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Background and aims: Cancer has significant effects on the lives of cancer patients and their families, so effective communication skills are an integral part of the process of caring. This study aims to investigate the effect of Peplau’s Therapeutic communication model on body image and pain among cancer patients. Methods: The present research is a quasi-experimental study conducted with the attendance of 64 cancer patients undergoing radiotherapy in Shahrekord Parsian Hospital in 2020-2021. First, the research units were selected purposefully and then randomly assigned to intervention and control groups. In the intervention group, Peplau’s nursing model was done in four stages individually. Data collection tools were a demographic survey questionnaire, McGill Pain Questionnaire, and Body Image Questionnaire (MBSRQ). The mean scores before, immediately after, and three months after were compared using SPPS version 24 software. Results: Before interfering, the results of the study indicated the standard deviation±mean of body image scores in control and intervention groups were respectively 204.81±2.79, 206 (217-75.187)+that were not significantly different from each other (P≥0.568). Whereas these scores immediately and three months after had statistically significant differences from each other (P

Introduction: Diabetes mellitus (DM) is distinguished as a serious health problem worldwide. The universal outbreak of DM because of urban life and alteration of lifestyle, day to day is increasing. Objectives: The present investigation was designed to evaluate the nephroprotective effects of resveratrol (RSV) and silymarin (SM) on morphologic injury to renal tubular cells in adult male diabetic rats. Materials and Methods: Twenty-five male Wistar rats randomly were designated into five groups (n = 5) including group I (control); rats received normal saline by gavage for 14 days. Group II; rats received a single injection of STZ at a dose of 60 mg/kg intraperitoneally and were also given isotonic saline orally for 14 days. Group III; Rats, after STZ injection, received 100 mg/kg of SM by gavage for 14 days. Group IV; Rats, after STZ injection, received 100 ml/kg of RSV by gavage for 14 days. Group V; rats, after STZ injection, received the combination of SM and RSV at a dose of 100 mg/kg by gavage for 14 days. The kidneys were removed immediately after sacrificing and prepared for morphological examination. Kidney sections were examined for the intensity of kidney damage (vacuolization, flattening, degeneration and necrosis). Results: Significant differences were observed in types of morphologic injury to renal tubular cells (vacuolization, flattening, degeneration and necrosis) between groups (P

Introduction: It is crucial for patients with chronic disease to learn the skills they need to manage their illnesses, which is called empowerment. Objectives: This review study aimed to evaluate the need for empowerment and self-efficacy in patients with chronic disease. Methods: The keywords were looked up in articles published between 2014 and 2023 using electronic databases, including Web of Science, PubMed, Embase, Scopus, and the search engine Google scholar. All obtained pertinent papers and books were analyzed based on the search method and the established criteria, and all redundant and unrelated items were excluded. Results: Results showed that empowerment and self-efficacy were conducted as a technique or strategy to guide patients and caregivers. An empowerment and self-efficacy model can promote quality of life (QoL) in chronic disease patients. Despite empowerment being beneficial for patients with chronic illnesses in previous studies, it should also be implemented for patients with other diseases. Conclusion: Given this literature results, the empowerment and self-efficacy model can improve the QoL in patients with chronic illnesses. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID: CRD42023417639).

Introduction: Diabetes mellitus (DM) is a metabolic disease associated with the disorders in the metabolism of carbohydrates, proteins, and lipids that affect insulin action. Objectives: The present study was designed to evaluate the nephroprotective effect of Eryngium caucasicum (Eryngo) extract alone and in combination with metformin (MET) in adult male diabetic rats. Materials and Methods: Thirty male Wistar rats randomly were designated into five groups (n = 6) including; group I (Control); rats received normal saline by gavage for 15 days. Group II; rats received a single injection of STZ at a dose of 60 mg/kg intraperitoneally. Group III; rats, after STZ injection, received 30 mg/kg of MET by gavage for 15 days. Group IV; rats, after STZ injection, received 30 ml/kg of Eryngo extract by gavage for 15 days. Group V; rats, after STZ injection, received the combination of MET and Eryngo extract at a dose of 30 mg/kg by gavage for 15 days. The kidneys were removed immediately after sacrificing and prepared for morphological examination. Kidney sections were examined for the intensity of kidney damage (vacuolization, flattening, degeneration, and necrosis). Results: Significant differences were observed in types of morphologic injury to renal tubular cells between groups (P < 0.05). Eryngo extract had more protective effect against kidney damage due to DM compared to MET and the combination of MET+Eryngo. Additionally, in pairwise comparisons of groups, the relationship between group II (DM group) and group IV (DM + Eryngo) was significant (P < 0.05). Conclusion: The administration of MET and Eryngo extract alone and their combination ameliorate types of morphologic injury to renal tubular cells in diabetic rats, however, the renoprotective effect of Eryngo extract alone is more remarkable.

Abstract Introduction As a result of high transmission and mortality rates, the Covid-19 pandemic has led to a worldwide health crisis, isolation, and widespread fear, therefore negatively influencing people’s quality of life (QOL). The goal of the present study was to examine the psychometric properties (validity and reliability) of the Persian version of the COVID-19-Impact on Quality of Life (COV19-QoL) scale. Methods After translating the scale using the forward–backward method, face and content validly was qualitatively assessed. Then the scale was distributed to 488 individuals from the general population via online platforms. Construct validity was assessed using exploratory (EFA) and confirmatory (CFA) factor analysis. In addition, internal consistency was examined using Cronbach’s alpha coefficient and McDonald’s omega, relative stability was assessed using interclass correlation coefficient (ICC), and absolute stability was calculated through examination of standard error of measurement. Results The EFA revealed one factor that explained 55.96% of the total variance of the scale. Internal consistencies of 0.823 and 0.882 were found using Cronbach’s alpha coefficient and McDonald’s omega, respectively. In addition, an ICC of 0.837 (with a two-week interval) was found. Covid-19 had a greater impact on the QOL of healthy participants than that of those with underling conditions (p = 0.004), and also on the QOL of single participants than that of married ones (p = 0.032). Conclusion The Persian version of the COV19-QoL is a valid and reliable instrument that can be used to examine the impact of Covid-19 on QOL.

Biodegradable and absorptive wound dresses with antibacterial activity are in demand to accelerate wound healing along with eliminating bacterial infection. Plant-derived naphthoquinones compounds such as lawsone have shown sustained antibacterial functions to avoid development of bacterial resistance by reducing pH or attaching to bacterial proteins. Here the nanofibrous mats based on chitosan/polyethylene oxide (PEO) fibers containing various concentrations of lawsone (0, 1, 3, 7, 10% wt.) were fabricated by electrospinning for potential applications as wound dressing materials. The results exhibited that the chitosan/PEO/Lawsone nanofibers possess antibacterial activity toward Gram-negative and -positive bacteria. Surprisingly, the addition of lawsone in the proper amount into chitosan/PEO nanofibers not only introduced an antithetical property but also reduced the platform's cytotoxicity, promoting cell viability of normal human fibroblast cells. Accordingly, the achieved data suggest the potential application of biocompatible nanofibrous mats as an antibacterial wound dressing material.

Abstract 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

Introduction: Gentamicin, despite its beneficial effects, has significant nephrotoxic effects that are observed in 20% of the patients. Ezetimibe is recognized as an inhibitor of cholesterol absorption. Objectives: The present study aimed to investigate the histopathological effects of ezetimibe on gentamicin-induced kidney damage. Material and Methods: Twenty male Wistar rats were randomly divided into five groups and treated as the following; group 1 (normal group), group 2 [gentamicin group, daily 80 mg/kg, intraperitoneal (i.p.) for seven days], group 3-5 (gentamicin 80 + ezetimibe at doses of 2.5, 12.5, and 37.5 mg/kg, respectively). Kidney sections were examined for histopathological parameters including vacuolization of the tubular renal cells, degeneration, necrosis, flattening of the tubular cells and debris in the tubular lumen. Results: Gentamicin injection significantly induced histopathological alterations (P< 0.05). Ezetimibe therapy significantly decreased the levels of vacuolization, degeneration, necrosis, flattening of the tubular cells and debris in the nephrotoxic rats (P< 0.05). Conclusion: The results illustrated that treatment with ezetimibe can improve kidney damage caused by gentamicin injection.

Background and Aim: Nowadays, infertility has become a social concern and has associated with numerous problems. Social support as a protective factor can have a significant effect on the health and social functioning of infertile women. The aim of this study was to assess perceived social support and its related factors in infertile women referred to the Shahrekord Infertility Clinic in 2018. Methods: In the descriptive cross-sectional study, 400 infertile women (18-49years) referred to Shahrekord Infertility Clinic with primary and secondary infertility were enrolled on the basis of objective sampling. Demographic characteristics of infertile women were recorded and social support was determined by Social Support Questionnaire (SSQ) of Sarason. Data were analyzed using SPSS software and P

Introduction. Determining the prevalence of SARS-CoV-2 in blood donors makes the control of virus circulation possible in healthy people and helps implement strategies to reduce virus transmission. The purpose of the study was to examine the seroprevalence of COVID-19 in blood donors using systematic review and meta-analysis. Materials and Methods. The electronic databases PubMed, Scopus, Web of Science, and the Google Scholar search engine were searched using standard keywords up to 2022-04-26. The variance of each study was calculated according to the binomial distribution. Studies were combined according to the sample size and variance. Q Cochrane test and I2 index were used to examine the heterogeneity of the studies. Data analysis was performed in STATA 14 software, and the significance level of the tests was P

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 (P

Background: Osteoporosis in the elderly has dangerous complications, the most important of which are bone fractures and reduced quality of life in the elderly. The present study was aimed at estimating the prevalence of osteoporosis in Iranian elderly using systematic review and meta-analysis. Methods: This search was conducted using authentic Persian and English keywords in national and international databases including Scientific Information Database, Magiran, IranDoc, PubMed, Scopus, Cochrane, Embase, and Web of Sciencewith no time limit until 20.06.2020. Heterogeneity of studies was assessed using I2 index. Data were analyzed using STATA Ver. 15 software. Results: In 30 studies with a sample size of 13,347 people, the prevalence of osteoporosis and low bone density in people over 60 years in Iran were 34% (95% CI: 27%, 42%) and 47% (95% CI: 41%, 53%), respectively. We also found that 34% of women and 41% of men over the age of 60 suffer from osteoporosis. Prevalence of osteoporosis was in lumbar bone 23% (95% CI: 20%, 26%), spine 25% (95% CI: 19%, 31%), hip 35% (95% CI: 7%, 62%), and femur 23% (95% CI: 15%, 31%). Prevalence of low bone density was in lumbar bone 41% (95% CI: 19%, 63%), spine 30% (95% CI: 15%, 46%), and femur 35% (95% CI: 21%, 48%). Conclusion: The prevalence of low bone density in people over 60 years is higher than the prevalence of osteoporosis in them. About one-third of Iranian elderly people suffer from osteoporosis, but about half of them have low bone density.

Context: Hypertension is one of the most important issues in advanced and developing countries and is prevalent in diabetic patients. The present study was aimed at estimating the prevalence of hypertension in diabetic patients in Iran through meta-analysis. Evidence Acquisitions: 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 I2 indexes. Data were analyzed using STATA software version 11.1. Results: In 32 reviewed studies with a sample of 34714 subjects, the prevalence of hypertension in Iranian diabetic patients was 51% (95% CI, 43%-60%). The prevalence of hypertension was 55% in type I diabetics and 53% in type II diabetic patients. Metaregression showed that there was no significant relationship between the prevalence of hypertension in diabetic patients with the sample size and year of study. Conclusions: About half of the diabetic patients in Iran suffer from hypertension. Patients with type 1 diabetes suffer from hypertension 2% more than type 2 diabetes patients. The prevalence of hypertension in diabetic patients in Iran has not significantly decreased over the past years and diabetic patients in northern Iran are more likely to have hypertension than other parts of the country

Vitamin D or cholecalciferol, as a steroidal hormone, regulates the calcium homeostasis, and bone formation with reabsorption through kidneys, parathyroid glands and bowel. There are at least 800 human genes connected with vitamin D. Previous research has confirmed the relationship between vitamin D and colorectal cancers, infections, heart diseases, multiple sclerosis (MS), bone disorders, inflammatory and autoimmune diseases, inflammatory bowel diseases, diabetes mellitus type-I and II and also progression of kidney disease. However, the relationship of vitamin D deficiency and developing of breast cancer, rheumatoid arthritis and osteoporosis is unknown. In fact, the effect of vitamin D deficiency on pathogenesis of different diseases is controversial. To cope with vitamin D deficiency, there are different recommendations such as daily intake of vitamin D supplements and more exposure to sunlight.

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

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

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.

Background & Aim: Diabetes is one of the most common chronic metabolic disorders, and one of the most important health-related challenges in today’s world. In addition to different kind of disabilities, diabetes complications can severely impact the quality of life of patients. The present systematic review and meta-analysis is aimed at examining the quality of life of Iranian patients suffering from type 2 diabetes based on the World Health Organization Quality of Life-BREF. Materials & Methods: A total of 16 articles published in Persian and English were reviewed without any time limitation. The search was conducted in Iranian databases, including Scientific Information Database, Magiran, and IranMedex; and international databases, including Google Scholar, Web of Science, Pub Med, and Scopus. The data was examined using the meta-analysis method and the random effects model. Heterogeneity was assessed using the I2 statistic. The analyses were conducted in stata, version 11. Results: The mean quality of life score for patients with type 2 diabetes was 61.90 (95% confidence interval: 54.40-69.40). The highest and lowest quality of life scores were for social support (49.19) and mental health (42.96) dimensions, respectively. No significant association was found between the mean quality of life score and year of publication, methodological quality, and mean age of participants (P>0.05). Conclusion: Given that patients with type 2 diabetes have a lower quality of life, especially in terms of mental health, it seems necessary to better understand psychological problems common in this group of patients and design strategies to overcome them.

Introduction: In the past, patients with mental disorders were often isolated, but these patients now-a-days enter the society, as therapeutic interventions have advanced. Family members play an important role in the life of many adults with mental disorders and are under considerable amounts of stress that may affect caregiver’s physical health, quality of life and resilience. Aim: The present study aimed to determine the relationship between the resilience and quality of life in family caregivers of patients with mental disorders. Materials and Methods: The present cross-sectional, correlational, descriptive study was conducted on 238 family caregivers of patients with mental disorders. The Short Form Health Survey (SF-36) was used to measure the quality of life and the Connor and Davidson Resilience Scale was used to measure resilience in the participants. The SF-36 consists of two general dimensions and eight domains of health and the resilience scale consists of 25 items. The data obtained through the questionnaires were analysed in SPSS version 16.0 using Pearson’s correlation test. Results: The majority of the family caregivers were the patients’ mothers. The results showed a significant direct relationship between resilience and quality of life (p

In recent years, published systematic reviews in the world and in Iran have been increasing. These studies are an important resource to answer evidence-based clinical questions and assist health policy-makers and students who want to identify evidence gaps in published research. Systematic review studies, with or without meta-analysis, synthesize all available evidence from studies focused on the same research question. In this study, the steps for a systematic review such as research question design and identification, the search for qualified published studies, the extraction and synthesis of information that pertain to the research question, and interpretation of the results are presented in details. This will be helpful to all interested researchers.

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.

Background: Depression is one of the major psychiatric disorders in the world. The present study was conducted to determine the prevalence of depression among Iranian school students through a meta-analysis. Methods: All national and international information databases including PubMed, Scopus, Web of Science, SID, Magiran, Medlib were searched. The search phase was performed without language and time restrictions, but the searched studies were all in Persian and English, and the sources were updated by 03.08.2020. As the selected studies had high heterogeneity, the random effects model was used. Results: In 51 studies with a sample of 537144 people, the prevalence of depression in Iranian school students was 37% (95%CI: 32, 42). In addition, the prevalence of depression in girl school students was 45% (95%CI: 25-65) and in boys was 28% (95%CI: 20-35). The prevalence of mild, moderate and severe depression in school students is 31%, 18% and 11%, respectively. Also, the prevalence of depression in primary school students was 12%, middle school students 32%, high school students 47% and pre-university students 46%. Conclusions: About a third of Iranian school students suffer from some degree of depression, and the prevalence of depression in girls is about twice that of boys. The prevalence of mild depression among school students is higher than moderate and severe depression. On the other hand, the prevalence of depression in school students from primary to pre-university level is increasing, which is very worrying.

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.

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: Quality of work life (QWL) is considered as a universal concept in human resource management and organizational development, and its promotion is the key to the success of organizations' management. Therefore, the present study aimed to evaluate the QWL in Iran through systematic review and meta-analysis. Methods: In this study, all articles related to the QWL in Iran during the years 2011–2017 were systemically reviewed by searching national and international databases such as Science Direct, PubMed, Scopus, Web of Science, Springer, SID, Magiran, Barakat Knowledge Network System, Medlib, and the Google Scholar search engine using valid keywords. The results of the studies were combined using the random effects model. The heterogeneity of studies was studied using the I2 index. Data analysis was done using STATA ver 11. Results: The mean QWL score of 15,323 samples were 60.13, 36.80, 76.19, 58.90, 68.78, 50.69, 32.24, 8.01, 70.63, 39.70, and 44.41 based on Walton, Casio, Sirgy, Mirsepasi, SF-36, Ghasem zadeh, Dehghan, Dargahi, NIOSH, Venlar, Quality of nursing work life questionnaires, respectively. Meta-regression showed that the QWL of employees had no significant relationship with the sample size and years of research. Conclusions: The mean score of QWL in Iranian employees was 56.90, with the highest and the lowest score for the questionnaire.

Background: Hypertension is a major cause of noncommunicable diseases such as cardiovascular disease. Therefore, this study aimed to estimate the prevalence of hypertension in cardiovascular patients in Iran by meta-analysis. Methods: The search was carried out using authentic Persian and English keywords in national and international databases including IranMedex, Scientific Information Database (SID), Magiran, IranDoc, Medlib, ScienceDirect, PubMed , Scopus, Cochrane, Embase, Web of Science, and Google Scholar search engine without any time limitation until 2017. Heterogeneity of studies was assessed using I2 statistic . Data were analyzed using STATA 11.1. Results: In 66 reviewed studies with a sample of 111,406 participants, the prevalence of hypertension was 44% in Iranian patients with cardiovascular disease 67%(95%CI: 38%–49%) in women and 42% in men. The prevalence of systolic hypertension in cardiac patients was 25%, diastolic 20%, diabetes 27%, and overexposure 43%. The prevalence of hypertension was 44% in patients with coronary artery disease, 50% in myocardial infarction, 33% in aortic aneurysm, and 44% in cardiac failure. Conclusions: Hypertension has a higher prevalence in women with cardiovascular disease than men, and it increases with age. Among patients with cardiovascular disease, myocardial infarction patients have the highest levels of hypertension. The prevalence of systolic hypertension in cardiac patients is higher than diastolic hypertension.

Pressure ulcer is a health problem worldwide that is common among inpatients and elderly people with physical-motor limitations. To deliver nursing care and prevent the development of pressure ulcers, it is essential to identify the factors that affect it. This global systematic review and meta-analysis was conducted with the aim of evaluating the incidence of pressure ulcers in observational studies. In this study, databases including Web of Science, Embase, PubMed, Scopus, and Google Scholar were searched to collect data. Articles published from 1997 to 2017 about the factors influencing the incidence of pressure ulcers were retrieved and their results were analyzed using meta-analysis according to the Random-Effects Model. The heterogeneity of studies was investigated using the I2 statistic. Data were analyzed using the R and Stata software (version 14). In this study, 35 studies were included in the final analysis. The results showed that the pooled estimate of the incidence rate of pressure ulcer was 12% (95% CI: 10–14). The incidence rates of the pressure ulcers of the first, second, third, and fourth stages were 45% (95% CI: 34–56), 45% (95% CI: 34–56), 4% (95% CI: 3–5), and 4% (95% CI: 2–6), respectively. The highest incidence of pressure ulcers was observed among inpatients in orthopedic surgery ward (18.5%) (95% CI: 11.5–25). According to the final results, better conditions should be provided to decrease the incidence of pressure ulcers in different wards, especially orthopedics, and in patients with diabetes.

Objective: depression is one of the most serious and prevalent mood disorders. Aging population is an important economic, social, and health challenge of the 21st century. The present study aimed at estimating the prevalence of depression among the Iranian elderly through meta-analysis method. Method: Studies were searched in ISI, Scopus, Pub Med, Google Scholar, and in Iranian databases including Iran Medex, Magiran, SID, and Med Lib using the following keywords: “depression”, “prevalence”, and “elderly”. Data were analyzed using meta-analysis (random effects model). Heterogeneity among the results of the studies was examined by “I2” index. Beck, DASS-21, GHQ-28, and G DS questionnaires were used in this study, and analyses were performed using STATA Ver.11. Results: A total of 26 studies in Iran with a sample size of 5781 individuals had been found during 2001 and 2015. Prevalence of depression among Iranian elderly was estimated to be 43% (95% confidence interval (CI):30% - 55%). The findings showed that the prevalence of depression among Iranians were49% in women, 48% in men, 37% in unmarried, and 45%in the married. In addition, the prevalence of very severe, severe, moderate, and mild depression levels were estimated to be 5%, 19%, 33%, and 38% of the participants, respectively. No significant difference was observed between married and unmarried individuals. Most of Iranian elderly suffered from mild depression. Conclusion: There was high level of depression prevalence among Iranian elderly, and women were more depressed than men. So, policy makers must design and run mental health programs to decrease the prevalence of depression among Iranian elderly.

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.

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.