Background: Since the beginning of the coronavirus disease of 2019 (COVID-19) pandemic, concerns raised by the growing number of deaths worldwide. Acute respiratory distress syndrome (ARDS) and extrapulmonary complications can correlate with prognosis in COVID-19 patients. This study evaluated the association of systemic complications with mortality in severely affected COVID-19 patients. Materials and Methods: This retrospective study was done on 51 intensive care unit (ICU)-admitted COVID-19 adult patients who were admitted to the ICU ward of Khorshid hospital, affiliated with Isfahan University of Medical Sciences. Only the patients who had a definite hospitalization outcome (dead vs. survivors) were included in the study. Daily clinical and paraclinical records were used to diagnose in-hospital complications in these patients. Results: The sample was comprised of 37 males (72.5%) and 14 females (27.4%). The median age of patients was 63 years (Min: 20, Max: 84), with the mortality rate of 47.1%. In total, 70.6% of patients had at least one coexisting disorder. Chronic kidney disease was associated with the worse outcome (29.16% of dead patients against 3.70 of survived ones). Mechanical ventilation was used in 58.8% of patients. Patients who had received invasive ventilation were more likely to die (87.50% of dead patients against 7.40 of survivors), Complications including sepsis and secondary infections (odds ratio: 8.05, confidence interval: 2.11–30.63) was the strongest predictors of mortality. Conclusion: Complications including sepsis and secondary infections can increase the risk of death in ICU-admitted COVID-19 patients. Therefore, it is substantial that the physicians consider preventing or controlling these complications.

Purpose The aim of this review is to assess the efficacy and safety of using heat and cold therapy for adults with lymphoedema. Methods A multi-database search was undertaken. Only studies which included adults with lymphoedema who were treated with heat or cold therapy reporting any outcome were included. Screening, data extraction, and assessment of bias were undertaken by a single reviewer and verified by a second. Due to the substantial heterogeneity, a descriptive synthesis was undertaken. Results Eighteen studies were included. All nine studies which assessed the effects of heat-therapy on changes in limb circumference reported a point estimate indicating some reduction from baseline to end of study. Similarly, the five studies evaluating the use of heat-therapy on limb volume demonstrated a reduction in limb volume from baseline to end-of-study. Only four studies reported adverse events of which all were deemed to be minor. Only two studies explored the effects of cold therapy on lymphoedema. Conclusions Tentative evidence suggests heat-therapy may have some benefit in treating lymphoedema with minimal side effects. However, further high-quality randomised controlled trials are required, with a particular focus on moderating factors and assessment of adverse events. Implications for rehabilitation This review highlights the potential benefit that heat therapy may have on reducing limb circumference and volume for adults with lymphoedema. There was no evidence that controlled localised heat therapy was unsafe. The current evidence-base is at a point where no specific clinical recommendations can be made. The use of heat therapy should only be applied as part of a methodologically robust study to treat lymphoedema.

Background: It is critical to identify the factors affecting the academic success of students in the context of medical sciences. The research approaches in positive psychology have shown that the variables of hope and optimism play important roles in the academic achievement of college students. Objectives: The present study aimed to compare and evaluate the relationship between the academic achievement of medical and paramedical students with hope and optimism. Methods: A descriptive-correlative and cross-sectional research design was adopted in this study. The statistical population of the study consisted of all medical and paramedical students at Shiraz University of Medical Sciences. A total of 350 students were selected based on Cochran's sampling formula, out of who 306 ones completed and returned the questionnaires. In order to collect the required data, two valid and reliable scales, including the Adult Hope Scale (AHS) and the Academic Optimism Questionnaire, were used. Moreover, descriptive and inferential statistics were performed to analyze the data by using SPSS 21V software. Results: The findings showed that students’ academic optimism (r = 0.16, P ≤ 0.01) and hope (r = 0.17, P ≤ 0.01) were positively and significantly associated with their academic achievement. The results also indicated that there was a considerable, positive correlation between student identification and their academic achievement (r = 0.197, P ≤ 0.01). Furthermore, a significantly positive relationship was detected between student hope dimensions in terms of agency thinking (r = -0.15, P ≤ 0.05), pathways thinking (r = -0.17, P ≤ 0.01), and academic achievement. The findings demonstrated that paramedical students were significantly more optimistic than medical students (P ≤ 0.01). Conclusions: It was concluded that hope and academic optimism may have increased and improved students’ academic performance and, consequently, had a positive impact on their success and achievement in universities.