Permanent hemodialysis catheter complications in patients referred to Kashan Akhavan dialysis center from June 2013 to December 2013

Cuffed central venous catheters [CCVC]. as preferred types of vascular access for hemodialysis have several complications [e.g. infection, thrombosis, embolism, bleeding and fractures]. This study aimed to describe the complications of CCVC. In this cross-sectional study, the incidence of complications associated with CCVC in patients referred to Kashan Akhavan dialysis center was evaluated during a six-month period between June 2013 to December 2013. The census sampling method was used and patients in each dialysis session were evaluated for all catheter-related complications using the checklist. Finally, a nephrologist approved the complications. From a total of 183 patients admitted to the Kashan Akhavan dialysis center during the six months, 43 patients were enrolled with permanent hemodialysis catheters. Catheter-related infection and thrombosis were common complications. The incidence rates of catheter-related infection and thrombosis were 1.87 and 1.5 per 1,000 daily catheter use, respectively. Catheter-related infection and thrombosis are two common complications among hemodialysis patients used a CCVC. Therefore, the necessary measures should be taken to reduce these complications

[Comparison of occupational stress among female nurses and female members of the medical group in chosen training hospitals in Isfahan]

Introduction: Job stress is one of the most important factors in physical and psychological conditions in workers and reduces their efficiency. Job stress may affect physicians and nurses as major components of the healthcare system and therefore the quality of healthcare might be affected. Moreover, women are a vulnerable group in society. Therefore, this study aimed to compare job stress in female nurses and female members of the medical group in selected educational hospitals

Methods: In this comparative study, 130 nurses and 70 female members of the medical group of the two teaching hospitals of Isfahan city [Alzahra, Noor and Ali Asghar] were randomly recruited. Inclusion criteria included being female, aged between 22 to 50 years, nurses with bachelor's degrees or higher, interns, residents and general practitioners [Specialist physicians are not included in the study]. Data collection tools included hospital stress questionnaire [HSS] and demographic data form. Data analysis was performed using SPSS16 software. Descriptive statistics, Spearman correlation coefficient, Mann-Whitney U and Chi-Square testes were used

Results: the mean stress score was 3.027 +/- 0.453 in female physicians and 2.923 +/- 0.326 in nurses, respectively [p=0.037]. Mean scores of all stress subscales were significantly different in the two groups except for the three subscales of incompetence, role duality and relations with colleagues. In female nurses the biological agents subscale had the highest mean score [4.223 +/- 0.833], while the shift working obtained the highest mean score in the medical group [3.893 +/- 0.951]

Conclusion: This study shows that the mean of overall job stress score were significantly different among female nurses and female physicians. Moreover, mean scores of all stress subscales were significantly different in the two groups except for the subscales of incompetence, role duality and relations with colleagues

[ relationship between sleep quality and quality of life in older adults]

Introduction: Assessing the elders' quality of life [QOL] and its affecting factors such as sleep quality, is a useful method for detecting their health and determining the efficacy of delivered health care. This study aimed to evaluate the association between QOL and sleep quality in elderly people

Methods: This cross-sectional study was conducted on 370 elderly people in Kashan in 2013. Data was collected using a three part questionnaire including: demographics, the European Quality of Life-5 Dimensions [EQ5D] questionnaire and the Pittsburg Sleep Quality Index [PSQI]. Statistical analysis was performed using SPSS software, version 16

Results: The QOL was moderate and poor in more than a fifth of the elderly. The highest mean score of the QOL was in the area of self-care, and the lowest mean score of QOL was in the area of pain and discomfort. Moreover, the sleep quality was poor in 27.8% of the elderly. The Spearman correlation coefficient showed a significant reverse correlation between the PSQI scores and QOL scores in elderly people [p= 0.001, r=-0.489]

Conclusion: This study showed the elderly with higher PSQI scores had lower levels of QOL scores. It seems that lower levels of sleep quality can decrease the elders' QOL. Then, training the elderly people on the sleep quality may lead them to a higher level of QOL

[Effects of different levels of Artemisia sieberi essential oil on intestinal morphology characteristics, microflora population and immune system in broiler chickens]

Background: Essential oils as growth stimulant play an important role in improving intestinal microflora and morphological properties and immune system in broiler chickens

Objectives: The aim of this study was to investigate the effects of Artemisia sieberi oil on intestinal morphology, secum microflora and immune system in broiler chickens

Methods: Two hundred day-old broiler chickens [Ross 308] were allocated to 5 treatments, 4 replications with a completely randomized design during 42 days of age. Experimental treatments consisted of control [basal diet] or basal diets containing different levels of Artemisia sieberi oil [100, 200 and 300 mg/kg] and 600 mg/kg flavophospholipol antibiotic. On day 42 days of age, intestinal morphology and microflora population and immune system were evaluated by measuring the weight of bursa of fabricious and spleen and antibody production

Results: The results indicated that the highest lactobacillus count and the lowest Escherichia coli count of the caecum was found by inclusion of 300 mg/kg Artemisia sieberi oil in the diet [p<0.0001]. The antibiotic and Artemisia sieberi oil treatments showed higher villus height in the duodenum compared with control group [p<0.01]. Artemisia sieberi oil and antibiotic supplementations significantly decreased epithelial thickness and goblet cell number of the small intestinal compared with control group [p<0.05]. The dietary supplementation did not significantly affect the crypt depth and villus height to crypt depth ratio in small intestine. The level of 300 mg/kg Artemisia sieberi oil significantly increased antibody titration against Newcastle disease virus [p<0.01]

Conclusions: Adding Artemisia sieberi oil at levels of 300 mg/kg to broiler chicken diets can improve gut micro?ora [as measured by changes in populations of Escherichia coli and lactobacillus]

What matters in the patients' decision to revisit the same primary care physician?

To assess the priority of various aspects of the patient-primary care physician relationship in the decision to visit again that same physician. A total of 400 community residents in Ras Beirut, Lebanon. Study design: A cross-sectional community based study sampled by a nonrandom sex-education quota-based procedure. Participants were asked to fill a survey where they indicated the ranking of nine items by importance in their decision to revisit the same physician. The nine items were chosen from three categories of factors: professional expertise of the physician ; characteristics of the patient-physician relationship, office organization. Having a physician that gives the patient adequate time for discussion prevailed as rank 1 and luxurious clinic ranked as 9th. Affordability was one of the main concerns among men, those with poor health and those of lower socioeconomic status. Accessibility of the physician's phone was considered highly important among women and those of lesser education status. This study emphasizes the importance of adequate time with the patient, accessibility and affordability of the physician in maintaining continuity of care and patient satisfaction, beyond mere medical expertise

[ effect of oral administration of coated methionine on the female goats and suckling kids hair follicles: a histomorphometrical approach]

Using methionine in the diet of the small ruminants can induce the growth of follicles and their fibre growth. In this study, the effect of oral coated methionine on the hair follicles was determined in female Rayeni goats and their breastfed kids during the first 2 months of infancy. For this purpose, 60 healthy singleton born Rayeni goats, approximately 3 to 4 years of age with their one-day-old kids were randomly divided into 4 equal groups. The treated mothers group was given 3 gr/day pure oral methionine manually for 60 days. Skin samples of the 4 groups were taken from the middle of the left and right side, on zero, 30 and 60 days of experience. Routine histological processes were done. In each sample, primary and secondary follicles and skin follicles traits, the diameter of the primary and secondary follicles, the diameter of hair and cashmere, the diameter of dermal papilla of primary and secondary follicles and the number of primary and secondary follicles were measured respectively by linear graticule under light microscope. The diameter and percentages of the cashmere of mothers and kids, the firmness, and the length of the cashmere of kids were measured macroscopically. All data were analyzed with SPSS statistical software. The results showed that the oral coated methionine in the diet of the mothers could significantly increase the diameter of primary and secondary follicles and their dermal papilla. In the treated kids, the diameters of the primary and secondary follicles, the dermal papilla of the primary and secondary follicles and the number of secondary follicles showed significant change. According to the study, the oral coated methionine in the diet of the mothers during the first 2 months of infancy can significantly increase the diameter of primary and secondary follicles and their dermal papilla in the mothers and their treated kids. It can also increase the number of secondary follicles in the kids

Geographic epidemiology in a small area: cancer incidence in Baakline, Lebanon, 2000-2008

Aggregate data of the National Cancer Registry in Lebanon cannot discriminate cancer incidence in small areas. Trained community members surveyed the permanent population of the Baakline municipality using the verbal autopsy approach. We surveyed 1042 households with at least 1 member living permanently In Baakline during 2000-2008. Data covered 4330 persons yielding 34143 years of observation and 56 new cases of cancer were reported. Median age at diagnosis varied significantly between men [77 years] and women [56 years]. The most common types were lung cancer [20%] followed by colorectal [12.5%] and breast [9%]. Estimated crude cancer incidence rate was164 cases/100 000 persons/year, significantly higher in men [194] than women [130], and much lower overall than the national figure [218]. The permanent Baakline population Is older than that of Lebanon itself, yet the cancer Incidence rate is markedly lower than the national figure. This finding pleads for serious efforts to preserve the low environmental | contamination and the healthy lifestyles In food and tobacco abstinence that have protected the population so far

Health-care-seeking behaviour among university students in Lebanon

This cross-sectional study assessed the health-care-seeking behaviour, barriers to accessing care and associated factors among a sample of 543 Lebanese students at Saint-Joseph University. Data were collected on health-care-seeking behaviour for health issues in the previous 12 months using an anonymous questionnaire. Health-care-seeking behaviour was categorized as: formal [professional help sought]; informal relational [help sought from friends/family]; informal personal [self-help]. The health issues examined were: physical, psychological, social and relational, sexual, drug, alcohol and smoking. When facing health-related issues, the students tended to seek informal health care. Formal health-care-seeking behaviour was almost non-existent for psychological issues [3.3%], relational and social issues [1.8%], and issues related to substance use [5.1%]. The barriers to seeking formal health care fell into 2 categories: accessibility and relational. To encourage young people to access formal health care, specific health services should be provided for them where they are assured of confidentiality and understanding

Physical and verbal/emotional abuse of schoolchildren, Lebanon, 2009

The extent of physical and verbal/emotional abuse in schools in Lebanon is currently unknown. This cross-sectional study aimed to determine the prevalence and patterns of both forms of abuse among a nationally representative sample of Lebanese schoolchildren, aged 10-18 years, using a self-reported questionnaire. A total of 1177 schoolchildren, 49.6% females, median age 14 years, completed the survey; 76.4% and 81.2% of these had experienced physical and verbal/emotional abuse respectively at least once at school. Male students [adjusted odd ratio [AOR] = 3.4, P< 0.01], children in public schools [AOR = 1.9, P< 0.01] and in South Lebanon [AOR = 2.2, P< 0.01] and Bekaa [AOR = 1.7, P< 0.05] regions were more likely to have experienced physical abuse than females, children from private schools and from Beirut. Male students [AOR = 1.3, P< 0.01] and children in public schools [AOR = 1.6, P< 0.01] were also more likely to experience verbal abuse, with no regional differences. The prevalence of physical and verbal/emotional abuse in schools in Lebanon is high and solutions should be sought to correct the problem engaging political and social leaders, the mass media, law enforcement agencies, parents and educators

[ effect of massage therapy by a nurse and the patient's companion on the anxiety of male patients hospitalized in CCU: a clinical trial]

Anxiety can change the heart rate and also increase the myocardial oxygen demand and the risk of mortality in patients with heart diseases. This study aims to examine the effects of massage therapy by a nurse or the patient's companion on anxiety of the male patients admitted in coronary care unit. An RCT was conducted on three randomly allocated groups [massage by a nurse, massage by a patient's companion, and control group] of male patients admitted to coronary care units of Kashan's Shahid Beheshti hospital [n=30]. In the intervention groups, total body massage was done for 60 minutes. The third group [control] did not receive any intervention. Data was collected using Spillberger anxiety inventory and was analyzed by SPSS-PC [v.11.5], using independent t-test, paired t test, One-way ANOVA, Tukey test, Chi-square, and Fisher exact test. The mean scores for the Stat and Trait anxiety of the two intervention groups were significantly decreased after the massage therapy sessions [p<0.001]. However, no significant differences were found between the mean scores of stat or trait anxiety of the groups who received massage by a nurse or by the patients' companion [P.0.05]. However, significant differences were found between the mean scores of stat or trait anxiety of the two intervention groups and the control group [P<0.05]. Considering the effect of massage therapy on decreasing the level of anxiety and finding no difference between the effect of massage by nurses and patients' companions, massage therapy by the patients' companions can be used as an anxiolytic method in CCU patients

Evaluation of old-age disability and related factors among an Iranian elderly population

Old-age disability has become a public health concern. This study was conducted to evaluate the prevalence of disability and its related factors among the elderly population in Kashan city, Islamic Republic of Iran. A cross-sectional study was conducted on a multistage random sample of 350 elderly people. The World Health Organization Disability Assessment Schedule II was used as the disability measure. Overall, 37.1% had mild ageing disability, 38.6% moderate, 20.0% severe and 4.3% extreme disability. Significant relationships were observed between disability and sex, age, living status, needing help, marital status, urban/rural residence, drug addiction, duration of addiction, employment status, having regular physical activity, level of education, health perception, history of hospitalization in the last year and having multiple diseases. Considering the rapid increase in the aged population in Islamic Republic of Iran, more attention should be paid to the health of elderly people

[Oral care in ICU patients: a review of research evidence]

Considering the importance of oral care in the ICU and the lack of comprehensive protocols for oral care, the present study was conducted to review the available literature on oral care and to present an evidence-based protocol for oral care in ICU patients. Fifty-four full-texts original articles, systematic reviews and metaanalysis papers on mouth care in ICU patients published from 2001 to the end of 2010 in English and indexed in the Pubmed, Ovid, Elsevier, and ProQuest databases were searched by using the relative key-words [e.g. oral care, mouth care, critical care, and intensive care] in the title or abstract and then evaluated. ICU patients are prone to dental plaque and VAP due to conditions such as impaired immunological deficiency, the presence of an endotracheal tube, drug side effects, and difficulty with swallowing food and fluids. Due to the lack of a standard protocol for oral care in ICU, oral cares haven't properly done in ICU wards. Studies have shown that some oral care interventions [e.g. tooth brushing with toothpaste, brushing all surfaces of teeth, tongue and palate, and also the use of chlorhexidine solution] have largely reduced the incidence of VAP in ICU patients. The results revealed that the oral hygiene may reduce the incidence of VAP. Hence assessing patients, implementing mechanical and pharmaceutical interventions are important in oral care and applying the protocol presented in this study can improve the oral health of patients in the ICU

[Mothers' satisfaction of hospital care in the pediatric ward of Kashan Shahid Beheshti hospital during 2010-11]

Despite the importance of patient satisfaction as an indicator of care quality, no data are available on the satisfaction of mothers whose children admitted to hospitals. This study aimed to evaluate the mothers' satisfaction of hospital care in the pediatric ward of Kashan Shahid Beheshti hospital. a descriptive study was conducted using the pediatric family satisfaction [PFS] questionnaire and through interviewing with 280 mothers during 2010-11. Data were analyzed using SPSS software and descriptive statistics. Mean maternal age of subjects was 28.04 years. Average age of admitted children was 2.4 years and the mean of hospital stay 4.97 days. The mothers were dissatisfied with doctors for not being available on time and their failure to notify the results of their child's tests. They were also dissatisfied with nurses for the lack of education about their child's treatment and also the lack of post-discharge care. The mothers were also dissatisfied with welfare services [e.g. providing an appropriate play room for children [71.4%]. Average satisfaction scores for the medical, nursing and welfare staff were 22.25 +/- 6.19, 29.05 +/- 6.88 and 26.68 +/- 6.93, respectively. A significant relationship was observed between the child's disease and the mother's satisfaction [P<0.0001]. Overall satisfaction with medical, nursing and welfare staff was low in pediatric ward of this hospital. doctors and nurses' attention to the quality of care can reduce the levels of dissatisfaction

[Effect of vitrification on sperm parameters and apoptosis in fertile men]

Today, cryopreservation of the human sperm is a common technique for treating infertility. It has been indicated that cryopreservation by different methods decrease the sperm motility and viability in fertile men, but still effect of freezing of the sperm by vitrification method have not been evaluated on sperm parameters and apoptosis. The aim of this study was to evaluate the effect of vitrification of sperm of fertile men on different sperm parameters [motility, morphology, viability and count[and apoptosis after thawing. In this experimental study which was conducted at Yazd Infertility Research and Clinical Center in 2009, seventeen semen samples were collected by masturbation from people who came to this centre. Semen analysis was performed according to WHO standards. Smear was provided from these samples and fixed for TUNEL staining. Some samples were directly cryopreserved by cryoloope in liquid nitrogen and stored at least for Seven days. After thawing, samples were evaluated for sperm parameters. The collected data was analyzed by the SPSS software using paired T-test and Willcoxon statistical test. The progressive movement of sperm was significantly decreased by vitrification. Also significant decrease in viability and morphology of the sperm and increase in the rate of apoptosis was observed after vitrification. The amount of apoptosis had negatively correlated with normal parameters of spermatozoa [especially progressive motility and viability]. These results indicated that vitrification is harmful for sperm parameters and of apoptosis rate in fertile men. However, the apoptosis rate was lower compared to other freezing methods

[Assessing quality of life of elders with femoral neck fractures, using SF36 and EQ5D]

Most of studies on quality of life in Iran have been conducted using SF36 questionnaire. Even though its efficiency has been demonstrated in different studies, but using shorter instruments with easier application, particularly for elders could be more suitable. The aim of present study was to assess and compare quality of life of patients with femoral neck fractures, measured by two questionnaires of SF36 and EQ5D. A cross-sectional study was conducted with 70 elders with femoral neck fracture. EQ5D and FS36 questionnaires were used to assess the general health related quality of life. Data were analyzed using statistical tests like Chi square, T-test, analysis of variance, Pearson and Spearman correlation coefficient. Totally, 70 elders with a mean age of 73.15 years [ranging in age from 60 to 90 years] were participated in the study. The mean score of quality of life was 43.58+/-15.76 measured by EQ5D and 35.15 +/- 12.50 for SF36. The Spearman correlation coefficient was 0.76[P=0.000]. Considering the results which showed quality of life scores measured by two instruments were correlated, it is suggested to use EQ5D in accessing quality of life of elders with femoral neck fractures, in view of being shorter and simpler. Meanwhile, the study revealed the low quality of life scores in elders with femoral neck fractures, which calls healthcare workers to plan for improving the situation

[Seeking treatment behaviors for acute myocardial infarction symptoms in patients referred to Kashan Shahid Beheshti Hospital 2006-7]

Background: The time spend for prehospital action and the type of seeking treatment behaviors of MI patients are important. The present study was conducted to answer seeking treatment behaviors at patients with myocardial infarction [MI] in Kashan Shahid Beheshti Hospital

Materials and Methods: A cross-sectional case study was conducted on 280 patients with MI during 2006-7. Data were gathered using a questionnaire including 7 questions related to the demographic characteristics of subjects, the time of manifestation of symptoms, the hospitalization history, the initial perception of symptoms, the patient's seeking treatment behaviors and methods using to come to the hospital. The patient's behaviors were categorized in two groups of appropriate and inappropriate

Results: From a total of 280 samples 73.8% were men [mean age: 61.37+/-13.34 years] and 26.4% were female [mean age: 67.21+/-9.97 years]. The most revealed behaviors were rest [42.5%], self medication [34.3%] and calling the Emergency Medical Service [22.85%], using sublingual TNG [20.5%], respectively. Only 107 patients had appropriate seeking treatment behaviors. On the other hand, 60 patients displayed inappropriate treatment behaviors. A combination of appropriate and inappropriate seeking treatment behaviors have also reported by 113 patients

Conclusion: A considerable number of the patients with MI demonstrated inappropriate seeking treatment behavior. Public education would be helpful to reduce the prevalence of the inappropriate behaviors

[Nurses perception of professional support]

Background: Professional support has frequently been mentioned as one of the basic prerequisite for nurses' job satisfaction and, creativity and quality in nursing care. However, perception of a professional support to this job has not been studied adequately. The present study was made to clarify the concept and the process to professional support in nursing

Materials and Methods: this qualitative study was conducted using the grounded theory method during 2005-9. The research question was that of what experiences and perceptions the nurses have of the concept of professional support, 29 nurses were interviewed semistructurally in several educational hospitals in Tehran and Kashan. Data were analyzed using Straus and Corbin's method

Results: Seven categories were emerged from data including the concept of support, feeling of being sheltrles, decreased self-confidence, decreased quality of care, avoidance, decreased professional unity and legitimate support. Participants defined professional support as any material or spiritual backing to strengthen their capabilities in nursing care. They believed that professional support increases capabilities of nurses to make clinical decisions. However, feeling to be unsupported made them to be indifferent, low in self-expression, distrusted them to their managers, powerlessness and shortcoming in conflicts. Lack of legitimate support decreases the nurses' decision-making power and made them to avoid of autonomous intervention. Nurse managers had also a sense of lacking legitimate support

Conclusions: Although, the professional support enable nurses to offer a good care for their clients, however, sometimes they feel left unsupported. Developing the legitimate support may decrease the nurses feeling of being unsupported

[ effectiveness of non-myeloablative stem cell transplantation and DLI as a selective treatment in class III beta-thalassemic patients]

At present, the only curative treatment for beta-thalassemia major is allogenic bone marrow transplantation accompanied with considerable mortality and morbidity in class III beta-thalassemia. Regarding few case reports on successful non-myeloablative stem cell transplantation in class III beta-thalassemic cases, we evaluated the effectiveness of this type of allogenic stem cell transplantation, considering less toxic non-myeloablative conditioning regimen. In this prospective study in Shariati Hospital bone marrow transplantation center during 2001-3, 13 class III beta-thalassemia patients [on the basis of history and physical examination and liver biopsy] were transplanted with peripheral blood and bone marrow stem cells from their HLA-identical siblings. Non-myeloablative conditioning regimen included fludarabine; busulan; antithymocyte globulin. Graft versus host disease [GVHD] prophylactic regimen was cyclosporin and metothrexate. In the case of the declining chimerism, the patients were treated with donor lymphocyte infusions [DLI]. The conditioning regimen was tolerated well without any considerable toxicity in hematologic, gastrointestinal and pulmonary systems. Five [38.5%] patients had acute and 2[15.4%] had chronic GVHD. Two patients died after transplantation. While two cases had a thalassemia-free survival. Although associated with high graft failure and the recurrence of disease, nonmyeloablative stem cell transplantation may be used as a curative, less toxic posttransplantation treatment for class III beta-thalassemia

Research in action: mammography utilization following breast cancer awareness campaigns in Lebanon 2002-05

Four consecutive annual surveys of 1200 women each were conducted in Lebanon in connection with the National Breast Cancer Awareness campaigns [2002-05] to measure the prevalence of mammography utilization and the impact of these campaigns, and to highlight regional and demographic differences. The utilization of mammography in the previous 12 months was low and increased only slightly over 4 years [from 11% to 18%]. In the 2005 campaign, it was twice as high [25%] in greater Beirut than in mostly rural areas, and among women aged 40-59 years [about 21%] compared with younger [12%] or older [11%] women. In each wave, repeat mammograms were less common than first time screening