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Aims: Breast cancer is the leading cause of cancer death among women in Asia, including Iran. Mammography is used for the early detection of breast cancer for about 73% of cases. This study aimed to determine the effect of educational intervention on mammography among women referring to health centers using planned behavior theory. Materials & Methods: This randomized controlled trial study was conducted on 140 women referring to Health Centers in Khorramabad in 2018 who were randomly selected and divided into two experimental and control groups. Data collection tools consisted of a demographic information questionnaire, knowledge, and researcher-made questionnaire based on the TPB structures. The intervention was held in four 45 minute sessions for four weeks. Both groups completed the questionnaires before and three months after the intervention. The data were analyzed by SPSS 23 software using chi-square, independent t-test, and paired t-test. Findings: After the educational intervention, Mean±SD constructs of knowledge, attitude, subjective norms, perceived behavioral control, and the behavioral intention was 10.97±5.07, 41.24±3.44, 26.54±5.3, 47.36±3.91, and 8.87±2.78, respectively. All the mentioned constructs were statistically significant (p

Introduction: One of the most common complications after intrathecal anesthesia is chills during surgery. The second most common complaint followed by intrathecal anesthesia is nausea and vomiting. The aim of this study was to evaluate the effect of adding fentanyl to bupivacaine on chills and vomiting nausea in patients undergoing femoral surgery Methods: This randomized double-blind clinical trial study was performed on 40 patients aged 18 to 50 years with anesthesia classes 1 and 2 who were candidates for femoral orthopedic surgery. Patients were randomly divided into two equal groups. The intervention group received 12.5 mg bupivacaine (2.5 cc) and 10 mg fentanyl (control group) and the control group received 12.5 μg bupivacaine (0.5 ml normal). Patients with dry mouth, nausea, vomiting and shivering were evaluated at 1, 2, 6, 12 and 24 hours after surgery. Data analysis was performed using SPSS software version 21 and descriptive and inferential statistical tests. Results: Forty patients undergoing spinal orthopedic surgery with spinal anesthesia participated in two equal groups (bupivacaine-fentanyl (n = 20) and bupivacaine (n = 20). There was no significant difference between fentanyl and bupivacaine in terms of recovery from nausea and postoperative times (p> 0.05) and differences between bupivacaine-fentanyl and bupivacaine in shivering at 6, 12, 18 and 24 hours postoperatively. There was no significant (p> 0.05). Conclusion: In the present study, although fewer complications such as shivering and nausea and vomiting were reported within minutes of the study in the fentanyl group, this decrease was not statistically significant.

Aims: This study was conducted to determine the effects of spiritual practice along routine medical care on the recovery of patients admitted with Covid-19. Materials & Methods: In a single-blinded clinical trial study 64 hospitalized patients with Covid-19, were randomly assigned in to two groups of intervention (spiritual practice+ routine treatment) and comparison (routine treatment). The intervention was performed using religious teachings, spiritual practice was taught to the patients in the intervention group with the intention of recovery and comfort. Spiritual practice was reciting Surah "Al-Hamd" and "Ya-Allah". The intervention group accomplished spiritual practice three times a day (21 times in total) for 7 days. Information gathered on demographic characteristics, depression and anxiety score, length of hospital stay, ICU transfer, intubation, and patient death. The Hospital Anxiety and Depression Scale (HADS) questionnaire was used to determine the symptoms of depression and anxiety. Findings: A total of 35 participants in the comparison group and 29 in the intervention group completed the study. After intervention, there was no significant difference between the length of hospitalization days between the intervention group (5.8±1.7) and the comparison (6.7±1.7). The rate of ICU request was significantly higher in the comparison group (40%,n=14) than in the intervention group (3.4%, n=1) (P

Introduction: Ankle sprains are one of the most common sports injuries. This injury can affect the kinematics of the athlete's lower extremities. Therefore, the aim of this study was to compare the effect of 6 weeks of balancing and hopping strengthening training on the kinematics of the lower extremities of athletes with functional ankle instability while running. Methods: The present study was a randomized clinical trial on 36 athletes with functional ankle instability who were randomly divided into three groups: hopping training, balance strengthening and control. The training lasted for six weeks and 3 sessions per week. Kinematic data were recorded by 3D OptiTrack camera while running at 10 km/h before and after training. SPSS software version 20 and ANCOVA test were used to compare the effect of exercises. Results: The results showed that there was a significant difference among the 3 groups in dorsiflexion (P = 0.009), inversion (P = 0.001) and knee flexion (P = 0.001). The results of Benferoni test also showed that hopping training in dorsiflexion, ankle inversion and knee flexion were significantly different from the control group (P = 0.009, P = 0.001, P = 0.001). The results also showed that balance strengthening training in the above movements were significantly different from the control group (P = 0.005, P = 0.002, P = 0.006) and in knee flexion, hoping training showed a significant difference compared to balance strengthening training (P =0.012). The results showed that both hopping and balance strengthening training improved the dorsiflexion, inversion and knee flexion angles in the initial contact in running. However, hopping exercises is better than balance strengthening in improving knee flexion angles. Conclusion: Therefore, according to the presented results, it can be concluded that the rehabilitation course of ankle sprains in athletes, coaches and sports rescue specialists should use a combination of balance strengthening training and hopping as a comprehensive program. In addition, hopping training can be used as a good alternative to balance training in places where there is not enough equipment.

Objective: Stress and anxiety are common in patients with Multiple Sclerosis (MS). These complications exacerbate the symptoms of MS. This study aims to evaluate the effect of acupressure on stress and anxiety of MS patients. Methods: In this randomized clinical trial, participants were 106 MS Patients referred to Multiple Sclerosis Society in Mashhad, Iran. After signing an informed consent form, they completed a demographic form and stress, and the Depression Anxiety Stress Scale - 42 items (DASS-42). Then, they were randomly assigned into intervention and sham groups by tossing a coin. Participants in the intervention group were asked apply a pressure on the Shenmen and Yin Tang acupoints for one month (once per day for 15 minutes), while the sham group applied pressure 2.5 cm below the Shenmen acupoint and 3 cm above the Yin Tang acupoint. Participants in each group were then completed the DASS-42 again one hour after the final session. Data were analyzed using chi-square test, Kolmogorov-Smirnov test, independent t-test, and Paired t-test. Results: In the intervention and sham groups, there was no statistically significant difference between the mean pre-test scores of stress (34.73±5.80 vs. 33.06±6.42) and anxiety (27.09±6.99 vs. 25.31±6.88), and neither between the mean post-test scores of stress (29.20±6.21 vs. 33.73±9.44) and anxiety (22.79±5.68 vs. 25.21±6.72) (P>0.05). However, comparison of DASS-42 scores between groups showed that the mean scores of stress and anxiety in the intervention group were significantly lower than in the sham group (P< 0.05). Conclusion: It seems that acupressure can be used along with other therapeutic and pharmacological interventions to reduce stress and anxiety in patients with MS.

Objective: One of the major problems of patients after orthopedic surgeries is acute pain. The present study aims to evaluate the effect of foot reflexology massage on postoperative pain in patients undergoing plating surgery for tibia fracture. Methods: This study is a randomized clinical trial conducted on 96 patients who were candidates for tibia plating surgery referred to Imam Ali Hospital in Bojnourd, Iran, randomly divided into intervention and control groups. Foot reflexology massage in the intervention group was performed on patients’ healthy feet for 10 minutes, one hour before surgery. In the control group, the foot sole was touched for one minute without any pressure. Pain intensity was measured using the standard Visual Analog Scale before and immediately after the intervention and 2, 4, 6, 12 and 24 hours after surgery. Data were analyzed using chi-square test, t-test, repeated measures ANOVA, Mann-Whitney U and Friedman tests. Results: The baseline pain scores in the intervention and control groups were reported 8.1±0.9 and 8.4±0.9, respectively. After the intervention, the pain score in these groups was reduced to 6.9±1.1 and 8.1±1.0, respectively (P

Background and Aim: Epistaxis is one of the most common symptoms referring to emergency department, which suitable and effective treatment needs in short term. Therefore the purpose of the present study was to compare the outcome of topical tranexamic acid (TA) with nasal tampon in management of epistaxis. Materials and Methods: The present clinical trial study was performed on 150 patients with epistaxis in three groups. The patients of the first group were treated as a control group with a tampon that was lubricated with tetracycline ointment. The second group (TA group) received 15 cm gauze coated with TA and put in the nasal cavity. The third group received 15 cm gauze coated with TA and then nasal tampon coated with lubricant and tetracycline ointment. Then bleeding and nausea were assessed and recorded in the first 24 hours and the first week after intervention. Finally, statistical analysis was performed with SPSS software and Chi-square and one-way analysis of variance tests were used. Results: The time of bleeding cessation was significantly more in control groups as compared to intervention groups(P=0.04). The incidence of complications such as nausea and vomiting was much lower in the TA group than in the control group (P

Objective: The integration of various senses with each other in the form of perceptual-motor activities can lead to the promotion of different aspects of physical, perceptual, cognitive, and psychosocial development. Decreased visual acuity in children with visual impairment makes it difficult to develop motor skills, including gross motor skills. A few studies have used perceptual-motor interventions in these children with no specific framework. The purpose of this study is to evaluate the effect of a perceptual-motor intervention based on Johnstone and Ramon’s method on the gross motor skills of children with visual impairment. Materials & Methods: In this randomized controlled trial, the study population consisted of children aged 7-10 years with visual impairment (blind or with low vision) studying in three schools of Narjes (Girls’ school), Shaid Mohebbi, and Shahid Khazaeli (Boys’ schools) in Tehran City, Iran in 2018 (n=140). Of these children, 24 who had met inclusion criteria were selected and randomly assigned into two intervention (n=12) and control (n=12) groups. The perceptual-motor program was designed based on Johnstone and Ramon’s method and validated by a panel of experts that included four members of the Department of Occupational Therapy, the University of Social Welfare and Rehabilitation Sciences, and one optometrist from the Baqiyatallah University of Medical Sciences. The intervention group received the perceptual-motor program for two months, three 45-min sessions per week (24 sessions in total). The gross motor skills of both groups were measured by the second edition of Movement Assessment Battery for Children (MABC-2) test (aiming/catching and balance subscales) and the second edition of Test of Gross Motor Development (TGMD-2) (locomotor and object control subscales) in three stages: Pre-test, post-test, and 1-month follow-up. Data analysis was performed using the Shapiro-Wilk test, Mann-Whitney U test, Friedman test, Bonferroni test, and generalized estimating equation in SPSS v. 22. The significance level was set at 0.05. Results: The mean±SD ages of children in the intervention and control groups were 9.2±1.1 and 8.3±1.2 years, respectively. The mean±SD scores of aiming/catching skill in the intervention group reached from 4.17±2.82 in the Pre-test phase to 11.17±1.95 in the post-test and 10.92±1.62 in the follow-up phases. In the control group, the mean±SD scores were 3.83±2.79 in the Pre-test, 4.25±3.08 in the post-test, and 4.67±2.93 in the follow-up. The mean±SD scores of the balance skill increased from 6.25±2.42 in the Pre-test to 10±2.13 in the post-test and 9.92±2.19 in the follow-up phase. In the control group, the scores were 3.50±3.09) in the Pre-test, 3.83±3.46) in the post-test, and 4±3.36) in the follow-up phase. The mean±SD score of the locomotor skill was 40.92±9.34 in the Pre-test, 47.58±1.17 in the post-test, and 47.42±1.08 in the follow-up phase. In the control group, these scores increased from 35.83±12.92 in the Pre-test to 36.83±13.17 and 37.67±13.24 in the post-test and follow-up phases, respectively. The mean±SD scores of object control skill increased from 32.50±14.74 in the Pre-test to 47.50±1.24 in the post-test and 47.66±1.15 in the follow-up, while in the control group, the scores were 29.25±12.93 in the Pre-test, and 30.17±12.89 and 30.08±13.34 in the post-test and follow-up phases. The aiming/catching, balance, and object control skills of children were significantly improved after the intervention (P0.05). Conclusion: The perceptual-motor interventional program can be useful in promoting the gross motor skills of children with visual impairment. It is suggested that this program be used in other studies on visually-impaired children.

Background & Aims: Despite the rapid prevention, diagnosis, and management of stroke, the patients are still at a high risk of complications. From hospital admission to discharge and at home, liaison nurses help the patients with the complicated care issues caused by stroke. The present study aimed to investigate the effect of the performance of liaison nurses on the incidence of motor complications in stroke patients after discharge from the hospital. Materials & Methods: This quasi-experimental study was conducted on 80 patients in a hospital in Shiraz, Iran during 2016-2017. The patients were selected via purposive convenience sampling and randomly divided into two groups of intervention and control. Before discharge, the patients in the intervention group were examined, and a care and educational program was provided by the liaison nurse based on their needs and to prevent the incidence of motor complications (e.g., constipation, fall, bedsore). The educational contents were handed to the patients or their caregivers in the form of a booklet. If needed, the nurse would attend at the patient's bedside at home to address their problems, and the contact between the nurse and patients was maintained. The patients in the control group received routine care and were discharged. Two weeks and two months after discharge, the patients were followed-up in terms of the prevalence of bedsore or fall based on self-report or reports provided by their families. In addition, the prevalence of constipation was assessed based on the Rome 3 criteria. Data analysis was performed using Mann-Whitney U test and Chi-square. Results: The two groups were homogenous in terms of the mean age and stroke criteria, and the patients were distributed homogenously in terms of gender based on the Braden and Mors criteria. No significant difference was observed between the groups in terms of the frequency of bedsore (P=0.068), while they were significantly difference in terms of constipation (P

Osteoporosis is rapidly turning into a global epidemic, leading to high rates of morbidity and mortality due to the resulting complications such as osteoporotic fractures in older people. Therefore, this review investigated the findings of clinical trials regarding the effects of medicinal herbs on osteoporosis. To this end, several keywords were used to search for relevant articles indexed in the Institute for Scientific Information and PubMed, including "Osteoporosis" or "Bone loss" AND "medicinal plant" or "phyto*" or "herb*". Finally, 43 articles were included in the review. There are several mechanisms for anti-osteoporosis effects. Estrogen-like effects, especially soy phytoestrogenic compounds and other herbal compounds and formulations, can enhance bone formation markers, as well as antioxidant and anti-inflammatory capacity, while decreasing bone resorption biomarkers. Therefore, they can be used as complementary medicine for osteoporosis, especially in postmenopausal older women. However, for more reliable evidence, further studies are still needed because most studies have addressed soy, and the number of randomized controlled trials conducted on other herbal drugs is small. The plants possess the androgen-like properties that play an important role in the promotion of bone health. In addition, herbal treatments are supportive and slow-acting and thus such treatments are suggested for prevention and maintenance purposes rather than fast-acting treatments. Keywords: Medicinal herbs, Osteoporosis, Bone loss, Phytoestrogen

Introduction: Pain management in children with burn is one of the most important issues in pediatric medicine. Non-pharmacological methods of pain control can play an important role in patients. Therefore this study was conducted to investigate the effect of medical directed play on the severity of pain during burn dressing change. Methods: To conduct this two-group clinical trial, 78 children of 3-6 years old with burn surface area ranging less than 25% who had referred to Shahid Motahari Medical Center for their first burn dressing change, were selected. After obtaining the ethics approval for conducting the study, the patients were placed as random allocation in control and intervention groups. For the intervention group, the pre-dressed directed medical play was done and routine care was taken for the control group. The FLACC scale was used in both groups to measure the severity of pain before and during the dressing; the arterial blood oxygen level and heart rate were also measured and compared. For data analysis, SPSS 20 was used. Results: There were significant differences between the two groups during burn dressing change of mean pain (P=0.041) and pulse (P=0.037), and the mean of both indices in the control group was high. The mean of the arterial blood oxygen level during burn dressing change did not differ significantly between the two groups (P=1). Conclusion: Directed Medical play effectively reduces the pain of pediatric burn dressing change. This technique is cost-effective, so it can be widely used for pain management in pediatric department.

Background Myocardial infarction (MI) is among the most frequent causes of mortality and morbidity, with socioeconomic harms. Upper limb exercise, as part of cardiac rehabilitation program, is one of the secondary prevention methods of further MI and disease improvement. Objective The present study investigated the effect of upper limb sport on the rate of readmission in patients with myocardial infarction. Methods In this randomized clinical trial study, 54 patients with MI were randomly divided into two groups of 27 patients (intervention and control). The intervention group performed upper extremity exercise for 6 weeks, twice a week and for 40 minutes per session. The demographic information of both groups was obtained before the exercise program, and at the end of the intervention. Furthermore, a checklist for referral to physicians and readmissions was completed. The collected data were analyzed using Independent Sample t-test and Chi-squared test. Findings The number of readmission in the control group was higher than the test group; however, the group difference was not significant in terms of readmission (P=0.250). Moreover, in terms of the reasons of readmission (P=0.434), and the duration of readmission (P=0.095), there was no significant difference between the two groups. The difference between the two groups in terms of the number of referral to physician (P=0.231), and the reason for referral to physician, was not significant (P=0.111). Conclusion The involvement of upper extremity exercises did not significantly change the rate of readmission and referral to physician of patients with myocardial infarction. Thus, further investigations are required in this regard.

Introduction: Patients with epilepsy need to learn to identify seizure-inducing factors in order to adapt to seizure activity and disease management and taking precautionary measures to minimize seizure damage. The aim of this study was to determine the effect of an educational program on self-management empowerment of patients with epilepsy. Methods: This quasi-experimental study was conducted on 90 patients with epilepsy referring to Iranian Epilepsy Association. The study used convenient sampling and samples were randomly divided into two groups: control (n= 45) and experimental group (n=45). The control group received routine training and the experimental group in addition to routine training, participated in three educational sessions held by the researcher in Epilepsy Association. All the patients completed a self-management questionnaire before and six weeks after the intervention. The data were analyzed by SPSS 22 using Kolmogorov-Smirnov, independent paired t-test and descriptive statistics. Results: The findings showed that there were no significant differences between the two groups in terms of demographic characteristics (P>0.05). Before implementing educational program, the two groups showed no significant difference in medication, knowledge, information, safety and seizure scores (P> 0.05). After implementing educational program the two groups showed significant difference in the scores (P

Introduction: Asthma is one of the most common chronic respiratory diseases and one of the major problems in health systems in many societies around the world including Iran. Self-care is one of the most important factors in raising the awareness and attitude of individuals. The purpose of this study was to investigate the effect of self-care education on knowledge and attitude of patients with asthma. Methods: In this quasi-experimental study, 104 patients with asthma were selected by available sampling method and randomly divided into two groups (n=52) and control (n=52). Both groups filled the questionnaire of awareness and attitude before the intervention. The self-care group was trained in four sessions of 60 minutes. The questionnaire was filled again this time by both groups, 8 weeks after the intervention. and the data was analyzed using SPSS 16, descriptive statistics, independent t-test and paired t-test at 95% confidence interval. Results: The results showed that there was no significant difference between the mean and standard deviation of knowledge and attitude scores before and after self-care education (P> 0.05). There was a statistically significant difference between the mean and standard deviation of the knowledge and attitude of the experimental and control groups after the training (P

Background and Objectives: Osteoporosis is one of the disasters of the recent century. Given the greater involvement of women in all age groups, prevention of osteoporosis is essential in women. Individual empowerment is one of the strategies to prevent the growth of osteoporosis. In this research, the role of empowerment model-based education, was investigated in the prevention of osteoporosis in female students. Methods: In this controlled trial, the target community (before and after) included female students of Islamic Azad University, Shahrekord Branch. The sampling method was two-stage stratified random sampling and the sample size was determined (75 people for each) in intervention and control group. Data were collected using a demographic questionnaire and a researcher-made questionnaire on individual empowerment for the prevention of osteoporosis (before the intervention and 3 months after intervention). Statistical analysis was carried out by independent t-test, paired t-test and Chi-square. Results: In this study, there was a significant increase in the scores of the constructs of knowledge (p

Introduction: To start and continue breastfeeding, primiparous women have many challenges. Breastfeeding self-efficacy is an important psychological and motivational variable, but is also modifiable for the continuation of nutrition with mother milk. The aim of this study was to investigate the effect of education through cyberspace on breastfeeding in women with their first birth. Methods: This classic experimental study was carried out on 65 primiparous women that referred to Shahrood maternity preparatory centers during their 28-32 pregnancy weeks in 2018. Two centers were randomly selected from four health centers and then, in an accessible way, 65 people were assigned to control and experimental groups. The experimental group received breastfeeding training educational program in 7 sessions with intervals of 45-60 minutes. The data was collected using a demographic questionnaire and breastfeeding self-efficacy and were analyzed using SPSS 21, independent sample, paired sample and covariance tests considering P

Background Mindfulness-based intervention has been found efficacious in reducing primary headaches and negative cognitive-related pain. However, little is known about the potential moderators in this regard. One of the most important moderators affecting the headaches is Alexithymia. Objective The present study investigated the moderating role of Alexithymia on the effect of Mindfulness- Based Cognitive Therapy (MBCT) on pain intensity in patients with primary headache. Methods A clinical trial was conducted in 2017 and 2018 at Imam Hossein Hospital of Tehran City, Iran. Using judgment sampling method, of 94 inpatients with chronic headache, 85 were selected and randomly assigned into the two groups of MBCT (43 patients) and control (42 patients). The Numerical Rating Scale (NRS) of Pain Self-Efficacy Questionnaire (PSEQ) and Pain Catastrophizing Scale (PCS) were applied to collect data. The obtained data were analyzed by Independent Samples t-test and Chi-squared test; longitudinal data were analyzed using linear mixed model analysis. Findings Statistically significant time×group interactions were found for pain intensity (P

Background and Objectives: Furosemide is one of the elements of drug therapy for cardiogenic pulmonary edema, but its systemic administration is associated with complications, such as hypotension, renal damage, and decreased serum potassium. Inhalation administration is a new route, which does not have the side effects of systemic administration, but its effectiveness is still unclear. The aim of this study was to determine the effectiveness of treatment with the nebulized furosemide in patients with acute cardiogenic pulmonary edema Methodes: This clinical trial study was conducted on 125 patients with acute cardiogenic pulmonary edema reffering to the Department of Emergency Medicine of Rasoul Akram and Firouzgar hospitals in 2017. The samples were randomly assigned to two groups of experimental (62 individuals receiving furosemide with nebulizer) and control (63 individuals receiving normal saline with nebulizer). After the vital Signs intervention, the data relating to the lung were compared using t-test and Chi square test. Results: There was no difference between the two studied groups in terms of the mean changes in systolic (intervention 129, plasebo 128.9) and diastolic blood pressures (intervention 79.2, plasebo 78), pulse rate (intervention 92.2, plasebo 91.8), respiratory rate (intervention 22.8, plasebo 22.3), and blood oxygen saturation (intervention 92, plasebo 91.7). Changes in lung auscultation showed no statistically significant changes between the groups (p = 0.56). Conclusion: The finding of the present study revealed that inhaled furosemide had no positive effect in the patients with acute pulmonary edema. Therefore, considering the novelty of the issue, further studies are recommended.

Background and Objectives: Performing physical activity is one of the inexpensive and available interventions in the field of self-care of gestational diabetes. Changing and modifying health behaviors in individuals can lead to preventing or delaying the disease and its complications. The aim of this study was to determine the effect of physical activity counselling based on the theory of planned behavior (TPB) on glycemic indexes in women with gestational diabetes. Methods: In a randomized clinical trial, the effect of counselling based on TPB was investigated in 50 women with gestational diabetes. The eligible subjects were assigned to two groups (control and intervention) using randomized block design; then, glycemic indexes were measured (pre- and post-intervention). Data were analyzed using independent and paired t-test. Results: In this study, the mean FBS (p=0.028), hemoglobin A1C (p=0.008), 2-hour postprandial blood sugar (p=0.002) and the number of admission (p

Introduction: Kangaroo mother care is a standard method based on skin contact with the mother and newborn skin. The aim of this study was to evaluate the effect of kangaroo mother care counseling on postpartum blues in women in Fatemieh Hospital, Hamadan. Methods: A randomized clinical trial was conducted on 104 pregnant women who referred to Fatemieh hospital in Hamadan city, 2016. Those who had gestational age of 37-42 weeks were randomly divided in to two groups of case and control according to the day of delivery. Postpartum routine care was performed in both groups. In the case group in first 24 hours after delivery, kangaroo mother care was taken with a counseling session (20-30 minutes) was performed until the 10th day of delivery. The after birth Stein questionnaire was completed before and after intervention in two groups. Data was analyzed using SPSS16, t-test and ANOVA. Results: The results showed that the intervention in the experimental group was about 4 times lower in postpartum distress score (P

Background: Rheumatoid arthritis (RA) is a chronic inflammatory polyarthritis with multiple clinical symptoms and psychological problems, such as depression. Psychotherapy can play an important role in achieving therapeutic goals. Objective: The purpose of this study was to determine the effect of cognitive behavioral therapy for adherence, depression (CBT-AD) and negative illness representations in people with RA. Methods: A clinical trial was conducted in Rheumatology’s clinic in a Shariaty hospital in Tehran during 2016-2017, Iran. Then, among 151 patients with rheumatoid arthritis, 28 patient were selected using the sampling judgment and half of them were randomly assigned to the CBT-AD (14 patients) and the others were in the control group (14 patients). Psychological questionnaires including the illness perception questionnaire-revised, beck depression inventory and general adherence Scale were measured. All data were analyzed by independent ttest, Chi-square and multivariate covariance analysis. Findings: The results showed that the baseline, post-test score between two intervention and control groups in three dimensions of illness representations (P

Background: Maternal request for caesarean section due to fear of normal vaginal delivery is one of the main reasons for the high rate of caesarean section. Objective: The aim of this study was to examine the effect of the presence of spouse in preparation class of delivery on fear of parturition in the nulliparous women. Methods: This controlled randomized trial was conducted in 152 pregnant women nulliparous referred to delivery preparation class in Qazvin. We received informed consent from participants. The samples were randomly assigned to intervention (n=76) and control groups (n=76). Eight sessions of the childbirth preparation classes were held for the intervention and control groups with or without the spouse respectively. Data collection tools were demographic characteristics and childbirth attitude questionnaire. Statistical testes such as T-test, and repeated measure were used for analysis. Findings: The mean age of the mothers participating in the study was 25.85±4.42 years. The decrease in mean of fear scores in the intervention group was significantly higher than the control group (28.58±6.47 and 32.82±5.79, respectively) (P

Background: According to national tuberculosis control guide, two-step tuberculin skin test (TST) should be done in the elderly, if the initial test is negative. However, it raises questions about the usefulness of this approach. Objective: This study aimed to explore the effects of fish oil supplements on the two-step tuberculin test in hospitalized patients. Methods: In this randomized controlled clinical trial, 128 patients randomly allocated to control group (receiving placebo, n=64) and treatment group (receiving fish oil supplements, n=64) during 2016. Fish oil supplement group was treated with 2 g daily for 4 consecutive days. The outcome was considered a change in 2 sequential TST induration sizes. Significant increase in the size of the secondary induration compared to primary was considered 6 mm or more. Findings: There was significant difference between primary and secondary indurations of two groups (higher in treatment group) (P=0.04). According to the results of analysis of variance and correlation tests, two effective factors were identified: initial induration and residence location (P=0.014 and P=0.002, respectively). In both groups, no clinically significant increase in the size of induration was observed. Conclusion: It seems that the number of cases considered as infected with tuberculosis does not increase with two- rather than one-step tuberculin skin test. Also, the short-term administration of fish oil supplements does not change this result. Keywords: Fish oils, Polyunsaturated fatty acids, Dietary supplements, Tuberculin test, Clinical trial

Background: Cesarean delivery is the most common surgical procedure and this prevalence is on the rise. Given these trends, cesarean wound complications, such as disruption or infection, remain an important cause of post-cesarean morbidity. Methods: We conducted a single-center randomized controlled trial that included women with viable pregnancies (≥24 weeks) undergoing cesarean delivery at Motahary University Hospital, Urmia, Iran from April to November 2014. All cesarean types were included: scheduled or unscheduled and primary or repeat cesareans. Women were excluded for the following reasons: inability to obtain informed consent, immune compromising disease (e.g. AIDS), chronic steroid use, diabetic mellitus and BMI≥30. Of 266 women, 133 were randomized to staples and 133 women to suture group. Results: The mean±SD age of the staples group was 27.6±5.4 years and mean±SD age of suture was 28.7±5.9 years. Multiparity is the most frequent in both groups that by using Chi-square test, no significant differences were observed between the two groups (P=0.393). The most frequent indication for cesarean section in both groups was history of cesarean section in staple 40 cases (30.1%) and suture 32 cases (24.1%). The survey was conducted using the Chi-square test was not significant (P=0.381). Pain at 6 weeks postoperatively was significantly less in the staple group (P=0.001). Operative time was longer with suture closure (4.68±0.67 versus 1.03±0.07 minute, P

Background: Infertility is defined as failure to achieve pregnancy after one year of unprotected sexual intercourse. Infertility can be related to male or female factors. Varicocele is the most common cause of infertility in men that is correctable with surgery. The purpose of this study was to determine the effects of recombinant follicle-stimulating hormone (rFSH) on semen parameters in infertile men. Methods: This randomized clinical trial was done on 96 infertile men admitted to the Women's General Hospital Mohebe-Yas from September 2014 to September 2015. Inclusion criteria were to include varicocelectomy for unilateral idiopathic varicoceles and consent to participate in the study. Allergy to the drug combination and patient dissatisfaction were exclusion criteria. Patients participating in the study were divided into two groups randomly, one group received recombinant FSH three times a week and the other group received a placebo (normal saline) in the same way. After three months, the improvement of semen parameters, including motility, morphology and sperm count as well as the complications were determined in both groups. The data were analyzed with statistical software SPSS version 13 (Chicago, IL, USA). Results: A total of 96 patients were enrolled in two groups of 48 men and women; both groups were matched in terms of underlying factors. The rate of improvement in the morphology and motility of sperm in the treated group was significantly more than the placebo group (P= 0.0001); but the changes in sperm count were not significantly different between the groups (P= 0.495). Conclusion: In summary, based on the results obtained in this study, it can be concluded that recombinant FSH is effective on improving semen parameters in infertile men after varicocelectomy compared with a placebo group and its major impact is on the morphology and motility of sperm.

Objectives: The elderly population is increasing globally and as the age increases and the functions of some organs decrease, some problems in elderly age, including sleep problems increase. Sleep disturbances cause neurological, autonomic, and biological changes. Therefore, attention should be paid to the problems that eliciting for the elderly and their families subsequently. The aim of this study was to evaluate the effect of oil on lemon on sleep disorders in the elderly. Methods & Materials: The study is a stratified design with IRCT2016061528485N1 registration Code and IR.USWR.REC.1395.50 Code of Ethics approved by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences. A total of 93 subjects (45 men and 48 women) were enrolled in the intervention, 22 men in the intervention group, 23 in the control group, 24 in the intervention group and 24 in the control group. Of these, 85 participated in the third stage of the intervention, 43 women (51%) and 42 men (49%), 41.17% in the age group of 74-60 years and 58.82% in the age group above 75 years. The Mean±SD age of the elderly was 75.88 ± 9.19 years, with the lowest age of 61 years and the highest age of 94 years. Outbreaks were hospitalized, departures and deaths. After completing an examination, a score of more than 5 Pittsburgh questionnaires, a visit by a psychiatrist and a self-reported sleep disorder, and considering the medical records, consumables , and entry criteria they were studied according to the randomization tables and divided into intervention and control groups. Validity and reliability of Pittsburgh questionnaire have been studied in various research. The intervention group received oil from the lemon and the inactive oil control group for four weeks, once daily, twice daily in the morning and night, with a drop per nose. No specific side effects were reported. In 3 cases, mild headache was reported, which was associated with a history of sinusitis, and the intervention was either performed or excluded from the tampon. Results: At the beginning of the study, demographic questionnaires, Pittsburgh Sleep Quality Index, and then Pittsburgh Questionnaire 2 and 4 weeks after the beginning of the intervention, were again asked by interview method and the data were analyzed by SPSS v. 23. The tests were one-way variance analysis, follow-up tests, independent samples T and single-sample t-test. Conclusion: Based on the results of the study, the oil to lemon has been shown to improve the sleep disorders of the elderly in the intervention group (P 000.03) and Effect size = 0.155). Sleep disturbances The intervention group improved in the second week and the fourth week after the onset of intervention compared to the control group

Aim: the efficacy and safety of combined therapy with anticholinergics and alpha blockers in comparison with alpha blockers monotherapy among patients with BPH. Methods: We conducted a single blinded RCT and 80 patients with BPH who referred to Ali-ebn-abitaleb, Zahedan were included. One group received 0.4 mg/d Tamsulosin in addition to Tolterodine and the other group received the same doses of Tamsulosin in addition to placebo. Both groups were evaluated before and 6 months after treatment with special attention to clinical symptoms, life quality improvement and treatment satisfaction. SPSS was applied for data analysis. Results: There is no significant difference between these two groups of patients’ demographics and basic indices such as PVR, PSA and the volume of prostate. IPSS was significantly improved among patients who received Toltrodine (p=0.0008) whereas both groups showed same score before treatment. Conclusion: It seems that combined therapy with anticholinergics and alpha blockers is a safe and efficient regimen among patients with BPH, either as primary or alternative treatment after the failure of conventional treatments.