Medical Care Monitoring Research Articles

Survival, mortality and epidemic risk status of COVID-19: a population-based Study in Golestan province, Iran

BackgroundAppreciating the various dimensions of the coronavirus disease 2019 (COVID-19) pandemic can improve health systems and prepare them to deal better with future pandemics and public health events. This study was conducted to investigate the association between the survival of hospitalized patients with COVID-19 and the epidemic risk stratification of the disease in Golestan province, Iran.MethodsIn this study, all patients with COVID-19 who were hospitalized in the hospitals of Golestan province of Iran from February 20, 2020, to December 19, 2022, and were registered in the Medical Care Monitoring Center (MCMC) system (85,885 individuals) were examined.The community's epidemic risk status (ERS) was determined based on the daily incidence statistics of COVID-19. The survival distribution and compare Survival in different subgroups was investigated using Kaplan–Meier and log-rank test and association between the survival and ERS by multiple Cox regression modeling.ResultsOut of 68,983 individuals whose data were correctly recorded, the mean age was 49 (SD = 23.98) years, and 52.8% were women. In total, 11.1% eventually died. The length of hospital stay was varying significantly with age, gender, ERS, underlying diseases, and COVID-19 severity (P < 0.001 for all). The adjusted hazard ratio of death for the ERS at medium, high, and very high-risk status compared to the low-risk status increased by 19%, 26%, and 56%, respectively (P < 0.001 for all).ConclusionsEnhancing preparedness, facilitating rapid rises in hospital capacities, and developing backup healthcare capacities can prevent excessive hospital referrals during health crises and further deaths.

Investigating the trend of demographic changes, mortality, clinical and paraclinical findings of patients hospitalized in the Corona ward, before and after the start of general vaccination of COVID-19

BackgroundPrioritizing prevention over treatment has been a longstanding principle in the world health system. This study aims to compare the demographic changes, mortality, clinical, and paraclinical findings of patients hospitalized in the Corona ward before and after the start of general vaccination.MethodsThis cross-sectional study utilized the simple random sampling method in 2022, analyzing 300 medical records of patients admitted to the Corona ward at 22 Bahman Khaf Hospital. Data were collected using a checklist with the help of the Medical Care Monitoring System and analyzed using SPSS-22 statistical software and Chi-square statistical test at a significance level of p < 0.05.ResultsBefore the start of general vaccination for COVID-19, the majority of patients were hospitalized in the Corona Intensive Care Unit (59.3%), aged between 51 and 65 years (47.3%), hospitalized for more than 3 days (54%), required intubation (49.3%), had SPO2 < 93% (60.7%), and exhibited common symptoms such as cough, shortness of breath, and loss of consciousness. Paraclinical findings included positive CRP, decreased lymphocytes, and ground glass opacity (GGO). After the start of general vaccination for COVID-19, most patients were hospitalized in the general care department of Corona (68%), aged between 36 and 50 years (47.3%), hospitalized for less than three days (66%), required intubation (20%), had SPO2 ≥ 93% (77.3%), and exhibited common symptoms such as weakness, headache, and body pain. Paraclinical findings were within the normal range.ConclusionsGeneral vaccination for COVID-19 has significantly reduced patient mortality and morbidity. Health policymakers should prioritize general vaccination to achieve herd immunity and improve public health.

Excess Deaths During the COVID-19 Pandemic in Southern Iran: Estimating the Absolute Count and Relative Risk Using Ecological Data.

The coronavirus disease 2019 (COVID-19) pandemic led to increased mortality rates. To assess this impact, this ecological study aimed to estimate the excess death counts in southern Iran. The study obtained weekly death counts by linking the National Death Registry and Medical Care Monitoring Center repositories. The P-score was initially estimated using a simple method that involved calculating the difference between the observed and expected death counts. The interrupted time series analysis was then used to calculate the mean relative risk (RR) of death during the first year of the pandemic. Our study found that there were 5571 excess deaths from all causes (P-score=33.29%) during the first year of the COVID-19 pandemic, with 48.03% of these deaths directly related to COVID-19. The pandemic was found to increase the risk of death from all causes (RR, 1.26; 95% confidence interval [CI], 1.19 to 1.33), as well as in specific age groups such as those aged 35-49 (RR, 1.21; 95% CI, 1.12 to 1.32), 50-64 (RR, 1.38; 95% CI, 1.28 to 1.49), and ≥65 (RR, 1.29; 95% CI, 1.12 to 1.32) years old. Furthermore, there was an increased risk of death from cardiovascular diseases (RR, 1.17; 95% CI, 1.11 to 1.22). There was a 26% increase in the death count in southern Iran during the COVID-19 pandemic. More than half of these excess deaths were not directly related to COVID-19, but rather other causes, with cardiovascular diseases being a major contributor.

The impact of long COVID on health-related quality of life in patients 6 months after discharge with severe COVID-19.

This study investigates the relationship between long COVID and health-related quality of life (HRQOL) in patients discharged for 6months. It included 192 patients with a history of severe COVID-19 and 192 patients with a history of non-severe COVID-19 patients that were selected through quota sampling methods from the Medical Care Monitoring Center (MCMC) of hospitals in Shiraz, Iran, in 2020. Phone-based interviews were conducted to collect data using the short form of the 12-item health-related quality of life (SF-12) questionnaire. Descriptive statistics, including mean (standard deviation) and frequency (percentage), were utilized. Statistical tests, such as the chi-squared test, independent samples t-test, Fisher's exact test, and multiple linear regression models were performed. Statistical analysis was performed using SPSS software version 24, with a significance level of 0.05. Among 384 patients, 79.95% were married, with a mean age of 53.95years. The majority of patients in both groups were male (57.81% in the severe group and 51.04% in the non-severe group). Patients with severe COVID-19 had significantly lower quality of life scores compared to those with non-severe COVID-19 (p < 0.001, 34.45 [SD = 6.59] versus 39.64 [SD = 5.07]). Furthermore, multiple linear regression analysis indicated that severe COVID-19 inducts a significant negative effect on HRQOL in patients after adjustment of confounders (p < 0.001, B = - 4.84). Patients with severe COVID-19 had lower HRQOL compared to those with a non-severe level. It is necessary to consider implementing policies aimed at providing social, psychological, or medical support to improve the HRQOL of patients with a history of severe COVID-19.

Usability Evaluation of Two National COVID-19 Registration Systems: A Heuristic Evaluation

Background: Data related to COVID-19 are increasing daily; the data analysis of the COVID-19 registry can provide critical information to policymakers and researchers for planning. The poor user interface design of these systems leads to problems in interacting with them. The present study aimed to evaluate the usability of two national systems to record daily data related to COVID-19 patients throughout hospitals in Iran called the "Medical Care Monitoring Center" (MCMC) and the "Electronic System for Syndromic Surveillance of Infectious Diseases" (ISSS). Methods: The interface of the aforementioned systems was assessed using a heuristic evaluation (HE) method in this descriptive, cross-sectional study. Using Nielsen’s 10 usability principles, three trained evaluators identified problems and determined each system’s severity rates independently. Results: This evaluation identified 164 usability problems, including 59 issues in the "ISSS" system and 105 violations in the "MCMC" system. The highest number of ISSS system problems was related to "Consistency and standard" and "Flexibility and efficiency of use". The average severity of problems in this system varied from 2 concerning "Consistency and standards", "Help users recognize, diagnose, and recover from errors", and "Help and documentation" to 3.6 concerning "Visibility of system status". The highest number of MCMC system problems was associated with "Help and documentation" and "Consistency and standards". The average severity of problems in this system varied from 2 to 3.28 regarding "Help and documentation" and "Recognition rather than recall", respectively. Conclusion: Errors may be decreased, data quality can be raised, and interactions can be enhanced by taking into account standards and guidelines for user interface design, such as the HE utilized in this work.

Evaluating the Usability of a Medical Care Monitoring Center System Using Heuristic Method

Introduction: Simultaneously with the COVID -19 epidemic, many efforts were made to manage and treat the disease. One of the main activities was the development of health information systems to help monitor this disease, but due to the speed of the disease’s spread, there was not enough time to evaluate the usability of these systems. Therefore, the present research was conducted to evaluate the usability of the Medical Care Monitoring Center (MCMC) system . Method: In this cross -sectional descriptive study (2022), the usability of the MCMS system was evaluated using a heuristic evaluation method. The system’s usability was investigated based on the Nielsen’s usability principles. All the problems identified by evaluators were collected in a single list and the mean severity of each problem was calculated. Results: There were 41 usability problems. The lowest mismatch with usability principles was related to "Help and documentation" (n=1) and the highest one was related to "user control and freedom" (n=8) and "Match with real world" (n=7). In addition, most of the identified problems had a relatively high degree of severity and were placed in the category of major problems. Conclusion: Using the usability evaluation, a significant number of usability problems of the system were identified which, if not resolved, can cause increased errors, dissatisfaction, and decreased quality of information; therefore, it is necessary to solve these problems by the designers and developers of this system.

Intensive care unit admission and associated factors in patients hospitalised for COVID-19: A national retrospective cohort study in Iran

ObjectivesThis study aimed to determine factors associated with intensive care unit (ICU) admission in patients hospitalised due to COVID-19.DesignRetrospective cohort.SettingConfirmed hospitalised patients from all over Iran were considered for the...

Predictors of hospital length of stay and mortality among COVID-19 inpatients during 2020-2021 in Hormozgan Province of Iran: A retrospective cohort study.

About one-fifthof patients with COVID-19 need to be hospitalized. Predicting factors affecting the hospital length of stay (LOS) can be effective in prioritizing patients, planning for services, and preventing the increase in LOS and death of patients. The present study aimed to identify the factors that predict LOS and mortality in COVID-19 patients in a retrospective cohort study. A total of 27,859 patients were admitted to 22 hospitals from February 20, 2020to June 21, 2021. The data collected from 12,454 patients were screened according to the inclusion and exclusion criteria. The data were captured from the MCMC (Medical Care Monitoring Center) database. The study tracked patients until their hospital discharge or death. Hospital LOS and mortality were assessed as the study outcomes. As the results revealed, 50.8% of patients were male and 49.2% were female. The mean hospital LOS of the discharged patients was 4.94. Yet, 9.1% of the patients (n = 1133) died. Among the predictors of mortality and long hospital LOS were the age above 60, admission to the ICU, coughs, respiratory distress, intubation, oxygen level less than 93%, cigarette and drug abuse, and a history of chronic diseases. Masculinity, gastrointestinal symptoms, and cancer were the effective variables in mortality, and positive CT was a factor significantly affecting the hospital LOS. Paying special attention to high-risk patients and modifiable risk factors such as heart disease, liver disease, and other chronic diseases can diminish the complications and mortality rate of COVID-19. Providing training, especially for those who care for patients experiencing respiratory distress such as nurses and operating room personnel can improve the qualifications and skills of medical staff. Also, ensuring the availability of sufficient supply of medical equipment is strongly recommended.

Clinical Manifestations and Associated Mortality Factors of COVID-19: A Large Population-Based Study in the Northeast of Iran During 2020-2021

Background and aims: The emergence of the coronavirus disease 2019 (COVID-19) has become one of the greatest health problems of the 21st century. The current study was conducted to investigate COVID-19’s clinical manifestation, mortality factors, and their association with each other during the three devastating waves of the pandemic in Razavi-Khorasan province, Iran. Methods: This cross-sectional epidemiological population-based study was performed in Razavi-Khorasan province, Iran from January 21, 2020, to March 20, 2021. The data, including demographic characteristics and clinical presentations of the patients, were extracted from the Medical Care Monitoring System (MCMS), disease management portal in the Deputy of Health and hospital information system (HIS) of the medical universities/faculties of the province. Results: Overall, 80499 patients were admitted to all hospitals of Khorasan-Razavi with the laboratory/ clinical COVID-19 confirmed disease. The male-to-female ratio and the mean age of our COVID-19 individuals were 1.10:1 and 55.67±23.27, respectively. The most frequently reported presenting symptoms in histories provided at the admission time were respiratory distress (58.2%), fever (36.7%), and cough (34.9%), while the less common ones were abdominal pain (2.7%) and alternation in smell/ taste (0.9%). Male gender (odds ratio [OR]=1.32, P&lt;0.001), age over 60 (OR=2.59, P&lt;0.001), and presence of at least one comorbidity (OR=1.32, P&lt;0.001) were significantly associated with higher mortality rates. Conclusion: Healthcare providers and public health managers can benefit from the findings of this study to detect and emphasize patients with poor prognoses.

COVID-19 Enfekte Hastalarda Eşzamanlı Hastalık ve Ölüm Riski: Kuzeydoğu İran'da Kesitsel Bir Çalışma

Objective: The coronavirus disease-2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2, started in Wuhan, China, and was recognized as a pandemic by the World Health Organization. In Iran, the first confirmed COVID-19 case was officially reported on February 19. The aim of this study was to investigate the epidemiological and clinical characteristics, and comorbid conditions, and determine risk factors for the mortality of COVID-19 patients as well as provide a comparison of the epidemiological features between the 3 waves of COVID-19 in the North-East of Iran from January 21, 2020, to March 20, 2021. Material and Methods: The current retrospective epidemiological population-based study was conducted on COVID-19 patients who were admitted to the hospitals affiliated to the Mashhad University of Medical Sciences in Razavi-Khorasan province, Iran. The data were extracted from the Medical Care Monitoring System of the Mashhad University of Medical Sciences. Results: In total, 43.6% of subjects had at least one coexisting underlying medical condition. The most common comorbidities were hypertension, diabetes, and cardiovascular diseases with the prevalence of 19.7, 15.1, and 13.3%; respectively. The overall case fatality rate was 15.0%, following a median of 4 days [interquartile range (IQR) 1-10] of hospitalization. The mean±SD and the median (IQR) of age in expired subjects were 67.40±18.27 and 70 (59-81) years; respectively. Conclusion: Our results demonstrated that age >60, male sex, loss of consciousness, respiratory distress, having at least one comorbidity, and diabetes were mortality risk factors among COVID-19 patients.

Effectiveness of COVID-19 vaccines on hospitalization and death in Guilan, Iran: a test-negative case-control study

ObjectivesThe present study was conducted to estimate the effectiveness of (BBIBP)-CorV (Sinopharm), ChAdOx1-S/nCoV-19 (AZD1222, Oxford-AstraZeneca), rAd26-rAd5 (Gam-COVID-Vac, Sputnik V), and BIV1-CovIran (COVIran Barekat) and BBV152 COVAXIN (Bharat Biotech) vaccines against hospitalization and death of COVID-19 in Guilan Province of Iran from May 22 to December 21, 2021. MethodsThis test-negative case-control study was conducted on the population aged 5 years and above by extracting information from local databases (The Medical Care Monitoring Center and The Integrated Health System). A logistic regression analysis was performed to estimate the effectiveness of the vaccines against COVID-19 hospitalization and death. ResultsThe total study population was 42,084, including 19,500 cases (with a positive Reverse Transcriptase-Polymerase Chain Reaction test admitted to hospitals in Guilan Province) and 22,586 controls (with a negative Reverse Transcriptase-Polymerase Chain Reaction test). Among the admitted patients, 1887 deaths occurred. The maximum effectiveness of BBIBP-CorV (Sinopharm) in preventing temporary hospitalization and regular hospitalization was observed 151 days after receiving the second dose, 95% (95% CI: 67-99.4%) and 85% (95% CI: 77-91%) respectively. The maximum effectiveness of the BBIBP-CorV (Sinopharm) vaccine 91-120 days after receiving the second dose against death was showed 56% (95% CI: 33-71%). The maximum effectiveness of ChAdOx1-S/nCoV-19 (AZD1222, Oxford-AstraZeneca) and BIV1-CovIran (COVIran Barekat) in preventing regular hospitalization and death was observed 121-150 and 61-90 days (respectively) after receiving the second dose, reaching 98% (95% CI: 94-99%) and 92% (95% CI: 48-99%), respectively for ChAdOx1-S/nCoV-19 and 95% (95% CI: 91-97%) and 89% (95% CI: 55-98%) respectively, for BIV1-CovIran. ConclusionFor almost all vaccines, the study observed an increase in effectiveness against hospitalization and death over time.

Prognosis of COVID-19 infection among opium users in Iran,2020: a hospital-based study

ABSTRACT Introduction Since Iran has the highest opioid consumption in the world and the literature surrounding the association of COVID-19 with opioid consumption is still insufficient, in this study, we aimed to present the individual, clinical, and outcome characteristics of patients with COVID-19 disease who had a history of opium use. Methods In this cross-sectional study, 1,985 patients, with a history of opium consumption, who were admitted to hospital because of COVID-19 disease were evaluated. Data were obtained from February 24, 2020 to June 21 2021, using the Medical Care Monitoring Center (MCMC) system of Shiraz University of Medical Sciences located in the province of Fars. Results The mean age of patients was 57.3 ± 17.1 years. The most common symptoms of COVID-19 disease were loss of consciousness (77.4%). 25% of patients had underlying diseases, the most common of which were cardiovascular disease (21.4%) and hypertension (21.2%). Out of 1,985 patients 251 (12.6%) died due to COVID-19. Multiple logistic regression showed that age, gender, having underlying diseases and high-resolution (HRCT) of lung are associated with mortality. Conclusion Our results showed, age 40–59 years, male gender, presence of underlying disease(s) and HRCT of the lung with finding, are correlated to the mortality of COVID-19 hospitalized patients with a history of opium consumption.

The Association of Opium Abuse with Mortality Amongst Hospitalized COVID-19 Patients in Iranian Population.

Opioid abuse is a serious problem in the society. Since the first months of COVID-19 pandemic, several myths, rumors and misconceptions have been spread about the benefits of opium consumption for COVID-19 outcome. In addition, data are limited on the relationship between opium abuse and COVID-19 mortality amongst hospitalized COVID-19 patients. In this historical cohort study, we assessed the risks of several variables for mortality amongst all hospitalized COVID-19 patients from the beginning of COVID-19 pandemic in South of Iran from March 15th, 2021 to October 14th, 2021. Data was acquired from the Medical Care Monitoring Center (MCMC), affiliated to Shiraz University of Medical Sciences. A total of 64,427 hospitalized COVID-19 patients were included into the analysis. The mortality rate was 10.59% (n = 6756). Of all, 2030 (3.15%) patients—1702 males and 328 females—reported the positive history of opium abuse with a mean age of 57 ± 17.21 years. The results of multivariable risk showed that the positive history of opium abuse had a significant association with mortality (adjusted RR: 1.173; p = 0.007). Other significant predictive risk factors were male gender, elder ages, and comorbidities such as pulmonary diseases, cardiovascular disease, cancer, nephrological diseases, neurological diseases, and diabetes. However, being a health care worker and having thyroid gland diseases were protective factors amongst hospitalized COVID-19 patients (adjusted RR: 0.650 and 0.642; p = 0.040 and < .0001, respectively). Opium abuse is a risk factor for mortality amongst hospitalized COVID-19 patients. It is vital to educate societies about the consequences of unauthorized opium consumption.

Demographics, clinical characteristics, and outcomes of 27,256 hospitalized COVID-19 patients in Kermanshah Province, Iran: a retrospective one-year cohort study

BackgroundSince the first official report of SARS-CoV-2 infection in Iran on 19 February 2020, our country has been one of the worst affected countries by the COVID-19 epidemic in the Middle East. In addition to demographic and clinical characteristics, the number of hospitalized cases and deaths is an important factor for evidence-based decision-making and disease control and preparing the healthcare system to face the future challenges of COVID-19. Therefore, this cohort study was conducted to determine the demographics, clinical characteristics, and outcomes of hospitalized COVID-19 patients in Kermanshah Province, west of Iran.MethodsThis multicenter retrospective cohort study included all suspected, probable, and confirmed cases of COVID-19 hospitalized in Kermanshah Province, Iran during the first year of the COVID-19 pandemic. Demographics, clinical characteristics, outcomes and other additional information of hospitalized patients were collected from the COVID-19 database of the Medical Care Monitoring Center (MCMC) of Kermanshah Province.ResultsKermanshah Province experienced three waves of COVID-19 infection considering the hospitalization and mortality rates between February 20, 2020 and February 19, 2021. A total of 27,256 patients were included in the study: 5203 (19.09%) subjects were suspected, 9136(33.52%) were probable, and 12,917 (47.39%) were confirmed COVID-19 cases. The mean age of the patients was 53.34 ± 22.74 years and 14,648 (53.74%) were male. The median length of hospital stay among COVID-19 survivors and non-survivors patients were 4 (interquartile range [IQR] 1–6) and 4 (IQR 1–8) days, respectively. Among patients with COVID-19, 2646 (9.71%) died during hospitalization. A multivariable logistic regression revealed that odds of death among patients ≥ 85 years was significantly greater than among patients < 15 years (adjusted odds ratio [aOR] 4.79, 95% confidence interval [CI] = 3.43–6.71, p≤ 0.001). Patients with one (aOR 1.38, 95% CI 1.21–1.59, p = 0.04), two (aOR 1.56, 95% CI 1.27–1.92, p = 0.001) or more (aOR 1.50, 95% CI 1.04–2.17, p = 0.03) comorbidities had higher odds of in-hospital death compared to those without comorbidities. The male sex (aOR 1.20, 95% CI 1.07- 1.35, p = 0.002), ICU admission (aOR 4.35, 95% CI 3.80–4.97, p < 0.001), intubation (aOR 11.09, 95% CI 9.58–12.84, p < 0.001), respiratory distress (aOR 1.40, 95% CI 1.22–1.61, p < 0.001), loss of consciousness (aOR 1.81, 95% CI 1.45–2.25, p < 0.001), anorexia (aOR 1.36, 95% CI 1.09–1.70, p = 0.006) and peripheral oxygen saturation (SpO2) < 93(aOR 2.72, 95% CI 2.34–3.16, p < 0.001) on admission were associated with increased risk of death in patients with SARS-CoV-2 infection. Having cough (aOR 0.82, 95% CI 0.72–0.93, p = 0.003) and headache (aOR 0.70, 95% CI 0.50–0.97, p = 0.03) decreased the odds of death.ConclusionThe mortality rate of the patients admitted to the general wards and ICU can be a guide for allocating resources and making appropriate plans to provide better medical interventions during the COVID-19 pandemic. Several risk factors are associated with the in-hospital mortality of COVID-19, including advanced age, male sex, ICU admission, intubation, having comorbidity, SpO2 < 93, respiratory distress, loss of consciousness, headache, anorexia, and cough. These risk factors could help clinicians identify patients at high risk for death.

A description of spatial-temporal patterns of the novel COVID-19 outbreak in the neighbourhoods' scale in Tehran, Iran.

Background: Analyzing and monitoring the spatial-temporal patterns of the new coronavirus disease (COVID-19) pandemic can assist local authorities and researchers in detecting disease outbreaks in the early stages. Because of different socioeconomic profiles in Tehran's areas, we will provide a clear picture of the pandemic distribution in Tehran's neighbourhoods during the first months of its spread from February to July 2020, employing a spatial-temporal analysis applying the geographical information system (GIS). Disease rates were estimated by location during the 5 months, and hot spots and cold spots were highlighted. Methods: This study was performed using the COVID-19 incident cases and deaths recorded in the Medical Care Monitoring Centre from February 20, to July 20, 2020. The local Getis-Ord Gi* method was applied to identify the hotspots where the infectious disease distribution had significantly clustered spatially. A statistical analysis for incidence and mortality rates and hot spots was conducted using ArcGIS 10.7 software. Results: The addresses of 43,000 Tehrani patients (15,514 confirmed COVID-19 cases and 27,486 diagnosed as probable cases) were changed in its Geo-codes in the GIS. The highest incidence rate from February to July 2020 was 48 per 10,000 and the highest 5-month incidence rate belonged to central and eastern neighbourhoods. According to the Cumulative Population density of patients, the higher number is estimated by more than 2500 people in the area; however, the lower number is highlighted by about 500 people in the neighborhood. Also, the results from the local Getis-Ord Gi* method indicate that COVID-19 has formed a hotspot in the eastern, southeast, and central districts in Tehran since February. We also observed a death rate hot spot in eastern areas. Conclusion: Because of the spread of COVID-19 disease throughout Tehran's neighborhoods with different socioeconomic status, it seems essential to pay attention to health behaviors to prevent the next waves of the disease. The findings suggest that disease distribution has formed a hot spot in Tehran's eastern and central regions.

Evaluation of Status and Income Effects of Admission and Referral of Patients in Need of Vascular Surgery Service in Hospitals of Iran University of Medical Sciences

Background: Admission and dispatch of patients is considered as part of the patient treatment process. The aim of this study was to investigate the status and income effects of admission and dispatch of patients in need of vascular surgery in hospitals of Iran University of Medical Sciences in 2018-2019. Methods: The present study is a descriptive cross-sectional study in which a checklist was compiled and the required information about admission and dispatch of patients in Iran University of Medical Sciences was extracted from the MCMC (Medical Care Monitoring Center) system. In order to extract the income of services related to vascular surgery service from the average income of each patient file in need of this service, university hospitals were used. The sampling method was census and 14,481 patients admitted and dispatched were examined. The data were analyzed by descriptive statistics using Excel software. Results: The total number of registrations for dispatch of vascular surgery service was 605, 378 of which were successful. Of these, 145 were from hospitals affiliated to private hospitals and other hospitals affiliated to other medical universities, 233 were related to vascular surgery admissions, and 227 patients were related to failure to dispatch and death. The lost income due to dispatching patients is equal to 4,875,100,680 Rials. Also, the hospitals affiliated to the university have gained income equal to 7,833,782,472 Rials by admitting and not dispatching these patients. Conclusion: The findings showed that the lost income due to dispatching patients requiring vascular surgery is 4,875,100,680 Rials. Also, the earned income resulting from the existence of medical facilities in the field of the patients’ admission to the hospitals affiliated to the university is 7,833,782,472 Rials.

The Future Of Palliative Care: Covid-19 Pandemic Process And A Brief Overview On Telemedicine/Telehealth Applications

Due to the prolonged life expectancy worldwide, the number of individuals in need of home care and palliative care is increasing. In the process of palliative care, the needs of patients and caregivers that affect the quality of life and can contribute to daily life activities should be identified. The COVID-19 pandemic, which is spreading rapidly all over the world, and the changes it has made to social life have affected individuals with chronic diseases and/or long-term care patients. The needs and service demands of palliative care patients and their families may vary during their processes. The epidemic increases the demand for health services in society and has a compelling effect on health systems. In this case, remote access auxiliary support services may be raised in order to carry out medical care monitoring of patients. Although tele-medicial/tele-health applications are not a substitute for a face-to-face meeting between physician and patient in terms of medical service delivery, interest in these applications is increasing day by day to protect vulnerable patient groups from the risk of transmission and to ensure the continuity of care services. In this review, the discussion of the changing care needs of patients in need of palliative care and home care during the pandemic process and the use of new tools to meet health demands in a way that includes less risk will be reviewed. © 2021 Ankara Yildirim Beyazit University. All rights reserved.

Regional COVID-19 registry in Khuzestan, Iran: A study protocol and lessons learned from a pilot implementation.

Disease registry systems provide a strong information infrastructure for decision-making and research. The purpose of this study is to describe the implementation method and protocol of the COVID-19 registry in Khuzestan province, Iran. We established a steering committee and formulated the purposes of the registry. Then, based on reviewing the literature, and expert panels, the minimum data set, the data collection forms and the web-based software were developed. Data collection is done retrospectively through Hospital Information Systems, Medical Care Monitoring Center system (MCMC), Management of Communicable Disease Prevention and Control system (MCDPC) as well as, patients' records. For prospective data collection, the data collection forms are compiled with patients' medical records by the medical staff and are then entered into the registry system. We collect patients' administrative and demographic data, history and physical examinations, test and imaging results, disease progression, treatment, outcomes, and follow-ups of the confirmed and suspected inpatients and outpatients. From April 20 to December 5, 2020, the data of 4,812 confirmed cases and 7,113 suspected cases were collected from two COVID-19 referral hospitals. Based on our experience, recording information along with providing care for patients and putting patients' data registration in the medical staff's routine, structuring data, having a flexible technical team and rapid software development for multiple and continuous updates, automating data collection by connecting the registry to existing information systems and having different incentives, the registration process can be strengthened.

Application of Improved LANDMARC Indoor Positioning Algorithm in Neurology Medical Care Monitoring and Positioning System

The paper proposes an improved LANDMARC positioning algorithm to improve the location accuracy of environmental obstacles for medicine care monitoring in neurology. The paper proposes a log path loss correction model and uses the model to compensate the positioning signal to improve the positioning accuracy of the algorithm caused by the attenuation of the indoor positioning signal by the wall. The experimental results show that the LANDMARC positioning algorithm based on the log path loss correction model can improve the positioning accuracy of medical monitoring in neurology.

Metallic Sandwiched-Aerogel Hybrids Enabling Flexible and Stretchable Intelligent Sensor.

Flexible strain sensors have been widely investigated with their rapid development in human-machine interfaces, soft robots, and medical care monitoring. Here, we report a new in situ catalytic strategy toward the fabrication of metallic aerogel hybrids, which are composed of vanadium nitride (VN) nanosheets decorated with well-defined vertically aligned carbon nanotube arrays (VN/CNTs) for the first time. In this architecture, the two-dimensional VN nanosheets as the main bone structure are favorable for the flexible devices due to their excellent structural compatibility during the repetitive deforming process. In addition, the sandwiched aerogel hybrids form highly conductive 3D network, affording outstanding sensitivity for the strain-responsive behaviors. Further, the VN/CNTs-based flexible strain sensors are successfully fabricated, showing a high gauge factor of 386 within a small strain of 10%, fast response, and extraordinary durability. The monitoring of physical signals and an actual real-time human-machine controlling system based on the sensors are also presented.