IMEMR
66.92

About Journal of Clinical Care and Skills

Journal of Clinical Care and Skills (JCCS) is a quarterly peer-reviewed online journal that has been published by the Afarand Scholarly Publishing Institute in Iran since Winter 2020. It was established in 2018, at the Hazrat-e Zeynab Faculty of Nursing, affiliated with Yasuj University of Medical Sciences, Iran. The JCCS's main objective is to publish researches on the health of Iranian people. The mission of JCCS is to help promote studies in health sciences and educate experts and specialists in health centers across Iran as well as other countries.
 
6.7 days
Submission to First Review
60 days
Submission to Accept
25.2 days
Accept to Publish
61.74 %
Acceptance Rate
Editor-in-Chief
Nazafarin Hosseini; PhD
Professor of Nursing; Yasuj University of Medical Sciences, Yasuj, Iran
Scientific Supporters
Yasuj University of Medical Sciences
Articles

Lethal Intracranial Injury as a Complication of Septorhinoplasty; A Case Report

H. Ganjali, H. Attaran, A. Hedjazi, H. Chavoshi
Aims: Nasal septoplasty is one of the most frequently performed surgical procedures with several common and uncommon complications. Although rare, intracranial adverse events of septorhinoplasty are life-threatening, and there are few case reports of fatal intracranial complications.
Patient & Methods: A healthy 47-year-old woman underwent septorhinoplasty, then had a decreased level of consciousness and finally died due to subarachnoid and intraventricular hemorrhage caused by a bone fragment isolated from the fractured sphenoid sinus.
Findings: The complication was attributed to the surgeon's carelessness, and he was considered liable for patient death due to medical negligence.
Conclusion: Surgeon experience in septoplasty surgery is essential, and meticulous attention to anatomical landmarks is paramount to prevent a serious outcome that may lead to patient death and surgeon conviction.
 
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Comparing the Anticandidal Activities of Salvia macrosiphon essential oil and Fluconazole

S. Nouripour-Sisakht, A. Diba, D. Razmjoue, H. Sadeghi Mansourkhani , P. Zanganeh , M. Salahi, M. Gharaghani
Aims: Candidiasis is the most opportunistic infection with a high rate of recurrent infection. Salvia macrosiphon has an antibacterial effect; however, its antifungal effect was not studied. This study aimed to investigate the chemical composition of essential oil from leaves of Salvia macrosiphon and its antifungal activity compared with fluconazole.
Materials & Methods: Salvia macrosiphon leaves, a native plant of Kogiluyeh and Boyerahmad province, were collected from Zagros Heights and used in this study. Then, the essential oil of this plant was tested for antibacterial and antifungal properties and compared with fluconazole.  The chemical composition of the essential oil was analyzed by GC/MS (Gas Chromatography Mass Spectrometry), and the antifungal activity of the plant's essential oil was compared with that of fluconazole.
Findings: The results of GC-MS analysis proved the presence of at least 29 compounds in the essential oil of Salvia macrosiphon. Amon these constitute butyl benzoate (49.16%), n-hexyl benzoate (7%), and isopatolenol (4.83%) were the main compounds. The minimum inhibitory concentration (MIC) of the essential oil (µl/ml) of Salvia macrosiphon and fluconazole (μg/ml) were 0.44 and 0.7 for Candida albicans, 0.056 and 0.7 for C. glabrata, and 0.1 and 0.088 for C. parapsilosis, respectively. Also, statistical analysis demonstrated a significant difference between the mean of fluconazole and essential oil in total Candida isolates (p=0.001).
Conclusion: The essential oil of Salvia macrosiphon has stronger antifungal activity than fluconazole.
 
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Facilitating and Impeding Factors in Care of Patients with Obesity

A. Heydari, Z.S. Manzari, M. Bagheri
Aims: Nurses caring for patients with obesity face difficulties in providing services. The difficulty of care causes inaccurate and incomplete care and sometimes not receiving care, which can lead to many complications for the patient. For this purpose, this study was conducted to explain nurses' experiences facilitating and impeding factors in providing care to patients with obesity.
Participants & Methods: In this qualitative conventional content analysis study, 20 nurses and 6 patients with obesity in two large hospitals affiliated with Mashhad University of Medical Sciences were interviewed. The participants were selected by purposeful sampling, and the interviews were conducted in-depth and semi-structured. Data analysis was done using content analysis & MAXQDA software.
Findings: The facilitating and impeding factors in providing care to patients with obesity in the hospital were divided into four categories; "cooperation versus passivity in the process of self-care," "influential level family involvement at the patient's bedside," "organizational challenges in care," and "nurse competence level in care ."
Conclusion: Organizational changes such as creating collaborative care in difficult situations, considering the patient classification system for patients with obesity, providing large-sized welfare and treatment equipment, increasing the skill level of nurses, and ways to improve interaction with the patient and his family can be practical solutions in providing care to patients with obesity.
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Effect of an Exercise Program on Glenohumeral Rotator Cuff Muscles Strength in Overhead Athletes with Scapular Dyskinesis

H. Naderifar , L. Ghanbari , R. Najafi-Vosough
Aims: Scapula dyskinesis and reduced strength of the glenohumeral external rotator muscles are shoulder risk factors. The shoulder joint's unstabilizing mechanisms can cause a decrease in the strength of the external rotator muscles, an imbalance of the rotator cuff muscles, and scapula dyskinesis. This study aimed to investigate the effect of an exercise program on scapula dyskinesis and the strength of glenohumeral rotator cuff muscles in overhead athletes.
Materials & Methods: The present quasi-experimental study with a control group and pre- and post-test plan was conducted on 62 female handball players (club-level, 18-25 years old) with scapula dyskinesis from 2021 to 2022 in Hamadan City, Iran. The lateral scapular slide test and hand dynamometers were used to measure scapula dyskinesis and the strength of glenohumeral rotator cuff muscles, respectively. The participants in the intervention group participated in eight weeks of three sessions of an exercise program. Data were measured before and after the intervention and were analyzed using the Mann-Whitney U test.
Findings: According to this test, there is a significant difference between the strength of external rotator muscles (p<0.001) in the intervention and control groups after exercises, so the strength of external rotator muscles and the strength of external/internal rotator muscles ratio (p<0.001) has increased after exercises. Also, scapula dyskinesis after exercises has decreased significantly (p=0.013).
Conclusion: The exercise program increases the strength of external rotator muscles and the ratio of external/internal rotator muscles and improves scapula dyskinesis in overhead athletes.
 
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Comparing the Effectiveness of Nutritional Education with and without Physical Activity on Blood Lipids and Liver Aminotransferase Enzymes in Non-Alcoholic Fatty Liver Diseased Men

H. Jamshidi, J.M. Malekzadeh , A. Afrasiabifar , A.K. Alamdari, H. Zamani Habibabad , N. Hosseini
Aims: Fatty liver disease is a type of fat accumulation in the liver parenchyma that can be related to lifestyle. Therefore, this study compared the effectiveness of nutrition education with and without physical activity on blood lipids and liver aminotransferase enzymes in men with non-alcoholic fatty liver disease.
Materials & Methods: This study is a randomized clinical trial with a control group, carried out on 80 employees working in the South Pars gas complex in Jam, Iran, suffering from fatty liver. The participants were allocated to four nutrition education groups; a physical activity group, a nutrition education group with physical activity, an education group without physical activity, and a control group (20 people each) using a random block sampling method. In all four groups, 48 hours before the intervention, 3 and 6 months after the intervention, blood lipids and liver enzymes were measured and recorded in a form. Data were analyzed using SPSS 21 software and chi-score statistics, one-way ANOVA, and repeated measures ANOVA test.
Findings: Alanine aminotransferase enzyme showed a significant improvement in each of the 3 intervention groups compared to the control group at 3 and 6 months after the research intervention (p=0.001). Low-density lipoprotein showed a significant improvement in 6 months, which was related to the group of physical activity combined with nutrition education (p=0.005).
Conclusion: Exercise and education interventions are more effective over a longer period of time in preventing and treating non-alcoholic fatty liver disease.
 
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Rate of Cesarean Section in Hospitals Affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran

E. Babadi, Z. Abbaspoor, S. Ghanbari, S. Mohammadi , M. Javadnoori
Aims: The cesarean section rate in Iran is much higher than the rate recommended by the World Health Organization. Implementation of effective measures to reduce the cesarean rate requires proper analysis and classification. Robeson's classification can be useful in identifying the groups that play the most important role in the cesarean section rate. The present study was conducted to analyze the rate of cesarean section based on Robson's system in hospitals affiliated with Jundishapur University of Medical Sciences, Ahvaz, Iran.
Instrument & Methods: This multi-center cross-sectional study, in 2019, examined 950 pregnant women admitted for delivery or cesarean section in two teaching hospitals affiliated with Jundishapur University of Medical Sciences, Iran, using a convenient sampling method. The data collection tool was a checklist based on Robson's ten classification system. Data were analyzed using SPSS 22 software and descriptive-analytical statistical tests.
Findings: The overall cesarean rate was 48.94%. the largest relative contributions to the CS rate were group 5, group 10, and group 1, respectively. The main causes of cesarean section in all groups were previous cesarean section, fetal distress, and severe pre-eclampsia. The number of cesarean sections in midwife-led hospitals was less than in physician-centered hospitals.
Conclusion: Group 5 of Robeson's classification, representing repeated cesarean sections, contributed the most to the overall cesarean rate.
 
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Assessment of Depression Symptoms, Motor Learning, and Cognitive Function after Transcranial Direct Current Stimulation in Ischemic Stroke

A. Zakerian Zadeh, M. Dadashi, M. Maghbooli, F. Zarei, R. Zakeryanzade
Aims: Stroke leads to many symptoms, such as defects in motor, sensation, language, and cognitive functions, which may help patients recover sooner using complementary techniques. Therefore, this study was conducted to evaluate depression symptoms, motor learning, and cognitive function after transcranial direct current stimulation in patients with ischemic stroke.
Materials & Methods: The current randomized controlled clinical trial was conducted on patients with ischemic stroke in Zanjan City in 2019-2020. 35 patients were randomly selected and assigned to the tDCS (12), Sham (12), and Control (11) groups. The Fugl-Meyer Assessment, Hamilton depression symptoms test, Montreal Cognitive Assessment, and Mini-Mental State Examination were used for evaluation. The first group received consecutive anodal stimulation in M1damH+Left-DLPFC areas, 12 sessions of 60 minutes, the second group received Sham-tDCS, and the third group (the control group) did not receive any intervention. The Data were analyzed using descriptive statistics and multivariate covariance analysis using SPSS 23 software.
Findings: A significant difference was observed between the study groups after the intervention and one month later in motor function, depression symptoms, and cognitive function (p=0.001). According to the paired comparison, the differences between the tDCS group and each of the sham and control groups were bigger. Still, no significant difference was detected between the control and sham groups in these outcome variables.
Conclusion: tDCS leads to the improvement of motor learning, cognitive functions, and depression symptoms in stroke patients, and its effects remain significant after the intervention.

View Abstract

Genital Tuberculosis in Women; A Systematic Review

F. NematiShahri, O. Pouresmaeil, A. Sharifi, F. Mardani, J. Mardaneh
Aims: Female genital tuberculosis is an infrequent form of tuberculosis that is often underestimated due to its low prevalence in developed countries, difficult and delayed diagnosis, and misleading clinical presentation. This systematic review aimed to describe the epidemiology, clinical presentation, diagnosis, and treatment of female genital tuberculosis during 2000-2021.
Information & Methods: The current study is a systematic review that was conducted through exploration of English keywords like “female genital tuberculosis”, “vulva tuberculosis”, “tuberculosis”, and “genital system” as well as, Persian keywords. Furthermore, a similar search methodology was employed in various international databases, including PubMed, Scopus, and Web of Sciences, as well as in certain Iranian databases, like Irandoc and Magiran, between 2000 and 2021.
Findings: Most patients (37.5%) were from India. Upper genital tuberculosis was more common among women of reproductive age, and the most involved upper genital organs were the endometrium and fallopian tubes. In contrast, vulvar tuberculosis was more prevalent in postmenopausal women, and the vulva was the most common site involved in lower genital tuberculosis. Weight loss (31.25%) and vaginal discharge (31.25%) were the most common symptoms reported by the study participants. The main histologic finding in female genital TB was the presence of epithelioid cell granulomas (81.25%). 29 (90.6%) patients received the standard antibiotic therapy (combination of rifampicin, isoniazid, ethambutol, and pyrazinamide), all of whom responded positively.
Conclusion: Most patients experience prolonged vulva ulcers and inadvertently receive various antibiotics. The typical lesions are epithelioid cell granulomas, which may be accompanied by Langerhans giant cells.
 
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Relationship of Serum Lipid Profiles and Serotonin with Major Depression: A matched case-control study

Hashemi Mohammad-Abad Nazir, Liela Hoseiniyan
Background: several studies have explored the relationship between blood lipid levels and depressive disorders. Specific studies reported an association between lower serum cholesterol and depressive disorder, while some other studies no connection. The aim of this study was to evaluate the relationship of serum lipid profiles and serum serotonin with depressive disorder.
Methods: In the present study, the total serum cholesterol, LDL-C, HDL-C and serum serotonin of 45 patients with 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 by using both the Beck and Hamilton depression Rating scale, followed by an interview by a psychiatrist.
Results: The LDL-C serum concentrations of the case group was higher than the control group (121.1±30.9 vs107.9±36.9; P<0.1); 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 case group was higher than the control group, but this difference was not statistically significant (455.9±393 vs. 418.1±224.4).The total cholesterol and TG of case group were higher than 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).
Conclusions:
The Serum HDL-C concentration of depressed patients was significantly lower than the control group, suggesting a possible convers relationship between serum HDL-C and Depression. The serum LDL-C concentration of depressed patients was also higher than the controls showing a possible relationship. However there was no statistical significant difference between the total serum cholesterol, triglyceride and serum serotonin between two groups.
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Effectiveness of adolescent-specific prenatal clinics on improving birth outcomes: a systematic review

solmaz mohammadi, Zahra Sadat Pajohideh, zeinab rabiei
Aims: Adolescent pregnancy is associated with adverse pregnancy outcomes, including preterm delivery, low birth weight, and perinatal death. Therefore, the purpose of this systematic review was the effectiveness of prenatal clinics for adolescents in improving birth outcomes.
Methods: In this systematic review, electronic databases, including Scopus, the Cochrane Library, PubMed, Web of Science, and grey literature databases were searched with keywords related to mesh for published studies from January 1, 1990, to December 31, 2022, in both Persian and English languages. Inclusion criteria included clinical trials and cohort studies focused on prenatal care in adolescent pregnant women with at least one perinatal outcome. Evaluation of the quality of the studies was done using the GATE tool.
Findings: Out of 3261 studies found in the database, eight studies were included in this systematic review. All included studies were cohorts (retrospective, prospective, and mixed). The study was deemed to be of poor quality. These studies investigated the effectiveness of clinics for adolescents on outcomes such as premature birth, low birth weight, intrauterine growth restriction, instrumental delivery, cesarean delivery, and perinatal mortality. Most studies were conducted in high-income countries. Seven of the Eight studies (7/8,87.5 %) had reported preterm birth as an outcome. Overall, 57.14% (4/7) of studies showed an association between adolescent-specific prenatal clinic use and decreased preterm birth.
Conclusion:
The effectiveness of adolescent-specific prenatal clinics in improving birth outcomes is uncertain. there is insufficient high-quality evidence for some outcomes, indicating the necessity for additional research.
 
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Men’s health status at preconception care in couples covered by Ahvaz health care centers

Ms Somayeh Mashayekhi,Dr Zahra Abbaspoor,Dr Bahman Cheraghian,professor@gmail.com mozhgan javadnoori
Background and Objectives: The importance of men's health prior to applying for pregnancy has been considered in the last decade. Identifying and eliminating risk factors for ensuring the success of fertility, and the desired outcomes of pregnancy is especially important. Preconception care in Iran focuses mainly on women. Little is known about men’s preconception health, this study was conducted to evaluate the health status of men in pre-conception in couples in Ahvaz health care centers in Iran.
Materials and Methods: In this descriptive study, 384 married men were selected among the couples covered by health centers in 2019-2020 in Ahvaz Iran. The inclusion criteria were intention for pregnancy during next 3 months or having a pregnant woman in their first trimester of pregnancy. The data were gathered using demographic, men's health status and mental health questionnaires, and were analyzed by SPSS, software.
Findings: 72.9% of men had at least one pre-pregnancy male risk factor: abnormal BMI (33.9%), hypertension (10%), borderline or abnormal blood glucose (20.8%), a disease affecting reproductive health (17.18%), mental health was seriously damaged (37.2%), drug consumption (14.3%), substance abuse (38%), and exposure to environmental and occupational hazards (51.3%).
Conclusion: most of men have at least one risk factor related to pregnancy/fertility undesirable outcomes. So it is necessary to pay attention to preconception care for men -in addition to women- to decrease pregnancy undesirable outcomes and promote reproductive health.  

Keywords: preconception care, men’s health, risk factors, pregnancy outcome
 
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Investigating the level of positive and negative emotions and perception of empathy among Shahrekord University of Medical Sciences employees (doctors and medical staff) among the survivors of deceased patients of covid-19

foruzan ganji, Mahyar Ghasemi, masood lotfizadeh
Aims: The corona virus pandemic has faced many challenges to the medical staff and people in the society. Therefore, this study aims to investigate the amount of positive and negative emotions and the perception of empathy of the medical staff of Shahrekord University of Medical Sciences in the survivors of the deceased patients of covid-19. Was performed.
Methodology: This descriptive-analytical cross-sectional study was conducted on 402 companions of patients who died of covid-19, from 2020 to 2022 in Kurd city, using questionnaires on the perception of doctor's empathy and the scale of positive and negative emotions. The data were analyzed using independent t-test, analysis of variance and Scheffe's test at an error level of 0.05 and using SPSS version 26 software.
Findings: Empathy had a significant relationship with the place of residence, family history, education level and occupation of companions (p<0.05). And positive emotion had a significant relationship with the history of illness, family history, education level and occupation of the companions (p<0.05). However, negative emotion had a significant relationship with drug use, hospitalization of the deceased in ICU, family relationship, level of education and occupation (p<0.05).
Conclusion: Considering the low level of empathy of doctors and the increasing effect of empathy on improving the treatment of patients, the need to change the current situation is felt. Therefore, it is recommended that the training of medical staff and doctors and changes in the existing guidelines and their continuous monitoring should be placed on the agenda of hospitals and healthcare organizations.
 
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Comparing the Effect of Two Methods of Cryotherapy on the Pain of Vascular Needles Insertion in Hemodialysis Patient

A. Sasani, K. Rahzani, D. Hekmatpou, F. Haghverdy
Maximum within 1 minute after cannulation, the pain intensity of the patients was measured and recorded based on the visual comparison scale of pain measurement (VAS). Then the data was analyzed with SPSS version 22 software.
Results:
The results showed that the average pain intensity caused by vascular needle insertion in the cold therapy group at the needle insertion site was 3.1±86.81. On the other hand, the average pain intensity caused by vascular needle insertion in the cold therapy group was 4.2±65.05 in Hugo point. The results also showed that there was no significant difference in the average pain intensity between the two cold therapy groups at the needle insertion site and Hugo point (p-value < 0.05). Although the average pain intensity at the needle insertion site was lower in the cold therapy group, this difference was not significant.
Conclusion: The results of this study showed that there is no significant difference in the average pain intensity between the two cold therapy groups at the needle insertion site and the Hugo point. Although the average pain intensity at the needle insertion site was lower in the cold therapy group, this difference was not significant. Therefore, it is suggested that nurses use both methods according to the existing conditions and according to their own preferences in order to reduce the pain of dialysis needle insertion and improve the satisfaction of patients.
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Unilateral multiple Renal Congenital Anomalies: Renal Pelvic Ectopia; Double Collecting system; uretero-pelvic junction obstruction; uretero- vesical junction obstruction; Lower Moiety Ureter to Upper Moiety Ureter Reflux; A Case Report

prof seyed mohammadreza rabani
Aim: The urinary tract is a site for common anomalies. Ureteropelvic junction obstruction and double collecting system are among the most common anomalies in the body, but gathering all of the, but gathering all of these anomalies reported in our patient and being unilateral may be a rare entity. Hereby we report a case with such a rare condition.
 Methods: The patient is a 19-year-old army male that presented with left lower quadrant abdominal pain after blunt abdominal trauma, accompanied by gross hematuria. 
Findings: Ultrasonography suggested ectopic pelvic left Kidney with hydronephrosis and ureteropelvic junction obstruction with distal ureteral dilatation. Exploration was done through a Gibson’s retroperitoneal incision, and pyeloplasty accompanied by ureteroneocystostomy was carried out.
Conclusion: The collection of unilateral renal ectopia, double collecting system, lower moiety ureteropelvic junction obstruction, and finally ending to a common ureter with ureterovesical junction obstruction, maybe a rare condition, but we found all of these in a young male.
 
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Childhood hepatoblastoma: A case report

N. Ashayeri, E. Zarei, M. Shamspour, M. Targrian
Childhood hepatoblastoma is a rare type of embryonal primary liver tumors. The mass may be completely asymptomatic and may be discovered quite incidentally or manifested by general conditions. Early suspicion of the tumor can be raised by observing a liver mass with increased alpha fetoprotein level followed by liver ultrasonography and CT scanning, especially to detect lung metastasis. However, ultimate diagnostic confirmation is usually achieved by histological approach. Therapeutically, a complete surgical resection remains the mainstay of hepatoblasoma treatment that can be managed by postsurgical chemotherapy. Herein, we presented a case of hepatoblastoma fetal type and described our experience in its clinical management. The patient was successfully managed by surgical resection followed by chemotherapy leading complete improvement within six-month postoperative following-up.       
 
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Relationship between health literacy and medication adherence in cirrhosis patients

Azam Ghorbani, Elham Karim Abed, Shrahrzad Ghiyasvandian, Moein Salami
Aims: Health literacy (HL) is a critical factor in achieving good health, as it plays a central role in health and healthcare. Another important factor affecting health outcomes is medication adherence, especially in patients with chronic liver disease and cirrhosis. Therefore, this study aimed to investigate the relationship between health literacy and medication adherence in patients with cirrhosis.
Instruments and Methods: This descriptive cross-sectional study involved 141 cirrhosis patients from two teaching hospitals in Iraq, recruited using a convenience sampling method. Data collection involved three self-report questionnaires including demographic characteristics, the All Aspects of Health Literacy Scale (AAHLS), and the Adherence to Refills and Medications Scale (ARMS). Data analysis was performed using SPSS software version 16.
Findings: The findings indicated that most patients (92.90%) exhibited non-adherence to medication, with a medication adherence score of more than 16. Additionally, 75.88% of patients demonstrated a low level of health literacy. A positive and significant correlation was observed between medication adherence and total health literacy score (r = 0.358, p<0.001).
Conclusion: The majority of patients exhibited low health literacy and non-adherence to medications. Therefore, implementing educational programs to improve health literacy could potentially increase patients’ medication adherence.
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Patient' spiritual support pattern for nurses based on Quranic verses: a way to provide mental health

majid tavakol,tavakkol2769@yahoo.com nahid tavakol
Aim
The purpose of this research is to examine and introduce Quranic verses that the nurse can use and remind the patient to provide spiritual support and mental health to the patient in different stages of disease.
Method
This study has been done using a review-descriptive method and a library method. The main source of the study was the Holy Quran and appropriate Quranic keywords related to the spiritual support of the patient were selected, related verses labelled and categorized thematically.
Findings
The verses examined in the 12 concepts of having children, patience, Satan's temptation, asking for help to endure suffering and hardship, remembrance and prayer, repentance and return, asking for a good end, remembrance of the Resurrection, getting rid of the evil of the envious and tempters, ceasing hope of God's mercy, Rewards and thanks for the blessings of God were classified.
Conclusion
The results of this study showed that many verses in the Holy Quran can be used for spiritual support by nurses and care providers in different stages of the disease and provide mental health to the patient. The nurse can use the verses of the Holy Quran for spiritual support by laying the groundwork in the matter of spirituality so as to calm and accept the condition of the disease, as well as grounding the descent of God's mercy. The results of this study can be used in developing plans for providing spiritual and mental health care to patients.
 
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Test 1

Hamed Bastin
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The assessment of the relationship between spiritual intelligence and self-care in adolescents with type 1 diabetes

M. Rahmanian, M. S. Mirzaei
Background: Spiritual intelligence includes problem-solving behavior and adaptability, also spiritual intelligence helps a person to coordinate and integrate into the environment.
Objective: This study aimed to determine the relationship between spiritual intelligence and self-care in adolescents with type 1 diabetes.
Methods and materials: This was a cross-sectional study of an analytical type, 200 adolescences with type 1 diabetes in 2020 were selected using the available sampling method. It collected information from the SISRI spiritual intelligence questionnaire and Tobert's self-care questionnaire. Data were analyzed using SPSS 18 series software.
Findings: There was an inverse and indirect relationship between the total score of self-care and all subscales of spiritual intelligence (r=-0.02). There was also an inverse and indirect relationship between the total score of self-care and the age of adolescents with diabetes (r = -0.17).
Conclusion: Based on the findings of this study, we recommend that more serious and practical studies be conducted to investigate the relationship between spiritual intelligence and self-care in adolescents with type 1 diabetes.
 
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The Relationship between Transformational and Transactional Leadership Styles, and the Attitude towards Organizational Change in the Educational Staff of Yasouj University of Medical Sciences

M. Hosseini, N. Razmjoee, M. Momennasab
Background and Aim: Improving the quality of public health depends on improving the quality of medical education. The National Committee for Quality Improvement has emphasized on creating a change in the management system and leadership of medical education in the Ministry of Health. In this regard, this study was conducted to investigate the relationship between transformational and interactive leadership styles with attitudes toward organizational change in the teaching staff of Yasuj University of Medical Sciences.
Method: This is a descriptive-correlational cross-sectional study that was conducted by census method and its statistical population includes all teaching staff of Yasuj University of Medical Sciences over 300 people who volunteered to participate in the study. Bass Multi-Factor Leadership Questionnaires were completed to assess transformational and interactive leadership and the Dunham Scale was completed to assess attitudes toward organizational change.
 Results: Among the variables included in the regression equation, the ideal influence variable is a significant predictor of the emotional dimension in the attitude to organizational change (P <0.01, β = 0.170). In the cognitive field, the variable of job satisfaction was a significant predictor for the cognitive dimension (P <0.01, β = -0.164) and also the variable of intellectual stimulation was a significant predictor for the criterion variable (P <0.01, β = -0.130).               
Conclusion: Transformational and interactive leadership, each based on certain dimensions of their existence can affect parts of the tendency to organizational change.
 
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The effect of caffeine on cough in 36-3 months old Children

Dr. Marjan Tagrian Esfahani,Dr. Kambiz Keshavarz,Dr. Mohammad Zoladl
Introduction & Objective: Cough is an important problem in pediatric medicine. One of the drug regimens for the treatment of children cough are bronchodilators such as salbutamol, aminophylline, and theophylline (methyl xanthene), while the response to thromboembolism is not predictable, regardless of the underlying cause. Accordingly, since caffeine, as a central nervous system stimulant of the methylxanthine group, inhibits the alpha-Tumor necrosis factor (TNFα) and lacto-synthetase and reduces inflammation and initiates the immune process, the aim of this study was to determine the effect of caffeine on cough in 36-3 months old Children.
Materials and Methods: In this clinical trial study, 120 children aged 3 to 36 months with  the cough due to bronchiolitis, lower respiratory viral disease, elevated airway sensitivity or persistent asthma among the patients referred to the Children's Clinic of Martyr Mofattah  of Yasuj Were mild and eligible to enter the study and were randomly assigned to two groups of intervention and control. While the control group received routine treatment, the group received caffeine in combination with routine treatment. In addition to completing demographic information at the beginning of the study, information was provided the rate of daily cough and night cough at the beginning of the study, 48 hours, one week and two weeks after the start of the drug; then the collected data were analyzed by SPSS software version 21 through descriptive statistics and parametric or nonparametric statistical tests Corresponding to 95% confidence level (P = 0.05).
Result: No significant statistical difference was found between the experimental and control groups in terms of demographic and background characteristics, and the two research groups were similar at the beginning of the study (P <0.05). The rate of daily cough and night cough at 48 hours, one week and two weeks after starting treatment in the intervention group was significantly reduced in comparison with the control group (P <0.05). It is worth that in this study, nausea and vomiting as side effects of Caffeine reported in 3 cases only.
Conclusion: According to the findings of this study, it seems that the use of caffeine is effective in improving children's cough.
 
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Circumferential incision line compressive dressing in Circumcision; a comparative study between conventional dressing, no dressing and our innovative dressing

MD seyedmohammadreza rabani,MD Ali MOUSAVIZADEH,MD seyedhossein rabani
 Circumferential incision line compressive dressing in Circumcision; a comparative study between conventional dressing, no dressing and our innovative dressing
  Abstract
Background and Goal: Circumcision is a minor urologic surgery that is widely used in our country and other Muslim and non-muslin countries. Although this procedure is used as a religious duty, but there are evidence based data about its preventive role for urinary tract infections and even for genital malignancies. A common complication following this procedure is bleeding. The aim of this study was to compare our innovative dressing with no dressing and conventional dressing options for circumcision in point of bleeding after circumcision.
Patients and Methods
Between October 2010 and July 2016, 126 boys underwent elective circumcision. The patients were randomized in 3 groups. In group one conventional dressing, group 2 no dressing, and in group 3 innovative dressing was done. Patients were followed for one week and outcomes were recorded and compared.
Results:
The demographic criteria were similar in 3 groups, there were 15 reattendances for bleeding; 8 patients in group one, 7 patients in group 2 and no patients in group 3, but all had minimal bleeding and no life- threatening bleeding was encountered.
Conclusions
Circumcision is a well-known procedure with different methods of surgery, and different medical and cultural aims of performing. Bleeding is the most common complication of circumcision. In experienced hands, bleeding can be ignorable in this procedure by choosing a suitable dressing and/or good hemostasis.
Key Words: Circumcision, Bleeding, complication
 
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The effect of Hypnotherapy on the improvement of symptoms of sufferers from Asthma

MSc shahla najafi,dr mohammad zoladl,dr oriad hossein,dr mohammad malekzade,dr hesamodin nabavizade,MSc maryam niazi,dr zinat mohebi dolat abadi
Introduction and Objective: Asthma is a chronic inflammatory disease of the air ways, resulting in air way hyperresponiveness, mucosal edema and mucus production. According to the estimations done, near by 17 million Americans are affected by this disease and more than 500 persons die due to it's affection yearly. The present research has been carried out with the aim to assess the effect of Hypnotherapy on the improvement of symptoms of sufferers from Asthma referred to the Shahid Mofateh clinic of Yasouj city among which, 72 patients were selected as study samples. Considering the shortage of 10.0%, statistical analysis was carried out on the relative data of 64 patients. Samples were selected according to the block randomization sampling method and thereafter, each individual from case group underwent Hypnotherapy by scientific method for one session of 1.5 hours. The disease severity was studied immediately, 2 weeks and 4 weeks after intervention. Data collection were done using check list questionnaire that was completed by internist based on examination of patients and doing Peak Flow Meter before and after Hypnotherapy. Collected data were analyzed using SPSS software, descriptive statistics and inferential statistics such as X², t-test, Mann-Whitney and repeated measurement.
Results: Statistical results of Analysis of Covariance (ANCOVA) with repeated measurements indicated that, time alone had significant effect on Asthma severity (P<0.05). As a whole, changes of Asthma severity were statistically different between two case and control groups with time-lapse and without concerning time (P<0.05).
Conclusion: Totally, it seems that, Hypnotherapy as a complementary treatment in improving the symptoms of Asthma disease is effective though; the necessity of Randomized Controlled Trial (RCT) with more samples and following patients after intervention for longer period is felt.
 
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Comparison the Impact of face-to-face education and Educational Booklet Methods on Health-related Quality of Life in Patient with Type 2 Diabetes

Alikaram alamdari, razieh taheri, ardashir afrasiabifar, Mohammadlatif rastian
Introduction & Objective: Diabetes is among the expensive diseases and in most countries. It is the primary reason for blindness, amputation and chronic renal failure. Although diabetes conditions are preventable or postponable, different studies have reported diabetes control situation as undesirable. So, this study is performed to compare the effect of face-to-face education and educational booklet on health-related quality of life in patients suffering from type 2 diabetes.
Materials & Methods: This study is clinical trial study which was performed in order to compare the effect of face-to-face education and educational booklet on health-related quality of life in patients suffering from diabetes type 2 in Jahrom city. 120 patients qualified to enter the study were selected by random sampling. They were among the patients visiting the selected clinics; they were randomly allocated to three groups: education through educational booklet, face-to-face group, and control group. In order to gather the data, personal and social information form, standardized health-related quality of life questionnaire in diabetic patients were used. Questionnaires about complying the health-related quality of life were completed before and two weeks after the intervention. Gathered data was analyzed by SPSS software. Due to the aims of the study, absolute and relative frequency distribution were used; moreover, in order to investigate the relation between the variables depending on distribution of consequence variables, parametrical and non-parametrical tests were used in a 95 percent confidence interval.
Findings: Intergroup comparison of the average results of health-related quality of life in the face-to-face, booklet and control groups, before and after the intervention, reveals that average results for quality of life in three groups had no significant difference before the intervention (P=0.1). However, after the intervention, average results for quality of life in face-to-face (59.37±5.6) and booklet group (57.47±9.26) were more were more than the control group (48.8±9.6) and there was a significant difference (P=0.001).
Conclusion: Although face-to-face and booklet education have the same effect on quality of life, both interventions could improve dimensions quality of life in comparison with control group.
 
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The effect of early ambulation in bed on hemodynamic parameters of sleeve gastrectomy

Seyed Javad sadat, mohammadreza koohpeyma, ardeshir afrasiabifar, mohammad zoladl
Aim: Determine the effect of early ambulation in bed on hemodynamic parameters and complication of sleeve gastrectomy.
Materials and Methods: In this randomized clinical trial, 88 volunteer patients were selected by available sampling method. Hemodynamic parameters were recorded for all patients at the time of entry to the department immediately, six hours, twelve hours and twenty four hours after leaving the bed. 
 Results: The changes in systolic blood pressure and diastolic blood pressure in the intervention group at each time interval after the intervention were significantly different in the control group compared with those in the control group. Also, changes in arterial oxygen saturation in the intervention group, at each time interval after the intervention  were statistically significant in comparison with these changes in the control group.
Conclusion: The effect of early out of the bed compared to the conventional procedure for the removal of the patient from the bed following the sleeping gastrectomy surgery is in the balance of systolic blood pressure, diastolic blood pressure and arterial oxygen saturation .
 
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The effect of individual psychotherapy based on self-‎efficacy on quality of life of patients with major thalassemia

Mrs Pari Taheri,Dr. kheirollah nooryan,Dr. Mohammad Zoladl,Dr. Zohreh Karimi

Parigol Taheri*, Kheirollah Nooryan**, Mohammad Zoladl*, Zohreh Karimi*
* Yasuj University of Medical Sciences,Yasuj, Iran
**Corresponding author: Kheirollah Nooryan, Email: khnooryan@gmail.com

Abstract
Background & Objective: Thalassemia is a one of the most common inherited chronic diseases in the world. Hereditary disease, which emerged in the first years of life, the risk of physical abnormalities and ongoing need for blood transfusion and chelation have significant impact on the growth and evolution of patients with thalassemia and their relationship with other members of the family. So, the study aim was determine the effect of individual psychotherapy with a focus on self-efficacy on quality of life in patients with thalassemia major.
Materials & Methods: In this clinical trial study sample was 50 patients with thalassemia major referred to Shahid Rajai Hospital in Gachsaran (Southern Iran) that has eligible and defined criteria for research units. Using block random allocation 25 of them in the intervention group and 25 of them was assigned to the control group. Data were collected in this study using a three-part questionnaire consist of demographic questionnaire, Quality of Life Questionnaire (SF-36) and Scherer Self-efficacy Questionnaire was completed by the subjects.  Data were analyzed using SPSS software version 21, by descriptive and inferential test, considering the 95% statistical confidence interval.
Results: The findings showed that the mean age of 21±6.27 years and rank of their children in the family was 3.24±1.94, the highest level of high school education, majority of singles, highest mean employment for people who are studying, more patients in the city and more patients have changed in appearance. The mean score of self-efficacy in two groups were significantly different (P<0.05). There were no significant different between mean scores of physical dimension for quality of life in the two groups, but the mental aspect of quality of life were significantly different (P<0.05).  
Conclusion: According to the results, it seems to increase the self-efficacy and following quality of life in patients, measures such as training workshops for patients, the presence of psychologists in the field of blood transfusion and facilitating therapy can be effective.
 
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Evaluation of the effect of purgative manna, Alhagi pseudoalhagi, and their simultaneous use on healing icterus of infants hospitalized in Imam Sadjad hospital of Yasuj

dr jamshid mohammadi,dr bahram mohammadi,dr hossein sadeghi,dr azam daliri
Background and objective: From past times, herbal medicine had wide usage in Iranian conventional medicine, and nowadays, Alhagi pseudoalhagi (that is the gum of Alhagi plant) and purgative manna are still used for treatment of icterus in infants. The aim of this study was to assess the effect of purgative manna, Alhagi pseudoalhagi, and their simultaneous use on healing icterus of infants hospitalized in Imam Sadjad hospital of Yasuj in 2016.
Materials and Methods: In this interventional study with clinical trial, the groups were divided into three groups including two intervention groups (Alhagi pseudoalhagi extract group, purgative manna extract group) and one control group, and grouping performed by random block allocation. 30 infants placed in each group that needed treatment. At the end, age, gender, blood group, total and direct bilirubin, and G6PD were evaluated in the patients. Data were statistically analyzed using SPSS software version 21, and using One-way ANOVA and Tukey's follow-up test. P<0.05 was considered to be statistically significant.
Results: Results of this study showed that the phototherapy group had higher total and direct bilirubin mean in comparison to the Alhagi pseudoalhagigroup. Based on our results, Alhagi pseudoalhagi had more effectively decreased bilirubin level in comparison to the phototherapy and purgative manna groups. Phototherapy and,purgative manna groups had similar results. No significant difference was seen regarding serum bilirubin reduction between two phototherapy (control) and,purgative manna groups, and in spite of conventional ideas had no effect on reduction of icterus in hospitalized infants.
Conclusion: Regarding our results and assessment of the effect of oral Alhagi pseudoalhagiand purgative manna on reduction of icterus in infants in different studies, using oral Alhagi pseudoalhagi(5 drops for 3 times per day and for 3 days) is recommended for helping treatment of icterus in infants.
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The effect of intervention relying 5 A’s program of self-management on fatigue severity of cancer patients under chemotherapy: a clinical trial study

Mrs. Marjan Rozitalab,Dr. Nazafarin Hosseini,Dr. Mehrdad Vossoughi,Dr. Mohammad Zoladl
Introduction & Objective: Cancer is an important chronic non communicable disease. Chemotherapy as one of main treatment of cancer had side effects, especially fatigue as one of prevalent side effects of chemotherapy. Accordingly and because despite the confirmation of the positive effect of psychological and self-management based interventions on the relief of side effects of chronic diseases, so this study carried out to determine the effect of intervention relying 5 A’s program of self-management on fatigue severity of cancer patients under chemotherapy.
 Material & Methods: In this randomized clinical trial, 60 cancer patients under chemotherapy who referred to Chemotherapy Center of Shahid Motahari Clinic of Shiraz University of Medical Sciences, and were eligible based on inclusion criteria,  selected using convenience sampling, then using block random allocation divided to experimental and control group with the equal number. While control group received routine treatment and care related to chemotherapy, 5 A’s program of self-management including assessment, advisement, agreement, assistance and arrangement in the four sessions (two individual sessions, two group sessions),during four months was applied for experimental group based on protocol in addition to routine treatment and care related to chemotherapy. The data gathering tool of current study consists of a demographic questionnaire and Multidimensional fatigue inventory (MFI) completed by all subjects at the beginning of the study, end of the intervention, and 3 months later. The data analyzed by the descriptive statistic such as mean and standard deviation, and analysis of variance with repeated measurement as an inferential statistic using SPSS 21 software.
Result: Immediately after research intervention, the fatigue severity amount in the intervention group(43.4±7)was less than this amount in the control group(46.8±13); but 3 months after research intervention, the fatigue severity amount in the control group(34.7±10.1) was more less than this amount in the intervention group(42±4.8); which these differences were statistical significance. In the intervention group, there were 11.4 and 12.8 significant decrease between the fatigue severity of immediately and three months after the end of the intervention compared to the starting point of the study accordingly(P<0.05); but there were no significant differences regarding 1.5 decreases between the fatigue severity of the follow up compared to post-test (P>0.05). In the control group, there were no significant differences regarding 2.2 decreases between the fatigue severity of the end of the intervention compared to the starting point of the study (P>0.05); but there were 14.3 and 12.1 significant decreases between the fatigue severity of  the three months after the end of the intervention compared to the starting point of the study and immediately after the end of the intervention accordingly (P<0.05).
Conclusion: The  finding showed that the 5 A’s program of self-management produce a decrease  in fatigue severity of cancer patients under chemotherapy who were in the intervention group: but this independent variable couldn't perform significant differences between the intervention group and  control group regarding fatigue severity that confirmed the effectiveness of mentioned intervention; so wider researches with more accurate and more sensitive design  recommended.
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Effect of Faye Glenn Abdellah's Nursing Theory on Quality of Life in Cancer Patients: A Randomized Controlled Trial

Z. Mahmoudi, F. Rahimi Dolat Abad, L. Gholami, A. H. Bayat, M.S. Mirzaee, M. Alishapour
Aims: Cancer disrupts the quality of life of patients, as well as increases the care burden of the patients' families. The current study aimed to determine the effect of Glenn Abdellah's nursing theory on quality of life of patients with cancer.
Materials & Methods: In this randomized control trial, 60 patients with cancer were selected by purposive sampling method in Shahid Modarres Hospital, Saveh city in 2020.
Then the samples were divided into intervention and control groups using random allocation. Then the samples were divided into intervention (n=30) and control (n=30) groups using random allocation. The intervention related to ten steps in Faye Glenn Abdellah’s Nursing Theory was implemented for intervention group, but there was no intervention in the control group. Information was collected before, after the intervention, and one month after the intervention through World Health Organization Quality-of-Life Scale (WHOQOL-BREF). Data were analyzed by SPSS 22 software, using descriptive statistics methods and inferential analysis tests.
Findings: In the intervention group, the mean score of patients' quality of life increased significantly after intervention and one month after intervention (p<0.001). After intervention and the follow-up period, the quality of life in the intervention group was better than that of the control group (p<0.001).
Conclusion: The use of nursing care theories, such as Faye Glenn Abdellah's nursing theory, can improve the quality of life in cancer patients.

 
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Effect of Hypnosis on Pulmonary Function and Severity of the Disease in Asthmatic Patients: A Randomized Clinical Trial

Z. Mohebbi, Sh. Najafi Doulatabad, M. Malekzadeh, S H Nabavizadeh, H. Marioryad, E. Momeni , M. Niazi, M. Zoladl
Abstract
Aim: Asthma is one of the common, chronic respiratory diseases which psychological factors play an important role in it and comorbidities of several psychological disorders such as anxiety, depression, and panic attacks are common in asthmatic patients. The aim of this study was to determine the effect of hypnosis on pulmonary function and severity of the disease in asthmatic patients.
Materials and Methods: This randomized clinical trial study, was carried out on 64 asthmatic patients, who referred to the clinic of Shahid Mofattah in Yasuj, Iran in 2010. The subjects were selected by purposeful sampling method, and randomly assigned into the tow group of the intervention (subjects were treated by solo hypnosis in a 90-minute session and conventional treatments) and control group (subjects were treated by conventional treatments, in addition, providing an explanation about requirement care point for improvement of asthma in 15 minutes) by use of balanced block randomization. In addition to completing demographic information at the beginning of the study, determination of pulmonary function and asthma severity were conducted respectively through measurement of FEV1 and NAEPP classification (EPR-3) at the starting point of the study and one month after the completion of the research intervention. Data were analyzed using SPSS 21 software, through independent sample t-test, paired sample t-test, Chi-square test, and marginal homogeneity test.
Findings: one month after completing the research intervention, the FEV1 in the intervention group increased than the control group and the severity of asthma in the intervention group decreased than the control group.
Conclusion: Hypnosis as an adjuvant treatment is effective in the improvement of pulmonary function and reducing the disease severity in asthmatic patients.
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Psychometric Properties of the Iranian Version of Physical Disability Sexual and Body Esteem Questionnaire in Women with Polycystic Ovary Syndrome

Sh. Aramesh , H. Allan, F. Bazarganipour , Z. khashavi, M. Taheri, Sh. Salari
Aims: The objective of this study was to evaluate the psychometric properties of the Iranian version of the physical disability sexual and body esteem questionnaire (PDSBE) in women with polycystic ovary syndrome (PCOS).
Materials & Methods: The present cross sectional study was conducted on 100 women with PCOS referred to the infertility clinic in Hormozgan province, Iran. After translating the questionnaire and to determine the linguistic validity, a panel of experts evaluated the content validity index (CVI) and content validity ratio (CVR). Exploratory factor analysis (EFA) was done to assess the questionnaire structure. Discriminate and convergent validity were evaluated, using known group comparisons and correlating PDSBE with body image concern inventory (BICI).
Finding: CVI and CVR results were 0.9 and 0.95, respectively. The results of EFA showed a 2 factor structure (sexual esteem and sexual attraction perceived by others) responsible for 61.21% of variance. A Cronbach's alpha test of the questionnaire was satisfactory. The results of known group comparisons showed that PDSBE differentiates well between patients, who differ in terms of clinical characteristics. Moreover, the results of convergent validity were indicative of a desirable correlation between the scores of BICI questionnaire and the domains of sexual esteem (r=0.43, p<0.001) and attractiveness of PDSBE (r= 0.48; p<0.001).
Conclusion: The PDSBE is an understandable and readable questionnaire. Also, women with normal clinical features had higher level of sexual esteem and felt more attractive.
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Effect of Caffeine on Coughing in Children Aged 3-36 Months: A Randomized Clinical Trial

M. Tagrian Esfahani , K. Keshavarz, A. Keshtkari, H. Sadeghi Mansourkhani, M. Akbartabar Toori , M. Zoladl
Aims: Coughing is one of the most common clinical complaints in pediatric medicine. Since caffeine, as a central nervous system stimulant from methylxanthine, inhibits tumor necrosis factor-alpha (TNFα) and leukotriene synthesis and reduces inflammation and initiates the immune process, the aim of this study was to determine the effect of caffeine on coughing in children aged 3-36 months.
Materials and Methods: In this randomized clinical trial study in 2015, among children referred to the Shahid Mofateh Pediatric Clinic of Yasuj, 120 children aged 3-36 months with coughing due to bronchiolitis, lower respiratory viral disease, increased airway sensitivity, or moderate persistent asthma were selected by convenience sampling method. They were assigned in intervention (reciving salbutamol and caffeine) and control (reciving salbutamol alone) groups by quadratic block randomization. In addition to completing demographic information at the beginning of the study, data on daily and nocturnal cough at the beginning of the study, 48 hours, 1 week, and 2 weeks after starting the drug were recorded. The data were analyzed by SPSS 21 software, using Mann-Whitney test, Chi-square or Fisher's exact test, generalized estimating equation, Friedman, and Wilcoxon statistical tests.
Findings: Daily cough and nocturnal cough significantly decreased in the intervention group at 48 hours, 1 and 2 weeks after beginning the treatment (p<0.05).
Conclusion: Prescription of caffeine with salbutamol is effective in accelerating improvement of cough in children.
 
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Comparison of the Effect of Two Doses of Vitamin D (Vit D-Ca and Vit D-Ca+Vit D) from the 16th Week on Preterm Labor in Pregnant Women

N S Mosallanejad, A V Taghavi, M Saadat, M Rajaii, F Bazarganipour
Aims Preterm labor (delivery earlier than 37 weeks) is one of the most common problems
with midwifery. Recently, vitamin D deficiencies have been reported with adverse maternal
outcomes such as pregnancy toxicity, intrauterine growth limitation, and preterm labor. The
aim of this study was to compare the effect of 2 doses of vitamin D (Vit D-Ca and Vit D-Ca+Vit
D) from the 16th week on preterm labor in pregnant women.
Materials & Methods The present single-blind randomized clinical trial was conducted
on 202 pregnant women referred to 5 obstetric and gynecological clinics in Bandar Abbas,
Hormozgan province, Iran during January 2016 to March 2017. The subjects were selected
by randomization sampling method and were randomly assigned into group A (n=150) and
group B (n=152). Group A received Vit D-Ca supplements, containing 400 IU/day, and group
B received Vit D-Ca supplement plus Vit D (with D3 brand), containing 1000 IU/day from
the 16th week of pregnancy until delivery. The subjects were examined from the 16th week
of pregnancy until delivery. The data were analyzed by SPSS 21 software, using independent
t-test, Mann-Whitney U test and Chi-square test.
Findings The incidence of preterm labor in the group receiving Vit D-Ca+Vit D (group B) was
24 (16.0%) and in the group receiving Vit D-Ca alone was 25 (16.7%). There was a significant
difference between the two groups in terms of preterm labor (p=0.01).
Conclusion Vit D-Ca plus Vit D intake reduces preterm labor in pregnant women more than
Vit D-Ca alone intake.
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Comparison the Effect of Fennel on Maternal Serum Prolactin Level and Neonatal Weight Gain with Effect of Domperidon and Placebo

A. Keshtkari, A. Mehboudi, M.A. Ghatee, N. Bagheri

Aims: Breastfeeding is an economic and valuable method to protect infant health during the life and provides unique biological and emotional effect for mothers and infants. The aim of this study was to compare the effect of fennel on maternal serum prolactin level and neonatal weight gain to effect of domperidon and placebo on these variables.
Materials & Methods: In this single blind randomized clinical trial (RCT), 150 volunteer mothers who had delivery and their newborns in Imam Sajad Hospital of Yasuj University of Medical Science, Yasuj, Iran in 2018, were selected by convenience sampling method and randomly assigned into three equal groups: placebo, domperidone, and fennel groups. Participants used placebo, domperidone tablets and fennel seeds powder for 14 days. Serum prolactin levels of mothers were measured with ELISA method before and after interventions. The weight of newborns were measured using digital scales on birth day, 14th and 28th days of study. Data were analyzed by SPSS 21 software using Chi square test, paired t-test, and one-way ANOVA.
Findings: The mean serum prolactin level of the mothers before and after intervention in all three groups were not significantly different (p>0.05). The mean weight of neonates on the birth day, 14th day and 28th day in three groups did not show any significant difference (p>0.05).
Conclusion: Fennel and domperidone have no effect on the serum prolactin level of lactating mothers and weight gain of newborns.

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Performance Indicators of Affiliated Hospitals to Yasuj University of Medical Sciences, Iran (2011-2018): Pabon Lasso Model

A. Mousavizadeh, L. Manzouri, A. Karimibaseri
Aims: Hospital indicators are one of the most important criteria of hospital efficiency. The aim of this study was to determine the performance indicators of affiliated hospitals of Yasuj University of Medical Sciences in 2011-2018.
Instruments & Methods: This cross-sectional descriptive study was conducted on 5 hospitals, including Shahid Beheshti, Shahid Rajaei, and Emam-Sajjad Yasuj hospitals, and Shahid Rajaei Hospital in Gachsaran and Emam-Khomeini Hospital in Dehdasht affiliated to Yasuj University of Medical Sciences in 2011-2018. Bed Occupancy Rate (BOR), Bed Turnover (BTR) and Average Length of Stay (ALS) were collected through hospital information system and analyzed according to Pabon Lasso model and compared with the standard levels.
Findings: The mean BTR (98.76 times per year), ALS (2.12 days) and BOR (70.9%) in hospitals in 2011-2018 were favorable. ALS was 15.24 days in Shahid Rajaei hospital in Yasuj. Shahid Beheshti hospital was in zone 3 in all years. Emam-Sajjad hospital was in zone 3 in all years except 2014. Shahid Rajaei hospital of Yasuj was in zone 4 in 2011-2018. Emam-Khomeini hospital was in zone 1 in 2015-2016, zone 3 in 2011-2012, 2014, 2017-2018, and zone 4 in 2013. Shahid Rajaei hospital of Gachsaran was in zone 3 only in 2012, zone 1 in 2016-2019 and zone 2 in 2011 and 2013-2015.
Conclusion: The performance indicators of affiliated hospitals of Yasuj University of Medical Sciences are at the favorable and moderate level, and in total, in 2011-2018, most of the hospitals have been in zone 3, which indicates good performance.
 
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Effect of Aspirin on Pre-eclampsia and Fetal Growth Restriction in Obese Pregnant Women: A Randomized Controlled Clinical Trial

R. Vanda, Sh. Aramesh, M. Sadeghian, M.A. Ghatee, P. Ghaffari
Aim(s): Obesity in pregnant women is a serious health problem that has many complications such as pre-eclampsia and fetal growth restriction (FGR). The aim of the present study was to evaluate the effect of aspirin on prevalence of pre-eclampsia and FGR in obese pregnant women.
Materials & Methods: This randomized controlled clinical trial was conducted on 187 pregnant women referring to birth center of Mofatteh Clinic, Yasuj University of Medical Sciences, Yasuj, Iran in 2017-2018.
The subjects were selected using purposive sampling method and randomly divided into two groups; intervention group (n=89) and control group (n=98). The intervention group received 80mg/day aspirin and the control group received placebo at 13-20 weeks of gestation until 34 weeks of pregnancy. Data were analyzed by SPSS 21 software using Chi square test.
Findings: The prevalence of pre-eclampsia (1.1 vs. 11.2) and FGR (3.4 vs. 21.4) were significantly lower in the intervention group compared to the control group (p<0.05).
Conclusion: Administration of 80mg/daily of aspirin from 13-20 weeks of gestation in obese pregnant women reduces the incidence of pre-eclampsia and FGR, which could support the positive role of aspirin in preventing pre-eclampsia and FGR.
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Association between IL-10 rs1800872 Polymorphism in the Promoter Region of Human IL-10 Gene and Susceptibility to Rheumatoid Arthritis in the Patients in Southwest of Iran

S. Hassanzadeh, F. Hedayati, E. Hosseini, J.M. Malekzadeh, E. Masnavi, A. Keshtkari
Aims: Interleukin-10 is an important immunoregulatory cytokine that has an inhibitory effect on the initiation and progression of inflammatory responses in different situations such as autoimmune diseases including rheumatoid arthritis. Polymorphism in IL-10 promoter region affects the expression of this gene. It therefore seems reasonable that these polymorphisms may contribute to rheumatoid arthritis susceptibility in special populations. the aim of this study was to investigate the association between IL-10 rs1800872 polymorphism in the promoter region of human IL-10 gene and susceptibility to rheumatoid arthritis in the patients in southwest of Iran.
Materials & Methods: The present study is a case-control study conducted among patients with and without rheumatoid arthritis referred to the Mofateh clinic in Yasuj, Iran. Both case (n=64) and control (n=65) groups were selected using purposive sampling and were matched in terms of age, gender and ethnicity. Peripheral blood samples were collected from subjects and rs1800872 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism method. SPSS 26.0 software was used for statistical analysis of data
Findings: The association between the frequency of TT genotypes and the incidence of rheumatoid arthritis was significant (OR=6.45; 95% CI= 1.30-32.00; p=0.023). On the other hand, the distribution of the T allele showed a significant relationship with rheumatoid arthritis (OR= 2.23; 95% CI= 1.26–3.97; p=0.006).
Conclusion: TT genotype of rs1800872 polymorphism is associated with rheumatoid arthritis susceptibility in southwestern Iranian population and can be considered as a risk factor for rheumatism.
 
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A survey about psoriasis patients in Yasuj, Iran

Z. Saeedi Nezhad, N. Dabiri
Aims: Psoriasis is a common immune-related skin disorder that affects 2-3% of worldwide people. This study aimed to determine the disease characteristics of psoriasis patients.
Materials & Methods: In this descriptive cross-sectional study, using the convenience sampling method, 164 psoriatic patients who were referred to a dermatology clinic in Yasuj from 2013 to 2014 participated. Demographic information and medical parameters were collected by a dermatologist through observation and using a researcher-made checklist. SPSS software version 19 was used for the statistical analysis of data.
Findings: Participants were consisting of 106 males and 58 females. The mean age of females was 28.72±15.89, and for males was 29.83±23.19. Most of them had the mild disease (48.3%), and common plaque-type psoriasis (87.7%). Sites of skin involvement were 80.4% on extremities. Nail involvement was 31.7% and arthritis was detected in 3% of cases. There was a history of pruritus or burning sensation in 41.5% of cases. There was only a 17.1% positive family history.
Conclusion: According to the results of this study, the ratio of men with psoriasis to women was higher. Most of the skin lesions caused by this disease were observed in the extremities, head, face and trunk, respectively, and in this respect both gender were similar and few participants reported a positive family history in this regard.
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Comparison the Effect of Omeprazole, Esomeprazole and Lansoprazole on Treatment of Gastroesophageal Reflux Disease in Infants

R. Abassi , F. Abassi , A. Mosavizadeh , H. Sadeghi , A. Keshtkari
Aims: Gastroesophageal reflux Disease (GERD) results impairment in the quality of life of the infants. Various studies have shown that proton pump inhibitors have a beneficial effect on the treatment of GERD. The aim of this study was to compare the effect of omeprazole, esomeprazole, and lansoprazole in the treatment of GERD in infants.
Materials & Method: This study is a randomized double blinded clinical trial that was conducted on 2-24-month-old infants with GERD referred to the Shahid Mofatteh clinic in Yasuj, Iran in 2016. 90 samples were selected by purposive sampling method and randomly assigned to three intervention groups including lansoprazole, omeprazole and esomeprazole (30 subjects per group). Infants in each group daily received 1mg/kg body weight of their prescription drugs. Before and after two and four weeks of treatment, the GERD-Q questionnaire was completed. Data were analyzed by SPSS 21 software using statistical tests.
Findings: There was no significant difference in the severity of GERD among the 3 groups before and 2 and 4 weeks after the intervention. Although, esomeprazole had a greater and faster effect on recovery. The symptoms of GERD in esomeprazole group were similar to the other two groups, but this difference was not significant. However, each of the three interventions alone improved GERD.
Conclusion: All three drugs, lansoprazole, omeprazole, and esomeprazole, are effective on GERD recovery. In comparison, although there is no significant difference among these 3 drugs, However esomeprazole appears to have a better clinical effect.
 
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Comparison of the Effect of Teach-Back Method and Video Clip Training on the Sense of Coherence of Mothers with Children Suffering from Asthma

A. Poursamad, Z. Karimi, M.S. Mousavi
Aims: Mothers whose children suffer from chronic diseases experience high levels of stress. Promoting the sense of coherence can be a way to reduce the stress. The aim of this study was to compare the effect of teach-back method and video clip teaching on the sense of coherence of mothers with children suffering from asthma.
Materials & Methods: In this randomized controlled trial, 75 eligible mothers with children suffering from asthma in Yasuj in 2020 were selected by convenience sampling method and randomly assigned into three groups: video clip group, teach-back method group and control group. In video clip group, training was performed through a 15-minute clip in two sessions. In teach-back method group 8 training sessions were held. Data were collected using the Antonovsky's Sense of Coherence scale-13 at baseline and one month after the intervention. Data were analyzed using SPSS 21 by descriptive and inferential statistics.
Findings: Before the intervention, there was no significant difference in the mean score of sense of coherence and its subscale in the three groups (p>0.05). One month after the intervention, there was a significant difference in the mean score of sense of coherence and its subscales between the two intervention groups with the control group (p=0.001). Also, a significant difference was observed between the two intervention groups in the mean scores of the sense of coherence and comprehensibility (p<0.05).
Conclusion: Both video clip and teach-back methods improves mothers' sense of coherence, but teach-back method is more effective than video clip teaching.

 
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Effect of Prayer-Based Movements on Pain and Endurance of Flexor Muscles in Patients with Non-specific Chronic Low Back Pain

A. Jokarborzabad, Z. Karimi, P. Yazdanpanah, N. Roustaei, S. Mohammadhossini


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.
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Effect of Individual Psychotherapy with a Focus on Self-Efficacy on Quality of Life in Patients with Thalassemia Major: A Clinical Trial

P. Taheri, Kh. Nooryan, Z. Karimi, M. Zoladl
Aims: The aim of this study was to investigate the effect of individual psychotherapy with a focus on self-efficacy on quality of life in patients with thalassemia major.
Materials and Methods: In this randomized clinical trial study in 2016, among patients with thalassemia major referring to Cooley's anemia ward of Shahid Rajaie Hospital in Gachsaran, Iran, 50 eligible patients were selected by convenience sampling method. They were assigned in intervention (n=25) and control (n=25) groups by quadratic block randomization. Each of 50 subjects signed the informed written consent. Demographic questionnaire and 36-Item Short-Form Health Survey (SF-36) were used as the research tool. The data were analyzed by SPSS 21 software, using Chi-square test, independent T-test, and the Mann-Whitney U test.
Findings: One month after the intervention, the scores of the Physical Component Summary (2461.8±15.7) and the Mental Component Summary (1873.0± 21.6) in the intervention group were significantly higher than the same scores (2283.2±279.8) and (1712.6±270.5) in the control group (p<0.05). At this time, the score of all Health Domain Scales of SF-36 Health Survey in the intervention group were higher than the same scores in the control group. These differences were significant except for the Role-Physical and Bodily Pain (p<0.05). 
Conclusion: Individual psychotherapy with a focus on self-efficacy is effective on increasing quality of life of patients with thalassemia major.
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Fibroepithelial Stromal Polyp as Low Back Lesion in 88-year-old Man: a Case Report

z. daneshyar, M. Shokripour
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.

 
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Efficacy of Pregabalin on Reducing Pain in Patients with Lumbosacral Radiculopathy

H. Mohammadi, M. Afkari, N. Salehi, A. Roozbehi
Aims: Pregabalin is one of the anti-seizure and analgesic drugs, which is widely used in the treatment of neuropathic pain and chronic radiculopathy in the form of monotherapy. The aim of this study was to evaluate the effectiveness of pregabalin drug therapy with common treatment (an NSAID) on reducing pain in patients with lumbosacral radiculopathy.
Materials & Methods: In this clinical trial, 90 patients with lumbosacral radiculopathy referring to the clinic of Shahid Mofatteh, Yasuj, Iran in 2018, were selected using purposeful convenience sampling and divided into intervention (N=45) and control (N=45) groups. The pain severity was assessed by a standard visual analog scale (VAS). In the intervention group, 100 mg celecoxib every 12 hours, plus 75 mg per day pregabalin, and in the control group, 100 mg celecoxib every 12 hours, plus 75 mg per day pregabalin placebo were prescribed. After 8 weeks, the severity of the pain was again assessed and compared.
Findings: At the beginning of the study, the mean pain severity in the intervention and control group did not differ significantly (p>0.05). After the intervention, the mean pain severity between the two groups did not show a significant difference (p>0.05). The severity of the pain did not differ significantly between the two groups of intervention and control according to age, disease history, location of pain, and body weight (p>0.05).
Conclusion: The efficacy of pregabalin and NSAID in comparison with NSAID use in patients with lumbosacral radiculopathy is not different in reducing pain severity.Aims: Pregabalin is one of the anti-seizure and analgesic drugs, which is widely used in the treatment of neuropathic pain and chronic radiculopathy in the form of monotherapy. The aim of this study was to evaluate the effectiveness of pregabalin drug therapy with common treatment (an NSAID) on reducing pain in patients with lumbosacral radiculopathy.
 
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Health Measures in the Event of an Earthquake during the COVID-19 Pandemic

H. Seyedin, A. Nasiri, M. Ahmadi Marzaleh, A. Marzban, M. Dowlati
There is no abstract.
 
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Burnout in a Sample of Iranian Nurses during COVID-19 Pandemic

M. Dadkhah-Tehrani, M. Adib-Hajbaghery
Aims: Currently, the outbreak of COVID-19 has imposed a wide range of stressors that can negatively affect nurses and other health care workers. This study aimed to investigate the severity of burnout among nurses working in COVID-19 wards.
Instrument & Methods: This cross-sectional descriptive study was conducted in 2019 on 372 nurses working in the clinical wards of Shahid Beheshti Hospital of Kashan, Iran. A two-part questionnaire was used for data collection. The first part consisted of demographic questions and the second part was the Maslach burnout inventory. Data analysis was conducted by the SPSS 16 using Mann-Whitney U and independent samples t-test.
Findings: Of 372 nurses who participated in this study the mean overall occupational burnout was 45.16±22.84 which shows burnout at a moderate level. The mean occupational burnout was significantly higher in nurses over the age of 30 (p< 0.01), in males (p=0.05), and nurses working in operating rooms (p<0.001).
Conclusion: The level of nurses' burnout was moderate.

 
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Serum Leptin, Plasma Glucose, and Lactate Changes following Aerobic Exhaustive Incremental Exercise in Trained 18-26 Years Old Men

M. Hosseini, B. Mohammadi, J. Mohammadi
Aims: This study aimed to examine the acute effects of exhaustive incremental exercise on serum leptin, glucose, and lactate in one session in trained 18-26 years old men.
Material & Methods: The present study was conducted in 2021 on male physical education students available at the Faculty of Sports Sciences of the Shahid Chamran University of Ahvaz in Iran. Thirty students who had 18-26 years old, with body fat between 15-25% and VO2max between 35-45ml/kg/min, were simple randomly selected through 200 physical education students, and they were divided into two equal training and the control groups (each of them consists of 15 subjects). The exercise test included the Astrand test on a treadmill that performed exhaustive incremental exercise. Blood samples have been collected from two groups in pre and post-test and 9 hours after exhaustive incremental exercise. The statistical analyses used were the Independent T-test and one-way ANOVA tests by SPSS version 20.
Findings: Results showed that serum leptin did not change between three measurement sets in the training group in comparison to the control group (p>0.05). Plasma glucose significantly changed between pre and post-test and pretest and 9 hours later (p<0.001). Plasma lactate significantly changed in post-test in comparison to pretest and 9 hours later to post-test (p<0.001).
Conclusion: Incremental exhaustive exercise has no significant effect on serum leptin.
 
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Comparison of the Specificity and Sensitivity of the Infrared Temporal Artery and Digital Axillary Body Temperature Measurements with Nasopharyngeal Method in Adult Patients

Z. Mahmoudi , F. Jahanpour , P. Azodi , A. Ostovar
Aims: Accurate and timely determination of body temperature as one of the vital signs of the body is the key to diagnosis and treatment. Temporal artery thermometer is one of the new tools for measuring body temperature that is still unknown regarding for its accuracy and reliability. Therefore, this study aimed at comparing the specificity and sensitivity of two methods of body temperature measurement by electric subroutine thermometer and digital temporal artery in comparison with nasopharyngeal thermometer in adult patients.
Materials & Methods: This descriptive-analytical and cross-sectional study was performed on 200 adult patients over 17 years old admitted to the ICU of Shohadaye Khalije Fars Hospital, Bushehr, Iran in 2015. The samples were selected by convenience sampling method. For all samples, body temperature was measured and recorded using three methods, including nasopharyngeal (gold standard), axillary, and temporal arterial methods. Data were analyzed by SPSS 20 and STATA 11 software using Pearson correlation coefficient, chi-square test and ROC curve.
Findings: The sensitivity, specificity, and accuracy of the temporal artery method with fever threshold of 37.7°C were 94.0%, 85.0% and 86.5%, respectively, and showed a good agreement between the axillary and temporal artery methods with a kappa coefficient of 0.67.
Conclusion: Body temperature measurement by temporal artery method is precise, fast, comfortable and safe for patients in comparison with nasopharyngeal and axillary methods and the best threshold for fever in this method is 37.7°C.
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