Journal of Clinical Research in Paramedical Sciences
Year:2015 | Volume:4 | Issue:2|Papers Count:9

Background: Although evidence-based medicine is an important part of recent research attempts to reform the healthcare system, it requires to be evaluated in real situations of the society and patients. The current study was conducted to explain the concept of evidence-based medicine according to the academic and medical experiences of the clinical faculty members of Kermanshah University of Medical Sciences.Methods: This study was designed as a qualitative phenomenology. The statistical society comprised of the clinical faculty members of Kermanshah University of Medical Sciences. The participants were selected through purposeful sampling. The study sample was determined by the sufficiency principle. Data were collected through semi-structured interviews. The obtained data were analyzed by Collaizzi’s model at the time of data collection.Results: Three major themes were extracted from the analysis of data, including unawareness and lack of use (unaware of the concepts, lack of use, referring to the colleagues, test prescription), conscious or unconscious use (use of journals, academic sites, aware of the processes) and beliefs (believing in the necessity and not believing the necessity).Conclusion: A regular educational planning aiming to change the behavior is required to change the behavior of the clinical faculty members from an inactive state to an active use of evidence-based medicine and to change negative beliefs to the positive ones. Moreover, providing appropriate facilities and infrastructure and removing the obstacles of evidence-based medicine can be effective in this regard.

Background: A pulmonary embolism is partial obstruction of the pulmonary artery or one of its branches by a blood clot. The early detection of this disease is very important to save the patient. The proper detection method for embolism is lung perfusion scintigraphy with nuclear medicine system, performed by 99mTc-albumin macroaggregated (MAA) that are radiolabeled particles. There are some difficulties in synthesizing of the particles and imaging with them has some that we used chitosan microparticles as an alternative choice.Methods: The chitosan particles were synthesized by ionotropic gelation method and radiolabeled with 99mTc after Purification. The quality control tests including determining particles size, labeling efficiency, stability in saline buffer, Biodistribution and imaging study in the mice were performed.Results: The size of particles was 10-60 micron. The labeling efficiency: 95±4%, the good stability in saline buffer and high accumulation of activity in mice lung were seen. The slow excretion activity was observed in the lungs of mice after 15 minutes.Conclusion: The results showed that the 99mTc-Chitosan microparticles may be considered as a promising radiopharmaceutical of lung perfusion scintigraphy that needs more investigations in future.

Background: mental cardiopulmonary resuscitation actions are the critical ones to save patients affected by respiratory-cardiac arrest which needs high level of related skill of knowledge. So, this study was conducted to the level of Skills and knowledge of bachelor freshman Emergency Medical Students about the cardiopulmonary resuscitation life supports in 2014.Methods: A descriptive- analytical study was conducted on 146 bachelor freshman Emergency Medical Students. Data was collected using a demographic questionnaire, an attitude questionnaire, and a checklist for assessing skills by researchers. Data was analyzed by descriptive statistics and one sample t test through IBMSPSS21 software Results: The mean score of Students’ knowledge about basic cardiopulmonary resuscitation (CPR) life supports was 22.90 out of 36 (maximum score). Thus, a negative knowledge and skill gap was observed which was equal to 13.1 and statistically significant (P<0.01). Categorizing by knowledge, 31.4% of students had low, 59% moderate and only 9.6% had high theoretical knowledge of CPR life supports. Also, there was a significant difference between students’ practical skills and optimal skills of CPR life support actions one by one.Conclusion: According to the results, there is a distance between students’ current knowledge and skill of CPR life supports with optimal one. Thus, planning training courses for students who are in medical centers whit high rate of CPR life supports should be given high priority.

Background: Anxiety disorders are one of the most common psychiatric disorders in heart patients. Due to the side effects of medication, the use of non-drug treatments seem necessary. We aimed to determine the efficacy of resiliency training reduces anxiety symptoms in adolescents with heart disease.Method: This quasi-experimental design and pretest - posttest - follow-up control. This study of 20 subjects (16 males and 4 females) of patients referred to Imam Ali hospital in Kermanshah were available for sampling were selected and randomly assigned into two groups. Patient's anxiety questionnaire (Beck, 1990) before the intervention and after the intervention and follow-up sessions after the test was completed. Data were analyzed using ANCOVA spss19 and statistical methods. Participants were trained in 12 sessions.Results: The differences compared to the pre-test and post-test scores in the experimental group (P<0.001), which showed a significant decrease. Test Track (P<0.393) showed no significant difference in post-test and follow-up.Conclusion: Resiliency training has significant effects on reducing anxiety symptoms and follow the same quarter has proved, so as to reduce anxiety in people with heart disease can be used for resiliency training.

Background: While sleeping is among the basic and physiological needs of the human, sleep disorder is a common problem in patients with end stage kidney disease. The aim of this study was to determine the effect of progressive muscle relaxation technique on the quality of sleep in hemodialysis patients.Methods: In this randomized clinical trial, the effect of progressive muscle relaxation technique on the quality of sleep in 100 hemodialysis patients of Kermanshah Imam Reza Hospital was investigated. There were an experimental and a control group. Employing Pittsburgh Sleep Quality questionnaire the study was conducted in 2011. The data analysis was performed using software SPSS 16.Results: In this study, no significant differences were observed) P=0.15 (in the experimental and control group for their mean change in sleep quality before and after relaxation. However, no significant differences were observed in the case group (P=0.005) for the sleep quality scores before and after intervention, Conclusion: Although relaxation improved sleep quality in patients, it failed to reach to its full potentiality. And, it approved the disrupted sleep quality in patients and failure to control some of the influential factors.

Background: Nowadays, caregivers’ general health has an influential impact on patients’ and attendants’ education as well as the management of chronic diseases. This study aimed to design, develop and evaluate an Android application based on a user-led approach to educate caregivers of children with cerebral palsy.Methods: To conduct this applied developmental study, we first assessed the educational needs of caregivers using the standard Canadian Occupational Performance Measure questionnaire. Seven caregivers participated in this phase. Based on the known training needs, we developed and evaluated a prototype in several iterations with the participation of these seven caregivers. For final evaluation, 17 new caregivers participated. A validated researcher-designed questionnaire was used in order to evaluate its application. For data analysis, descriptive statistics using SPSS software version 16 was employed.Results: User’s feedback during designation of the application resulted in some changes. The final application involved 7 educational modules (including knowing about cerebral palsy, movement principles, nutrition, WC, bath, transportation, and game) and a drug reminder module. All of the participants (100%) were satisfied with the graphical features, the appearance and the content of the application. They (100%) expressed that the application is easy to use. More than 82 percent of the users believed that the application could meet their information needs for caring their children. In addition, over 75 percent of caregivers stated that it has been highly practical and that they had employed it in their everyday life care.Conclusion: It seems that this application can help caregivers of children with cerebral palsy to access the information required to provide daily care for their child at anytime and anywhere.

Background: Prevention of traffic accidents requires the exact understanding of the risk factors. Analysis of these factors requires the collection of authentic and standard data. The aim of this study was to compare the data elements of traffic accidents related to the police, the pre-hospital and hospital care in Iran with Europe and America standards.Methods: This descriptive cross-sectional study was performed in 2014. Data resources for Iran included data base and forms in police office, traffic accident information management system in hospital and forms in medical emergency centers. Standards for data elements in America (MMUCC) and Europe (CADaS) were retrieved from the internet. Data elements from aforementioned resources were merged together and a complete list of them were listed in the tables. Then, comparison of the data elements was performed and final results were displayed in the descriptive tables.Results: Results showed that defined levels of non-fatal injury, type and expiration date of insurance, driver’s physical conditions, previous conviction and history of traffic offenses for police data elements, classification and rating for the injury severity of pre-hospital care and assessment of the injury severity, the time and cost of rehabilitation for the hospitals in Iran were not existing. Also, vision obstacles, repairing road and technical inspection were data elements existing only for Iran.Conclusions: Prevention of traffic accidents requires access to standard data. Standardization of data for traffic accidents are the key elements for analysis and comparison on a global level. Traffic accident information system in Iran lacks some of the major data elements. Therefore, it is essential that these data elements be considered.

Background: Pseudomonas aeruginosa is an opportunistic pathogen associated with nosocomial infections. The emergence and dissemination of metallo-b-lactamases (MBLs) and extended-spectrum- b -lactamases (ESBLs) have contributed to the high rate of resistance among the p. aeruginosa isolates. This study investigated the prevalence of IMP, SHV and PER genes in p. aeruginosa isolates.Methods: Antibiotic susceptibility testing was performed using the minimal inhibitory concentrations (MIC). Then the polymerase chain reaction (PCR) was used for the detection of 3 genes encoding IMP, SHV and PER.Results: Of the 60 isolates tested, 38 (63.3%) were resistant to piperacilin, 42 (70%) to ceftazidime, 44 (73.3%) to imipenem and 45 (75%) to cefepime. Five (8.3%) and 8 (13.3%) of the isolates had PER and SHV genes by PCR results. In this study IMP gene was not found.Conclusion: According to this study, P. aeruginosa isolates were highly resistant to antibiotics. Therefore the susceptibility of isolates should be tested before treatment. Among the three b -lactamases genes studied the highest prevalence was related to SHV gene. Given the clinical significance of MBLs and ESBLs producing isolates, identification of these organisms is essential in the hospitals in order to get a better therapeutic response and control of bacterial dissemination.

Background: Diabetes mellitus is a metabolic disorder which may lead to hospital readmissions and can impose increasing costs to the medication system. This study investigated factors affecting readmission of patients with type II diabetes in selected hospitals in Kermanshah in 2013.Methods: This is a cross-sectional and descriptive analytic study with 140 diabetic patients. Participants were selected based on available sampling from the three hospitals of Imam Khomeini, Taleghani and Imam Reza. Data collection tools included questionnaires on demographic characteristics, adherence to treatment and the stressful event. Reliability of the study measured r=0.84. Data were analyzed with SPSS- 16 software and used with x2, ANOVA and t-test.Results: The most frequency rate of readmission for women pertained to those who had experienced one readmission before and for men, those who had a record of more than two readmissions. Results of chi-square showed significant relationships between readmission rates and age, occupation, number of children, exercise, smoking, drug abuse, and history of disease (P<0.05).Conclusion: Findings of this study revealed that most readmissions for patients with diabetes were for those above 60 years old and with multi-risk factors. And that the recurrent readmissions of diabetic patients can be avoided by allocating a suitable treatment-rehabilitation approach.