Background: Several studies show a high prevalence of vitamin D deficiency in Asia. Data regarding the prevalence of vitamin D deficiency in southeast Iran are inadequate. Objectives: The purpose of this study was to determine the prevalence of vitamin D deficiency in Zahedan, a sunny area in southeast Iran. Subjects and Methods: This population-based cross-sectional study was performed on 993 apparently healthy subjects. Serum levels of 25-hydroxy vitamin D (25-OH vit D), parathyroid hormone, calcium, phosphate, and alkaline phosphatase activity were measured. Results: Inadequate vitamin D status was diagnosed in 94.7% of the subjects (25-OH vit D <30 ng/ml). The frequencies of deficiency (<20 ng/ml), insufficiency (20–30 ng/ml), sufficiency (30–150 ng/ml), and toxicity (>150 ng/ml) were 85.2, 9.5, 5.3, and 0.0%, respectively. Conclusion: The results indicate that vitamin D deficiency is common in the population of Zahedan. Based on our results, fortification of milk and the use of supplements is suggested in this region.

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Our findings showed that audiovisual distraction had a positive effect on the tolerability of FB. This method has important potential as a simple and practical approach in reducing discomfort during invasive diagnostic and treatment procedures.

Background: Breast cancer patients who undergo mastectomy encounter numerous problems, the most annoying of which is lymphedema followed by pain and decreased function in the affected limb. Objectives: This study examined the effect of self-care training on upper limb function and pain after breast surgery. Methods: This quasi-experimental study was performed on two groups of 60 patients with breast cancer in the Oncology Ward of Zahedan University of Medical Sciences in 2021. The patients were selected based on the inclusion criteria and through convenience sampling and were then randomly divided into intervention and control groups. The patients in the intervention group attended self-care training and exercise programs implemented in five sessions in addition to the routine care. One and three months after the intervention, upper limb function and pain were measured with DASH and McGill pain questionnaires. The repeated measures analysis of variance (ANOVA) and Bonferroni test were used to compare the pre-, and post-intervention mean scores and mean differences in the two groups. Results: The mean scores of upper limb function one and three months after the training program in the intervention group were lower than the mean scores of the control group. In other words, the quality of upper limb function was not significantly different despite the changes in the first month, but upper limb function significantly improved three months after the intervention (P < 0.001 vs. P = 0.06). The mean pain scores before, one month, and three months after the intervention in the intervention group were 10.4, 35.7, and 6.26, respectively, and the corresponding values in the control group were 10.8, 41.7, and 21.1, respectively, showing significant differences between the two groups, with the intervention group having lower pain scores than the control group (P = 0.001). Conclusions: Since lymphedema and its consequences, including decreased upper limb function and pain, are very serious issues, medical staff can give priority to this training program and implement it to prevent and control these complications.

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Background: Although it is vital to prevent catheter-related infections (CRIs) as the most common cause of hospital infections, there is still no agreement on the best antiseptic agent. Objectives: The aim of the present study was to compare the effects of chlorhexidine, alcohol, and alcohol-chlorhexidine solutions on local CRIs in patients admitted to coronary care units (CCUs). Methods: This randomized double-blind clinical trial was performed on 150 patients admitted to the CCUs of the hospitals affiliated to Zahedan University of Medical Sciences, Iran, in 2017. The subjects were selected using the convenience sampling method and randomly divided into three groups of 50, including groups A (alcohol), B (chlorhexidine), and C (alcohol-chlorhexidine). The injection site was disinfected with 70% alcohol, chlorhexidine solution, chlorhexidine-alcohol solutions in groups A, B, and C at a radius of 5 cm from the center. Local CRIs rate was assessed based on results of a culture test. After removing the catheter from the vessel, the tip was separated with a scissor and transferred to the culture medium under sterile conditions. It was then sent to laboratory for microbiological evaluation, and the culture results were compared. In case of growth of more than 15 colonies in each plate, the colony was considered to be positive. Patients and laboratory experts who reviewed and reported the results of the culture were blind to the group allocations. Data were then analyzed by using Chi-square test and Fisher's Exact test in SPSS, version 16. Results: We found a significant difference between the three groups in terms of local CRIs (A: 20%, B: 22%, and C: 4%; P: 0.024). There was a significant difference between the chlorhexidine and alcohol-chlorhexidine groups (P = 0.007) and between the alcohol and alcohol-chlorhexidine groups in this regard (P = 0.014). The prevalence of local CRIs was significantly lower in the alcoholchlorhexidine group than the alcohol and chlorhexidine groups. Conclusions: Since the findings of the present research showed that skin cleansing with alcohol-chlorhexidine solution compared to alcohol and chlorhexidine could more effectively reduce local CRIs, it is recommended to use this formulation for disinfection of the intravenous catheterization site.

Background: Physicians, as the leading decision-makers of the health system, are affected by various clinical statuses. Objectives: This study aimed to compare the clinical skills of medical students as future physicians with the educational standards of Zahedan University of Medical Sciences in 2020 - 2021. Methods: This study was performed on 107 medical students (53 stagers and 54 interns). After obtaining students' consent and recording their demographic and academic information, clinical skills were assessed using the Clinical Medical Skills Questionnaire. The obtained data were analyzed using SPSS software Ver. 20. Results: The least trained skills in the surgical department were suprapubic puncture and thoracotomy with a needle in compressive pneumothorax. In the pediatric ward, no clinical skill training was in good condition, and only practical measures to monitor growth and development were adequately trained. In the internal ward, the least training skill was related to lumbar puncture and aspiration of knee joint fluid. In the gynecology ward, abortion evacuation with pairs of forceps in cases of life-threatening bleeding and postpartum hemorrhage were considered the least instructed clinical skills. Finally, in the emergency ward, nasal bleeding catheter, suprapubic sampling, and cricothyrotomy were the least instructed clinical skill. Conclusions: The results showed a low number of encounters of medical students with the minimum expected clinical skills in the investigated medical school, indicating the poor quality of clinical training. The medical programs should be modified so that learners can be equipped with “the must learn” clinical skills.

Background: Patients with heart failure (HF) need continuous medical care, including regular follow-up, training, and information acquisition to increase self-care capacity. Adherence to self-care behaviors reduces patient readmission Objectives: This study examined the impact of the continuous care model (CCM) on self-efficacy and readmission of patients hospitalized with HF. Methods: This quasi-experimental study was conducted on patients with HF visiting two teaching hospitals in southeastern Iran in 2021. The participants were 70 patients who were selected using convenience sampling and were placed into two control and intervention groups, each with 35 patients through limited random sampling. The patients in the control group received routine care, but the CCM was performed for the patients of the intervention group in the form of individual training for 6 sessions in the hospital and after discharge and then through telephone follow-up once a week until the end of the twelfth week. The instruments used to collect the data were a demographic information form that assessed patient readmission and their demographic information and Sullivan's Cardiac Self-Efficacy Scale. The collected data were analyzed with SPSS software (version 22) using the chi-square test, independent and paired samples t-test, and analysis of covariance at the significance level of P < 0.05. Results: Analysis of covariance showed that the mean self-efficacy score of the patients with HF was significantly different between the two groups after implementing continuous care (P = 0.001). The results of the independent samples t-test suggested that the mean and standard deviation of readmission frequencies in the control group (1.03 ± 1.01) were significantly higher than the mean readmission frequencies of the patients in the intervention group (0.34 ± 0.68) (P = 0.001). Conclusions: Given the positive and significant effect of the CCM on increasing patient self-efficacy and reducing the frequency of readmissions, and considering the ease, applicability, and low cost of this intervention, relevant authorities need to make effective planning and policies to implement the CCM for patients with HF.