Purpose Unidentified dynamics for the causative agent of COVID-19, SARS-Cov-2, led to the critical public health issue. Suspicion for the airborne potential of SARS-Cov-2 is an important problem for its transmission and relevant epidemics. This research investigated hospital indoor air quality to SARS-Cov-2 occurrence and determination its air born potential. Methods The site study was a referral hospital with 630 beds for admitting of COVID-19 patients. Air sampling was done (n = 31) on selected wards including Emergency 1, Emergency 2, bedridden (4-B, 10-D), ICU 2, ICU 3, CT-SCAN, and laundry. The average temperature and relative humidities were 22 ± 1°C and 43 percent respectively. All glass impinger used for sampling in which the sampling pumps capacities were 5 and 40 L.min − 1. Sampling duration time was 20 and 15 minutes and 100 to 1000 L of air were gathered. All parts of the sampling equipment were completely disinfected by hot water, ethanol (70%), chlorine solution (1000 ppm), hot water (70°C for 1 min) and washed with distilled water. The transmitting media (7 ml) was injected into impinger and residual of this media (2 ml) was sent to the virology laboratory within 2 hours and preserved on refrigerator < 4°C. Analysis of samples was performed by RT-PCR and repeated for accuracy control. Results All of the samples were negative for SARS-Cov-2 occurrence. These results showed that SARS-Cov-2 had not airborne potential in this hospital. Conclusions Although SARS-Cov-2 similar to the SARS virus but, SARS-Cov-2 is not an airborne virus.

Bedside ultrasonography (BUS) has been widely used in many emergency evaluations, but the technique was not thoroughly evaluated for use in adult fractures. The water bath technique (WBT) is a modality which overcomes some important limitations of using BUS in extremity fractures. The study aims to evaluate and compare diagnostic values of BUS and WBT. The sensitivity, specificity, positive and negative predictive values (PPV and NPV), positive and negative likelihood ratios (LR+ and LR-), and accuracy of BUS and WBT were calculated and compared by the McNemar chi-square test. BUS had the highest sensitivity, specificity, PPV, and LR+ in the distal forearm. The highest NPV and LR- of BUS were seen in phalangeal and wrist injuries, respectively. The WBT examination had the highest sensitivity in phalangeal injuries and the highest specificity, PPV, and LR+ in the distal forearm. The highest NPV and LR- of the WBT examination were seen in phalangeal and wrist injuries, respectively. The McNemar χ (2) values for the comparison of BUS and WBT indicate that the two techniques provide statistically different results. The ultrasound revealed excellent diagnostic values which make it a favorable alternative in evaluating upper extremity fractures in adults. The WBT provides even better results.

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Introduction. Citrullus colocynthis Schrad. is a commonly used medicinal plant especially as a hypoglycemic agent. Case Presentation. Four patients with colocynth intoxication are presented. The main clinical feature was acute rectorrhagia preceeded by mucosal diarrhea with tenesmus, which gradually progressed to bloody diarrhea and overt rectorrhagia within 3 to 4 hours. The only colonoscopic observation was mucosal erosion which was completely resolved in follow-up colonoscopy after 14 days. Conclusion. The membranolytic activity of some C. colocynthis ingredients is responsible for the intestinal damage. Patients and herbalists should be acquainted with the proper use and side effects of the herb. Clinicians should also be aware of C. colocynthis as a probable cause of lower GI bleeding in patients with no other suggestive history, especially diabetics.

IntroductionClinical practice guidelines are structured recommendations that help physicians and patients to make proper decisions when dealing with a specific clinical condition. Because blunt abdominal trauma causes a various range of mild, single-system, and multisystem injuries, early detection will help to reduce mortality and resulting disability. Emergency treatment should be initiated based on CPGs. This study aimed to determine the variables affecting implementing blunt abdominal trauma CPGs in an Iranian hospital.MethodsThis study was conducted as a qualitative and phenomenology study in the Family Hospital in Tehran (Iran) in 2015. The research population included eight experts and key people in the area of blunt abdominal trauma clinical practice guidelines. Sampling was based on purposive and nonrandom methods. A semistructured interview was done for the data collection. A framework method was applied for the data analysis by using Atlas.ti software.ResultsAfter framework analyzing and various reviewing and deleting and combining the codes from 251 codes obtained, 15 families and five super families were extracted, including technical knowledge barriers, economical barriers, barriers related to deployment and monitoring, political will barriers, and managing barriers.ConclusionStructural reform is needed for eliminating the defects available in the healthcare system. As with most of the codes, subconcepts and concepts are classified into the field of human resources; it seems that the education and knowledge will be more important than other resources such as capital and equipment.