Background:Admission to an intensive care unit (ICU) is not only stressful to the patients but the patients' family members. Families are believed not to receive their required attention because their needs are incorrectly and inaccurately evaluated by the health care team. Therefore, the present study aimed to examine the perceptions of ICU nurses and families regarding the psychosocial needs of families of intensive care patients.Materials and Methods:This descriptive-analytical study was conducted on a randomly selected population of 80 nurses and 80 family members of ICU patients. Data were collected using a two-part questionnaire containing sociodemographic characteristics and the Critical Care Family Need Inventory (CCFNI).Results:The rank order of the five most important CCFNI item needs identified by families were as follows: “To feel that the hospital personnel care about the patient”, “to be assured that the best care possible is being given to the patient”, “to have questions answered honestly”, “to know specific facts concerning patient's progress”, and “to be called at home about changes in the patient's condition.” The top five CCFNI item needs identified by nurses were in the following order: “To be assured that the best care possible is being given to the patient”, “to be told about transfer plans while they are being made”, “to feel that the hospital personnel care about the patient”, “to have questions answered honestly”, and “to know specific facts concerning patient's progress.”Conclusion:The present study showed there are similarities and dissimilarities between nurses and family members in their perceived importance of some family needs in the ICU. It can thus be inferred from our results that the participating nurses misestimated the needs of family members, attested by their wrong estimation of the most need statements.

Background:Diabetic nephropathy is the most important cause of end stage renal disease (ESRD). Aldosterone is involved in renal damage through induction of fibrosis, inflammation and necrosis in the kidney tissue. Previous studies have demonstrated that the combination of angiotensin receptor blocker (ARB) and spironolactone (an anti-aldosterone drug) are efficient for albuminuria reduction.Objectives:This study was designed to evaluate the effect of spironolactone alone on diabetic nephropathy.Patients and Methods:In this double blind randomized clinical trial, 60 type II diabetic patients with microalbuminuria were enrolled. They were divided into two groups: case group (spironolactone 25 mg and placebo, 30 cases) and control (spironolactone 25 mg plus losartan 25 mg, 30 cases). The treatment success rate (more than 50% reduction in microalbuminuria) was compared between the two groups.Results:After three months, successful treatment was seen in 70% (95% CI: 52 - 83) and 83.3% (CI 95%: 66 - 93) of case and control groups, respectively (P = 0.4). Mean ± SD of serum potassium levels after three months in case and control groups were 4.56 ± 0.38 and 4.39 ± 0.34 mEq/L, respectively (P = 0.08). Mean ± SD of systolic blood pressures in case and control groups were 129.67 ± 9.4 and 130.97 ± 9.4 mmHg, respectively (P = 0.6). Mean ± SD of serum creatinine levels at the end of the study were 0.95 ± 0.15 in case and 0.90 ± 0.22 mg/dL in control group (P = 0.4).Conclusions:Spironolactone alone is as effective as the combination of spironolactone and losartan on albuminuria reduction in type 2 diabetic patients and can be used alone as an effective drug for diabetic nephropathy.

Background The first large serosurvey in Iran found a SARS-CoV-2 antibody seroprevalence of 17.1% among the general population in the first wave of the epidemic by April, 2020. The purpose of the current study was to assess the seroprevalence of COVID-19 infection among Iranian general population after the third wave of the disease. Methods This population-based cross-sectional study was conducted on 7411 individuals aged ≥10 years old in 16 cities across 15 provinces in Iran between January and March, 2021. We randomly sampled individuals registered in the Iranian electronic health record system based on their national identification numbers and invited them by telephone to a healthcare center for data collection. Presence of SARS-CoV-2-specific IgG and IgM antibodies was assessed using the SARS-CoV-2 ELISA kits. The participants were also asked about their recent COVID-19-related symptoms, including cough, fever, chills, sore throat, headache, dyspnea, diarrhea, anosmia, conjunctivitis, weakness, myalgia, arthralgia, altered level of consciousness, and chest pain. The seroprevalence was estimated after adjustment for population weighting and test performance. Results The overall population-weighted seroprevalence adjusted for test performance was 34.2% (95% CI 31.0-37.3), with an estimated 7,667,874 (95% CI 6,950,412-8,362,915) infected individuals from the 16 cities. The seroprevalence varied between the cities, from the highest estimate in Tabriz (39.2% [95% CI 33.0-45.5]) to the lowest estimate in Kerman (16.0% [95% CI 10.7-21.4]). In the 16 cities studied, 50.9% of the seropositive individuals did not report a history of symptoms suggestive of COVID-19, implying an estimation of 3,902,948 (95% CI 3,537,760-4,256,724) asymptomatic infected individuals. Conclusions Nearly one in three individuals were exposed to SARS-CoV-2 in the studied cities by March 2021. The seroprevalence increased about two-fold between April, 2020, and March, 2021.

Background and Purpose: The goal of this study is application of the proportional hazards model (PH) and accelerated failure time model (AFT), with consideration Weibull distribution, to determine the level of effectiveness of the factors affecting on the level of disease-free survival (DFS) of the patients with breast cancer. Materials and Methods: Based on the retrospective descriptive studies, 377 female patients with primary breast cancer that had been treated at oncology section (Omid Hospital) in Mashhad, Iran, were considered for participation in the study. Results: The median was 2 years and 10 months (mean 2 years and 4 months, interquartile range 3 years and 7 months, range 1-2920 days or 8 years). The average age of patients was 49.2 ± 11.5 (range 25-80 years). The rate of DFS determined with 52.5%. Base on the result of PHs Weibull model, the risk of the metastasis after surgery in the patients with invasive tumors to the skin and chest and positive lymph node was more than 2 times [hazard ratio (HR) = 2.53; confidence interval (CI): 1.26, 5.06] and (HR = 2.37 CI: 1.42, 3.98), respectively. Hormone therapy after surgery decreases the risk of the metastasis to 0.63% (HR = 0.63; CI: 0.41, 0.95). In the AFT model, characteristic tumor decelerated (γ < 1) the DFS time by a factor of 0.30 and 0.33, respectively. Furthermore, the hormonal therapy accelerated (γ > 1) the DFS time by factor of 1.8. Conclusion: In this study, the PH and AFT assumption have been satisfied by data and characteristics tumor and the hormonal therapy decrease and increases time until recurrence, respectively.

Topically administered minoxidil is of equal efficacy as diltiazem in the treatment of chronic anal fissure with low frequency of adverse effects. Thus, it can be considered as an agent for chemical sphincterotomy of anal fissure, but the itching at the beginning of the treatment can affect the adherence of the patient to treatment. Trial registration number IRCT2015041414483N6 (the full trial protocol could be accessed online at www.irct.ir ).