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Objectives: Social anxiety disorder (SAD) is one the most prevalent psychiatric disorders and generates severe negative effects on patients' mental, individual, and social health. Decreased responsibility, absenteeism, and poor life quality can be the consequences of this disorder. Considering the effective empirical background of both therapeutic approaches in reducing social anxiety symptoms and the lack of research on combining both interventions to reduce anxiety, this study was performed to determine the effects of acceptance-commitment therapy (ACT) and psychodrama therapy on nurses' social anxiety. Methods: This randomized trial research was conducted at Torbat Heydarieh University of Medical Sciences in 2017 with a pre-test-post-test design. A total of 48 nurses with SAD who were referred to the university counseling center were chosen at random and entered into 4 equal groups (12 subjects) (an intervention group and 3 control groups). The intervention group received a combination of psychodrama and ACT therapies in twelve 90-minute treatment sessions (2 meetings every week). The control groups were provided with psychodrama therapy, ACT, and no treatment. The study data were collected by Connor's social anxiety questionnaire (2000). The collected data were analyzed by analyses of variance and covariance. Results: A decrease was observed in the social anxiety scores in the four groups of the study after psychological therapies. The Mean±SD of the social anxiety score in the treatment group based on psychodrama was 64.75±13.37 before the study period and 49.08±6.71 after that. While in the ACT group, it was 59.65±12.21 and 42.66±8.05 before and after the study, respectively, and in the group provided with a combination of both therapies, it was 62.75±13.49 before the study period and 35.75±7.19 after that. A lack of significant difference (P=0.86) could be detected in the mean anxiety score in the group of control. However, the social anxiety score of the group with a combination of both therapies significantly decreased (P<0.001) compared to other studied control groups. Discussion: The data analysis showed that a combination of ACT and psychodrama therapies significantly reduced the social anxiety of nurses. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 has widely affected the health and care of people with chronic diseases, especially those with breast cancer. Because the health status of women with breast cancer in Iran has been unknown during the COVID-19 outbreak, we aimed to explore the challenges related to care of Iranian women with breast cancer during this pandemic. Methods: Using the qualitative content analysis design, 31 semi-structured face-to-face interviews were conducted from September 2020 to January 2021, with purposefully selected participants including 17 women with breast cancer, 7 health-care providers, and 7 family caregivers. Data were analyzed using the conventional content analysis. Results: Challenges related to health care for Iranian women with breast cancer can be classified into ten subcategories and three main categories. "Lack of specific functional and information resources," "Limited equipment and active medical centers," and "Intensification of the chemotherapy drug crisis" comprised the main category of "Inefficiency of care and treatment services." "Lack of access to family caregiver," "Ignoring the psychological burden imposed on patients," and "Inadequate financial support from insurance organizations" were categorized as "Inadequate patient support." "Avoiding receiving timely and appropriate treatment and care," "Failure to accept self-responsibility for health," "Misconceptions about COVID-19," and "Ignoring breast cancer in the COVID-19 pandemic" comprised the subcategories of "ineffective self-care." Conclusion: The present study provided a new understanding of the challenges regarding the health status of women with breast cancer during the COVID-19 pandemic. The findings could be used to develop effective interventions. [ABSTRACT FROM AUTHOR]

Objectives: Considering the need of diabetic patients for accessing the care system and the role of modern media in health education and culture, we aimed to determine the effectiveness of educating via mobile SMS in controlling blood sugar. Moreover, the adherence to drug treatment of patients with type 2 diabetes was assessed. Methods: This quasi-experimental study was conducted in Isfahan City, Iran in 2018. A total of 100 diabetic patients participated in the case (intervention) and control groups. The control group underwent conventional therapies and training. SMS training was applied for the intervention group in addition to the conventional therapies. Collecting the information and data to assess adherence to patients' treatment was done using a researcher-made 18-item questionnaire. Analyzing data was performed in SPSS software, version 20 through the employment of the independent t test, paired t test, and multivariate analysis of covariance. Results: Based on the independent t test results, no significant difference was detected between the two study groups at any time points (P>0.05) in terms of the mean fasting blood sugar. However, by analysis of covariance and adjusting the fasting blood sugar level before the intervention in the studied groups, the mean fasting blood sugar was recognized to be significantly lower in the intervention group compared to the control group in the second month (P=0.048) and the third month after the intervention (P=0.008). Discussion: There is an association between SMS education and fasting blood sugar control and adherence to treatment in the studied patients. In the field of health care education, it is possible to use patient communication techniques and short message services to control follow-up and monitor interventions. [ABSTRACT FROM AUTHOR]

Objectives: The COVID-19 pandemic exposed healthcare workers to heavy stress and made them vulnerable to various types of mental illnesses. This study aims to evaluate the psychological effects of the COVID-19 pandemic on the mental health of healthcare workers in the COVID-19 ward. Methods: This study was performed during the first peak of the COVID-19 pandemic in 9-Dey Hospital of Torbat Heydarieh in Iran, in which a total of 178 healthcare workers in the COVID-19 ward participated via the census sampling method. In this study, we employed the Goldberg general health questionnaire along with a researchermade questionnaire on the experience of exposure to COVID-19 disease. Following the completion of the questionnaires, the participants' data were analyzed by the SPSS software and statistical tests (the Spearman and Pearson correlations). Results: Our results showed 91.1%, 77.57%, 87.55%, 87.07%, 56.75%, and 74.16% for the general health, physical symptoms, anxiety symptoms, sleep disorders, social dysfunction, and depression symptoms, respectively, during the COVID-19 pandemic conditions. The results showed a significant association between the experience of exposure to COVID-19, anxiety symptoms, and sleep disorders (P<0.05). Discussion: Access to counseling and psychotherapy systems, rehabilitation, and the improvement of working conditions can effectively enhance resilience and promote the mental health of healthcare workers and increase the quality of care and treatment services. [ABSTRACT FROM AUTHOR]

Background: Cleaning is one of the most important steps in preparing surgical instruments for reuse. Thorough cleaning can ensure more effective sterilization, protect treatment teams and patients from transmissible infections, and extend the life of surgical instruments. This study was conducted to compare the manual, automated, and ultrasonic methods of cleaning surgical instruments. Methods: In this quasi-experimental study, three types of surgical instruments, namely curved hemostats, suction tips, and Metzenbaum scissors, (n=90) from among 20 surgical sets were randomly selected and assigned to three cleaning groups viz manual, automated, and ultrasonic. After the instruments were cleaned, surface protein and blood residue swab tests were conducted and the results were recorded on a data-registration form. Data were analyzed using SPSS version 16 and descriptive and inferential statistical methods. Results: According to the research results, in manually cleaned instruments group, 8 (26.7%) tested positive for blood and 10 (33.3%) tested positive for protein. Of the 30 automatically cleaned instruments, 6 (20%) tested positive for blood and 7 (23.3%) tested positive for protein and of the 30 ultrasonically cleaned instruments, 1 (3.3%) tested positive for blood and protein. The chi-square test showed a statistically significant difference between the three methods of cleaning residual blood and protein from the surgical instruments (p<0.05). Conclusion: The results revealed that according to the research results, of the three cleaning methods, ultrasonic cleaning was by far the most effective in removing blood and protein residues from the surgical instruments. Hence, we suggest that ultrasonic cleaning can be routinely utilized as an efficient cleaning method in medical centers. [ABSTRACT FROM AUTHOR]

Background: Proteus mirabilis is one of the most important causes of urinary tract infection (UTI) and an opportunistic pathogen that can cause infection, especially in the urinary tract and bladder, pyelonephritis or kidney stones, especially in people with catheters or people with abnormalities of the urinary system. The pathogenicity of this bacterium causes by several genes, and sulfonamides prevent the growth of these bacteria by inhibiting DNA synthesis. The study aimed to investigate the pathogenic genes that cause sulfonamide antibiotic resistance in Proteus mirabilis isolated from urinary infections in Iran. Methods: In this study, biochemical tests were performed to confirm the identity of Proteus mirabilis bacteria and DNA extraction, and then multiplex PCR tests were performed to identify pathogenicity genes Fal and Urea and antibiotic resistance genes Sul1 and Sul2 using specific primers. Results: In this research, biochemical tests confirmed the identity of the bacteria and the target strain, and multiple resistance of the Proteus mirabilis strain was observed to several different types of antibiotics. In addition, Multiplex PCR verified that more than 90% of the isolated strains had pathogenic genes (91.7% Fal and 95% Urea gene), and more than 50% of the strains had antibiotic resistance genes (51.7% Sul1 and 56.7% Sul2). Conclusion: Considering the excessive use of antibiotics worldwide and the increasing spread of antibiotic resistance, it is better to check the pathogenic genes and their resistance to the antibiotics during the outbreak of the disease, consequently, the use of the antibiotics and their side effects must be reduced and to prevent the spread of antibiotic resistance. [ABSTRACT FROM AUTHOR]

Aims: In any organization, there is a set of safety hazards that, if ignored, can lead to accidents. Universities can be considered a small example of organizations with all kinds of risks. The aim of this study was to investigate the level of safety noncompliance of Kashan University of Medical Sciences with the safety audit method. Materials and Methods: The present study is a descriptive cross-sectional study in which the safety status of faculties of Kashan University of Medical Sciences was assessed by audit. Audit checklists were prepared in accordance with national safety standards and regulations as well as the expert opinion of safety experts, including electrical safety, fire safety, general safety, safety requirements, beam safety, emergency response program, safety the pressure system, the safety of the elevators, and the general specifications of the faculties. Results: Based on this study, it was observed that in the areas of public safety, the highest noncompliance was reported in the areas of emergency, safety requirements, and pressure system with 88 cases (88.23%) and no noncompliance in the areas of public safety and elevators 0 (0%). According to the year of construction, the highest noncompliance was reported in the areas of emergency and safety requirements (100%) in 17 cases and the lowest noncompliance was in the field of public safety, which had no noncompliance 0 (0%). Conclusion: The safety situation of the classes of the studied faculties, especially in the subjects of safety requirements, emergency response program, and safety system under pressure, was at an unfavorable level. The most important reason for this was the lack of clear responsibilities and the lack of organizational structure in the field of safety issues, which in order to improve it, universities need to establish a safety management system. [ABSTRACT FROM AUTHOR]

Objective: Statement of Problem: Adequate bond strength between glass ionomer cements and composite resin is necessary for the success of the sandwich technique. Purpose of Study: This study assessed the micro-shear bond strength of composite resin to glass-ionomer cements (GIC) using self-etch adhesives with different pH values. Materials and Methods: One hundred specimens (6x4x2 mm) were made using Fuji II and Fuji II LC GICs and treated with different adhesives as follows: Group 1:Fuji II+ Adper Prompt L-Pop, Group-2: Fuji II+SE bond, Group-3: Fuji II + AdheSE, Group-4:Fuji II+ Protect bond, Group-5: Fuji II + Single bond, Group-6:Fuji II LC+ Adper Prompt LPop, Group-7: Fuji II LC+SE bond, Group-8:Fuji II LC+ AdheSE, Group-9: Fuji II LC+ Protect bond, and Group-10: Fuji II LC+ Single bond. Each group consisted of 10 specimens. A cylinder of Z100 composite resin was placed on each sample and light cured. After 24 hours of water storage (37°C), the specimens were subjected to micro-shear bond strength tests (0.5 mm/min). Data were analyzed using two-way ANOVA and Tukey's test. Results: The mean micro-shear bond strength of groups 1-10 was 11.66±1.79, 16.50±1.85, 18.47±1.77, 13.95±1.77, 15.27±1.49, 15.14±0.90, 20.03±1.19, 17.48±3.00, 16.24±1.98 and 16.03±1.49 MPa, respectively. There were significant differences between groups 1 and 7 (P<0.05). No significant difference was observed between other groups (P>0.05). Fuji II LC showed higher bond strength than Fuji II (P<0.05). Conclusion: Type of self-etch adhesive had no significant effect on micro-shear bond strength of glass-ionomer to composite resin. Resin modified glass ionomer cement (RMGIC) exhibited higher bond strength than the conventional GIC. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases have the highest death rates in human society. Coronary artery disease is among the most important of these diseases. No treatment of cardiovascular disease has as much impact on the quality of life of the patients as the heart surgery. The recovery from heart surgery is associated with symptoms of pain and psychological distress. In the early recovery period, the patients will face moderate symptoms of anxiety and depression. In this regard, various measures of nursing, as complementary therapy practices have been performed to help the patients for overcoming the physical and psychological needs. One of these methods, in recent years has been the use of complementary and alternative therapies, particularly massage therapy, after heart surgery. Thus, the aim of this study was to determine the effectiveness of massage therapy on the mood of patients after open-heart surgery in Isfahan Chamran Hospital during 2010-11. Materials and Methods: In this study 72 patients, who underwent coronary artery bypass surgery, were selected. They were randomly assigned to the two case and control groups. The patients of the case group (n = 36) received Swedish massage for 20 minutes in 4 sessions in 4 consecutive days, 3 to 6 days after the open-heart surgery. The patients in the control group received only the routine care. The mood questionnaire (POMS) which was used in this study has been completed the day before the start of the study and intervention and again after the last day of the intervention. SPSS software version 12 and descriptive and inferential statistical methods were used for data analysis. Findings: The comparison of study results showed that massage decreased the overall rating of the patients' mood after the surgery. Conclusions: The use of massage therapy as an effective nursing intervention can improve the patients' mood after open-heart surgery. Due to the low cost and simplicity of this method, it can perhaps be used as a complement to drug therapy and postoperative interventions used in these patients. [ABSTRACT FROM AUTHOR]

The article discusses a study comparing the onset time and duration of analgesia from a lidocaine-magnesium sulfate combined with the one produced by lidocaine-distilled water administered in the epidural space of goats. Experiment on producing caudal epidural anesthesia were done on seven adult goats through 2% lidocaine with 1 milliliter of distilled water and repeated after two weeks through 2% lidocaine combined with magnesium sulfate. Results showed no significant differences on vital signs that surgery on goats can be done after epidural injection.

Abstract: This study was performed to compare the onset and duration of analgesia produced by either a lidocaine−MgSO4 or lidocaine−distilled water combination administration in the caudal epidural space of horse. Seven healthy adult horses, aged 11.7 ± 1.4 years (mean ± SD), body weight (kg) 567 ± 32.5 (mean ± SD), were selected for this study. Caudal epidural anesthesia was produced in all horses by administering 2% lidocaine (0.22 mg/kg) diluted in 1 mL distilled water and repeated with 2% lidocaine (0.22 mg/kg) diluted in 1 mL 10% MgSO4 2 weeks later. Time to onset (minutes), duration (minutes), and cranial spread of epidural analgesia were recorded. Heart rate (HR), respiratory rate (RR), and body temperature (°C) were recorded. Measurements were taken at 0 (as a baseline value before epidural administrations) and at 5, 10, 15, 30, 60, and 75 minutes after the epidural administrations of each treatment. Statistical analyses included paired Student t test and analysis of variance (computer program SPSS, Analytical Software, version 15.00). Statistical significance was set at P < .05. Onset of analgesia was significantly different (P < .001) between lidocaine-distilled water (2.38 ± 0.47 minutes) and lidocaine−MgSO4 (4.62 ± 0.54 minutes). Duration of analgesia after lidocaine−MgSO4 (186.0 ± 7.0 minutes) was longer than lidocaine-distilled water (54.5 ± 7.3 minutes). No significant differences were recorded for HR, RR, and body temperature in comparison with baseline values for each group. Using the lidocaine−MgSO4 combination for obstetric and surgical procedures could commence relatively soon after epidural injection and could be completed without readministration of anesthetic agent. [Copyright &y& Elsevier]

Statement of Problem: Adequate bond strength between glass ionomer cements and composite resin is necessary for the success of the sandwich technique., Purpose of Study: This study assessed the micro-shear bond strength of composite resin to glass-ionomer cements (GIC) using self-etch adhesives with different pH values., Materials and Methods: One hundred specimens (6×4×2 mm) were made using Fuji II and Fuji II LC GICs and treated with different adhesives as follows: Group 1:Fuji II+ Adper Prompt L-Pop, Group-2: Fuji II+SE bond, Group-3: Fuji II + AdheSE, Group-4:Fuji II+ Protect bond, Group-5: Fuji II + Single bond, Group-6:Fuji II LC+ Adper Prompt LPop, Group-7: Fuji II LC+SE bond, Group-8:Fuji II LC+ AdheSE, Group-9: Fuji II LC+ Protect bond, and Group-10: Fuji II LC+ Single bond. Each group consisted of 10 specimens. A cylinder of Z100 composite resin was placed on each sample and light cured. After 24 hours of water storage (37°C), the specimens were subjected to micro-shear bond strength tests (0.5 mm/min). Data were analyzed using two-way ANOVA and Tukey's test., Results: The mean micro-shear bond strength of groups 1-10 was 11.66±1.79, 16.50±1.85, 18.47±1.77, 13.95±1.77, 15.27±1.49, 15.14±0.90, 20.03±1.19, 17.48±3.00, 16.24±1.98 and 16.03±1.49 MPa, respectively. There were significant differences between groups 1 and 7 (P<0.05). No significant difference was observed between other groups (P>0.05). Fuji II LC showed higher bond strength than Fuji II (P<0.05)., Conclusion: Type of self-etch adhesive had no significant effect on micro-shear bond strength of glass-ionomer to composite resin. Resin modified glass ionomer cement (RMGIC) exhibited higher bond strength than the conventional GIC.