Background:The relationship between the oral care and ventilator-associated pneumonia (VAP) was confirmed in patients undergoing ventilation. Objectives: The current study aimed at investigating the effects of chlorhexidine gluconate (CHX) and ozonated water on the prevention of VAP. Methods: The current double-blind, randomized, clinical trial with the experimental and control groups was conducted in Iran in 2014. In the current study, 75 inpatients undergoing ventilation were grouped through the convenience sampling method and randomly allocated into 2 groups based on the inclusion criteria. In the experimental group (39 patients), oral care provided by ozonated water, while in the control group (35 patients), oral care was provided via CHX. Clinical pulmonary infection score (CPIS) was used to examine the rate of VAP infection. Results: According to the results of the current study, the occurrence rate of VAP in the experimental and control groups were 2.4% and 8.3%, respectively that was equal until the 3rd day (P value = 0.339). However, on the 4th day, the VAP occurrence rate in the experimental group (14.6%) was significantly lower than that of the control group (30.6%) (P value = 0.02). Conclusions: Based on the results, ozonated water was more effective to prevent VAP than CHX. Ozone water can be used as a suitable alternative mouthwash in patients undergoing mechanical ventilation.

Background: Surgery is a stressful event that can be accompanied by a great deal of fear and anxiety, especially in emergency situations. Objectives: This study aimed to determine the level of fear of hospitalization and associated anxiety and factors in the candidates of emergency surgery referring to the hospitals affiliated with Zanjan University of Medical Sciences. Methods: This descriptive cross-sectional study was performed on 304 patients admitted to the emergency department and their family members, referring to the hospitals affiliated with Zanjan University of Medical Sciences in 2020. The patients were recruited by convenience sampling. Data collection tools included a questionnaire for demographic information and disease specifications, the hospitalization fear questionnaire (Slobodan M. Jankovic), and the Visual Analogue Scale (10-point) to assess pain and anxiety in the emergency departments. For data analysis, independent t-test, analysis of variance (followed by the LSD post hoc test), Pearson correlation, and stepwise multiple regression were used by SPSS 22. Results: The results showed that a higher number of the patients (61.4%) experienced anxiety rather than hospitalization fear (23.2%). The pain had a negative correlation with patients' and their companions' fear of hospitalization and a positive correlation with their level of anxiety. Also, the anxiety of the patient's companion increased with the prolongation of the waiting time. The companion's hospitalization fear and anxiety significantly correlated with the patient's level of anxiety (P<0.05), and the patient's anxiety was negatively associated with systolic and diastolic blood pressure and the level of consciousness. In addition, fear of hospitalization and anxiety positively and significantly correlated with the pulse rate (P<0.05). Conclusion:According to the results of this study, it is recommended to provide psychological support to the patient and his/her family, try to stabilize the patient's clinical condition, and shorten the waiting time in the emergency department to be able to manage the patient's fear of hospitalization and anxiety.

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Background:The COVID-19 disease has worse outcomes in individuals with underlying diseases and elderly individuals. Therefore, identifying COVID-19 risk perception and its related factors and outcomes in vulnerable groups is essential for the health system. Objectives: This study aimed to determine COVID-19 risk perception, its related factors, and outcomes in vulnerable groups (individuals with underlying diseases, smokers, opioid addicts, the elderly, and pregnant women). Methods: This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was carried out using the keywords "Risk perception" and "COVID-19" in PubMed, Scopus, Science Direct, SID, Proquest, and Magiran databases in the period from 2019 to July 3, 2021. The quality of selected studies was checked by two authors independently according to Newcastle-Ottawa Scale adapted for cross-sectional. Results: In the initial search, 640 articles were found, of which 56 remained in the screening phase. Then, the full text of 56 articles was studied. Eventually, based on the inclusion and exclusion criteria of the articles, 8 articles were reviewed. This systematic review showed that suffering from an underlying disease, more anxiety, younger age, and female gender are associated with higher COVID-19 risk perception. The outcomes of COVID-19 risk perception were higher COVID-19 risk perception, delayed treatment sessions, increased anxiety and fear, increased ineffective safety behaviors, and greater compliance with health protocols. Conclusion:Creating sensitivity and proper COVID-19 risk perception is necessary to follow health protocols, but high COVID-19 risk perception can endanger vulnerable groups' mental and physical health. Besides, reducing the sensitivity of vulnerable groups toward COVID-19 can expose them to the disease.

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