[Effectiveness of the plissit-based counseling on sexual function of women]

Sexual dysfunction is common among women. It affects on all aspects of women's life. Majority of these problems can be treated in early stages with counseling and a few numbers of them need to be treated by specialists. The aim of this study was to assess the effectiveness of PLISSIT-based counseling model on sexual function of women. This was a randomized clinical trial study. It was conducted in an urban health center in Zanjan. Eighty women who were married in the previous 5 years, and had sexual problems, randomly assigned to control and experimental groups. The experimental group received consultation based on PLISSIT model [Permission-limited Information-Specific Suggestion- Intensive Therapy] by a trained midwife and the control group received routine sexual consultation. Demographic and obstetric information were gathered through standard questionnaire. FSFI [Female Sexual Function Index] questionnaire were used for assessing sexual function. Data were collected from participants at three points: before consultation, 2 weeks and 4 weeks after consultation. Mann-Whitney, T-tests and x[2] used for data analysis. Mean scores of sexual function were 25.3 before consultation, 28.8 two weeks after and 29.4 four weeks after consultation in experimental group. These differences were statistically significant [p<0.001 and p<0.001 respectively]. In control group, mean scores of sexual function were 24.48, 24.44, 23.74 before, 2 weeks, 4 weeks after consultation respectively. These differences were not statistically significant [p=0.946 and p=0.375]. There was no significant difference in mean score of sexual function between control and experimental groups before intervention [p=0.408]. However 2 weeks and 4 weeks after the consultation this difference was significant [p<0.001 and p<0.001 respectively]. Based on the result of this study, we can claim that sexual problem in women decreased by using the PLISSIT model. Using the PLISSIT model is recommended in health care setting.

[ comparison among perspective of doctors, nurses and patients towards nursing advocacy role]

Patient advocacy is one of the most controversial issues in nursing during recent two decades. The purpose of this study was to determine perspective of doctors, nurses and patients towards the advocacy role of nurses about patients in hospitals affiliated to Shahid Beheshti University of Medical Sciences. This descriptive- comparative study was conducted on a sample of 329 doctors and 345 nurses and 225 patients, selected by a multi-stage sampling method. Data were collected using a demographic questionnaire and a Nursing-Advocacy-Perspective-Scale. The content and construct validity as well as internal consistency and test-retest reliability method were assessed and confirmed beforehand. The data was analyzed using SPSS 16 and statistical tests at the significant level of P<0.05. There was a significant difference among the three groups in average scores perspective [p<0/05]. Average scores of patients were higher than nurses and doctors, and nurses average scores were significantly higher than physician [p<0/05]. The nurse managers should promote the role of the facilitator and prevent loss of nursing advocacy and creating opportunities to provide this role in hospitals. In this regard the views of interest groups may help.

[Genetic association of some haplotypes to level of hdl-c, triglyceride, and waist in family members with metabolic syndrome using haplotype based association test]

Haploytpes are important elements in study of genetic associations. The haplotype based association test [HBAT] is a method to study genetic association of haplotypes with one or more traits. The test statistic in this method, which is calculated for all haplotypes, follows a standard normal distribution. In this study, in order to find the chromosomal area locus of genes affecting metabolic syndromes, the HBAT method was used to investigate the genetic association of haplotypes of some candidate microsatellites with HDL-C, triglycerides, and waist. A sum of 125 families with at least one member having metabolic syndrome according to ATPIII, and at least two members with low HDL-C levels were selected from among participants of the Tehran Lipid and Glucose Study [TLGS]. The genetic association of HDL-C, triglycerides, and waist with haplotypes of some microsatellites of chromosome 8, 11, 12, and 16 was studied, using HBAT. Data was obtained for 125 families, consisting of 563 individuals, aged 20 years or above [269 males and 294 females]. Genetic association of the haplotype 2-2-2-2 of chromosome 8 showed significant association with HDL-C and triglycerides. Haplotypes 2-2-1 and 2-2-2 of chromosome 12 showed significant association with triglycerides. In addition, haplotype 1-1-2 of this chromosome was found to be associated with waist [P<0.05]. Researching haplotypes provides more information on genetic associations, and identification of haplotypes influencing HDL-C level, triglycerides, and waist may be helpful in designing future research aimed at determining the genes predisposing persons to metabolic syndrome.

[Fuzzy clustering approach in DNAmicroarray]

Microarray techniques are successfully used to investigate thousands of gene expression profiling in a variety of genomic analyses such as gene identification, drug discovery and clinical diagnosis, providing a large amount of genomic data for the overall research community. Statistical analysis of such databases included normalization, clustering, classification, etc. The present study surveyed the application of fuzzy clustering technique in DNA microarray analysis. Golub, et al collected data bases of leukemia based on the method of oligonucleotide in 1999. The data are on the internet for free. In this paper we did analysis on this data set and gene expression data were clustered by fuzzy clustering. Data set included 20 Acute Lymphoblastic Leukemia [ALL] patients and 14 Acute Myeloid Leukemia [AML] patients. Efficiency of clustering was compared with regard to real grouping [ALL and AML]. We used R software for data analysis Specificity and sensitivity of fuzzy clustering in diagnosing of ALL patients are 90% and 93%, respectively. These results show a good accomplishment of both clustering methods. It is considerable that, due to clustering methods results, one of the samples was placed in ALL group, which had been in AML group in clinical test. With regard to concordance of the results with real grouping of data, it could be said that we can use these methods in cases where we don't have accurate information of real data grouping. Moreover, results of clustering might distinguish subgroups of data in such a way

Study of association between lifestyle and hemorrhoids among patients referring to Tehran University of medical sciences hospitals in 2007

Study of association between lifestyle and hemorrhoids among patients referring to Tehran University of medical sciences hospitals in 2007 Hejazi Sh1, Alavi Majd H2, Najafi Abedi Z3 1 Instuctor, MSc of Nursing, Deputy of Education and Research, Faculty of Nursing and Midwifery, Islamic Azad University, Tehran Medical Branch, Tehran, Iran. 2 Associate Professor, PhD of Biostatistics, Shaheed Beheshti University, Tehran, Iran. 3 Student of MSc of Nursing, Faculty of Nursing and Midwifery, Islamic Azad University, Tehran Medical Branch, Tehran, Iran. Hemorrhoid is a chronic disease that has been known as a problem since 4 thousand years ago. Healthy lifestyle is an important mean of decreasing incidence and complications of chronic diseases. Considering the vast influence of lifestyle on chronic diseases symptoms, the goal of this study was to determine these influences on hemorrhoid. The present research is a case-control analytical study. The study population included all patients with hemorrhoid referring to Tehran University of medical sciences hospitals. The study group comprised 101 patients suffering from hemorrhoid, and the control group included 101 healthy individuals. Both groups have been matched in age and sex. The data were collected by using a questionnaire. The questionnaire scientific validity and reliability were determined with content validity and test-retest respectively. We used descriptive and inferential [Chi-square test, Fisher exact test and Mann-Whitney test] statistics for analyzing data. The majority of patients in study group didn't have their meals on a fixed schedule [p > 0.001], had less than three meals per day [p = 0.021], had less daily fluid consumption [p = 0.001], always used spicy food [p = 0.001], and had less fiber consumption, had sedentary activities [p > 0.001], never had walkings [p = 0.001], and neither in past nor in present they had exercises, had defecation only one time in 3-5 days [p > 0.001] with severe pressure and difficulty, and the duration between 5-10 minutes [p > 0.001]. This study showed that there was a significant relationship between lifestyle and hemorrhoid

[ comparative study of therapeutic effects of Zataria Multiflora vaginal cream and metronidazole vaginal gel on bacterial vaginosis]

Bacterial vaginosis [BV] is one of most prevalent complications among fertile women. Metronidazole prescription which is considered the first choice remedy for BV is usually followed by few side-effects. Besides, there is a growing tendency toward herbal medicines for treatment of vaginitis. Antibacterial and antifugal effects of Zataria multiflora have been demonstrated through in-vitro and in-vivo. This study aimed to compare therapeutic effects of Zataria Multiflora vaginal cream and Metronidazole vaginal cream on bacterial vaginosis. This was a randomized clinical trial on 90 married women aged 18-40, affected by bacterial vaginosis who attended for treatment to gynecology clinic of "Shabih-Khani hospital". They randomly divided into two groups each consisted 45 participants. Diagnostic criteria were Amsel's criteria and gram-stain. Zataria Multiflora vaginal cream or Metronidazole vaginal gel was prescribed for a five-night period for each group. After 2 to 7 days of administration, therapeutic effects, complications and the Amsel criteria were reassessed. Data analysis was performed by McNemar test to compare both the complications, Amsel's criteria and gram-stain in each group in their before and after treatment course. Fisher exact test was applied to compare the therapeutic effects between two groups. Complication and the Amsel criteria significantly decreased after treating by Zataria Multiflora vaginal cream or Metronidazole vaginal gel [P<0.05]. Relative risk for unresponsiveness treatment with Zataria Multiflora, to Metronidazole treatment was 1.5 [CI 95%: 0.27-8.27] which was not significant and both had therefore, similar therapeutic effects on VB. Zataria Multiflora vaginal cream has similar therapeutic effects to Metronidazole vaginal gel on VB. Thus, it could be an appropriate choice for VB treatment for those interested in herbal medicines or affected by side-effects of Metronidazole

Effects of intermittent and continuous oxytocin infusion on outcomes of pregnancy

Induction of the labor is one of challenging therapies in midwifery. Synthetic oxytocin has been used for many years in obstetric practice for the induction and augmentation of labor. Common side effects of oxytocin are overstimulation, fetal distress and emergency Caesarian section. Despite its extensive use, there is no consensus regarding the initial dose, dosage increments and/or the maximal dose. In addition, there is not enough data to know whether induction or argumentation of labor with oxytocin should be continued or stopped after the onset of active labor. Prolonged oxytocin infusion causes desensitization of oxytocin receptors and reduction of oxytocin receptors MRNA. This study was accomplished to compare the effects of intermittent and continuous oxytocin infusion on outcome of pregnancy in those referring to hospital in Maraghe in 2006. 102 pregnant women were randomly selected and divided into two groups of intermittent and continuous oxytocin infusion. The groups were then matched in terms of parity, age, BMI before pregnancy, gestational age, indication of induction and Bishop score for initiation of oxytocin infusion. Induction of labor in the groups was started by oxytocin infusion of 2mu/min [10 IU of oxytocin was dilated in 1000cc of 0.9% normal saline] and the dosage in the continuous group was increased every 15 minutes by 2mu/min until 3 regular contractions at least 45-60 seconds with moderate severity over 10 minutes. Infusion of oxytocin in intermittent group was discontinued when cervical dilation reached to 5-6 cm but, in the continuous group, infusion of oxytocin was continued at the same level until delivery. Data were collected by a questionnaire, observation of vagina and physical examination. No significant difference was found between the groups regarding the quality of contractions in terms of frequency, duration and severity of contractions [p>0/05]. The rate of overstimulation in the continuous group was more. The lengths of active phase in intermittent group were less and the rate of fetal distress in continuous group was more. The rate of Cesarean section in continuous group was less than intermittent group. Further studies in this regard are warranted

Knowledge and attitude of nurses regarding bioterrorism

Modern biotechnology has enabled man to make benefit of microorganisms more efficiently than before but it is obvious that this powerful tool can be beneficial or dangerous to human beings depending on its use. Bioterrorism using biological weapons in terrorism is of great concern especially for healthcare workers as the first respondents to the victims. This descriptive study was conducted to identify attitudes and knowledge of nurses concerning bioterrorism at hospitals affiliated to Mazandaran Medical University in Sari. 65 nurses were selected by non-probability sampling method. A questionnaire was used for collecting data. Content and Cronbach's methods were used for validity and reliability of it. Findings showed that 96.9% of the subjects had a very low knowledge concerning bioterrorism and 96.9% of them was also indifferent. Performing educational programs regarding bioterrorism is recommended because knowledge of nurses in this regard seems to be very low

Midwives' views regarding educational needs in perimenopausal health and care

Today, due to medical improvements, 95% of women reach menopausal age. As a result, health providers should properly educate these women regarding physical and psychological changes of this period. Continuing education of midwives as health care providers is a necessity in this respect. Hence, assessing educational needs of them becomes a determinant factor in guaranteeing efficient educational program. Accordingly, assessing these needs is likely to support national health and wellbeing. This descriptive study was conducted to determine the views of midwives regarding health education and care during perimenopausal period in Rafsanjan in 2006. All 97 midwives working in private and governmental sectors in Rafsanjan were chosen. Data were collected using a questionnaire consisted of two parts: demographic characteristics and items related to midwives' views regarding educational needs. The validity of the questionnaire was determined by content validity and its reliability by test-retest. Findings indicated that the most urgent need was nonmedical treatments in menopause [80%]. The next priority of midwives was sexual problems [76.25%], medical and hormonal treatments [75.75%], counseling during menopausal period [75.75%], exercise during menopausal period [72%], recognition of signs and symptoms of menopause [58%] and nutrition in menopause [53.5%]. Recently, special attention has been given to menopause. Our findings showed that nonmedical treatments in menopause are the first priority of midwives regarding educational needs. This verifies nonmedical approaches in treatment during past decades. It is expected to use these approaches in educational planning of midwives. To make continuing education programs for midwives efficient, studies on assessing educational needs in other aspects of midwifery are warranted

Types and rates of occupational accidents in nursing students at nursing and midwifery colleges in Tehran

Today, humans are at increased risk of occupational accidents. Healthcare workers and students expose to many occupational hazards and accidents. Lack of experience and technical expertise places students at more risk. This descriptive study was conducted to determine types, rates and causes of occupational accidents in nursing students at Nursing and Midwifery Colleges in Tehran. 180 nursing students were selected by stratified sampling method. Data were collected with a questionnaire validated and made reliable by content and test-retest methods respectively. 31.3% of the students experienced needle stick, 41.7% sharp injury, 84.8% blood and body fluid exposure, 46.7% exposure to chemotherapy agents, and 33.3% injury and bruise in the past 12 months. There were significant differences in the year of education. Medical, surgical, emergency and oncology wards were identified as risky. Application of protective devices was not satisfactory. According to high rates of some accidents, appropriate educational programs regarding occupational accidents, prevention and timely reporting is necessary

Relation between Helicobacter pylori and nausea and vomiting in pregnant women

Gestational nausea and vomiting in pregnant women have a high prevalence. The disorder will usually be better after the third trimester but, in some cases, it persists throughout pregnancy and makes the life of pregnant women disturbed. This case-control retrospective study was conducted to determine the relation between Helicobacter pylori and nausea as well as vomiting in pregnant women referring to the healthcare centers affiliated to Mashhad University of Medica Sciences in 2006. 187 pregnant women at the third trimester of their pregnancy were selected. According to the experience of nausea and vomiting from the first trimester, they were divided into two groups: 89 women with the disorder and 98 women without it. A questionnaire in three parts was used for data collection: demographic information, history of nausea and vomiting, and socioeconomic status. The questionnaire was validated by context validity and reliability by test-retes method. Anti-Hp immunolobin G [IgG] serum antibody wastested by ELISA it determine seropositivity [r=0/89]. The result showed a significant relation between helicobacter pylori and nausea and vomiting during pregnancy. The subjects did not have significant differences in terms of height, job, education of spouse, husbands' job, pregnancy and BMI except for age and socioeconomic status [P=0.037 and P<0.001 respectively]. The results may show that nausea and vomiting during pregnancy can be prevented by diagnosing helicobacter pylori infection in women. Also, it seems that there should be a training program in knowing Helicobacter pylori infection and its complications. Considering the results of this research, studying women with nausea and vomiting during pregnancy for helicobacter pylori infection is advisable

Comparing between the healing effects of chamomile solution and topical steroid on peristomal skin wound

Peristomal skin breakdown is one of the most common complications of ostomy. This problem results in physical, psychosocial and economical complications for patients with negative impact on adaptative behaviors and, to some extent, reduce their ability in stoma care and other duties. Since steroids have different side effects in healing process, methods with less adverse reactions are sought by researchers. This clinical trial was conducted to compare between the healing effects of chamomile solution and topical steroids on peristomal skin wounds of colostomy patients. 72 patients in two groups with some degree of peristomal skin breakdown reffering to Tehran Ostomy Association participated in the study. Data were collected by a 2-part form regarding demographic and disease characteristics and an observational checklist to measure the healing process. In 36 patients, chamomile compress was used twice a day and in other patients hydrocortisone 1% ointment was used once a day. Healing process was evaluated 3, 6, 9, 12 and 15 days after the interventions. Findings indicated a significant difference between the two groups, i.e., healing took place more quickly in chamomile group than hydrocortisone group. It seems that chamomile solution is more effective than hydrocortisone in healing of peristomal wounds. Therefore, it is recommended for these wounds

Effects of touch on O[2] saturation in newborns with respiratory distress syndrome

Approximately, 7% of all newborns weigh less than 1500 gr. 10% - 15% of newborns less than 2500 gr. may develop respiratory distress syndrome. Because of their anatomic, chemical and physiologic immaturity and instability, premature infants are unable to fully modulate extrauterine stressors, a critical challenge for care providers. A wide variety of sensory stimulations has been found to be beneficial for premature infants. This quasi-experimental research was conducted to determine the effects of touch on oxygen saturation of arterial blood in newborns with respiratory distress syndrome. Subjects in this clinical trial included 37 affected infants in neonatal intensive care unit of Mofid Pediatric Hospital. An information form and a pulse oxymeter were used for data collection. Validity of the form was measured by content validity. The pulse oxymeter was selected from famous brands to ensure its validity. It was then calibrated for reliability. Data was collected in 3 consecutive days. At first, oxygen saturation was checked and, after 5 minute, the subjects were touched for 5 minutes. O[2] saturation was then checked after 5 and 15 minutes again. Findings showed that oxygen saturations 5 and 15 minutes after touch were more than those of before touch [p<0.01]. However, there was no significant difference between saturations 5 and 15 minutes after touch. There was also no significant difference between saturations over 3 days. Findings suggest that touch can increase O[2] saturation. For nurses working at NICUs, the importance of touch should be emphasized in the care of premature infants. Further research in this regard is warranted

Occupational stress and low-back pain in nurses

Low-back pain is an important health and socio-economic problem. It signifies not only high prevalence and incidence but also important consequences such as disability, heavy expenses and absenteeism. Low-back pain is associated with occupational, psychological and physical factors. As compared with other occupations, nursing is ranked the highest risk for it. The prevalence of low-back pain in nurses was reported 43% to 76% during 12 months. This case-control study was conducted to determine association between occupational stress and low-back pain. 160 nurses were selected by convenience sampling and randomly divided into two equal case and control groups from five teaching hospitals of Shaheed Beheshti Medical University in Tehran. Case group was regarded as those subjects who had experienced low-back pain in 12 months. Control group was considered as those subjects who had experienced no low-back pain in the same period. A questionnaire consisted of 3 sections including demographic information, history of low-back pain and of occupational stress was used for data collection. Data regarding occupational stress was obtained by modified nursing-stress scale which was translated into Persian language. Validity and reliability of the questionnaire were determined by content validity and test-retest method [0.91] respectively. Finding indicated that an association existed between low-back pain and occupational stress. A relation also existed between low-back pain and working hours per month. Statistical tests showed no significant difference between the two groups in terms of age, gender, marital status, parity, gravidity, smoking, exercise, work shift, and clinical experience. The majority of nurses [45%] had a high level of occupational stress. Mean stress scores were 61.12 and 54.45 in case and control groups respectively. The major finding of this study was that an association existed between occupational stress and low-back pain. This finding is important in the prevention of occupational low-back pain, especially for nurses. This study highlights an urgent need for the development of effective prevention and training programs for low-back pain. Many experiences of low-back pain may be the result of cumulative effects of repeated stress on the back. It is necessary to implement preventive measures such as promoting psychological health at work place, and teaching stress reduction techniques before experiencing disability secondary to low-back pain

Relation between duration of menstruation and gestational diabetes in women referring to teaching hospitals in Tehran

Gestational diabetes is defined as carbohydrate intolerance of variable severity at or during pregnancy. Approximately, of pregnancies is affected by diabetes mellitus, of which represents gestational diabetes mellitus [GDM]. Detection of risk factors in GDM may reduce the risk of complications. A new risk factor suggested is abnormal menstrual duration. This case-control study was conducted to determine the relation between duration of menstruation and gestational diabetes in women referring to teaching hospitals at Tehran in 2005. 120 women [60 in case group with GDM and 60 in control group without GDM] referring to GDM and Prenatal Clinics in Shariati and Taleghani hospitals were selected by convenience sampling. An information form was completed by interview for data collection. Content and test re-test methods were used for validity and reliability respectively. Demographic characteristics and abnormal duration of menstruation as well as its etiology were compared between the groups. Those with the history of fetal macrosomia [weight >4500g], diabetes, diabetes in previous pregnancies, neonatal morbidity and mortality, recurrent abortion, smoking before or during pregnancy and preterm delivery were excluded from the study. The groups were matched in terms of their age, parity, body mass index, diabetes mellitus in their close relatives and the history of stillbirth or congenital anomalies. Demographic characteristics and duration [in the case and in the control] as well as etiology of abnormal menstruation were similar between the groups [p=0.34]. No significant relation was found between duration of menstruation and GDM. The relationship between duration of menstrual bleeding and gestational diabetes is disputable

Relation between sleep disorders in the last month of pregnancy and type of delivery in women referring to health centers at Saghez

Pregnancy can affect on sleep pattern. About 2/3 of pregnant women complain of their sleep pattern. Besides having physical and psychological outcomes, the pattern can influence on labor and the type of delivery. This cohort study was conducted to determine the relation between sleep disorders in the last month of pregnancy and the type of delivery. 139 subjects [59 women without sleep disorders and 85 with sleep disorders] were selected by sequential sampling method and followed until their delivery. A questionnaire, an observation form and a checklist were used for data collection. Findings indicated that the chance of Cesarean section in women with sleep disorders were 2.7 times more than the other group [CI=0.83-8.5, RR = 2.7]. However, Qui-square test showed no significant difference between the groups [p= 0.096]. Sleep disorders have no effect on increasing Cesarean prevalence