Hospitals In Tabriz Research Articles

Comparison of the Effects of Injectable Enoxaparin With Oral Rivaroxaban in Deep Vein Thrombotic Prophylaxis in Patients With Femoral Peritrochanteric Fracture: A Randomized Clinical Trial

Objectives: The prevalence of deep vein thrombosis (DVT) following orthopedic major surgery, such as peritrochanteric femoral fracture, is high. Also, there is a lack of accurate information about the results of using rivaroxaban in Iran. This study aimed to compare the effects of injectable enoxaparin with oral rivaroxaban in DVT prophylaxis in patients with femoral peritrochanteric fracture. Materials and Methods: This randomized single-blind clinical trial included 88 patients with femoral peritrochanteric fracture in Shohada Hospital of Tabriz, Iran from January 2019 to December 2019. The participants were randomly allocated into two equal groups (n=44 each) receiving enoxaparin (40 mg subcutaneously once daily for 28 days) and rivaroxaban (10 mg orally once daily for 28 days). Using independent t test in SPSS version 20, the results of clinical examinations and ultrasonography for the diagnosis of DVT at the end of intervention were compared between the two groups. A P value less than 0.05 was considered as statistically significant. Results: No significant differences were observed in laboratory results and DVT-related symptoms between the two groups, as well as before and after the intervention (intragroup). Also, the prevalence of DVT at the end of the study was zero. Conclusions: According to our results, there was no difference in the prevalence of DVT and short-term (one-month) complications between the two groups receiving rivaroxaban and enoxaparin after the peritrochanteric femur fracture.

Career Development of Nursing Preceptors in Iran: A Descriptive Study

Background: The career development of nursing preceptors is key to improving the quality of clinical education. However, there is a lack of sufficient and specific information about the career development of nursing preceptors in Iran. Objectives: This study aimed to investigate the nursing preceptors’ career development status. Methods: A descriptive cross-sectional study was carried out with the participation of 92 nursing preceptors. Participants were selected by census sampling method from 5 hospitals in Tabriz, Iran. Demographic and 6-dimension career development questionnaires were used to collect data. The collected data were analyzed using SPSS version 22, and the significance level for all statistical tests was determined to be less than 0.05. Results: Participants received the highest career development on ethical, cultural, and individual dimensions with mean scores of 3.55 ± 0.471, 3.41 ± 0.525, and 3.38 ± 0.540, respectively. However, they obtained the lowest career development on the organizational, research, and educational dimensions with mean scores of 2.68 ± 0.580, 2.28 ± 0.672, and 2.20 ± 0.690, respectively. Moreover, a comparison of career development based on demographic information showed that female preceptors, preceptors with more than 20 years of work experience, preceptors with master’s degrees, and contract employees had the highest mean scores for career development. Conclusions: Given the preceptors’ cooperation with nursing faculty as clinical nursing educators and their role in nursing education, officials of nursing faculties should develop specific career development programs (especially in organizational, research, and educational dimensions) and establish an effective relationship between preceptors and professors to enhance nursing students education.

Evaluation of Medication Errors in Preparation and Administration of Intravenous Medicines in Intensive Care Units in Imam Reza and Shohada Hospitals in Tabriz

Background: Studies have shown that medication errors and adverse drug reactions are among the main causes of adverse events in hospitals leading to disability and death. Errors occur in the process of drug prescribing, dispensing, and administration. errors are most often made on the patient care units with various risk factors. The aim of the study was to evaluate medication errors in preparation and administration of intravenous medications in two Intensive Care Units of two university hospitals in Tabriz.
 Methods: An observational and single-blinded study was carried out in the pulmonary ICU of Imam Reza hospital and the ICU of Shohada hospital using general and mono-drug checklists of error-prone situations. 14 different error categories were studied.
 Results: Total of 367 administrations for 26 different drugs were observed. among 4558 opportunities for errors, 640 errors were identified. Error rate of 15.99 % and 10.96 % were reported in Imam Reza and Shohada hospital, respectively. Wrong rate error and controls during administration had the highest rate of errors in Imam Reza and Shohada hospitals, respectively. Streptokinase in Imam Reza hospital and ceftazidime in Shohada hospital were the drugs with highest error rate. Midnight and 10 PM administration rounds had the highest error rate in Imam Reza and Shohada hospitals, respectively. Error rate in Imam Reza hospital was significantly higher.
 Conclusion: It is concluded that medication errors occur in all stages like preparation and administration mostly related to rate of administration and controls needed while administration; Strict controlling, training programs, and presence of clinical pharmacists are highly recommended.

Detection of ESBLs types blaCTX-M, blaSHV and blaTEM resistance genes among clinical isolates of Pseudomonas aeruginosa

Pseudomonas (P.) aeruginosa is a leading cause of nosocomial infections in most part of the world. The production of extended spectrum β-lactamases (ESBLs) is an essential mechanism of ß-lactam resistance in these bacteria. This study aimed to investigate the prevalence of ESBL types blaTEM,blaSHV, and blaCTX-M in P. aeruginosa isolates from the patients hospitalized in Emam Reza Educational Hospital in Tabriz, northwest of Iran.A total of 100 P. aeruginosa nonduplicated isolates were collected from patients hospitalized in Emam Reza Educational Hospital. Antibiotic susceptibility was determined by the disk diffusion method. ESBL production was confirmed by ceftazidime discs alone and in combination with clavulanic acid (ceftazidime + clavulanic acid). The presence of ESBLs genes of blaTEM, blaSHV, and blaCTX-M were screened by Polymerase Chain Reaction (PCR) and sequencing tests. The DNA of bacteria was extracted and entered in a PCR reaction with primers specific for the proposed genes sequences.Among P. aeruginosa isolates, the highest antibiotic resistance was shown to ceftazidime 70 (70 %), and the highest susceptibility was shown to imipenem 55 (55 %). The results of combined disc test indicated that 66 % of isolates were ESBL producers. Screening for ESBLs genes revealed that ten strains (14 %) were positive for blaSHV, 26 % were positive for blaTEM, and 5 % isolates were positive for blaCTX-M genes.The results of this study showed a noteworthy prevalence of blaTEM,blaSHV, and blaCTX-M genes in the studied region that, suggests the necessity to take the preventing measures for controlling the dissemination of these resistant isolates.

Illness perception and cardiovascular risk factors in patients with myocardial infarction undergoing percutaneous coronary intervention in Iran

BackgroundKnowing of perception of the illness, and cardiovascular risk factors in patients with myocardial infarction is crucial in engaging in effective secondary prevention. This study aimed to examine illness perception and cardiovascular risk factors in patients with myocardial infarction undergoing percutaneous coronary intervention.MethodsThe participants comprised 131 patients undergoing a first-time percutaneous coronary intervention at a metropolitan, tertiary referral hospital in Tabriz, Iran. The convenience sampling method was employed to select the research sample within a six-month period. The instruments used were as follows: (1) Demographic and health information form, (2) The Brief Illness Perception Questionnaire (3) The Health Risk Assessment framework developed by the Centers for Disease Control and Prevention. The design of the study was descriptive, cross sectional. The continuous variables were analyzed using Independent t-test and analysis of variance (ANOVA); and categorical variables were compared using the chi-square test.ResultsMost participants had a positive family history of cardiovascular disease (54.2%), with 66.4% of participants having at least one cardiovascular risk factor such as diabetes (36.6%) hypertension (32.8%) and dyslipidemia (16%). Most participants were physically inactive (78.6%), about 48.9% were overweight, 34.4% suffered from obesity and 26% were smokers. Illness perception in this study was seen to be high (6.21), with highest scores occurring in the illness control dimension (6.83) and lowest scores occurring in the understanding dimension (3.77). There was a significant relationship between illness perception and physical activity, nutrition, sleep and general health. Direct significant relationships between biometric values (cholesterol, glucose, blood pressure); psychological factors (depression, anxiety and stress) and illness perception were also found to exist.ConclusionsLow scores in two dimensions of illness perception may lead to psychological consequences such as stress, anxiety, and depression. The relationship between illness perception and some risk factors of cardiovascular disease such as physical activity, diet and biometric values, reveal the need for more attention to patient education and counselling.

Prediction of PTSD related to COVID-19 in emergency staff based on the components of self-compassion and perceived social support

BackgroundOn March 11th, 2020, the World Health Organization (WHO) proclaimed Coronavirus Disease of 2019 (COVID-19) a pandemic. In addition to severe health problems, the disease has had a major psychological impact on the public. The aim of this research was to examine the association between Post-Traumatic Stress Disorder (PTSD) related to COVID-19 in emergency staff and self-compassion and perceived social support.MethodsData were collected from 222 emergency staff working in two referral educational and health centers for COVID-19 affiliated to Tabriz University of Medical Sciences. The participants were recruited six months following the first case of hospitalization for COVID-19 in these two hospitals in Tabriz, Iran. Four questionnaires were used to measure the variables, including a researcher-made demographic checklist, PTSD Checklist for DSM-5 (PCL-5), the Multidimensional Perceived Social Support Scale (MSPSS) and the Self-Compassion Scale.ResultsThe findings showed that age (r = 0.17, P = 0.034), self-judgment (r = 0. 36, P < 0.001), isolation (r = 0.44, P < 0.001) and over-identification (r = 0.15, P = 0.031) were associated with PTSD score, and there was also a statistically significant inverse relationship between the score of the self-kindness (r = - 0.19, P = 0.006) subscale and the overall score of PTSD in the emergency staff.ConclusionDuring the COVID-19 pandemic, emergency staff have persistently faced potentially traumatic situations as first-line healthcare workers, suggesting the direness of this group’s mental health. By identifying the predisposing factors of the psychological pathology under study, this research can be applied in clinical practice and provide useful information for designing special interventions and protocols for emergency staff.

Nurses, physicians and patients’ knowledge and attitudes about nurse prescribing

BackgroundOne of the roles that nurses have acquired in recent years is the role of prescribing. This study aimed to investigate the knowledge and attitudes of critical care nurses, physicians and patients about nurse prescribing.MethodsA descriptive cross-sectional study with the participation of 152 nurses, 53 physicians and 75 patients was carried out. Participants were selected by stratified random sampling from the critical care units of six hospitals in Tabriz, Iran. Demographics and participants’ knowledge and attitudes about nurse prescribing questionnaires were used to collect data. The collected data were analyzed using SPSS-22 software.ResultsThe mean scores of total knowledge about nurse prescribing in nurses, patients and physicians’ were 15.41 ± 1.85,16.45 ± 2.31, 14.74 ± 1.7 respectively (from a range of 10 -20), and the mean score of knowledge by physicians was significantly higher than others (P = 0.000) and they had more knowledge about nurse prescribing. The mean scores of the attitudes towards nurse prescribing in nurses, physicians and patients were 40.62 ± 3.68, 37.98 ± 5.92 and 39.38 ± 4.39 respectively (from a range of 10 -50). However, the total mean score of attitudes among nurses was significantly higher than others (P = 0.000) and nurses had more positive attitudes toward prescribing.ConclusionThe results showed that the participants have a good understanding and attitudes toward nurse prescribing. Nurse prescribing as a new duty and authority can be considered in providing more effective care by specialist nurses. The results of this study can also be used in the future planning of health policy for nurses to have the right to prescribe and ultimately improve the quality of patient care.

Dietary patterns in association with the expression of pro-metastatic genes in primary breast cancer.

Metastasis is a major leading cause of mortality in female breast cancer (BrCa). Cellular motility is a pathological process of metastasis remarked by the overexpression of cortactin (CTTN), Ras homolog family member-A (RhoA), and Rho-associated kinase (ROCK) genes.Their balanceisresponsible forupholding the integrity of healthy epithelial cell junctions. This study aimed to explore the associations between a posteriori dietary patterns and theexpression levels of pro-metastatic genes in primary BrCa. In this consecutive case series, 215 eligible women, newly diagnosed with histologically confirmednon-metastatic BrCa (stage I-IIIA), were recruited from Hospitals in Tabriz, NorthwesternIran (2015-2017). The tumoral expression levels of genes were quantified using real-time reverse transcription-polymerase chain reaction. Dietary data assessment was carried out using a validated food frequency questionnaire. Three dietary patterns were identified using principal component analysis (KMO = 0.699). Adherence to the "vegan" pattern (vegetables, fruits, legumes, nuts, seeds, and whole grains) was inversely associated with the expression levels of RhoA (ORAdj.T3vs.T1 = 0.24, 95%CI 0.07-0.79) and ROCK (ORAdj.T3vs.T1 = 0.26, 95%CI 0.08-0.87). In addition, the highest adherence to the "prudent" pattern (spices, seafood, dairy, and vegetable oils) decreased the odds of overexpressions at RhoA (ORAdj.T3vs.T1 = 0.26, 95%CI 0.08-0.84) and ROCK genes (ORAdj.T3vs.T1 = 0.29, 95%CI 0.09-0.95). The highest adherence to "Western" pattern (meat, processed meat, hydrogenated fat, fast food, refined cereals, sweets, and soft drinks) was a risk factor associated with the overexpression of RhoA (ORAdj.T3vs.T1 = 3.15, 95%CI 1.12-8.85). Adherence to healthy dietary patterns was significantly associated with the downregulation of pro-metastatic genes. Findings provided new implications to advance the nutrigenomic knowledge to prevent the odds ofover-regulations in pro-metastatic genes of theprimary BrCa.

The association between the inflammatory potential of diet and the risk of histopathological and molecular subtypes of breast cancer in northwestern Iran: Results from the Breast Cancer Risk and Lifestyle study.

This study explored the association between diet-associated inflammation and the risk of different molecular subtypes of breast cancer (BrCA) in a large, population-based case-control study conducted in northwestern Iran. The study consisted of 1007 women with histopathologically confirmed BrCA and 1004 controls admitted to hospitals in Tabriz, northwestern Iran, for nonneoplastic conditions. Dietary Inflammatory Index scores and energy-adjusted Dietary Inflammatory Index (E-DII) scores, with and without supplements, were computed on the basis of dietary intake collected using a validated 136-item food frequency questionnaire. Women with the highest E-DII scores (quartile 4) versus those with the lowest E-DII scores (quartile 1) showed a significantly increased BrCA risk (odds ratio for quartile 4 vs quartile 1 [ORQ4vsQ1 ], 1.87; 95% confidence interval [CI], 1.42-2.47), particularly for lobular carcinoma (ORQ4vsQ1 , 3.07; 95% CI, 1.34-7.02). Findings were similar for premenopausal women diagnosed with luminal A BrCA (ORQ4vsQ1 , 2.71; 95% CI, 1.74-4.22) or luminal B BrCA (ORQ4vsQ1 , 2.86; 95% CI, 1.39-5.89). Women consuming the most proinflammatory diets were 3 times more likely to have triple-negative BrCA (ORQ4vsQ1 , 3.00; 95% CI, 1.002-8.96) while compared to luminal A BrCA. The BrCA risk for women consuming diets in the highest half of E-DII scores (E-DII > 0) was 59% greater than the risk for those in the lowest half (95% CI, 1.29-1.97). Also, higher E-DII scores that took into account supplements were associated with larger tumor sizes (T3 > 5 cm; P < .05). A proinflammatory diet, as indicated by higher E-DII scores, appears to increase the risk of BrCA in Iranian women. Large increases in risk were seen in invasive molecular subtypes of BrCA. Anti-inflammatory diets are suggested to prevent the risk of overall BrCA and more aggressive forms of BrCA in particular.

The Effect of B-Cell Lymphoma 2 and BCL2-Associated X Polymorphisms on the Survival of Acute Lymphoblastic Leukemia Patients: Application of Frailty Survival Models

Background:B-cell lymphoma 2 (BCL-2) and BCL-2 associated X (BAX) polymorphisms are important in the apoptosis process, response to treatment and survival in Acute Lymphoblastic Leukemia (ALL) patients. We aimed to investigate the effect of these genes with other predictors corresponding to the survival of ALL patients with an appropriate frailty survival model.Methods:Our study was performed in 2020 on sixty-two cases of childhood aged 3–16 (year) with ALL disease who were selected by convenience sampling from the two hospitals of Tabriz, Iran. RFLPPCR method was used for genotyping the promoter region of the BAX and BCL-2 genes. We used different frailty survival models, to control heterogeneity between individuals due to unmeasured factors affecting their survival. All analyses were implemented using Stata 16.Results:Based on the result of log-logistic model along with frailty gamma, the proportional odds (standard error) of survival for a CC allele of BCL-2 patient compared to a AA allele patient were 6.0 (1.47); P<0.001 and for a AC of BCL-2 allele patient were 0.57 (1.23); P=0.009. Patients with AG allele of BAX had 2.05 (1.26) times greater odds of surviving than a AA allele patient (P=0.003). The odds of survival of patients with abnormal white blood cell (WBC) were 92% less than normal WBC (P<0.001).Conclusion:With controlling unmeasured factors affecting, the BCL-2 and BAX genes promoter polymorphism are effective in the survival rates for ALL.

Malnutrition and Weight Loss as Prognostic Factors in the Survival of Patients with Gastric Cancer

Introduction There are limited prospective studies assessing the post-diagnosis nutritional status of patients with gastric cancer (GC). This study aimed to assess the association between nutritional status and three-year survival of patients with GC. Methods In this prospective study, we included all histologically confirmed GC patients admitted to the Imam Reza Hospital in Tabriz, Iran from September 2016 to October 2019. The nutritional status of patients was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA) form. All patients were followed up every six months for three years. The overall survival (OS) was calculated from the diagnosis date to the date of death or last visit. Results In this study, 302 patients (mean age: 67.39 ± 12.04 years) with GC were included. The median OS was 11.00 mo, (95% CI: 80.03, 13.96). Only 28.4% of patients were well-nourished, and survived significantly longer than malnourished patients (20.5 vs. 8 mo, P = 0.01). The mortality hazard rate in patients with moderate and severe malnutrition was 2.04 times higher than well-nourished patients. Conclusion According to our results, the nutrition status of GC patients at the time of diagnosis was independently associated with their survival rate.

Iranian Nurses' Attitudes and Readiness for Nurse Prescribing: A Cross Sectional Study

Introduction: Since prescribing is a new subject in the nursing profession, it is necessary to assess nurses' attitudes to and readiness for this new responsibility. Objective: This study aimed to investigate nurses' attitudes to and readiness for nurse prescribing in teaching hospitals of Tabriz City, Iran. Materials and Methods: This cross-sectional analytical study was conducted on 335 nurses working in the hospitals of Tabriz from June to October 2019. The participants were selected with a stratified random sampling method, and study data were collected using a two-part questionnaire: demographics and the nurse prescribing questionnaire.The demographics were analyzed using descriptive statistics. The Spearman rank correlation coefficient and the Mann-Whitney U tests were employed to examine the correlation and to compare the mean scores, respectively. The significance level for all tests was determined to be less than 0.05. Results: About 82.1% of participants were female, 59.7% were working in general wards, and 42.1% were in critical care units. The results showed that the mean ±SD scores of attitude and readiness were 34.79 ±8.15 and 36.99 ±6.01, respectively. Moreover, 71.6% of nurses agreed with nurse prescribing. The results showed that the score of attitudes towards prescribing the drug was significant in terms of gender (P = 0.039), employment status (P = 0.032), work experience (P =0.041), and academic degree (P = 0.028). Also, results showed readiness to implement was significant in terms of gender (P = 0.028), employment status (P = 0.049), work experience (P = 0.037), and academic degree (P = 0.042). Finally, there was a positive and significant correlation between nurses' attitudes toward and readiness for prescribing (P = 0.042, rs=0.626). Conclusion: Because nurses have a positive attitude toward and are ready for prescribing, it is possible to make them more prepared for this new role by increasing their pharmacological knowledge and improving their accountability.

Evaluation of the Long noncoding RNA NONHSAT037832 Gene Expression Changes in Patients with Thyroid Carcinoma

Background &amp; Objective: Thyroid cancer is the most common endocrine disorder in the world. One of the main causes of this cancer is genetic changes, in particular mutations in the tumor and oncogene inhibition genes. In addition to mutations, some non-encoding RNAs called lncRNAs play an important role in the progression of tumors. NONHSAT is a lancer and has recently been referred to the role of this gene in various types of cancer. This study aimed to evaluate the lncRNA-NONHSAT037832 gene expression changes in patients with thyroid carcinoma.&#x0D; Materials &amp; Methods: A cross-sectional study was conducted on 140 homogeneous samples (70 cancer tissue homogeneous samples and 70 homogeneous healthy tissue samples) from patients with thyroid cancer referred to Alzahra Hospital in Tabriz. Using the Real-Time PCR, changes in the expression of the lncRNA-NONHSAT037832 gene were evaluated. In addition, the relationship between lncRNA-NONHSAT037832 gene expression changes and clinical parameters was investigated.&#x0D; Results: The results showed that the expression of lncRNA-NONHSAT037832 gene expression in the tissues of cancer was significantly higher than healthy tissues (P &lt;0.001) and a significant relationship with MTN (P = 0.001) and node metastasis Lymphoma was shown (P = 0.30).&#x0D; Conclusion: According to the results, the lncRNA-NONHSAT037832 gene may be used as a prognostic biomarker for thyroid cancer. &#x0D;

The Relationship Between Women’s Satisfaction with Personnel’s Support During Labor, Fear of Childbirth, and Duration of Labor Stages

Objectives: The main role of women’s caregivers is to provide supportive care. This research aimed to determine the relationship between women’s satisfaction with personnel’s support during labor, fear of childbirth, and duration of labor stages. Methods: Following a cross-sectional design, this study was performed on 301 women at Taleghani and Alzahra hospitals of Tabriz, Iran. Fear of childbirth was assessed using Delivery Fear Scale (DFS) at 3 - 4 cm dilatation, and satisfaction with the personnel’s support was measured with Mackey’s satisfaction scale within 12 - 24 hours after delivery. The partograph diagram was used to assess the duration of the labor stages. The Pearson correlation test, independent t-test, one-way ANOVA, and multiple linear regression were used for data analysis. Results: The mean ± SD score of satisfaction with personnel’s support equaled 52.12 ± 13.9 (score range: 17 to 85), and the mean score of FSD equaled 40.2 ± 20.2 (score range: 10 to 100). Satisfaction with the personnel’s support showed a significant negative correlation with the fear of childbirth (r = -0.782, P &lt; 0.001), duration of the active phase of labor (r = -0.14, P = 0.013), and total duration of labor (r = -0.14, P = 0.013). The multiple linear regression model indicated that fear of childbirth (β = -0.53; 95% CI: -0.58 to -0.48; P &lt; 0.001) and total duration of labor (β = -0.007, 95% CI: -0.013 to -0.001; P = 0.029) were inversely related with the women’s satisfaction with the personnel’s support. Conclusions: This study demonstrated that the FOC and prolonged labor can decrease satisfaction with the personnel’s support during labor.

Frequency of Human Papilloma Virus 16/18 Patients With Prostate Cancer by Polymerase Chain Reaction Method in Hospitals of Tabriz City, Iran

Background: Prostate cancer (PCa), as the fifth leading cause of death, is the second most common cancer diagnosis in men worldwide. Human papillomavirus (HPV) can potentially contribute to PCa development and chronic inflammation. HPV infection leads to malignant and benign lesions in the genital areas of men and women. The data on the role of HPV in PCa development is contradictory. Objective: This study aims to investigate the frequency of HPV in PCa samples in hospitals in Tabriz City, Iran. Methods: This study was conducted in a cross-sectional descriptive manner. Paraffin tissue blocks including 50 patients with primary prostate adenocarcinoma and 50 patients with benign prostatic hyperplasia (BPH) were selected from Tabriz hospitals. All samples were examined for the presence of HPV16/18 by the polymerase chain reaction (PCR) method. Findings: 3 out of 50 PCa patients are infected with HPV18. None of the benign and malignant prostate samples are infected with HPV 16. Therefore, in our study, no connection exists between HPV and PCa. The Mean±SD age of HPV positive samples was 61.33±11.50 years. Conclusion: The result of this research does not support the role of HPV in the development of PCa. Therefore, additional studies are necessary to clarify the possible role of HPV in prostate carcinogenesis.

A Randomized, Single-blind, Comparison Trial of Beractant (BeraksurfTM) versus Poractant Alfa (Curosurf®) in the Treatment of Respiratory Distress Syndrome in Preterm Infants

Background: Neonatal respiratory distress syndrome (NRDS) affects approximately up to 7% of all term newborns. This study aimed to assess the efficacy and safety of investigational beractant (BeraksurfTM, Tekzima Company) in comparison with poractant alfa (Curosurf®, Chiesi Pharmaceuticals) as surfactant replacement therapy in NRDS. Methods: This trial was a randomized, controlled, single-blind, phase III study of two natural surfactants which was conducted in NICU of Alzahra hospital in Tabriz for 8 months. 220 infants were enrolled in 2 groups to receive either 100 mg/kg BeraksurfTM or 200 mg/kg Curosurf® as an initial dose endotracheally. Additional doses were given if needed. Infants’ gestational age, birth weight, discharge weight and other demographic information were recorded. Efficacy outcomes were changes of fraction of inspired oxygen (FiO2) and the number of infants who reached FiO2 less than 0.3 (treatment success rate) which were compared between both groups with analysis of covariance (ANCOVA). Results: The results showed that the treatment success rate was 92% and 72% in BeraksurfTM and Curosurf® groups, respectively (Pvalue&lt; 0.001). In addition, no difference was observed in the efficacy of these two treatments in terms of binary outcomes and incidence of complications such as mortality. Conclusion: The result analysis of current study implies BeraksurfTM has same beneficial impact on clinical management of RDS as Curosurf® among infants below 32 weeks. However, larger studies are needed to evaluate further efficacy and safety outcomes of this surfactant in comparison with the reference products in other subgroups.

The role of pain, hopelessness, belonging, and suicide capacity in predicting suicide attempt in people with psychiatric disorders

Background. The idea and attempt of suicide are highly predictive of deaths due to suicide and can lead to several negative consequences for both the individual and his family and for society. Therefore, this study was conducted with the aim of the role of pain, hopelessness, belonging and suicidal capacity in predicting suicide attempt in people with psychiatric disorders. Methods. The research method of this study was correlational and the statistical population included all individuals referred to psychiatric outpatient clinics of Razi Hospital in Tabriz in 2020-2021. Sample sizes According to Klein criterion and according to the 62-item questionnaire, 298 subjects were selected. Research tools also include the Suicide Attempt Scale, the Suicide Capacity Scale and to examine the three variables of pain, hopelessness and belonging to the Suicide Motivation Questionnaire were used. Structural equation modeling was used to analyze the data using Smart pls software version 2. Results. In this study, 63.3% of the respondents were men and 36.7% of the respondents were women. The mean and standard deviation of the age of the respondents was 37.26±10.88 years. According to the results of the path coefficients between hopelessness with suicide capacity (β= 0.63), sense of belonging with suicide capacity (β= 0.28) and suicide attempt (β= 0.21), suicide capacity with suicide attempt (β= 0.59) were at a significant level (P&lt;0.05). On the other hand, suicidal capacity had a significant mediating role in the relationship between hopelessness and sense of belonging with suicide attempt. Conclusion. The results showed that the three-step model of suicide has the ability to predict suicide attempt in the community of patients with psychiatric disorders. Practical Implications. The results of this study are very important for professionals who work with people with psychiatric disorders to distinguish the idea of suicide from suicide attempt.

Skin injuries in neonates admitted to three Iranian neonatal intensive care units

Hospitalized neonates are exposed to numerous interventions by the medical teams. Therefore; maintaining skin integrity is essential. The aim of this study was to investigate the types, causes, and areas of skin injuries in neonates admitted to the three Iranian neonatal intensive care units. This study utilized a cross-sectional descriptive method. Participants were 265 neonates admitted to neonatal intensive care units of teaching Hospitals in Tabriz. Data collection tools included the neonates’ demographic characteristics questionnaire and skin injury types according to the Skin Risk Assessment and Management Tool. Data were collected by observing neonates two to eight times during the study period. Results showed that seventy-two percent of neonates had skin injuries. Bruises (49.4%) were the most common injuries. The most affected area was the hand (41.83%). The relationship between the total number of injuries with gestational age, birth weight, and length of hospitalization was significant (p < 0.05). According to the high incidence of skin injuries, there is a vital need to prevent them by using appropriate devices for predicting these injuries. These results have shown that neonates are at high risk of skin injuries, supportive skincare policies, guidelines, and knowledge regarding daily care is essential to reduce skin injuries incidence and improve neonatal skin care.

The association of professionalism and systems thinking on patient safety competency: A structural equation model

The aim of this study is to identify how professionalism and systems thinking contribute to patient safety competency among Iranian nurses. Professionalism, systems thinking and patient safety competency play important roles in the quality of care. Strategies to enhance the patient safety competency of nurses must be devised by identifying the relationships between these variables. A cross-sectional, descriptive survey study was conducted in 10 teaching hospitals in Tabriz, Iran. A total of 358 nursing staff with at least 12 months of experience in nursing were enrolled. Data were collected using the Professionalism scale, Systems Thinking Scale and Patient Safety Competency Self-Evaluation tool. Structural equation modelling analysis was performed to test the relationship between variables. The final model illustrated a good fit (χ2 /df =2.329, goodness-of-fit index =0.990, Tucker-Lewis index =0.906 and root mean square error of approximation =0.068). Professionalism directly influenced patient safety competency (β =0.59, p<0.001) and indirectly influenced systems thinking (β =0.29, p<0.001). Systems thinking directly influenced patient safety competency (β =0.46, p<0.001). Results indicated that 91% of the variance in patient safety competency was explained by professionalism while 40.1% of the variance in the systems thinking was explained by professionalism. The professionalism and systems thinking of hospital nurses play a pivotal role as predictors in patient safety competency. Training opportunities, mentorship and nursing managers' leadership are needed to assist hospital nurses in their perceptions of professionalism and systems thinking. Nursing educators and managers should implement patient safety training strategies and improve the professionalism and systems thinking of hospital nurses to promote patient safety and quality care.

Diagnostic value of red blood cell distribution width in patients with organophosphate poisoning in emergency department of Sina hospital in 2019

Introduction: Organophosphates are pesticides used for agricultural purposes, and their poisoning has critical complications. The purpose of this study was to determine the estimated Red Blood cell distribution width (RDW) prognostic role in patients with organophosphate poisoning in the emergency department. Materials and methods: In this Descriptive-analytical study, patients with acute organophosphate poisoning referred to the emergency department of Sina Hospital in Tabriz from March 2019 to March 2020 were enrolled. The primary outcome of the patients including, organophosphate-induced RDW changes, and the secondary outcome including, organophosphate-induced death were recorded. Results: Eighty two patients with organophosphate poisoning were enrolled in this study. The mean age was 36.21 years. Of 82 patients, insecticidal poisoning, herbicide, fungicides, and acaricide were seen in 62 (76.8%), 16 (19.5%), 1 (1.2%), and 1 (1.2%) patients respectively. There were no statistically significant difference observed between types of pesticides and patients’ outcomes (p&gt; 0.05). There was no statistically significant difference between different organophosphates in terms of pH, HCO3 , PCO2 , WBC, Hb, platelets, RDW, sodium, potassium, PT, PTT, INR, urea, creatinine, and cholinesterase (p&gt; 0.05). Conclusion: Generally, RDW in patients with organophosphates toxicity does not have prognostic value and is not affected by the severity of poisoning.