[Self-control: an important educational need in diabetic patients9 mental health]

Diabetes is a kind of chronic conditions which needs a kind of adaptation during all time, thus some behavioral and psychosocial adoptive mechanism should be considered by the patient. Lack of self-control skills and information will lead to poor glysemic control among diabetics. Educational in this context has an important role in patient's well-being, the study aims to describe the concept of self-control as an important educational need in the diabetic patients' mental health. The qualitative content analysis method was employed in the study. Study population including health professionals [3 nurses and 4 physicians] and diabetic patients [n=12] were selected purposefully and were interviewed in-depth. Three main categories including three concepts were identified namely fight with self, internal versus external control, and dominance over self. The findings showed that such patients faced with various and often conflicting alternatives that resulted in experiencing internal breaking and conflict. It was founded that the patients' perception of their power span and whether they have control over disease was an underlying factor to deciding about the health related behaviors' alternatives. Such findings emphasized on importance of supporting the diabetic patients in the rout of being responsible about their physical and mental status. Preparing the patients to maintain and expand their control over self is important specifically through developing communication, decision making and self supervising skills

[Epidemiologic study of Organophosphate and Organochlorate pesticides poisoning in hospitalized patients in Khorramabad Shohada Ashayer hospital from Mars to August 2006]

Poisoning is one of the most common medical emergencies. Every year many people refer to emergency wards due to poisoning and some of them are treated and some die because of severe complications. Most patients who refer to emergency wards are those who commit intentionally to suicide. This study is conducted to determine the prevalence of poisoning with pesticide [organophosphate and organochlorine] in persons referred to Shohada Ashaier hospital of Khorramabad in the first six months in 2006. Required information of poisoned people with poisoning pesticide [organophosphate and organochlorine] were collected using questionnaires which were distributed among the subjects. In this study 153 patients including 118 patients who poisoned with organophosphate and 35 patents with organochlorine were studied. Most of the patients [34.6%] aged between 21-71 years including 57.5% female and 42.5% male and their education was about under secondary school, 91.5% of them attempted to suicided. The total mortality rate was 12 that 7 of them died by toxifications with organochlorine and 5 cases by organophosphate, which in turn was due to their respiratory complications like ARDS and aspiration pneumonia. Findings indicate that due to high prevalence and mortality of poisoning with pesticides, this problem should be taken into consideration

[Effects of self care planning on reduction of A1C hemoglobin in adults with diabetes mellitus]

Diabetes mellitus [DM] is one of the most important health problems throughout the world. Although in many diseases, physicians are the main responsible for disease control and patients play an inactive role in their management, in DM, patients are themselves the main part of treatment process. This study was designed to demonstrate the effect of self care plan on reduction of A1C hemoglobin level in adults affected by DM. Sixty patients with type 2 DM were randomly selected. They were divided into two subgroups [30 patients in the intervention group and 30 in the control group]. The intervention group had 3-4 sessions of education concerning insulin injection, hypoglycemic drugs, diet and metabolic control and then was followed during following 3 months in order to control the implementation of self care plan program. During the same time, the control group was observed every 2 weeks, regularly. Blood level of A1C Hemoglobin was measured in both groups, before and after self care teaching program. There was no significant difference in the blood level of A1C Hemoglobin in the intervention and control groups before self care teaching program, but after 3 months of education, the A1C level showed a significant decrease in the intervention group [p<0.001]. Based on the study results, self care teaching program can cause a significant improvement in glycemic control of adults involved with DM

[ effect of self-care programe on foot healing in diabetic patients]

Diabetes is a major endocrine disorder and is characterized by metabolic abnormalities, retinopathy, neuropathy, nephropathy and atherosclerosis. In this disease, the patients play important role in their treatment. Therefore, this study was performed to show the importance of self-care on foot healing of diabetic patients. In this quasi-experimental study, 54 diabetic patients with foot wound were randomly divided into two groups of case [n=30] and control [n=24]. The case group was followed up for 3 months after 3 or 4 self-care educational sessions about insulin ejection, drug administration, diet and wound care. In order to evaluate the outcome of educational program, a checklist was filled every other week. Also wound condition was checked 1, 2 and 3 months after the intervention. HbA1c was measured before and after the intervention as self-care criteria. The amount of HbA1c was not different between two groups before intervention but it decreased in the case group 3 months after the intervention [p<0.05]. Also the wound recovery grade increased [p<0.05] in the case group 3 months after the intervention. Findings of this study showed that self-care in the diabetic patients has a great influence on treatment and prevention of complications of the disease

[Locoregional anesthesia intravenous [a about 500 cases]]

Intravenous locoregional anesthesia [IVLRA] is simple, efficient, and low cost technic ; it is indicated in a hand and forearm surgery especially in emergency and ambulatory patient. A 500 patients series during 7 years experience is reported. These patients were admitted in our hospital for surgical indications concerning their hand or their forearm. 310 patients were treated by delayed surgery and 190 others treated in emergency. Double tourniquet technique was used and the drug injected was 0.5 percent lidocaine without any adrenaline. Average duration of tourniquet put on was 75 minutes [30-120 minutes]. 15 cases of IVLRA were converted to general anesthesia: 10 for very painful tourniquet and 5 others for surgical act needing more than 120 minutes