Iranian Red Crescent Medical Journal <p>The Iranian Red Crescent Medical Journal (IR<span style="color: #ff0000;">C</span>MJ) is an international, open access, peer-reviewed, monthly, and ISI- Journal, affiliated to&nbsp;<strong>Iranian Hospital- Dubai</strong>, publishes original scientific studies in English that have direct clinical significance on&nbsp;<span style="color: #0033ff;">Basic Science, Clinical Medicine, Humanitarian Assistance, Trauma, and Disaster Management</span>.&nbsp;The journal strives to strengthen connections between research and practice, so enhancing professional development and improving practice within the field of medicine. Original papers submitted to this journal which do not adhere to the Instructions for Authors will be returned for appropriate revision to be in line with the Instructions for Authors. They may then be re-submitted.</p> ZamenPub en-US Iranian Red Crescent Medical Journal 2074-1804 Balanced Blood Product Transfusion during Adult Liver Transplantation <p><strong> </strong><strong>Background</strong>: Orthotopic liver transplant (LT) is often associated with massive blood loss and significant transfusion requirements. Recent recommendations for resuscitation strategy in bleeding patients include transfusion of balanced blood products, fresh frozen plasma (FFP), platelets, red blood cells (PRBC), and restricted use of crystalloids.<br /><strong>Objectives:</strong> To evaluate whether the intraoperative transfusion ratio of fresh frozen plasma to packed red blood cells units (FFP: PRBC ≤1:1 versus &gt;1:1) plays a positive role in reducing PRBC transfusion in LT.<br /><strong>Methods:</strong> This is a retrospective study of 84 liver transplant recipients who received at least one PRBC unit during the surgery. The patients were grouped: into those who received intraoperative FFP: PRBC ratio ≤ 1:1 (low) versus the ratio &gt; 1:1 (high). Selected perioperative variables were compared between the two groups. The variables included; baseline characteristics of the patients, intraoperative transfused PRBC and blood products, postoperative mean hemoglobin, platelets, international normalized ratio, postoperative transfused PRBC and blood component, early postoperative complications as re-operation due to bleeding, portal vein thrombosis, and duration of stay in the intensive care unit.<br /><strong>Results:</strong> There was a significant difference between the two groups in preoperative BMI (P = 0.04) and hemoglobin (P = 0.005), and the two variables were higher in the high-ratio group. Patients in the ≤1: 1 group versus &gt;1:1 had lower intraoperative requirements for PRBC (P&lt;0.001). Importantly, the postoperative mean PRBC transfused units in the high ratio group were 1.76 times that of the low ratio group (incidence rate ratio [IRR], 1.76; 95% CI, 1.07 –2.90).<br /><strong>Conclusion:</strong> In patients undergoing LT, intraoperative plasma transfusion with a PRBC ratio of ≤1:1 was associated with a reduced need for PRBC transfusion.</p> Soheyla Milani Monavvar Afzal Aghaee Hamideh Shademan Nima Khodarahmi Razia Toloue Copyright (c) 2022 Iranian Red Crescent Medical Journal 2022-11-30 2022-11-30 24 11 10.32592/ircmj.2022.24.11.2050 The Effects of Regular Exercise, Arts (Origami), and Group Psychotherapy on Quality-of-life, Anxiety, Depression, Patient Satisfaction, and Hope in Cancer Patients in Remission: A Prospective Study <p><strong>Objectives: </strong>We determined the effects of a “Quality-of-Life Support Program (QOLSP)” for cancer patients in remission.</p> <p><strong>Methods: </strong>Twenty-six cancer patients, being monitored while in remission, were included. During our 8-week-long prospective study, a QOLSP was implemented weekly. The patients’ hope, anxiety, depression, and quality-of-life (QoL) were assessed using scales. Additionally, questionnaires assessed the “status of program satisfaction” and the “arm utilization angle” of the breast cancer patients (n=20).</p> <p><strong>Results: </strong>The total mean score on the hope scale was initially 25.6±3.9 and increased to 29.7±1.9 post-QOLSP (p˂0.001). Additionally, the total mean score on the EORTC QLQ-C30 scale was initially 68.9±4.9 and increased to 92.6±2.2 post-QOLSP (p˂0.001). Moreover, the total mean anxiety and depression scores on the Hospital Anxiety and Depression Scale (HADS) decreased (p&lt;0.001 and p&lt;0.001, respectively) post-QOLSP. The factors affecting the hope score differences, the hope pre-score and the sap score (Loss of Appetite) on the EORTC QLQ-C30 symptom scale, were significant (p&lt;0.001 and p=0.01, respectively). The factors affecting the anxiety and depression score differences were the HADS anxiety (p=0.001) and depression (p&lt;0.001) pre-scores, respectively. Moreover, the factor affecting the sql2 score, evaluating General Health Status on the EORTC QLQ-C30, was the sql2 pre-score (p&lt;0.001). All 26 patients were “very satisfied” with the program, and the arm usage angle of the 20 operated breast cancer patients improved.</p> <p><strong>Conclusion: </strong>Facilities that can provide a multidisciplinary QOLSP throughout treatment and follow-up will favorably affect QoL, anxiety, depression, hope, and satisfaction among cancer patients.</p> Deniz Arslan Seyda gunduz Olcay Akkoyun Pembe Taşkın Tennur Yerlisu Lapa Faik Ardahan Hakan Bozcuk Copyright (c) 2022 Iranian Red Crescent Medical Journal 2022-11-30 2022-11-30 24 11 10.32592/ircmj.2022.24.11.743 Fecal Calprotectin Level in Children with Cystic Fibrosis <p><strong>Background: </strong>Early diagnosis of cystic fibrosis (CF) and hence the initiation of symptomatic and prophylactic treatment can help improve the outcomes of CF patients. Fecal calprotectin (FC) is a marker of inflammation in the intestinal tract that is elevated in several gastrointestinal inflammatory diseases, but little is known about its value in CF.</p> <p><strong>Objectives: </strong>This study, therefore, aimed to survey the associations of FC among CF patients and its correlation with the clinical manifestations of CF.</p> <p><strong>Methods:</strong> This descriptive cross-sectional study was performed on 52 children with CF visiting the Children’s Hospital of Tabriz, Iran, during 2018-2019, selected through the census sampling method. The calprotectin values of &lt;50 μg/g were considered normal.</p> <p><strong>Results:</strong> There was no clinically relevant association among FC levels concerning pancreatic insufficiency, diabetes, and airway colonization with Pseudomonas. In a comparison of the number of exacerbations and Forced Expiratory Volume in the first second (FEV1), the levels of electrolytes showed no significant difference between patients with normal calprotectin and elevated FC. The results of the performed analysis indicated no significant difference between the low-fecal elastase and the FC levels in patients with CF (P=0.53).</p> <p><strong>Conclusion:</strong> Demographic and clinical parameters, such as age, gender, FEV1, or Body Mass Index, had no clinically significant relationship with FC. However, serial and longitudinal calprotectin levels should also be checked, which may have clinical relevance during symptomatic episodes.</p> Mandana Rafeey Amir Hossein Jafari-Rouhi Suzan Hejrati Sepideh yasari Maryam Hosseinpour Sarmadi Ebrahim Farhadi Copyright (c) 2022 Iranian Red Crescent Medical Journal 2022-11-30 2022-11-30 24 11 10.32592/ircmj.2022.24.11.1531 The Development of a Dashboard to the Emergency Department during COVID-19 <p><strong>Background:</strong> Information dashboards are useful tools for up-to-date decision-making by visualizing data.</p> <p><strong>Objectives:</strong> This study aimed to report the development of a dashboard in the emergency department (ED) during COVID-19 in a big hospital in Iran.<br /><strong>Methods:</strong> The authors developed a dashboard by user-centered design (UCD) methodology in four phases, namely specification of the context of use, specification of the requirements, creation of design solutions, and evaluation. Indicators were determined by reviewing previous studies and interviewing focus groups with an expert panel. The Power BI Desktop software was used for the development of the dashboard. Users’ comments about the dashboard were collected. The dashboard was then developed and revised according to the users’ feedback and suggestions. Finally, user satisfaction was evaluated.<br /><strong>Results:</strong> The authors identified 30 indicators for COVID-19 ED, classified as input, output, and process indicators. The final version of the dashboard was implemented in 2021, and then 28 ED and managerial staff participated in the evaluation of the dashboard. The average score of the system usability scale of the dashboard was 84.10 points, and the situation awareness index was 3.97, which indicates “good” usability and situation awareness.<br /><strong>Conclusion:</strong> This dashboard presented key managerial and clinical indicators for decision-making in ED. Future studies can be designed to develop dashboards for accidents and burns EDs and create emergency information dashboards for several hospitals for better management in times of crisis.</p> Somayeh Fazaeli Mehdi Yousefi Mohsen Shokoohizadeh Copyright (c) 2022 Iranian Red Crescent Medical Journal 2022-11-30 2022-11-30 24 11 10.32592/ircmj.2022.24.11.2241 Mental Health of Nursing Students and Associated Factors during the COVID – 19 Pandemic: A Cross-sectional Web-based Study <p><strong>Background: </strong>Specific conditions arising from the COVID-19 pandemic may affect the mental health of nursing students.</p> <p><strong>Objectives: </strong>This study aimed to investigate the mental health of nursing students and associated factors during the COVID-19 pandemic at Ahvaz and Kermanshah Universities of Medical Sciences in Iran.</p> <p><strong>Methods:</strong> This cross-sectional study was conducted on 384 nursing students at Ahvaz and Kermanshah Universities of Medical Sciences in Iran from May 10, 2021, to June 26, 2021. The required data were collected using a web-based questionnaire via social networks, such as WhatsApp and Telegram. Symptom Checklist-25 (SCL-25) was used to measure mental health. Descriptive statistics and stepwise linear regression were used to analyze the data.</p> <p><strong>Results:</strong> The mean total mental health score was 47.48±16.03, and 235 (61.0%) students had good mental health, 124 (32.2%) cases had suspected mental disorders, and 26 (6.8%) respondents had severe mental disorders. Using the stepwise regression method, four variables, including gender, history of mental illness, history of coronavirus infection or being suspected of having coronavirus, and level of trust in statistics about the incidence and mortality rate of COVID-19 had the greatest impact on mental health modeling.</p> <p><strong>Conclusion:</strong> In general, the COVID-19 pandemic may have a negative impact on the mental health of nursing students. Therefore, it is very important to identify and consider the factors that can reduce their mental distress. </p> Nesa Cheraghbeigi Somaieh Bosak Mehdi Sayyah Erfan Javanmardi Dariosh Rokhafrooz Copyright (c) 2022 Iranian Red Crescent Medical Journal 2022-11-30 2022-11-30 24 11 10.32592/ircmj.2022.24.11.2087 Special DVT in a Child: A Case Report <p><strong>Background: </strong>Agenesis of inferior vena cava (IVC) is an extremely rare congenital malformation. Although frequently symptomatic, due to its low prevalence, agenesis of IVC may often be missed in normal workup. At present, most of the reports are simple loss of IVC, and the simultaneous loss of bilateral iliac veins and IVC is more rare. Chronic deep venous ulcer is also one of the causes of acute venous thrombosis. In children with acute DVT, which is also an important cause of neglect and missed diagnosis. When color Doppler ultrasound can not be clear, we must pay attention to CT examination.<br /><strong>Case Presentation:</strong> We reported a case of inferior vena cava(IVC) below renal vein hypoplasia in a 8-year-old girl who presented bilaterally with venous stasis dermatitis and ulcers in the lower extremity limb area. Ultrasonography revealed no clear inferior vena cava and iliofemoral venous system under the renal venous plane. Magnetic resonance venography subsequently confirmed the same findings.</p> <p><strong>Conclusion: </strong>This case is a rare case of congenital malformations of the inferior vena cava and is rare in pediatric patients in which symptoms of venous thrombosis have been reported. We want to intended to demonstrate the etiology of the appearance of venous thrombosis in children through this case.</p> Xiaorong Wen Zhoupeng Wu Copyright (c) 2022 Iranian Red Crescent Medical Journal 2022-11-30 2022-11-30 24 11 10.32592/ircmj.2022.24.11.2136 A Rare Case: Laryngeal Sarcomatoid Carcinoma <p>Laryngeal cancer is the most common cancer in the head and neck region. They account for approximately 3% of all malign tumors seen in adults. 85-90% of laryngeal cancers are squamous cell carcinoma (1-2). Spindle cell carcinoma (sarcomatoid carcinoma) is a rare carcinoma that accounts for &nbsp;2-3% of all laryngeal malignancies (3-4). Sarcomatoid carcinoma, most commonly seen in the head and neck region, is a rare variant of squamous cell carcinoma. This tumor, which shows a very aggressive course, is mostly seen in patients receiving head and neck radiotherapy. These tumors are generally seen in the anterior of the vocal cord as glottic localized and polypoid masses that have the ability to infiltrate and metastasize. The histogenetic origin and morphological classification of sarcomatoid carcinoma is it is not clear. Especially, ıt is important to distinguish it from sarcomas in diagnosis.</p> Hüseyin Günizi Copyright (c) 2022 Iranian Red Crescent Medical Journal 2022-11-30 2022-11-30 24 11 10.32592/ircmj.2022.24.11.679 Cost management strategies in health insurance: a scoping review <p><strong>Background:</strong> Insurance plays a significant role in health systems financing. The existence of multiple risks has led to an increase in the costs of insurance organizations.<br /><strong>Objective:</strong> The study aimed to identify cost management strategies in health insurance.<br /><strong>Methods:</strong> A scoping review was conducted by focusing on published studies in Farsi and English languages in the field of health insurance through the world by the end of June 2020. Search was performed using valid keywords in PubMed, Scopus, Web of Science, SID, Magiran, Google and Google scholar search engines. A list of credible sources and journals were assessed, too. Finally, 51 articles fulfilled the inclusion criteria, were reviewed and analyzed using MAXQDA software.<br /><strong>Results:</strong> In total, 97 cost management strategies were identified which were classified into 3 groups: providers, insured people and insurance organizations. Modification of payment methods to providers and monitoring of services provided and medications prescribed in the field of providers, cost sharing, deductible, consumption management and culture building in using services in the field of insured people, strategic purchasing, coverage constraints, internal controls, using risk management and employing specialized personnel were among the most important cost management strategies in the field of insurance internal processes. Other institutions that make policy and oversee the insurance industry will also play a significant role in reducing the costs.<br /><strong>Conclusion:</strong> Understanding the solutions to cost control in health insurance helps policymakers and managers to plan and apply corrective interventions and appropriate changes that lead to reduce the costs of insurance companies.</p> Sajad Ramandi Ali Mohammad Mosadeghrad Mahya Abbasi Copyright (c) 2022 Iranian Red Crescent Medical Journal 2022-11-30 2022-11-30 24 11