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R. Safaeian, Sh. Shaeghi,
Volume 8, Issue 23 (6-2001)
Volume 8, Issue 23 (6-2001)
Abstract
For evaluating the safety of pediatric anesthesia in an outpatient setting, 100 cases were selected by covenient sampling method in Mofid children hospital. Informations about postoperative complications (during 24h) were gathered by telephone interview.
Most of patients were in the 1-4years age group(55%), 4-8years, 1 month to 1 year, above 8years and below 1 month. were situated respectively. Four surgical procedures of inguinal hernia, hydrocele, circumcision and ectopy of testis consist 73% of all the surgeries. Ninety eight Percent of the surgeries were performed under general anesthesia. In these patients, 25% received narcotics, and in 42% regional block were combined with general anesthesia. Fifteen Percent of the patients were intubated. Complications that occurred at home were pain and restlessness (29%, most common), Nausea and vomiting (17%), sleep disturbances (11%), fever (7%), Anorexia (6%), Urinary retension (5.3%), hoarsness 4% and cough 3%.
A Afkham Ebrahimi, M Nasr Esfahani, N Saghafi, ,
Volume 11, Issue 41 (9-2004)
Volume 11, Issue 41 (9-2004)
Abstract
The aim of this study was to determine the expectations of the patients and their satisfaction with their treating physician and health services. 375 outpatients from different day clinics of Hazrat Rasoul Akram Hospital were sampled by proportional sampling and the “Patients’ Request Form” which measured three different expecations(explantion, emotional support and investigation and treatment)was administered. A satisfaction questionnaire which addressed patients’ compliance to medical advices and their general level of satisfaction was also administered. The findings were then transferred to SPSS for further analysis. The results which were upon four hypothesis showed a significant difference among the expectations(emotional support and the investigation and treatment) of the patients of the different clinics. Moreover, there was a significant correlation between patients’ satisfaction and the fulfillment of “explanation” request. Also, a positive and significant relationship was found between satisfaction and adherence to medical prescriptions and change of the physician. In conclusion, physicians’ knowledge of the patients’ expectations and the factors affecting their satisfaction improve the patient-doctor relationship and the quality of health care which is the end goal of health system.
F Fakour, M Falahati, F Zaini, N Mousavi Nasab,
Volume 11, Issue 41 (9-2004)
Volume 11, Issue 41 (9-2004)
Abstract
Diabetes mellitus is the most common endocrine disease. Because of defect in immunity system of diabetic patients, these patients often experienece frequent infections just related to increase in blood suger level. This study was conducted to study the candiduria level in diabetic patients of Zanjan, their colony count along with determining candida species as compared to healthy individuals. In this study, samples were taken from urine of 227 diabetic patients with strict sterile and standard techniques during an 8 month period. Then, direct microscopy and culture as well as colony count and complementary tests for identification of yeasts species was conducted on them and they were compared to those of healthy individuals. The data were analyzed by chi-squared test and t-test. Of 227 urine samples in target group, candiduria was observed in 31 cases(13.65%), and of 226 sampels in control group, it was observed in 11 cases(4/9%). In target patients, candida glabrata(62.5%), candida albicans(28.12%), candida krusei(6.25%) and cryptococcus albidus(3.12%) were the most common organisms extracted from the urine. In contrast, the isolated yeast organisms in control group included: candida albicans(54.54%), candida glabrata(27.3%), candida krusei(9.09%) and candida kefyr(9.09%). Frequency of candida glabrata was observered especially in urine including 150-500mg/dl levels of glucose(32.25%). Through this study it was found that candiduria in diabetic patients was closely related to the level of glucosuria(P=0.02). In addition, the yeast colony count in this study was not significantly different from normal controls(P=.11). It is concluded that in diabetic patients with good glucose control, the percentage of candiduria will be low and similar to healthy individuals.
L.m Jouybari, S.f Haghdoost Oskouee, F Ahmadi,
Volume 12, Issue 45 (6-2005)
Volume 12, Issue 45 (6-2005)
Abstract
Patients’ comfort is an integral part of nursing care and a valued outcome of nursing actions. This article is part of a larger study which aimed to explore patients’ experiences and perceptions of comfort and discomfort. A qualitative approach using grounded theory was adopted. Data was collected via semi-structured interviews and participants’ observations. A purposive sample of 31 medical-surgical patients, and also 10 relatives who were subjected to questions and constant comparative analysis were selected from 5 educational health centers. Data analysis uncovered a number of themes. The theme of patients’ perceptions and experiences with nurses is the subject of this paper. The other four themes of a comforting nurse were: availability, monitoring, humanistic approach and providing physical comfort. The findings of this study help nurses to know the patients and their needs better and also to find what comfort means to them. Consequently, nurses can plan, imply and evaluate nursing interventions most appropriately.
M Samiee, F Davachi, R Ghorbani,
Volume 12, Issue 45 (6-2005)
Volume 12, Issue 45 (6-2005)
Abstract
Angiotensin converting enzyme (ACE) drugs like captopril are proposed as a resistant factor against the effect of erythropoietin. As these groups are used as a choice to treat hypertension, so conducting more studies with regard to their effects on erythropoietin efficacy is important. This interventional study was performed on 19 patients with chronic hemodialysis. Patients were divided into two groups 9 cases received the low dose captopril (6.25% mg/daily) and 10 cases received high dose (25mg/TDS). None of the patients had any acute inflammatory or infectious process, iron deficiency and other causes of anemia at the time of study. They were followed for 3 months and their hematocrit was measured before intervention at the end of the first, the second and the third months. Erythropoietin dose was constant during 3 months. To analyse the data, Wilcoxon and Mann-Whitney tests were used with the significant level of 5%. The mean of hematocrit changes in patients with low dose captopril was 1.1 in the first month with standard deviation (SD) of 3.07 (P=0.325), in the second month 1.46 with SD of 3.42 (P=0.27) and in the third month was 0.9 with SD of 4.44 (P=0.495). None of the changes was statistically significant. The mean of changes in cases with high dose captopril was 1.45 in the first month with SD of 3.76 (P=0.26), in the second month 1.40 with SD of 4.76 (P=0.528) and in the third month was 0.87 with SD of 4.79 (P=0.838). In this group, none of the changes was statistically significant. In conclusion, it seems captopril with high and low doses of treatment does not reduce hematocrit in the hemodialysis patients receiving the synthetic erythropoietin.
Gh Shah Hosseini, E Ebrahimi Takamjani, H Saeedi, B Haji Aghaee,
Volume 12, Issue 46 (9-2005)
Volume 12, Issue 46 (9-2005)
Abstract
Below knee amputation, which is noticed as one of the most common lower extremity amputations, is caused as a result of various factors like trauma, disease, or congenital limb deficiencies. In order to take these amputees back to daily life, below knee prostheses are used as an alternate to original limb. Comfort and patients’ satisfaction with prostheses are directly related to each prosthesis socket, and socket composing design itself is associted with various casting techniques. The main objective of this study was to compare the patients’ satisfaction with sockets made by three casting techniques including weight-bearing, air-pressure, and elastic stockinet casting techniques. Other aims of this study were to detect the relationship between dimensional measures of three made sockets and patients’ satisfaction, to find out the effect of various casting techniques and socket dimensional changes on patients’ satisfaction and, finally, to offer correct techniques for optimizing the prosthesis making process. Ten, over 20-year-old below knee amputees with unilateral amputation who referred to technical orthopedic clinic at least one year after their amputation were selected in a nonrandom manner. Subsequently, casting was performed through three different techniques and positive casts were provided. Sockets made by lamination technique were then connected to other components made below knee prostheses by the help of which patients walked with and declared their level of satisfaction. In addition, positive casts were measured in order to be compared with each other. In descriptive statistics, including comparison between average dimensional casts measures and levels of satisfaction, variables showed significant differences. However, in analytical statistics, data were analysized via Pierson correlative statistical test. The relationship between distal anterior-posterior socket diameter and the level of patient satisfaction in weight-bearing casting technique was 0.58 which was so closed to 0.60 (the significant base of chart), but they had a converse relationship. Relation between socket volume and the level of satisfaction in weight-bearing technique, with 0.70, was conversely significant, and also in air-pressure technique, with 0.66, was directly significant. The relationship between socket height and level of satisfaction in air-pressure casting, with 0.69, was significant and direct. Despite low differences between levels of satisfaction in various casting techniques, air-pressure casting technique had higher level of satisfaction than the other two techniques. Based on the obtained hypotheses, patients were more satisfied with more voluminous and higher sockets.
Gh.r Anaraki Mohammadi, A.r Sadeghipour, P Vossough, I Nour Mohammadi, A.m Mirnateghi,
Volume 12, Issue 47 (12-2005)
Volume 12, Issue 47 (12-2005)
Abstract
Background & Objective: Human T-Lymphotropic Virus type 1(HTLV-1) is a human retrovirus which has been known to cause Adult T-Cell Leukemia/Lymphoma(ATLL), HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis(HAM/TSP) and some other inflammatory disorders. One of the important pathways of transmission of this infection is transfusion of blood and its products. This study was designed to find seroepidemiologic prevalence of HTLV-1 infection in thalassemic patients with frequent blood transfusion and compare it between male and female population in Tehran province.
Method: This cross-sectional epidemiologic study was performed on 175 cases including 101 males and 74 females. Serum samples were screened for Anti HTLV by using ELISA method. The positive samples of screening test were serotyped and confirmed by Western Blot analysis. Results were analyzed by using subjective statistical parameters and compared between males and females by Chi Square test.
Results: Prevalence of Anti HTLV-1 was 6.3% in our studied patients, including 6.9% in males and 5.4% in females. This study revealed no significant statistical difference in Anti HTLV-1 prevalence between males and females but showed that prevalence of HTLV-1 infection correlated with increasing age and numbers of received blood units. Also by using ROC curves, the age 21 was defined as an indicator for increasing risk of HTLV-1 infection in our study.
Conclusion: With respect to the high prevalence of Anti HTLV-1 in the studied population, it can be expected that prevalence of HTLV-1 infection in blood donor population in Tehran would be considerable.
A. Afkham Ebrahimi, M.f. Ghale Bandi,, M Salehi,, A.r. Kafian Tafti,, Y. Vakili,, E. Akhlaghi Farsi,,
Volume 15, Issue 0 (6-2008)
Volume 15, Issue 0 (6-2008)
Abstract
Background & Aim: Almost any medical illness that causes significant pain or discomfort may negatively affect the quality of sleep. Illnesses affecting cardiovascular, respiratory, gastrointestinal, and nervous systems and injuries disrupt the quality of sleep. The objective of this study is to investigate the parameters of sleep and the factors affecting the quality of sleep in medically ill patients. Patients and Method: In a descriptive cross-sectional study, a total of 300 medical patients with various somatic complaints who attended internal, ENT, orthopedic, neurology, urology and surgery clinics were selected. The assessment instrument was Pittsburgh Sleep Quality Index(PSQI) which measures the quality of sleep in 7 major domains. A score of >5 is considered as a significant sleep disturbance. The data were analyzed using descriptive statistics and one-way ANOVA. Results: The mean PSQI score of the patients from all six selected clinics was higher than anchor point(M=8.02). Significant differences were found in sleep duration, sleep disturbances and daytime dysfunction among the clinics. Pain and worry were the major causes of sleep disturbances. Conclusion: Based on the findings of this study, the majority of medical conditions can cause sleep disturbances per se. Because pain and worry may adversely affect the quality of sleep, they should be considered in the assessment and treatment of various medical conditions.
Shila Jalalpoor, Sina Mobasherizadeh,
Volume 18, Issue 85 (7-2011)
Volume 18, Issue 85 (7-2011)
Abstract
Background: Urinary Tract Infection (UTI) is the second most common infection in human. Most of UTIs are due to Escherichia coli ( E.coli) and Klebsiella pneumoniae ( K.pneumoniae) . These bacteria are relevant opportunistic pathogens that account for nosocomial infections. Prevalence of Extended-Spectrum Beta-lactamase (ESBLs) in pathogenic bacteria leads to antibiotic resistance and mortality and morbidity in patients. The best method for controlling strains that produce ESBLs is use of standard method for recognizing ESBLs producer strains. The objective of this study was to evaluate and compare the frequency of ESBLs in Escherichia coli and Klebsiella pneumoniae strains isolated from hospitalized and out-patient with urinary tract infection in selective centers from Esfahan.
Methods: The research was of descriptive type and performed in Al-zahra, Shariaty, and Kashany hospitals and Reference and Mahdieh laboratories during 2009-2010 in Isfahan. According to statistical formula 378 UTI samples were randomly selected . Bacterial identification was performed with microbiological methods and ESBLs production was performed with screening and confirmatory test. For data analysis, Chi square test and Whonet 5.4 software was used.
Results: From 378 samples, 167 bacteria were from hospitalized cases and 211 bacteria were from out-patient samples. Frequency of E.coli in hospitalized and out-patients was respectively 52% and 64% and frequency of K.pneumoniae in hospitalized and out-patient was respectively 64% and 22%. Frequency of ESBLs in E.coli strains in hospitalized and out-patient was respectively 58% and 17% and frequency of ESBLs in K.pneumoniae strains in hospitalized and out-patient was respectively 64% and 22%.
Conclusion : The results showed high rate of nosocomial UTI and high frequency of ESBLs in isolated bacteria from hospitalized cases as compared to out-patients that represent high incidence of antibiotic resistant strains in hospitals.
Nafiseh Mohebi, Mansoureh Mamarabadi, Mehdi Moghaddasi,
Volume 19, Issue 105 (3-2013)
Volume 19, Issue 105 (3-2013)
Abstract
Background: Multiple sclerosis (MS) is the
most prevalent central nervous system demyelinating disease. There are known
risk factors for MS. However, there is uncertainty in its protective factors.
Few studies have demonstrated that some chronic infections may have protective
effects on this disease. We carried this study to investigate the relation
between Helicobacter pylori (HP) infection and the prevalence and
severity of MS.
Methods: In this case-control study, 163
MS patients and 150 sex- and age- matched controls were included. Blood samples
for IgG and IgM anti HP antibodies were collected from all individuals. Also
the Expanded Disability Status Scale (EDSS) was used to evaluate the MS
patients. Suitable statistical analysis was applied.
Results: A significant difference was
observed in seropositivity between these two groups. (p<0.001), but no
significant difference was seen in seropositivity between conventional and
opticospinal MS (p=0.522). No significant difference was observed in
seropositivity among ages (p=0.075) and between genders (p=0.204). A
significant difference was seen in EDSS value between seropositive and
seronegative patients (p=0.017).
Conclusion: We concluded that patients with
HP infection had lower incidence of multiple sclerosis and MS patients with HP
infection showed lower neurologic complications, which can demonstrate that HP
infection may have a protective influence on MS pathogenesis.
Neda Haghighat, Ali Rostami, Shahryar Eghtesadi, Farzad Shidfar, Iraj Heidari, Aghafatemeh Hoseini,
Volume 20, Issue 113 (11-2013)
Volume 20, Issue 113 (11-2013)
Abstract
Background: Chocolates
and other cocoa products, as a none-pharmacologic treatment get attention due
to their lowering blood pressure activity. The purpose of this study was to
determine the effects of 8 weeks consumption of 25 gr dark chocolate (450
mg/day polyphenols) on glycemic control and blood pressure in hypertensive
diabetic patients.
Methods: This clinical
trial was conducted on 69 hypertensive diabetic patients who were randomly
assigned in two (intervention and control) groups. Groups (n=25) received 25 gr
dark chocolate (450mg/day polyphenols) or similar amounts of White chocolate.
Blood samples of patients were collected to measure Fasting Blood Glucose
(FBS), fasting insulin and HbA1c level.
Physical activity levels and nutrients intake were evaluated before and after
intervention and were compared between the groups.
Results: At the end of the study, intervention
group had significantly lower systolic and diastolic blood pressure (p< 0.001) than control group. FBS, HbA1c, systolic and diastolic blood
pressure declined significantly in intervention group during the trial.
Conclusions: These data
suggest that polyphenols rich in dark chocolate may improve blood pressure and
glycemic control in hypertensive diabetic patients.
, , ,
Volume 22, Issue 132 (6-2015)
Volume 22, Issue 132 (6-2015)
Abstract
Background: One of the treatments in patients with dangerous
diseases particularly heart failure, is Implantable Cardioverter Defibrillator
(ICD) that is used to prevent sudden cardiac death. Regarding to the
superiority of ICD rather than medical treatment, the purpose of this study is
the assessment of time-dependent effective factors on the rates of entered
shocks to patients with ICD.
Methods: In this paper, we studied heart patients in Ghaem
Hospital of Mashhad from 2005 to the first half of 2008. For various clinical
reasons, ICD has been improvised for these patients. The QRS duration was
measured by a digital caliper with an accuracy of a thousandth of a millimeter
before we implanted ICD. Moreover, age of patients and type of ICD for each
patient were recorded. Finally, we analyzed data set by a survival
semiparametric statistical model through R statistical software.
Results: For these patients, all mentioned variables had
time-varying effects. Age, had an additive effect on the entered shocks by this
device in all patients over time. Type of ICD has both an additive effect in
the period of time and depressive effect in another period. Also QRS influences
the shocks induced by ICD with gentle slope.
Conclusion: For a specified patient, based on three explanatory variables,
the introduced model could be used in reinforcement of correct diagnosis in
installation of ICD. The single chamber type of ICD, entered less inappropriate
shocks to the heart of patients than the two
other types of ICD i.e CRTD and two chamber.
Majid Mahmoud Alilou, Mosayeb Yarmohammadi Vasel, Ahmad Bayat, Seyed Esmaeel Hosseini,
Volume 22, Issue 139 (1-2016)
Volume 22, Issue 139 (1-2016)
Abstract
Background: Nowadays psychological well-being is one of the important subjects in the studies of chronic diseases. Cardiovascular diseases are directly due to some wrong behaviors of people, their psychological traits, stress and anxiety. The aim of this study was to study and describe the psychological well-being components of heart patients referred to Ekbatan hospital of Hamedan.
Methods: Method of research is survey and its type is descriptive. 82 heart patients of Ekbatan hospital of Hamedan were selected with available sampling method. Subjects completed Ryff Psychological Well-Being Scale. The data was analyzed using SPSS-16, descriptive statistical methods and Manova method.
Results: Findings indicated that mean of psychological well-being in heart patients is 257.5 and mean of personal growth, purpose in life, environmental mastery, self-acceptance, autonomy and positive relations with others are 45.085, 44.866, 44.537, 45.33, 47.733 and 50.5, in order. Also, there was statistically significant difference between psychological well-being components in men and women (p< 0.05); while, there was no statistically significant difference between age and education in association with psychological well-being components (p> 0.05).
Conclusion: Psychological well-being of heart patients of Hamedan is relatively average or low. We can say that psychological well-being of these patients, in comparison with healthy people, is remarkably low. Psychological well-being of men and women patients was different, but considering age and education there was no difference in psychological well-being of heart patients. Thus, we cannot predict psychological well-being based on the basis of age and education.
Doctor Mahshid Talebi-Taher, Doctor Tahereh Naimi, Doctor Nasrin Shayanfar, Doctor Marzieh Nojomi, Doctor Mitra Barati,
Volume 23, Issue 143 (5-2016)
Volume 23, Issue 143 (5-2016)
Abstract
Background: Candiduria is known as the most frequent nosocomial fungal infection. The aim of this study was to determine the frequency of candiduria in ICUs patients in a teaching hospital.
Methods: In a retrospective descriptive cross sectional study, 500 hospitalized patients in four ICUs in Rasoul-e-Akram hospital were studied.
Results: Mean age was 62±19.6 years and candiduria was confirmed in 69 (13.8%) patients with 40 (58%) men and 29 (42%) women. Risk factors of candiduria were age, duration of staying at hospital and ICU, long term catheterization, use of antibiotics and corticosteroids. This study didn’t confirm the association of candiduria with diabetes mellitus.
Conclusion: The frequency of candiduria in ICU patients can be decreased by shortening the duration of admission at ICU, urinary catheterization, avoiding long duration of antibiotics and corticosteroid
, Doctor Maryam Niksolat, Doctor Sara Minaeian, Doctor Niloofar Khodabandelou, Doctor Zhaleh Zandieh,
Volume 24, Issue 156 (6-2017)
Volume 24, Issue 156 (6-2017)
Abstract
Background: Urinary tract infections (UITs) are the most common hospital-acquired infections and elderly people hospitalized in the intensive care unit (ICU) are highly susceptible to this infection. In this study, according to the hypothesis that probiotic organisms may represent a safe and effective intervention for control purposes infection, the role of a probiotic consists of four strains of Lactobacillus in the prevention of UITs in elderly patients hospitalized in the ICU were studied.
Methods: A randomized, double-blind, placebo-controlled study was conducted on 50 elderly patients admitted to ICUs. Patients in addition to conventional treatment, received randomly either probiotics contained 107 × 5 CFU viable lyophilized bacteria consisting of 4 strains of Lactobacillus (Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus Gasser and Lactobacillus Plantarm) or placebo, twice a day for seven days. At baseline and on the fourteenth day of the study, two groups in terms of the level of CRP, urine culture test results and leukocyturia were compared. Acute Physiology and Chronic Health Evaluation (APACHE II) score and survival status at follow-up one-month also were measured.
Results: Probiotics could significantly reduce the number of leukocyturia (p=0.002) and a positive urine culture (p=0.002) in the probiotic group compared to placebo. The use of probiotics had no significant effect on the levels of CRP. Despite the reduction in APACHE II score and lower mortality rates in the probiotic group compared to the placebo group, these differences were not statistically significant.
Conclusion: Probiotics can significantly prevent UITs in elderly patients hospitalized in the ICU. Administering probiotics led to changes in the urinary tract microflora and reduced the colonization of pathogens. Therefore, probiotics can be considered as an adjunctive therapy in critically ill elderly patients.
Shahnaz Olyan Ajam, Alireza Ghasemizad, Abbas Gholtash,
Volume 26, Issue 5 (8-2019)
Volume 26, Issue 5 (8-2019)
Abstract
Background: Patient’s education is one of the standards of the quality of care and a factor affecting the cost, recovery and treatment of the patient. Considering the importance of patient’s education in hospitals, the present study aimed at designing the patient’s instruction model in a hospital through process-based model.
Methods: The present study was qualitative and based on the grounded theory. The statistical society included nurses, department heads and education employees who were chosen purposefully. The interview was conducted in the form of open and deep questions. The interview was conducted in the form of open and deep questions. The participants included 12 clinical nurses, 5 department heads and 3 education experts. Data was analyzed using open-axial-selective coding method. The methods of credibility, transportability, reliability and verifiability were used for certifying the data.
Results: The components of the patient's education process included the assessment of need for education, index development, process identification, educational planning, material provision, resources, educational equipment, training program conducting, process monitoring, training effectiveness, process improvement and corrective actions. The patient’s education process began with the assessment of need for education and was followed up to process monitoring.
Conclusion: To succeed in patient’s instruction in hospitals, a systematic approach is needed. Process-based education is a regular and transparent, verifiable and evaluable method; a process that continues to promote and improve. This method requires the identification of educational needs, educational planning, conducting of educational programs and the evaluation of the educational process.
Ali Sobhani Firuzabadi, Nahid Kianmehr, Amir Davoodabadi Farahani, Azam Sameii, Anousheh Haghighi,
Volume 26, Issue 12 (2-2020)
Volume 26, Issue 12 (2-2020)
Abstract
Background: Musculoskeletal problems include motor movement constraints in hemodialysis patients, which affects their quality of life. Ultrasonography is currently used to evaluate superficial tendons and ligaments attached to the joint. The aim of this study was to determine the frequency and Achilles tendon’s changes as an example of tendon involvement in patients with renal failure under regular hemodialysis using ultrasound examination and its related factors.
Methods: This case-control study was performed among healthy individuals and patients referred to hemodialysis unit in dialysis unit of Rasoul Akram hospital in a period of one year (from April 2017 to April 2018). The inclusion criteria were end stage renal disease (ESRD) and regular hemodialysis for at least 6 months three times a week and 4 hours each session. Patients were excluded from the study because of systemic inflammatory disease, such as rheumatoid arthritis, systemic lupus erythematosus as the cause of renal failure, previous trauma and bone fracture, TB disease. The control group was selected among healthy volunteers. An ultrasound evaluation was performed using probes with dynamic and linear array scanners with a frequency of 12 MHz.
Results: Thirty patients and 30 healthy subjects were enrolled. In the ultrasonography of the tendon in patients, the median and proximal areas of the right and left Achilles were compared in two groups. The ultrasonic indexes of the different parts of the Achilles tendon were higher in the patients than healthy subjects. Of course, this difference was statistically significant only in the left Achilles proximal area. In general, the elastography of left and right Achilles tendon was lower in the healthy group. There was no correlation between the mean elastography of right and left Achilles tendon with age and PTH in participant groups.
Conclusion: Finally, the findings from the study showed that in the patients’ group, the thickness and area of Achilles tendon and left ventricle were higher than the control group. Also, evaluation of elastography indices showed tenderness of elasticity of tendon in dialysis patients compared to healthy subjects.
Mona Alipour Shahir, Atena Esfahani Khaleghi, Mehdi Arabzadeh, Bahareh Alipour Shahir,
Volume 28, Issue 3 (5-2021)
Volume 28, Issue 3 (5-2021)
Abstract
Background & Aims: Cardiovascular disease is considered one of the most important causes of mortality in many countries of the world. Cardiovascular disease causes physical and psychological complications for these patients. Their quality of life is usually reduced under the influence of simultaneous feelings of depression, anxiety, anger and stress (12). Stress has been shown to affect a wide range of cognitive and non-cognitive skills. It has been shown to impair memory, cognitive and executive functions, and to affect risk-taking behavior, which in turn impacts important day-to-day decisions. Prolonged stress can lead to both physical health problems (e.g., heart disease, high blood pressure, diabetes) and mental health problems (e.g., depression or anxiety), although the effects are not always clear (34). There is a lot of evidence associated with the psychological, physical and emotional implications associated with heart failure in patients. In addition, the family of cardiovascular patients who have the responsibility to take care of them also have many problems (13). Positive psychology is a new advent approach in psychology that addresses the happiness and well-being of individuals. This approach tries to use people's abilities and capacities to increase people's lives in the face of events and disadvantages, and increase their satisfaction with life (31). In recent years, the fields of preventive cardiology and positive psychology have both set ambitious goals that go beyond simply reducing risk of disease to include increasing healthy longevity, improving quality of life, preserving good mental health (32). The relationship of mindfulness with the pathological variables such as stress and health variables like adjustment ability and emotional functioning,psychological well-being, and emotional, psychological and social wellbeing have been well illustrated. Other variables that are significant in the field of health and positive psychology are the concept of happiness tha is composed of cognitive and emotional components (31). Happiness promotes activity and initiative, but no indication for negative effects on creativity. Last but not least, happiness is positive for health; happy people live longer (33). and Hope increases the ability to cope with problems. Hope is an important adaptation mechanism in chronic diseases including cardiovascular disease (10). Mindfulness reduces negative thoughts and increases mental and physical health (16). Mindfulness means maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment, through a gentle, nurturing lens (14). Mindfulness training, which are more concerned with the development of focus attention., could be associated with significant improvements in selective and executive attention. This mental state allows one to experience thoughts and feelings in a way that emphasizes their subjectivity and transient nature. Mindfulness has been associated with increased health outcomes. Mindfulness therapy and medical care together are effective methods for treating cardiovascular patients. According to recent research, mindfulness, reduces physical problems and psychological disorders and increases happiness, hope and quality of life (12, 10). Recently, due to the development of chronic physical and psychological disorders the mindfulness and lifestyle have been drawn into attention. But there are few empirical research on these subjects and most research has been performed on recognition of the therapeutic effects of mind-consciousness. Therefore, The purpose of this study was to determine the effectiveness of mindfulness on stress, happiness and Hope in cardiovascular patients.
Methods: According to the purpose, this study is applied. In this study which was a Quasi-Experimental with per-test, post-test with the control group, the sample group was selected by available sampling method from all cardiovascular patients referred to Shahid Rajaei Heart Hospital and Shariati Hospital in Karaj. Therefore, 40 cardiovascular patients were chosen and assigned to Experimental and control groups. To assess the severity of Stress, Dass-21 test was used, happiness Oxford OHI and Hope was measured by Snyder Hope Questionnaire. The experimental group received 10 90-minute mindfulness training sessions. After training, Dass-21, Oxford OHI and Snyder Hope were used again for both experimental and control groups.
Results: Data were analyzed by SPSS 22 and the results of ANCOVA showed that There was a significant difference between groups regarding stress, happiness and Hope. Mindfulness has been able to reduce stress, and increase happiness and Hope of participants in the experimental group. According to the results, 72.2% of stress changes, 72% of happiness changes and 86% of Hope changes in the experimental group were related to the impact of mindfulness The results showed that mindfulness training has been effective in reducing stress mindfulness, improving happiness and Hope in cardiovascular patients.
Conclusion: The results showed that mindfulness training has been effective in reducing stress, improving happiness and Hope in cardiovascular patients. mindfulness meditation techniques as they are empowering and teach skills individuals can use on their own to control depression and other health problems. It has been associated with enhanced emotional regulation It can be defined as bringing non-evaluative awareness to one’s inner and outer environment and then focusing attention on a limited range of experience (29). Mindfulness training focuses on attention to moment-by-moment experience and consists of routine exercises such as bringing the mind’s attention to the present (for example, by focusing attention on one’s breathing or on what one is eating). These techniques are seen as ideal training to improve self-control, perhaps because most of the exercises focus on training the ability to inhibit one’s impulses (34). mindfulness may decrease stress and mood dysfunction-related psycho physiologic activation by strengthening positive reappraisal and emotion regulation skills. Mindfulness has helped patients to understand the events without distortion and judgment. Mindfulness, in general, through ultra-consciousness, delaying conceptual processing and separating a person from cognitive events can be effective in improving lifestyle (22). Happiness through better assessment of individual skills and more positive life events than negative events, interpersonal skills, Optimism, hope and a positive look at life can motivate and empower people to lead a healthier lifestyle, better manage stress and a sense of responsibility for health (31). Joyful people usually evaluate their skills better than others and remind positive events more than negative ones and make better decisions in their life In other words, mind-consciousness can create positive changes in happiness and psychological well-being. Therefore, Mindfulness can improve cardiovascular Patients stress, happiness and Hope.
Erfaneh Movahedi, Mahdi Saberipirouz, Sedigheh Moradi, Fatemeh Golgiri, Jahanbakhsh Khamseh, Mohana Eskandari,
Volume 29, Issue 6 (9-2022)
Volume 29, Issue 6 (9-2022)
Abstract
Background & Aims: Thyroid disorders including hypothyroidism and hyperthyroidism are common condition in the world and the right diagnosis and treatment are important. Now a days screening for thyroid dysfunction recommend only in a specific situation, thus unnecessary tests could have undesirable outcomes such as improper sampling and costs related to long-term follow-up which could affect patients and health system. (5-10. Except for cases of inappropriate doing thyroid function tests, it should be noted that TSH measurement alone has a high sensitivity for the initial investigation and diagnosis of thyroid diseases (7, 10) so, in context of abnormal TSH it is necessary to measure other thyroid hormones. It is worth mentioning that in the case of hospitalized patients, thyroid laboratory disorders are more common without the presence of thyroid gland homeostasis disorder (11), which shows the necessity of paying more attention to the target population in requested examinations. Therefore, according to the importance of the subject, the present study investigated the request patterns of thyroid function tests and the logical cases of their request in Tehran's Firouzgar Hospital affiliated to Iran University of Medical Sciences, during the second 6 months of 2017. In this cross-sectional study, 484 inpatients for whom each of the Thyroid function tests was requested selected as a sample by census and included in the study. The samples included in the study were evaluated by clinical evaluation and history taking with the aim of finding the indications for thyroid test request, and if it is possible to diagnose thyroid function disorders in the next stage of the requested tests in terms of compliance with the algorithms and instructions The existing one was checked. Finally, if the laboratory tests lead to the final diagnosis, the proportionality of the requested functional test with the final diagnosis is checked.
Methods: In this study, the definition of essential thyroid tests included the patients who have a known thyroid disease based on previous history or hospital records and clinical examinations, or there is a high clinical suspicion for their thyroid disease, it is reasonable to perform TSH & T4 & T3RU or TSH & FT4 tests. SPSS version 24 software was used for statistical analysis of data.
Results: The average age of the participants in the study was 54.2 years with a standard deviation of 17 years and 59.4% were female. In total requested tests the most patients 101 (20.7%) were hospitalized in the neurology department and the least patients 2 (0.4%) were from the toxicology ward. Out of a total of 488 patients for whom thyroid tests were requested, only 259 patients were found to have a specific reason for requesting these types of tests based on the clinical records, history or clinical examination, and 99 patients (38.2%) were hypothyroid. TSH was requested for 477 patients, and the mean TSH was 3.583. Out of a total of 69 patients whose treatment status changed, 27 patients (39.1%) had an increase in the treatment dose. The most patients whom TSH was requested without indication, most cases (26.3%) were admitted to the neurology department. The most common pattern of requesting thyroid tests in people participating in our study was the combination of TSH, T3, T4. In this study, 69 patients out of 488 patients for whom thyroid tests were performed treatment was changed. Out of 194 patients who had a logical reason to request thyroid tests based on their previous history of thyroid diseases or current examination and history, only 54 patients, equivalent to 27.83%, have undergone treatment change.
Conclusion: The purpose of this study was to examine the patterns of requests for thyroid function tests and to determine the logical cases of their requests in Firozgar Hospital in a period of 6 months. Considering that hypothyroidism and hyperthyroidism have a significant prevalence in the world and also due to the high prevalence of iodine deficiency in our country, thyroid diseases are also common. Since the symptoms of thyroid diseases are mostly non-specific and shared with other diseases, it is better to avoid unnecessary sampling and related problems, including high cost, the need for long follow-up and the patient's and family's concern about the results. As a result of the tests, the measurement of thyroid function tests should be used only in reasonable cases and with a suitable pattern. There is no need to check thyroid tests in all hospitalized patients who are unrelated to thyroid diseases. In general, it seems that the measurement of thyroid tests in logical cases and with the correct pattern has positive results for the patient and health system. In the current study, thyroid tests were requested for 488 patients, compared to the study of Small et al., it can be said that the sample size of our study was slightly smaller than that study. (11) About 60% of the studied patients were women, which can indicate that thyroid tests are more common in women than in men, regardless of whether the request is reasonable or unreasonable. In terms of average age, it can be stated that thyroid tests are performed at different ages of people, although the average age in this study was 54 years, but a wide standard deviation of 17 years was also observed among patients. Regarding the frequency of unnecessary requests, T3 with 99.2%, TSH with 60.6%, and T4 with 59.4%, T3RU with 59%, and Anti TPO Ab with 38% had the highest to lowest amount respectively. It should be noted that all requests for fT3 and fT4 tests were unnecessary. In our study, the most number of cases for whom thyroid tests were requested were hospitalized in the departments of neurology, endocrinology, neurosurgery, and neurology ICU, respectively. It seems that this amount can be reduced if endocrinologists are consulted about the indication of requesting thyroid tests. The most common request patterns for thyroid function tests were TSH&T4&T3 with 69.87% and TSH&T4 with 15.57% respectively. In the study of Roti et al., the most common requested pattern with 56% was the combination of TSH, T3, T4, and for this reason, the two studies are similar (10). was requested, 27.83% of them had a change in their treatment procedure, which is higher compared to the study of Mr. Small et al., where only 2% of patients had a change in treatment (11). In our study, among the patients whose test results were in favor of changing the treatment or starting of thyroid medication or increasing the dose of drugs was the most common case with 39.1%. In this study, among patients who had a history of thyroid problems, TSH and T4 tests were reported as the most frequently performed tests among these people.
In general, based on the obtained results, it seems that requesting all thyroid indicators at the same time is a common finding. It can also be added that the unusual patterns of requesting thyroid function tests, multiple cases of requesting thyroid function tests, and the non-optimal contractual TSH threshold level cause unnecessary requests for thyroid function tests. One of the most important limitations of this type of study is that the algorithms and instructions are different in different field of medicine and the way of requesting thyroid function tests may be different between two medical specialties. Another limitation of this study is the lack of sufficient previous studies. One of the final suggestions can be the point that cases of inappropriate requests for thyroid hormones in free hormones are taken at the same time as taking total hormone levels, which are the most suitable places for intervention to reduce cases of inappropriate requests for thyroid function tests. It is also suggested that studies with a larger sample size and a longer follow-up period be conducted in the future.
Shahin Afsharpoor, Ali Pouladi Reyshahri, Moloud Keykhosrovani, Kamran Ganji,
Volume 29, Issue 9 (12-2022)
Volume 29, Issue 9 (12-2022)
Abstract
Background & Aims: Chronic diseases such as diabetes have a complex origin, slow onset, and unpredictable deterioration and recovery that requires self-care due to the long process. Diabetes, especially type 2 diabetes, is one of the major threats to human health in the 21st century. This disease is one of the global problems and the main cause of death and disability. Uncontrolled diabetes often leads to complications such as heart disease, stroke, high blood pressure, blindness, kidney disease, and amputation. Despite the cost of preventing and controlling diabetes, the number of patients is increasing every day, which seems to be a weakness in the psychological and self-care variables of these patients. Diabetes is at the heart of behavioral issues and psychological factors. And society plays a vital role in its management. Therefore, the study of psychological factors affecting this disease can be effective in controlling it. One of the most important psychological factors associated with diabetes that has been considered by researchers is the meaning of life. The meaning of life deals with the category of purpose or goals of human life in this world. A goal is a location and time that the person or other creature is looking for. Having a goal and using it among people helps them to seek the meaning of life in life. Research shows that there is a significant relationship between low hope and depressive symptoms. One of the effective treatments for people with chronic diseases is self-care. In this treatment, instead of focusing on changing people's self-esteem, people's relationship with their self-esteem changes. Self-improvement exercises emphasize relaxation, calm mind, self-compassion, and mindfulness, which will play an important role in calming the mind, reducing stress and negative spontaneous thoughts. In addition, compassion-focused therapy helps reduce clients' psychological problems by increasing internal awareness, acceptance without judgment, empathy, and constant attention to inner feelings. The effectiveness of this therapeutic approach on improving coping with stressful situations and reducing self-criticism, self-destructive thoughts, and rumination in patients has also been confirmed. Another therapeutic approach used for patients is positivist group therapy. Comparing different therapeutic interventions and finally choosing the best type of intervention based on the research results can be helpful. Among these, according to studies, the therapeutic approaches in the present study, ie positive psychotherapy due to focus on strengths and abilities on the one hand and compassion-focused treatment due to creating a sense of responsibility and self-worth on the other hand, can be effective in the field that for more certainty and to determine a stronger type of intervention in the present study, we seek to compare these interventions. In general, the results of this study can be used both theoretically and practically in medical science health centers, diabetes research centers, doctors, psychiatrists and psychologists, and scientific research centers such as universities.
Methods: The method of the present study was quasi-experimental with pre-test-post-test design with control and follow-up groups. The statistical population of the study consisted of all patients with type 2 diabetes in Bushehr in 1399, from which 45 people were selected by available sampling method and randomly in two experimental areas (15 people in each group) and The control group (15 people) was replaced. One experimental group was taught 8 sessions of the self-compassion therapy program and the second experimental group was taught 6 sessions of positive psychotherapy. The data collection included the meaning of life questionnaires of Steger et al. (2006), Hurts life expectancy (1992), and self-care behaviors of Diabetes Tobert, Hampson, and Glasgow (2000). Data were analyzed by multivariate analysis of covariance and Bonferroni post hoc test.
Results: The results showed that both self-compassion and positive psychotherapy treatment programs increase the meaning of life, life expectancy, and self-care behaviors in patients with type 2 diabetes (P<0.05).
Conclusion: The results showed that both treatments cause significant changes in the meaning of life, life expectancy, and self-care behaviors in patients with type 2 diabetes in the post-test and follow-up period and differ in the effectiveness of both. There is no intervention type. In other words, both types of treatment are beneficial for patients with diabetes. The findings will be explained below: The first finding of the study showed that both treatments increased the meaning of life in patients in the experimental groups. In this regard, it can be said that compassion itself has appropriate coping resources that help people to face the negative events of their lives. Self-compassion enhances the ability to interact with others and provides a clearer quality of dealing with emotions. Therefore, it can be said that injured people, by learning new sources of coping, can effectively and efficiently deal with the negative events of their lives and show good adaptation. Self-compassion is one of the most important components of mental health and has capabilities that people can achieve happiness and psychological well-being by learning and performing related skills. The second finding of the study showed that both treatments increased the life expectancy of patients in the experimental group. In the present explanation, it can be stated that although the presence of illness causes major psychological damage to the individual, but in the meantime, self-compassion training can act as a motivating force for the individual. Compassion in itself leads to increased social communication and reduced self-criticism, reduced rumination, reduced thought suppression, anxiety, and stress, as well as psychological balance, all of which play a key role in increasing their life expectancy. Thus, flexibility in thoughts and kindness to oneself causes people to have a realistic judgment about themselves, to analyze their functional shortcomings, and to make appropriate decisions to address them. The third finding of the study also showed that there was a significant difference between the self-care behaviors of patients in the experimental and control groups. In the present explanation, it can be stated that negative ideas and attitudes about themselves are the main part of the change, and through the treatment of compassion, individuals learn to apply new experiences that this It promotes ideas such as alternative and more adaptive burdens; adaptive adaptation to unpleasant events such as chronic illness by focusing on assessing that situation increases patients' ability to make new connections. See ideas, organize information, integrate, and come up with new solutions to problems. In other words, increasing self-compassion leads to more self-care.
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