Koomesh
Year:2017 | Volume:19 | Issue:2 (66)|Papers Count:34

Introduction: todays, kidney failure is one of the costly problems of human society and use of renal replacement therapy is increasing in the world and Iran. Survival analysis is one of the fields in medical prognosis and data mining is a process of discovering unknown relationship and is a useful pattern from data and is known as a highly efficient method in survival analysis. Conclusively, the purpose of this study is predicting the survival of the kidney transplant patient's according to variables before kidney transplant.Materials and Methods: In order to identify important factors for predicting survival in kidney transplant, informative requirements assessment was done by using self-designed questionnaire. Then, obtained information from the analysis of questionnaire was reviewed and data from 513 medical record of kidney patient in Sina Urology Research Center was extracted. Ultimately, by applying CRISP methodology, data mining was done by IBM SPSS Modeler 14.2 and C.5 algorithm.Results: In this study, BMI, ESRD and dialysis time were evaluated as the most effective factors in survival kidney transplant and extracted rules from the model can be used for predicting the survival of the transplanted kidney before the surgery. Accuracy rate of this model was estimated at 96.77%.Conclusion: The high accuracy rate of C5.0 model shows the power of it in survival prediction. Furthermore, the most effective kidney transplant survival factors were identified and kidney transplanted survival of a new patient with distinctive features, can be predicted.

Introduction: Lavandula angustifolia (lavender) is an aromatic evergreen of laminacea family with some medicinal characteristics. The effect of lavender aqueous extract on improving learning and memory in Alzheimeric model of animals has been proved. Reduced acetylcholine due to increased activity of acetylcholine esterase is one of the main symptoms of Alzheimer's disease. This research was accomplished in order to evaluate the anti-acetylcholine esterase activity of the aqueous extract of lavender. Meanwhile, the toxic effect of the herbal medicine on hepatic HepG2 cell line was considered.Materials and Methods: The dried flowers of lavender were mixed with boiled water and then evaporated. In this experimental study the acetylcholine esterase inhibitory activity of lavender was assessed using Ellman’s colorimetric method in 96 well microplates at 405 nm. Also the toxicity effect of lavender was evaluated on HepG2 cell line.Results: Comparing the results taken from the treated and untreated solutions showed that the aqueous extract of lavender did not affect efficiently the acetylcholine esterase inhibitory activity. Also the microscopic evaluation of the HepG2 cells indicated no granulation of the treated cells compared with the untreated cells; confirming that the aqueous extract of lavender has no toxic effect on the HepG2 cell line.Conclusion: The aqueous extract of lavender is not affected impressively the acetylcholine esterase activity and also is not toxic to the hepatic cells.

Introduction: Embryonic period is the most sensitive stage of the human life in confronting with taken material by mother. The goal of this study was to evaluate the overdose effect of folic acid on days 8-9-10 gestation on the pancreatic tissue.Materials and Methods: Twenty pregnant mice were equally divided into four groups. The control group received no injection. The sham group received distilled water injection and experimental groups received folic acid in doses of 0.45 mg (1 experimental group = E1) and 0.6 mg (2 experimental group = E2) intra peritoneally on days 8, 9 and 10 of gestation.Results: No significant differences were found in morphological and histological abnormalities among control, sham and experimental groups. The crown-rump length and weight of the fetuses in the E1 group was significantly increased compared to control group. Morphometric studies of the pancreatic tissue of fetuses revealed the mean area of the pancreas in E1 group which had an insignificance increase in compression with control group. Percent of the connective tissue, in E2 group, was no significantly increased compared to control group. On the other hand, the percent of the parenchyma in E2 group was no significantly decreased compared to control group. The percent of the islets of Langerhans in E2 group was significantly increased. Percent of Acini in E2 group, significantly decreased compared to control group.Conclusion: It seems that administration of extract of folic acid to pregnant mice cause histological and histomorphometrical changes in the development pancreatic tissue. Therefore, it is recommended to consume this vitamin during pregnancy carefully and also prescribing by a physician.

Introduction: Postpartum weight retention plays an important role in the development of obesity and its associated health risks in women. The objective of this study was to determine the postpartum weight retention rate and its relationship with postpartum depression.Materials and Methods: An analytical study performed on 309 women, 6 months after childbirth. Data was collected by self-constructed demographic/obstetric characteristics questionnaires and Edinburgh postnatal depression scale.Results: At six months after child birth 83.5% of the women did not achieve pre-pregnancy weight and the average retained weight was 4.04 kg. Forty five point five percent of women faced substantial postpartum weight retention (≥5 kg). Eighteen point one percent of women were at risk of postpartum depression. Based on logistic regression analysis, inadequate sleep (P<o.oo1) and lack of postpartum care (P<0.04) had important role in causing depression. There was no significant difference between the mean weight retention in depressed and non-depressed women.Conclusion: The results of this research highlight the importance of postpartum weight retention and its role in women’s health. Due to the high levels of postpartum weight retention, the need for specific educational programs about postpartum weight management by healthcare providers is crucial.

Introduction: This study aimed to investigate the effects of eight weeks intensive resistance training combined with the ginger supplement on body composition, waist to hip ratio (WHR) and boday mass index (BMI) in obese women.Materials and Methods: Participants were 18 women (with an average age of 30.11 ± 06.45 years, weight 82.46±12.40 kg, BMI 31.60±03.99 kg per square meter). The participants were split into resistance training + daily Ginger supplements (n=10) and resistance training + placebo (n=8) group randomly. All groups performed high intensity resistance training for eight weeks, three sessions per week (totally 24 sessions). Resistance training per session includes 8 exercise with upper-lower orders and 80-85 percent of 1RM, three set with 20 s rest intervals. Before and after the eight-week training, the examiner administered a protocol to assess body composition using Bioelectrical Impedance BOCAX1. The supplementation group consumed capsules containing ginger supplement (Zintoma Manufacturing Co. Goldaroo) 1000 mg per day in the morning and evening after meal and placebo group received 500 mg of starch in gelatin capsules similar to ginger supplementation in a double blind way. The participants used supplements twice a day (morning and afternoon) after their meals.Results: Comparison of changes in different variables showed that only reductions in weight and fat mass were significantly different between groups. The placebo group had more reduction in their weight and fat mass while ginger plus group showed less reduction. In both groups, other variables showed reductions too but the changes did not reach the significance level (0.05<p).Conclusion: It seems that resistance training alone can have more positive effect compared to resistance training plus ginger supplements capsule. Perhaps long-term use of ginger supplements or changes in its usage level combined with resistance training even repetition of the present study in a larger group may provide different results. Future studies can take a fresh look to resistance exercise and herbal supplements in different demographic groups to see their effects.

Introduction: Many nursing students have clinical work while studying full-time. The nurses, who work in clinical wards with these students, encountered some challenges. The purpose of this qualitative study was to explain the nurses' perceptions of work during studying challenges.Materials and Methods: This qualitative study was conducted in four teaching hospitals of Hormozgan University of Medical Sciences. Individualized deep and semi-structured interviews and field notes were used for data collection. The interviews were written verbatim to provide feedback for the next interview and the adequacy of the data. Data were analyzed using qualitative inductive content analysis with phases of open coding, creating categories and abstraction.Results: In this study, 45 graduate nurse and head nurse aged 23 to 40 years were participated. In this way, 695 initial codes were extracted, and finaly, after the reduction, elimination and integration took place at different stages; themes of physical and mental health problems, educational problems, professional problems and underdevelopment were extracted.Conclusion: In the perspective of nurses, students work creates some challenges for students who have not peyed attention to these challenges and may interfere with patient care and threaten patient safety and professional values.

Introduction: Despite growing knowledge about pain assessment and intervention, neonatal infant pain remains a challenge to neonatal care providers because these infants cannot speak and advocate for themselves. The aim of this study was to explore the effective factors in the implementation of neonatal pain management from of nurse’s perspectives in NICU.Materials and Methods: In this qualitative study, a content analysis approach was used. Participants consisted of 25 nurses working in neonatal intensive care unit of Alavi hospital in Ardabil, North east of Iran. Data were collected using four focus group discussions and were analyzed using conventional content analysis.Results: The results of the data analysis eventually led to the creation of two abstract themes that were effective for pain management. The two themes “Individual Factors” and “Organizational Factors” were introduced. First theme contains categories of “Knowledge of the personnel” and “Attitude of the personnel” and the second theme include “Policy of pain control”, “Working conditions of nurse” and “Management performance”.Conclusion: The findings of this research indicate that the implementation of neonatal pain management has been affected by the problems and obstacles that are not a priority in the field of study about pain management Therefore; there is a need for strategies to reduce or remove these barriers.

Introduction: Many evidences show the association between genital warts and cancer. By identifying the related risk factors, in addition to prevention, timely detection of cancer can be taken. Due to its prevalence in the population, the present study was done to determine the risk factors associated with genital warts in men in Semnan, Iran.Materials and Methods: This case-control study was done on <15 years of old men referred to general and specialized clinics at Fatemieh hospital in Semnn in 2013. Case group was included of 70 incident patients newly diagnosed by a medical specialist in the dermatology clinic while 280 people were randomely selected of who referred to other clinics as control group. Age, age at first intercourse, marital status, level of education, number of sexual partners in the last 6 months, cigarette and alcohol consumption, condom use and new sexual partner were considered as risk factors of interest.Results: Except for age and smoking, the other factors examined in the study had shown association with the disease. Having new sexual partner was the most associated factor with the disease in term of odds ratio (OR=3.21; 95% CI: 1.69 to 6.08; P<0.001). Number of sexual partners and the level of education (P<0.001), as well as the age at first sexual contact (P=0.001) in case group was significantly higher than the control group. The percentage of married and alcohol consumers in the case group was higher (p<0.05) while condom use was lower in the case group (P=0.03).Conclusion: According to the results having a new sexual partner can be considered as the most important risk factor for genital warts. The observed association between the uses of alcohol with increasing of the odds of disease can be justified by more sexual contacts and partners of these people. The married men with a higher education level can be considered as more vulnerable men to the disease. According to the above and the observed association between older age at first intercourse with increases of the odds of the disease, early marriage and fidelity are the most important preventive measures can be obtained suggested from this study.

Introduction: Rate of speech as a supra-segmental feature, directly affects the speech fluency and Intelligibility. Studies have shown some factors such as gender, age, living place, and accent can influence on speaking rate. So, it is important to consider norms of each language during assessment and diagnosis. Since studies to determine the standards for speaking rate is very limited in Farsi language, this survey was done to compare speaking rate and articulation rate in young and elderly Farsi speakers who live in Tehran city.Materials and Methods: 52 young and elderly men and women participated in this cross sectional study and convenience sampling approach was used for this selection. Two different speaking samples were recorded for each participant including a reading text sample and a 3 minute spontaneous speech sample. Speaking rate was determined and articulation rate in reading and spontaneous speech were considered after excluding filled and empty pauses.Results: The highest rate belonged to articulation during speaking, articulation during reading and spontaneous speech respectively. Both of speaking rate and articulation rates were significantly less in elderly than youth and also more in men than women.Conclusion: Age, gender and task affect on speaking rate. Hence, such factors are important to be considered by speech and language pathologists during diagnosing and assessing the fluency problems.

Introduction: Depression and anxiety are the most common psychiatric disorders. In this account, the aim of this study was to investigate the comparison of aerobic and anaerobic exercise effect on depression and anxiety in students.Materials and Methods: In this study, 120 male students were randomly divided into 3 groups of 40, including the first group to do 3 aerobic exercise sessions of 60 minutes per week for 8 weeks. The second group was trained in anaerobic exercise, whereas the third one as the control group of non-exercising subjects gets involved in no intervention/interference. Afterwards, the groups were checked in the terms of anxiety and depression by STAL and Beak depression inventory.Results: The results showed that mean changes before and after the intervention in depression with exercise 7.23±8.81, 5.89±7.75 in anaerobic training group and the control group 1.23±4.73 which the difference was significant (p=0.001). So that, the aerobic group (p=0.001) and also in anaerobic (p=0.012) more than the control group, but the difference was not significant in aerobic and anaerobic groups (p=0.725). The mean change in anxiety before and after the intervention in the aerobic exercise 8.45±8.81, 8.05±8.07 in anaerobic training group and the control group was 2.15±8.32 which is a significant difference and it was (p=0.600). The amount of anxiety in the group with aerobic exercise (003.0=p) and the anaerobic group (006.0=p) was significantly more than the control group, but the amount decreased in both groups with aerobic exercise and aerobic (975.0=p) were not significantly different.Conclusion: Overall, study findings indicate that aerobic exercise and anaerobic exercise for eight weeks resulted in a significant reduction in depression and anxiety, and the most significant differences were observed in training method. So, aerobic and anaerobic exercises are recommended to reduce the depression and anxiety.

Introduction: Breast cancer is the second most common cancer worldwide and the most common cancer among women and notably the fourth leading cause of death worldwide. Overweight and obesity are two main risk factors which have been proven the creation of breast cancer after menopause. Therefore, this study aimed to investigate the relationship between anthropometric and body composition in pre-menopausal and post-menopausal breast cancer risk.Materials and Methods: In this case-control study, 88 patients with breast cancer (n=48 pre-menopausal and post-menopausal 41) and 86 controls (45 premenopausal and 41 postmenopausal) who were matched by age, studied respectively. The cases, women who were admitted to Shohada Hospital recently diagnosed with breast cancer and had not chemotherapy or radiation therapy. The controls of women who were admitted to the same hospital had no history of any type of cancer or hormonal disease. The subjects were studied anthropometric indices and body composition was also measured by tanita Body Composition analyzer. For analysis the findings, chi-square and logistic regression was used.Results: In the study of case and control groups separately menopausal status, in pre-menopausal population, overweight women (BMI=24.91-29.9kg/m2) had lower odds ratio of developing breast cancer (OR=0.23 CI=0.84-0.06). In postmenopausal population with waist-to-hip ratio (0.80-0.84), WHR was significantly associated with breast cancer risk (OR=0.09 CI=0.60-0.02).Conclusion: In this study, premenopausal overweight women had lower odds ratio of developing breast cancer. High WHR was associated with breast cancer risk in postmenopausal women.

Introduction: Nursing students become responsible for many elements of nursing care. Their efforts of care generate caregiving burden. This study was conducted to determine caregiver burden and related factors in nursing students.Materials and Methods: This cross-sectional study performed by using a convenience sampling method in 2015. One hundred and thirty-three nursing student from Semnan University of Medical Sciences participated in this study. The Caregiver Burden Inventory (CBI), Demographic and Educational Status Questionnaire (DEQ) were used to assess the caregiver burden and related factors in nursing students. The range of tools to measure caregiver burden scores from 0 to 100. Spearman correlation and Chi-Square tests were used to analyze the relationship between demographic and educational factors with caregiver burden.Results: The mean scores of total caregiver burden in nursing students were 39.47±11.52. Subscale analysis on the CBI revealed that the mean scores of time dependence, developmental, physical, social and emotional burdens were respectively 8.77±3.05, 10.04±2.88, 8.37±3.86, 6.02±3.37, and 6.27±3.44. The Spearman correlation test demonstrated that having a history of patient care was significantly associated with total CBI (p=0.049). Also, there was no significant difference between other nursing student's demographic and educational status characteristics with total CBI (P>0.05).Conclusion: Caregiver burden is one of the educational problems in nursing students. Therefore, recommended that during clinical training, nursing students more supported by teachers and nursing staffs.

Introduction: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that due to destruction and deformity of the joints, is associated with physical disability, mental problems and reduced quality of life of patients. Several therapeutic advantages for fasting are mentioned in recent studies and islamic references. One of these advantages is decreasing the severity of auto-immune diseases. This study was performed with the aim of evaluating the effect of fasting on quality of life, physical disability, disease activity and depression in RA patients.Materials and Methods: In this prospective study, 25 eligible women with RA were participated in the study. Quality of life (SF-36), physical disability (HAQ), disease activity (DAS-28) and Beck Depression Inventory (BDI) questionnaires were completed for patients in four sessions in days zero (before Ramadan), 30, 60 and 90. Analysis were performed with SPSS-16 statistical software using a general linear model with repeated measure and Bonferroni adjustment for the subsequent comparisons. The significance level of 5% was considered for the test.Results: Mean age ± SD of the 25 participating patients was 43.8 ± 11.2. Changes in the quality of life (p=0.002) and the depression scores (p=0.029) during the study were statistically significant and relatively stable. While changes in other indicators showed a numerical improvement of the situation immediately after Ramadan (day 30) comparing to what it was before, but these changes were not statistically significant and were not stable during the time.Conclusion: This study confirmed the relationship between fasting and improvement of quality of life and the level of depression in patients with RA. Due to the side effects of the common drugs, more detailed studies is recommended to use fasting as a complementary method in order to reduce the dosage of drugs and symptoms of patients.

Introduction: Frailty models were utilized in survival models to take into account created heterogeneity and dependence between experimental units. Parametric and semi-parametric methods are considered for estimation of parameters in frailty models. In parametric frailty models, to frailty and baseline hazard, a parametric distribution is assumed, while the distribution for baseline hazard function is not considered in semi-parametric methods. Besides, the parameters using EM algorithm or penalized likelihood are estimated in the mentioned methods. The purpose of this study is the comparison of parametric and semi-parametric methods in frailty models.Materials and Methods: Two hundred thirteen of the warfare victims that treated with dental implants during 2000 to 2010 were enrolled in this study. In order to investigation effective factors in survival of the dental implants placement, frailty models are fitted. Parameters are estimated using the three methods, parametric approach, semi- parametric using EM algorithm and Semi parametric using penalized likelihood. Statistical analysis was carried out using Frailtypack package in R software version 3.3.1.Results: Estimation of the semi parametric using penalized likelihood approach is contained a smaller magnitude of AIC as compared to parametric and semi-parametric approach of EM algorithm. Smoking and implant length are significant factors on survival implants (p<0.05).Conclusion: In survival analysis using frailty models made more valid results in order to consider depending between survival times of experimental units. The penalized likelihood method has a better fit in order to estimate parameters in the frailty models.

Introduction: Achieving an adequate level of sedation for patients who receive mechanical ventilation is a big critical care challenge. This study aimed to determine the effect of sedation guideline on the duration of mechanical ventilation and length of stay in intensive care unit (ICU) patients.Materials and Methods: This clinical trial study was conducted in an ICU located in Isfahan, Iran, from September 2012 to February 2103. A sedation guideline was developed based on the recent 10 years existing literatures as well as the recommendations of the practicing anesthesiologists and nurses. Coresspondingly, fifty patients who had undergone abdominal surgery with vertical incision and were receiving mechanical ventilation were recruited by convenience sampling method and divided to treatment (guideline) and control (routine) groups. At first, twenty five patients (need to sedation based on Richmond scale) were sedated by using the routine sedation method. The remaining 25 patients were treated by sedation guideline. The two groups were compared in terms of duration of mechanical ventilation and length of stay in ICU. Data collection tools were include patients’ demographic characteristics questionnaire, APACHE II, Richmond scale, the dose of administered sedatives, the duration of mechanical ventilation and length of ICU stay.Results: About 76% of the participants were male. The mean of the participants’ age was 53.3. The mean of mechanical ventilation duration in the control group was significantly different from the treatment group (220.80±91.4 vs. 116.4±96.4 hours; P value <0.001). Moreover, the implementation of the developed sedation guideline decreased the length of staying in ICU by 8.6 days.Conclusion: In patients receiving mechanical ventilation and requiring sedative, the use of sedation guideline decreases the duration of mechanical ventilation and the length of ICU stay. Hence, it is recommended using this guideline by nurses in patient sedation.

Introduction: Family caregivers of hemodialysis patients faced with multiple problems in the fieldes of care and treatment which lead to the reducing their life quality. However, so far no intervention found for improving their life quality. Therefore, this study aimed to examine the effectiveness of problem-focused coping strategies on the quality of life in family caregivers of hemodialysis patients.Materials and Methods: This study is a randomized controlled clinical trial that was conducted on caregivers of hemodialysis patients referred to Shahid Hasheminejad hospital in Tehran, 2015. The caregivers were allocated into intervention and control groups, randomly. The intervention group received four training sessions on problem-focused coping strategies during two weeks. The data was collected using the SF-36 quality of life questionnaire before and after intervention.Results: The results showed that the quality of life in the intervention group increased at the end of study and significant difference was found between the mean scores of life quality of the intervention group, before and after the intervention (45.95±14.94 vs.63.51±11.55, P<0.001). However, no significant difference was found between the mean scores of life quality of the control group before and after intervention (45.08±11.02 vs. 41.74±10.51, P=0.039).Conclusion: Problem-focused coping skills can improve the life quality in caregivers of hemodialysis patient's .Therefore, it is recommended to the health system menager to encourage their staffs to provide coping skills training.

Introduction: There is some evidence indicating that nutritional status of elderly has a significant impact on their physical health, but its relationship with their mood, especially depression, requires careful and systemic consideration. The aim of this study was to determine the relationship between nutritional status and depression in elderly people.Materials and Methods: In this descriptive cross-sectional study, 260 elderly individuals from the city of Semnan (Iran) were enrolled in 2015, with considering the inclusion and exclusion criteria. The data collection tool was questionnaire scales that briefly assess the demographic and nutritional status with mini nutritional assessment (MNA) and depression with geriatric depression scale (GDS(.Results: Results indicated that 5.8% (n=15) had malnutrition, 53.1% (n=138) were at the risk of malnutrition and the other 41.2% (n=107) were normal. Also 21.9% (n=57) were at severe depression (20-30), 34.2% (n=89) had mild depression (10-19) and the other seniors 43.8% (n=114) were not depressed. Remarkably, there was a significant negative correlation (R=-0.594, P<0.001) between the healthy nutritional status and the depression.Conclusion: The finding showed that more than half of the elderly people in Semnan were at risk of malnutrition. The association of nutritional status with depression was significant in the elderly. The identification and basic planning are needed to revise and improve the nutritional status of this important group with vulnerable mental status.

Introduction: The approach and function of students can consider as a basis for future intervention in order to improve and enhance their attitude and function. So, this study purposed to detect the attitude and function of university students to research process in Semnan University of medical sciences.Materials and Methods: A cross sectional study was designed to measure the attitude and function of 190 students of Semnan University of medical sciences (Seman, Iran) toward the research process. Data were gathered by a Likert handmade questionnaire with 27 items. Finally, data were analyzed by descriptive and inferential statistics.Results: Results showed 60 percent of students were interested to research process. The students’ attitude was positive to following items: “promoting science by research in human world”, “meaning of research as integrating factor of past experience with science for a better future”, and “scientific research as a complementary for learning”. The most practice of students was related to items such as: “accompanying with teachers in research projects”, “presence in scientific congress or seminars”, and “membership in the student research center and research methodology workshops”. Also, least students’ function was related to items such as “paper publication in scientific journals”, “participation in research, and “as a main researcher in research projects".Conclusion: In regards of interesting of students to research process, holding classes of research methodology, collaboration of faculty members with students, and removing limitations to research acivities, can change the attitude and of students.

Introduction: Nurses are confronted continuously with pain, suffering, injuries, deaths and experience high job stress in their workplace. The aim of this study was to evaluate the effect of lavender oil inhalation on nurses' job stress.Materials and Methods: In this clinical trial study, 78 nurses who working in social security hospitals in 2015 were selected by convenience method. In this way, nurses were selected with randomized block in two groups, lavender and control. Participants were used lavender or sesame oil for two hours in the early hours of shifts and during four weeks. Job stress were determined and compared in both groups before the intervention, as well as the second and fourth weeks by 34 Gry- Taft Anderson job stress questionnaire. Data were analyzed and compared by descriptive- analytical statistics.Results: The mean of nurses' job stress had 87.09±17.41 job stress and had no significant difference in both groups at the end of the second week of aromatherapy (P=0.304), but this difference was significant at the end of the fourth week (P=0.003).The results showed that after four weeks using lavender essential oil with a mean of 8.89 ± 2.38 than to the first stage, it has been effective in reducing job stress (P=0.002). Aromatherapy had no effect in the control group (P<0.21).Conclusion: The use of lavender for more than two weeks can be effective in reducing job stress. Therefore, the use of scent as a useful method, recommended in nursing environments.

Introduction: Improving the respiratory function of patients for weaning Mechanical Ventilation (MV) is one of the caring challenges in critical care settings. The aim of this study was to eamine the effect of sensory stimulation on respiratory function of patients with MV.Materials and Methods: This pilot study is a quasi-experimental study that performed on 30 patients undergoing MV which selected with available sampling in intensive care units in Kashan. After recording demographic parameters and physiologic variables, sensory stimulation program was performed for 25 minutes in the morning by companion of the patient. Then respiratory and physiologic parameters of patients were measured immediately and one hour after intervention.Results: Findings showed that mean age of patients were 57.1±19.5 years and mean of days for MV was 5.7±4.4 days. In the most of patients (66.6%) MV was used because of respiratory failure. Sensory stimulation was significantly increased respiratory rate, minute ventilation, heart rate, oxygen saturation and systolic blood pressure (P<0.05), but did not change tidal volume, lung compliance and peak of inspiratory pressure (P>0.05). Notably, the respiratory and physiologic parameters were declined one hour after the sensory stimulation.Conclusion: Sensory stimulation could be use for driving respiratory center in patients undergoing MV but did not affect on weaning indices. We suggested more study to evaluation the sensory stimulation on preparation of patients with MV for weaning in a long time

Introduction: Stroke is one of the most important neurological diseases that annually causes death and long-term disability in patients in the world. The incidence of motor impairment in the upper extremity and hand as a result of stroke as compared to the lower extremity are more prevalent and less recovery. This pilot study was performed to Investigate of upper extremity and hand muscular power in patients with stroke.Materials and Methods: In a descriptive-analytical study, 36 patients with stroke were investigated, in internal medicine ward of Kowsar hospital in Semnan. Sampling method was easy, available, and purposeful. In the study, the section of upper extremity and hand assessment of Fugl-Meyer scale were used to measure the upper extremity motor function and also hand dynamometer were used to measure hand muscular power.Results: In this study, the mean score of affected upper extremity motor function in stroke patients was 8.2±8.73, mean score of affected hand motor function was 5.3±5.6, and mean of affected hand muscular power was 2.64±3.8. No significant relationship between demographic variables and affected upper extremity, hand motor function score and affected hand grip power of subjects were observed.Conclusion: The results of the study showed that upper extremity motor function and hand muscular power in patients with stroke was reduced considerably. Due to the high prevalence of this motor impairment after stroke and its consequences, health care personnel should design appropriate care and rehabilitation programs to more control these damages.

Introduction: Lack of adequate information related to disease and self- care after discharge leads to poor self-care, readmissions and low quality of life for patients. This study aimed to investigate the effect of training and post discharge follow-up on self- care behavior of patients with ischemic heart disease.Materials and Methods: In this single blind randomized clinical control trial study (2015), 90 patients with ischemic heart disease hospitalized at Cardiac Care Units and were divided in 1 control group and 2 intervention groups by Block random allocation method. Control group received only usual training for discharge. One intervention group received usual post discharge training and call follow- up for 1 month. Another intervention group received complete training package and comprehensive follow-up for 1 month. Valid and reliable Miller self-care behavior tool for patients with cardiovascular diseases were used for data collection. They were completed at discharge day, 15 and 30 days after discharge for each patient.Results: In complete training package group with comprehensive follow-up, means of self-care score were 60.2±13.6, 87.6± 6.5 and 86.9±8.9 at discharge day, 15 and 30 day, respectively. Means of self-care score in usual post discharge training and call follow up were 64.7±19, 82.9±8.6 and 80.9±9.5 at discharge day, 15 and 30 days, respectively. In control group, means of score were 69.6±10.7, 82.6±6.2 and 78±10.8 at discharge day, 15 and 30 days, respectively.Conclusion: Results showed that self-care score was increased following 15 days and was decreased after 30 days. This reduction was subtle in the group receiving comprehensive training package with follow-up and reflects the impact of this program on the continuation of self-care.

Introduction: Scoring systems are considered as a guideline for caring personnel in intensive care units (ICU) to evaluate patients’ status or estimate recovery chance. Nine Equivalents of Nursing Manpower Use Score (NEMS) is one of these systems. Considerably, the credits of obtained scores of NEMS in different days after patients’ admission or deciding about current status of patients according to previous scores of NEMS are not clear properly. So, this study was performed to evaluate the mean alteration trends and credit of Nine Equivalents of NEMS in internal patients’ admission in intensive care units.Materials and Methods: In a descriptive-prospective study, the information of 156 patients that admitted in critical care units of Edalatian hospital of Mashhad city, were calculated and recorded until 7 days according to demographic questionnaire and NEMS. A purposeful sampling method was adopted and all eligible patients were included. Then using the ROC curve, the validity of daily NEMS scores of patients were demonstrated.Results: The curve of mean alteration trends of NEMS of expired patients was increased and for discharged patients was decreased during seven days of admission in ICU. Also, the ROC curve showed that with increasing duration of hospital stay, NEMS ability to diagnosis of critically ill patients was improved.Conclusion: The credit of NEMS increases with duration of hospital staying. So, it is suggested when using the NEMS, the scores of final days of hospitalization in ICU be considered more seriously.

Introduction: Taking care of people with Alzheimer’s disease is a stressful task and home caregivers of such patients are posed to anxiety, physical and mental exhaustion, as well as losing their caregiving performance. This study was conducted to determine the effect of spiritual care in reducing anxiety in caregivers of the elderly with Alzheimer's disease.Materials and Methods: This work is an experimental study, where 60 home caregivers of the elderly with Alzheimer's disease were selected in Rafsanjan using the convenience sampling method. Next, based on the inclusion criteria for the study, they were randomly assigned into two test and control groups. Relativly, the data were collected using demographic forms and Beck anxiety inventory before and after the intervention. Then, the spiritual care was provided for intervention group within five 45-60 minute sessions each week while the control group received no intervention.Results: The average of pre-intervention anxiety scores in the intervention and control groups was 14.04 and 13.71, respectively. The independent statistical t-test showed no significant difference between these two groups before intervention (P=0.907). The mean post-intervention score of anxiety in the intervention and control groups was calculated as 7.92 and 13.85, respectively. In comparison, the statistical independent t-test showed a significant difference between these two groups after intervention (P=0.028).Conclusion: Spiritual care can reduce anxiety in home caregivers of the elderly with Alzheimer's disease. Thus, it is recommended for all caregivers.

Introduction: Despite the development of hospitals in recent years, there is a gap between the number of hospital beds in our country and standard number of hospital beds, and they are faced with increased workload. The aim of this study is to explain the role of counseling centers and nursing services in reducing the workload of hospitals.Materials and Methods: This study was conducted using qualitative method. The main research participants were managers of counseling and nursing care services Centers. Purposive and theoretical sampling was used in this study. In total, 26 managers of various centers and institutions providing health care services, physicians, and clients were interviewed. Data were analyzed using content analysis.Results: The final research findings emerged on three main themes "outpatient care of patients at home", "decreased care coverage of acute patients at home", "limited cooperation in the care of hospitalized patients" with several subcategories.Conclusion: Providing community-based services, particularly providing care for critically ill patients hospitalized at home has been reduced in recent years, and large part of this care is transferred again to the hospital. Therefore, it is necessary to revise the executive programs to develop interactive work and regulated the relationship between counseling and nursing care services Centers and hospitals.

Introduction: One of the main causes of cancer related deaths among women are gynecological cancers. According to the variety of geographical distribution of gynecological cancers, understanding the epidemiologic pattern of cancers in an area can help us to develop series of educational, therapeutic, and research programs which are responsive to the requirments of that specific region. Current study was performed to determine status of the epidemiological-histopathological of gynecological cancers in Semnan (Iran) from 2001 to 2009.Materials and Methods: In this descriptive and retrospective study, the incidences of gynecological cancers among the samples were sent to Pathobiology Center of Kowsar Hospital (Semnan, Iran) during the years 2001-2009 and was assessed based on the available data.Results: Among the samples we resent to Pathobiology Center of Kowsar Hospital of Semnan from 2001 to 2009, 8420 cases were related to gynecological system. Among those, 64 cases were suffering from gynecological cancer, 29 cases (45.3%) were suffering from uterine body cancer, 24 cases (37.5%) were suffering from ovarian cancer, 10 cases (15.6%) were suffering from cervical cancer and 1 case was suffering from (1.6%) vulve cancer. The most common type of cancer in the uterus was endometrial adenocarcinoma, in ovary was serocyst-adenocarcinoma and in cervix as well as vulve was squamous cell carcinoma. There was no meaningful correlation between age and different kinds of cancers. (p=0.622).Conclusion: In the present study we found that among gynecologic cancers, uterine cancer is the most common cancer. Ovarian, cervical and vulve cancers are the second, third and fourth most common types. It is required to improve the knowledge level of women on risk factors, screening methods and the setting priorities for prevention of gynecological cancers, particularly ovarian and uterine body cancers which indeed require systematic planning and effective measures.

Introduction: In spite of improvement in quality of life after heart transplantation, this procedure can cause some new challenges and problems for heart recipients. Identifying these problems can help to the increasing numbers of these patients. This study was done with the aim of exploring challenges of living after heart transplantation in Iranian heart recipients.Materials and Methods: This study was done with content analyzing approach. We used purposive sampling methods with 12 heart transplant recipients that were referred to one of the active heart transplantation hospitals in Tehran. We used semi-structured interview until data saturation ensured. All interviews was recorded and transcript verbatim and analyzed with deductive content analysis method.Results: Three major themes emerged form data analysis, which explore challenges of living with transplanted heart. Meaningly, these themes were “buckle with post-transplant issues” with four category: derangement in personal functions, difficulty of follow up treatment, transplantation complications and being under pressure of drugs, “Continuing family involvement” with three category: psychological tension, financial hardship and physical consequences and “interaction with donor and their family” with two category: engagement with donor and new relationship with donor family that depicted full challenges life after heart transplantation.Conclusion: Findings of this study showed that heart transplant recipients in Iran experiences few challenges related to their personal life, about their families and about donor and donor's family that necessitate giving support and counseling from health care providers.