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One of the most essential physical prerequisites for human survival is sleep. Patients undergoing hemodialysis often experience a lack of sleep, and it is one of the decisive variables in dialysis patients' quality of life. The objective of this study was to assess the effects of inhaling lavender essential oil on sleep quality in hemodialysis patients. A total of 30 patients were enrolled in the before-and-after intervention trial, which took place in a tertiary care hospital's dialysis unit. The study participants were selected using the purposive sampling technique and they received lavender oil inhalation therapy. The sleep quality was measured using the Pittsburgh Sleep Quality Index. The mean age of the participants was 55.11 (SD = 8.45) years. The mean posttherapy Pittsburgh Global Sleep Quality Index score was 8.8 ± 1.89 compared with the pretherapy score of 14.73 ± 1.53. Patients undergoing hemodialysis experienced a substantial improvement in sleep quality (P.05). Aromatherapy using lavender oil is effective in enhancing sleep quality in hemodialysis patients.

Background Major cardiac surgery could be physically and mentally stressful. Anxiety and pain are commonly experienced by patients while undergoing cardiac surgery. Yoga is recognized as the most beneficial complementary and alternative therapy. Objective To assess the effect of alternate nostril breathing exercises (pranayama) on anxiety and pain among patients undergoing cardiac surgery. Methods A non-randomized controlled trial was adopted as study design and involved 48 patients undergoing cardiac surgery. The experimental group (n = 24) received pranayama study intervention while the control group (n = 24) received routine care of the hospital. Outcomes were state anxiety and pain, measured with the state anxiety inventory and a visual analogue scale respectively. Data were analyzed by SPSS version 20.0. Repeated measures ANOVA was used to test the effect of the intervention. Results Study results showed that patients in the experimental group experienced a significant decrease in anxiety (p Conclusion These findings support the use of pranayama for decreasing anxiety among patients undergoing cardiac surgery. However, there is a need for randomized controlled trials with higher sample size to confirm this results. Future trials also should focus on the estimation of relevant biomarkers such as endorphins to understand the scientific rationale.

Background/Objectives: Health literacy is a global concern and is varied across the general population. It is the means to enhance public access to health information and services. The objective of this study was to compare the health literacy among health science and non-health science members and to identify the barriers to health literacy. Methods: A cross-sectional study was conducted among the faculty of health sciences and health sciences teaching institutes. A total of 230 samples were included using stratified proportionate sampling. The Health Literacy Questionnaire (HLQ) and the tool on perceived barriers to health literacy were used to collect the data. Results: The health literacy among health sciences people was better compared to the non-health sciences people (p 0.2 and

Aim The aim of the study was to assess the level of adherence to dietary and fluid restrictions among patients undergoing hemodialysis. Background Patients with end-stage renal disease are non-compliant to fluid and dietary restrictions lead to undesirable effect on health. Methods The observational study design and 60 samples were adopted. The samples were selected by purposive sampling technique who full fill the inclusion criteria. Self-reported fluid and dietary adherence questionnaire were used to collect the data. Data were analyzed using SPSS software version 16.0. Results The study revealed that there was a fair to good adherence level for fluid and dietary restrictions. Conclusion However the adherence level varies among hemodialysis patients, individually tailored interventions and constant motivation is needed to improve the adherence level and positive clinical outcome.

Aim: The aim of this study is to evaluate the effectiveness of music on anxiety and pain among patients following cardiac surgery. Background: Cardiac surgery affects patients physically, psychologically and socially. Anxiety and pain are the usual problems among patients following cardiac surgery. Design: The study design is a systematic review and meta-analysis. Data sources: The Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medica database (EMBASE) and Web of Science databases were searched for randomized controlled trials from January 2000 to December 2017. Review methods: The Cochrane collaboration guidelines were followed and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to summarize the quality of evidence. Results: Fourteen studies were included in systematic review and 13 in meta-analysis. The meta analysis revealed that there was a significant reduction in anxiety and pain among patients who received musical intervention compared with those who did not. Conclusion: Music has positive benefits on anxiety and pain. However, well-designed and high-quality trials are needed to generate higher quality evidence.

Objectives To determine the effects that an olive oil massage has on fatigue among patients undergoing hemodialysis, and the associated sociodemographic factors that can reduce fatigue. Methods The study used true experimental pre- and post-test research design. A total of 200 patients were recruited in a selected hemodialysis unit in southern India and were allocated to either a study or control group by randomization, with 100 patients in each group. All the patients in the intervention group were given a lower back and lower leg massage using olive oil at the beginning, and after every hour, of their hemodialysis using olive oil for a period of eight weeks. In contrast, the control group continues to receive routine care. The level of fatigue was measured using the Fatigue Severity Scale both before and after massage therapy. Results Between 73 and 80% of patients were suffering from severe fatigue and the mean fatigue score was 5.53 (SD 1.82) and 5.56 (SD 1.57) for the study and control group, respectively. After eight weeks of massage therapy, the results showed that 53% of patients in the study group showed borderline fatigue, with a mean score of 4.39 (SD 2.37), whereas in the control group 73% patients showed severe fatigue, with a mean score of 5.17 (SD 2.00). The independent t-test between the study and the control group showed a statistically significant reduction in fatigue in the study group with a mean difference (MD) of 3.56 (t=−1.24; p=0.000). There were also statistically significant changes noted in gender and in the duration of the hemodialysis (χ 2 = 6.043; p=0.049) and (χ 2 = 6.611; p=0.046) respectively. Conclusion The study concluded that patients undergoing hemodialysis experienced moderate to severe levels of fatigue. In patients with no or mild anemia, massage has been shown to decrease fatigue and increase energy levels among patients undergoing hemodialysis for chronic kidney disease.

Background Anxiety, pain, and fatigue are common postoperative problems that disturb the recovery and quality of life in patients undergoing coronary artery bypass graft (CABG) surgery. These postoperative problems are associated with prolonged recovery and decreased quality of life. This study was aimed at evaluating the combined effects of foot massage and patient education on anxiety, fatigue, pain, self-efficacy, and quality of life in patients undergoing CABG surgery. Material and methods In this randomized controlled trial (RCT), 130 participants were randomly allocated to experimental (n = 65) and control (n = 65) groups. The experimental group received a combination of foot massage and patient education as interventions and the control group received usual care of the hospital. Results The experimental group had a significant decrease in anxiety (p = 0.001), fatigue (p = 0.001), pain (p = 0.001), and increased self-efficacy (p = 0.001) and quality of life (p = 0.001). Conclusion The combined form of foot massage and patient education is effective in decreasing anxiety, fatigue, pain, and increasing self-efficacy and the quality of life. These interventions will support the recovery of patients and reduce their suffering.

Objective: The objective of this study was to assess the postoperative outcomes after utilizing the Del Nido cardioplegia as compared to conventional cardioplegia, in patients undergoing isolated mitral valve replacement surgery. Methods: This was a single-center retrospective study conducted with the data from 80 patients with mitral valve disease, who underwent cardiopulmonary bypass. The outcome assessments of the Del Nido group (n = 40) was compared with that of the non-Del Nido group (n = 40). Various time factors were analyzed as end points that included cardiopulmonary bypass time aortic cross clamp time, duration of mechanical ventilation, need for postoperative inotropic support, volume of packed red blood cells (RBCs) transfusion, length of ICU and hospital stay, among others. Results: The current study showed that the mean cardiopulmonary bypass time and aortic cross-clamp time were significantly shorter in the Del Nido group when compared to the non-Del Nido group (P

Aim To evaluate the evidence pertaining to the efficacy of the supplementation of probiotics on the blood glucose level of pregnant women with gestational diabetes mellitus (GDM). Background Women with the GDM are subsequently at risk to develop type 2 diabetes mellitus, within three to six years after delivery. This makes it crucial for all pregnant women with the GDM, to monitor their blood glucose levels regularly to minimize the adverse pregnancy outcomes. The earlier studies revealed that the probiotics could improve glycaemic control and mitigate the adverse effects of type 2 diabetes mellitus. Design A systematic review and meta-analysis. Data sources The Google Scholar, Pubmed/Medline, Cochrane library, ProQuest, Ovid, and EMBASE were systematically searched for the available clinical trials. Review methods Randomized clinical trials (RCTs) for evaluating the effects of the probiotics on the pregnancy outcomes such as glycaemic control as primary outcome were included to achieve the aim of this review and meta-analysis. Two reviewers from the team extracted the data and assessed the risk of bias in the eligible studies independently. The meta-analysis was performed by applying a model of fixed effects using the Revman 5.3 software. Results Nine clinical trials involving 1053 participants were included in the meta-analysis. Though the components of probiotics varied significantly, Lactobacillus species was given to all the participants in all the trials included in this review. The results showed that the probiotics asignificantly improved the glycaemic control biomarkers (Fasting blood glucose and insulin sensitivity level) (P Conclusion Probiotic-supplements seemed to improve the glycaemic control biomarkers. Thus, this review highlights the considerable evidence that the supplementation of probiotics has the beneficial effects on the glycaemic control markers and may be useful as a supplementary therapy among the women with the GDM. This finding would foster the health care professionals and the nurses to create awareness on the potential benefits of the supplementation of the probiotics among the women with the GDM and elevated glycaemic control biomarkers.

Aim: To appraise the evidence concerning the effect of reflexology on the anxiety in patients undergoing cardiovascular interventional procedures. Background: Anxiety, fear, and other unpleasant emotional experiences are common among patients before and after cardiovascular interventional procedures. The higher anxiety may affect prognosis and recovery of patients. Design: A systematic review and meta‐analysis. Data sources: The MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Central Register of Controlled Trials (Cochrane Library), EMBASE, PsycINFO, and Web of Science were searched between 2001–2017. Review methods: Randomized controlled trials evaluated the effectiveness of reflexology on anxiety among patients undergoing cardiovascular interventional procedures were included. Meta‐analysis was done using Revman 5.3. Results: Ten trials, representing 760 patients with the mean age of 59, fulfilled the inclusion criteria. Reflexology significantly decreased the anxiety of patients undergoing cardiovascular interventional procedures in the treatment group compared with the control group. Conclusion: Reflexology has some positive effects on anxiety among patients undergoing cardiovascular procedures. It may be a useful complementary therapy and further research is necessary to create reliable evidence.

Cardiovascular diseases are increasing rapidly and have become a major health problem worldwide. The incidence and prevalence of cardiovascular disease are increasing rapidly, predominantly in the developing countries. Patients with cardiovascular disease who do not respond to routine medical treatment will have to follow cardiac surgical procedures. The objective of this study was to apprise the evidence of the effect of various complementary therapies on postoperative outcomes among patients undergoing cardiac surgery. A comprehensive literature search was made on PubMed-Medline, CINAHL, Science Direct, Scopus, Web of Science, and the Cochrane Library databases for original research studies published between 2000 and 2015. Original articles that reported the effect of complementary therapies in patients undergoing cardiac surgery were included. Twenty-eight studies were analyzed, and they have produced conflicting results. Most of the studies (n = 25) have documented the effects of complementary therapies on improving postoperative outcomes of patients, whereas other studies (n = 3) found no evidence of improvement. Although methods varied considerably, most of the studies included in this review reported positive results. Therefore, there is some evidence that complementary therapies can lead to positive postoperative outcomes. Evidence of the efficacy of complementary therapies in cardiac surgical patients remains inconclusive. Additional research is needed to provide a strong evidence base for the use of complementary therapies to improve postoperative outcomes and recovery in patients undergoing cardiac surgery.

According to Indian menopause society research there are about 65 million Indian women over the age of 45. Average age of menopause in around 48 yrs but it strikes Indian women as young as 30-35 years.The main aim of the study is to assess the menopausal transition among women residing at selected rural community, Punjab. The study was conducted from July 2012 to December 2012.The sample from the selected rural community and the research design used for this study was Non experimental design – descriptive survey method. The sample size selected for this study consists of 30 rural women 40-55 years of age from selected rural community at Amritsar. Purposive sampling method was used to select the samples. The tool used in this study was ZEG Berlin menopause rating scale to assess the menopausal transition. The data analysis was done using both descriptive and inferential statistics.The results reported that more prevalent symptoms were feeling tired (92.90%), headache (88.80%), joint and muscular discomfort (76.20%), physical and mental exhaustion (60.09%), sleeplessness (54.40%), depressive mood (37.30%), irritability (36%), dryness of vagina (36%), hot flushes and sweating (35.80%) and anxiety (34.50%).The rural women of Amritsar, Punjab experience high prevalence of menopausal symptoms. The high percentage and scores of MRS were observed in perimenopausal and postmenopausal women.