Yekta Rahimi

Introduction: Pain, a common symptom of coronary artery disease (CAD), changes physiological parameters, which can aggravate ischemia and increase cardiac workload. Acupressure, as a complementary therapy, can be beneficial by relieving pain and modulating vital signs. This systematic review and meta-analysis aimed to determine the effect of acupressure on pain severity and physiological parameters in patients with CAD. Methods: A systematic search of randomized controlled trials in PubMed, Embase, Web of Science, Scopus, and Cochrane databases was conducted to investigate the effect of acupressure on pain and vital signs in adult CAD patients, following the PRISMA-2020 guideline. The quality assessment of the included studies was conducted using the RoB-2. A DerSimonian and Laird random effects model was undertaken using Stata-17.0 software. Results: A total of 9 studies (857 patients) were included in the meta-analysis. At the time of measuring the results immediately after the intervention, acupressure had a statistically significant effect on reducing systolic blood pressure (SBP), heart rate (HR), and pain severity, with the mean difference of MD=-3.66, 95% CI (-5.44, -1.87) and MD=-2.46, 95% CI (-3.29, -1.64) and MD=-0.24, 95% CI (-0.42, -0.07) respectively. However, the results of diastolic blood pressure (DBP) and respiratory rate (RR) measurements were not significantly different. HR was also measured 30 minutes after the intervention in two studies. Based on the meta-analysis, acupressure did not significantly reduce HR 30 minutes after the intervention. Conclusion: Acupressure can be a useful, non-pharmacological, and simple method in short-term reducing of pain severity, HR, and SBP, along with pharmacological management. However, the overall certainty of evidence and number of included studies are low, indicating a need for further high-quality research for a more certain conclusion.

Introduction: Patients in intensive care units (ICUs) have poor oral health due to several factors, such as mechanical ventilation and reduced consciousness, which can lead to serious complications. Objective: This study aimed to investigate the impact of a multimedia evidence-based oral care training program on the oral hygiene of ICU patients. Methods: This randomized controlled trial involved 60 nurses and 56 patients in two general ICUs, allocated into control and intervention groups using cluster randomization. Nurses in the intervention ICU received multimedia educational content based on an evidence-based oral care algorithm, along with face-to-face training for one month. They then provided the intervention to patients. During the next 3 months, the oral hygiene scores of newly admitted patients were evaluated using the Beck Oral Assessment Scale (BOAS) three times: upon admission to the ICU, 24 h, and 48 h after admission. The control group continued with usual oral care as before. Data were analyzed using SPSS-26 software. The Chi-square test, Fisher's Exact test, Independent T-test, Mann-Whitney U test, and repeated measures analysis of variance (ANOVA) were used. Results: There were no significant differences between the patients’ and nurses’ groups regarding baseline characteristics. Also, BOAS scores of patients upon admission did not significantly differ between groups ( P = .863). In the intervention group, patients’ BOAS scores significantly decreased (improved) from 12.11 ± 1.03 to 7.93 ± 1.61 (24 h after admission) and then to 6.11 ± 1.26 (48 h after admission) ( P < .001). However, BOAS scores in the control group did not improve significantly within 24 or 48 h after admission. Conclusion: This study indicates that multimedia training of an evidence-based, comprehensive oral care algorithm improves the oral hygiene of ICU patients, especially those requiring higher levels of care.

Every day in intensive care units (ICUs), many alarms from several devices -especially ventilators- are generated, creating a noisy environment, which is on the top of technology-related hazards and may lead to alarm fatigue among nurses. This study aimed to investigate the impact of a clinical approach to ventilator alarm management on nurses’ alarm fatigue and alarm frequency in ICUs. This randomized controlled trial involved 75 nurses in two general ICUs allocated into control and intervention groups using cluster randomization. In the intervention group (IG), clinical causes and solutions of common ventilator alarms were trained in a 4-hour online webinar. Then, an evidence-based guideline for alarm management was attached to all ventilators in the intervention ICU. Additionally, nurses of the IG were trained virtually and face-to-face regarding the fundamentals of mechanical ventilation and how to manage ventilator alarms for one month. Before and after the intervention, nurses’ alarm fatigue and frequency of three common alarms were recorded for five consecutive days. The control group (CG) did not receive the educational content. Data were analyzed using SPSS-26. This study adheres to CONSORT guidelines. The baseline characteristics were not significantly different between the groups. Also, alarm fatigue scores of nurses did not significantly differ between groups before the intervention (p = 0.17). In the IG, nurses’ alarm fatigue scores significantly decreased from 24.86 ± 6.65 to 20.24 ± 4.39 (p < 0.025) and its difference was significant between the groups (p < 0.001). However, alarm fatigue scores in the CG did not improve significantly after one month. As a secondary outcome, the frequency of three common alarms including high pressure (–34.3%), high minute volume/tidal volume (–28.6%), and high respiratory rate (–25.4%) was reduced after the intervention. This study indicated that training and implementing an evidence-based clinical approach to ventilator alarm management not only reduced nurses’ alarm fatigue but also could lead to a significant reduction in the common ventilator alarms frequency. This study was prospectively registered by the Iranian Registry of Clinical Trials ( https://irct.behdasht.gov.ir/ ) on 01/09/2024 with registration ID: IRCT20240306061197N2.

Background: Cancer poses an escalating public health challenge, necessitating a comprehensive understanding of cancer incidence to formulate effective control strategies.Aims: This study aims to present a comprehensive overview of cancer incidence in Iran, utilizing data from the Iranian National Population‐based Cancer Registry (INPCR) for the year 2016.Methods: The study employed INPCR data to compute crude and age‐standardized incidence rates (ASR) per 100 000 for the most common cancers among men and women across Iran's 31 provinces. Data analysis utilized Excel (2019) and STATA 14.Results: In 2016, 124 833 new cancer cases were registered, with 65 495 (52.90%) occurring in men and 58 312 (47.10%) in women. ASRs for all cancers in the total population were 177.48, with specific rates for men and women at 192.96 and 162.33, respectively. The five most common cancers in men were prostate (23.25), stomach (21.56), colon (19.30), bladder (16.20), and lung (13.15). Among women, the leading cancers were breast (40.60), colon (14.64), thyroid (10.84), stomach (10.25), and lung (5.63). West Azarbaijan had the highest incidence among men, while Yazd topped the list for women. Age‐specific incidence rates revealed peaks in the 67–74 age group for men and the 40–50 age group for women.Conclusion: This study affirms that while Iran exhibits a lower cancer incidence compared to global averages, there has been a temporal increase. Disparities in ASR exist across sexes and provinces, with shifts in the ranking of common cancers by sex compared to previous reports.

Background: Drug use, especially injecting drug use, is associated with a higher risk of tuberculosis (TB). This study aimed to systematically review the prevalence of TB among people who use drugs (PWUD) in Iran. Methods: A systematic search was conducted in international and national databases. All studies that provided data on the prevalence of TB among PWUD based on screening tests and diagnosis from 1990 up to August 2019 were assessed. Meta-analysis was performed on the prevalence of active TB among people who inject drugs (PWID). Findings: Overall, nine studies were included. The studies were carried out from 1994 to 2012 in seven out of the 31 provinces of Iran. Seven studies provided data on the prevalence of TB diagnosis among 1087 PWID. The pooled prevalence of TB diagnosis was 10.1% (95% CI: 4.5, 15.8) in studies carried out in hospitals and 0.54% (95% CI: 0.04, 1.04) in other settings. Conclusion: The present review suggests an approximately 40 times higher prevalence of TB among PWID compared to the general population. However, most of the included studies were conducted on a subpopulation of drug users, and caution should be exercised when generalizing the findings.

Objective Gaming motivations are a central aspect of playing video games, and their importance to understanding both healthy and problematic gaming behavior has been increasingly elucidated. In this study, we aimed to translate the 18-item Gaming Motivation Scale (GAMS-18) to Persian and validate it in a population of Persian speaking gamers, specifically for the assessment of online gaming.Methods After translation from English to Persian, content validity of the questionnaire was assessed by a panel of experts and test–retest reliability was calculated in a sample of 70 students. Data from an online survey of 791 Iranian online gamers were used for the assessment of construct validity using confirmatory factor analysis.Results The item content validity index and the scale content validity index for clarity and relevance ranged from 0.80 to 1.00. Internal consistency reliability of the GAMS-18 was 0.90 and the test–retest reliability was 0.89. The test–retest reliability of the GAMS-18 was 0.89, and the internal consistency was 0.90. The GAMS factors had acceptable correlation with other motivational scale such as Player Experience of Need Satisfaction. Incorporating the proposed additional error paths improved the model fit to an acceptable level.Conclusion The Persian version of the GAMS can assess digital gaming behavior based on the six self-determination theory motivation types, and measures different aspects of motivation that other instruments. It is also demonstrated to have good reliability and validity and could be used in research on the motivations of online gamers in Persian-speaking populations.