Background and Aim: Moral sensitivity is a feature that enables a person to recognize his/her moral conflicts and to understand the results of moral judgment about others. Considering that this issue is more important in the ICUs and since observance of patients' rights is one of the aspects of moral care, this study aimed to determine the relationship between nurses' moral sensitivity and respect for patients' rights in ICUs in 2016. Materials and methods:In this descriptive-correlational study, 260 nurses working in ICUs of hospitals affiliated to Tehran University of Medical Sciences were selected by accessible method. To collect data, the Lutzen's Moral Sensitivity Questionnaire and Researcher-made Patients' Rights Questionnaire were used. The Data were analyzed using SPSS 20 and statistical tests. Ethical considerations: Participation in the study was optional and informed written consent was obtained from nurses to participate in the study. In addition, the information confidentiality of the participants was observed. Findings: The mean of moral sensitivity of nurses in intensive care units (160.58±18.30) and respect for patients' rights by them (12.19±127.81) were higher than average. There was a direct significant correlation between the nurses , moral sensitivity and the degree of observance of patient's rights in ICUs (P<0.0001 and r=0.326). Conclusion: Regarding the observed relationship between moral sensitivity and observance of patients' rights, it is suggested to adopt appropriate strategies to improve the observance of patients' rights in order to increase the level of moral sensitivity of nurses and provide high-quality care.

Introduction: Hospitalization of patients in the intensive care units always has negative consequences such as anxiety and concern for patients and their families. This study aimed to investigate the effect of programmed family presence in intensive care units on patients’ and families’ anxiety. Methods: This was a quasi-experimental study conducted in Iran. The eligible patients and a member of their families were assigned into two groups (N = 80) through convenience sampling. The family members in the experimental group were allowed to attend twice a day for 15 minutes in a planned way beside the patient and contribute to their clinical primary care. In the control group, the family members had a strict limitation to visit their patients based on the usual policy. Anxiety in both groups at the beginning and on the third day of patient’s admission was measured, using Spielberger’s questionnaire. The data were analyzed with SPSS version13. Results: The mean score of anxiety in the control group did not show significant difference in patients and in families, however it had decreased significantly in the experimental group after the intervention for both patients and families. The results showed that mean differences between the two groups was statistically significant in patients and families. Conclusion: The planned presence of the family of patients in coronary care unit (CCU) played a crucial role in reducing the anxiety of patients and their family. Furthermore, it is recommended that strategies of visiting policy in intensive care units (ICUs) should be revised and the possibility be provided for the families’ planned presence and participation in the patient care.

IntroductionTinnitus is the phantom auditory perception of sound in the absence of an external or internal acoustic stimulus.1 This symptom is a debilitating condition that is widespread yet difficult to successfully diagnose and treat. The prevalence of chronic tinnitus in general population is estimated between 5%-15%. It causes serious psychosocial complications in 1% to 3%.2 For some subjects, tinnitus is disabling and restricts their work, sleep, and social activities. [3][4][5] This symptom has forced clinicians to attempt to establish protocols for accuracy of tinnitus diagnosis and treatment. 6 There are various modalities in the treatment of the chronic tinnitus (pharmacotherapy, physiotherapy, psychotherapy, surgery etc) targeted at diminishing tinnitus loudness and annoyance. The disappearance of tinnitus occurs very rarely among the subjects with chronic tinnitus and according to the literature they do not represent a statistically significant group. The new medical therapeutic method of low-level laser therapy (LLLT) uses low-energy-lasers or light-emitting diodes to stimulate or inhibit cellular function.7 Lowlevel laser (LLL) is widely used by specialists to treat non-healing ulcers, autoimmune diseases, acute and chronic musculoskeletal pains, chronic inflammations, hemangiomas and burns. It has been suggested to be Abstract Introduction: Tinnitus is the phantom auditory perception of sound in the absence of an external or internal acoustic stimulus. The treatment is difficult due to multiple etiologies and great psychological influence. The purpose of this study was to determine alterations in auditory physiological and electrophysiological responses associated with temporary suppression of tinnitus induced by low-level laser (LLL) irradiation. Methods: This study was conducted on 20 subjects with subjective tinnitus. All subjects signed the informed consent form and satisfied all the study eligibility criteria. Visual analog scale (VAS) for loudness, loudness matching of tinnitus (LMT), pitch matching of tinnitus (PMT), Persian-tinnitus questionnaire (P-TQ) and Persian-tinnitus handicap inventory (P-THI) were conducted pre-and post-low level laser therapy (LLLT) for all the subjects. Electrocochleography (ECochG) and distortion product otoacoustic emissions (DPOAEs) were recorded in 11 subjects. Continuous wave diode lasers, including red (630 nm) and infra-red (808 nm) were applied, and were both designed by the Canadian Optic and Laser (COL) Center. Twelve sessions of laser therapy were performed, 2 sessions per week for each subject. Total dose was 120 Joule/ ear/session. Results: LLL irradiation could cause a significant decrease in subjective tests scores consisting of VAS for loudness, PMT, P-TQ, P-THI, but did not result in a significant improvement of objective evaluating parameters except for compound action potential (CAP) amplitude. Conclusion: LLLT might be a subjectively effective treatment for short-term improvement of tinnitus. Defining a new protocol for optimizing LLLT paramete...

Introduction: Myofascial pain syndrome (MPS) treatment is challenging with a high recurrence rate and still lacks a clear treatment frame. Therefore research on new, more efficient and long lasting effect treatment modalities is necessary. This study looked at the effects of intravenous laser therapy (IVL) and percutaneous low level laser (PLLL) in the management of shoulder MPS. Methods: In this randomized controlled trial, 30 patients fulfilling inclusion criteria were randomly equally allocated to 3 groups, control, IVL and PLLL. Control group received 12 sessions of placebo low level laser, IVL group received 12 sessions of IVL therapy, and PLLL group received 12 sessions of PLLL therapy. All patients were trained for better body posture, body mechanics, gentle massage of trigger points, stretching exercises of affected muscle (trapezius), and received 10 mg of oral nortriptyline regimen every night for 3 months. Outcomes included pain severity, functional disability, and quality of life. Patients were assessed using Numeric Rating Scale (NRS), Pain Disability Index (PDI), and Short Form Health Survey (SF-12). Data collected were analyzed using analysis of variance (ANOVA), Mann-Whitney and t tests. Results: The mean of PDI and maximum pain intensity during day and night significantly reduced in both PLLL and IVL groups compared to control group. Although pain severity and PDI reduction was more pronounced in IVL group compared to PLLL group, the differences were not statistically significant. Also, quality of life statistically significantly improved in both IVL and PLLL groups compared to control group was more, and although higher in IVL group, the difference was not statistically significant when compared to PLLL group. No side effects were observed in the intervention groups. Conclusion: Intravenous laser and PLLL therapy had a positive effect on pain severity and PDI reduction, and quality of life in this study. Also no adverse event was recorded. Thus, intravenous lasers and PLLL therapy seem to be effective complementary modalities in managing patients with shoulder MPS.

Introduction: Currently, the COVID-19 pandemic is an important health challenge worldwide. Due to the cytokine storm, the mortality rate in acute respiratory distress syndrome (ARDS) is high, but until now no therapy for these patients was approved. The aim of this review was to discuss the possible anti-inflammatory effect of photobiomodulation therapy (PBMT) on ARSD patients and present the potential role of low-level laser therapy (LLLT) in the improvement of respiratory symptoms associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: Studies about PBMT in inflammation and ARSD patients were examined. A primary search with reviewing English-language citations between 2005 and 2020 using the keywords COVID-19, ADRS, cytokine storm, low-level laser therapy, anti-inflammatory, and photobiomodulation was performed. The initial search yielded 818 articles; however, 60 articles were selected and discussed in the present study. Results: The results of the selected studies showed the usefulness of PBMT in the treatment of inflammation and ARSD in patients with COVID-19 infection. This therapy is non-invasive and safe to modulate the immune responses in ARSD patients. Conclusion:PBMT can potentially reduce the viral load and bacterial super-infections in patients with COVID-19 infection and control the inflammatory response. Therefore, the use of PBMT could be an efficient strategy for preventing severe and critical illness in SARS-COV2 infection.