2026-08-08T14:00:07+03:30 http://jccs.yums.ac.ir/browse.php?mag_id=6&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 2021 2 1 K. Nedaei Z. Salehi B. Alipoor M. Jafarzadeh M. Aljamal mohammad.aljamal@aaup.edu M. Zoladl Introduction: Retinoblastoma (RB) is a malignant retinal tumor, which affects infants and children. This cancer happens through a mutation in the retinoblastoma tumor suppressor genes (RB1). Inactivation of RB1 has been observed in more than 97% of all retinoblastoma patients with mutations. In recent years, RB treatment has developed significantly. RB's treatment methods can be one or a combination of the following treatments, including chemotherapy, non-ionizing, or ionizing radiation. This article aimed to review each treatment method's role and its effectiveness in the treatment of RB. Several articles from 2004 to 2020 were reviewed in PubMed, Web of Science, Google Scholar, and Scopus, based on the RB treatments, of which 73 were selected for this study. Conclusion: It can be concluded that ionizing and non-ionizing radiation play an important role in treating retinoblastoma. It was also shown that a combination of radiation treatments is more effective than traditional therapeutic methods. Ionized and non-Ionized radiations can be used as an effective treatment to cure retinoblastoma. Retinoblastoma Treatment RB1 Gene Ionizing Radiation Non-Ionizing Radiation 2021 1 01 1 8 http://jccs.yums.ac.ir/article-1-76-en.pdf 10.52547/jccs.2.1.1

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 1 P. Rad N. Zahmatkeshan nasrin.zahmatkeshan@yums.ac.ir H. Delaviz E. Enanat Aims: Active and progressive resistance training has a key role in functional recovery and quality of life in patients with MS. Therefore, this study aimed to investigate the effects of isotonic and isometric exercises on balance and ability in patients with MS. Materials & Methods: In this randomized clinical trial, 60 patients with MS admitted to MS Special Diseases Center in Yasuj during 2016-2018 were selected by convenience sampling method and randomly divided into two equal groups of isotonic and isometric exercise. The expanded Disability Status Scale (EDSS) and the Berg Balance Scale (BBS) were used to measure the disability and balance status. Each exercise was performed 3 days per week for 8 weeks. Both groups were evaluated before intervention and on days 28 and 56 of treatment. Findings: 28 and 56 days after treatment, the mean scores of BBS increased, and the mean scores of EDSS decreased in both groups; such that the increase in the BBS score was significant on day 56 after treatment compared to the pretest in the isometric group (p<0.05). Also, the mean scores of EDSS decreased significantly on day 56 after treatment (p<0.05) compared to the pretest in the isotonic group and on days 28 (p<0.05) and 56 (p<0.01) after treatment compared to the pretest in the isometric group. Conclusion: Eight weeks of isotonic and isometric exercise are an effective treatment for MS patients without any advantage of one type of exercise over another.   Multiple Sclerosis Balance Disability Exercise 2021 1 01 9 13 http://jccs.yums.ac.ir/article-1-88-en.pdf 10.52547/jccs.2.1.9

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 1 M. Pouzesh M. Nakhaee Moghadam M. Davoodi davoodi.ma@gmail.com Aims: Preterm labor (PTL) is one of the most important medical community problems and the main cause of infant morbidity and mortality after congenital anomalies. Several studies have shown a significant association between the abnormal levels of quadruple test with PTL. However, there is no general agreement on the value of quadruple tests for predicting complications among studies. This study aimed to determine the diagnostic accuracy of maternal serum biochemical markers (HCG, AFP, UE3, and Inhibin A) in the second trimester of pregnancy and their effect on PTL. Methods & Methods: This longitudinal study was performed on 240 pregnant women who underwent quad-marker testing in the second trimester of pregnancy in Yasuj in 2019. Pregnancy and labor information was followed up and recorded in a checklist. Also, ROC (Receiver Operative Characteristics) was used to determine the test efficiency in PTL and the optimum point with the highest sensitivity and specificity. All analyses were performed using SPSS 22 software. Findings: 19 pregnant mothers (7.9%) had PTL. The best amount of AFP to detect PTL with a sensitivity of 72% and a specificity of 68% was estimated at 1.515. The best values of Inhibin A and HCG were also estimated at 1.245 and 0.885, respectively. Conclusion: Of the quadruple tests, three AFP tests, HCG and inhibin, effectively diagnose PTL during pregnancy.   Preterm labor Second trimester Gonadotropin AFP Inhibin A 2021 1 01 15 19 http://jccs.yums.ac.ir/article-1-87-en.pdf 10.52547/jccs.2.1.15

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 1 M. Salari salarimo@yums.ac.ir A. Zarifi R.A. Tarmizi Aims: The present study aimed to investigate the effects of Problem based Learning strategies on communication skills in pediatric nursing learning among undergraduate nursing students. Materials & Methods: This quasi-experimental study with a nonequivalent control group posttest-only design was conducted on undergraduate nursing students in Kohgiluyeh-Boyer Ahmad province. The sampling method was multistage cluster sampling. The total sample size was 95 in different classes of Traditional Problem Based Learning (TPBL=30), Hybrid Problem Based Learning (HPBL=30), and Conventional Teaching and Learning (COTL=35). The experiment was conducted over eight weeks, during which the participants met one two-hour session and two two-hour sessions each week. The three groups were compared for their communication skills at the end of the instruction. Data were collected using the Bayer-Fetzer Kalamazoo communication skill checklist and analyzed by one-way ANOVA and Tukey's post hock test. Findings: There was a statistically significant difference in the mean scores of communication skills for the three groups evaluated by the simulated patient (p=0.001) and the researcher (p=0.001). TPBL and HPBL instructional strategies enhanced students’ communication skills more than COTL. Conclusion: TPBL and HPBL instructional strategies are more effective than COTL, and PBL can be useful where there are shortages of instructors or faculty members to teach PBL groups in a large classroom setting.   Problem-Based Learning Communication Pediatric Nursing Learning 2021 1 01 21 27 http://jccs.yums.ac.ir/article-1-86-en.pdf 10.52547/jccs.2.1.21

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 1 H. Sadeghi M. Alamdari S. Hasanzadeh sajadhasanzadeh@yahoo.com S. Jokar E. Panahi Kokhedan J. Malekzadeh R. Abassi Aims: Constipation is an important problem and dysfunction of the digestive system. In the traditional beliefs of different parts of the world, especially Iran, Rosa damascene Mill. has several properties, including sedative, anti-inflammatory, anti-seizure, anti-depressant, and laxative effects. This study aimed to evaluate the effect of hydroalcoholic extract of Rosa damascene Mill. in treating chronic constipation in adults. Materials & Methods: This randomized clinical trial was performed in 2018 in Shahid Mofteh Specialized Clinic of Yasouj on 160 patients with chronic constipation referred to internal medicine and gastroenterologists. Extracted hydroalcoholic extract of Rosa damascene Mill. and lactulose syrup was used; The control group received 20cc of lactulose syrup twice a day, and the intervention group received a hydroalcoholic extract of Rosa damascene Mill. two times a day in the form of 500mg capsules twice a day for one month. Data were analyzed using SPSS 19 software and T and chi-square tests with 95% confidence interval. Findings: During the intervention process, 16 people did not refer to the necessary follow-up, and the necessary information was collected from 144 patients with chronic constipation. Sixty-eight patients (4.2%) were male, and 76 (52.8%) were female. The mean age of patients was 43.18±13.67, and the age range was 18 to 75 years. There was no statistically significant difference between the two groups' mean age and sex under Rosa damascene Mill.'s intervention. Hydroalcoholic extract and lactulose (p<0.05). Also, there was no statistically significant difference between the variables of frequency and ease of defecation between the two groups receiving lactulose and Rosa damascene Mill. hydroalcoholic extract before and after the intervention (p<0.05). Conclusion: Hydroalcoholic extract of Rosa damascene Mill. has a similar effect to lactulose in the treatment of chronic constipation in adults.   Chronic Constipation Hydroalcoholic Extract of Rosa damascene Mill Lactulose 2021 1 01 29 34 http://jccs.yums.ac.ir/article-1-67-en.pdf 10.52547/jccs.2.1.29

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 1 L. Manzouri manzourileila@gmail.com S. Parhizkar S. Amiri Aims: Breast cancer with known risk factors and preventive factors is one of the most important health concerns and the most common cancer among women worldwide. This study was conducted to assess breast cancer risk factors and protective factors in women aged 20-69 years in Yasuj, Iran. Instruments & Methods: In this descriptive cross-sectional study, a total of 492 women aged 20-69 years were selected through systematic random sampling method. Data were collected through a demographic checklist and a checklist of potential and proven risk factors and protective factors based on textbooks and the Up To Date web site. Data analysis was performed by SPSS 16 software using descriptive statistics. Findings: The most common risk factors were overweight (41.1%), obesity (27.2%), and exposure to smoking (27.6%). Among the probably protective factors, the most frequent were breastfeeding for at least 16 months (83.5%), then the number of pregnancy≥5 (33.5%), and normal BMI after menopausal (18.5%). Conclusion: The most common risk factors and protective factors are modifiable and related to the lifestyles.   Breast Cancer Risk Factors Protective Factors Iran 2021 1 01 35 39 http://jccs.yums.ac.ir/article-1-91-en.pdf 10.52547/jccs.2.1.35

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 1 z. Daneshyar M. Shokripour shokripurm@sums.ac.ir Introduction: Fibroepithelial stromal polyp (FESP) of the female lower genital tract is a rare benign lesion characterized by polypoid proliferation of stroma, covered by a benign squamous epithelium in the vulvovaginal region. These hormone-sensitive lesions usually occur in young to middle-aged women. The lesions are typically no larger than 5 cm in diameter and are found randomly during routine gynecologic examinations. Patient Information: The case of this study was an 88-year-old man with a solitary polypoid lesion measuring 3×2×2 in the low back area showing the histological appearances of those described in the vulvovaginal region. It was a well-circumscribed gray-brown lesion covered by wrinkled skin. Histopathological examination revealed edematous hypocellular lesion at low magnification with hyperplastic squamous epithelium coating with reactive epithelial change. At high magnification, the lesion consisted of bland-appearing spindle and stellate-shaped cells in an edematous and fibrous stroma with a large number of variably-sized blood vessels. Immunohistochemistry showed the lesional cells to be focally immunoreactive for EMA and negative for CD34, SMA in stromal cells. Conclusion: FESPs is an uncommon benign lesion that can occur in men and areas other than the genitals with independence from female sex hormones. Although this is a benign finding, reporting it will increase the knowledge about this rare tumor.   Polyp Skin Back Fibroepithelial 2021 1 01 41 43 http://jccs.yums.ac.ir/article-1-89-en.pdf 10.52547/jccs.2.1.41

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 1 S.M. Rabani rabani.smr@yums.ac.ir A. Mousavizadeh S. Rabani Aims: Renal vascular clamping during partial nephrectomy can lead to renal ischemia and kidney damage due to reperfusion injuries, but a surgical technique without any ischemia can eliminate such unwanted effects on kidney function. The present study aimed to demonstrate the feasibility of partial nephrectomy in conditions where the renal artery is ready to be clamped. Patient Information: In this case series study, 24 eligible patients with small solitary renal masses were included in the study between 2013 and 2018. The option of surgery was open partial nephrectomy. During the time corresponding to the hilar clamping in standard techniques, the renal artery was exposed and ready for clamping if needed, and in this situation, resecting the mass was carried out. Findings: The mean tumor resection time was 22.08±2.50 minutes, and the mean procedure time was 92.00±4.60 minutes. Clear cell renal cell carcinoma was seen in 19 patients, papillary renal cell carcinoma in 3, and oncocytoma in 2 patients. There was no positive surgical margin in specimens with cancer. Lower pole, mid zone, and upper pole masses were observed in 14, 2, and 8 cases, respectively. Conclusion: Although this technique can potentially be a dangerous procedure, in a situation in which the renal artery is well exposed and ready to be controlled, especially when the tumor is in Polar Regions, the mass resection can be safely done without any type of ischemia. Therefore, this procedure can be suggested as a viable one in comparison with other related procedures.   Kidney Neoplasm Nephrectomy Ischemia 2021 1 01 45 49 http://jccs.yums.ac.ir/article-1-74-en.pdf 10.52547/jccs.2.1.45