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Background and Objective: Prolonged hospitalization lead to considerable financial burden for patients as well as health care system. This study aimed to identifying important factors resulting in excess hospitalization days in patients undergoing abdominal surgeries using the multilevel zeroinflated Poisson regression model
Methods: In this descriptive - analytic study, 485 patients from five teaching and private hospitals in Shiraz [southern Iran] were selected based on convince sampling method. Multilevel zero-inflated Poisson regression model was used to determine the risk factors of excess hospitalization day.Maximum likelihood method was used to estimate parameters of the model. Moreover, Akaike Information Criterion [AIC] and Bayes Information Criterion [BIC] indices were applied to assess the goodness of fit of the model
Results: The primary analysis of data showed that 81.2% of the patients did not undergo excess hospitalization days. Based on findings, age, respiration rate, blood infusion, fever, smoking and drug abuse did not affect excess hospitalization days. In contrast, gender, renal diseases, operation history, laparoscopic gallbladder removal, prostate surgery and ileus significantly led to excess hospitalization days [P<0.05]. Laparoscopic gallbladder removal, prostate surgery increased the chance of excess of hospitalization days to 4.64 and 9 times, respectively [P<0.05]
Conclusion: Geder, renal diseases, operation history, laparoscopic gallbladder removal, prostate surgery and ileus significantly led to excess hospitalization days
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Background: This study examined the impacts of an Emotional Focused Intervention on emotional abuse behaviors and marital satisfaction among the elderly married couples
Methods: This randomized controlled trial study was carried out in Shiraz-Iran, during September 2013-2014. The elderly couples were invited to join an emotional focused intervention, following the advertisement and announcement on bulletin boards in the elderly day clinic centers and all governmental primary health care centers. Then, 57 couples [114 participants] who were eligible for study were assigned in two groups by block randomization [29 in the experimental and 28 in the control group[.The couples in the experimental group received intervention twice a week for four weeks. Each session lasted 90 minutes. The control group didn't receive any intervention and the subjects were put in the waiting list. The outcome measures were evaluated by Multidimensional Measure of Emotional Abuse Questionnaire [MMEAQ] and Marital Satisfaction Questionnaire for Older People [MSQFOP]. Repeated measurement ANOVA was used to detect any significant changes between groups in their mean scores of emotional abuse behaviors and marital satisfaction from pre- to post-test, and 3 months after the intervention. Analysis of data was performed using SPSS, version 19, and P
Results: The mean duration of marriage was 39.56+/-9.64 years. In the experimental group, the abusive behaviors decreased significantly [P<0.001] at times 2 and 3 compared with time 1, and marital satisfaction improved significantly only at time 3 [P<0.001]. These differences were not significant in the control group
Conclusion: Emotion-focused couple-based interventions are helpful in reducing the spousal emotional abuse and improving marital satisfaction in among the elderly couples
ABSTRACT
Background: non-alcoholic fatty liver disease [NAFLD] is characterized by macro vesicular steatosis in the absence of alcohol. Patients with [NAFLD]need extensive education and support in their treatment. Our aim was to investigate the effect of telenursing on liver enzymes [ALT and AST] in patients with NAFLD
Methods: our study is a randomized controlled clinical trial. In this study, 60 patients were enrolled from patients who referred to subspecialty gastrointestinal clinics affiliated to Shiraz University of Medical Sciences. Specialists confirmed their diseases by ultrasound and laboratory test. Simple randomization, based on random number table, was used to randomize the participants into intervention [N=30] and control [N=30] groups. Patients in both groups received dietary advice from a nutritionist and were trained to perform physical activities. Telephone intervention in the intervention group lasted for 12 weeks, in order to see the effect of follow up on the recommended diet and physical activities given by the specialist, while; the control group subjects were only followed up as usual by their physician
Results: the result of an independent t-test showed that the mean difference of liver Enzymes between the two groups was statistically significant [P<0.001]. The difference of AST and ALT in the intervention and control groups was 18.03, -1.27 and 40.70, 1.52, respectively
Conclusion: we found out that; telenursing could have a positive effect on reduction of liver enzymes [ALT, AST] in patients with NAFLD
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Objective: vascular endothelial growth factor [VEGF] and VEGF receptors [VEGFRs] play important roles in angiogenesis of different developmental mechanisms such as wound healing, embryogenesis and diseases, including different types of cancer. VEGFR2 is associated with cell proliferation, migration, and vascular permeability of endothelial cells. Blocking VEGF and its receptors is suggested as a therapeutic approach to prevent tumor growth. In this study, we aim to block VEGF signaling via small interfering RNA [siRNA] inhibition of VEGFR2
Materials and Methods: in this experimental study, we used the RNA interference [RNAi] mechanism to suppress expression of the VEGFR2 gene. We conducted the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide [MTT] assay, real-time polymerase chain reaction [PCR], Western blot, and flow cytometry analyses of VEGFR2 expression
Results: real-time PCR and Western blot results showed that VEGFR2 expression significantly downregulated. This suppression was followed by inhibition of cell proliferation, reduction of viability, and induction of apoptosis in the cancer cells
Conclusion: these findings suggest that VEGFR2 has a role in cell proliferation and tumor growth. Accordingly, it is suggested that VEGFR2 can be a therapeutic target for controlling tumor growth and proliferation
ABSTRACT
Rheumatoid Arthritis [RA] is a systemic and inflammatory disease of unknown etiology which is mostly characterized by inflammation of the synovial joints. Studies have proved that most people with RA avoid doing physical activities due to fear that it may worsen the pain or cause pressure on joints, resulting in decreased muscle strength and ultimately leading to disability of patients. We aimed to investigate the effects of conditioning exercises on the health status and pain in patients suffering from RA. In this randomized controlled clinical trial, we enrolled 66 women with confirmed RA referred to the rheumatology clinic of Hafez hospital, Shiraz, southwest Iran during May-July 2013. Balanced block randomization method was used to randomize the participants into case and control groups [two groups of 33 each].Data were collected using visual analog scale [VAS], Arthritis Impact Measurement Scales 2 short form [AIMS2-SF], and demographic questionnaire. After obtaining written informed consent, the participants in the case group were asked to participate in conditioning exercise programs including aerobic, isometric, and isotonic exercises and received a training booklet explaining the exercises that they could do at home after the intervention. There was a statistically significant difference between the health status scores of the patients in the case groups before and after the intervention [P=0.001]. The pain score also decreased significantly in the case group compared with the control group after the intervention [P=0.003]. We concluded that physical training programs, especially conditioning exercises, could improve the health status and reduce pain in patients with RA
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The paper presents a new trend of weight-for-height index of 2397 school children [1268 boys and 1129 girls] aged 6.5-11.5 years by sex in a representative sample from primary schools of Shiraz [Southern Iran[at an interval of 15 years [1988-2003] and its relation to the center for Disease Control and Prevention [CDC] data [2000]. The data relate to a multi-stage random sample of healthy school children in Shiraz, southern Iran, collected in 2002-2003 academic year. The mean +/- SD age of these children was 9.1 +/- 1.4 years. The weight and height were estimated as 28.2 +/- 6.9 kg and 131 +/- 9.6 cm, respectively. Cross-sectional weight-for-height curves were constructed for both sexes. Parametric Lambda-Median-Standard Deviation [LMS] method was applied to estimate weight-for-height centiles. Weight-for-height centiles for boys and girls were nearly close to each other, except for the children of older age in which boys' centiles lay below those of girls. Centiles of the present study lay above previous ones. In both sexes CDC weights were greater than those of Iranians for a given height. This discrepancy was more pronounced in extreme high centiles. The necessity for updating local weight-for-height reference data for clinical work in Iran is emphasized. The positive trend in weight-for-height had been influenced by socio-economic development and improvement of health indicators in Iran during the post war reconstruction period
Subject(s)
Humans , Male , Female , Body Height , Growth Charts , Schools , Child , Reference Values , Cross-Sectional StudiesABSTRACT
Psychological problems like as anxiety in patients who are coronary artery bypass graft [CABGs] may increase mortality and morbidity. The effect of reassurance and preoperative information in decreasing of anxiety is uncertain. This study designed to address the effect of preoperative information and decreasing of anxiety of patients who are candidate for CABGs. With experimental study and randomize sampling 85 [55male and 30female] of 238 patients who were candidate for CABGs included and completed spilberger anxiety test on the day of admission. Preoperative information and reassurance done and test completed again on the day before surgery. Mean number of anxiety score in patients with mild anxiety disorder [21 patients] were 34 +/- 4.2 before and 39 +/- 5.8 after intervention. In patients with moderate anxiety disorder [39 patients] the number decreased to 53.88 +/- 7.6. All of differences were significant statistically. In patients with mild anxiety preparative information and reassurance resulted in increasing anxiety but in patients with moderate or server anxiety disorder, anxiety level decreased significantly