Background Health care personnel are exposed to ergonomic hazards, musculoskeletal disorders, and other work-related injuries. Low back pain is the most common musculoskeletal disorder. The aim of this study was to determine the prevalence of low back pain and the risk factors in health care personnel at the hospital in a form of a systematic review and meta-analysis. Methods In this systematic review and meta-analysis, the articles published in international electronic databases including Web of Knowledge, Embase, Scopus, PubMed were searched until May 2019. We included cohort, case-control and cross-sectional studies estimate the prevalence and risk factors for low back pain in health personnel. Data were analyzed using Stata-14 software and random effect model at 95% confidence level. Findings 154 studies were included in the study for analysis. The estimated lifetime prevalence of lower back pain in health care personnel was 54.8%. The estimated odds ratios were as follows: age 1.23, female gender 1.11, BMI 1.17, lack of regular physical activity 1.56 occupational factors 1.12, patient related factors 1.24, body position at work 2.55, and stress 1.67. Conclusions /application to practice: The prevalence of low back pain in health care personnel is high. Body position at work, stress and lack of physical activity were the strongest risk factors, respectively. Future studies and educational programs are required to reduce the incidence of low back pain in health care personnel.

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Introduction Evaluation of electrolyte status and homeostasis is one of the most important components of evaluation and treatment of critically ill patients, especially those with multiple trauma. Electrolyte imbalance can be associated with a bad prognosis and the need of specialized consultancy. Aim The aim of this study was to evaluate and determine the electrolyte status of patients with multiple trauma and evaluate the relationship of electrolyte disorders with patient outcome. Methods In this cross‐sectional study, 370 patients who were referred to the emergency department of Besat Hospital in Hamadan, Iran with multiple trauma were studied. Demographic parameters clinical characteristics such as blood pressure, heart rate, respiratory rate, consciousness score and body temperature, paraclinical characteristics including radiographic status, ultrasound, and electrocardiography and serum levels of sodium, potassium, creatinine, hemoglobin, hematocrit, and BUN and urine analysis was performed. Data regarding the discharge from emergency department or referral to other units were also complete in a questionnaire for each patient. Statistical analyses were performed using SPSSv24. Results Three hundred seventy patients with multiple trauma were studied where 73% of patients were men and 27% were women. One hundred ninety‐six patients were discharged from the emergency department, and 174 patients were referred to other units of the hospital. The most common electrolyte abnormalities were hypotension (62.7%), hypernatremia (9.5%), hypokalemia (6.8%), and hypercreatinine (4.6%). The results of independent t ‐test showed that heart rate and potassium level were significantly higher in patients referred to other units than in patients discharged from the emergency department and respiratory rate and hematocrit were significantly lower in patients referred to other units. Conclusion Hypotension, hypernatremia, hypokalemia, hypercreatinine, and abnormal urine analysis were more frequent in patients referred to other units than in patients discharged from the emergency department. These variables can be considered in predicting patient status for referral to other units and delayed hospital discharge.

Background: Computerized tomography (CT) scan is one of the widely used imaging modalities for the diagnosis of anomalies and diseases. Nonetheless, increased exposure to the radiations is one of its overlooked side effects. Objective: The aim of this study was to determine the causes of cerebral CT scan in patients with minor trauma. Method: In this cross-sectional study, 550 patients with minor head trauma referred to (XXX) were evaluated. The data are collected and completed using a questionnaire comprising of variables such as age, sex, type of trauma, trauma severity, CT scan results, associated symptoms based on NEXUS II, CCHR and NOC criteria and underlying diseases. The data were analyzed using statistical tests and SPSS software version 22. Result: The mean age of patients was 32.5 years and 62% of patients were male. 67% of the patients visited the hospital on their own. The cause of the trauma in 29% patients was car accident, 19% fall from height and 16.5% conflict. Scalp lesions were seen in 30.5%, hematomas in 4.9%, dizziness in 8.9%, history of comorbidities in 5.8%, episode of vomiting less than 2 in 7.3%, episode of vomiting more than 2 times in 1.1%, headache with score ≥7 in 5.8%, headache with score ≤7 in 23.1%, postoperative forgetfulness in 0.2%, raccoon eyes in 0.2% and nose bleeding in 1.5%. Findings of CT scan were abnormal in 0.2% of patients. The patient's condition declared cleared in 94.5% cleared and 5.5% referred to a neurosurgery. Statistically, CT scan had significant role in predicting the patient's neurosurgery counseling status (P < 0.05). Conclusion: The majority of patients with minor head trauma had normal brain CT scan and was discharged without the need for neurosurgery counseling. Therefore, it seems necessary to reduce brain CT scans without indication to reduce the radiation dose among patients with minor head trauma. Highlights: