2026-08-08T13:46:29+03:30 http://jccs.yums.ac.ir/browse.php?mag_id=22&slc_lang=en&sid=1

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 3 F. Foroozanfard H.R. Gilasi M.S. Maboodi S.A. Taghavi Aims: In the field of infertility treatments, intrauterine insemination (IUI), with or without ovulation stimulation, is considered the first line of intervention. This study aimed to assess the relationship between various factors and the rates of biochemical and clinical pregnancy following IUI treatment over a five-year period. Instrument & Methods: This cross-sectional study was conducted at Kashan, Iran, 2023. The medical records of patients diagnosed with infertility and treated with IUI at the infertility center in Kashan were reviewed. The primary outcomes were biochemical and clinical pregnancy rates, along with associated factors. Data were analyzed using the Chi-square test and independent t-tests, with statistical significance set at p≤0.05. Findings: A total of 334 patients were included in the study. The mean age of those with positive biochemical (p<0.006) and clinical pregnancy outcomes (p<0.008) was significantly lower compared to those who did not achieve pregnancy. A significant correlation was found between endometrial thickness and both biochemical (p<0.002) and clinical pregnancy rates (p<0.007). However, no significant associations were observed between the other variables and pregnancy outcomes. Conclusion: Increasing maternal age is associated with a decline in biochemical and clinical pregnancy rates. In contrast, an increase in endometrial thickness positively correlates with higher biochemical and clinical pregnancy rates. Ovarian Stimulation Pregnancy Rate Infertility Clinical Pregnancy 2024 9 01 111 116 http://jccs.yums.ac.ir/article-1-272-en.pdf 10.58209/jccs.5.3.111

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 3 N. Mirbagher Ajorpaz M. Mohammadi Z. Sadat Z. Rahemi S.M.S. Mousavi Aims: One of the frequent problems in hemodialysis patients is sleep disorders. The aim of this study was to assess the effect of Thai massage therapy on the sleep quality of hemodialysis patients. Materials & Methods: This was a randomized controlled trial conducted in Kashan in 2020. For this randomized single-blinded clinical trial study, 80 hemodialysis patients in Kashan Hemodialysis Center, Iran, were selected. Using the block randomization method, these patients were randomly assigned to intervention (n=40) and control (n=40) groups. In the intervention group, in addition to routine care for hemodialysis patients, 60-minute Thai massages were performed three times a week for a month based on the participants’ convenience for morning or afternoon massages. For the control group, only routine care was done. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the quality of sleep. Data was analyzed using the independent t-test, Chi-square, and two-way analysis of variance with repeated measures. Findings: The total sleep quality score one month after the intervention was 8.15±2.52 in the intervention group and 10.09±3.01 in the control group. The independent t-test showed a statistically significant difference between the two groups (p=0.004). Conclusion: Thai massage therapy effectively improved the participants’ quality of sleep.   Hemodialysis Sleep Quality Thai Massage 2024 9 01 117 123 http://jccs.yums.ac.ir/article-1-271-en.pdf 10.58209/jccs.5.3.117

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 3 F. Goudarzi S.F. Hekmatzadeh Aims: Cesarean section is one of the most common surgeries worldwide. Pain management and the acceleration of cesarean wound healing are important and necessary for the mother, baby, and breastfeeding. Herbal medicines with anti-inflammatory and antibacterial effects have been used in wound management and care in traditional medicine. This systematic review assessed the efficacy of herbal products used in clinical trials for cesarean wound healing. Information & Methods: In this systematic review, keywords, including “cesarean section,” “wound healing,” “herbal medicine,” “complementary medicine,” and “alternative care” were searched in PubMed, Scopus, Web of Science, Cochrane Library, and ProQuest databases. The Persian equivalents of these terms were searched in the SID and Magiran databases. The search was conducted with no time limit until April 2024. Studies published in Persian and English that investigated herbal products for the healing of cesarean section wounds were included in this study. The quality assessment of the articles was conducted using the CONSORT 2018 checklist. Data analysis was performed qualitatively and reported. Findings: Among 471 articles, eight articles assessing seven plants were investigated. Most of the studied plants improved cesarean wound healing. The results of two studies on the effect of turmeric on cesarean wound healing were consistent. Conclusion: The medicinal products prepared in all the studies are effective in cesarean wound treatment. Cesarean section Wound Healing Systematic Review Herbal Medicine 2024 9 01 125 135 http://jccs.yums.ac.ir/article-1-283-en.pdf 10.58209/jccs.5.3.125

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 3 B. Enjezab M. Zare F. Shokrirafsanjani Aims: Pain and fatigue are common in women with breast cancer. Mindfulness-based stress reduction training has shown varying results regarding pain and fatigue scores. Therefore, this study was conducted to determine the effect of mindfulness-based stress reduction intervention on pain and fatigue in women with breast cancer in Yazd, Iran. Materials & Methods: This quasi-experimental study was conducted on 56 women with breast cancer in Yazd City, Iran. Using a simple randomization method, participants were assigned to the intervention and control groups (28 patients per group). Mindfulness-based stress reduction training was conducted via WhatsApp in eight virtual sessions for the intervention group. Data were collected using an electronic demographic form and the Fatigue Severity Scale Questionnaire (FSS) and Brief Pain Inventory (BPI) before the intervention, immediately after the intervention (week eight), and four weeks after the intervention (week 12). Descriptive statistics and both parametric and nonparametric analyses were performed using SPSS 16 software. Findings: There was no significant difference in demographic and clinical characteristics between the groups. The mean fatigue score of the intervention group improved at week eight compared to the control group (p<0.001). However, there was no significant difference between the two groups in the average pain score after the intervention, although a decreasing trend was observed (p>0.05). Conclusion: MBSR training reduces fatigue in women with breast cancer, and although it decreases pain, this reduction is not significant. Mindfulness Stress Physiological Pain Fatigue 2024 9 01 137 144 http://jccs.yums.ac.ir/article-1-254-en.pdf 10.58209/jccs.5.3.137

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 3 R. Abbasi Larki A. Azad R. Jannesar L. Manzouri S. Jahanbani Aims: Concomitant Helicobacter pylori (H. pylori) infection in patients with chronic kidney disease (CKD) may increase the risk of CKD progression. Maybe the eradication of Helicobacter pylori improves the Glomerular Filtration Rate (GFR), however, there is a challenge between studies. Therefore, this study aimed to demonstrate whether eradication of this infection improves GFR in CKD patients. Materials & Methods: This is an interventional study on 270 CKD patients with GFR between 30 to 60 mL/min who were evaluated for H. pylori infection. A total of 79 patients were eligible for inclusion in the study. The patients underwent an early eradication treatment for H. pylori infection. The trend of changes in GFR was evaluated and compared in CKD patients in whom H. pylori infection was successfully eradicated (group A) to those whose infection had not been eradicated (group B) in a six-month follow-up period. Findings: A total of 49 patients with chronic kidney disease (CKD) and a positive stool antigen test for H. pylori completed the study. In Group A, which received treatment for H. pylori infection, the mean glomerular filtration rate (GFR) showed an upward trend, rising from 48.54 ± 8.66 mL/min at baseline to 49.5±14.4 mL/min at six months. However, this increase was not statistically significant (P=0.18). In contrast, Group B exhibited a downward trend in GFR over the study period, decreasing from 45.77±7.92 mL/min at baseline to 45.48±14.33 mL/min at six months, with this change also not reaching statistical significance (p=0.48). Conclusion: There is no significant difference in GFR between groups, however GFR in CKD patients with H. pylori infection eradication is increased.   Helicobacter Pylori Chronic Kidney Disease Glomerular Filtration Rate Infection Disease Eradication 2024 9 01 145 150 http://jccs.yums.ac.ir/article-1-251-en.pdf 10.58209/jccs.5.3.145

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 3 F. Rrashidpour F. Mazloomirad S.S. Khoramrooz A. Sharifi M.A. Ghatee S.R. Khosravani A. Mansourian S.A. Khosravani Aims: Klebsiella pneumoniae is a common cause of urinary tract infections (UTIs), especially in hospitals. Quinolones work by blocking bacterial DNA gyrase and topoisomerase IV, but the presence of qnr genes enables bacteria to survive despite these drugs. This study aimed to evaluate antibiotic susceptibility and the prevalence of plasmid-mediated quinolone resistance genes (qnrA, qnrB, qnrS) in these isolates. Instruments & Methods: In this descriptive, cross-sectional study, 142 K. pneumoniae isolates were collected from UTI patients at Imam Sajjad and Kosar hospitals in Yasuj and Shiraz, Iran, during 2020-2021. The disk diffusion method assessed resistance to various antibiotics, with a focus on quinolones. Multiplex PCR was used to detect qnrA, qnrB, and qnrS genes in quinolone-resistant isolates. Findings: Ciprofloxacin showed the highest resistance rate (60.6%). Sensitivity was comparatively higher for sulfamethoxazole-trimethoprim (39.4%) and nalidixic acid (39.7%). The qnrA, qnrB, and qnrS genes were found in 31.4%, 55.8%, and 10.5% of isolates, respectively. Coexistence of qnrA and qnrB occurred in 11 isolates, while qnrB and qnrS coexisted in 5 isolates. One isolate exhibited all three genes. Conclusion: The study reveals a substantial prevalence of plasmid-mediated quinolone resistance genes in K. pneumoniae isolates from UTIs in these hospitals. Klebsiella Pneumoniae Antibiotic Drug Resistance Quinolones Genes 2024 9 01 151 156 http://jccs.yums.ac.ir/article-1-284-en.pdf 10.58209/jccs.5.3.151

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 3 E. Masnavi S. Hassanzadeh K. Karimi J. Malekzadeh S.S. Khoramrooz Aims: Every year around the world, hospital infections and resistance to antibiotics lead to many complications in hospitalized patients. This study aimed to determine and compare the antibacterial effect of hydroalcoholic extract of Rosa canina plant (Rosa canina L) on Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus bacteria isolated from surgical wounds in Yasuj hospitals. Materials & Methods: In this cross-sectional study, the effect of Rosa canina L hydroalcoholic extract on 20 samples of Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus was investigated. The Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) and zone of inhibition (ZOI) of each clinical sample were investigated and compared with the standard sample. The results were statistically analyzed by SPSS 16 software. Findings: Rosa canina L hydroalcoholic extract had no antibacterial effect on Pseudomonas aeruginosa. The lowest inhibitory concentration was related to Staphylococcus aureus 125 µg/ml, Escherichia coli 325 µg/ml and Klebsiella pneumoniae 350 µg/ml, respectively. The difference in minimum MIC, MBC and ZOI between clinical and standard samples was not statistically significant. The ZOI diameter of Klebsiella pneumoniae and Escherichia coli clinical samples were equal (9.8 mm). Conclusion: The hydroalcoholic extract of Rosa canina L has a better antimicrobial effect on Staphylococcus aureus than the other 3 investigated bacteria and has no effect on Pseudomonas aeruginosa. There is no difference between the effect of the examined extract on clinical and standard samples, and the effect of this extract on different bacteria is different.   Plant Extracts Rosa Anti-Bacterial Agents Bacteria 2024 9 01 157 163 http://jccs.yums.ac.ir/article-1-264-en.pdf 10.58209/jccs.5.3.157

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 3 Sh. Ansari Damavandi D. Amirkashani M. Tagrian Isfahani Aims: Thalassemia major patients are at a heightened risk for osteopenia and osteoporosis, influenced by factors including hypogonadism. However, treatment with steroids alone has not consistently yielded substantial improvements in bone density indicators. This study aimed to evaluate the impact of bisphosphonate therapy, both with and without testosterone, on bone density indices in male patients with thalassemia major. Materials & Methods: This quasi-experimental study included 40 male patients with thalassemia major, selected through convenience sampling, and divided into four groups: 1) a hypogonadism group receiving testosterone and alendronate (HTA group), 2) a hypogonadism group receiving testosterone alone (HT group), 3) a non-hypogonadism group treated with alendronate (NHA group), and 4) a hypogonadism group that declined any treatment (H group). Bone density was evaluated using Bone Mineral Densitometry via Dual-energy X-ray absorptiometry, both before and one year after the interventions, with results compared across the groups. Data analysis was conducted using SPSS version 24, with a significance level set at p<0.05. Findings: Thirty-eight participants, with a mean age of 22.46 ± 4.64 years, completed the study. Post-intervention results showed significant improvements in Lumbar Z score (p=0.001), Hip Z score (p=0.001), and Radius Z score (p=0.005) across the four groups. One year after intervention, the HTA group demonstrated greater improvements in bone mineral density compared to the NHA and HT groups. Conclusion: Combining bisphosphonates with testosterone in thalassemia patients with hypogonadism enhances bone density more effectively than treatment with testosterone or bisphosphonates alone. Bisphosphonate Testosterone Bone Mineral Density Thalassemia 2024 9 01 165 171 http://jccs.yums.ac.ir/article-1-252-en.pdf 10.58209/jccs.5.3.165