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INTRODUCTION. Depression, anxiety, and stress are common problems among nurses. OBJECTIVE. This meta-analysis was conducted to investigate the prevalence of depression, anxiety, and stress among nurses working in Iranian hospitals. MATERIALS AND METHODS. Published studies on nurses working in Iranian hospitals were investigated in this meta-analysis. All national and international online databases, including Web of Science, PubMed, Scopus, Embase, Cochrane Library, Scientific Information Database (SID), MagIran, and IranMedex, as well as Google Scholar, were searched using related keywords without any time limits until September 2017. The heterogeneity of studies was assessed using the I2 index. Data were analyzed in STATA version 11.1. RESULTS. In 28 studies with a sample size of 6581 people, the prevalence of depression was 31% (n=2040) among Iranian nurses (31% in females and 28% in males) according to Beck’s Depression Inventory (BDI); 30% (n=1974) (54% in females and 40% in males) according to the 21-Item Depression, Anxiety and Stress Scale (DASS-21); and 9% according to the General Health Questionnaire (GHQ-28). The prevalence of mild, moderate, and severe depression in nurses was 39%, 16%, and 20% according to the BDI; 8%, 24%, and 4% according to DASS-21; and 48%, 36%, and 16% according to GHQ-28, respectively. The prevalence of anxiety and stress was 85% and 67% in Beck’s inventory, 28% and 38% in DASS-21, and 46% and 49% in GHQ-28, respectively. CONCLUSION. According to the BDI and DASS-21, about one-third of Iranian nurses have depression with a female predilection. Nurses play an essential role in improving the quality of treatment; therefore, health policymakers must pay attention to reducing depression among nurses.

Knee osteoarthritis is the most common articular disease, and non-medical treatment of this disease has attracted the attention of researchers. The purpose of this study was to compare the effects of aromatherapy and massage therapy on knee pain, morning stiffness, daily life function, and quality of life in patients with knee osteoarthritis.This is a clinical trial. In this study, 93 patients referred to the Imam Ali Hospital (Physical Therapy Clinic) who entered the study were randomly divided into three groups including massage therapy (n = 31), aromatherapy (n = 31), and the control (n = 31). The data gathering tools were a demographic characteristics questionnaire and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The questionnaire was completed before intervention and at the 5th and 10th sessions after intervention in all three groups. Data were analyzed by SPSS software version 20, and Chi-square, Fisher's exact test, repeated measures test, one-way ANOVA test, and Tukey's post hoc test were used for analysis.The study shows that mean score subscale Symptoms and dryness in the 5th session and 10th session of intervention in the aromatherapy group is significantly higher than in the control group (p0.05). The massage therapy group had the highest pain score at the beginning of the intervention, but at the end of the 10th session of intervention had the least pain score. Mean score subscale Performance of daily life in the 5th session and 10th session of intervention in the aromatherapy group is significantly higher than in the control group (p0.05). Mean score in the subscale Performance, exercise, and recreational activities significantly differs between the aroma therapy and massage therapy groups compared with the control group in all times of interventions (p0.05), and in the mean score in the subscale Quality of life, there is no significant difference between the groups in all times of interventions (p0.05).The use of both massage therapy and aromatherapy is recommended for patients with knee osteoarthritis. Interventions should be prolonged for at least 6 months in patients so their effects appear on the patient.Hintergrund: Osteoarthritis des Kniegelenks ist die häufigste Erkrankung der Gelenke, und ihre nicht-medikamentöse Behandlung steht zunehmend im Fokus der Forschung. Das Ziel dieser Studie war es, bei Patienten mit Osteoarthritis des Kniegelenks die Auswirkungen von Aromatherapie und Massagetherapie auf Knieschmerzen, Morgensteifigkeit, Funktionsfähigkeit im Alltag und Lebensqualität zu vergleichen. Methoden: Es handelt sich um eine klinische Studie. In dieser Studie wurden 93 Patienten, die dem Imam Ali Hospital (Klinik für physikalische Therapie) zugewiesen und in die Stu­die aufgenommen wurden, per Randomisierung in drei Gruppen aufgeteilt: Massagetherapie (n = 31), Aromatherapie (n = 31) und eine Kontrollgruppe (n = 31). Die Datenerhebung erfolgte mit einem Fragebogen zu demografischen Merkmalen und dem KOOS-Fragebogen (Knee Injury and Osteoarthritis Outcome Score). Die Fragebogen wurden in allen drei Gruppen vor der Intervention und beim 5. und 10. Termin nach Interventionsbeginn ausgefüllt. Die Daten wurden mit der Software SPSS Version 20 analysiert; getestet wurde mittels Chi-Quadrat-Test, Fisher-Exact-Test, Test mit Messwiederholungen, einfaktorieller ANOVA und Tukey-post-hoc-Test. Ergebnisse: Die Ergebnisse der Studie belegen, dass der mittlere Score auf der Subskala für Symptome und Trockenheit beim 5. und 10. Behandlungstermin in der Aromatherapie-Gruppe sich signifikant von dem der Kontrollgruppe unterscheidet (p0,05). Die Massage­therapie-Gruppe hatte zu Beginn der Intervention den höchsten Schmerzscore, am Ende des 10. Behandlungstermins jedoch den niedrigsten Schmerzscore. Auch beim mittleren Score auf der Subskala für die Alltags-Performance liegt beim 5. und 10. Behandlungstermin ein signifikanter Unterschied zwischen Aromatherapie-Gruppe und Kontrollgruppe vor (p0,05). Beim mitt­leren Score auf der Subskala für Performance bei Sport- und Freizeitaktivitäten bestehen sowohl in der Aromatherapie- als auch in der Massagetherapiegruppe zu jedem Interventionszeitpunkt signifikante Unterschiede zur Kontrollgruppe (p0,05), während beim mitt­leren Score auf der Lebensqualität-Subskala zu keinem der Interventionszeitpunkte ein signifikanter Unterschied zwischen den Gruppen besteht (p0,05). Schlussfolgerung: Sowohl die Massagetherapie als auch die Aromatherapie werden als Behandlungsmaßnahmen für Patienten mit Osteoarthritis des Kniegelenks empfohlen. Der Interventionszeitraum sollte mindes­tens 6 Monate betragen, damit die Wirkung sich beim Patienten entfalten kann.

Background Diabetes foot self-care is one of the self-management behaviors of diabetic patients leading to a reduction in the incidence of pressure ulcers and amputation. Having a valid, reliable, simple and comprehensive tool is essential in measuring the self-care behavior of diabetic patients. The aim of this study was to evaluate the psychometric properties of the Farsi version of the diabetes foot self-care bahavior scale (DFSBS) in Iran. Methods In this cross-sectional and methodological study, 500 patients with type 2 diabetes were recruited by convenience sampling. Construct validity was assessed by exploratory factor analysis (over 300 patients) and confirmatory factor analysis (over 200 patients). Internal consistency was calculated by Cronbach’s alpha coefficient and its stability was calculated by intraclass correlation coefficient (ICC). Results In the exploratory factor analysis, two self-care factors related to feet and shoes were extracted which had specific values of 38.49 and 1.24, respectively, and were able to account for 56.22% of the total self-care variance of diabetes foot. Confirmatory factor analysis had excellent fit model. The internal consistency and ICC of the whole instrument were 0.83 and 0.791 (95% CI: 0.575–0.925; P Conclusions The Farsi version of DFSBS (F-DFSBS) has good validity and reliability, and due to its appropriate psychometric properties, this tool can be used in future studies.

INTRODUCTION. Chronic non-communicable diseases (NCDs), global health problem and it is a threat to health and the development of countries. Currently, the number of people with COVID-19 as well as the resulting death toll is rising sharply worldwide. People with underlying diseases may be at greater risk. AIM. The purpose of the present study was to investigate the chronic non-communicable diseases in the epidemic (COVID-19): Investigation of risk factors, control and care. METERIALS AND METHODS. To access the articles, including international databases Scopus, PubMed, Web of Science, Embase were searched using the keywords of chronic non-communicable diseases (NCDs), chronic, risk factors, prevention and control, self-efficacy and self-care and their various combinations using AND/OR operators. No language restrictions were applied to the search process. RESULTS. Based on the evidence, NCDs, exacerbate the negative consequences of COVID-19. according to the results of this study, Among the patients admitted with COVID-19, The most common underlying diseases, were in these people, include, cardiovascular disease, hypertension, chronic obstructive pulmonary disease (COPD), smoking, malignancy, chronic kidney disease, and diabetes mellitus. Obesity may be considered as a potential COVID-19 risk factor. CONCLUSIONS. Although lifestyle, nutrition, and medical interventions are important for the early prevention of NCDs, having the tools and resources to use information more effectively is more important One of the determining and effective factors in maintaining health and preventing the aggravation of signs and symptoms of the disease COVID-19, especially in chronic diseases, is to perform self-care behaviors.

The aim of this study was to explore the effectiveness of Methadone Maintenance Treatment (MMT) from the perspective of drug users and their families. For this qualitative content analysis study, 1...

This article reports the findings of a study designed to investigate the effectiveness of the Roy Adaptation Model, as it relates to improvements in nursing care outcomes for patients undergoing coronary bypass graft surgery. Results revealed that the implementation of a training program based on this model enhanced staff education and led to decreases in the level of fatigue and improved the quality of life for this group of patients.

Introduction: Diabetic nephropathy (diabetic kidney disease) is a complication of diabetes that begins and progresses with several factors, including hyperglycemia, inflammation and oxidative stress. Objective: This study demonstrates the effect of sevelamer carbonate administration on hemoglobin A1c levels, blood sugar and inflammatory factors in diabetic nephropathy patients. Patients and Methods: In this clinical trial, 48 diabetic patients under treatment of least one drug who have proteinuria (urinary protein to creatinine ratio greater than 0.5) ≥ 2 times during the past 18 months, received sevelamer carbonate or placebo for two months. Patients’ blood samples were taken before and after the intervention. Data were analyzed by SPSS software. Results: According to the results, fasting blood sugar (FBS), hemoglobin A1c (HbA1c), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) showed no significant difference between the study groups before and after the intervention (P>0.05). The mean ICAM-1(intercellular adhesion molecule-1) and VCAM-1 (vascular cell adhesion molecule1) showed no significant difference between the study groups before the intervention (P>0.05). However we found a meaningful difference after the intervention, which was significantly lower in the intervention group (PConclusion: Sevelamer carbonate administration in patients with diabetic nephropathy has a significant effect on decreasing ICAM-1 and VCAM-1 levels. Trial registration: The trial protocol was approved in the Iranian Registry of Clinical Trial (identifier: IRCT20191111045401N1; https://en.irct.ir/trial/43662, ethical code; IR.SKUMS. REC.1397.181).

Type 2 diabetes mellitus (T2DM) is a multi-factorial disease in which influenced by several genetic and environmental factors. Insulin receptor substrate 2 (IRS 2) is the main mediator of insulin in the liver which controls insulin sensitivity. Gly1057Asp polymorphism is one of the candidates to increase risk of T2DM. The present study is an attempt to study the relationship of Gly1057Asp polymorphism of IRS-2 and T2DM by a meta-analysis. A systemic search was conducted in English and Persian databases such as Scopus, PubMed, Google Scholar, SID, and other academic databases for studies that have investigated the relationship of Gly1057Asp polymorphism of IRS-2 and T2DM. This association was determined using odds ratios (ORs) with a confidence interval of 95% (CIs). Heterogeneity of the studies was examined by I2 index. Funnel plots and Egger tests were used to determine bias or publication bias. The collected data was analyzed in STATA through meta-analysis. Nine articles were selected as eligible for further analysis, which represented 3,196 patients with T2DM and 3409 controls subjects without T2DM. The present meta-analysis showed a significant relationship between GA genotype of Gly1057Asp polymorphism and T2DM (OR=0.88; 95% confidence interval, 0.79-0.98), whereas no significant relationship between GG and AA genotype with T2DM was seen; OR for GG and AA genotypes were 1.10 (95% CI, 0.99 -1.22) and 1.13 (95% CI, 0.95- 1.33), respectively. The results of our study show that genotype GA of Gly1057Asp polymorphism of IRS-2 gene plays a protective role and may decrease the risk of T2DM, whereas GG and AA genotypes are considered as a risk factor and related to development of T2DM to some extents.

Chronic obstructive pulmonary disease (COPD) is an irreversible pulmonary obstruction. Respiratory exercise training by a feedback-based model besides the routine managements have been considered to perform.Eighty exacerbated COPD patients with informed consent were divided to the control group (n = 40) received the routine approach and the intervention group (n = 40) received a teach-back training method (TBTM) of respiratory exercise including diaphragmatic breathing (DB), pursed-lip breathing (PLB), and effective coughing (EC) plus routine approach. The clinical outcomes were evaluated by measurement of the FEV1/FVC ratio, the Borg scale of dyspnea (BSD), and the 6-minute walking test (6MWT) results at the baseline, just after TBTM, and next 3 months.FEV1/FVC ratio has been indicated the significant improvement followed by TBTM compare to the baseline (p 0.001). Moreover, the BSD scores in 3-month follow-up after TBTM were significantly lower compared to the baseline (6 ± 1.3 vs. 3.8 ± 0.78, p 0.001). Although a significant difference was reported in 6MWT distance between two groups after 3-month follow-up (p 0.001), there was no significant difference immediately after the TBTM (p = 0.992) that suggested a long-term effect of educational intervention on physical activity.Significant enhancement in the clinical variables can demonstrate the efficacy of the TBTM program in reducing COPD patients' symptoms.http//www.irct.ir.Unique identifier: IRCT20181024041449N5.

Background: Coronary angiography is an invasive procedure used to diagnose coronary artery disease, and standard nursing care before, during, and after this procedure. A comparison of the current care with the existing standards can lead to improved nursing care quality, increased patient safety, and reduced medical costs. Objectives: Therefore, the aim of this study was to audit the nursing care provided before angiography. Methods: In this analytical descriptive study, the nursing care provided to 400 patients undergoing coronary angiography was evaluated using the event-based sampling method in the angiography ward of hospitals affiliated to Shahrekord University of Medical Sciences. Data were collected by a demographic form and a standard nursing care checklist. Data were analyzed using descriptive statistics (i.e., frequency, mean, and standard deviation) and analytical statistics (i.e., chi-square, independent t-test and analysis of variance) in SPSS 18 version. Results: Before angiography, nursing care compliance score was 51.63 ± 4.21, which was significantly different than the normal value (normal score: 61 - 81). At the preoperative stage, 25 (6.3%), 374 (93.5%), and 1 (3%) caring cases, the standard of nursing care was poor, moderate, and good, respectively. Conclusions: Based on our results, in one case, the provided nursing care was in accordance with the standard of nursing care at the preoperative stage of angiography, which can be attributed to the lack of education, control, facilities and awareness among nurses about the importance of standard care.

Objectives Self-care is a major factor in managing diabetes. This study aimed to determine the self-care status of Iranian patients with diabetes and to estimate the percentage of self-care in these individuals through a systematic review and meta-analysis. Methods In this systematic review and meta-analysis 53 domestic articles published in Farsi and English were evaluated. We conducted database searches in domestic and foreign databases of Scientific Information Database (SID), MagIran, Google Scholar, Web of Science, Pub Med, and Scopus with no time limit. Data analysis was performed in Stata version 12 using meta-analysis method and the random effects model. Results A total of 50 articles (53 groups) with a sample size of 9565 were systematically reviewed. The percentage of self-care in patients with diabetes was reported to be 48.86 (95% confidence interval [CI]: 43.79–53.94). According to the results, the percentage of self-care score was higher in patients with type I diabetes (55.53) when compared with patients with type II diabetes (49.26). Conclusions Since patients with diabetes obtained only half of the self-care score and given the importance of self-care in controlling and treating diabetes, it is necessary to perform actions to improve self-care such as benefiting from health facilities, and social and family support.

Patients with type 1 diabetes mellitus (T1DM) are at high risk for celiac disease (CD) due to the common genetic background and interaction between environmental and immunological factors. The purpose of this systematic review and meta-analysis was to estimate the prevalence of CDamong Iranian patients with type 1 diabetes. The search for articles was conducted using the following keywords: “celiac disease,” “celiac,” “coeliac disease,” “diabetes,” “Iran,” and all other possible combinations of these terms. The following databases were searched from inception to June 2019: Scientific Information Database (SID), MagIran, Web of Science, PubMed, and Scopus. Meta-analysis was performed using the random-effects models, and the heterogeneity of results across the studies was assessed using the Cochran’s Q test and quantified by the I2 statistic. Data analysis was performed by Stata version 14. A total of 14 papers were included in the meta-analysis, involving 2030 Iranian patients with T1DM. The pooled prevalence of CD in patients with T1DM was 5% (95% CI 3–7). The prevalence of CD in Tehran (4%; 95% CI 1–6) was lower than in other provinces of the country (6%; 95% CI 4–8). Meta-regression analysis showed that, with increasing sample size, the prevalence of CD was significantly reduced (p = 0.018).Given the adverse effects of CD, such as osteoporosis and malignancy (especially lymphoma), patients with T1DM must be screened for CD.

Objective: Pancreatic cancer is one of the leading causes of mortality in developed countries and a lethal malignant neoplasm worldwide. This study aims to evaluate the epidemiology of pancreatic cancer incidence and mortality and its relationship with HDI. Methods: This is a descriptive cross-sectional study that is based on cancer incidence data and cancer mortality rates derived from the GLOBOCAN in 2018. The incidence and mortality rates of Pancreas as well as Pancreas cancer distribution maps were derived for world countries. The data analysis was conducted using a correlation test, and regression tests were used to evaluate the correlation of the incidence and mortality of Pancreas with HDI. The statistical analysis was carried out by Stata-14, and a significance level of 0.05 was considered. Results: The highest incidence of pancreatic cancer was reported in Asia with 214499 (46.7%) cases and the lowest incidence was related to Oceania with 4529 cases (0.99%). The results showed a positive and significant correlation between incidence (r = 0.764, P Conclusion: Given the higher incidence and mortality of pancreatic cancer in countries with HDI, it is necessary to pay a greater attention to risk factors and appropriate planning to reduce these factors and minimize the impact and mortality rate of this disease.

Objective: The aim of this study was to explore the burden of care for patients undergoing hemodialysis from the experiences of family caregivers. Methods: In this qualitative study, a content analysis approach was used for data collection and analysis. Participants were 16 family caregivers selected through purposive sampling from four medical education centers affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran. Semi-structured interviews were held to collect data. Results: Four categories were developed as follows: ‘care challenges’, ‘psychological vulnerabilities’, ‘the chronic nature of care ’and “care in the shade”. The categories led to the development of the main theme of ‘progressive exhaustion’ experienced by the family caregivers during the provision of care to patients undergoing hemodialysis. Conclusion: Family caregivers have a significant role in the process of patient care, and this role leads them to progressive exhaustion; therefore, the overall health of the caregivers should be taken into account and more attention should be paid to their quality of life, social welfare, and satisfaction level. Keywords: Family caregivers, Hemodialysis, Progressive exhaustion, Qualitative study

Background: Chronic kidney disease (CKD) is a consequence of progressive and irreversible destruction of nephrons, mainly due to uncontrolled diabetes mellitus and high blood pressure. Ghrelin is a peptide hormone which could play a substantial role in hunger sensation, may increase body fat percentage and might adjust the long-term body weight and is mostly secreted in the stomach. Objectives: This study aimed to evaluate the relationship between ghrelin levels and various biochemical and demographic indices in a group of non-diabetic hemodialysis patients. Patients and Methods: Around 39 non-diabetic patients undergoing hemodialysis in Hajar hospital at Shahrekord city were enrolled. Results: The mean age of patients was 57.10±20.20 years. Their mean weight was 56.65 ±16.25 kg. Their hemoglobin level mean was 10.43±1.84 g/dL. The serum ghrelin level had a positive but not significant correlation with the age, dialysis quality, dosage, calcium level, alkaline phosphatase (ALP), parathormone, vitamin D and hemoglobin in these patients. Conclusions: More studies in this subject of hemodialysis patients to define the exact role of ghrelin in hemodialysis patients are recommended.

Context: Type 2 diabetes mellitus (T2DM) is a multi-factorial disease with several genetic and environmental factors known to be associated with the disease. Tumor necrosis factoralpha (TNF-α) acts on fat cells associated with increased insulin resistance and obesity and its increase can be associated with the prevalence of T2DM. Previous studies on the relationship between 308 G/A polymorphism in TNF-α and T2DM were not conclusive. The aim of this study was to investigate the association between 308 G/A polymorphism in TNF-α gene and T2DM using a systematic review and meta-analysis. Evidence Acquisitions: In this systematic review we searched all published studies about the association between TNF 308 G/A polymorphism and T2DM through databases such as Scopus, Science direct, PubMed and Google scholar. A fixed or random effect model was used on the basis of heterogeneity. The heterogeneity was assessed using the I2 index. We used STATA software (version 11.2) for data analysis. Results: In 22 selected papers, the total number of T2DM and control subject was 8485 and 8615, respectively. Odds ratios (ORs) with 95% confidence intervals(CI) for the GG genotype polymorphism 308 G/A in total, Asian populations and whites (Caucasian) were estimated as OR=0.98 (95% CI: 0.96-1.00), OR=0.96 (95% CI: 0.93 to 0.99) and OR=1.00 (95% CI: 0.97 to 1.40). The Publication Bias/or heterogeneity was observed in this study. Conclusions: The present investigation have shown that 308 G/A polymorphism GG and GA genotypes in TNF-α gene cannot be considered as predictors of T2DM (P

Aims and background:Breast cancer (BC) is responsible for a large proportion of incidence of cancer in the world. Identifying the risk factors contributing to the incidence of BC is crucial to find efficient preventive and management strategies for this disease. Several studies have examined Arsenic (As), Cadmium (Cd), and Nickel (Ni) as risk factors for BC. The present study aimed at studying the link between As, Cd, and Ni concentrations and BC by using a meta-analysis. Materials and methods: All case�control studies addressing the relationship between As, Cd, and Ni concentrations with BC were identified through electronic search databases ( Scopus, ISI Web of Science, PubMed, EmBase, and Cochrane Library). The relevant data obtained from these papers were analyzed by a random-effects model. The heterogeneity of studies was secured by using I2 index. Funnel plots and Egger�s test were used to examine publication bias. Results: In the present study, due to different measurement methods used for measuring As, Cd, and Ni, the concentration of these elements was measured in various subgroups (1: plasma, 2: breast tissue, and 3: scalp hair and nail) of individuals with BC and healthy subjects. The overall integration of data from the 3 groups led to the conclusion that there was a significant difference in Cd and Ni statuses between healthy and BC patients; the standard mean difference was 2.65 (95 CI: 1.57�3.73; P=0.000) and 2.06 (95 CI: 1.20�3.32; P=0.000), respectively. Whereas, there was no significant statistical difference in As status between healthy subjects and BC patients; the standard mean difference between them being 0.52 (95 CI: �0.12�1.16; P=0.114). Conclusion: The present study indicates that there is a direct and positive association between Cd and Ni concentrations and BC risk. It is a warning to health care providers and policy makers to find viable solutions and take requisite measures to reduce BC risk in the society. © 2018 Jouybari et al.

Introduction: Anemia is a common complication of chronic kidney disease (CKD) due to the insufficient production of erythropoietin by the kidneys. The administration of erythropoietin is one of the most common methods for the treatment of patients with anemia. Objectives: This study aimed to investigate the effect of the administration of synthetic erythropoietin on hemoglobin levels in dialysis patients using a systematic review and meta-analysis. Methods: In order to identify the related studies, the international databases of Web of Science, PubMed, Scopus, and Embase were searched from 2015 to 2020 using standard and valid keywords. The data were analyzed using STATA software (version 14), and a p-value of less than 0.05 was considered statistically significant. Results: In 12 reviewed articles with a sample size of 4,060 individuals, the standard effect size of the effect of synthetic erythropoietin on Hb in dialysis patients was reported as 2.08 (95% CI: 1.53-2.63), which was statistically significant; however, erythropoietin biosimilars did not show similar results. Conclusion: The administration of erythropoietin to hemodialysis patients increases Hb levels by more than 2 units.

OBJECTIVES: This study was conducted to determine the efficacy of mindfulness-based cognitive therapy (MBCT) on psychological symptoms and quality of life (QoL) in patients with systemic lupus erythematosus (SLE). METHODS: We conducted a randomized single-blind clinical trial in patients with SLE referred from the Imam Ali Clinic in Shahrekord, southwest Iran. The patients (46 in total in two groups of 23 each) were randomly assigned into the experimental and control groups. Both groups underwent routine medical care, and the experimental group underwent eight group sessions of MBCT in addition to routine care. The patient,s QoL was assessed using the General Health Questionnaire-28 and 36-Item Short Form Health Survey before, after, and six months after intervention (follow-up). RESULTS: A significant difference was seen in psychological symptoms and QoL between MBCT and control groups immediately after the intervention and at follow-up (p ≤ 0.050). However, the difference was not significant for the physical components of QoL (p ≥ 0.050). CONCLUSIONS: MBCT contributed to decreased psychological symptoms and improved QoL in patients with SLE with a stable effect on psychological symptoms and psychological components of QoL, but an unstable effect on physical components.

Background: Cardiac and respiratory arrest is reversible through immediate cardiopulmonary resuscitation (CPR). However, survival after CPR is very low for various reasons. This systematic review study was conducted to assess the effect of palliative care on quality of life and survival after CPR. Methods: In the present meta-analysis and systematic review study, two researchers independently searched Google Scholar and MagIran, MedLib, IranMedex, SID, and PubMed for articles published during 1994–2016 and containing a number of relevant keywords and their Medical Subject Headings (MeSH) combinations. A total of 156 articles were initially extracted. Results: The success of initial resuscitation was reported to be much higher than the success of secondary resuscitation (survival until discharge). Moreover, the early detection of cardiac arrest, a high-quality CPR, immediate defibrillation, and effective postresuscitation care improved short- and long-term outcomes in these patients and significantly affected their quality of life after CPR. Most survivors of CPR can have a reasonable quality of life if they are given proper follow-up and persistent treatment. Conclusions: Concerns about the low quality of life after CPR are therefore not a worthy reason to end the efforts taken for the victims of cardiac arrest. More comprehensive education programs and facilities are required for the resuscitation of patients and the provision of post-CPR intensive care.

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

Background: Thalassemia is considered as a group of genetic blood disorders, characterized by anemia. The present research aimed at evaluating the effects of aquatic exercise on quality of life and blood indices in patients with beta-thalassemia major. Methods: A clinical trial study involving 40 patients with thalassemia major, divided into two groups: experimental and control. The tools used to collect the data included demographic information questionnaire, blood indicators questionnaire, and SF-36 quality of life questionnaire. The experimental group performed exercise in water three times per week for 8 weeks in the pool after obtaining the consent. In this research, the quality of life questionnaire was filled out 24 h before the intervention, 24 h after the last session of the exercise program, and 2 months after the end of the exercise program. Results: The current research revealed that exercise in water affected the quality of life, hemoglobin, hematocrit, iron and ferritin of serum such that the mean score of quality of life and blood indicators in the study showed a significant difference in the experimental group. Conclusions: The use of a regular exercise program combined with drug therapy and blood transfusion can be useful in the treatment of beta-thalassemia patients.

BACKGROUND: Although stenting for the treatment of large and multiple common bile duct stones has been acceptable to everyone, its efficacy and outcome have not been studied in comparison with other endoscopic procedures. The purpose of this study was to compare the consequences of stenting and endoscopic papilla balloon dilatation for the treatment of large and multiple common bile duct stones. METHODS: In a double-blind clinical trial, of 431 patients with bile duct stones referred to the treatment center, 64 patients with multiple common bile duct stones (≥3) and more than 15 cm were selected for the study, then by random allocation rule the participants were allocated in two groups. They were entered into two different endoscopic papillary balloon dilatation (EPBD) and common bile ducts stenting treatments so that both procedures were performed by a person. Both groups were assessed from the point of views therapeutic outcomes such as duct cleaning, pancreatitis, isolated pain, and duct rupture. Data were collected by a self-made questionnaire that was used before and after the procedure to obtain the needed information. Then data were analyzed using SPSS software version 22 and descriptive and analytical tests were used as appropriated. RESULTS: Although the duct cleaning and the complete removal of the stones in the stenting treatment procedure was 93.8%, and in EPBD was 78.3%, no significant difference was observed between the two groups ( p =0.14). Pancreatitis significantly increased after the first and second endoscopic retrograde cholangiopancreatography (ERCP) in the stent group compared with EPBD ( p =0.02). Also, the most frequent cases of isolated pain were in the endoscopic group EPBD ( p =0. 0). However, the occurrence of perforation after first ERCP and EPBD was zero, but in the second stage of ERCP, 3.3% of the patients had perforations ( p = 0.99). The results indicated that the shape of the stone (circular and angled) was not effective in the result of treatment in the two groups. CONCLUSION: The results of this study indicated that in case of experience and skill in conducting the ERCP, common bile duct stenting is still the first line of treatment for large and multiple stones of the common bile ducts. KEYWORDS: s CBD stone, Endoscopic treatment of EPBD, CBD stenting, ERCP

Introduction: Prostate cancer is the most common malignant cancer in men worldwide and after lung cancer, it is the second leading cause of cancer mortality in men. The purpose of this study was to investigate the relationship between prostate cancer and metformin consumption in men. Methods: The current study is a systematic and meta-analysis review based on the PRISMA statement. To access the studies of domestic and foreign databases, Iran Medex, SID, Magiran, Iran Doc, Medlib, ProQuest, Science Direct, PubMed, Scopus, Web of Science and the Google Scholar search engine were searched during the 2009- 2018 period for related keywords. In order to evaluate the heterogeneity of the studies, Q test and I2 indicator were used. The data were analyzed using the STATA 15.1 software. Results: In 11 studies with a sample size of 877058, the odds ratio of metformin consumption for reducing prostate cancer was estimated at 0.89 (95%CI: 0.67-1.17). Meta-regression also showed there was no significant relationship between the odds ratio and the publication year of the study. However, there was a significant relationship between the odds ratio and the number of research samples. Conclusion: Using metformin in men reduces the risk of prostate cancer but it is not statistically significant.

Background: Hypertension is a risk factor for renal disease. Therefore, this study was aimed at estimating the prevalence of hypertension in renal patients in Iran through meta-analysis. Methods: The search was carried out using authentic Persian and English keywords in national and international databases including IranMedex, SID, Magiran, IranDoc, Medlib, ScienceDirect, Pubmed, Scopus, Cochrane, Embase, Web of Science, Medline, and Google Scholar search engine without any time limitation until 2017. Heterogeneity of studies was assessed using the I2 index. Data were analyzed using STATA ver 11. Results: In 35 reviewed studies with a sample of 39,621 subjects, the prevalence of hypertension in renal patients was 35% (95% CI: 29%–41%) (25% in women and 18% in men). The prevalence of systolic hypertension in renal patients was 5%, diastolic hypertension 26%, and diabetes 23%. The prevalence of hypertension in hemodialysis patients was 34%, 27% in peritoneal dialysis, 43% in kidney transplantation, and 26% in chronic renal failure. In addition, meta-regression showed that the prevalence of hypertension in renal patients did not significantly decrease during the years 1988–2017. Conclusions: More than a third of kidney patients in Iran suffer from high blood pressure. The diastolic blood pressure of these patients is about five times higher than their systolic blood pressure. Moreover, the age group under 30 is a high-risk group. The prevalence of hypertension in women with kidney disease is higher than in men. In addition, patients who have kidney transplants are more likely to have high blood pressure than other kidney patients.

Background: Diabetes is the fifth leading cause of death in the world, which reduces the patients' quality of life (QOL) and is considered as an important subject especially in medicine and medical community. The present study aimed at investigating the QOL of diabetic patients in Iran through meta-analysis. Methods: The search was conducted using relevant keywords in national and international databases including Iranmedex, SID, Magiran, IranDoc, Medlib, Science Direct, PubMed, Scopus, Cochrane, Embase, Web of Science. Questionnaires WHOQOL, SF-36, SF-20, DQOL, QOL, PedsQL, ADDQOL, D-39, DQOL-BCI, SWED-QUAL, IRDQOL, PHG-2, EQ-5D, and IDQOL-BCI were used to assess the QOL. Heterogeneity of studies was assessed using I2 index. Data were analyzed using STATA version 11. Results: In 96 studies of 17,994 people, the mean score of QOL in diabetic patients was based on the questionnaires WHOQOL [66.55 (95% CI: 45.83, 87.26)], D-39 [129.43 (95%CI: 88.77, 170.10)], SF-36 [65.64 (95% CI: 59.82, 71.46)], SF-20 [46.50 (95% CI: 37.19, 55.81], DQOL [61.19 (95% CI: 35.73, 86.66)], QOL [117.91 (95% CI: -62.97, 298.79)], PedsQL [34.36 (95% CI: -31.49, 100.22)], ADDQOL [41.76 (95% CI: 12.01-71.50)], SWED-QUAL [59.19 (95% CI: 21.15, 97.23)], IRDQOL [105.92 (95% CI: 102.73, 109.10)], PHG-2 [61.00 (95%CI: 59.63, 62.37)], EQ-5D [0.62 (95% CI: 0.61, 0.64)], DQOL-BCI [3.40 (95% CI: 3.31, 3.49)], and IDQOL-BCI [22.63 (95% CI: -2.38, 47.64)]. Conclusions: The QOL of diabetic patients was evaluated according to different types of questionnaires and the QOL of diabetic patients was found to be lower than normal population.

Increasing awareness regarding CKD and self-care during COVID-19 pandemic has become the most important aspect for the nephrologists. Hence it is appropriate that the theme of the forthcoming World Kidney Day on 11 March 2021 should be "Strive for kidney health for everyone during COVID-19"

Background and aims Cardiovascular disease (CVD) remains an important cause of mortality and morbidity that can be prevented by the consumption of healthy foods. These include blueberry, a dark coloured berry containing extremely high amounts of functional ingredients. We therefore examined the extent to which supplementation with blueberry effects on CVD risk indices. Methods We searched the ISI Web of Science, Scopus, PubMed and Cochrane Library on March 2020 and checked reference lists from primary studies and review articles for any additional studies. No language restrictions were applied. All randomized and controlled clinical trials (RCTs) using blueberry supplements to modify CVD risk factors were included in our analysis. Results Mean Difference (MD) was pooled using a random effects model and 11 studies were included in the final analysis. Pooled effect size showed that supplementation with blueberry had a small insignificant effect in reducing plasma triglycerides (MD = −0.27 mmol/l; 95 % CI: −0.57, 0.17, p = 0.06). Although current study found no differences between blueberry and control groups for any other outcomes, subgroup analysis suggested a favourable impact of blueberry on reducing body weight. Significant weight loss was indicated from studies longer with a follow up of more than 6 weeks or with blueberry powder or freeze-dried blueberry. Conclusion Current evidence is insufficient to show a benefit of blueberry supplements in modifying CVD risk factors across a variety of adult populations. Robust data and larger studies are required to assess potential effects.

Contrast medium is used daily for accurate and effective diagnostic procedures. They are often necessary to provide an exact diagnosis and are almost safe and effective when used correctly. However contrast media can sometimes be life-threatening especially in elderly, since the elderly suffer from several problems. Aging is frequently accompanied by chronic diseases like chronic renal failure, comorbidity, frailty and disability. Therefore, it is important to know how reactions to contrast agents manifest and how to manage them immediately. Decreased kidney functions are sometimes seen after intravenous contrast media injection therefore radiologists should monitor all stages of the contrast injection. Accordingly, the medical team should have information on the complications, prevention and care of the patients under contrast media.

Background and Objective: Bladder cancer (BC) is the most common cancer of the urinary and genital tract. Many factors, including environmental and socioeconomic factors, also affect the incidence and mortality of BC. The aim of this study was to evaluate the epidemiology of BC incidence and mortality worldwide based on the data extracted in 2018. Materials and Methods: The present study is a descriptive-analytic study that extracts the incidence and mortality rates of cancer from the World Bank in 2018. The incidence and mortality rates and BC distribution maps were drawn for world countries. To analyze data, correlation test and regression tests were used to evaluate the correlation between the incidence and mortality with the Human Development Index (HDI). The statistical analysis was carried out by Stata-14 and the significance level was estimated at the level of 0.05. Results: The results showed a positive and statistically significant correlation between the incidence (r = 0.587, P

Background: Improved living conditions and increased life expectancy have led to aging in societies. Increased incidence of chronic heart disease is one of the most important economic, social, and health challenges of the 21st century. Aim: This study aimed to examine the effect of exercise training on dimensions of quality of life and mental status in people with congestive heart failure Class II and III. Materials and Methods: This study was carried out on patients with chronic heart failure. For this purpose, 52 eligible patients were chosen and randomly divided into case and control groups. The participants in the case group were asked to follow an exercise program three sessions per week in the morning for 24 weeks. This exercise program comprised 5–10 min of warming, 20–30 min of exercise, and 5 min of cool-down. Data were collected by the SF-36 questionnaire and analyzed by the SPSS version 18. Results: The results revealed that there was a significant difference in the mean score of various dimensions of quality of life including NYHA functional Classes II (P = 0.032) and III (P = 0.027), fatigue, BP, and general health in Classes II (P

Introduction Substance Use Disorders (SUDs) represents a serious problem in Iranian community that may lead to psychological disorders in families. Aim This study was conducted to investigate the association of SUDs with family members' psychological disorders. Materials and methods The sample size of the study consisted of 724 people referred to a counseling and psychology clinic in Shahrekord, southwest Iran. For data gathering, random method was adopted. After the relationship was established with the patients during the counseling and their confidence was gained, development of SUDs and related effect on the referred patient's family members were investigated by a pre-developed checklist. The statistical tests used to analyse the data were chi-square, Fisher's exact test, and odds ratio. Results The most frequent disorder noted was depression (40.5%) followed by generalized anxiety disorder (21%), minor interpersonal and children's behavioural problems (15%), and hysteria (8%). Depression, hysteria, and minor interpersonal and children's behavioural problems in the women and men were reported 48% vs. 20%, 9% vs. 5%, and 10% vs. 27%, respectively. A significant association was seen between SUDs in the patients' spouses and children as well as in their families, and gender, marital status, and occupation, but not place of residence and education. Conclusion An association was seen between the psychiatric disorders in the people referring the studied center and SUDs in their families. Addiction in family plays an important role in developing or recurring psychiatric disorders in other family members.

Introduction: In the light of the advances in treatment measures and early discharge of patients with mental disorders from psychiatric hospitals, families play important role in caring for such patients. Aim: The aim of this study is to determine the Quality of Life (QoL) of the family caregivers of patients with mental disorders. Materials and Methods: This cross-sectional study was conducted in teaching health care centers affiliated with medical universities in Tehran, Iran. Sampling was conducted by convenience random technique. Participants were 238 family caregivers of mental disorder patients and the Short-Form Health Survey Questionnaire was used to gather data. The data were analyzed by Spearman’s correlation, t-test and ANOVA in SPSS 18.0. Results: The women’s mean QoL was lower than the men’s. Regarding family relationship with the patients, the lowest QoL was observed among the mothers. There was a significant relationship between the caregivers QoL and economic status, the caregivers gender, family relationship with the patients and the patients’ gender (p

Background: Quality of life in patients affected with chronic diseases has developed into a therapeutic objective as the best tool to evaluate response to treatment and medical care. The purpose of this study was to evaluate quality of life and its related factors in tuberculosis patients receiving directly observed treatment short-course in Iran. Methods: This was a cross-sectional research with a descriptive-analytic design. Sample size included 71 patients affected with tuberculosis based on census method; so that, at the time of the study, all the tuberculosis patients were recruited in this research. The data collection instrument was a questionnaire comprised of two parts including demographic characteristics information and standard 36-Item Short Form Health Survey (SF-36). The data were also analyzed using SPSS Statistics along with descriptive and analytic statistics and independent t-tests, analysis of variance (ANOVA), and Chi-square test. Results: The lowest mean score was 63.58 ± 10.16 and 62.82 ± 15.2 related to limited physical activity following mental problems and social functioning, respectively. Furthermore, the findings of the independent t-test demonstrated that the mean scores of quality of life among men and women, those with pulmonic and non-pulmonic tuberculosis, patient's place of residence and the stage of treatment were statistically and significantly different. Conclusion: According to the above results, tuberculosis and its treatment have impact on the social function, mental, and emotional aspects of the quality of life of patients, Attention to and monitoring of the quality of life as a follow up of the treatment and care intervention in these patients is necessary. Keywords: Tuberculosis, Quality of life, DOTS, Iran

Introduction: In the developed world, infertility is on rise and has become a social concern. This is considered as a serious stress in life and exerts a severe psychological impact on the couple. Aim: This study was conducted to study the efficacy of stress management based on group cognitive-behavioural therapy on marital satisfaction in infertile women. Materials and Methods: This was a quasi-experimental study with a pretest-post-test design and control group. The study sample consisted of 40 infertile women enrolled based on convenience sampling and randomly assigned to two groups: experimental and control, of 20 each. Then, the experimental group underwent 10 two-hour stress management sessions per cognitive-behavioural therapy. The instruments used in this study were marital satisfaction inventory ENRICH and a checklist of demographic characteristics. Immediately and three months after completion of the intervention, the instruments were administered to the participants. The data was analysed by analysis of covariance in SPSS 18. Results: There was a significant difference in marital satisfaction between the experimental and control groups in both post-test (p=0.001) and follow-up (p=0.001). Conclusion: The stress management based on cognitivebehavioural therapy could contribute to increasing marital satisfaction in infertile women. The effect could remain stable three months after the last interventions (follow-up).

Introduction: Multiple sclerosis (MS) as a chronic disease could affect patients’ various domains of life. Aim: This study was conducted to study the effect of yoga on the physiological indices, anxiety and social functioning of patients with MS in southwest, Iran. Materials and Methods: In this clinical trial study, 60 MS patients were enrolled according to inclusion criteria and randomly assigned to two groups of 30 each. Prior to and after intervention, the patients’ vital signs were measured. For case group yoga exercises were performed three sessions a week for 12 weeks while control group performed no exercise. The data were gathered by questionnaire and analysed by descriptive and analytical statistics in SPSS. Results: Prior to intervention, there was no significant difference in fatigue severity and pain between the two groups but the mean fatigue severity and pain in case group decreased compared to the control group after the intervention. Prior to intervention, there was no significant difference in mean physiological indices between the two groups but the mean physiological indices in case group decreased significantly after the intervention (p

Although pharmacotherapy with atypical antipsychotics is common in child psychiatry, there has been little research on this issue. To compare the efficacy and safety of risperidone and aripiprazole in the treatment of preschool children with disruptive behavior disorders comorbid with attention deficit-hyperactivity disorder (ADHD). Randomized clinical trial conducted in a university-affiliated child psychiatry clinic in southwest Iran. Forty 3-6-year-old children, diagnosed with oppositional defiant disorder comorbid with ADHD, were randomized to an 8-week trial of treatment with risperidone or aripiprazole (20 patients in each group). Assessment was performed by Conners' rating scale-revised and clinical global impressions scale, before treatment, and at weeks 2, 4, and 8 of treatment. The data were analyzed by SPSS version 16. Mean scores between the two groups were compared by analysis of variance and independent and paired t-test. Mean scores of Conners rating scales were not different between two groups in any steps of evaluation. Both groups had significantly reduced scores in week 2 of treatment (P = 0.00), with no significant change in subsequent measurements. Rates of improvement, mean increase in weight (P = 0.894), and mean change in fasting blood sugar (P = 0.671) were not significantly different between two groups. Mean serum prolactin showed a significant increase in risperidone group (P = 0.00). Both risperidone and aripiprazole were equally effective in reducing symptoms of ADHD and oppositional defiant disorder, and relatively safe, but high rates of side effects suggest the cautious use of these drugs in children.

Introduction: Irritable bowel syndrome (IBS) is one of the most prevalent gastroenterological disorders. IBS is characterized by abdominal pain, cramping, diarrhea, constipation, bloating and flatulence. Complementary therapy is a group of diverse therapeutic and health care systems and products that are used in treatment of IBS. Hypnotherapy helps to alleviate the symptoms of a broad range of diseases and conditions. It can be used independently or along with other treatments. Aim: This study was conducted to compare therapeutic effect of hypnotherapy plus standard medical treatment and standard medical treatment alone on quality of life in patients with IBS. Materials and Methods: This study is a clinical trial investigating 60 patients who were enrolled according to Rome-III criteria. The sample size was determined per statistical advice, previous studies, and the formula of sample size calculation. The participants were randomly assigned to two groups of hypnotherapy plus standard medical treatment group (n: 30), and standard medical treatment group (30). The study consisted of three steps; prior to treatment, after treatment and six months after the last intervention (follow-up). The instruments of data gathering were a questionnaire of demographic characteristics and standard questionnaire of quality of life for IBS patients (Quality of Life IBS-34). The data were analysed by analysis of co-variance, Levene’s test and descriptive statistics in SPSS-18. Results: There were significant differences between the two groups of study in post-treatment and follow-up stage with regards to quality of life (p

Introduction: Sleep is referred a regular, recurring and easily revocable state of organism which is characterized by relative immobility and significant increase in response threshold to environmental stimuli. Sleep disorders are common among haemodialysis patients. Aim: The aim of this study was to investigate the effect of sleep hygiene education on sleep quality in haemodialysis patients. Materials and Methods: This study is a randomized controlled clinical trial. The participants of this study were 60 haemodialysis patients admitted to the Dialysis Center of Shahid Ayatollah Madani Hospital of Khoy, affiliated with the Urmia University of Medical Sciences. Sampling was done randomly and the partcipants were randomly divided into intervention group (30 patients) and control group (30 patients). Sleep quality of participants was measured before and after the intervention by Pittsburgh Sleep Quality Index (PSQI). Training process for sleep hygiene behaviours was presented to the participants face-toface. The data were analysed using SPSS 16. Results: A significant difference in the mean (standard deviation) score for PSQI (p

Introduction: Needlestick and sharps injuries (NSIs), are among the main job-related injuries that health care workers experience. In fact, contraction of hepatitis B or hepatitis C from work-related NSIs is one of the most common occupational hazards among health care workers. Aim: The aim of this study was to determine the factors associated with NSIs in health care occupation. Materials and Methods: In this study, a systematic and purposive review with emphasis on the research question was run to retrieve, evaluate and consolidate the required information. The following four key words were used to search for the relevant articles published from January 1998 to May 2015: NSI health care workers, risk factor and factors associated, in Science direct, EBSCO Host, PubMed, ProQuest, SID and Cochrane Library. Several steps of evaluation were taken to select and analyse the full texts of relevant articles. According to the inclusion criteria, we finally selected 11 articles from the 18642 retrieved articles. Results: The data of the analysed articles indicated that the highest incidence of NSIs was seen in nurses and that the associated factors were age, level of education, number of shifts per month and history of related training. The highest rate of NSIs was related to instrument preparation followed by injection and recapping of used needles. Findings show that health care workers suffer a high rate of needlestick injuries. Conclusion: It was seen that device, location, or action cannot be separately considered as responsible for all types of the NSIs. Rather, each of them has a contribution to the NSIs. Nevertheless, factors with higher frequency should be given a higher priority.

Otitis media (OM) is a relatively common infectious disease, and its chronic form may lead to complications such as hearing impairment. This study aims to determine the prevalence, etiology, antibiotic susceptibility, and complications of OM in Iran through meta-analysis. English language databases, including Science Direct, PubMed, Scopus, Web of Science, and Persian language databases, including SID, Magiran, Iranmedex, Medlib, as well as the Google Scholar search engine, were searched from 1994 to 2017, using the Mesh keywords: Otitis media, Middle ear, Causality, Etiology, and Iran. The heterogeneity assessment of the studies was done using Q-Cochran test and I2 index. Considering the high heterogeneity of the studies, the random effects model was used to estimate the point prevalence with 95% confidence interval. Data were analyzed using STATA version 11.1 software. Fifty-one articles with a sample size of 10,675 were reviewed in this study, the most common types of OM involvement were right otitis (51% [95% confidence interval (CI): 33–68]), left otitis (44% [95% CI: 36–52]), and bilateral otitis (33% [95% CI: 7–59]). The most common bacterial etiologies involved in OM were Pseudomonas aeruginosa (26% [CI 95%: 17–35]), Proteus (21% [95% CI: 0%–45%]), and Staphylococcus (20% [95% CI: 0–42]). The fungal etiology of OM was estimated to be 22% (95% CI: 4–40). The most common OM pathologies were ossicular changes (56%[95% CI, 27–85]), granulation (49% [95% CI: 18–80]), cholesteatoma (32% [95% CI: 13–51]), tympanosclerosis (17% [95% CI: 10–23]), and cholesterol granuloma (11% [95% CI: 0–26]). The results of this meta-analysis provide useful information on the epidemiology of OM in Iran to otorhinologists and health policymakers.

Background This study was conducted to investigate the effects of family training and support on quality of life and cost of hospital readmissions in congestive heart failure patients. Methods In this single-blinded, randomized, controlled trial, the participants were heart failure patients hospitalized in an Iranian hospital. Data were collected from available hospitalized patients. The participants were enrolled through randomized sampling and were divided randomly into two groups, an intervention group and a control group. The intervention group received extra training package for the disease. Training was provided at discharge and three months after. A standard questionnaire to assess the QoL was filled out by both groups at discharge and six months after. Results Mean scores of QoL domains at the beginning of the study decreased in control group and increased in intervention in comparison with six months after ( p Conclusion Nursing care follow-up according to heart failure patients' needs promoted their QoL.

Background: Ejection fraction promotion in heart failure patients reduces mortalities and limitations. Objectives: This study was to investigate the effect of exercise on ejection fraction of chronic heart failure patients. Patients and Methods: The present study was conducted on patients with chronic heart failure. 66 patients were divided randomly into two experimental and control groups of 33 each. The subjects were male and female. The patients in experimental group followed an exercise program three sessions per week for 24 weeks. Echocardiography and quality of life questionnaire were used to gather data. The data were analyzed by SPSS 18 through pair and independent t-test. Results: The results indicated a significant difference in left ventricular diameter (LV-ESD, LV-EDD) and ejection fraction at the end of exercise program in experimental group and 24 weeks after in control group. There was a significant difference in quality of life in physical performance, activity limitation following physical problems, energy and fatigue, social performance, physical pain, and public health (P < 0.05 for all) between two groups. Conclusions: Exercise program increases ejection fraction and quality of life in chronic heart failure patients, associated with management of disease by health team.

Background: Today, chronic low back pain is one of the special challenges in healthcare. There is no unique approach to treat chronic low back pain. A variety of methods are used for the treatment of low back pain, but the effects of these methods have not yet been investigated adequately. Aim: The aim of this study was to compare the effects of Pilates and McKenzie training on pain and general health of men with chronic low back pain. Materials and Methods: Thirty-six patients with chronic low back pain were chosen voluntarily and assigned to three groups of 12 each: McKenzie group, Pilates group, and control group. The Pilates group participated in 1-h exercise sessions, three sessions a week for 6 weeks. McKenzie group performed workouts 1 h a day for 20 days. The control group underwent no treatment. The general health of all participants was measured by the General Health Questionnaire 28 and pain by the McGill Pain Questionnaire. Results: After therapeutic exercises, there was no significant difference between Pilates and McKenzie groups in pain relief (P = 0.327). Neither of the two methods was superior over the other for pain relief. However, there was a significant difference in general health indexes between Pilates and McKenzie groups. Conclusion: Pilates and McKenzie training reduced pain in patients with chronic low back pain, but the Pilates training was more effective to improve general health.

Background: Hepatitis is an inflammatory disease which has many adverse effects on patients' life because of its chronic nature. Since Orem's theory of self-care is a grounded theory, the concepts and applications of this theory in patients with chronic hepatitis who have special needs may lead to some challenges. The purpose of this study was to explore self-care in patients with chronic hepatitis. Methods/Design: A directed content analysis was used in this qualitative study. Participants were recruited from a metropolitan area. Data were collected through semi-structured interviews. The verbatim transcripts of the participants' interviews were analyzed according to directed content analysis. Results: In this study, four themes, suggested by Orem, were drawn from the data according to directed content analysis. The codes generated from the data were classified into concepts and then the concepts were assigned into these four themes. These themes were needs in the matrix of time and place, self-care agency, need for change in self-care and consequences of hepatitis. Conclusion: The use of Orem's self-care theory cannot meet the need for self-care in hepatitis patients because these patients have vital sexual, respect and belonging, physical, economical, and psychological-behavioral needs, and lack adequate knowledge about self-care. Consequently, the specific self-care model developed in this study helps health professionals identify self-care activities in patients with chronic hepatitis.

Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder among preschool children but the number of controlled clinical trials regarding psychopharmacological treatment in this age group is limited. The aim of this study was to compare methylphenidate with the combination of methylphenidate and risperidone in preschool children with ADHD. Forty-two preschool children, aged 3-6 years, diagnosed with ADHD by a child and adolescent psychiatrist according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-Text Revision criteria, were enrolled in a 6-week, single-blind clinical trial and administered with methylphenidate (5-30 mg/dl) or the combination of methylphenidate and risperidone (0.25-2 mg/dl) in Iran. Treatment outcomes were assessed using the Conners′ Rating Scale and Clinical Global Impression (CGI) Scale at baseline and 3 and 6 weeks after starting the drugs administration. Side effects were rated by a checklist and body weight was measured at each visit. There were no significant differences between the two protocols in Parent Conners′ Rating Scale scores (P > 0.05) and CGI scores (P > 0.05). Both groups showed a significant improvement in ADHD symptoms over the 6 weeks of treatment for Parent Conners′ Rating Scale (P < 0.001). The combination group used significantly lower doses of methylphenidate compared to the other group (P = 0.002). The most common adverse effects were anorexia (21.7%) and daytime drowsiness (17.4%) in combination treatment group and insomnia (33.3%) and anorexia (25%) in methylphenidate group. Risperidone and methylphenidate may be effective and well tolerated in preschool children with ADHD, and adding risperidone to methylphenidate may decrease the occurrence of some side effects of methylphenidate such as insomnia and anorexia and lower the dose of methylphenidate may be needed to control symptoms.

The objective of this study is to describe the quality of life (QoL) in cancer patients with solid tumors and at different chemotherapy (CT) cycles.A total of 200 cancer patients were included. With some modification, the European Organization for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ-C30) was used to measure QoL in the student patients.There was no correlation between the QoL and variables such as age, sex, marital status, duration of disease, economic conditions, and occupational function. Furthermore, no correlation was found between QoL and the patients' educational level (literate or illiterate). Nevertheless, a significant difference was found between the level of QoL in patients with ≤ 2 CT cycles and/or with 3-5 cycles (p0.001).This study suggests that encouraging cancer patients to complete a CT course plays an important role in the treatment outcome and the QoL in cancer patients undergoing CT.