Excessive dependence of preschool children on their parents has led to a significant increase in the incidence of home injuries. Therefore, the present study aimed to evaluate factors influencing the knowledge and attitudes of mothers in this group regarding their adoption of preventive measures for home injuries. The subjects in this descriptive/analytical study consisted of all mothers of preschool children with home injuries, who had referred to the emergency department of Imam Hussein Hospital and Shohada-e-Haftome Tir Hospital in Tehran, Iran. After knowledge levels and attitudes of mothers were divided into two groups, multivariate logistic regression analysis and chi-squared test were used. Finally, 230 mothers, with a mean age of 29.4 ± 5.2 years, were evaluated, 75.0% of whom had good knowledge and 46.2% had positive attitudes. High school education, mothers' employment and mothers' absence from home for at least 8 hours a day were the factors predicting poor attitudes of mothers. There was a close correlation between mothers' knowledge and attitudes. The results of this study showed that mothers' high educational status, absence, occupation and the number of children in the family and history of accidents during the previous 3 weeks are important predicting factors.

Transplantation of Schwann cells can moderately improve motor function recovery. It seems that inter-species differences might exist regarding the efficacy of this cells. Therefore, this should be taken into account when using Schwann cells in clinical trials regarding spinal cord injuries.

Background:Anterior shoulder dislocation (ASD) is one of the most common reasons for referrals to emergency departments (ED). Usually, a combination of an intravenous narcotic and a benzodiazepine is used for procedural sedation and analgesia (PSA) in such cases.Objectives:This study compares the efficacy of two combinations to reduce ASD.Patients and Methods:The subjects in this clinical trial consisted of 48 patients with ASD who were randomly assigned to midazolam/fentanyl and propofol/fentanyl groups for PSA. The two groups were compared to the time interval between injection and induction of sedation (T1), duration of time from sedation to awakening (T2), the duration of time between sedation and full awareness to time, location and individuals (T3), and possible side effects.Results:Twenty-nine subjects (60.4%) were sedated with midazolam and 19 (39.6%) were sedated with propofol. During the procedure, one patient in the propofol group experienced apnea (P = 0.39) and three patients (one in the midazolam group and two in the propofol group) experienced bradycardia (P = 0.34). The mean T1, T2, and T3 were significantly shorter in the propofol group (P < 0.001).Conclusions:It seems that propofol and fentanyl can be used as a safe and fast combination for PSA in the reduction of ASD.

Introduction: COVID-19 pandemic led to various consequences in medical care that had been long provided for the patients referred to the hospitals. Objective: We conducted this study to derive and validate a new scoring system that can accurately differentiate COVID-19 patients who may have a worse outcome from others at the prehospital stage. Methods: This study was performed on probable/confirmed COVID-19 patients, who were transferred to the hospitals by Tehran emergency medical services (EMS). Occurrence of one of the items including: in-hospital death, intensive care unit (ICU) admission, or hospitalization for more than 20 days was considered to indicate a “severe disease”. Univariate and multivariate logistic regression were used for assessment of the relationship between all independent variables and the outcome. In the validity assessment step, area under the receiver operating characteristic (ROC) curve was calculated for a data set independent from the data based on which the model was designed. The sensitivity and specificity were also presented based on the best suggested cutoff point. Results: In this study, the data of 557 cases were analyzed in the derivation step and 356 cases were assessed in the validation step. The univariate logistic regression showed that age, weakness and fatigue, disease history, systolic blood pressure, SpO2, respiratory rate, and Glasgow coma scale (GCS) were statistically significant in severe disease group. The area under the ROC curve (AUC-ROC) of the tool was 0.808 (95% CI: 0.779, 0.834). The best cut-off point for screening was the score of ≥4, in which the sensitivity and specificity of the tool for the best cut-off point were 71.87% and 78.06%, respectively. In the validation step, the AUCROC of the tool was 0.723. Conclusions: Seven criteria of severe COVID-19 (SCSC) tool could properly differentiate probable/confirmed COVID-19 patients with severe outcomes in the pre-hospital stage.

IntroductionPatient satisfaction (PS) is the ultimate goal of any medical institute. Evidence shows that satisfied patients are more compliant with their treatments and are more likely to return for future care (1).The primary goal of caregivers should be providing quality care; and PS is not always in line with quality care. Nonetheless, PS determines many outcomes that are important to physicians and managers alike, which make it an important goal for all. There is an ongoing debate over the relationship between clinical outcomes and indices of PS (2, 3). Regardless of this debate, such indicators have been incorporated into the assessment and reimbursement processes of emergency departments (EDs). Therefore, many management decisions aim to improve these indices. Moreover, PS surveys allow insurance companies and health ministries to evaluate physicians, while consumer-oriented Web sites often report PS scores and influence consumer choice (2,4). In the ED, achieving PS is very difficult. The encounter between caregivers and patients in the ED is often complicated by many factors. These complexities often lead to a discrepancy between quality service, as perceived by caregivers, and PS (4,5). In the ED, time and resources are often limited and caregivers cannot fulfill the patients' discretionary needs just to improve their satisfaction. Therefore, a comprehensive consideration of the factors predicting PS can help us make improvements. Often, the perception and interpretation of satisfaction is closely related to the cultural and socio-economic context and the strategies needed for its improvement are not universal. In this study, we aimed to assess patients' satisfaction in the ED of a major trauma center in the city of Qom in Iran. MethodsThis cross-sectional study was designed to assess the factors affecting PS in Nekoee hospital, a regional trauma center in Qom, Iran. Samples were collected randomly from different shifts during a one week period in the summer of 2015. All patients disposed from the emergency department during each shift were included in the study. Patients were excluded if they were unable to answer questions (significant cognitive impairment, were unable to communicate in Farsi) or were unwilling to participate. The questionnaires were completed prior to disposition from the ED. The patients or their designated relatives were introduced to the study by a member of the research team which was not involved in the patient's treatment Original Article AbstractObjective: Patient satisfaction (PS) is a major quality assessment index for the emergency department (ED) which affects patient safety, litigation, reimbursements, and consumer satisfaction. In this study we aimed to recognize the factors affecting PS in our center. Methods: Random shifts during a week were selected and all patients disposed from the ED were asked to fill out a revised and validated Persian version of the Press-Ganey questionnaire with the help of a research assistant. Results were analyzed using a linear regression...