bluuebunny/crossref_metadata_2025 huggingface dataset:
Testosterone therapy in hypogonadal men: a systematic review and network meta-analysis
Authors: Elliott Jesse , Kelly Shannon E , Millar Adam C , Peterson Joan , Chen Li , Johnston Amy , Kotb Ahmed , Skidmore Becky , Bai Zemin , Mamdani Muhammad , Wells George A
Published: May 2024

Objective

To assess the relative effects of individual testosterone products among hypogonadal men.

Design

Systematic review and network meta-analysis.

Methods

We searched MEDLINE, Embase, Cochrane CENTRAL, and grey literature (25 May 2017) for randomised-controlled trials (RCTs) and non-randomised studies (NRS) that involved hypogonadal men given testosterone replacement therapy (TRT) for ≥3 months. Comparators were placebo, another TRT, or the same product at a different dose. Outcomes were quality of life, depression, libido, erectile function, activities of daily living and testosterone levels, as well as cardiovascular death, myocardial infarction, stroke, prostate cancer, heart disease, diabetes, serious adverse events, withdrawals due to adverse events and erythrocytosis. RCT data were pooled via meta-analysis and network meta-analysis. Risk of bias was assessed using Cochrane’s risk of bias tool (RCTs) andScottish Intercollegiate Guidelines Network (SIGN)50 (NRS).

Results

Eighty-seven RCTs and 51 NRS were included. Most were at high or unclear risk of bias, with short treatment duration and follow-up. When compared as a class against placebo, TRT improved quality of life (standardised mean difference (SMD) −0.26, 95% CI −0.41 to –0.11), libido (SMD 0.33, 95% CI 0.16 to 0.50), depression (SMD −0.23, 95% CI −0.44 to –0.01) and erectile function (SMD 0.25, 95% CI 0.10 to 0.41). Most individual TRTs were significantly better than placebo at improving libido (6/10). Only one TRT was better than placebo at improving quality of life, and no individual TRTs improved depression or erectile function. There was no increased risk of adverse events, with the exception of withdrawals due to adverse events with the use of some TRTs.

Conclusion

Despite a class effect of improving quality of life, depression, erectile function and libido, major improvements were not observed with the use of any individual product. We observed no statistically significant increase in the risk of adverse events; however, longer-term high-quality trials are needed to fully assess the risk of harm.

PROSPERO registration number

CRD42014009963.
A CENTURY OF PUBLIC HEALTH POLICY IN IRAN: AN ANALYSIS OF INTELLECTUAL TRENDS IN IRAN'S DEVELOPMENT PLANS
Authors: Doshmangir Leila , Moshiri Esmaeil
Published: May 2024

Background and aims:

Every individual is entitled to the right to health, and public health policies are the direct result of this principle. Both from a humanism perspective and due to the inherent requirements of a universal public health system, maintaining health has priority over treatment. Accordingly, any system aiming to promote public health must adjust its decisions, policies, and activities so as to continuously and progressively improve the quality of health services. The present research analyzes the role of Public health policies and intellectual trends in developing Iran's health system. The results can be used to outline the future of primary healthcare at different levels of health system.

Methods:

Data were gathered through a review of the literature as well as relevant documents and round table discussions. Data was analyzed using content analysis.

Results:

Clarification of health policies and distinguishing between key and ideal choices allows for more rigorous pursuit of the fundamental goals of the health system. Adherence to the guiding principles of a comprehensive health system, implementation of an all-inclusive network of health services, issues related to training human resources, the role of the government and the Ministry of Health in providing health services, and the basic needs of the health system are the most important factors that require more attention for further development of healthcare at different levels of Iran's health system.

Conclusion:

By analyzing the experiences of Iran's health system and by understanding the status quo, the strength and weakness of the system can be identified and a systematic approach can be taken to develop and implement new and better policies. Health issues are interrelated and are even affected by social conditions. Increasing the number of physicians, having extra funds, and building new hospitals with more beds are not as effective as promoting the concept of prevention in solving the problems that people faces today. The health system must be viewed as a whole made up of various intertwined parts. Its goals must be clarified, its requirements, resources, and limitations must be specified, and a systematic approach must be taken to solve the problems of the health system by taking into account all the contributing factors.
113: SPECIFIC TARGETING OF HER2-POSITIVE BREAST CANCER CELL LINE (SK-BR3) USING IDARUBICIN-LOADED ANTI-HER2 IMMUNOLIPOSOME
Authors: Pourshohod Aminollah , Zeinali Majid , Afrakhte Moslem , Jamalan Mostafa
Published: May 2024

Cytotoxic chemotherapy drugs which are used for treating malignant cells cannot distinguish between normal and cancerous cells. This would lead to adverse side effects. Moreover, drug resistance is another major problem of the classical chemotherapy during the treatment period. Recently, various therapeutic strategies have been developed for cell-specific targeting of anti-neoplastic drugs. Among the various kinds of drug delivery systems, (immuno) liposome has attracted high attention for its unique features such as high loading capacity, lower toxicity, delivery of soluble/non-soluble drugs, targeting and versatile structural specifications that permit easy surface decoration. Idarubicin is a semisynthetic anticancer drug that is widely used for treatment of leukemia as well as other kinds of cancers.

In this study, liposomes were covered with biocompatible polyethylene glycol (PEG) and dress up with a monoclonal antibody (mAb) Trastuzumab (Herceptin®). Trastuzumab is a humanized mAb approved by FDA for ablation of HER-2 over express cells in metastatic breast cancer. The constructed immunoliposome was loaded by Idarubicin. Shape, polarity, and size of synthesized immunoliposomes were characterized by the Atomic Force Microscopy (AFM) and Dynamic Light scattering (DLS) methods. SK-BR3 and MCF7 cell lines were used as HER2- positive and HER2-negative cells, respectively. Cell lines were treated with different concentrations of Idarubicin either in the free form or entrapped in liposomes/ immunoliposomes. After treatment, growth of malignant cells was evaluated by MTT assay.

Mean diameter and zeta potential of the prepared Idarubicin-loaded anti-HER2 immunoliposomes were 160 nm and –20 mV, respectively. Cell lines responded to Idarubicin in a concentration dependent manner. According to the obtained results, Idarubicin showed potent toxic effect on both kinds of cell lines, however; SK-BR3 cells were significantly more sensitive. In comparison, Idarubicin in the form of immunoliposome was more potent in the killing of SK-BR3 malignant cells.
116: SURVEYING THE INFORMATION SEEKING BEHAVIOR AND INFORMATION NEEDS OF NURSES WORKING IN AHVAZ HOSPITALS AFFILIATED TO JUNDISHAPUR UNIVERSITY OF MEDICAL SCIENCES IN USING UP-TO-DATE DATABASE
Authors: Aghazadeh-Asl Ebrahim , Ghassemi Ali Hossein , Bigdeli Zahed , Soosani-Gharibvand Bahram , Saki-Malehi Amal
Published: May 2024

Nursing as one of the largest groups in providing health care needs modern and updated information to improve quality and quantity of health care services, clinical activities, etc. In the meantime, evidence-based databases (such as Up-To-Date Database) significantly contribute to improved performance and efficiency of health services by providing the latest findings on health issues. The present study aimed to survey the Information Seeking Behavior and Information Needs of nurses working in Ahvaz hospitals affiliated to Jundishapur University of medical sciences in using Up-To-Date database. In this descriptive-analytical study, the statistical population consisted of 1246 nurses working in hospitals of Ahvaz University of Medical Sciences among which 293 people were selected. The required data was collected using a questionnaire developed by the researchers. Validity and reliability of the questionnaire were confirmed by Cronbach's alpha coefficient as 0.71. Descriptive statistics and Kruskal-Wallis Test were used for data analysis. The results showed that most nurses needed information about new developments in the field of nursing and medications. A majority of nurses used simple searching technique to find the required information. Most nurses aimed to update their information using Up-To-Date Database. The main barrier to update information was shortage of time. Therefore, it is essential to teach information skills to nurses, so that they can access modern and updated information in the field of nursing and obtain the latest information in this field from evidence-based information sources and databases.
142: THE IMPACT OF VISITORS ON THE QUALITY OF HOSPITALIZED PATIENTS' TREATMENT
Authors: Shamloo Marzieh Beigom Bigdeli , Bahrami Hadi
Published: May 2024

Background and aims:

Visiting is one of the basic requirements of patients, but most doctors and nurses know visiting as a stressor. This study aimed to evaluate the effect of the presence of visitors on the quality of patients' treatment.

Methods:

In this review, we studied 20 reliable documentations and sources extracted from sites of SID, PUBMED, and magazines inside and outside the country about the presence of visitors, fellows and training them in various sectors and also treatment processes and the results of the reviewed articles were compared.

Results:

The results showed that there was a statistically significant difference between the anxiety and severe physiological changes in patients who had visitors and those who had no visitors. (P<0.05) In addition, the length of delivery in women who had visitors was statistically different and longer than those who had no visitors (P<0.05). Also, there was a statistically significant difference between the rates of death in patients who had no visitors and the patients who had visitors (P<0.05).

Conclusion:

The presence of visitors has reduced anxiety and death in patients and has prevented severe changes in physiological indicators. Moreover, the presence of visitors reduces the duration of delivery, which of course should be accompanied with proper training.
152: A MEASURE FOR ESTIMATING THE MAGNITUDE OF UNNECESSARY OVERTREATMENT, OVER TESTING AND OVER PREVENTING
Authors: Pezeshki Mohammad Zakaria , Pezeshki Sina
Published: May 2024

There is not any summary measure in EBM for showing the magnitude of unnecessary medical interventions including overtreatment, over testing and over preventing. Based on the finding of a valid and reliable double blinded randomized controlled clinical trial (RCT) with a good external validity, two groups of patients may receive unnecessary overtreatment: the first group consists of patients who will not respond to medication or surgery. The second group consists of patients who respond to the placebo or sham surgery. Here we define an index to cover these two groups: Unnecessary Overtreatment Index (UOI). Based on the finding of RCTs, the UOI is defined as summation of two proportions: the proportion of patients who do not respond to medication/surgery and the proportion of patients who are improved by the placebo or sham surgery intervention as well. For example if the RCT shows that 30/100 of patients who received medication/surgery have improved and for the placebo intervention group only 20/100 patients have also improved, then the UOI is summation of (1–30/100) and 20/100. It means if a physician prescribes the medication/surgery to 100 patients then 90 of these patients will be treated unnecessarily. Seventy out of 90 are patients who will not be improved and 20 out of 90 are patients who would be improved even if they received placebo intervention. The 95% Confidence Interval can be calculated for UOI. An interesting point is the relation of UOI with Absolute Risk Reduction (ARR). Considering the definition of UOI and ARR, we will show that UOI is equal to “1- ARR. As in the example, ARR is 10/100 (30/100–20/100). Then, it can be stated that UOI=1–10%=90%. If the RCT is a diagnostic trial examining a diagnostic test, then we can define Unnecessary Overtesting Index and if the RCT examines a preventive intervention, we can define Unnecessary Over preventing Index. The utility of UOI in clinical practice will be discussed with demonstrating a few examples.
164: COMPARE OF IMPORTANCE OF GOOD PATIENT –PROVIDER COMMUNICATION FROM THE PERSPECTIVE OF HOUSEHOLDS LIVING IN HIGH AND LOW INCOME DISTRICTS OF MASHHAD
Authors: Fazaeli Somayeh , Yousefi Mehdi , Ershadnia Zahra-Sadat , Fazaeli Saeed
Published: May 2024

Background and aims:

Provide needed information, get feedback and answer the questions of patients, that the World Health Organization calls it as clarity of communication of patient- health care personnel and is one of the eight domains of health system responsiveness, which is important in the delivery of high-quality health care. This study was done to compare of importance of good communication of health care providers with patients from the perspective of households living in high and low income districts of Mashhad.

Methods:

In this cross-sectional and explanatory study, 923 household were selected randomly from two high and low income districts of Mashhad in 2014. World Health Organization (WHO) questionnaire was used for data collection. Data were analyzed using Ordinal Logistic Regression (OLR), descriptive and non-parametric statistics by SPSS 19 at a significance level of 0.05.

Results:

Percentage of people who said it's very important to have good communication between health care providers and patients in high and low income districts of Mashhad were 56% and 48% respectively. Also there were a statistically significant differences between importance of good communication with living districts: low/high income (P-Value ≤0.05), having a person in need of care living in household (P-Value ≤0.01) and Education (year) of respondents (P-Value ≤0.01).

Conclusion:

As shown, having good communication between health care providers and patients from the perspective of majority of services users in high and low income districts of Mashhad were important and very important. Also improving the level of education in population can help to increase awareness of them about effective role of good provider-patient communication in the delivery of high-quality health care.
167: CRITICALLY APPRAISE OF THE REPORTING QUALITY OF RANDOMIZED CONTROLLED TRIALS ARTICLES IN THE FIELD OF DIABETES IN MEDICAL GUIDELINES IN IRAN
Authors: Aletaha Azadeh , Baradaran Hamid Reza , Soltani Akbar , Ramezani Amir
Published: May 2024

Background and aims:

To determine the quality of randomized controlled clinical trial reports in diabetes research in Iran and their presence in domestic and foreign credible guidelines which can imply whether randomized controlled trial articles in the field of diabetes are of good quality or not with respect to their high level of received citations, quality and credibility.

Method:

We included RCTs conducted on Diabetes mellitus in Iran. Animal studies, educational, interventions, and non-randomized trials were excluded. This was a bibliographic study examining published journal articles involving RCTs in diabetes research from Iranian authors. A systematic search of ten databases(ISI Web of science, Scopus, PubMed, Science Direct, The Cochrane Library, Taylor & Francis Online, Biomed Central, EBSCO, ProQuest and OVID)were undertaken from July 2004–2014. We excluded duplicated publications reporting the same groups of participants and intervention two independent reviewers identify all eligible articles specifically designed data extraction form. Two reviewers assessed the quality of reporting by CONSORT 2010 (Consolidated Standards of Reporting Trials) checklist statement and also evaluate each article with Scientometry tools in 260 valid English diabetes guidelines.

Result:

Overall, we included 185 RCTs on diabetes mellitus, One hundred and eight five (185) studies were included and appraised. Half of them (55.7%) were published in Iranian journals. Most (89.7%) were parallel RCTs, and being performed on type2 diabetic patients (77.8%). Less than half of the CONSORT items (43.2%) were reported in studies, totally. The reporting of randomization and blinding were poor. A few studies 15.1% mentioned the method of random sequence generation and strategy of allocation concealment. And only 34.8% of trials report how blinding was applied. From 185 articles, twelve articles (10%) are presented in 260 Guidelines.

Conclusion:

The reporting quality of abstracts of RCTs on Diabetes mellitus still should be improved. After the publication of CONSORT for abstracts guideline, the RCT abstracts reporting quality were improvement to some extent. The presence of RCTs on diabetes mellitus in guidelines was poor. This indicates that RCTs on diabetes mellitus need substantial improvement. In order to present an adequate reporting of the randomized controlled trial results, it is necessary that comprehensive information be given about the study's design, implementation, included groups, and method of data analysis and interpretation of the results.
171: DISSEMINATION OF EVIDENCE BASED KNOWLEDGE ON METABOLIC SYNDROME (MS) FROM RESEARCH TO PRACTICE: BANGLADESH CONTEXT
Authors: Natasha Khurshid , Liaquat Ali
Published: May 2024

Background and aims:

Local context of knowledge, attitude and practice (KAP) is of central importance to reduce the public health concerns like metabolic syndrome and thus designing of proper strategies to improve health in a population requires sufficient data which are scanty in Bangladesh. Therefore a project was designed an attempt to start a solution by BIRDEM and WDF (Jan 06–Aug 11). The goal was to create awareness and impact on health professionals and policy makers regarding MS absolutely from local perspective of Bangladeshi people.

Methods:

The TEAM contacted each and every single institute/university/organization over the whole country to collect primary/secondary – chemical, biological and sociocultural data from research on MS. Data on about 1000 food items and 12000 socioeconomic related KAP were sum-upped, compiled and edited for database. Then a substantial volume of culturally sensitive health promotional/educational tools like followings:

▸ Publication and circulation of several health articles, magazines, calendar, Leaflets and Alphabet book.

▸ Distribution of ‘Clay-models’.

▸ Dispersion of thousands of Mini-display-boards.

▸ Training of health professionals

▸ Special Classes for patients (337)

▸ ‘Series of Dissemination Seminars’ for all (15)

▸ Launching of websitewww.pushti.org

▸ Broadcast of 3 mini docudramas through >12 satellite channels…. were developed.

Results:

The KAP level is significantly improved after promotional activities. Benefitted people: 3000000 Patients and Relatives, 1200 Doctors, 600 Paramedics, 800 Nurses, 100 Dieticians/Educators, 60000000 Mass people. Recently this research work has been accepted in different institutes to practice further.

Conclusion:

Allied persons are now giving the second thoughts to design, run or implement new endeavour focusing the key findings of this project.
174: ETIOLOGY AND PATTERNS OF FACIAL FRACTURES IN IRAN: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Amirzade-Iranaq Mohammad Hossein , Masoumi Seyyed Mohammad Reza
Published: May 2024

Background and aims:

One of the highest rates of car accidents and related morbidities and mortalities in the world is reported from Iran. Facial structures are usually injured in such accidents. This study is conducted to find the patterns and etiologies of mid-facial fractures in Iran.

Methods:

Electronic search performed based on PubMed, Scopus, ISC and Web of Science for relevant studies and also hand-searching for recognizing non-indexed sources. English and Persian languages restriction included and only cross sectional studies entered to this study. 32 articles found through databases searching and also 3 Additional records identified by hand-searching. After excluding of duplicates and studies not meeting inclusion criteria like knowledge attitude studies, at last 8 Full-text articles assessed for eligibility. Quality assessment of this study was executed by using the Critical Appraisal Skills Programme (CASP). All of these studies were selected for meta-analysis by Comprehensive meta-analysis version 2.0.

Results:

With male to female ratio of 4:1, 41% of fractures were related to automobile accidents, and 21% were attributed to motorcycle accidents. Other etiologies are collisions, falls, physical abuse, bicycle events, occupational events and sport events. Most fractures occurred in zygoma followed by Le Fort and nasal bone fractures.

Conclusion:

The main etiology of mid-facial fractures is automobile and motorcycle accidents. Protective measures were not observed in the majority of patients.
176: EVIDENCE-BASED AND EFFECTIVE RESEARCH SKILLS OF IRANIAN MIDDLE SCHOOL STUDENTS
Authors: Mostafaei Helia , Sadeghi-Ghyassi Fatemeh , Mostafaei Hadi
Published: May 2024

Background and aims:

Recently, digital research is very popular in schools. The capacity of students to do an effective search is unclear which can lead to utilization of unacceptable evidence in their research.

Aims:

To evaluate middle school students' effective search skills.

Methods:

This survey was done during the summer school of Farzanegan talented students middle school. The self-administrated questionnaire studied 30 items about effective search and digital research skills of students. One hundred questionnaires were distributed in this summer school and students in the 7th and 8th grades filled the questionnaires. The administration of the questionnaire was counted as their concept. All data was analyzed at Excel 2013.

Results:

Eighty percent of students including 67.5% of the seventh and 32.5% of the eighth grade students responded to the questionnaires respectively. Shockingly, 96.2% of students only googled and most of them (73.7%) type the topic of their research in Persian to start their research strategy. More than half of them (52.5) believed the result of their search is mostly or always correct and 66.2% of them copy-pasted their findings without any assessment. Surprisingly, only 27.5% of them have proposed that they had problem with appraising the evidence. The best sources of the students for finding the answer of their questions were: Wikipedia, telegram, TV, books, E-Books, YouTube, classmates, Facebook and student information websites, and EBSCO, accordingly. 76.2% acknowledged that internet has turned students into copy machines. Only 31.2% agreed their teachers taught them how to do effective research.

Conclusion:

Most of the students were not familiar with valid sources of research evidence. Language barrier may limit their access to best evidence. Most students were not used to retrieving the evidence.
195: SYSTEMATIC REVIEW AND META-ANALYSIS ON THE STUDY OF BRONCHOSCOPY TRAINING BASED ON VISUAL REALITY SIMULATION
Authors: Sokouti Massoud , Rezaei Peyman , Ghojazadeh Morteza , Sokouti Mohsen , Sadeghi Ramin , Pashazadeh Saeid , Eslami Saeid
Published: May 2024

Background and aims:

Bronchoscopy training based on virtual reality simulators are being used increasingly but effectiveness remains uncertain. The aim of this study is to perform a systematic review of published works on virtual reality bronchoscopy training.

Methods:

We searched PubMed, Scopus, and Google Scholar for eligible articles from first of January 2000 to 15 May 2016. We included all original articles involving virtual reality Bronchoscopy training performed by flexible and rigid Bronchoscopy. Study selection and data abstraction were performed separately. Novices and experts were trained and comparisons of trained novices with novices (Group A), trained experts with experts (Group B), and trained novices with experts (Group C) were performed. Pooled results were analyzed by random effect meta-analysis.

Results:

From an initial pool of 2831 articles (179 Scopus, 32 PubMed, and 2620 Google Scholar) we identified eight studies relating virtual reality Bronchoscopy training based on simulation. The results of forest plots of meta-analysis in group A is Hedge's g=1.038, SE=0.271, Z-value=3.825, P-value=0.000, and in group B is Hedge's g=0.820, SE=0.283, Z-value=2.928, P-value=0.003 and group C is Hedge's g=–0.652, SE=0.219, Z-value=–2.975, P-value=0.003. P-values of all Groups are significant and virtual reality training is effective in these groups. Heterogeneity and Egger's regression tests were also performed in all groups.

Conclusion:

Virtual reality Bronchoscopy training based on simulation would help to improve technical skills if theoretical knowledge acquisition designed as a learning instrument. This meta-analysis assessment seems to be valid and reliable.
204: THE ROLE OF IMCI PROGRAM IN THE RATIONALIZATION OF MEDICAMENT USE IN PEDIATRICS
Authors: Ahmad Chreitah
Published: May 2024

Background and aims:

Integrated management of childhood illness (IMCI) is an EBM guideline prepared by WHO and UNICEF guideline in primary health care for better assessment and management in pediatrics. The study was carried out to demonstrate the reduction of medicament prescription by the application of IMCI program in two months up to five years old children presenting with an infectious disease.

Methods:

Before and after study was carried out in July 2012 at a pediatric E.R children who met with the inclusion criteria were rolled in:

▸ Consulting for infectious disease.

▸ With no anterior treatment with antibiotics.

▸ No need of hospitalization.

In total 112 patients were assessed separately by two groups of doctors (classical approach vs. IMCI guideline).

The two prescriptions of each patient were analyzed using Mac Nemar, comparison of proportion tests.

Results:

112 patients (64 boys, 48 girls) with cough, diarrhea, sore throat, otalgia and fever were studied. In total 280 medicaments were prescribed firstly vs. 160 medicaments with IMCI guideline (P<0.0001). There were 103 oral antibiotics prescribed vs. 28 with IMCI guideline (P<0.0001). There were 20 intra muscular injections prescribed (15 antibiotics) vs. 9 with IMCI guideline (P<0.02). Only 37 antibiotics were justified vs. 82 non-justified (p<0.0001).

Conclusion:

the assessment and management by IMCI program for children age 2 months up to 5 years in outpatient clinic may contribute for a better prescription with a significant reduction in total medicament prescribed, in oral antibiotics and intra muscular injections.
27: BRIDGING THE GAP BETWEEN EVIDENCE BASED KNOWLEDGE AND PRACTICE: A CONCEPTUAL FRAMEWORK FOR KNOWLEDGE TRANSLATION
Authors: Mardani Davoud , Molavi Mehdi
Published: May 2024

Background and aims:

Much of early medical and nursing practice was based on nonscientific traditions that resulted in variable and haphazard patient outcomes. These traditions and rituals, which were based on folklore, gut instinct, trial and error, and personal preference, were often passed down from one generation of practitioner to another. It has become essential for practitioners to use the best data available to make patient care decisions and carry out the scientific and evidence-based interventions. The aim of this study is suggestion of a framework for easily translation of evidence-based knowledge into clinical practice.

Methods:

This discussion paper explains the process that evidence-based knowledge is created from crude scientific knowledge, disseminated among stakeholders, implemented into clinical practice and ultimately evaluated. In May 2014, the primary author searched electronic and scientific databases without limiting searches by publication date, to find applicable literature.

Results:

This framework presented how evidence-based knowledge can be created and distributed among stakeholders to implement into practice. Additionally, this framework explains interactions between stakeholders, context, and evidence-based knowledge from acquirement to adherence. Knowledge can easily translate into clinical practice by step-by-step following of 4 phases consisted of knowledge creation, knowledge dissemination, knowledge implementation, evaluation and feedback.

Conclusion:

Today, evidence based knowledge translation has become an imperative component for healthcare disciplines and identified as one of most important priorities of present millennium. Evidence-based knowledge translation is a simple and feasible way to bridging the gap between evidence-based knowledge and clinical practice that can be carry out trough utilization of current conceptual framework.
3: A REVIEW OF NGAL BIOMARKER OR NEUTROPHIL GELATINASE ASSOCIATED LIPOCALIN
Authors: Bahramzadeh Behzad
Published: May 2024

Background and aims:

Neutrophil gelatinase-associated lipocalin or NGAL is biomarker protein by weight of 25 kDa that a bacteriostatic agent in the physiological state of the body against Gram-negative bacteria by binding tightly to protect siderophore. The identification of these biomarkers as one of the key regulators of the immune system can be used as a biomarker for the diagnosis and treatment of infection.

Methods:

The most recent findings of recent years and the relevant articles in prestigious scientific sites and the results were obtained.

Results:

NGAL,an early sign of acute kidney injury in newborns, especially before changes in creatinine and urea testing occurs. Increased NGAL levels in 2–6 hours of the onset of kidney damage have been observed. NGAL with a mechanism of non-receptor tyrosine kinase inhibitor of Focal Adhesion Kinase serves as a key metastatic cancer cells. As well as when E-Cadherin externally expressed could be NGAL of expression is increased. E-cadherin cell adhesion molecule that causes the calcium-dependent. Protein expression and stimulates epithelial cells, the cells adhere to each other and prevent metastasis.

Conclusions:

NGAL as a diagnostic and prognostic marker in mature granulocytes in the bone marrow for a short period, but it stimulates the synthesis of the inflammatory process and malignant epithelial cells occurs. This marker against neutrophil oxidative acts as an inhibitor. Studies show that NGAL in wound healing by increasing the synthesis of cartilage by chondrocytes involved.
32: CLINICAL GUIDELINE OF NURSING CARE FOR NEONATAL AIRWAYS
Authors: Abdolalipur Marzieh , Janani Raheleh , Mahalleii Majid , Hoseini Mohammad Bagher , Mohammadzadeh Masoumeh
Published: May 2024

Background and aims:

Respiratory diseases are the most common cause of hospitalization and mortality of neonates in NICUs. Necessity of advanced and standard care of airways, especially when patient is under mechanical ventilation or respiratory support is obvious of every one. The usual intervention in NICUs is tracheal intubation, which lack of perfect care, can cause many side effects. Although putting Nasal-CPAP and the following nursing care requires full skill, in order to prevent occurrence of any side effects. One of the basic ways in reducing mortality rate in NICU is improvement of nursing care based on studies of Evidence Based Practice.

Methods:

This study has been extracted from scientific database such as Pub med, Science Direct, Trip Database and Cochrane Database which was confirmed with cooperation by physicians and experienced nurses of NICUs. Clinical guideline of neonatal airways as a practical guideline of care giving for specific respiratory care as below:1. Nursing care of Intubated neonates during Intubation and fixation of tracheal tube.2. Protocol of neonatal Indotracheal suctioning.3. Protocol of contrivance of Nasal-CPAP in neonates and required nursing care.

Conclusion:

By considering the spread and different level of health centers in the country and lack of standard clinical guide line, in many circumstances, respiratory care is with some deficiencies and sometimes with complications for neonates. Promoting of such clinical guide lines in NICUs will benefit a scientific pattern in order to a standard and safe nursing care. This guide line includes 3 sections: 1. Protocol of tracheal tube fixation: tracheal tube must be fixed by leucoplast strip and tracheal tube should be indirect position for perfect ventilation. 2. Protocol of Indotracheal suctioning: Indotracheal suctioning, if necessary must be done by assessment of neonates requirement. Suctioning indications: decrease of oxygen saturation, bradycardia, takycardia, decrease of chest movements, visible secretions in tracheal tube, agitation, decrease of respiratory sounds, increase of airway pressure and…. In order to prevent any possible damages, the length of suction catheter shouldn't exceed 1CM of tracheal tube. There are two methods of suctioning.1) Open method 2) Closed method. 3. Protocol of NCPAP care: Mask and nasal prong must be controlled regularly to prevent damage and necrosis. Nasal prong should be fixed 1-2MM from nasal septum and suitable size of hat and nasal mask and prong is required. Use of deoderm adhesive for protection of skin and nasal septum is recommended. Calming of neonate is necessary in prevention of CPAP pressure variation.
52: EFFECTIVENESS OF MASSAGE THERAPY IN IMPROVING SYMPTOM IN CHILDREN WITH ALLERGIC ASTHMA: A RANDOMIZED CLINICAL TRIAL
Authors: Goli Hamideh , Shabestari Mahnaz Sadeghi
Published: May 2024

Background and aims:

Patients with asthma suffer from dyspnea, cough, wheeze in their daily life and this may be by stress and anxiety. Massage may promote relaxation and relieve symptom. Thus, it is appropriate to explore the effectiveness of massage on symptom in patients with asthma.

Methods:

This study was a randomized-controlled trial that was performed in the Immunology and Allergy Clinics of Tabriz University of Medical Sciences, Iran. 60 children with allergic asthma of 6–12 year–old were invited to participate in this study; only 58 of them agreed. They were divided into two groups at random. Subjects in the massage therapy group received a 30 minute massage therapy by their parents at home before bedtime every night for 4 weeks in addition to the standard asthma treatment. The control group received the standard asthma treatment alone for 4 weeks. Both groups were given a diary notes to monitor symptoms.

Results:

The results of this study showed that symptom Scores in massage group were improved significantly compared with control group, and the rate of dyspnea, cough and wheeze in the experimental group than the control group were reduced by approximately 45%, 56% and 52%.

Conclusion:

The findings suggest that massage might reduce anxiety in patient with asthma and may have a beneficial effect on symptoms of asthma, such as dyspnea, cough, and wheeze. Therefore can be used as a nursing education for parents to improve dyspnea in children with asthma.
6: A SYSTEMATIC REVIEW OF QUALITY ASSESSMENT OF RANDOMIZED CONTROLLED TRIALS IN COCHRANE ARRHYTHMIAS SYSTEMATIC REVIEWS
Authors: Parnianfard Neda , Eskandariyan Ilghar , Parvan Reza , Azizi Hanieh
Published: May 2024

Background and aims:

An arrhythmia is an abnormality in the heart's rhythm, or heartbeat pattern. The heartbeat could be too slow, too fast, have extra beats, skipa beat, or otherwise beat irregularly. Meta-analysis of randomized controlled trials (RCTs) with low risk, considered the highest level of evidence available for evaluating an intervention. The aim of this study was to systematically review the quality of RCTs included in Cochrane reviews regarding arrhythmias.

Methods:

We reviewed all RCTs from systematic reviews published between1999-2015 by the Cochrane databases of systematic reviews. The titles were screened and those related to arrhythmias were chosen. The risk of bias of randomized controlled trials included in each review was studied. Also, it was assessed whether or not the studies had come to a particular conclusion.

Results:

We found 800 reviews in group of Heart and Circulation Cochrane, of the total 21 RCTs were included. There was a study that did not report any high risk of bias. The studies did not report high or unclear risk of reporting biases and any publication biases. The maximum number of biases reported for high risk of performance bias was 87, while the total maximum number of biases reported for detection bias was 109.

Conclusion:

The risk of providing a treatment based on a biased effect estimate must be balanced against the difficulty of conducting trials with very low risk of bias. Bias in RCTs may overestimate or underestimate the true effectiveness of an intervention. Better understanding of the risk of bias may result in improved trials with a closer estimate of the true effectiveness of an intervention. Based on these results we recommend more high quality evidence based RCTs in the field of arrhythmias.
60: EVIDENCE-BASED NURSING IN THE WOUND BED
Authors: Esmaeilnezhad Mahdieh , Rasooli Alehe Seyyed , Sedghivash Saba , Vatani Parisa
Published: May 2024

Background and aims:

Pressure sores are areas of tissue in the elderly or patients who can no independently change their situation happening pressure sores significant financial burden on health care systems impose a negative impact on quality of life and their frequency. Change the status of patients in hospitals or long-term care for the prevention of pressure ulcers is a common strategy.

Methods:

We searched the data base in COCHRANE, MEDLIBE, GOOGLE SCHOLAR, PUBMED, and UP TO DATE with keywords evidence base and nursing bed sore following evidence obtained:

Results:

The study Qinhongzhanget al.(2015) called massage therapy to prevent bed sores showed that currently there is no credible study that shows that massage therapy can help to prevent bed sores. Study Brigidgillespieet al.(2014) “The movement to preven pressure sores showed that the movement of the patient from position 30 degrees every 3 hours instead of the standard 90 degrees every 6 hours to waste energy and time nurses a significant impact on the evolution of the treatment of patients. Chichfengchen studyet al.(2014) as phototherapy for the treatment of pressure ulcers showed that the group treated with ultraviolet radiation completing the treatment period shorter than the control group (p=0.003).

Conclusion:

According to findings from the EBN seen, non-drug, non-invasive nursing interventions can have a preventive effect on pressure sores.
76: IDENTIFICATION OF RETENTION STRATEGIES FOR NEUROSURGEONS IN IRAN: RESULTS FROM EXPERT PANELS
Authors: Ezzatabadi Mohammad Ranjbar , Zadeh Sina Abdollah , Rafiei Sima
Published: May 2024

Background and aims:

The key challenge is how to encourage and retain health professionals in their work location. There is a list of policy options for the purpose but applying an appropriate and effective set of strategies requires a country level research. Our study aimed to identify retention strategies for neurosurgeons and examine both the importance and feasibility of the identified strategies using expert panels' point of view.

Methods:

First of all, a literature review was conducted to identify retention strategies for physicians. Then to gain consensus on the strategies and determine their importance and feasibility an expert panel was organized and a modified-delphi process was used.

Results:

A total of 40 strategies were identified by the panel classified in seven categories of income and economic factors, professional/job factors, clinical infrastructure, personal/family factors, living condition and welfare, educational factors and career development, governmental regulations and management policies.

Conclusion:

Based on the study results, three areas of economic incentives, personal and professional factors got the greatest priority in health professional planning for retention purposes.
81: INVESTIGATE THE ROLE OF LIBRARIANS AND MEDICAL INFORMATICS SCIENCES AMONG GRADUATES BETWEEN 1380-1393 YEARS IN VARIOUS RESEARCH AND EDUCATIONAL CENTERS OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Authors: yengejeh Shirin , Gavgani Vahideh Zarea , mostajer Fatemeh , Salehnia Fatemeh
Published: May 2024

Over the years, the library activity has been focused on libraries programs. But today, according to the scientific development of information technology in various fields including medicine Librarians and Medical Informatics sciences skills in new areas serving the medical community and patients has changed. In addition to changing activities, medical librarians working in the libraries of traditional state-centered research activities, new jobs have been created for graduates. In this study, a qualitative interview from librarians graduated between the years 80 to 93 and working in different parts of Tabriz University of Medical Sciences was created. According to the qualitative interviews, medical librarians have a strong presence in these activities:

As well as doctors and care team members in different centers, such as research centers, training and knowledge management university, helping in the search for papers for scientific and academic staffs and provide access to the best evidence for them, Evidence-Based Medicine center(EBM), Research Development & Coordination Center (RDCC), Activity in publication center and convert documents into a suitable format and accepted as HTML or PDF or XML for inclusion in the Institutional Repository of the University Process data recording, content management, workshops for faculty and students, University survey activities in science centers, medical education and e-learning as well as other ancillary activities. Therefore, with respect to this research, due to the active participation of the medical librarian in research and teaching. In addition to the presentation of their competences librarians and medical informatics university, to show their presence and active. It is also supporting the Ministry of Health and medical universities, medical librarians and creating new posts of employment, their potential for research use,
Suitability of current definitions of ambulatory care sensitive conditions for research in emergency department patients: a secondary health data analysis
Authors: Frick Johann , Möckel Martin , Muller Reinhold , Searle Julia , Somasundaram Rajan , Slagman Anna
Published: May 2024

Objective

The aim of this study was to investigate the suitability of existing definitions of ambulatory care sensitive conditions (ACSC) in the setting of an emergency department (ED) by assessing ACSC prevalence in patients admitted to hospital after their ED stay. The secondary aim was to identify ACSC suitable for specific application in the ED setting.

Design

Observational clinical study with secondary health data.

Setting

Two EDs of the Charité—Universitätsmedizin Berlin.

Participants

All medical ED patients of the ‘The Charité Emergency Medicine Study’ (CHARITEM) study, who were admitted as inpatients during the 1-year study period (n=13 536).

Outcome measures

Prevalence of ACSC.

Results

Prevalence of ACSC in the study population differed significantly depending on the respective ACSC set used. Prevalence ranged between 19.1% (95% CI 18.4% to 19.8%; n=2586) using the definition by Albrechtet aland 36.6% (95% CI 35.8% to 37.5%; n=4960) using the definition of Naumannet al. (p<0.001). Overall ACSC prevalence (ie, when using all diagnoses used in any of the assessed ACSC-definitions) was 48.1% (95% CI 47.2% to 48.9%; n=6505). Some frequently observed diagnoses such as ‘convulsion and epilepsy’ (prevalence: 3.4%, 95% CI 3.1% to 3.7%; n=455), ‘diseases of the urinary system’ (prevalence: 1.4%; 95% CI 1.2% to 1.6%; n=191) or ‘atrial fibrillation and flutter’ (prevalence: 1.0%, 95% CI 0.8% to 1.2%, n=134) are not included in all of the current ACSC definitions.

Conclusions

The results highlight the need for an optimised, ED-specific ACSC definition. Particular ACSC diagnoses (such as ‘convulsion and epilepsy’ or ‘diseases of the urinary system’ and others) seem to be of special relevance in an ED population but are not included in all available ACSC definitions. Further research towards the development of a suitable and specific ACSC definition for research in the ED setting seems warranted.

Trial registration

German Clinical Trials Register Deutsches Register für Klinische Studien: DRKS-ID: DRKS00000261.
Assessing the consequences of gestational diabetes mellitus on offspring’s cardiovascular health: MySweetHeart Cohort study protocol, Switzerland
Authors: Di Bernardo Stefano , Mivelaz Yvan , Epure Adina Mihaela , Vial Yvan , Simeoni Umberto , Bovet Pascal , Estoppey Younes Sandrine , Chiolero Arnaud , Sekarski Nicole
Published: May 2024

Introduction

Gestational diabetes mellitus (GDM) is a state of glucose intolerance with onset during pregnancy. GDM carries prenatal and perinatal risks as well as long-term risks for the mother and her child. GDM may be involved in the foetal programming of long-term cardiovascular health. However, evidence is sparse and the effect of GDM on cardiovascular health is unknown. To address these issues, we will conduct MySweetHeart Cohort study. The objectives are to assess the effect of GDM on offspring’s cardiovascular health early in life by using surrogate markers of cardiovascular disease and atherosclerosis.

Methods and analysis

This is a cohort study of 100 offspring of women with GDM and 100 offspring of women without GDM. At inclusion, a baseline assessment of the mothers will be conducted through means of self-report questionnaires, a researcher-administrated interview, blood pressure and anthropometric measurements, and a maternal blood sampling. Between the 30th and 34th weeks of gestation, a foetal echography will be performed to assess the foetal cardiac structure and function, the fetomaternal circulation and the hepatic volume. At birth, maternal and neonatal characteristics will be assessed. An echocardiography will be performed to assess cardiac structure and function 2–7 days after birth; carotid intima-media thickness will be also measured to assess vascular structure. MySweetHeart Cohort is linked to MySweetHeart Trial (clinicaltrials.gov/ct2/show/NCT02890693), a randomised controlled trial assessing the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention to improve the cardiometabolic and mental health of women with GDM and their offspring. A long-term follow-up of children is planned.

Ethics and dissemination

Ethical approval has been obtained through the state Human Research Ethics Committee of the Canton de Vaud (study number 2016–00745). We aim to disseminate the findings through regional, national and international conferences and through peer-reviewed journals.

Trial registration number

ClinicalTrials.gov (clinicaltrials.gov/ct2/show/NCT02872974).