Background:Pain resulting from muscle cramps is one of the most common outcomes of hemodialysis. One of the mechanisms associated with muscle cramps is unnatural muscle metabolism. Because acupressure improves muscle metabolism through the releasing of energy, this study was performed with the purpose of determining the impact of acupressure on muscle cramps.Materials and Methods:This study was a single-blind clinical trial. Accordingly, 64 patients were selected and intensity and frequency of muscle cramps were determined by randomly categorizing them into two groups. The intervention group received 9 sessions of acupressure and the control group received 9 sessions of placebo intervention. The intervention was performed 15 min before hemodialysis in both groups. In both the groups, average intensity of pain and the frequency pain was compared before, after, and 1 month after completion of the intervention.Results:Data analysis revealed that there were no significant statistical differences between the two groups in terms of mean value of intensity (P = 0.586) and frequency (P = 0.780) of muscle cramps before the intervention. We observed a significant difference after completion of intervention sessions (P < 0.001). Moreover, there were no significant differences between mean value of intensity (P < 0.001) and frequency (P = 0.030) of muscle cramps in the control group before, after, and 1 month after the completion of 9 sessions of placebo intervention.Conclusions:Employing acupressure may result in decrease of muscle cramps in patients undergoing hemodialysis.

Introduction: The role of vitamin D in metabolism, bone-mineral regulation, and anti-oxidation effect has drawn researchers’ attention toward its exact role in hemodialysis. Objectives: In this study, the effect of uric acid level reduction on serum 25-hydroxy vitamin D levels in hemodialysis patients was assessed. Patients and Methods: This study is a triple-blind clinical trial conducted on 81 hemodialysis patients suffering from asymptomatic hyperuricemia. Serum uric acid levels were assessed at the start of the study. Then patients were divided randomly into two groups of intervention and control. The intervention group received 100 mg of allopurinol tablets daily for two months. The control group received placebo tablets for the same duration. At the end of the study, 25-hydroxyvitamin D and uric acid levels were assessed. Data were analyzed using SPSS software and chi-square, independent t test, Mann–Whitney U, and Spearman’s rank correlation tests. Results: In our study, two groups of control and intervention were similar in terms of patients’ demographic and hemodialysis characteristics. After the intervention, compared to the control group, the serum uric acid levels were significantly lower in the intervention group, while the level of 25-hydroxyvitamin D showed no significant difference between the two groups. Conclusion: In this study, no significant effect of uric acid lowering therapy with vitamin D elevation in hemodialysis patients was detected. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT2015041721803N1; https:// en.irct.ir/trial/18996, ethical code#IR.SKUMS.1395.231).

Background: Laboratory activities must be planned and organized carefully because of the danger they may cause. The purpose of this study was to assess students' awareness and comprehension of chemical hazard warning signs at the

Background: Patients undergoing hemodialysis experience painful complications such as restless leg syndrome and poor sleep quality, which negatively affect their quality of life.Purpose: This study aimed to compare the effect of reflexology and Swedish massage on restless leg syndrome and sleep quality in patients undergoing hemodialysis. Method: This is a randomized clinical trial conducted on 90 patients undergo-ing hemodialysis. The two intervention groups received either foot reflexology (n = 30) or Swedish massage (n = 30) for four weeks. In the sham group (n = 30), a simple touch of the knee down was performed with the same conditions as the intervention groups. Each sample completed the International Restless Leg Syndrome and Pittsburgh Sleep Quality Index Questionnaires before, immediately after, and one month after the intervention.Result: The results showed that immediately after the intervention, rest-less leg syndrome and sleep quality were significantly better in the foot reflexology massage group than the Swedish massage and sham groups (PRLS < 0.001, PPSQI < 0.001); also, changes in restless leg syndrome and sleep quality, respectively, before and one-month follow-up after the intervention were not significant in all three groups (PRLS = 0.47, PPSQI = 0.95), (PRLS = 0.91, PPSQI = 0.87).Conclusion: Reflexology and Swedish massage, as complementary methods, can improve the restless leg syndrome and sleep quality of patients undergoing hemodialysis. However, foot reflexology massage had been more effective.

Introduction: Thyroid status because of the expression of angiotensin-converting enzyme-2 (ACE2), which is a functional receptor for coronavirus disease 2019 (COVID-19) in thyroid glands, maybe affects COVID-19 patients’ outcomes. Objectives: This study aimed to evaluate the correlation of thyroid status with the severity and mortality of COVID-19 patients. Patients and Methods: In a retrospective cohort study conducted on 521 COVID-19 patients, data were collected by a demographic questionnaire and a checklist of patient outcomes (death/recovery) from the hospital information system (HIS) and analyzed by SPSS version 26 and binary logistic regression. Data about thyroid status were collected from clinical documents and laboratory test data. Results: Most patients were male (57.2%) with a mean age of 56.12 ± 17.4 years. Seventy-seven patients had a severe stage of disease, and 55 patients died. Twenty-one patients had hyperthyroidism, and 53 patients had hypothyroidism. Results showed that the correlation between hypothyroidism and hyperthyroidism with severity and mortality risk of COVID-19 patients was insignificant (P > 0.05). Conclusion: In this study, we concluded that, thyroid status is not associated with COVID-19 outcomes such as severity or mortality.

Article Info Background: Work related musculoskeletal disorders (WRMSDs) have been described as one of the main health problems among healthcare workers. Adverse symptoms and disorders of the musculoskeletal system represent an important cause of occupational morbidity for employees around the world. Materials and Methods: The present study was performed with the aim to identify and characterize musculoskeletal symptoms in a sample including oral and maxillofacial surgeons In Tehran, Capital city of Iran. A cross-sectional identity self-reported Nordic Musculoskeletal Questionnaire (NMQ) was sent to 45 oral and maxillofacial surgeons. Study population completed the Standardized Nordic questionnaire. Results: Data were analyzed using descriptive statistics in the Statistical Package for the Social Science (SPSS) software. Of the study sample (n = 40), 63.0% and 37.0% of the participants were men and women, respectively. Musculoskeletal symptoms in the lower back with 56.8% were reported to be the most incident symptom, followed by the neck, upper back, and shoulders with a rate of 84.6%, 44.1%, and 37.4%, respectively. The most common symptoms were stiffness in the neck, pain in the lower back, numbness in the wrist/hand, weakness in the wrist/hand, and contusion in the shoulder as 84.0 %, 64.3%, 18.5%, 29.0%, and 42.0%, respectively. As the weight of most of the participants was in the normal range, body mass index (BMI) was not associated with musculoskeletal disorders (MSDs). Conclusions: This study showed a high incidence of self-reported musculoskeletal symptoms in some body regions among Iranian oral and maxillofacial surgeons. This indicated the need for developing occupational health programs for managing MSDs among surgeons.

Introduction: Hypertension is one of the most common diseases and is the main cause of disability and mortality worldwide. Hyperuricemia has been recognized as one of the main causes of hypertension; however, few studies have been conducted to determine the correlation between serum uric acid reduction and blood pressure changes. Objective: This study aimed to assess the correlation between serum uric acid-reduction and blood pressure changes in a group of hemodialysis patients. Patients and Methods: This descriptive-analytical study was conducted on 21 hemodialysis patients taking allopurinol for the first time. Serum uric acid, systolic blood pressure, and diastolic blood pressure were measured before taking allopurinol, then patients were followed for two months, and these parameters were remeasured. Data were collected and the correlation between serum uric acid-reduction and blood pressure changes was evaluated. Results: Most patients were female, with a mean age of 56.81 ± 15.59 years. Results showed that the correlation between serum uric acid reduction and blood pressure changes was statistically significant with a ratio of 3.6 reduction for systolic blood pressure and 2.17 for diastolic blood pressure per one unit of uric acid reduction (P<0.05). Conclusion: Uric acid reduction is correlated with blood pressure reduction with both systolic and diastolic blood pressures.

Implication for health policy/practice/research/medical education Middle East pain syndrome is a novel disease, which requires more knowledge on its pathogenesis, prevention, and treatment. Possible cadmium contamination should also be considered. Notably, symptoms of this syndrome improved by fibromyalgia therapy consisting of muscle relaxants and vitamin D3 supplementation, and other related drugs. Therefore, we suggest more attention to this syndrome, in patients with various complaints as mentioned above.