Iranian Red Crescent Medical Journal

Water Cooling, Ice Pack Application, and Cold Wet Compress Treatment of Burn Wounds in Children before Admission, Effects on Tissue Healing and Safety Research: Systematic Review and Meta-Analysis

2023-06-17T16:18:07+0430

Introduction: Burn injuries are caused by electricity, heat, radiation, cold, friction, or chemicals and lead to tissue destruction due to energy transfer from the sources to the tissues and cells. The present study aimed to perform a systematic review and meta-analysis of water cooling, ice pack application, cold and wet compress treatment of burn wounds in children before admission, and to evaluate their effects on tissue healing and safety.

Materials and Methods: We systematically searched PubMed, CINAHL, Cochrane Library, and Embase from inception to March 2023. Review Manager (version 5.4) was used to assess the risk of bias in selected studies and a meta-analysis of all dichotomous and continuous outcomes in the selected studies was performed. Out of 590 studies, seven studies based on the PRISMA protocol in the meta-analysis were included.

Results: Based on the duration of cooling, no significant differences in the depth and size of burn wounds were found. Moreover, we established that cooling burn wounds significantly reduces tissue damage and limits the spread of burns to the surrounding tissues. A higher heterogeneity was observed in the selected studies based on methodology, implying different designs affecting our findings.

Conclusion: There is inconclusive evidence on the recommended optimum duration of cooling burn wounds. However, cooling burn wounds has a beneficial impact on reducing tissue damage and limiting the spread of burns.

Investigation of Microbial Biofilms during the COVID-19 Pandemic: A Bibliometric Analysis

2023-05-15T12:11:46+0430

Background: The Corona pandemic caused by the COVID-19 disease has become a trending topic in recent years. Moreover, microbial biofilms have received a lot of attention due to the problems they cause in industry and medicine.

Objectives: The present study aimed to examine the published documents concerning the Corona pandemic and microbial biofilms.

Materials and Methods: Document review was performed in Web of Science Core Collection, Scopus, and PubMed databases; then, due to the publication of more documents in the Scopus database, information from this database was used for bibliographic analysis by VOSviewer and Rstudio.

Results: The obtained results showed that the process of publishing documents increased during 2005-2022, and the type of documents mostly were articles (49%) and reviews (38%). Most published cases were in the field of medicine, immunology, and microbiology.

Conclusion: Studies can be examined from three medical, environmental, and engineering perspectives. The structure and composition of biofilm, the interaction of microorganisms in biofilm, the investigation of the dental biofilm infection in the infected people and waste systems, as well as the use of engineered biofilms for virus isolation, are among the recommended topics for further research.

Effectiveness of Crisis Intervention Program in Post-traumatic Stress Symptoms in COVID-19

2023-05-26T23:09:34+0430

Background: At the close of 2019, the world faced a phenomenon that plunged all human beings into extreme fear and anxiety. A new type of coronavirus began to spread among people across the globe, and this was the beginning of one of the greatest pandemics and its associated problems in the world. People with COVID-19 have low psychological tolerance and are highly exposed to psychological disorders. One of the most important psychological disorders that can harm the mental health of people affected by COVID-19 is post-traumatic stress disorder (PTSD).

Objective: The present study aimed to evaluate the effectiveness of the crisis intervention program in PTSD symptoms among people with COVID-19.

Method: This applied experimental study was conducted based on a pretest-posttest control group design. The statistical population consisted of all individuals with COVID-19 in Rasht, Iran, in 2019, of whom 30 people were selected using the available sampling method and were randomly assigned to the experimental group (n=5) and the control group (n=15). The participants in the experimental group received 10 sessions of the crisis intervention program. Mississippi (2006) PTSD analogy (Scale) was used to collect data. Data were analyzed using the analysis of covariance.

Results: The results showed a significant difference between the post-test scores of the experimental and control groups, demonstrating that the crisis intervention program was effective in PTSD (re-experience, withdrawal, numbness, arousal, and masochism) in COVID-19. The subjects in the experimental group had significantly less post-traumatic stress in the post-test group than those in the control group (P<0.01).

Conclusion: It can be concluded that the use of crisis intervention programs can reduce PTSD in people with COVID-19. Therefore, it is recommended that psychologists use this therapeutic approach to reduce the psychological problems of people in crisis.

Clinical profile and quality of life in patients with resistant to treatment vitiligo lesions in Iran: Vitiligo patients need medico-psycho-social assistance

2023-02-09T11:01:48+0330

Background: Vitiligo is a common chronic disease associated with physical effects, psychological impacts, and impaired quality of life (QoL). Lesions in acral areas are resistant to treatments. Since these areas are exposed and visible, they have a profound effect on patients' self-confidence. Despite the high prevalence of these conditions, information in this field, especially for Iranian patients, is scarce.

Objectives: To study the clinical profile of patients with vitiligo lesions in the acral areas, assess the burden of QoL impairment, and investigate the association between patient's characteristics and their QoL outcomes

Methods: A total of 84 patients with non-segmental vitiligo who had involvement in resistant treatment areas were recruited in this study. Clinical characteristics and disease outcomes, with a special emphasis on the quality of life (QoL), were investigated using the Dermatology Life Quality Index (DLQI) questionnaire. Furthermore, the extent of the disease was calculated by utilizing the Vitiligo Area Scoring Index (VASI). Descriptive and comparative analyses were conducted using SPSS software (version 29).

Results: The most common comorbidity observed among the patients was various types of immune diseases. The mean total score of DLQI was 8.1, indicating a moderate effect of the disease on the patient's life since the score falls within the range of 6-10. The Kruskal-Wallis non-parametric test illustrated a significant difference in QoL among different age groups (P=0.020). The results indicated a positive, direct, and significant relationship between the extent of the disease and DLQI (r=0.269,;P=0.013). Nonetheless, the relationship between the engagement of the genital area in married patients and difficulties in sexual relations was not found to be statistically significant at α=0.05.

Conclusion: The involvement of end-extremities based on existing studies is a frequent occurrence in vitiligo. These affected areas hold considerable significance in terms of the patient's quality of life (QoL) due to their prominent visibility and resistance to available treatments. Considering the high prevalence of psychological consequences, diversity in skin phototypes, and social acceptance, regional studies are necessary for more efficient and responsive medical management integrated with psychosocial assistance.

Improving Diabetes Self-Help in Natural Disasters: Qualitative Parameters and Recommendations Running Title: Diabetes During Disasters

2023-08-11T23:01:11+0430

Background: When natural disasters occur, people with diabetes face more physical and mental challenges than healthy individuals. Therefore, innovative programs and policies are crucial for providing ongoing education to patients on how to better manage their condition.

Objectives: The present study aimed to identify the components of empowerment literacy for diabetic patients during disasters.

Materials and Methods: The present research employed a qualitative content analysis approach using a conventional deductive method. Purposive sampling was conducted, and data were collected through semi-structured interviews. The panel consisted of 24 participants, including native Iranian endocrinologists, nurses, emergency medical center managers, and experts in the field of medical librarianship and information. These participants had direct experience in relief efforts during critical situations such as natural disasters. The interviews were recorded and transcribed into written format. Data analysis was performed using thematic analysis with the assistance of MaxQDA software.

Results: The content analysis resulted in identification of 10 main categories, 61 sub-categories, and five themes, including Disaster risk perception literacy, Medication literacy, Resilience literacy, Nutrition literacy, and Self-help literacy.

Conclusion: The obtained findings have informed the creation of targeted health literacy education materials for policymakers in disaster scenarios, specifically designed for individuals with diabetes. Diabetic individuals, particularly those residing in disaster-prone areas, should possess knowledge of emergency and disaster policies to enhance their health literacy. They should actively manage their condition while keeping abreast of policymakers' guidelines.

Comparative Study of Thrombosis after Peripherally Inserted Central Catheter Catheterization in Cancer Patients with Different Materials and Different Structures

2023-04-25T08:22:25+0430

Background: To observe the effect of different materials of catheters on thrombosis after peripherally inserted central catheter (PICC) catheterization in cancer patients.
Methods: Clinical data of 165 patients with PICC catheter cancers implanted in PICC outpatient clinic of our hospital from January 2019 to December 2019 were collected. The control group was patients with catheter cancers without valvular structure and high pressure resistant polyurethane material, and the observation group was patients with catheter cancers with valvular structure and high pressure resistant polyurethane material.
Results: A total of 58 patients in the control group received non-valved high pressure resistant polyurethane material, 25 patients had total venous thrombosis, accounting for 43.10%; 52 patients in the observation group received valvular high pressure resistant polyurethane material, 11 patients had total venous thrombosis, accounting for 21.15%; there was a very significant difference between the two groups (χ²=6.000, P=0.028).
Conclusions: Cancer patients after PICC catheterization are prone to venous thrombosis, occlusion and other complications due to the disease itself, chemotherapy, age and other factors. In addition to the above factors of venous thrombosis, this study found that the catheter material, catheter inverted cone structure may be one of the factors of venous thrombosis, catheters should pay attention to the material and structure of catheters before catheterization, and evaluate the special structure of catheters for catheterization.

Four-drug combination therapy for VOD prophylaxis after stem cell transplantation

2023-07-06T17:19:56+0430

Hepatic sinusoidal occlusion syndrome (SOS) or venous occlusive disease (VOD) is a common complication of allogeneic Hematopoietic stem cell transplantation (allo-HSCT). The mortality of patients with severe VOD is extremely high. It is of great significance to explore practical ways to reduce the incidence of VOD. The efficacy and safety of a combined prostaglandin E1(PGE1), Dalteparin, low molecular weight glucan dextran (LMWD) ,and ursodeoxycholic acid (UDCA) prophylaxis strategy were evaluated. We conducted a single-center retrospective cohort study of 225 patients who received allo-HSCT for hematological disorders between 2008 and 2022, all of whom received these four medications for VOD prophylaxis. Among the 225 patients, we included patients ranging in age from 6 to 58 years, whose donors were classified as related donors (75.5%) and unrelated donors(24.5%). All patients underwent a myeloablative conditioning regimen before transplantation. Each patient had at least one VOD risk factor, and 74.2% were at high risk for VOD (N = 167), but ultimately only two patients developed VOD, with an incidence of only 0.89%, of whom one was late-onset VOD. The bleeding rate was 32.9%, and the bleeding degree was mainly grade 1-2(93.2%). The incidence of bleeding is the same as reported in other literature. The mortality of bleeding during transplantation was only 1.8%, which was significantly lower than the average. The results showed that four PGE1-based drugs were effective and safe in preventing VOD after allo-HSCT.

Observation on the Curative Effect of Lateral Transforaminal Endoscopic Treatment of Thoracic Disc Herniation

2023-08-05T11:48:49+0430

Background: The importance of lateral transforaminal endoscopic treatment of thoracic disc herniation is that the use of a needle can remove some of the disc contents and cause the disc herniation to disappear. The aim of this study is to evaluate the effect of percutaneous endoscopy in the treatment of patients with thoracic disc herniation.

Objective: To investigate the clinical efficacy and feasibility of transforaminal endoscopic discectomy in the treatment of thoracic disc herniation.

Methods: A retrospective analysis was conducted between January 2014 and December 2019 . This study was conducted on patients who had thoracic hernia. total of 13 operative cases with census sampling were selected, through lateral endoscopic treatment of thoracic disc herniation was performed on the patients and they were followed up for 6-18 months. All patients were assessed by visual analogue scale Visual Analogue Score (VAS) and Oswestry Disability Index (ODI) before and first days, first weeks, third months and sixth months after operation respectively.

Results: The sample included 13 patients with a mean age of 60.3 years. The location of the thoracic disc herniation varied among the patients. The VAS score before surgery was 7±0.8 points, one day after surgery it was 3.3±0.6 points, one week after surgery it was 2.3±0.8 points, three months after surgery it was 1.4±0.3 points, and six months after surgery it was 1.3±0.4 points. Which showed a significant decrease (P≤0.001). ODI score before surgery was 65.2±5.8%, one day after surgery was 11.5±5.3%, one week after surgery was 8.9±3.3%, three months after surgery was 5.3±2.5 points, and six months after surgery was 4.7±3.5 points. which showed a significant decrease (P≤0.001). The score of Macnab standard, a rating system evaluating the effectiveness of spine surgeries, was also satisfactory.

Conclusion: Based on the results of the study, it was shown that percutaneous endoscopy in the treatment of patients with thoracic disc herniation was able to improve the clinical condition of patients and replace the previous methods of thoracic hernia surgery as an effective, efficient and safe method.

Preoperative Hypoalbuminemia and Development of Surgical Site Infection and Anastomotic Leakage in Emergency Colorectal Surgery

2023-05-26T10:55:37+0430

Background: Although hypoalbuminemia is a well-known predictor of postoperative complications, including surgical site infection (SSI) and anastomotic leakage (AL) in gastrointestinal surgery patients, which requires necessary interventions before surgery, there is limited opportunity for preoperative optimization and intervention in emergency colorectal surgeries.
Objectives: Therefore, this study aimed to assess the relationship between preoperative serum albumin levels and the development of SSI and AL in emergency colorectal surgery patients.
Methods: In this cohort study, patients who underwent emergency colorectal surgery during 17 months, were assessed. Albumin level was measured before surgery, and patients were followed for 1 month after surgery to identify the development of SSI and AL.
Results: In total, 173 patients were enrolled in the study, but data analysis was performed on 170 patients. They were divided into hypoalbuminemia group (n=98, 57.6%) and non-hypoalbuminemia group (n=72, 42.4%). The mean ages of patients in each group were 57.17±16.19 and 51.61±16.14 years old, respectively (P=0.028). The AL was observed in 4 (2.4 %) patients; 3 patients in the hypoalbuminemia group and one patient in the non-hypoalbuminemia group (P=0.205, relative risk=2.33, 95% CI: 0.42-12.82). The SSI was observed in 13 patients (7.6%) during the 1-month follow-up; 8 patients (5.1%) had superficial SSI and 5 (3.2%) had deep ones. Albumin level was significantly lower in patients with AL (2.9±0.48), compared to those without AL (3.6±0.7 g/dL). Moreover, albumin level was higher in patients with SSI (3.11±0.62), compared to patients without SSI (3.6±0.7 g/dL). The incidence of complications, either AL or SSI, was significantly higher in hypoalbuminemia patients, compared to non-hypoalbuminemia patients (P=0.017, Odds Ratio=4.24, 95% CI: 1.29-13.9). Adjusted OR for age was 3.82 (95% CI: 1.15-12.75, P=0.029); therefore, a 13.5% reduction in OR indicated that age is a confounding factor.
Conclusion: Preoperative hypoalbuminemia was significantly associated with post-development of complications in emergency colorectal surgery and older age and lower preoperative albumin levels may serve as valuable indicators for the identification of patients at higher risk of complications.