Nilofar Massoudi

Previous studies show that both the frequency of surgeries and incidence of surgical site infections (SSIs) have been lower during the coronavirus disease 2019 (COVID‐19) pandemic. This study's purpose is to analyse the possible association of the COVID‐19 epidemic‐related increased health measures, such as protective equipment and products, increased hand hygiene and restrictions imposed, on the incidence of SSIs in an academic medical centre. We designed a single‐centre, retrospective cohort study and collected data on the frequency of surgeries and the incidence of SSIs, among patients who had surgeries pre‐ and post‐COVID‐19 pandemic. Besides the intervention and outcome variable, we sought information on patient gender, surgery type, body mass index (BMI), smoking, and type II diabetes mellitus. We used Wald 95% confidence interval (95% CI) and the p values of the odds ratio (OR) to report results. Of the N = 24 098 surgeries performed in this hospital, there were 269 patients who reported post‐surgical SSIs in this hospital between March 2019 and March 2021. The OR of developing a post‐surgical SSI was 0.40 (95% CI: 0.33–0.57, p < 0.05; adjusted for confounders 0.39 [95% CI: 0.30–0.52, p < 0.05]) among patients who had surgery under post‐pandemic infection control measures, as compared to patients who had surgery under pre‐pandemic usual care infection control measures. Our significant results conclude that an association may exist between the enhanced infection control measures used during the COVID‐19 pandemic and lower incidence of SSIs we observed during this period.

Background: After graduation, physicians should be able to provide professional and safe services without the need for supervision by their clinical professors, mandating a competency-based medical education (CBME) approach. Objectives: This study aimed to develop a national model of entrustable professional activities (EPAs) based on our experiences in the Department of Anesthesiology and Critical Care (DACC), Shahid Beheshti University of Medical Sciences (SBMU). Methods: The primary EPA design plan was designed in a 10-step model as a career roadmap for the project. The texts were prepared according to a consensus-based approach. On the other hand, the texts were reviewed and revised by a broad team of faculty in a daily workshop. Results: The final product included 14 topics for EPA as the first round of targeting topics for anesthesiology residents. The texts were developed using previous studies and were standardized considering national standards. Conclusions: We described a clear path toward designing and implementing EPAs in anesthesiology residency programs to improve the quality of the graduated residents. Though the basic theory is the same, each country needs its formula for implementing the process.

Background: COVID-19 was a worldwide pandemic with international health emergencies and great challenges; health care personnel shortage and physician burnout is a potential major challenge that should be planned and managed; especially in those countries with a high COVID-19 occurrence. Objectives: This study was designed to assess the attitudes of 3rd-year anesthesiology residents toward an independent one month-length clinical care course for patients with COVID-19. Methods: A closed self-administered questionnaire was developed to assess the attitudes of 3rd-year clinical anesthesiology residents. A self-administered closed questionnaire was developed. Cronbach’s alpha was calculated to measure the reliability of the questionnaire; added with a factor analysis process. Results: All 19 clinical anesthesiology residents took part in the study, with a 100% response rate. Cronbach’s alpha for the reliability of the questionnaire was 0.678. The eigenvalue for 8 factors was equal to 1; however, further assessment led us to 7 factors. Conclusions: This one-month period could improve the competencies of the 3rd year clinical anesthesiology residents based on their viewpoints. Since the COVID-19 pandemic is ongoing health and social problem worldwide, 3rd-year anesthesiology residents could help the health system to recover health care delivery faults regarding manpower; a promising point for crisis preparedness in the COVID-19 pandemic. Besides, there were many constructive results for the clinical anesthesiology residents regarding their training and clinical service delivery.

Purpose The influenza vaccine is essential in reducing the influenza burden, especially among healthcare workers (HCW). Experimental studies suggest both coronaviruses and influenza viruses engage with the angiotensin-converting enzyme 2 (ACE 2) and tetraspanin antibodies, and that ACE 2 tetraspanin antibodies in turn may inhibit both coronavirus and low-pathogenicity influenza A viruses (LP IAV) infections. This study aims to investigate the potential clinical association between receiving the 2019 influenza vaccine and the incidence of COVID-19 among HCW. Methods We designed a case–control study within a hospital setting in Iran when it became a center for treating COVID-19 patients. We collected data and calculated relevant incidence and associative measures among HCW who had received the 2019 influenza vaccine as compared to HCW who had not received the vaccine. Results Our total sample size was 261 HCW. Of 80 COVID-19 incident cases, three cases had received the influenza vaccine, while 87 of 181 controls had received the vaccine. The odds ratio (OR) and confidence interval (CI) of being vaccinated were 0.04 (95% CI: 0.01 to 0.14) among COVID-19 cases as compared to controls. Conclusions Significant findings suggest that the 2019 influenza vaccine may have a protective association against COVID-19 among HCW.

Background: Accreditation Council for Graduate Medical Education (ACGME) has been used to evaluate the residents’ competency; however, the thriving of residents needs especial training methods and techniques. Small group learning has been used for this propose. Objectives: This study assessed the attitudes of CA-1 to CA-3 anesthesiology residents toward level-specific small-group blended learning. Methods: Anesthesiology residents from Department of Anesthesiology, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran participated in this cross-sectional attitude assessment descriptive-analytical study throughout the 2nd academic semester (May-October 2019). They took part in a level-specific small-group blended learning program and filled out an attitude assessment questionnaire. The questionnaire included eight closed questions and was filled out anonymously. Results: The residents believed that this program made important contributions to their theory training and clinical skills of anesthesia; while created a greater sense of solidarity. In addition, nearly the majority of the respondents did not believe that participating in the classes made interference in their clinical duties or was a difficult task. Instead, the majority of residents believed that these classes were in favor of reducing their burnout. The reliability of the questionnaire based on Cronbach’s Alpha was 0.885. Conclusions: Anesthesiology residents are in favor of small-group learning, especially when considering their clinical setting and the degree of burnout they tolerate.

Renal ischemia-reperfusion (RIR) is a pathological condition due to transient restriction of blood flow to the kidneys, which is followed by the subsequent recovery of perfusion and re-oxygenation. RIR injury contributes to the progression of renal dysfunction including acute kidney injury (AKI) in native and renal allograft transplant. The generation of reactive oxygen species (ROS) during oxidative stress contributes to the occurrence of RIR. Hence, the use of antioxidant compounds can improve oxidative stress due to RIR. This review highlights herbal antioxidant efficacy against RIR injury. The findings of this study indicate that antioxidant compounds with herbal origin could reduce complications due to oxidative stress related to RIR through diminishing lipid peroxidation, decreased production of malondialdehyde (MDA), apoptosis and increasing antioxidant enzymes activity. Reducing oxidative stress with the pharmacological approach of antioxidants can be a desirable target for ameliorating RIR.

Introduction: Continuous renal replacement therapy (CRRT) is the gold standard renal replacement therapy (RRT) for hemodynamically unstable patients. Objectives: To study the characteristics and survival of patients undergoing CRRT in Iran. Patients and Methods: This is a retrospective study conducted on 58 patients indicated for CRRT at the Shahid-Modarres hospital of Tehran during 2016-2017. Gender, age, underlying diseases, comorbidities, history of surgery, dialysis indication, and survival were gathered by reviewing patients’ medical records. The data was analyzed in SPSS version 21. Results: Sepsis constituted the most common underlying condition at admission. Overall, continuous venovenous hemodialysis (CVVHD) was performed in 72.4% of the patients. Diabetes and hypertension were the most common causes leading to RRT. The most common indication for CRRT was unstable hemodynamic condition. The patients were most frequently referred from ICU (34.5%), emergency department (20.7%), and CCU (15.5%). Conclusion: We here reviewed the characteristics of hemodynamically unstable patients undergoing CRRT. Our findings can help to understand the most important indications for CRRT and to standardize CRRT practice in Iran.