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Background and Objective: An increased risk of invasive infections with encapsulated bacteria such as Streptococcus pneumoniae has been described among splenectomized patients. Pneumococcal vaccination has been recommended in these patients. In this study, the serum antibody response to pneumococcal polysaccharide antigens in splenectomized patients with idiopathic thrombocytopenic purpura (ITP) or trauma who immunized with Pneumovax 23 was evaluated. Materials and Methods: This case - control study was performed on two groups of patients including fifteen cases of trauma patients (11 male, 4 female) and twenty patients with ITP (10 male, 10 female) along with 40 healthy volunteers as controls who were immunized with Pneumovax 23 to prevent pneumococcal infections. All patients received the pneumococcal vaccine before splenectomy. The serum antibody response (IgG and IgG2) to pneumococcal antigens was determined by enzyme-linked immunosorbent assay (ELISA) technique prior to vaccination and 4 weeks post-vaccination. Analyzing of data was performed using student t-test and linear regression test. Results: The mean of post-vaccination IgG or IgG2 titer to the pneumococcal antigens in ITP patient group was significantly lower than those in controls or in trauma group (P<0.05). No significant differences in IgG or IgG2 antibody titer increase were found between trauma group and healthy control group. Response to immunization was poor in 9 of 20 ITP patients. Conclusion: This study indicated that 45 percent of patients suffered from ITP who have undergone splenectomy responded poorly to pneumococcal antigens.

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Background and Objective: Triage is the most important and the first stage of patient’s management at the time of arrival to hospital emergency department. Emergency severity index (ESI) is a common triage system worldwide. This study was aimed to evaluate the accuracy of ESI in emergency department of Imam Hossein hospital in Tehran, Iran. Materials and Methods: In this descriptive study the result of patients’ triage based on ESI were gathered for all patients referred to emergency department of Imam Hossein Hospital from January to April 2011. A questioner was filled for each patient by the nurse and a emergency specialist independently. The l for the degree of agreement of triage between nurse and clinician was 81% (95% CI: 0.79-0.83). The sensivity of triage for step I, II, III, IV and V were 100%, 53.2%, 90.7%, 67.1% and 98% respectively. The specificity of triage for step I, II, III, IV and V were 99.8%, 97.5%, 93.7%, 98.3% and 94% respectively. There was a significant overlapping between the triage step and the patient clinical outcome. Conclusion: This study showed that five steps triage contain a high accuracy and estimation of patient outcomes.

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Background and Objective: Today, the role of family members in caring for cancer patients is becoming more important. Numerous cancer-associated problems affect both the patients and their caregivers. Little information is available about the social support and spiritual health of caregivers of cancer patients; therefore, this study was conducted to investigate the spiritual health and social support status of family caregivers of cancer patients in northeastern Iran.
Methods: This descriptive-analytical study was performed on 265 family caregivers of cancer patients. The subjects were selected by convenience sampling from inpatient wards and outpatient clinics of Babol University of Medical Sciences in 2019. Data were collected using the Social Support Questionnaire (by Vaux), the Spiritual Well-Being Scale (by Paloutzian and Ellison), and a socio-demographic questionnaire.
Results: The mean scores of social support and spiritual health of family caregivers of cancer patients were 98.86±14.58 and 91.32±11.97, respectively, which are at a desirable level. The age of caregivers and the duration of cancer had no significant relationship with the score of spiritual health and social support.
Conclusion: According to our findings, family caregivers of cancer patients have a desirable level of social support and spiritual health.