Background: Correct endotracheal tube suction is one of the effective methods to prevent ventilator-associated infection. Many studies have reported that normal saline and N-acetylcysteine (NAC) in the trachea lead the translocation of bacteria to lower levels and increase the risk of pneumonia. Objectives: The present study sought to examine the effect of tracheal suction with NAC on the incidence of ventilator-associated pneumonia (VAP). Methods: This single-blind randomized clinical trial study was conducted on 60 patients admitted to the intensive care unit (ICU) of the Khatam Al-Anbia Hospital in Zahedan, Iran, in 2020. The patients were selected using the convenience sampling method and assigned into two intervention and control groups by permutation block randomization. Before the intervention, the patients were evaluated using the Modified Clinical Pulmonary Infection Score (MCPIS), and the patients with scores < 5 on this scale were included in the study. Suctioning tracheal secretions in the intervention group was performed by pouring 2 cc of NAC into the tracheal tube during suction. The same suction procedure was performed for the patients in the control group by pouring 2 cc of normal saline into the tracheal tube in a standard way. The intervention was conducted for five days. After the intervention, the MCPIS scale was administered once more for the two groups. The collected data were analyzed using the independent samples t-test and chi-square test with SPSS software (version 25). Results: The independent samples t-test showed no significant difference between the intervention and control groups regarding the incidence of pneumonia (P = 0.31). Conclusions: Despite the effect of NAC on the incidence rate of pneumonia in patients under mechanical ventilation, there was no significant difference between NAC and normal saline in reducing the incidence of pneumonia. However, since NAC leads to no specific complication in patients, it can be safely used in the suction of tracheal lobule secretions in patients under ventilators. In this regard, further studies should examine the use of NAC for suctioning during tracheal tube obstruction by secretions.

Background: Anxiety about COVID-19 is very common and seems to be due to its high prevalence and mortality. Medical students may also be anxious about the disease. Therefore, the aim of this study was to evaluate the anxiety caused by COVID-19 disease in internship students in the field before entering the ward. Methods: This descriptive study was performed on 90 nursing students, operating room and midwifery intern in the field in February 1400 before entering the department at Zabol University of Medical Sciences. Sampling was done randomly. Coronary anxiety was assessed using the Corona Disease Anxiety Scale (CDAS). Results: The mean and standard deviation of the total score of coronary anxiety was 22.29 ± 16.10, which indicates mild anxiety. The mean and standard deviation of psychological and physical symptoms of anxiety caused by the disease in the research units were 32.82 ± 20.48 and 11.76 ± 14.73, respectively, which indicates the greater severity of psychological symptoms. Conclusion: According to the results of this study and mild anxiety due to the incidence and mortality of Covid-19 disease in students and the negative effects of anxiety due to this disease, including negative effects on their learning, it is necessary to take appropriate measures to prevent and control it Be.

Introduction: In previous studies, kidney stones was reported as a common complication in general populations. Objectives: This study aimed to evaluate kidney stone incidence and related factors in hemodialysis patients. Patients and Methods: This descriptive-analytical study was conducted on 284 hemodialysis patients in the Zahedan. Demographic and clinical data were collected. The incidence rate of kidney stone was calculated. The correlation between kidney stone incidence with predicting factors was explored by multivariate logistic regression. Results: Results demonstrated that most patients were male, with a mean age of 48.81 ± 16.84 years. The correlation between kidney stone incidence with gender, race, smoking, and blood group was not significant (P > 0.05); however, its correlation with diabetes mellitus, urinary tract infection, age, and body mass index (BMI) was significant (P < 0.05). The kidney stone incidence rate was 23.24%, while diabetes mellitus, urinary tract infection, older age, and higher BMI were the most common predictors. Conclusion: Diabetes mellitus, urinary tract infection, older age, and higher BMI were the common predictors for kidney stone incidence in hemodialysis patients. Identifying kidney stone incidence predictors in patients with hemodialysis can be helping in lower complications.

BackgroundReligious attitude and anger management are two psychopathological constructs receiving little empirical scrutiny in relation to smart phone addiction, but theoretically should demonstrate significant relationships. Today one of these new media that is used by many people around the world, is the mobile phone. Students are one of the most important groups that are affected by mobile social networks. The aim of this study was to determine religious attitudes and anger management as risk factors of mobile phone addiction in nursing and midwifery students. MethodsThis study was a cross-sectional study involving 200 nursing and midwifery students. Relevant data were collected through demographic information questionnaire, anger management skills questionnaire, religious attitude questionnaire, and mobile phone addiction questionnaire. A multiple regression model was used to examine the relationship between variables. ResultsThe mean age of the research subjects was 22.04 ± 3.30 years. Anger control and religious attitude were a significant risk factors of smartphone addiction (β=-0.500; p=0.000; β= -0.069; p=0.004, respectively). The variables of anger ýcontrol and spiritual attitude can predict and explain 33.6% and 2.7% (36.3% in total) of the ýchanges in the mobile addiction score. Anger control is the most influential risk factor of mobile phone addiction among nursing and midwifery students (Beta = -0.385). ConclusionFindings indicate the importance of controlling anger and strengthening religious attitude in reducing the rate of mobile phone addiction in students. This provides guidance to the future development of smartphone addiction prevention programs for students.