Beheshti Hospital Research Articles

Impact of Cooling Diabetic Patients’ Fingertips Compared to Vibrating Stimulation on Pain from the Glucometer Needle: A Cross-Over Trial Study

IntroductionBlood glucose measurements using glucometers can cause discomfort due to needle insertion. Implementing effective pain management strategies is essential to alleviate this discomfort. This study aimed to evaluate the effects of cold and vibration stimulation on pain perception during glucometer needle insertion in diabetic patients. MethodsSixty diabetic inpatients from Shahid Beheshti Hospital in Hamadan, Iran, participated in a crossover study, comprising 3 individuals with type 1 diabetes and 57 with type 2 diabetes. The cohort included 40 males and 20 females, with ages ranging from 18 to 70 years and a mean age of 55.7 years. The average duration of diabetes was 10 years. The study design consisted of six blocks, each containing three interventions: vibration stimulation (A), cold therapy (B), and a combination of both ©. The sequences of interventions (ABC, ACB, BCA, BAC, CBA, and CAB) were randomly assigned. Each participant received the interventions at three different times: before breakfast, one to two hours after lunch, and at dinner. One hand was randomly selected for the intervention, while the other served as a control, with only the needle inserted. Pain levels were assessed using the Numeric Rating Scale (NRS) for both hands. ResultsParticipants receiving vibration stimulation in one hand reported a significant reduction in pain intensity, with a mean difference of 1.21 (p < 0.001) compared to the control hand. In contrast, cold therapy did not significantly affect pain intensity, showing a mean difference of only 0.06 (p > 0.05). The combination of vibration and cold therapy also did not significantly alter pain intensity, yielding a mean difference of 0.33 (p > 0.05). A significant difference (p = 0.002) was noted among the interventions, indicating varying effects on pain intensity. ConclusionVibration stimulation effectively reduces pain associated with glucometer needle insertions. Among the methods examined, vibration stimulation proved to be the most effective for minimizing needle pain. Clinicians are encouraged to incorporate this technique into the care of diabetic patients to enhance their comfort during glucose monitoring.

Relationship between emotional intelligence, quality of life, and infertility stigma in infertile woman: A descriptive-correlational study.

Infertility is one of the major crises in couples' lives, affecting both mental and physical health. One of the most significant consequences of infertility is stigma; moreover, emotional intelligence and women's coping style with these consequences can affect the quality of this disorder. This study aimed to investigate emotional intelligence, infertility stigma, quality of life, and the relationship between these variables in infertile women. This descriptive-correlational study was conducted from April 2023 to February 2024 on 349 infertile women referred to "Hazrat Maryam Infertility Center in Shahid Beheshti hospital" and "Isfahan Fertility and Infertility Center" in Isfahan, Iran. Sampling was done using a convenience sampling method, and tools included 4 questionnaires, a demographic and midwifery information form, the quality of life questionnaire, the female-infertility-stigma-questionnaire, and the Schutte-Emotional-Intelligence scale. The results showed that the women's mean age was 35.08 7.60 yr. The mean score for emotional intelligence was 109.06 6.12, and the infertility stigma's was 56.1 14.73. The results indicated a positive correlation between emotional intelligence and infertility stigma (r = 0.13, p 0.001). Only the mean score of social well-being and general health dimensions had a significant relationship with the total score of emotional intelligence (r = 0.037, p 0.02). Infertile women have a lower quality of life and experience higher stigma. Since the quality of life and overall mental health affect the treatment process, also emotional intelligence plays an important role in human life, educational sessions and counseling should be considered in the treatment programs to improve the quality of life, thereby facilitating the treatment process with greater ease and speed.

Prevalence of Depressive Symptoms in People With Osteoporosis Referred to the Bone Densitometry Center of a Hospital in Kashan

Background and Objectives: Osteoporosis is a chronic disease characterized by decreased bone density and increased risk of bone fractures. Osteoporosis can affect the quality of life and lead to depression by causing bone fractures and associated complications such as reduced physical activity, weight gain, and reduced self-care. This study aims to investigate the prevalence of depression in people with osteoporosis referred to the bone densitometry center of a hospital in Kashan, Iran. Methods: In this cross-sectional study, 150 people with osteoporosis were selected from among those referred to the bone densitometry center of Shahid Beheshti Hospital in Kashan in 2021, who were selected by a systematic sampling method. To collect information, a demographic form and Beck’s depression inventory were used. Data were analyzed in SPSS software using chi-square test and independent t-test. Results: In this study, 86% of people with osteoporosis had depressive symptoms, of whom 42% had severe depression. The prevalence of depressive symptoms in osteoporosis patients with a T score was 37.9%, on average. There was a statistically significant difference in the severity of depression among patients in terms of the family history of depression and the use of psychiatric drugs (P&lt;0.001). Conclusion: The majority of people with osteoporosis in the study center in Kashan have some degree of depression symptoms, which shows the importance of early investigation and treatment of depression in these patients.

Jaw bone changes in panoramic radiography in patients with hyperparathyroidism

Background and aims: The current investigation aimed to evaluate jaw bone changes, and compare the presence of gonial cortex bone thickness, mental index (MI), lamina dura (LD), lower dental canal, and bone density in panoramic radiography, in patients with hyperparathyroidism. Methods: The present cross-sectional descriptive-analytical study was performed on 17 healthy individuals and 17 patients who suffered from resorptive hypercalciuria in the dialysis center of Shahid Beheshti hospital in Babol in 2018. If patients had two or more decayed teeth, they were referred to a specialized maxillofacial clinic by the dentist for free panoramic imaging. Mandibular cortical index, LD, bone change, mandibular resorption (MR), and general cortical indices underwent examination. Results: The mean age of the control and case groups was 36.58±11.81 years and 40.23±14.32 years, respectively (P=0.424). In addition, the mean MI was 4.27±0.87 and 2.98±0.75 in the control and case groups, respectively (P&lt;0.001). Based on the results, the mean gonion region’s cortical bone thickness was 0.93±0.23 and 1.09±0.24 in the case and control groups, respectively (P&lt;0.001). Further, bone changes (P=0.036) and MR (P=0.017) were significantly different in the case and control groups. However, LD vision showed no significant difference in the hyperparathyroidism and the control groups (P=0.141). Conclusion: The results demonstrated a decrease in the thickness of the cortical bone in the guinea pig, mental region, and lack of dental canal in resorptive hypercalciuria compared to healthy individuals.

Attitudes and Levels of Concern and Trust Towards COVID-19 Vaccination Among Patients Hospitalized at Shahid Beheshti Hospital in Kashan, Iran

Introduction: This study aimed to explore hospitalized patients' attitudes, concerns, and trust regarding Coronavirus disease 2019 vaccination. Materials and Methods: This descriptive-cross-sectional study was conducted on 128 patients hospitalized at Shahid Beheshti Hospital in Kashan, Iran, in 2022. Participants were selected using simple random sampling. The questionnaire included questions about demographic information, attitudes towards vaccination (7 items), levels of concern (14 items), and trust (15 items). Data were analyzed using SPSS 26 software. Descriptive statistical analysis and chi-square tests applied. Results: Fifty-three (41.4%) of cases had a history of two vaccinations. Sinopharm was used in 28.12% of patients. The average attitude score was 8.21 ± 2.88, significantly associated with age (p = 0.02), nationality (p = 0.01), education (p = 0.01), and vaccination history (p = 0.02). The mean concern score was 35.41 ± 11.87, significantly linked to gender (p = 0.01) and vaccination history (p = 0.02). The average trust score was 40.50 ± 13.64, significantly associated with age (p = 0.04), gender (p = 0.01), vaccination history (p = 0.01), hospitalization history due to COVID-19 (p = 0.03), and COVID-19 infection history (p = 0.03). Conclusion: The vaccination rate among participants was acceptable. However, concerns about vaccination and its complications were the primary reasons for vaccine hesitancy. Given that vaccine acceptance across various community groups is as crucial as vaccine development, it is recommended that health organizations provide information on vaccine benefits and address concerns about potential side effects.

Clinical and Laboratory Factors Associated with Mortality in ICU-Hospitalized COVID-19 Patients in a Western Center of Iran

Introduction: The purpose of this study was to investigate the demographic, clinical, and laboratory risk factors associated with mortality in Coronavirus disease 2019 (COVID-19) patients who were admitted to the intensive care unit (ICU) in Iran. Material &amp; Methods: This retrospective study analyzed data from 867 COVID-19 patients admitted to the ICU of Shahid Beheshti Hospital in Hamadan (west of Iran) from September 2020 to March 2022. The association between demographic, clinical, and laboratory factors and mortality rates was assessed using univariable and multiple logistic regression analysis. Results: During the study period, 512 (59.1%) patients were deceased from Covid-19. According to the adjusted logistic regression, the odds of death in patients with an age higher than 60 years were 1.12 (95% CI: 1.01- 1.24; p=0.026). The OR estimate of death in patients with bradycardia and tachycardia was 2.32 (95% CI: 1.72- 3.12; p &lt; 0.001) and 2.40 (95% CI: 1.67- 3.42; p &lt; 0.001), respectively. Moreover, SPO2 lower than 88%, WBC over 11 ×1000μL, K over 5.2 mEq/L, and LDH above 942 U/L were significantly associated with increased odds of death (p &lt; 0.05). Conclusion: The study identified several demographic, clinical, and laboratory risk factors associated with mortality in COVID-19 patients admitted to the ICU in Iran. These findings can help healthcare providers identify patients at higher risk of poor outcomes and tailor interventions accordingly.

Incidence of Thrombocytopenia After Enoxaparin and Heparin Taking in Hospitalized Patients

Background: Heparin is the most common administered anticoagulant in hospitalized patients. Thrombocytopenia can occur after heparin s administered in these patients. This study was conducted to determine the incidence of thrombocytopenia in patients treated with heparin and their clinical outcomes. Methods: In this descriptive cross-sectional study, 754 patients admitted to Shahid Beheshti Hospital in Hamadan, Iran, who were treated with heparin were examined for the incidence of thrombocytopenia during 2022-2023. Data were extracted from the medical records of the patients and analyzed using SPSS software version 26. Results: Among the patients, 50.4% were male, and 49.6% were female. The mean and standard deviation of the age of the patients were 63.12±16.82 years. Platelet counts before and after heparin administration were 244.75±79.64 and 207.66±83.39×103 /µL, respectively. The frequency of thrombocytopenia in patients was 25.5%. The incidence of thrombocytopenia was 29.5% and 21.4% in men and women, respectively (P=0.011), and 19.3% and 28.1% of patients received enoxaparin and heparin, respectively (P=0.010). The mean age of patients with thrombocytopenia was 67.25±15.10 years compared to 61.61±17.17 years for those without thrombocytopenia (P&lt;0.001). Furthermore, the length of stay in the hospital for patients with and without thrombocytopenia was 36.12±52.16 and 20.9±6.45 days, respectively (P=0.015). Moreover, the mortality rate was 35.34% and 10% in patients with and without thrombocytopenia, respectively (P&lt;0.001). Conclusion: About a quarter of patients developed thrombocytopenia within 72 hours after receiving heparin. A significant relationship was observed between thrombocytopenia incidence and older age, female gender, and heparin use. Additionally, thrombocytopenia was significantly associated with increased hospital stay duration and higher mortality.

Sleep quality and glycemic control in adults with type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) is a common disease that imposes a substantial burden on the healthcare system and patients. Lifestyle modification such as sleep hygiene plays a crucial role in glycemic control. Sleep disorders impact many aspects of health. In this study, we aimed to investigate the correlation between sleep quality and glycemic control in T2DM. Method: This cross-sectional study was performed on 163 T2DM patients, attending Shahid Beheshti Hospital in Hamadan, Iran from March 2020 to 2021. Besides recording the demographic data and HbA1c level of participants, they were asked the Pittsburgh Sleep Quality Index questionnaire for evaluating sleep quality. We employed SPSS ver. 21 for data analysis and considered 0.05 as a significant level. Among all participants, 62 (38%) were female and 30.7% were illiterate. The mean age was 56.67 ± 12.90 years, and HbA1c was 9.03 ± 1.92 mg/dL. Among sleep metrics, mean waking time was 8.74 ± 1.74 hours, and average sleep time was 12.90 ± 4.90 hours. Overall, 58.2% of the participants had poor glycemic control and 44.8% were suffering from poor sleep quality. We found that patients with poor glycemic control exhibited significantly higher levels of sleep disturbances compared to those with good glycemic control (P < 0.001). Sleep quality is associated with glycemic control in patients with T2DM. Sleep disorders are common among diabetic patients. Thus, healthcare providers need to consider sleep quality improvement in their holistic approach to diabetes management.

Studying the efficacy of low-dose colchicine on clinical outcomes of patients with STEMI: a randomized controlled trial

BackgroundNumerous studies have underscored the essential role of inflammation across all stages of atherosclerosis. While various anti-inflammatory interventions have been implemented to mitigate inflammation-induced injuries, outcomes have been conflicting. Given the essential role of inflammation in these patients and limited data regarding the efficacy of low-dose Colchicine as an anti-inflammatory drug, we aimed to study the efficacy of low-dose Colchicine on clinical outcomes of patients with STEMI in Iran.ResultsParticipants presented with STEMI and qualified revascularization at Shahid Beheshti Hospital in Qom during 2022 and 2023 were included into the study. This study included 172 STEMI patients (114 males and 58 females) within the mean age of 58.93 ± 7.79. Results indicate that colchicine (2 mg for loading dose and 0.5 mg daily for 30 days) and placebo group were not significant differences in identical profiles regarding age and gender. Analyses revealed no significant differences in clinical outcome after the 40-day follow-up period.ConclusionsThis study revealed that the addition of colchicine did not yield a significant benefit in enhancing the outcomes of patients with STEMI.Clinical trial registration: This study was prospectively registered on Iranian registry of clinical trials, with registration number (IRCT20231001059578N1).

Data Consistency of Two National Registries in Iran: A Preliminary Assessment to Health Information Exchange.

The National Spinal Cord Injury Registry of Iran (NSCIR-IR) and the National Trauma Registry of Iran (NTRI) were established to meet the data needs for research and assessing trauma status in Iran. These registries have a group of patients shared by both registries, and it is expected that some identical data will be collected about them. A general question arises whether the spinal cord injury registry can receive part of the common data from the trauma registry and not collect them independently. We examined variables captured in both registries based on structure and concept, identified the overlapping period during which both systems recorded data in the same centers and extracted relevant data from both registries. Further, we evaluated the data for any discrepancies in amount or nature and pinpointed the underlying reasons for any inconsistencies. Out of all the variables in the NSCIR-IR database, 18.6% of variables were similar to the NTRI in terms of concept and structure. Although four hospitals participated in both registries, only two (Sina and Beheshti Hospitals) had common cases. Patient names, prehospital intubation, ambulance arrival time, ICU length of stay, and admission time were consistent across both registries with no differences. Other common data variables had significant discrepancies. This study highlights the potential for health information exchange (HIE) between NSCIR-IR and NTRI and serves as a starting point for stakeholders and policymakers to understand the differences between the two registries and work toward the successful adoption of HIE.

Investigating Psychiatric Disorders in Patients with Suicide Attempt

Background Attempting suicide is considered one of the important indicators of the mental health of individuals in society. One of the important issues in suicide is psychiatric disorders and related factors. Given that no comprehensive study was conducted in Yazd province, this study aimed to assess psychiatric disorders in patients with suicide attempts. Methods This analytical cross-sectional study was conducted on 344 patients with suicide attempts at Shahid Beheshti Hospital from March 2021 to March 2022. The type of psychiatric illness was diagnosed based on the clinical interview and DSM-5 diagnostic criteria. All information was extracted from medical records entered into SPSS version 22 and analyzed. P &lt; 0.05 was assumed significant. Results The average age of the patients was 27.09 ± 11.78 years. Among them, 145 were men (42.2%) and 199 were women (57.8%). The most common psychiatric disorder was Major depressive disorder (MDD) (46.5%). Moreover, the lowest frequency of psychiatric disorders was schizophrenia (1.2%). There was a significant relation between psychiatric disorders and variables, including age, number of suicides, gender, and suicide method (P &lt; 0.05). A significant relation was seen between the severity of diseases and gender (P &lt; 0.05). Conclusion Among the various types of psychiatric disorders, MDD was more prevalent in individuals who commit suicide. Hence, it was essential to focus more attention on this particular group of patients. Additionally, the use of medication was the most common method of suicide. It should also be noted that the severity of suicide was higher in men.

Relationship between Blood Groups and the Risk of Covid-19 Infection; a Cohort Study

Background: ABO blood types are not known to cause diseases directly, but they can be vulnerable and surrender to diseases and health problems. This study aimed to evaluate the susceptibility to COVID-19 in individuals with different blood groups at different ages. Methods: An electronic health record was used in this retrospective cohort study at Shahid Beheshti Hospital. We studied 858 patients who were referred to Shahid Beheshti Hospital, we identified 434 of them as COVID-19 patients using RT-PCR. An analysis of the electronic record involved collecting retrospective laboratory data and demographic information, including age, sex, and blood type. Next, we examined the differences between the ABO blood groups of COVID-19 patients and the control group (1991 case). We used SPSS26 for statistical computations. Data were scrutinizeed with the χ2 test. P &lt; 0.05 was considered statistically outstanding. Results: Based on the distribution of ABO blood groups in 434 COVID-19 patients, it was revealed that 288 of them were male and 146 were female, and the majority of them were in their third decade of life. A total of 159 patients (36.6%) had type B blood, 116 had type A (26.7%), 109 had type O (25.1%), and 50 had type AB (11.5%). COVID-19 patients had a higher percentage of type B and AB blood than the control group.

The training effect of tracheal tube care standards on the care performance of nurses in the critical care units of Shahid Beheshti Hospital of Kashan: A semi-experimental study

The training effect of tracheal tube care standards on the care performance of nurses in the critical care units of Shahid Beheshti Hospital of Kashan: A semi-experimental study

Impact of Ultrafiltration Profiling Compared to Conventional Methods on Blood Pressure Regulation Among Hemodialysis Patients

Background: Standard hemodialysis sessions pose challenges for patients due to fluctuations in blood pressure. Alternative strategies, such as ultrafiltration profiling, have been proposed as potentially more effective treatments. Objectives: This study aimed to evaluate the effects of ultrafiltration profiling compared to the conventional method on blood pressure regulation among hemodialysis patients. Methods: This study employed a pre-test and post-test design, involving a single group of 30 hemodialysis patients undergoing treatment at Shahid Beheshti Hospital in Hamadan in 2022. The sampling method used was simple random sampling. The intervention consisted of three sessions using the routine method, followed by three sessions utilizing the ultrafiltration profile method, which employed an interval with a negative slope. Demographic and clinical information about the patients was recorded on a checklist. Systolic and diastolic blood pressure measurements were taken before the commencement of hemodialysis, at 1-, 2-, and 3-hour intervals post-treatment initiation, and again 15 minutes after completing hemodialysis. Results: The mean blood pressure changes observed during dialysis stages increased with both methods; however, there was a significant difference between the methods (P &lt; 0.001). Specifically, patients receiving the ultrafiltration profile method experienced significantly lower increases in blood pressure compared to those receiving the routine method. Conclusions: Based on the research results, integrating ultrafiltration profiling into hemodialysis can be regarded as an effective and viable strategy for enhancing blood pressure regulation in patients undergoing hemodialysis treatment. Therefore, it is recommended that this approach be considered in hemodialysis programs as well.

Association analysis of MnSOD-Ala16Val genetic variation and the risk of preeclampsia: A case-control study and in silico analysis

BackgroundPreeclampsia, a main contributor to maternal mortality worldwide, impacts women beyond 20 weeks of gestation, presenting with elevated blood pressure and proteinuria. The role of oxidative stress in the development of preeclampsia is considerable due to the increased oxygen requirement of placenta. The aim of this study is to evaluate the association between MnSOD-Ala16Val genetic variation and the risk of preeclampsia in a group of pregnant women in accompanying a bioinformatics analysis. Materials and methodsIn this case-control study, 136 pregnant women with preeclampsia vs. 173 healthy women without any history of known diseases as control group, were selected from cases who have referred to the Shahid Beheshti hospital of Kashan (Isfahan province, Iran). After sampling and DNA extraction, MnSOD-Ala16Val polymorphism was evaluated using PCR-RFLP for genotype assessment. Eventually, some bioinformatics tools were used for evaluation of the above-mentioned polymorphism on gene function. ResultsOur data illustrate the association between CT heterozygote genotype of MnSOD-Ala16Val polymorphism with enhanced risk of susceptibility to preeclampsia (OR = 1.865, 95%CI = 1.03–3.37, p = 0.039). Indeed, bioinformatics analysis demonstrated the significant impact of the above mentioned polymorphism on the structure of protein (Score: 49, Expected accuracy: 71%) and RNA (Distance: 0.1815, p-value: 0.1676; A p-value <0.2 is significant). ConclusionsAs a preliminary study, our findings suggest a potential association between the MnSOD-Ala16Val polymorphism and the risk of preeclampsia. However, more investigations with a larger sample size and in different ethnicities are essential for achievement of more precise outcomes.

Clinical nursing competency during epidemics: a qualitative content analysis

BackgroundNurses are on the frontline for managing epidemic diseases. Different aspects of clinical nursing competencies during epidemics are important issues that need investigation.ObjectivesThe aim of this study was to determine the required clinical competencies for nurses during epidemics. Understanding these competencies could provide valuable information for health care services and nursing education organizations to prepare nurses for future epidemics.MethodsThe qualitative conventional content analysis study was conducted using semi-structured interviews with 12 nurses that were actively engaged in providing patient care during COVID-19 pandemic in Shahid Beheshti hospital in Kashan/Iran, from October 2022 to March 2023. The data analysis process was conducted according to 5 steps suggested by Graneheim and Lundman.ResultsAfter analysis, the 159 competencies were derived from interviews that were categorized to 11 subcategories, and three categories of clinical nursing skills in epidemics, knowledge of epidemics, and soft skills for nurses in epidemics.ConclusionNurses need wide range of competencies to address the professional expectations regarding providing acceptable care during epidemics. Knowing these competencies can help nursing managers to prepare nurses for crisis such as what world experienced during COVID-19 pandemic.

Long-term COVID-19 Complications and Relevant Outcomes in Severe COVID-19 Survivors

Background: Long-term lung sequelae in patients who survived after severe COVID-19 are not clear. This study aims to evaluate complications and relevant outcomes of COVID-19 survivors within 6 months follow-up after discharge from the hospital. Methods: This study is a cohort of 50 patients with severe COVID-19 hospitalized in the intensive care unit (ICU) in 2020-2021 at Shahid Beheshti Hospital, Qom, Iran. The nasopharyngeal swab and reverse- transcription real-time PCR (RT-qPCR) assay were used to confirm COVID-19 in subjects. We used a checklist that compared symptoms, laboratory findings, and lung radiograph findings for patients at the time of admission and within 6 months follow-up after discharge from the hospital. The chest CT scans were used to verify lung involvement. The renal and liver function were assessed using alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), blood urea nitrogen (BUN), creatinine (Cr), and bilirubin. Results: 50 patients out of 384 participants who were hospitalized with severe COVID-19 were followed up within 6 months after discharge from the hospital. Findings revealed that, during the followup period, all clinical symptoms, except GI bleeding (p = 0.155), were significantly lower than the admission time (p &lt; 0.001). Also, the mean of laboratory findings, including lymphocyte, neutrophil, lactate dehydrogenase, international normalized ratio, prothrombin, partial thromboplastin time, ESR, and CRP, were significantly lower than admission time (p &lt; 0.001). Also, the mean of alanine transaminase (ALT) and aspartate aminotransferase (AST) between the admission and discharge time were significantly different (p &lt; 0.001). Within 6 months of follow-up after discharge, the frequency of ground glass opacities, crazy paving, consolidation, spider web sign, and vascular thickening were significantly lower than in the admission time. Conclusion: Our findings revealed that among severe COVID-19 survivors, liver outcomes, inflammation, and clinical factors returned to normal range within 6 months of follow-up after discharge from the hospital. Also, during this period, the radiological findings were significantly lower than in the admission time.

Delays in receiving Alteplase and related factors in patients with stroke referred to Shahid Beheshti Hospital in Kashan-Iran in 2020-2021.

The benefits of using Alteplase are time-dependent. This study aimed to evaluate delays between the onset of symptoms and the administration of Alteplase and related factors in patients with acute ischemic stroke (AIS). In this cross-sectional study, 60 AIS patients receiving Alteplase were selected by census sampling from July 2020 to July 2021 from the eligible patients referred to Shahid Beheshti Hospital in Kashan, Iran. The data collection tool was a researcher-made questionnaire containing demographic information, time periods from the onset of symptoms to the injection of Alteplase, and associated factors. The required information was collected from the patients, their relatives, their health records, and Kashan Emergency Medical Service (EMS) information system. Data were analyzed in SPSS-16. Eighty-five percent of the 60 patients participating in the study were transferred to the hospital by EMS ambulances. The mean time intervals between different phases were as follows: Onset-To-Door (OTD) time 81.35 ± 33.76 minutes; Door-To-CT (DTC) scan time 16.12 ± 17.46 minutes; Door-To-Needle (DNT) time 51.30 ± 26.14 minutes; and the overall Onset-To-Needle (ONT) time 133.75 ± 39.17 minutes. Also, the mean ONT in people transferred by EMS was about 129 minutes, and the longest prehospital delay in these patients was related to the time between the arrival of the EMS ambulance to the hospital. Marital status and geographical location where the stroke had occurred showed a significant relationship with prehospital delay and pre-hospital notification (PHN) by EMS But there was no relationship between underlying diseases or economic status and prehospital delays; also, the patient's diastolic blood pressure at the time of receiving Alteplase showed a significant relationship with in-hospital delay. The findings of the study showed that the majority of people trust and use EMS ambulances to transfer to the hospital and the time spent in different stages, from the onset of symptoms to the injection of the thrombolytic drug, was in an acceptable range in the patients.

A Comparative Study of Hospitals in Yasuj, Iran, in Terms of the Implementation of the Health System Planning and the Quality of Medical Services

Background: Today, the implementation of the health system plan has led to the reduction of people's payments and to equitable access to health services and the improvement of the quality of services. Objectives: The current research was conducted with the aim of a comparative study of hospitals in Yasuj, Iran, in terms of the implementation of the health system plan and the quality of medical service. Methods: The statistical population of the present descriptive study was 380 patients at Shahid Beheshti Hospital, Yasuj, 150 patients in Shahid Rajaei Hospital and 300 patients in Imam Sajjad Hospital, all located at Yasuj, Iran. According to Morgan's table, 181 patients at Shahid Beheshti Hospital, 108 patients at Shahid Rajaei Hospital and 169 patients at Imam Sajjad Hospital were included as the statistical sample. All the participants completed the questionnaire and the implementation status of the health system plan and the quality of medical services. One-way ANOVA was used to analyze the statistical findings. All statistical operations were performed using SPSS v.18 software Results: The results of the the present study indicated that the health system implementation status of Shahid Beheshti Hospital, Imam Sajjad Hospital and Shahid Rajaei Hospital in Yasuj was favorable. These findings indicated that the health system plan in Yasuj were properly and correctly implemented. Moreover, the quality of medical services at Shahid Beheshti Hospital, Imam Sajjad Hospital, and Shahid Rajaei Hospital in Yasuj were satisfactory. Also, the results showed that there is was no significant difference in the quality of medical services in Yasuj hospitals (P = 0.44 &amp; F = 0.81 &amp; 455 &amp; 2 F). Correspondingly, the results disclosed that there was no significant difference in the implementation status of the health system plan of hospitals in Yasuj city (P = 0.39 &amp; F = 0.93 &amp; 455 &amp; 2). Conclusions: Medical centers should continuously evaluate the quality of their services, since improving the quality of medical services encourages patients to follow their treatment instructions correctly and on time, and also accelerate the progress of treatments and achieves the main therapeutic goal of treating patients.

Investigating the Characteristics of Suicide And its Relationship with Family History of Suicide

Background: Several factors contribute to suicide attempts. To the best our knowledge, there is no study has been conducted to investigate the impact of a family history of suicide on suicide attempts. Objectives: This study aims to examine the characteristics of suicide and its association with a family history of suicide. Materials and Methods: This historical cohort study was carried out on individuals admitted to Shahid Beheshti Hospital in Taft and Shah Wali Hospital in Yazd for suicide attempts between 2018 and 2019. The study examined 73 individuals with a family history of suicide and 332 without such a history. It recorded demographic details, methods of suicide attempts, and family histories concerning the patients' mothers, fathers, and siblings. Data were collected and subsequently analyzed using ndependent t-tests, Mann-Whitney tests, chi-square and Fisher's exact test. A significance level of P &lt; 0.05 was considered. Results: The average age of the subjects was 28.02 ± 10.8 years, with 295 (72.8%) of the participants being women. There were no significant differences in mean income (P = 0.99), marital status (P = 0.06), gender (P = 0.35), place of residence (P = 0.06), and education level (P = 0.37) between individuals with and without a family history of suicide. Furthermore, our results indicated that the prevalence of mental illness was significantly higher in individuals with a family history of suicide (P &lt; 0.001). The average number of suicide attempts was 1.05 ± 1.90 for those with a family history and 1.21 ± 0.50 for those without, a difference that was statistically significant (P = 0.002). The timing, method, and reasons for suicide attempts were not associated with a family history of suicide. Conclusions: A family history of suicide was associated with an increased number of suicide attempts. There was no correlation between family history and gender, occupation, place of residence, number of children, timing of suicide, method of suicide, reason for suicide, and educational status of the patients. However, a significant relationship was found between a family history of suicide and a history of mental illness among the patients, indicating a higher prevalence of mental illness in the group with a family history compared to those without.