05). The H. pylori iceA1/2 and cagE genes revealed positive and negative correlations with the ΔCt value of the ptk2 gene (P < 0.05), respectively. Furthermore, a weak correlation was detectable between H. pylori babA2/B, oipA, and cagY genes and the ΔCt value of the mt2a gene in gastric antral epithelial cells of patients (P < 0.1). Conclusions: The results of the current study opened a view for more investigation on the stunning roles of H. pylori infection in clinical outcomes through mt2a and ptk2 gene expression in gastric antral epithelial cells.

Comparing the Effect of Ondansetron-dexamethasone and Metoclopramide-dexamethasone on Postoperative Nausea and Vomiting after Gynecological Laparoscopy: A Randomized Double-blind Clinical Trial.

Background: Nausea and vomiting is a common complication after gynecological surgeries, especially laparoscopy, which can lead to discomfort and restlessness in the patients. The aim of the study was to compare the effect of ondansetron-dexamethasone and metoclopramide-dexamethasone on postoperative nausea and vomiting following gynecological laparoscopy. Materials and Methods: In this double-blind clinical trial, 68 females scheduled for gynecological laparoscopy and age range of 18-40 years were randomly divided into two groups. Group OD received ondansetron 4 mg plus dexamethasone 8 mg and group MD received metoclopramide 10 mg plus dexamethasone 8 mg, 15 min before the end of surgery. The incidence of nausea and vomiting and need for rescue medication was assessed during the recovery period, as well as at 2, 4, 6, 12, and 24 h after surgery. The data were analyzed using STATA software version 12 and a significance level of <0.05 was considered in this research. Results: The incidence of nausea in ondansetron and metoclopramide groups was 23.3% and 33.3%, respectively, and the frequency of vomiting was 10% and 16.6%, respectively, which showed no significant difference (P > 0.05). The highest incidence of nausea and vomiting in patients belonged to the metoclopramide group inside 4-6 h after surgery. Conclusion: Our study showed that no significant difference was observed in the incidence of nausea and vomiting between ondansetron-dexamethasone and metoclopramide-dexamethasone groups following laparoscopic gynecological surgery; however, the number of patients with nausea and vomiting was lower in the ondansetron-dexamethasone group.

Effect of calcium hydroxide on morphology and physicochemical properties of Enterococcus faecalis biofilm.

Calcium hydroxide Ca(OH)2 has been used as an intracanal medicament to targets microbial biofilms and avert secondary infection in the root canal system. This study evaluated the effects of this material on the morphology and physicochemical properties of an established in-vitro biofilm of Enterococcus faecalis. A biofilm of E. faecalis was grown in multichannel plates. The chemicals including Ca2+, OH-, and saturated Ca(OH)2 (ie 21.6 mM) were prepared in order to evaluate which component eradicated or amplified biofilm structure. Various biochemical and microscopic methods were used to investigate the properties of the biofilm. Biofilms treated with Ca(OH)2 absorbed more Ca2+ because of the alkaline pH of the environment and the ions affected the physicochemical properties of the E. faecalis biofilm. A denser biofilm with more cavities and a granular surface was observed in the presence of Ca2+ ions. This resulted in a decrease in the surface-to-biofilm ratio with increases in its biomass, thickness, colony size, and volume. Calcium hydroxide did not destroy E. faecalis biofilms but rather contributed to the biofilm structure. This in-vitro study sheds light on a missing link in the formation of E. faecalis biofilm in which the Ca2+ in Ca(OH)2.

The association between methamphetamine use and number of sexual partners in men who have sex with men: a systematic review and meta-analysis.

BACKGROUND: Methamphetamine use in men who have sex with men population is significantly higher than that in the general population. Meth use can cause high-risk sexual behaviors, such as having sex with a variety of sexual partners. The aim of this study was to determine the association between meth use and the number of sexual partners in MSM. METHODS: Searching international databases (PubMed (Medline), Scopus, Web of Sciences, Embase (Elsevier), PsycInfo (Ovid), Cochrane CENTRAL (Ovid)) until March 2021 was performed in this meta-analysis using appropriate keywords terms to identify related articles. After retrieving articles in these databases, screening was performed based on the title, abstract and full text of the articles, and the final related studies were selected and evaluated using the Newcastle Ottawa scale checklist. RESULTS: The sample size consisted 18,455 people in this study, including four cohort studies with a sample size of 15,026 MSM and four case-control studies with a sample size of 3429 MSM. The results of meta-analysis showed that meth use increased the number of sexual partners in MSM (RR: 3.70; % 95 CI: 2.04-6.70). The results of subgroup analyze based on the number of sexual partners showed that in MSM taking meth, the risks of having one to three, four to five, and six or more than six sexual partners were respectively 2.82, 2.98 and 5.89 times higher than those in MSM who did not take meth. CONCLUSION: The results showed that meth uses in MSM increased the number of their sexual partners. Due to the fact that increasing the number of sexual partners and high-risk sexual behaviors increase the risk of contracting sexually transmitted diseases such as HIV, it is necessary to adopt control programs to prevent meth use by this group, or to implement programs of reduction in the risk of STIs for this group.

Serum Circ-FAF1/Circ-ELP3: A novel potential biomarker for breast cancer diagnosis.

BACKGROUND: Recently, measurement of serum circular RNAs (circRNAs) as a non-invasive tumor marker has been considered more. We designed the present study to investigate the diagnostic efficiency of serum Circ-ELP3 and Circ-FAF1, separately and simultaneously, for diagnosis of patients with breast cancer. METHODS: Seventy-eight female patients diagnosed as primary breast cancer participated in this study. We measured the level of circRNAs in serum specimens of the studied subjects. A receiver operating characteristic (ROC) curve was plotted and the diagnostic efficiency for both circRNAs was determined. RESULTS: Compared to non-cancerous controls, Circ-ELP3 was upregulated in breast cancer patients (p-value = 0.004). On the other hand, serum Circ-FAF1 was seen to be decreased in breast cancer patients than controls (p-value = 0.001). According to ROC curve results, the area under the curve (AUC) for Circ-ELP3 and Circ-FAF1 was 0.733 and 0.787, respectively. Furthermore, the calculated sensitivity and specificity for Circ-ELP3 and Circ-FAF1 were 65, 64% and 77, 74%, respectively. Merging both circRNAs increased the diagnostic efficiency, with a better AUC, sensitivity and specificity values of 0.891, 96 and 62%, respectively. CONCLUSION: Briefly, our results revealed the high diagnostic value for combined circRNAs panel, including Circ-ELP3 and Circ-FAF1 as a non-invasive marker, in detection of breast carcinomas.

Effect of Multimodal Intervention on Nursing Students' Adherence to Hand Hygiene: An Experimental Study.

BACKGROUND: Hand hygiene adherence is highly important in clinical practice and is influenced by various factors. AIMS: This study investigated the effect of multimodal intervention on nursing students' adherence to hand hygiene in clinical practice. METHODS: Internship nursing students were randomized into control (n = 20) and intervention (n = 26) groups. Adherence to hand hygiene was measured by self-report questionnaire and by observation. The intervention group received multimodal interventions for 1 week. FINDINGS: Results showed significant effects of multimodal intervention on adherence to hand hygiene in "before contact with the patient," "before and after contact with the patient" situations, and at the beginning of medication administration, catheterization, vital sign measurement, and blood sugar testing. CONCLUSION: The multimodal intervention improved adherence to hand hygiene in the intervention group. Given the importance of hand hygiene adherence by nursing students in all situations, designing and implementing context-based multimodal interventions are recommended as part of nursing students' educational programs.

Comparison of the effect of oral pregabalin with intravenous ketamine on reducing acute pain after abdominal hysterectomy: A randomized double-blind clinical trial.

BACKGROUND: The aim of this study was to compare the analgesic effects of pregabalin and ketamine on reducing pain after abdominal hysterectomy. METHODS: In this double-blind clinical trial, one hundred forty ASA I and II patients of age range 30-60 years scheduled for abdominal hysterectomy undergoing general anesthesia in 2018, were randomly divided into 4 equal groups. Pregabalin group received 300 mg oral pregabalin, ketamine group received 0.3 mg/kg of intravenous ketamine, and pregabalin- ketamine group received the combination of the two-above medication, and placebo group received the placebo and saline. Patients were evaluated for pain intensity according to the visual analogue scale (VAS) at 2, 4, 6, 12, 18, and 24 hours after surgery. Also, the need for analgesic drugs and the frequency of repetitions were also recorded. Statistical analysis was performed using STATA, Version 14. A p- value less than 0.05 was considered statistically significant. RESULTS: In the pregabalin and pregabalin-ketamine groups, pain in the first 6 hours after the end of operation was significantly less than the other two groups (p<0.05), but there was no significant difference between the 4 groups at 18 and 24 hours after surgery. The need for analgesic medications in the pregabalin group was lower than in other groups (p<0.05). CONCLUSION: The results of this study show that the administration of oral pregabalin with and without intravenous ketamine before abdominal hysterectomy can decrease postoperative pain and reduce the need for analgesia.

Investigating patients' attitudes toward receiving care from an opposite-gender nurse.

BACKGROUND: The imbalance in nurse-to-patient ratio and limited physical space may lead to care provision by a nurse of the opposite gender. On the other hand, the relationship with the opposite gender in Iran is limited due to cultural and religious beliefs. The aim of this study was to investigate patients' attitudes toward receiving care from the opposite gender nurse. MATERIAL AND METHOD: This descriptive cross-sectional study was carried out on 200 patients admitted to different hospital wards. The patients were recruited using convenience sampling. Data collection tools comprised of a demographic questionnaire and a researcher-made questionnaire. Data were analyzed using SPSS (version 16) and running descriptive statistics (i.e., χ2 , independent t test, and linear regression analysis). RESULTS: Male and female patients had 31.8% and 42.6% negative attitudes toward receiving care from the opposite gender, respectively, indicating a statistically significant difference (p = .05). Patients' attitudes had a significant and positive relationship with age, level of education, and experience of receiving care from a nurse of the opposite gender. CONCLUSION: A significant percentage of patients had a negative attitude toward receiving care from the opposite-gender nurse. Since people's attitudes affect their relationships, it is necessary to provide conditions for assigning the same gender nurse for patients and improving patients' attitudes toward nurses of the opposite gender.

Special care for oral tissue samples after biopsy: proper storage and transport ­ a comparative study / Cuidado especial para las muestras de tejido bucal después de la biopsia: almacenamiento y transporte adecuados ­ un estudio comparativo

Objective: Biopsy is the gold standard for the diagnosis of oral lesions. Correct management and care of biopsy at all steps (before, during and after obtaining a biopsy) is highly important to provide proper tissue samples for microscopic assessment by pathologists. This study aimed to assess and compare the knowledge of dental students (DSs) and general dentists (GDs) on post-oral biopsy instructions. Material and Methods: A questionnaire including two parts was used: 1) Demographic data and self-evaluation of biopsy knowledge by the participants and 2) 11 items about the correct oral biopsy storage and transport to a histopathology laboratory. The data collected from the questionnaires were analyzed by STATA. Results: 48 GDs and 131 DSs participated in this study. The knowledge score of the DSs (5.43±2.01) was significantly lower than GDs (8.33±1.78) (p<0.05). Moreover, there was no significant relationship between GDs' knowledge and their working experience, age, gender and the university they graduated from. However, there was a significant relationship between DSs' school year and their knowledge. Conclusion: The findings showed that the knowledge of DSs was lower than GDs. Since, these students will care for the oral and dental health of the community in the future, upgrading their training (by improving the quantity and quality of theoretical and practical training) is necessary to both understand the different aspects of biopsy, and to be familiar enough with proper oral biopsy storage and transport processes.

Objetivo: La biopsia es el estándar de oro para el diagnóstico de lesiones bucales. El manejo y cuidado correctos de la biopsia durante todos los pasos (antes, durante y después de obtener una biopsia) es muy importante para proporcionar muestras de tejido adecuadas para la evaluación microscópica por parte de los patólogos. Este estudio tuvo como objetivo evaluar y comparar los conocimientos de estudiantes de odontología (SD) y dentistas generales (GD) sobre las instrucciones posteriores a la biopsia oral. Material y Métodos: Se utilizó un cuestionario que constaba de dos partes: 1) Datos demográficos y autoevaluación del conocimiento de la biopsia por parte de los participantes y 2) 11 ítems sobre el correcto almacenamiento y transporte de la biopsia oral a un laboratorio de histopatología. STATA analizó los datos recopilados de los cuestionarios. Resultados: 48 GD y 131 SD participaron en este estudio. La puntuación de conocimiento de los DS (5,43 ± 2,01) fue significativamente menor que la de los GD (8,33 ± 1,78) (p <0,05). Además, no hubo una relación significativa entre los conocimientos de los GD y su experiencia laboral, edad, género y la universidad de la que se graduaron. Sin embargo, hubo una relación significativa entre el año escolar de los DS y sus conocimientos. Conclusión: Los hallazgos mostraron que el conocimiento de los SD era menor que el de los GD. Dado que estos estudiantes se ocuparán de la salud bucodental de la comunidad en el futuro, es necesario mejorar su formación (mejorando la cantidad y calidad de la formación teórica y práctica) tanto para comprender los diferentes aspectos de la biopsia como para estar familiarizados suficientemente con los procesos adecuados de almacenamiento y transporte de biopsias orales.

Frequency of Codon 306 Mutations in embB Gene of Mycobacterium tuberculosis Resistant to Ethambutol: A Systematic Review and Meta-Analysis.

BACKGROUND: Ethambutol (EMB) resistance is a major concern in patients with tuberculosis (TB). The aim of this study was to determine the frequency rate of mutations in the embB306 gene of Mycobacterium tuberculosis (M. tuberculosis) resistant to EMB, based on a systematic review and meta-analysis. METHODS: Thirty-seven original articles (1997-2015) that have been published in valid databases were considered for this research. The articles were systematically reviewed for the prevalence and rate of mutations in embB306 in EMB-resistant M. tuberculosis. Data were analyzed using meta-analysis and random effects models (CI 95%, P < 0.10). RESULTS: With a 6,931 sample size in 37 original articles, the lowest rate was related to EMB resistance that was observed in 2014 with 0.05 (95% CI: 0.04-0.07) and the highest prevalence rate was 0.84 (95% CI: 0.68-1.01), observed in 1997. Lowest and highest prevalence rates of embB306 gene mutation in M. tuberculosis were 0.03 (95% CI: 0.01-0.07) in 2014 and 0.78 (95% CI: 0.71-1.84) in 2005, in the USA, respectively. CONCLUSIONS: The present study revealed the prevalence and association of mutations in the embB306 gene of M. tuberculosis with resistance to EMB. Detecting EMB-resistant M. tuberculosis can help in controlling and correcting the administration of drugs for patients with TB.

Effect of an education program, risk assessment checklist and prevention protocol on violence against emergency department nurses: A single center before and after study.

AIM: The purpose of this study was to evaluate the effects of an education program, risk assessment checklist and preventive protocol on violence against emergency department nurses. METHODS: The design was a quasi-experimental before and after study of a group. A hospital emergency department's nurses participated in a workshop in which they were taught a method of using a risk assessment checklist and preventive protocol. The intervention lasted six weeks. The mean score and type of violence was measured before and after the intervention. The data were analyzed by SPSS. RESULTS: The mean score of violence before the intervention was 8.4 and after the intervention it was 2.7, which was statistically a significant difference (p < 0.0001). In addition, there were significant differences in the mean frequency of verbal abuse (p < 0.0001), assessment of workplace security (p = 0.006), fear of injury (p < 0.02) and type of reaction to violence (p < 0.01) before and after the intervention among the nurses. CONCLUSIONS: Using the BVC risk assessment checklist and preventive protocol can reduce the experience of violence and verbal abuse, which is the most common form of violence for emergency department nurses. Using this checklist and preventive protocol when patients arrive in emergency departments is recommended.

Salivary enzymatic antioxidant activity and dental caries: A cross-sectional study.

BACKGROUND: Oxidative stress has been identified as a predisposing factor for dental caries. Saliva, as a rich source of antioxidants, plays an essential role in the protection against dental caries. Salivary enzymatic antioxidants include superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx). OBJECTIVES: The aim of this study was to evaluate the correlation of salivary enzymatic antioxidant activity with different levels of dental caries in children. MATERIAL AND METHODS: In this cross-sectional study, 90 healthy children aged 7-12 years (36 girls, 54 boys) were investigated. Demographic information was gathered and dental examinations were provided for all participants. Then, unstimulated whole saliva samples were collected in the morning. The salivary SOD, CAT and GPx activity was measured spectrophotometrically. For statistical analysis, Spearman's correlation test, the Mann-Whitney U test and the Kruskal-Wallis test were used with the SPSS for Windows software, v. 16. RESULTS: Our results showed no significant correlation between SOD, CAT and GPx and the decayed, missing, filled teeth index for permanent/primary dentition (DMFT/dmft). The CAT activity was elevated in proportion to the number of decayed teeth. The SOD activity showed a positive correlation with the frequency of tooth brushing. The activity of SOD, CAT and GPx was higher in boys than in girls. An inverse relationship between enzymatic antioxidant activity and age was also observed. CONCLUSIONS: Although enzymatic antioxidants had no positive correlation with DMFT/dmft, they were positively correlated with the number of decayed teeth and the improvement of oral hygiene.

Association of CYP2C19 and HSP70 Genes Polymorphism with Aspirin- Exacerbated Respiratory Disease in a Kurd Population.

BACKGROUND: CYP2C19 a metabolizing enzyme and Heat Shock Proteins (HSP) are induced in stress conditions, such as hypoxia and ischemia. Recently, polymorphism in the CYP2C19 and HSP genes has been established in Aspirin-Exacerbated Respiratory Disease (AERD). OBJECTIVE: We investigated the polymorphism of these two genes in Kurdish patients with AERD. METHODS: This study involved 306 subjects, referred to the Be'sat hospital in Kurdistan Province, which were divided into three groups, (i) Aspirin Induced Asthma (AIA), (ii) Aspirin Tolerant Asthma (ATA), and (iii) healthy subjects as control. The subjects as control and ATA\AIA groups were verified by the physician. The demographic data of each subject with respect to age, sex, parental education, and residence was collected. Spirometry was performed on subjects and blood samples were collected for serum Immunoglobulin E (IgE) estimation and molecular tests. Genotyping was done for CYP2C19 681G>A، CYP2C19 636G>A, and HSPA1B1267A>G by using PCR- Restriction Fragment Length Polymorphism (RFLP) and for HSPA1B-179C>T by High Resolution Melting (HRM). RESULTS: Demographic statistics were not significantly different between the three groups (p>0.05). Further, genotypes were also not observed to be significantly different in the genes of CYP2C19 681G>A, CYP2C19 636G>A and HSPA1B1267A>G (p>0.05). However, the heterozygote genotype in HSPA1B-179 C>T in AIA group was higher than the control group (p<0.05). Notably, 92.8 % of the subjects showed heterozygote genotype in HSPA1B1267 A>G. In clinical tests, FEV-1, FVC, and asthma severity in the AIA group were higher than control and additionally IgE levels were lower in this group (p<0.05). CONCLUSION: The results confirm the association of polymorphism in the HSPA1B-179C>T and HSPA1B1267A>G with AERD in the Kurdish population.

Effect of gabapentin in comparison with hydrocortisone on postlaparoscopic cholecystectomy pain control.

BACKGROUND AND AIM: Although laparoscopic cholecystectomy causes less pain than open cholecystectomy, it is still not completely painless. Several methods have been used to relieve the pain of laparoscopic surgery. The aim of this research was to compare the effect of gabapentin and hydrocortisone on pain control after laparoscopic cholecystectomy. MATERIALS AND METHODS: In this double-blind clinical trial, a total of 60 adult patients aged 18-70 years from both sexes American Society of Anesthesiologists Classification (ASA Classification 1 and 2) who were selected for laparoscopic cholecystectomy were divided into two groups of 30 subjects to be studied. 150 mg gabapentin and 100 mg hydrocortisone were administered to the first and second groups before the operation, respectively. Pain score and vital signs (systolic blood pressure and heart rate) were recorded. Data were fed into SPSS 23 software and analyzed using Fisher-test, independent t-test, and repeated measurement. P < 0.05 was considered as significance level. RESULTS: Patients were similar in terms of age and sex. Mean score of visual analog scale (VAS) in the first 4 h after operation was 5.84 ± 2.33 and 5.20 ± 1.74 in the gabapentin group and was 7.03 ± 1.23 and 6.50 ± 1.30 in the hydrocortisone group (P < 0.05), respectively. Although mean VAS scores at 6, 12, and 18 h after operation showed no significant differences between gabapentin and hydrocortisone groups (P > 0.05), VAS score 24 hours after operation was 2.87 ± 1.57 and 3.92 ± 1.28 in gabapentin and hydrocortisone groups, respectively (P < 0.05), indicating a significant difference in VAS score between the two groups 2 and 24 h postoperation. CONCLUSION: The results of this study showed that gabapentin was more effective than hydrocortisone within the first 4 h of laparoscopic cholecystectomy. In addition, gabapentin was shown to be a better pain controller 24 h postoperation.

Iranian hospital efficiency: a systematic review and meta-analysis.

PURPOSE: The purpose of this paper (systematic review and meta-analysis) is to synthesize and analyze studies that assessed Iranian hospital efficiency. DESIGN/METHODOLOGY/APPROACH: A systematic literature search was conducted using both international (the Institute for Scientific Information, Scopus and PubMed) and Iranian scientific (Magiran, IranMedex and Scientific Information Database) databases. The review included original studies that used the Pabon Lasso Model to examine Iranian hospital performance, published in Persian or English. A self-administered checklist was used to collect data. In total, 12 questions were used for quality assessment. FINDINGS: In total, 34 studies met our inclusion criteria. The fixed-effects meta-analysis indicated that 19.2 percent (95% confidence interval (CI): 15.6-23.2 percent) of hospitals were in Zone 1 (poor performance: low bed turnover rate (BTR) and bed occupancy rate (BOR) and high average hospital stay (ALoS)), 23.7 percent (95% CI: 20.1-27.8 percent) were in Zone 2, 31.7 percent (95% CI: 27.7-36 percent) in Zone 3 (good performance: high BTR and BOR and low ALoS) and 25.4 percent (95% CI: 21.7-29.5 percent) in Zone 4. PRACTICAL IMPLICATIONS: Results help Iranian health policymakers to understand hospital performance, which, in turn, may lead to promoting greater awareness and policy attention to improve Iranian hospital efficiency. ORIGINALITY/VALUE: This study indicated that most Iranian hospitals had sub-optimal performance. Further studies are required to understand factors that explain the country's hospital inefficiency.

Effect of Interventional Educational Programs on Intensive Care Nurses' Perception, Knowledge, Attitude, and Practice About Physical Restraints: A Pre-/Postclinical Trial.

The article reports results of an educational program designed to modify negative attitudes of intensive care nurses regarding the use of physical restraints. Findings revealed that increased knowledge about appropriate utilization of various types of restraints positively impacted perceptions, attitudes, and patient care practices. Authors also explore restraint use in several countries and identify variations in use of restraining methods.