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Introduction: Tele-nursing is a modern way of promoting quality of nursing care, treatment outcome, reducing medical costs and the need for visits, patient and family involvement in decision making, and careful patient monitoring by using all kinds of technologies. The aim of this article was to determine the most popular methods and related reasons for their common use in Iran. Methods: In this narrative literature review, PubMed, Science Direct, Google Scholar, SID, and Nindex were searched for full texts of Iranian studies published in English or Persian by using the descriptors of Tele-nursing, MHealth, nursing care, Telecare, and follow-up with phone calls between 2010 and 2020. The search found 472 articles and after considering the eligibility of articles, 56 articles were included. Results: The review found that 74% of papers reported the telephone as the first common method for tele-nursing. The second popular method was short message service (SMS) followed by internet and smartphone software. Conclusion: Tele-nursing includes many methods that nurses can use for distance nursing care which is not limited to telephone or SMS. In Iran, about 68 million people have a smartphone and have access to the internet. Nurses can use this potential capacity to improve nursing care.

Introduction: The most important compliant of post-operative orthopedic patients is severe and intolerable pain. This pain has negative impacts on patient’s satisfaction with pain management and bone healing after surgery. This study was conducted with the aim of evaluating the effects of Melissa officinalis (Melissa) tea and Matricaria chamomilla (Chamomile) tea on pain intensity and satisfaction with pain management in patients after lower limb orthopedic surgery. Methods: This was a randomized controlled trial conducted on 96 patients after lower limb orthopedic surgery in Ayatollah Kashani hospital of Shahrekord city, Iran. Patients were randomized to M. officinalis, Chamomile and control groups with blocking randomization method. For M. officinalis group, 1 g of Melissa tea, for Chamomile group 1 g chamomile tea and for control group black tea was prescribed 3 times a day. Study variables were evaluated before and 30 min after each stage of intervention and then the mean changes of pain intensity and satisfaction before interventions and after each step of intervention were compared between groups. Significance level was considered as PResults: Before intervention, the mean scores of pain intensity and satisfaction with pain management had no significance difference between groups. The mean changes of pain intensity and satisfaction with pain management (after first 3 steps of intervention) in M. officinalis and M. chamomilla groups were significantly greater than the ones in control group (PConclusion: Prescription of M. officinalis tea or Chamomile tea might be used as effective remedy for reducing pain and increasing satisfaction with pain management after orthopedic surgery.

Background and aims: Constipation is one of the most common issues in pediatrics. The aim of this study was to compare the effect of polyethylene glycol and the simultaneous administration of polyethylene glycol along with probiotics in the treatment of chronic functional constipation. Materials and Methods: In this randomized double-blind clinical trial, 150 children with chronic functional constipation referred to Imam Ali Clinic affiliated with Shahrekord University of Medical Sciences from 2017 to 2018 were included. The first group (A) consumed 1 g/ kg of body weight per day of water-soluble polyethylene glycol powder and the second group (B) consumed a probiotic powder and 1 g/kg of body weight of the water-soluble polyethylene glycol powder daily. In weeks 0, 1, and 2, questionnaires were filled out by the parents of the children and the data were analyzed. Results: The results showed that there was no significant difference in any of the variables between groups A and B (P=0.07) including the frequency of fecal excretion in week 1 (77% and 71%) and week 2 (4% and 5.4%) and stool consistency in week 1 (4% and 6.7%) and week 2 (86.7% and 92%). Moreover, there was no significant difference between groups A and B in any of the variables frequency of painful excretion in week 1 (74% and 73%, respectively) and week 2 (5.3% and 4%, respectively), frequency of abdominal pain in week 1 (61.3% and 49.3%, respectively) and week 2 (4% and 5.3%, respectively), and the frequency of fecal incontinence in week 1 (22.77% and 18.7%, respectively) and week 2 (6.7% and 1.3%) (P>0.05, respectively). Conclusion: Our results indicated that the administration of probiotic supplement (Lactobacillus Rhamnosus, Lactobacillus acidophilus, Lactobacillous Bulgaricus) has no effect on the improvement of symptoms in children with chronic constipation.

Background and aims: Postpartum depression has a high prevalence in communities and needs great financial resources. On the other hand, the world views the spiritual health as a new and complementary dimension of health. The aim of this study was to investigate the correlation between postpartum depression and spiritual health.Materials and Methods: This correlational-analytic study was conducted on 152 women who gave birth 8 months ago, referred to Hajar Hospital, Imam Ali hospital, Molavi clinic, or other health centers of Shahrekord, and were also satisfied with participating in the study. They were selected by the simple sampling method and completed the Palutzian and Ellison Spiritual Health Questionnaire. Finally, the collected data were entered in SPSS software and descriptive statistics in addition to the Pearson correlation coefficient and K2 test were used to analyze the data.Results: In the present study, the mean age of the subjects was 29.15 (SD=5.45) with the range of 16-45 years. The mean scores of spiritual health and depression were obtained 96.3 and 8.94, respectively. The results of this study showed that the Pearson correlation coefficient was -75.5% (P˂ 0.001), demonstrating an inverse correlation between the scores of postpartum depression and spiritual health.Conclusion: In general, the correlation between postpartum depression and spiritual health was an inverse correlation and the level of depression decreased by an increase in spiritual health. It can be concluded that without the need for specific treatments, the level of postpartum depression can be reduced by increasing the level of spiritual health.

Background and aims: Multiple sclerosis (MS) is an inflammatory disease of the central nervous system. The impact of the number of attacks on the disease is undeniable. The aim of this study was to analyze the number of attacks in these patients. Methods: In this descriptive-analytical study, the registered data of 1840 MS patients referred to the MS clinic of Ayatollah Kashani hospital in Isfahan were used. The number of attacks during the treatment period was defined as the response variable, age at diagnosis, sex, employment, level of education, marital status, family history, course of disease, and expanded disability as the explanatory variables. The analysis was performed using zero-inflated negative binomial model via Bayesian framework in OpenBUGS software. Results: Age at diagnosis (CI: -0.04, -0.20), marital status (CI: -0.56, 0.002), level of education (CI: -0.81, -0.26), Job (CIHousewives vs Employee=[0.04, 0.64], CIUnemployee vs Employee=[-1.10,0.008])), and course of disease (CI: -0.51, -0.08) had a significant effect on the number of attacks. In relapsing-remitting patients, the number of attacks was partial significantly affected by expanded disability status scale (EDSS) (CI: -0.019, 0.16). Conclusion: Aging, being single (never married), high education, and not having a job decrease the number of attacks; therefore, lower age, being married, primary education, and being a housewife increase the number of attacks. An interventional or educational program is suggested in order to prevent the occurrence of further attacks in high-risk groups of patients and to increase their chances of recovery.

Background: Electroconvulsive therapy (ECT) is an effective strategy in the treatment of mood disorders; however, it is associated with some cognitive complications. Objectives: This study aimed to evaluate the efficacy of donepezil as an acetylcholinesterase inhibitor in improving cognitive impairment induced by ECT in mood disorder patients. Methods: Ninety-six mood disorder patients were randomly assigned to the donepezil (5mg/day) or placebo groups. The Persian versions of the Mini-Mental Status examination (MMSE) and Addenbrooke’s Cognitive Examination Revised (ACE-R) were used to evaluate cognitive performance before the first ECT session, after the fourth ECT session, and four weeks after the last ECT session. Results: The mean scores of MMSE and ACE-R revealed significant improvement in the donepezil group over time (P < 0.001). All ACE-R subscales increased significantly following the intervention implementation in the donepezil group (P < 0.001). Furthermore, the donepezil group reported no remarkable complications and completed the study. Conclusions: Donepezil co-administration with ECT may improve the ECT-induced cognitive disturbances.

Aims: Atherosclerosis and ischemic heart disease are more common in diabetic patients. Atherosclerosis process can disturb the normal functioning of the vascular endothelium and increase vessel wall thickness. The aim of this study was the comparison of Carotid intima-media thickness (CIMT) with Exercise tolerance test as an alternative way to evaluate cardiac ischemia in diabetic patients. Methods: In a cross-sectional study, 30 diabetic patients with positive exercise test and 30 diabetic patients with negative exercise test were enrolled. CIMT of the carotid artery in both groups of patients was measured. Result: CIMT in the patients with positive and negative exercise test were 1.04 ± 0.21 mm and 0.61 ± 0.11 mm, respectively (P

Background: Anxiety is one of the most common psychological problems after myocardial infarction and can lead to many problems in acute coronary syndrome (ACS). Two possible ways to reduce anxiety are to listen to music and to recite the Holy Quran, the effects of which have never been compared to date. Objectives: The aim of this study was to compare the effect of listening to instrumental music and listening to Quran recitation on the anxiety level of patients with acute coronary syndrome. Methods: This semi-experimental study was conducted among 96 patients with ACS referred to Hajar Hospital, Shahrekord, Iran, from 3/10/2019 to 4/30/2019. The patients were entered into the study using the convenience sampling method and then randomly assigned to the three groups of Quran recitation, instrumental music, and control. In this study, the patients’ anxiety level was measured using Spielberger’s state-trait anxiety inventory (STAI) before and after listening to Quran recitation and instrumental music. Data were analyzed by SPSS version 16 using descriptive and analytical tests, including paired samples t-test, Chi-square, and one-way ANOVA. Results: Anxiety level decreased from 43.1 ± 6.15 to 38.5 ± 3.82 in Quran recitation group (P < 0.001) and from 44.2 ± 1.21 to 39.1 ± 4.17 in the instrumental music group (P = 0.035), and from 46.3 ± 3.84 to 44.7 ± 6.21 in the control group (P < 0.001). There was no significant difference between the three groups before the program. However, the mean score of anxiety level showed a significant difference, indicating that listening to Quran recitation had a greater effect than listening to instrumental music in reducing the patients’ anxiety (P = 0.02). Conclusions: Both interventions can be useful in decreasing the anxiety level of patients with ACS; however, the Holy Quran recitation had a greater effect in this regard.

Some medications and herbal drugs are suggested to ameliorate impaired plasma glucose and its complications in pre-diabetic patients. This study aimed to assess the effect of cumin essential oil supplementation on metabolic markers and serum leptin in pre-diabetic subjects. In a double-blind randomized controlled trial, subjects of intervention group received one cumin soft gel (containing 75 mg of cumin essential oil) per day for 10 weeks, while subjects of control group received one placebo soft gel. Glycemic indices and serum leptin did not significantly improve in intervention group. Except serum total cholesterol, other markers of lipid profile as well as anthropometric indexes improved in intervention group. Subgroup analyses represented that lipid profile and anthropometric indexes were ameliorated in women after intervention, while did not show significant improvement in men. It can be concluded that cumin essential oil can be used as an adjuvant therapy to ameliorate metabolic status in pre-diabetics.

Introduction: Decreased vitamin D levels may have a role in the development of metabolic syndrome due to its effect on the metabolic syndrome components or because of insulin resistance. Objectives: The aim of this study was to investigate the prevalence of vitamin D deficiency in obese individuals and to determine the relationship between deficiency of vitamin D with metabolic syndrome in obese people with metabolic syndrome and healthy individuals. Patients and Methods: In this descriptive-analytical study, samples were selected among obese individuals admitted to Hajar and Kashani hospitals in Shahrekord. Metabolic indices of the samples were measured and recorded along with information such as demographic characteristics. According to the indices, the subjects (n= 192) were divided into two equal groups of healthy obese and obese people with metabolic syndrome. Vitamin D levels were measured in both groups followed by determination of relationships between the vitamin D levels with metabolic syndrome and its indices. Results: The mean ages of the patients and healthy groups were 50.09±1.95 years and 52.57±2.05 years, respectively. The average serum vitamin D levels in the two groups showed a significant difference with significantly lower vitamin D levels in the metabolic syndrome group than those in the obese subjects (P 0.05). Conclusion: The results of this study indicated that vitamin D determination can be used for the prognosis and early detection of people at risk for metabolic syndrome.

Introduction: Serum level of high sensitivity C-reactive protein (hs-CRP), as an inflammatory marker, can play a role in development of metabolic syndrome in obese individuals. Objectives: This study aimed to determine serum concentration of hs-CRP in obese patients with metabolic syndrome and determine the association of this factor with factors involved in the progression of metabolic syndrome. Patients and Methods: In this study, samples were selected by convenient method from obese patients, admitted to Kashani and Hajar hospitals (Shahrekord, Iran). First, based on NCEP-ATPIIIdefined metabolic syndrome, parameters of metabolic syndrome and serum levels of vitamin D were measured and a questionnaire containing demographics was completed for each participant. Accordingly, the samples (n=192) were divided into two identical groups; obese individuals without metabolic syndrome (controls) and obese individuals with metabolic syndrome (case group). HsCRP levels were measured in both groups. Results: Serum level of hs-CRP in the case group was 17.58±1.40 µg/mL and in the control group was 9.04±1.26 µg/mL, which was significantly higher in the case group than the control group (P 0.05). Conclusion: Hs-CRP can be used for prognosis and early detection of patients at risk of metabolic syndrome.

Background Prospective cohort studies are considered ideal choices to study multiple outcomes and risk factors for Non-communicable diseases (NCDs). Our aim is to set-up the protocol and analyze risk factors, incidence rates, prevalence, trends, and the models of environmental and genetic determinants of NCDs and their outcomes as well as interaction among such determinants. Methods Shahrekord cohort study (SCS) that is a population-based prospective, study on a cohort consisting of people aged 35-70 years started in November 2015 in Iran. The sample size of the original cohort is at least 10,000 people. Annual follow-ups (200,000 person-year) of the cohort were designed to be conducted up to 2036. Exposures (a detailed demographic, socioeconomic, general health, quality of life, physical activity, anthropometric indexes, stress, health literacy, social capital, nutrition and eating habits, lifestyle, occupational history, living place, blindness, deafness, electrocardiography, lung capacities, blood pressure, sleep, smoking and alcohol, contact to animals, physical examinations and medical history, dental health, used drugs and supplements, glucose and lipid profiles) were measured by relevant standard methods and questionnaires. Incidence of common NCDs (cardiovascular diseases, cancer, gastrointestinal, respiratory, renal, hepatic, accidents, injury and neurological diseases), trend of risk factors, hospitalization, disability, and death were considered the outcomes of the cohort. The definition of disease was determined based on the International Classification of Diseases 10th version (ICD-10). Routine hematologic and biochemical tests were conducted and an all-inclusive biobank (blood, hair, nail, and urine specimens) of the cohort was stored for future studies. All steps of data collection and examinations are directly monitored by the quality control team. Discussion The SCS is a unique study conducted in southwest of Iran that is a notable work given the climate conditions and ethnicity population (especially in Bakhtiari) of this region. By providing high quality the protocol and introduce it, the SCS can serve as a solid foundation for management and researchers in southwest of Iran. The SCS provides prerequisites for collaboration and regional, national, and international studies on NCDs. Data are available at the modeling in health research center, Shahrekord University of Medical Sciences, Shahrekord, Iran, for any collaboration.

Reactive dyes have been applying extensively in textile industries. The treatment of textile industry waste waters is one of the main concerns of environmental health experts due to having excessive dyes and pollution. The aim of this study was to remove the Reactive Black 5 (RB5) dye from synthetic textile waste waters using agricultural wastes and determination of adsorption isotherm. In this research, Glycyrrhiza glabra root ash was prepared in laboratory condition and graded by standard sieve. The reactive Black 5 dye removals from textile synthetic wastewater using this adsorbent were tested. The effect of some parameters such as contact time (10–180 min), initial dye concentration (20, 40 and 60 mg/g) adsorbent dosage (0.2–2 g) and pH (2–12) were evaluated. Measurements were performed using an ultra violet-visible spectrophotometer at a wavelength of 597 nm and adsorption isotherm analyses were carried out. The results showed that data follow better the Langmuir adsorption model and the RL = 0.1123 was in the range of 0 to 1. Adsorption efficiency was reduced with increasing initial dye concentration and decreasing the adsorbent dosage. According to the results, the remaining root as an agricultural waste showed proper efficiency economically for the removal of dyes from textile industry wastewater

Introduction: Some assumptions have been made on the probable association between fever and pyuria. Objectives: The present study aimed to investigate the association between fever and pyuria. Patients and Methods: In this case-control study, 90 febrile and 90 non-febrile children aged more than one month who were admitted to the pediatric ward were included. Urine specimens of children less than 2 years of age were collected by urine bag. Midstream urine samples were collected and immediately sent to the laboratory for complete urinalysis and urine culture. Results: Overall, 6.7% in febrile children and 2.2% in control group had pyuria however there was no significant association between fever and pyuria (P>0.05). Additionally, no association between the presence of pyuria and type of disease was detected (P>0.40). Conclusion: The present study could not reveal any association between fever and pyuria in children older than one month.

Having desired facial features creates a better mental image, results in increased self-confidence and boosts social activities to a more acceptable level. The goal of the current study is to investigate how rhinoplasty surgery affects patients admitted to Shahrekord surgical clinic. The study was conducted on 100 patients randomly selected and referring for rhinoplasty surgery. The required information was collected through demographic questionnaires of rhinoplasty outcomes F 36 and Rosenberg’s self-esteem scale. The questionnaires were filled out by patients before surgery and 3 months after surgery. The data were analyzed using SPSS and data mining software. Out of the hundred participants, 63% were female and 37% were male. The number of individuals in the studied groups decreased in older age groups so that most of the participants were in the 20–24-year group followed by 25–30 y/o group. Patients from other age groups were less frequent. In terms of educational attainment, the highest frequency was associated with a BSc and the lowest with a diploma. In terms of employment status, the highest frequency was among students and the unemployed and employees and the self-employed followed. Body image and self-esteem were significantly improved after surgery (p

OBJECTIVE AND AIM: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases. The patient's fear and anxiety of shortness of breath and coughing during exercise may lead to a decrease in patients' daily activities. Therefore, the present study aimed to determine the effect of empowerment program based on the social cognitive theory (SCT) on the daily activity of patients with COPD. METHODS: This quasi-experimental study was performed on 70 patients with COPD referred to Kashani and Hajar centers in 2019. Samples were randomly divided into two groups of experimental and control. Data collection tools included demographic information questionnaire and activity of daily living questionnaire, specific for COPD, and a researcher-made questionnaire for measuring SCT constructs. For the experimental group, the training program consisted of four theoretical and practical sessions of 40 min/week. The data were collected at three time points, before, immediately and 3 months after the training are 3 time. The data were analyzed by SPSS software using descriptive and inferential statistics. RESULTS: The difference between the mean scores of behavioral ability, self-efficacy, and empowerment in the three stages was significant only in the experimental group (P < 0.001). The mean daily activity score of patients before, immediately, and 3 months after intervention showed a statistically significant difference between the two groups (52.46 ± 21.98, 63.36 ± 21.95, and 71.34 ± 19.02), respectively, in the intervention group, and (51.79 ± 19.29, 53.70 ± 19.28, and 53.82 ± 19.26), respectively, in the control group (P < 0.001). CONCLUSION: The results of this study showed that empowerment of patients through interventions based on SCT can increase the daily activity of patients with COPD. Because nurses play an important role in patient education and improvement, it is hoped that the findings of this study will be used as a strategy to increase the daily activity and ultimately improve the quality of life in these patients.

Introduction: Jaundice is one of the most common causes of admission to hospital in newborns which is often associated with several complications. Aim: The present study was conducted to evaluate the effect of H. vulgare in reducing jaundice. Materials and Methods: In this double-blind, randomized controlled trials 70 term infants hospitalized due to jaundice in 2014 were enrolled. Control group was treated with full-time phototherapy alone using LED except when the infants were breastfed and case group with phototherapy, as per the protocol in the control group, along with and topical H. vulgare seed flour three times a day. Data were analysed using and analysis of covariance (ANCOVA) and paired t-test in SPSS version 16.0. Results: There was a significant difference in mean indirect bilirubin level between the two groups p0.05. Conclusion: H. vulgare flour can cause decrease in indirect bilirubin. Because the rate of decrease in indirect bilirubin can be effective in preventing severe complications due to bilirubinemia, H. vulgare can be used as a complementary therapy to treat jaundice.

Objective: Diarrhea is the second leading cause of death in children. Therefore, the aim of this study was to investigate the effect of probiotics in the treatment of acute noninflammatory diarrhea in children aged 2–10 years in the Pediatric Ward of Hajar Hospital in Shahrekord. Methods: This clinical trial was performed on 184 children with diarrhea. Eighty‑six children were randomly assigned to the KidiLact probiotic group and 87 ones to the control group. Patients’ demographic information, symptoms, and other variables were recorded in a checklist. The data were analyzed by SPSS version 16 (Chicago, IL) using Chi‑square and independent t‑test. Results: The mean frequency of diarrhea in the 2nd and 4th days (P < 0.001), duration of fever (P = 0.01), duration of diarrhea (P < 0.001), and duration of hospital stay (P = 0.001) were significantly lower in the probiotic group than those in the control group. The frequency of recovery in the 2nd (P = 0.013) and 4th (P < 0.001) days was significantly higher in the probiotic group than that in the control group. There was no significant difference in the frequency of dyspepsia between the patients of the two groups (P = 0.331). Conclusion: Probiotics are effective in the treatment of acute noninflammatory diarrhea in children aged 2–10 years and can be used as a safe treatment alongside the standard treatment.

Background: Considering the increasing trend of childhood obesity and subsequent burden of the disease in Iran and other countries and importance of early life intervention for achieving sustained effect on health of children and adolescents, this study aimed to investigate the effect of two different dose of folic acid on homocysteine (Hcy) level and insulin resistance of obese children. Materials and Methods: In this randomized, double-blind controlled clinical trial study, 60 obese and overweight children aged 5–12 years were enrolled. Selected obese children randomly allocated in two interventional (1 mg/day folic acid and 5 mg/day folic acid, for 8 weeks) and one control groups. Biochemical measurements including folic acid, Hcy, insulin and insulin resistance were measured between and within groups before and after trial. Results: In each group, 20 obese children were studied. The three groups were age and sex matched. After folic acid administration, mean of Hcy, insulin resistance and insulin decreased significantly in two groups which folic acid administrated with two different doses (P < 0.05). The reduction in studied biochemical variables was similar in two interventional groups (1 and 5 mg folic acid daily) (P > 0.05). Mean differences for Hcy, insulin resistance and insulin, in two intervention groups were significantly higher than the control group (P < 0.0001). Mean differences of Hcy, insulin resistance and insulin, in two intervention groups were not different significantly (P > 0.05). Conclusion: The findings of current trial showed that folic acid in two studied doses could be a safe and effective supplement for obese children to reduce Hcy level and insulin resistance, which consequently could prevent obesity-related complications including cardiovascular and metabolic disorders.