2026-08-08T14:11:39+03:30 http://jccs.yums.ac.ir/browse.php?mag_id=7&slc_lang=en&sid=1

7-96 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 2 F. Pirayesh Z. Karimi M.A. Ghatee P. Yazdanpanah S. Razmeh S. Mohammadhossini hossini3270@yahoo.com Aims: Stroke has unforeseen and destructive effects on patients' lives and reduces the quality of life of these patients leading to a decrease in quality of life, stress, and anxiety in these patients and disrupting their daily and daily activities. Therefore, this study aimed to compare the effect of core stability training using Otago exercises on quality of life in patients with stroke. Materials & Methods: The present clinical trial was conducted on all stroke patients referring to the educational and medical centers of Yasuj University of Medical Sciences in 2020. A total of 69 patients were selected by the convenience sampling method. The samples were randomly assigned to three groups: core stability exercises group (first intervention group, 23 people), Otago exercises group (second intervention group, 23 people), and control group (23 people). For patients in the first intervention group, core stability exercises were performed for 8 weeks and 3 sessions per week, and for patients in the second intervention group, Otago exercises were performed for 8 weeks and 3 sessions per week. No training was given to the control group. Demographic characteristics checklist and stroke Specific- Quality of Life (SS-QOL) were used to collect data before the intervention and one month after the intervention. The collected data were analyzed using SPSS software version 21 and descriptive statistics and Paired T-test, One-way Analysis of Variance, Bonferroni Post Hoc test. Findings: Before the intervention, there was no statistically significant difference in the overall score of quality of life in the experimental and control groups (p>0.001). At the end of the intervention, there was a statistically significant difference in the mean score of quality of life between the two groups of core stability and Otago exercises compared with the control group (p<0.001). After the intervention, the mean total scores of quality of life in the Otago group increased by about 11.86 points compared with the group core stability, and this difference was significant (p<0.001). Conclusion: Both core stability and Otago exercises improved patients' quality of life with stroke, but Otago exercise was more effective than core stability exercises. Core stability Otago Quality of life Stroke Exercises 2021 5 01 51 56 http://jccs.yums.ac.ir/article-1-96-en.pdf 10.52547/jccs.2.2.51

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 2 A. Jokarborzabad Z. Karimi P. Yazdanpanah N. Roustaei S. Mohammadhossini hossini2370@yahoo.com Aims: Chronic non-specific low back pain is the most common chronic lower back pain, and developing a therapeutic and rehabilitative plan to more rapidly mend patients with lower back pain has always been discussed. The present study aimed to determine the effect of prayer-based movements on pain and endurance of flexor muscles in patients with non-specific chronic low back pain. Materials & Methods: This quasi-experimental study was conducted on all the patients with a chronic non-specific LBP referring to Shahid Mofatteh Clinic No. 1 in Yasuj, 2020. According to block random assignment, Sixty-six patients were divided into two groups of the intervention and control. In the intervention group, prayer-based exercises were performed three sessions a week for eight weeks. The control group was not instructed. The demographic questionnaire and Quebec back pain disability scale were used to measure pain, and the maintain the 60° angle test was used to collect data before intervention; the visual pain measurement scale was used immediately after the intervention, and the endurance test of spine flexor muscles performed at the angle of 60° was used a week after the intervention. The collected data were analyzed by SPSS 21 using descriptive statistics and statistical tests of Paired T, Mann-Whitney, Independent T, Wilcoxon, Chi-square, and Shapiro-Wilk. Findings: There was no significant difference between the two groups in terms of pain severity and endurance of the flexor muscles at the starting point (p>0.05). The comparisons of the mean immediately and a week after the intervention were significant (p<0.05). Conclusion: Prayer-based exercises effectively affect pain severity and endurance of flexor muscles in patients with non-chronic lower back pain. Exercise Prayer Pain The Endurance of Flexor Muscles Chronic Non-Specific Lower Back Pain 2021 5 01 57 61 http://jccs.yums.ac.ir/article-1-99-en.pdf 10.52547/jccs.2.2.57

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 2 F. Pirami S. Zaboli A. Afrasiabifar S. Najafi Doulatabad shahlaiss@yahoo.com Aims: Pain is one of the most important complications after colorectal surgery, and recently the use of non-pharmacological methods to reduce this complication researchers' attention has been drawn. This study aimed to determine the effect of pelvic floor muscle exercise on the severity of pain in women after colorectal surgery. Materials & Methods: In this randomized clinical trial, all female patients with one of the benign colorectal diseases were referred to Be'sat, and Shahid Rajaei hospitals of Gachsaran and Shahid Beheshti hospital of Yasuj, Iran, in 2016 were studied. Ninety-six patients were selected by convenience sampling method and randomly assigned to intervention and control groups. Patients in the preoperative intervention group were trained to exercise the pelvic floor muscles, and these postoperative contraction exercises were performed 60-100 times a day. 6, 12, 18, 24, and 48 hours after surgery, pain intensity was collected using a numerical pain scale. Data collected in SPSS 22 were analyzed by independent t-test, chi-square, Fisher's exact, and Mann-Whitney tests. Findings: The mean pain intensity in both intervention and control groups decreased over time after surgery. No significant differences were comparing the means of pain intensity in 6, 12, 18, 24, and 48 hours after the surgery between the two groups (p>0.05). Conclusion: Pelvic floor muscle exercise intervention has no effect on the severity of pain in women after colorectal surgery. Kegel exercise pain wound healing colorectal surgery 2021 5 01 63 67 http://jccs.yums.ac.ir/article-1-92-en.pdf 10.52547/jccs.2.2.63

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 2 A.K. Alamdari N. Hosseini hosseinichenar@yahoo.com S. Ranjbar N. Roustaei Aims: Hypertension is one of the major problems in the world. Adherence to treatment of patients with hypertension is insufficient, and there are conflicting results regarding the effect of peer education. Therefore, this study was conducted to compare the effect of training by peers and health care staff on adherence to treatment in patients with hypertension. Materials & Methods: This clinical trial was done on patients with hypertension in Yasuj, Iran, in 2017. Two hundred sixty-four eligible individuals were selected using convenience sampling and randomly assigned to three peers, health center staff, and control groups (88 people in each group). The data collection tool was a researcher-made questionnaire assessing adherence to treatment of patients with hypertension, psychometrically evaluated. The questionnaire was completed by three groups before, after, and two months after the intervention by participants. Five education sessions were conducted weekly by the peer group for intervention group 1 and the health care personnel for intervention group 2. Data were analyzed by SPSS 24, using Repeated Measures Analysis of Variance, Chi-square test, and Bonferroni test. Findings: Both educational interventions by peers and health care personnel effectively increased adherence to treatment of patients with hypertension (p<0.05). Although at the end of the intervention, education by peers and health care staff had the same effect on increasing treatment adherence, two months after the intervention, peer education on adherence to treatment was greater than education by health center staff. Conclusion: Peer education also increases adherence to treatment in patients with hypertension; thus, due to its cost-effectiveness and the lack of special equipment, peer education is recommended as a suitable approach.   Hypertension Compliance Education Peer Group Health Personnel 2021 5 01 69 76 http://jccs.yums.ac.ir/article-1-101-en.pdf 10.52547/jccs.2.2.69

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 2 A. Azizi F. Arefpoor S. Jokar R. Hoseinpoor hosinpoorr83@gmail.com Aims: Acute appendicitis is the most common emergency surgery; thus, its diagnosis requires high accuracy. This study aimed to determine the agreement between clinical and paraclinical diagnoses in patients with acute appendicitis. Instrument & Methods: This descriptive study was performed on patients referred to Shahid Beheshti Hospital in Yasouj with suspicion of acute appendicitis in 2018. After considering the inclusion criteria, the files of 200 patients were included in the study by purposive sampling. Age, sex, main problem, symptoms, clinical signs, white blood cell count, and ultrasonography and pathology report were extracted from the patients' files, and the Modified Alvarado Score was calculated based on their information. Findings: The mean age of the patients was 24.3±13.2 years, and the most common symptoms were anorexia and abdominal tenderness. The Modified Alvarado Score was  4-6 in 126 (63%) and 7 or higher (37%) in 74 patients. In addition, 182 patients (91%) had a positive pathology for appendicitis. There was a statistically significant relationship (p=0.03) between Modified Alvarado Score and pathology; however, there was no statistically significant relationship (p=0.43) between Modified Alvarado Score and ultrasonography. There was a significant relationship (p=0.0001) between pathology and ultrasonography. The ultrasonography sensitivity was 37.1%, specificity was 87.2%, positive predictive value was 96.8%, and negative predictive value was 11.7%. Conclusion: There is an agreement between the Modified Alvarado Score and ultrasonography in diagnosing acute appendicitis with the pathology as the gold standard in the diagnosis of appendicitis; however, there is no agreement between the Modified Alvarado Score and ultrasonography.   Appendicitis Pathology Ultrasonography 2021 5 01 77 81 http://jccs.yums.ac.ir/article-1-97-en.pdf 10.52547/jccs.2.2.77

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 2 N. Hashemi Mohammad-Abad L. Hoseiniyan J. Malekzadeh malekjmd@yahoo.com Aims: Depression is a common mental disorder. This study aimed to evaluate the relationship between serum lipid profiles and serum serotonin with depressive disorder. Materials & Methods: This study was carried out on patients with depressive disorders referred to Shahid Mofteh Clinic in Yasuj, Iran, in 2016. The total serum cholesterol, LDL-C, HDL-C, and serum serotonin of 45 patients with the depressive disorder as a case group and 45 normal people without depressive disorder as a control group was measured. Age, sex, weight, and height were matched in both groups. Diagnosis of depression was conducted using both the Beck and Hamilton depression rating scale, followed by an interview by a psychiatrist. Data were analyzed using the SPSS 19 software by sample t-test and the chi-square test. Findings: The LDL-C serum concentrations of the case group was higher than the control group (121.1±30.9 vs107.9±36.9; p=0.07); moreover, the HDL-C serum of the case group was significantly lower than the control group (52.6±11.9 vs. 34.4±9; p<0.0001). The Serum serotonin of the case group was higher than the control group, but this difference was not statistically significant (455.9±393 vs. 418.1±224.4; p=0.58). The total cholesterol and Triglyceride of the case group were higher than the control group, but these differences were not statistically significant (178±37.8 vs. 191.2±47 and 127.4±56.2 vs. 148.5±88.4 respectively; p=0.14). Conclusion: The serum HDL-C concentration of depressed patients is lower than normal people, and the serum LDL-C concentration of depressed patients is higher than normal people. Depression cholesterol Serotonin LDL-C HDL-C. 2021 5 01 83 86 http://jccs.yums.ac.ir/article-1-84-en.pdf 10.52547/jccs.2.2.83

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 2 A. Najjar Mohiabadi M. Tajadini maryam.tajadiny@gmail.com S.H. Seyedbagheri Y. Soltanmoradi A.R. Sayadi F. Harandi M. Jamali M.H. Kamrani H. Khodadadi Aims: With the announcement of the coronavirus pandemic by the World Health Organization, many people experienced many waves of panic. The disease was a major threat to individuals' physical and mental health because of the rapid spread and severe mortality. The continued development and changes in the educational process can affect student's mental health. This study aimed to investigate the frequency of posttraumatic stress disorder, anxiety, depression, and stress in students of Rafsanjan University of Medical Sciences during the coronavirus outbreak in 2020. Materials & Methods: This cross-sectional descriptive study was conducted on students of Rafsanjan University of Medical Sciences. The sample size was 351 individuals selected by the convenience sampling method. Data were collected by DASS-21 and IES-R. Data were analyzed by SPSS18 using the chi-squared and Fisher's exact tests. Findings: The majority of students had moderate anxiety (33.6%) and posttraumatic stress disorder (26.2%). Depression (38.5%) and stress (55.3%) were not common in most students. Analysis of logistic regression showed a significant correlation between anxiety, stress, depression, and Posttraumatic stress disorder (p<0.05). Conclusion: The results suggest mental health problems among medical students. Therefore, it is recommended to implement psychological counseling programs to reduce these cases. COVID-19 Students Anxiety Depression Stress Posttraumatic stress disorder 2021 5 01 87 93 http://jccs.yums.ac.ir/article-1-100-en.pdf 10.52547/jccs.2.2.87

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2021 2 2 J. Mohammadi A. Ramezani M. Hosseini B. Mohammadi drmohammadi114@gmail.com A. Gaeini Aims: Obesity and immobility predispose to cardiovascular disease. Today, changing childhood lifestyle may affect cardiovascular disease factors. This research aimed to determine the effect of three types of exercise training, including endurance exercise, resistance exercise, and combined exercise, on lipid profiles, insulin resistance, and serum FGF21 in obese children. Materials & Methods: This experimental study was conducted on a total of 8-12 years old male students of elementary schools in Yasuj, Iran (N=18038) in October 2006. Sixty obese students, by the simple and voluntarily sampling method, were randomly allocated four groups (15 individuals): Resistance exercise, endurance exercise, and combined exercise, and control. Blood sampling was taken 24 hours before the start of the training period and 48 hours after the end latest session of the training period at the Laboratory of Shahid Beheshti Hospital in Yasuj, and the factors such as Glucose, TC, TG, LDL, VLDL, HDL, VO2max, HOMA-Insulin Resistance, and Serum FGF-21 were measured. Data were analyzed by SPSS 21 software using the ANCOVA test. Findings: Their BMI and VO2max were 32.36±2.31kg/m2 and 23.06±1.72 lit/kg/min, respectively, which showed that subjects were non-active (sedentary) obese in pre-training. Results showed that eight weeks of EE, RE, and CE had a significant effect on increasing serum HDL (F=3.04; p<0.001) and on decreasing of glucose (F=2.98; p<0.001), TC (F=4.33; p<0.001), TG (F=5.44; p<0.001), LDL (F=4.86; p<0.001), VLDL (F=5.58; p<0.001). There was a significant difference between the training intervention groups in pre-training and post-training in the HOMA-Insulin Resistance variable (F=3.28; p<0.001), which had decreased, and serum FGF-21 (F=2.45; p<0.001) which had increased. Also, results illustrated that the EE method was better than RE and CE in improving these variables. Conclusion: Applied training methods in this study, especially endurance exercise, can be considered suitable interventions to reduce cardiovascular risk factors related to obesity in childhood. Exercise Insulin resistance Fibroblast Growth Factor 21 Lipid 2021 5 01 95 101 http://jccs.yums.ac.ir/article-1-105-en.pdf 10.52547/jccs.2.2.95