bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metformin toxicity in the intensive care unit: A case series and review of the literature
Authors: Peake Katherine Nicole , Tessier Steven , Longo Santo , Stahlnecker Deborah M. , Idahosa Osamudiamen , Zanders Thomas , Ido Firas 
Published: March 2024

ABSTRACT
Metformin toxicity is a life-threatening condition with high morbidity and mortality. Toxicity predominantly occurs in the setting of acute renal dysfunction, as the drug is solely eliminated by the kidneys. While this risk is widely known to clinicians, diagnosing metformin toxicity is challenging because commercially available serum metformin levels require days to weeks to result. Therefore, the intensivist must rely on medical history, clinical presentation, and routine laboratory findings to make the preliminary diagnosis. Treatment of metformin toxicity includes supportive fluid hydration, vasopressors, and emergent hemodialysis (HD). We report three critically ill patients who had near-fatal severe metformin-induced lactic acidosis. Their metformin levels were markedly higher than the toxicity threshold reported by the Federal Drug Agency. These patients made a prompt and complete recovery after the initiation of HD. We also review the pathophysiology, clinical presentation, diagnosis, and treatment of metformin toxicity.
Prevalence and Related Factors of Postpartum Depression among Jordanian Mothers with a History of COVID-19 during Pregnancy or After Childbirth in a Developing Country
Authors: Hamadneh Shereen , Hamadneh Jehan , Abdalrahim Asem , ALBashtawy Mohammed , Suliman Mohammad , Alolayaan Main , Alkhawaldeh Abdullah 
Published: March 2024

Abstract

Background:
The magnitude of postpartum depression in Jordan during the COVID-19 pandemic is under-documented, and little is known about its potential social, demographic, and clinical correlates. This study aimed to explore the prevalence and related factors of postpartum depression among Jordanian mothers with a history of COVID-19 during pregnancy or after childbirth.

Materials and Methods:
This cross-sectional descriptive study was carried out in March-June 2021 among a convenient sample of 109 women with a history of COVID-19 during pregnancy or after childbirth, who were at a leading hospital equipped to care for COVID-19 cases in North Jordan. An online survey using the Edinburgh Postnatal Depression Scale (EPDS) was used to collect information from mothers with a history of COVID-19-positive tests.

Results:
Among the total number of women who participated in the study (n = 109), 73 women had postpartum depression. The prevalence of postpartum depression in the present study was 67%. In addition, the study found a positive statistically significant correlation between EPDS scores and being a smoker, delivery method, experiencing severe COVID-19 symptoms, and being hospitalized.

Conclusions:
During the COVID-19 pandemic, women had a high level of postpartum depression. It would be necessary to follow further the confirmed cases of COVID-19, and mothers should be screened for depressive symptoms during pregnancy and followed up for antenatal and postnatal care.
The Effect of a Training Program Based on the Theory of Planned Behavior on the Self-Care of Patients with Cerebrovascular Accident: A Randomized Controlled Trial
Authors: Salajegheh Zahra , Bagherian Behnaz , Rabori Roghayeh Mehdipour , Sabzevari Sakineh 
Published: March 2024

Abstract

Background:
Cerebrovascular accident dramatically impacts patients’ lives. However, this chronic disease could be managed by boosting self-care and following healthy behaviors. Accordingly, this trial sought to specify the impact of a training program established on the theory of planned behavior on the self-care of clients with this condition.

Materials and Methods:
This trial was performed on 80 clients, who were selected using a random numbers table and divided into two equal groups to receive either usual care alone or usual care plus a training program based on the theory of planned behavior (five in-hospital individual sessions for 5 weeks and weekly phone follow-ups for 2 months after discharge). Self-care and the dimensions of the theory of planned behavior were investigated at baseline and 2 months after the last in-hospital session using the standardized Shah version of the modified Barthel index and a researcher-made questionnaire, respectively.

Results:
The mean score of self-care was significantly higher in the experimental arm at the posttest (Mann–Whitney = 506.00, p = 0.005). Also, the increase in mean change of self-care from baseline to posttest was significantly more in the experimental arm (t78= −6.6, p < 0.001). Such findings were also found for all dimensions of the theory of planned behavior.

Conclusions:
Based on results, nurses and health policymakers can incorporate training based on the theory of planned behavior into routine care programs for patients with cerebrovascular accident to boost their self-care. The implemented intervention also could be reproduced in other contexts. Hence, further trials are requested to specify the sustainability of the findings.
Oral Health and Oral Health-Related Quality of Life among Elderly People in Iran
Authors: Jamalinasab Aliasghar , Tahani Bahareh , Maracy Mohammad Reza , Keshvari Mahrokh 
Published: March 2024

Abstract

Background:
The study aimed to investigate oral health status and its relationship with oral health-related quality of life in the elderly in Isfahan, Iran, in 2022.

Materials and Methods:
This cross-sectional study was conducted in Isfahan, with 460 elderly participants. During interviews with the participants, their demographic information, their medical and dental history, oral health-related behaviors, self-perceived oral health, and clinical examinations were collected, and the Geriatric Oral Health Assessment Index (GOHAI) was completed. The final conclusions were made using the Generalized Linear Model (GLM) test.

Results:
The mean (sd) scores were 45.05 (8.62) for GOHAI, 5.44 (2.96) for self-perceived oral health, and 18.11 (5.76) for DMFT (Decayed, Missing and Filled teeth). Moreover, the number of remaining teeth on average was 11.78 (11.89), 39.56% of the participants did not brush their teeth, 40% of the elderly had complete dentures, and 27.17% had dental insurance. After adjusting and modifying the variables, the GLM test revealed that strong predictors for higher GOHAI scores were the higher levels of education (p < .001), the higher frequency of remaining teeth (p = 0.002), more pleasant self-perceived oral health (p < .001), and dental insurance (p = 0.04).

Conclusions:
According to the findings, the elderly’s oral health-related quality of life in Isfahan was low, which was caused by the following factors: edentulism, few numbers of remaining teeth, high DMFT score, elderly’ non-adjustment with dentures and their low quality, inappropriate oral health-related behaviors, lack of complementary insurance for dentistry, and non-using dental services, and low levels of education.
Iranian Women’s Experiences of Breastfeeding Support during the COVID-19 Pandemic: A Qualitative Study
Authors: Pourghane Parand , Shirazi Morvarid Ghasab 
Published: March 2024

Abstract

Background:
The impact of the coronavirus disease 2019 (COVID-19) pandemic on health systems worldwide has been associated with less attention to maternal support in breastfeeding. The objective of this study was to explore the experiences of breastfeeding mothers, during the COVID-19 pandemic, and the impact of the pandemic on breastfeeding initiation and maintenance.

Materials and Methods:
A qualitative, descriptive study was conducted by means of in-depth semi-structured interviews. The study participants included 28 mothers who had children aged 0 to 12 months, lived in Guilan Province, Iran, and had breastfed their children at least once after March 2021. Conventional content analysis was performed simultaneously with data collection.

Results:
Data analysis led to the extraction of three main categories and nine subcategories: in the shadow of peace (receiving correct information from reliable sources, observing health and quarantine principles, and enjoying the awareness of not having COVID-19 [both the mother and the infant]), under the stress (information poverty, invalid and stressful information, and stressful association of underlying diseases), and in the delusion of exposure (refusal to breastfeed, and non-compliance with recommendations).

Conclusions:
Mothers’ breastfeeding experiences during the COVID-19 pandemic indicate factors such as receiving or not receiving breastfeeding support, quarantine and the resulting stress, and exposure to conflicting information. Mothers felt that their experience with breastfeeding during the pandemic encouraged them to continue breastfeeding, but it is important to support breastfeeding mothers. Monitoring and supporting vulnerable groups such as breastfeeding mothers, for mental health problems during the COVID-19 pandemic, should be considered during the planning phase.
Prevalence of Needlestick Injuries among Iranian Nurses: A Systematic Review and Meta Analysis
Authors: Isfahani Parvaneh , Samani Somaye , Bahador Rasoul Corani , Arefi Marzieh , Afshari Mahnaz 
Published: March 2024

Abstract

Background:
Injuries caused by sharp objects are a major health risk for nurses. These injuries can be extremely dangerous and lead to various diseases. The purpose of this study was to establish the pooled prevalence of Needle Stick Injuries (NSIs) among nurses in Iran.

Materials and Methods:
This study was a systematic review and meta-analysis. Eligible articles were searched from five electronic databases (Scientific Information Database (SID), Magiran, Web of Science, PubMed, and Scopus) and one search engine. A random effects model was conducted to estimate the pooled prevalence. The heterogeneity of the sample was tested using the I2 index, and the meta-regression function was used to evaluate variables suspected of heterogeneity at the 0.05 significance level. Finally, 21 articles were analyzed using the Comprehensive Meta-Analysis software (ver. 2.2.064).

Results:
Based on the random-effects model, the frequency of NSIs among Iranian nurses is 18.70% (95% CI: 15.10%–22.90%). The highest frequency is recorded in a teaching hospital in Tehran in 2007 (19.80%; 95% CI: 16.40%–23.70%), and the lowest frequency was recorded in a teaching hospital in Tehran in 2008 (17.90%; 95% CI: 14.60%–21.80%). Sample size, mean age, and work experience were significantly associated with and mean and frequency of NSIs in nurses (p < 0.05).

Conclusions:
NSIs occur in about one-fifth of nurses in Iranian hospitals. In addition to its cost burden, the increase in NSIs has negative consequences for nurses. Therefore, health policymakers and managers must take serious action to reduce these injuries.
Effect of Early Amniotomy on Delivery Outcome with/without Cervical Ripening: A Systematic Review and Meta-Analysis
Authors: Zeidi Banafsheh Mohammadi , Zare Ommolbanin , Kiapour Azadeh 
Published: March 2024

Abstract

Background:
Although shorter labors are the benefits of Early Amniotomy (EA), it may lead to risks such as non-reassuring fetal testing and cesarean delivery. Also, the effect of cervical ripening to induce labor before amniotomy is unknown. This systematic review and meta-analysis evaluated the effect of EA on the delivery outcome with or without cervical ripening.

Materials and Methods:
Bibliographic search was conducted without time limit until June 2020. PubMed, Scopus SID Magiran, Cochrane Library Science website, and ISI databases were searched with English and Farsi keywords, including amniotomy, delivery, induced, and pregnancy outcome.

Results:
The meta-analysis on ten clinical trials showed that the incidence of cesarean section was lower (0.89% VS 0.94; relative risk, 0.85; 95% confidence interval, 0.55–1.30) compared to the group without cervical ripening, and the time to induce labor was approximately 55 minutes (mean difference, 0.91 hour; 95% confidence interval, -1.43 to - 0.33).

Conclusions:
If EA is performed in women after cervical ripening, the incidence of cesarean section will not increase, and the duration of labor will be reduced. A shorter delivery time is associated with perinatal benefits and greater maternal satisfaction. Furthermore, EA with cervical ripening may reduce monitoring time in busy hospitals with limited medical staff.
Role Model Nursing Instructors and Facilitation of Students’ Professional Growth Process: Directed Content Analysis
Authors: Azadian Marzieh , Nasrabadi Tahereh , Ebadi Abbas , Nouri Jamileh Mokhtari 
Published: March 2024

Abstract

Background:
The professionalization of nursing is one of the goals of academic education, which needs to be nurtured during education, so this research was conducted to study the views and experiences of nursing students and instructors regarding professional growth through role mode nursing instructors.

Materials and Methods:
This was a qualitative study with directed content analysis based on the growing up and role modeling theory in nursing students’ education, which was conducted at two universities in Iran from April to September 2021. The participants included 16 undergraduate, master’s, and PhD students, and nursing instructors selected using purposeful sampling with maximum diversity. The data were collected through in-depth interviews.

Results:
From the data analysis, 689 unrefined primary codes and 76 integrated codes were extracted. The three subcategories of the previous study included “effort to improve educational quality,” “clinical effectiveness,” and “promotion of professional status.” Generic categories were formed based on the grouping of codes. “Effort to improve educational quality” included the six generic categories of educational effectiveness, effective classroom management, comprehensive evaluation, adherence to educational rules, application of knowledge, and efforts to promote research. “Clinical effectiveness” included the generic category of effective clinical training. “Promotion of professional status” included the two generic categories of effective professional interactions and striving for professional independence.

Conclusions:
It can be concluded that role model nursing instructors can increase the students’ abilities, and thus, facilitate their professional growth through a combination of strategies based on the generic categories mentioned.
“Interprofessional Collaboration” among Pharmacists, Physicians, and Nurses: A Hybrid Concept Analysis
Authors: Kobrai-Abkenar Faeze , Salimi Sanaz , Pourghane Parand 
Published: March 2024

AbstractBackground:“Interprofessional Collaboration” is associated with improving the quality of care. The objective of this study was the analysis of the concept of “Interprofessional Collaboration” using a hybrid model.Materials and Methods:A hybrid model was used in order to analyze the concept of “Interprofessional Collaboration.” The first phase was the scientific search of texts in all valid electronic databases. The second phase includes fieldwork in which medical, pharmaceutical, and nursing staff were interviewed. Data were collected, reviewed, and analyzed in the third phase.Results:The four main themes extracted in the theoretical phase included: “attributes of individual, team, organizational, and system.” In the fieldwork phase, three themes and seven sub-themes were identified: “Dynamism/effectiveness of collaboration, uncertain boundaries of collaboration, advanced organizational culture.” In the final phase, with the combination of the results of two previous phases, the final definition of the concept was presented: “A process that brings together systems, organizations and individuals from various professions to achieve common interests and goals. Achieving common goals and interests is influenced by individual, team, organizational, and system attributes.”Conclusions:Defining the concept of interprofessional collaboration and identifying its various aspects can be a practical guide for creating and evaluating it in educational and clinical settings.
Retrospective assessment of accuracy of nine intraocular lens power calculation formulae in eyes with axial myopia
Authors: Shetty Naren , Shetty Rohit , Nuijts Rudy M M A , Satija Anuj , Roy Abhijit S , Kaweri Luci 
Published: March 2024

Purpose:
To compare the accuracy of nine conventional and newer-generation formulae in calculating intraocular lens power in eyes with axial myopia.

Setting:
Tertiary eye care center, Bengaluru, India.

Design:
Retrospective cross-sectional, comparative study conducted in India.

Methods:
Patients undergoing uneventful phacoemulsification in eyes with axial length >26 mm were included. Preoperative biometry was done using Lenstar LS 900 (Haag-Streit AG, Switzerland). Single eye of patients undergoing bilateral implantation was randomly selected. Optimized lens constants were used to calculate the predicted postoperative refraction of each formula, which was then compared with the actual refractive outcomes to give the prediction errors, following which subgroup analysis was performed. The Kane formula, Barrett universal II, Emmetropia Verifying Optical (EVO) 2.0, Hill Radial Basis Function (Hill RBF) 3.0, Olsen formula, along with Wang Koch–adjusted four formulae, that is, Sanders Retzlaff Kraff/Theoretical (SRK/T), Holladay 1, Haigis, and Hoffer Q formula, were compared for intraocular lens power calculations.

Results:
One hundred and sixty-five eyes that fulfilled all the inclusion criteria were studied. Hill RBF 3.0 had the lowest mean and median absolute prediction errors (0.355 and 0.275, respectively) compared to all formulas. In subgroup analysis (26–28, >28–30, and >30 mm), significant difference was seen only in extremely long eyes (>30 mm). The Hill RBF 3.0 formula generated the maximum percentage of eyes with refractive errors within ±0.25, ±0.5, ±0.75, and ±1 D (46%, 76.2%, 89.9%, and 95.8%, respectively).

Conclusion:
This is the first study evaluating all the formulas exclusively in the myopic eyes. Hill RBF 3 was found to be superior in accuracy to all other formulas.
Protocols and procedures for safe administration of nitrous oxide–oxygen inhalational minimal sedation for anxiolysis in pediatric dentistry: A case series
Authors: Chengappa MM Dempsy , Bhatnagar Vidhu , Navin Kumar Andrews , Kannan Akshai , Bhandari Sujith Kumar , Yadav Ashok K , Ghavri Tarannum , Jain Parul 
Published: March 2024

Abstract
Fear and anxiety related to dental treatment are the most important causes of avoidance of oral care among pediatric patients. The majority of pediatric dental patients are managed with only behavior management techniques, without any pharmacological intervention. However, several pediatric dental patients, owing to noncooperation or the extent of surgery required may require pharmacological means of management, such as sedation or general anesthesia. Children with mild-to-moderate anxiety are suitable for management with inhalational sedation agents, such as nitrous oxide and oxygen (N2O–O2). An inhalational mixture of N2O–O2 has been used in this setting for over a century and has a high index of safety. With the advent of newer failsafe equipment for the delivery of these agents and the availability of trained dental and anesthesiology teams, this modality of sedation for behavior management of children while rendering dental treatment is gaining more acceptability. Proper case selection, informed consent from parents/guardians before the procedure, preprocedure and preprocedure counseling, and anesthetic evaluation of the child are important steps in the successful administration of sedation. The awareness of guidelines, alertness regarding adverse events, and preemptive preparation to manage any critical incident are essential for the safe administration of this inhalational mixture; thus, providing oral care to pediatric patients with the least amount of discomfort.
Care needs of adults with spinal trauma in the prehospital and hospital setting from the perspective of patient care team: A qualitative research
Authors: Behnammoghadam Mohammad , Alimohammadi Nasrollah , Riazi Ali , Eghbali-Babadi Maryam , Rezvani Majid 
Published: March 2024

BACKGROUND:
Appropriate care of patients with definite spinal cord injury or at risk of it in the prehospital and hospital stages requires comprehensive planning in the health system. It is also the requirement of any successful program to explain the needs from the perspective of its stakeholders. Thus, this study aimed to discover the care needs of adults with spinal trauma in prehospital and hospital settings from the perspective of the patient care team.

MATERIALS AND METHODS:
This qualitative study was conducted with the participation of urban and rural prehospital emergency personnel and emergency departments of educational and therapeutic hospitals affiliated to Isfahan, Tehran, Shiraz, Kermanshah, Ahvaz, and Yasuj Universities of Medical Sciences, through conducting 36 in-depth semi-structured interviews from September to December 2021. Using purposive sampling method, the participants were selected considering the maximum variation. The data saturation was reached after conducting interviews and group discussions with 36 subjects. Data were analyzed using conventional content analysis approach. Lundman and Graneheim approach were used for the study rigour. Data were simultaneously analyzed using MAXQDA software version 10.

RESULT:
During the data analysis, two themes of prehospital care with two main categories (emergency care and management of secondary complications of spinal trauma) and hospital care with two main categories (emergency care and management of secondary complications of spinal trauma) emerged.

CONCLUSION:
Emergency care and management of secondary complications of spinal cord injury in the prehospital and hospital stages can affect treatment results, improve quality of life, and reduce mortality rate, secondary injuries, and healthcare costs. Thus, identification of the care needs of the adults with spinal trauma from the perspective of the patient care team can help the authorities to plan appropriate interventions.