Background The outbreak of COVID-19 is an unprecedented challenge to the health systems in Iran. We aimed to assess the psychological impact of this outbreak on nurses in the hospitals of Guilan University of Medical Sciences that is one of the top provinces of incidence of COVID-19. Methods In a web-based cross-sectional study, 441 nurses working were selected from the hospitals, from 7 to 12 April 2020. Anxiety and depression were measured using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9, respectively. Simple and multiple logistic regression models were used to identify the factors related to anxiety and depression. Results The majority were in contact with suspected or confirmed COVID-19 cases (93.4%) and their relatives had been infected with COVID-19 (42%). The mean of anxiety-7 and depression total scores were 8.64 ± 5.60 and 8.48 ± 6.19, respectively. Female (OR = 3.27, 95% CI = 1.01–10.64), working in COVID-19 designated hospital (OR = 1.82, 95% CI = 1.13–2.93), being suspected with COVID-19 infection (OR = 2.01, 95% CI = 1.25–3.26), and insufficient personal protective equipment (OR = 2.61, 95% CI = 1.68–4.06) were associated with anxiety. Depression was significantly associated with female sex (OR = 4.62, %95 CI = 1.24–17.16), having chronic disease (OR = 2.12, 95% CI = 1.20–3.74), being suspected or confirmed with COVID-19 infection (OR = 3.44, 95% CI = 2.11–5.59, and OR = 2.21, 95% CI = 1.04–4.70, respectively), and insufficient personal protective equipment (OR = 1.86, 95% CI = 1.19–2.91). Conclusion The finding declares healthcare workers are at high risk for mental illness. Continuous supervision of the psychological consequences following infectious diseases outbreaks should be a part of the preparedness efforts of health care systems.

Introduction: The development of science and technology has provided more opportunities for patients to live and even receiving futile medical care or treatment with no hope of recovery. This process leads to awkward experiences and moral distress in nurses who frequently deliver with such care. Objective: This study aimed to determine the perception of futile care and its relationship with moral distress in nurses working in intensive care units Materials and Methods: This is a cross-sectional study conducted on 155 nurses working in Intensive Care Units (ICUs) employed in educational-therapeutic centers and hospitals of Guilan Province, Iran. They were selected by convenience sampling method. The study data were collected using the researcher-made questionnaire and Corley moral distress questionnaire. The obtained data were analyzed using descriptive statistics and inferential statistics the Kolmogorov-Smirnov test, nonparametric Mann-Whitney U, Kruskal-Wallis, Fisher exact and Backward logistic regression model. Results: The mean±SD age of the samples was 34.71±6.68 years; their mean±SD work experience was 10.24±5.63 years, and the mean±SD work experience in the ICU was 6.76±4.64 years. The results indicated that their mean±SD perception of futile care was 63±7, and their mean±SD moral distress was 92±54. The score of moral distress showed a low but significant and positive correlation with the legal and organizational aspects of futile care (r=0. 279, P=0.001) and the total score of perception futile care (r=0.2, P=0.012). In the multivariate analysis based on the logistic regression model of futile care, only the relationship between the legal and organizational score in care had a significant relationship with moral distress. So that by increasing one unit in the legal and organizational aspect of care, the chances of scoring above the mean of moral distress increases 1.2 times (P=0.0001, 95% CI; 1.077-1.324). Conclusion: Perhaps by familiarizing nurses with the legal and organizational nature of patient’s care, the moral distress of caring can be reduced.

Objectives: One of the most important problems seen in patients after stroke is that they cannot develop normal muscle strength. In recent years, the use of Mirror Therapy (MT) in the recovery of this condition has been noticed in different studies. This study investigated the effect of MT on motor recovery in patients after stroke. Methods: In this clinical trial, 93 patients were divided into three groups, including MT, non-reflective surface, and control groups. The tools used in this study included the patient’s profile questionnaire, Mini-Mental State Examination Test, and Brunnstrom Recovery Stages. After the routine physiotherapy program, the intervention groups underwent MT for 20 sessions. The analysis of data was performed by SPSS software v. 22. Results: There was a significant difference between the non-reflective surface and MT groups (P=0.043) in pairwise comparison of their motor recovery stages in the 20th session, but the difference between the non-reflective surface and control groups was not significant. There was also a significant statistical difference between the MT and control groups in motor recovery stages in the 20th session, (P=0.0332) Conclusion: The obtained findings suggest that MT can increase patients’ motor recovery after stroke. This method can be used as a simple, cheap, and usable method at home.

No abstract

No abstract

Oral cancer is a violent, 1 and devastating disease, which ranks second commonest malignancy in Pakistan. (Incidence rate, according to age standardised rates in the world, is 5.3 in males and 2.6 in females). Oral cancer is the great risk to public health of not only in Pakistan but all over the world, although a wide geographical variation noted in the occurrence and outcomes. 2 According to recent cancer registry record of Shaukat Khanum Memorial Hospital, Lahore, it is the eighth most common worldwide malignancy; but in the Pakistan, it is the second commonest malgnancy. It accounts for 15% of all new cancer cases in this region in comparison to 3% detected worldwide. 2 The prevalence of oral cancer is variable throughout the world. It is higher in Pakistan reaching the 10% of all cancers, and around 45% in India. A study conducted in Pakistan during 1995-2004 showed much higher incidence rate, 22.5% in males and 20.4% in females. 3 Over 300,000 new cases of oral and oropharyngeal cancer were diagnosed in 2004-2009 worldwide, and over 7,000 affected individuals died of these cancers. 4 It is estimated that more than 90% of all oral neoplasms are oral squamous cell carcinoma (OSCC), so this term tends to be used interchangeably with oral cancer. 4 Squamous cell carcinoma (SCC) comprises 90% of head and neck cancers; whereas, oral cavity squamous cell carcinoma (OCSCC) is the commonest. Subsites of oral cavity are lip, alveolar ridge, buccal mucosa, retromolar trigone, floor of mouth and tongue; 5 but buccal mucosa being the aggressive subsite. 6 Risk factors associated with SCC include betel quid chewing, tobacco and alcohol consumption. 7 Although there are rapid advancements in the diagnostic and therapeutic procedures in the past decades, but the five-year survival rate has showed none or only slight improvement at 65% between 2002-2008. 5 If disease is properly diagnosed and staging done at early phase, then treatment option is surgical (transoral

Purpose Concomitant kidney diseases raise the mortality rate due to the SARS-CoV-2 virus as an independent factor. Although a qualitative PCR test’s result is sufficient for diagnosis, Cycle threshold value may present relevant information to the physicians in providing faster treatment in patients with chronic conditions, including kidney diseases, to prevent morbidity and subsequent mortality. Thus, the present study was conducted to determine the relationship between the Cycle threshold value and clinical outcomes in renal patients with the coronavirus 2019. Methods This retrospective study was conducted on renal patients with the coronavirus 2019 infection admitted to Labbafinejad Hospital in Tehran, the capital of Iran, within a period of one year, from late February 2020 to February 2021. Data were collected per the prepared checklist. Cycle threshold values were measured by performing PCR on nasopharynx and oropharynx swab samples of patients. Results According to the adjusted analysis, having high viral load increased the odds of in-hospital mortality (aOR = 11.65, 95% CI 3.93–34.54), ICU admission (aOR = 5.49, 95% CI 2.16–13.97), and invasive ventilation (aOR = 7.18, 95% CI 2.61–19.74). Having high viral load also increased the odds of O 2 therapy (aOR = 3.08, 95% CI 0.79–12.01), although the difference was not statistically significant ( P = 0.105). Conclusion Cycle threshold value was a significant predictor of mortality in renal patients. Nevertheless, further studies are required on how to render optimal use of the Cycle threshold value, given that the quality of the test sample and the different groups of patients under study affect the effectiveness of this marker in predicting disease severity.

This study aimed to determine the relationship of death anxiety with quality of life and social support in hemodialysis patients. This cross-sectional research was conducted on 226 patients with chronic renal failure. The results indicated that the means and standard deviations of MSPSS, QoL, and death anxiety of patients were 57.4 ± 10.1, 28.8 ± 5.9, and 42.5 ± 4.1, respectively. A significant negative correlation was found between QoL scores and death anxiety in hemodialysis patients ( p = 0.007, r = −0.179). However, there was no statistically significant relationship between MSPSS scores and patients’ death anxiety. The total score of patients’ death anxiety decreased with increasing the total QoL score ( p < 0.001, b = −0.18). Different variables that can affect death anxiety and QoL should be identified in the patient examination process. Also, the health care system should consider necessary planning to increase the QoL and reduce death anxiety.