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Background: Recognition of mortality-related factors in Intensive Care Units (ICUs) could increase efficiency and effectiveness of these units. This research determined the relationship between the physical structure, human resources and their relevance to mortality rate in Intensive Care Units. Methods and Materials: In this cross-sectional study, all ICUs of hospitals in Markazi province were considered. Data gathering tools were resource (human, physical and training) questionnaires and checklists which their reliability and validity were accepted by Monitoring and Validation Center of Ministry of Health. Mortality rate after 24 hours of admition was also determined in relation to hospital resources and activities. Data were analyzed with descriptive statistics, Spearman and Kruskal-Wallis tests. Results: Total score of human, physical and training resources in hospitals of Markazi Province is 55 percent of the country standard score. Mortality ratio after 24 hours of admission, to all patients (released and deceased patients) was highest in Vali-e-Asr hospital (25%) and lowest in Saveh Shahid Chamran Hospital (5%). There wasn’t significant difference in this ratio among hospitals. There were no significant difference between obtained scores of each resource (human, physical and training) among University, Social Insurance and Qods (private) hospitals with respect to mortality rate 24 hours of admission. Conclusion: Human, physical and training resources have not direct effect on decreasing mortality rate after 24 hours of admission but can create necessary conditions for providing higher quality services.

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Background: APACHE IV scoring system is one of the most useful scoring systems for evaluating the quality of health care services in ICU. The aim of this study was to evaluate the quality of health care services in ICU wards of Valiasr and Amiralmomenin Hospitals of Arak. Materials and Methods: This cross-sectional study was conducted on 100 patients admitted to ICU wards in Valiasr and Amiralmomenin Hospitals of Arak. First, the predicted mortality and length of stay (LOS) in ICU were calculated by APACHE IV scoring system. Then the real mortality and the real length of stay in ICU were recorded. Data were analyzed by SPSS software version 11.5 and t-test. Results: Real mortality in men and women were 57.2% and 61.9%, respectively. The real length of stay in men and women were 11.58 and 11.62 days, respectively. Predicted mortality calculated by APACHE IV in men was 23.72% while it was 24.1% in women. Predicted LOS by APACHE IV in men was 15.02 days while it was 16.64 days in women. There was a significant difference between real mortality and predicted mortality (P = 0.001). Conclusion: The findings of this study indicate that the quality of health care services in ICU wards of Valiasr and Amiralmomenin Hospitals of Arak are far from international standards.

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Background: Influenza is an acute respiratory disease caused by influenza virus. Influenza epidemics are reported every year and worldwide pandemics occur with varying frequencies. The majority of mortalities are due to underlying diseases and complications associated with influenza. In this study, we evaluated ten fatal cases caused by the established type A influenza (H1N1) infection in the 2009-2010 pandemic. Materials and Methods: This mortality survey was compiled by a review of the deceased patients’ files. The assessed variables were demographic data, underlying diseases, secondary infections, delayed commencement of therapy, and non-medication. Collected data were analyzed by measures of central tendency and dispersion using SPSS software. Results: In the ten deaths due to the established H1N1 virus, the median of age was 30 years and 90% of the cases had underlying diseases. Ninety percent of the deaths occurred during October and November and the rest took place in December and February. Conclusion: The main cause of death was the delayed commencement of antiviral treatment. This emphasizes the importance of timely treatment in high risk patients. In flu pandemics, physicians should swiftly start specific therapy in at-risk groups to reduce the mortality rates.

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Background: The main purpose of this study was to measure the level of lipids in ICU patients and its clinical outcome, specially the mortality rate and the relationship between level of lipids and APACHE IV score.

Materials and Methods: This descriptive and cross-sectional study was conducted on 100 ICU patients. Cholesterol level was measured on the first and second days after admission of patients. This was followed by examination of clinical outcome (e.g. mortality rate) and duration of their real and predicted stay through APACHI IV. The results were analyzed by Pearson correlation using SPSS.

Results: Mean serum of HDL, LDL, and cholesterol was lower than normal. These values for the first day were 33.16, 67.97, and 131.38 and for the second day were 23.63, 54.99, and 119.88, respectively. Mean APACH E IV score was 67.72. Result of Pearson correlation coefficient showed significant relationship (p<0.05) between APACHI IV score and cholesterol level of the first and second day, LDL level of the first and second day, HDL level of the second day. Moreover, there were significant relationships were observed between the real mortality rate and the cholesterol level of the first and second days, LDL level of the first and second days, and HDL level of the first day. There was a significant significant correlation between cholesterol level and LDL of the first and second days as well as HDL of the first day and duration of admission in ICU as predicted by APACHI IV.

Conclusion: The significant relationship between lipoprotein level of serum and APACHI IV indicates considering serum lipid beside other physiologic parameters for prediction of clinical consequences including mortality rate of ICU patients

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Background: Early, complete, and stable coronary revascularization is the main criteria for standard treatment in patients with ST segment elevation myocardial infarction (STEMI). The aim of this study was to evaluate the safety and efficacy of integrilin as glycoprotein IIb/IIIa receptor inhibitor in treatment of STEMI patients undergoing primary percutaneous coronary intervention (PCI).

Materials and Methods: In this clinical trial study, 106 STEMI patients who complained of acute chest pain and were referred to Amir Al Momenin hospital, Arak, entered the study. Patients were randomly divided into two equal groups. The first group was treated with integrilin immediately before angioplasty. The 2nd group was treated with conventional percutaneous coronary intervention.

Results: After receiving treatment and undergoing angioplasty, TIMI Frame Count was equal to 15.7±8.04 in the 1st group and 14.2±5.4 in the 2nd group which showed no significant difference between them (p=0.4). Ejection fraction in patients receiving integrilin was significantly more than control group in first (p=0.043) and third month (p=0.012) after treatment.

Conclusion: Based on the results of the present study, it seems that using integrilin in standard time, causes long-term benefits for patients and reduces damage to the heart wall.

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Background and Aim: The new Coronavirus Disease 2019 (COVID-19) outbreak initiated from China in late December 2019, has posed a great global health threat. Since patients with high blood pressure, diabetes, and cardiovascular diseases are at high risk of COVID-19, this study aims to investigate the prevalence, severity, clinical manifestations, and mortality rate in COVID-19 patients with underlying diseases compared to those without underlying diseases.
Methods & Materials: This study was performed on 1408 patients with COVID-19 admitted to Golestan, Hajar, Khanevadeh and Besat hospitals in Tehran, Iran. Required data including disease prevalence, severity, clinical manifestations and mortality rate in patients with and without underlying diseases were collected and then analyzed using statistical tests in SPSS software, considering a significance level of P<0.05.
Ethical Considerations: This study was approved by the AJA University of Medical Sciences (Code: IR.AJAUMS.REC.1399.091). Ethical principles have been observed in accordance with the guidelines of the National Ethics Committee and the COPE regulations.
Results: Patients were 912 men (64.8%) and 496 women (35.2%) aged 18-98 years (Mean age= 57.8 years). Results reported that 27% of patients were intubated and 21.9% were died. Blood oxygen level in 53.7% of patients was less than 93 mg/dL; 36.1% had a history of hypertension, 24.1% had a history of diabetes, and 21.7% had a history of cardiovascular disease.
Conclusion: The severity, clinical manifestations, and mortality rate of COVID-19 patients with cardiovascular disease, diabetes and hypertension are significantly different compared to those without underlying diseases.

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Background and Aim: Attention Control Training is a new cognitive intervention that improves emotion regulation by reducing attentional bias towards negative information. Given the significant association between death anxiety and emotion dysregulation and death-related attentional bias, this study aimed to assess attention control training as an intervention for reducing death anxiety.
Methods & Materials: In this clinical trial, the Convenience Sampling Method sampled 50 university students in Tehran and was randomly assigned to 2 experimental and 1 control groups. Attention control training was delivered using death-related stimuli for the 1st experimental group and negative stimuli unrelated to death for the 2nd experimental group. The control group didn’t receive any interventions. In 3 measurements of pretest, posttest, and 3 months follow-up, death-related attentional bias, death anxiety, and sensitivity to mortality salience were assessed, respectively, using the Modified Stroop Test, Multidimensional Fear of Death Scale (MFODS), and Propensity to Moral Disengagement Scale (PMDS) after inducing Mortality Salience condition.
Ethical Considerations: This study was registered at the Iranian Registry of Clinical Trials (Code: IRCT20190406043181N1) and was approved by the research ethics committee of Shahid Beheshti University of Medical Sciences (Code: IR.SBMU.MSP.REC.1398.539).
Results: The study showed that after completing attention control training, the 1st experimental group’s death-related attentional bias, death anxiety, and sensitivity to mortality salience were significantly reduced (P<0.05), and this reduction was maintained at 3 months of follow-up. No significant changes were observed in the other two groups (P>0.05).
Conclusion: Based on the results of this study, it can be concluded that attention control training is capable of significantly reducing death-related attentional bias, and this reduction in attentional bias leads to decreased death anxiety and sensitivity to mortality salience