Background: Paying attention to the issue of mental health in the workplace, especially with current pandemic conditions of COVID-19 is of significant importance. Therefore, this study aimed to determine the factors affecting occupational burnout among health care center staff during the pandemic of coronavirus infection. Methods: The present study was a case-control study carried out in the first half of the year 2020 on medical staff working in hospitals in Tehran. The sample size was 324 individuals, including 175 employees working in general (non-COVID) wards and 149 people working in COVID-19 wards. Demographic characteristics questionnaire and two standard questionnaires of Maslach Burnout Inventory and Parker and DeCotiis Job Stress Scale were distributed. Results: Total score of job stress and its two dimensions (time and pressure) had a significant relationship with different levels of occupational burnout. Logistic regression analyses showed significant relations between job stress with emotional exhaustion (95% CI, 1.11-1.19, OR=1.15) and depersonalization. Participants in both wards experienced statistically significant increasing trends given the different components of occupational burnout concurrently by increasing their total stress score. Conclusion: Hospital staff’s levels of stress and occupational burnout regardless of where they worked (COVID-19 wards or general wards) were not significantly different and existed among the members of both groups. On the other hand, job stress and its dimensions (time pressure and anxiety) had a significant relationship with the main dimensions of occupational burnout.

Background: Peak oxygen consumption (VO2) measured by cardiopulmonary exercise testing (CPET) is a significant predictor of mortality and future transplantation in heart failure patients with severely reduced ejection fraction (HFrEF). The present study evaluated the differences in peak VO2 and other prognostic variables between treadmill and cycle CPETs in these patients. Methods: In this cross-over study design, thirty males with severe HFrEF underwent CPET on both a treadmill and a cycle ergometer within 2–5 days apart, and important CPET parameters between two exercise test modalities were compared. Results: Peak VO2 was 23.12% higher on the treadmill than on cycle (20.55 ± 3.3 vs. 16.69 ± 3.01, p < 0.001, respectively). Minute ventilation to carbon dioxide production (VE/VCO2) slope was not different between the two CPET modes (p = 0.32). There was a strong positive correlation between the VE/VCO2 slopes during treadmill and cycle testing (r = 0.79; p < 0.001). VE/VCO2 slope was not related to peak respiratory exchange ratio (RER) in either modality (treadmill, r = 0.13, p = 0.48; cycle, r = 0.25, p = 0.17). The RER level was significantly higher on the cycle ergometer (p < 0.001). Conclusion: Peak VO2 is higher on treadmill than on cycle ergometer in severe HFrEF patients. In addition, VE/VCO2 slope is not a modality dependent parameter and is not related to the patients’ effort during CPET.

Aeromonas salmonicida (A. salmonicida) is a facultative Gram-negative bacillus, inhabiting in water. It is a common source of furunculosis and septicemia in fish. Report on the human infection with this organism is rare. A male farmer referred with weakness and intermittent fever. He had cardiac valves’ regurgitation due to fever with rheumatic heart disease. He had a history of swimming in well water. Transthoracic echocardiography (TTE) revealed a mobile mass of 1.3 × 0.9 cm attached to the mitral valve chordae, suggestive of a vegetation. Aeromonas salmonicida was isolated from the blood. After cardiac surgery and taking ceftriaxone for 4 weeks, he was discharged in good general condition. Five previous case reports of human infection with this organism were found. The patient was the sixth human case, and the first endocarditis, reported with this organism. A. salmonicida is a rare agent for human infection. Contact with water is a risk factor for this type of infection. It seems that the use of modern diagnostic methods has been effective in identifying the microorganism.

BackgroundSeveral reports have suggested low bone mineral density (BMD) in patients with adolescent idiopathic scoliosis (AIS). We determined bone mineral status in patients with AIS to evaluate the effect of brace treatment on BMD.MethodsBMD was measured in 46 patients (mean age, 17.8 ± 4.9 years) with AIS (17 with brace and 29 without brace) by dual-energy X-ray absorptiometry scan and compared the results to an age-matched (mean age, 16.6 ± 3.9 years) control group (n = 54).ResultsThe AIS group had significantly lower bone mass at the lumbar spine (Z-score, -1.500 vs. -0.832) and hip (Z-score, -1.221 vs. -0.754) except at the femoral neck. No difference in BMD was found between patients with AIS who used a brace and those who did not.ConclusionsThe results confirmed that BMD was low in AIS patients and it was not affected by brace treatment.

Self-expandable nitinol stents for the treatment of native and recurrent CoA is safe and has good efficacy with acceptable midterm to long-term outcome.

Background: A primary aim of forensic medicine is gender determination. Although hip is the optimal bone for this purpose, different determining criteria of this bone do not have the same accuracy. This is important in conditions that only parts of hip remain to determine gender. This study aimed to evaluate the accuracy of different hip criteria in gender determination. Methods: This cross-sectional study evaluated a total of 160 paired hips (80 males and 80 females) removed from the bodies for bone transplantation. Morphometric criteria were vertical and horizontal acetabular diameters and superior and inferior pubic ramus widths. Morphological criteria were a greater sciatic notch, obturator foramen, pubic body, preauricular sulcus, acetabular fossa position, and ischial tuberosity. The obtained data were analyzed using Cross Tab, t-test, and logistic regression analysis by SPSS. The significance level was set at P<0.05. Results: There was no significant difference in morphometric and morphological criteria between the studied left and right hip bones (P>0.05). In gender determination, acetabular diameter and greater sciatic notch had the highest accuracy (85%), and obturator foramen (67.5%) and superior and inferior pubic ramus widths (65%) had the lowest accuracy. Conclusion: Hip bone is not always completely available and preserved to determine gender. Moreover, sometimes not all anthropometric criteria of the bone are in favor of one gender. Therefore, investigating the accuracy of different criteria can be very important in interpreting the results. Thus, it has always been emphasized on the use of all available information in gender determination.

Background and ObjectivesThere are limited studies regarding suicidal ideation among Iranian medical students. We aimed to evaluate the prevalence of suicidal ideation and its association with hopelessness among Tehran University of Medical Sciences (TUMS) medical students. MethodsWe designed a cross-sectional study conducted in TUMS in 2018. We developed a questionnaire consisting of three parts; the Beck Hopelessness Scale (BHS), four questions regarding suicidal ideation, and questions regarding demographic characteristics. We used the available sampling technique and sent the questionnaire to 517 medical students of TUMS. ResultsIn total, 224 medical students completed and sent back the questionnaire (response rate=43.32%). Participants' mean age was 22.68 (SD=3.38) years, and 140 participants (62.5%) were female. One hundred seven students (47.76%) had mild, 58 (25.89%) had moderate, and 13 (5.8%) had severe hopelessness. Males, senior students, and dissatisfied students with their academic performance experienced more severe hopelessness (P<0.05). Thirty-six participants (16.07%) had suicidal ideation. After adjusting for age, gender, marital status, and student's satisfaction with their academic performance, BHS total score was independently associated with suicidal ideation (OR=1.29, 95% CI=1.14-1.46, P<0.0001) ConclusionThe prevalence of suicidal ideation and hopelessness is relatively high among Iranian medical students. Students with more severe hopelessness are at higher risk of suicidal ideation, and evaluating hopelessness among medical students can be used to screen medical students at risk of suicidal ideation.

Primary percutaneous coronary intervention (PPCI) is the gold standard of treatment in patients with acute ST-elevation myocardial infarction (STEMI). The no-reflow phenomenon (NRP) is a detrimental consequence of STEMI. Colchicine is an antiinflammatory drug that may help prevent the NRP and improve patient outcomes. In a randomized, double-blind, placebo-controlled clinical trial, 451 patients with acute STEMI who were candidates for PPCI and eligible for enrollment were randomized into the colchicine group (n = 229) and the control group (n = 222). About 321 patients were eligible to participate; 161 patients were assigned to the colchicine group, whereas 160 patients were assigned to the control group. Colchicine was administered 1 mg before PCI and 0.5 mg daily after the procedure until discharge. NRP, measured by angiographic findings including the thrombolysis in myocardial infarction flow grade and the thrombolysis in myocardial infarction myocardial perfusion grade, was reported as the primary outcome. Secondary end points included ST resolution 90 minutes after the procedure, P-selectin, high-sensitivity C-reactive protein, and troponin levels postprocedurally, predischarge ejection fraction, and major adverse cardiac events (MACE) at 1 month and 1 year after PPCI. NRP rates did not show a significant difference between the 2 groups (P = 0.98). Moreover, the levels of P-selectin, high-sensitivity C-reactive protein, and troponin were not significantly different. MACE and predischarge ejection fraction were also not significantly different between the groups. In patients with STEMI treated by PPCI, colchicine administered before PPCI was not associated with a signif-icant reduction in the NRP and MACE prevention (trial registration: IRCT20120111008698N23).