Effect of the Theory-driven Educational Intervention on Self-Care Behavior and Glycosylated Hemoglobin Level in Patients with Type 2 Diabetes.

BACKGROUND AND AIMS: The diabetics' lack of knowledge about self-care and incorrect beliefs in this care are the reasons for their admission to hospitals. The present study aimed to examine the impact of education based on the theory of planned behavior (TPB) on intention, self-care behavior, and glycosylated hemoglobin (HbA1c) levels in patients with Type 2 Diabetes. METHODS: The present study was conducted on 60 diabetic patients who were randomly classified into intervention and control groups. In the intervention group, self-care education based on TPB was held, but the control group only received routine care. The data were collected using a fourpart questionnaire including characteristics, items of patients' knowledge, items of TPB constructs, and items of diabetes self-care. Data were analyzed in SPSS software. RESULTS: In intervention group, mean score of self-care behavior and its domains significantly changed from (total: 52.26±14.75, diabetic diet: 22.20±6.05, exercise: 5.17±4.04, blood sugar testing: 5.03 ± 4.15, medication: 5.40±2.28, foot care: 13.47±8.42) into 76.66±8.87, 29.43±5.48, 7.60±2.60, 8.73±2.31, 6.48±1.09, 23.53±3.09, respectively three months after intervention (p<0.01). In this case, these changes were not seen in the control group. The mean level of HbA1c in the intervention group (6.38±0.16) was significantly lower than before the intervention (7.56±1.08) and the control group (8.02±0.25) three months after intervention(p<0.01). CONCLUSION: Education based on the TPB was effective in improving the patients' self-care behavior and HbA1c index. Therefore, we suggest all medical centers to use the TPB as an effective and low-cost educational approach to improve diabetics' self-care behavior and health.

Evaluating the effect of educational intervention based on the health belief model on the lifestyle related to premenstrual syndrome and reduction of its symptoms among the first-grade high school girls.

INTRODUCTION: A healthy lifestyle can reduce the rate and symptoms of premenstrual syndrome. Thus, the present study evaluates the effect of educational intervention based on the Health Belief Model on the lifestyle related to premenstrual syndrome and reduction of its symptoms among the first-grade high school girls. METHODS: This quasi-experimental study was conducted on 80 first-grade high school girls. They were divided into two intervention and control groups (40 people in each group). The data collection tools included the participants' demographic information questionnaire, premenstrual symptoms screening tool, and a researcher-made questionnaire based on the constructs of the health belief model about PMS and the behaviors reducing its symptoms. Data were collected in two phases (before and three months after the educational intervention) via WhatsApp. Educational sessions were held in the form of four 45-min sessions for intervention group subjects regarding PMS and the behaviors that reduce its symptoms during one month via WhatsApp. RESULTS: According to the results of this study, the mean scores of knowledge about PMS and health belief model constructs (including perceived susceptibility), perceived severity, perceived benefits, perceived self-efficacy, cues to action, lifestyle/behaviors that reduce PMS symptoms) and the percentage of people who did not have PMS symptoms or had a mild type of PMS increased significantly after implementing the educational intervention in the intervention group compared to before the intervention and compared to the control group. Also, the perceived barriers construct score PMS decreased significantly. CONCLUSIONS: The health belief model education focused on a healthy lifestyle was effective in reducing PMS symptoms. It is recommended to use the educational intervention designed in this study, along with other health care in schools and during puberty as an easy, low-cost, and effective intervention.

A Study on the effect of lifestyle educational intervention based on the theory of planned behavior on promoting quality of life of middle-aged women.

The present study aimed to determine the effect of lifestyle educational intervention based on the theory of planned behavior on promoting the quality of life of middle-aged women. The present quasi-experimental study examined 80 middle-aged women and randomly divided them into two groups (intervention and control). Data collection tools included the demographic information questionnaire, the Health Promoting Lifestyle Profile-II (HPLP-II), the 12-Item Short-Form Health Survey (SF-12), and the author-developed questionnaire based on constructs of the theory of planned behavior. Data were collected via WhatsApp twice (before and three months after the educational intervention). Five 45-minute training sessions were held for the intervention group and a 60-minute session for a family member regarding physical activity and spiritual growth over two months via WhatsApp. Data were analyzed using SPSS, and the results were considered significant at a statistical level (p < .05). The implementation of the educational intervention significantly increased the mean scores of quality of life, physical activity and spiritual growth, knowledge regarding physical activity and spiritual growth, attitude toward physical activity and spiritual growth, subjective norms toward spiritual growth, perceived behavioral control for physical activity, and behavioral intention to perform physical activity and spiritual growth in the intervention group in comparison with the control group. The educational intervention, which was designed based on constructs of the theory of planned behavior, was influential in promoting the lifestyles and quality of life of middle-aged women. Therefore, it is suggested to use the educational program of the present study in addition to other middle-age health care.

The perceived social support by Iranian women with breast cancer: a qualitative study.

BACKGROUND: Social support has an important role in improving health outcomes and is considered as one of the crucial aspects of the modern care in cancer patients. Therefore, this article aims to explain the perceived experiences of women suffering from breast cancer towards social support. METHODS: In this qualitative study, 22 women with breast cancer were selected through purposive sampling from 5 hospitals affiliated to Urmia University of Medical Sciences. The data were collected through semi-structured interviews and were analyzed by the Conventional Qualitative Content Analysis and Graneheim's and Lundman's approach, using MAXQDA software, version 10. RESULTS: After completion of the analyzing process, 6 categories were appeared including "creating an empathic atmosphere by family and community," "being in relationship with others," "adaption to disease," "giving meaning to life," "satisfaction with the role of healthcare providers," and "the impact of others support in fighting with the disease." CONCLUSION: According to the findings, good social support during the illness can result in the spiritual, mental, and physical well-being of the patients and is one of the most effective factors in fighting the disease and feeling of recovery. The findings of this study can be used to develop plans to help the patients to achieve more support from the family, healthcare providers, and the community and even providing the required supportive care for this group of women.

Estimating the prevalence of high-risk behaviors using network scale-up method in medical university students.

BACKGROUND: There is not much information about high-risk behaviors in young groups, especially students. This study was conducted to estimate the prevalence of high-risk behaviors in students of universities of medical sciences in West Azerbaijan Province, Iran, by network scale-up (NSU) method. MATERIALS AND METHODS: This cross-sectional study was performed on 450 students from the universities of medical sciences. A researcher-developed checklist was used to collect the data. We considered number 16 for the social network size of students according to a previous study. Based on the response of individuals to each of the high-risk behaviors (including cigarette smoking, hookah use, opium consumption, alcohol drinking, tramadol/ecstasy taking, and extramarital sex) in their social network, the prevalence of these behaviors was estimated. The required calculations were performed using the NSU method. Furthermore, 95% uncertainty interval (UI) was calculated using the bootstrap method. RESULTS: Totally, 196 (44%) participants were male. The mean age (standard deviation) of the participants was 22 ± 2 years. Results showed that hookah use (20% 95% UI [18.9-21.1]) and opium consumption (0.4% 95% UI [0.24-0.6]) had the highest and lowest frequencies, respectively. Cigarette smoking (17% 95% UI [15.8-18]), alcohol use (8.3% 95% UI [7.5-9.1]), extramarital sex (8.2% 95% UI [7.4-9]), and tramadol/ecstasy taking (4% 95% UI [6.4-4.6]) were the next most common high-risk behaviors, respectively. CONCLUSIONS: Given that hookah use and cigarette smoking are the most common high-risk behaviors in students, especially males, appropriate cultural activities and educational programs should be employed by relevant authorities to reduce these behaviors.

Radiation dose and cancer risks from radiation exposure during abdominopelvic computed tomography (CT) scans: comparison of diagnostic and radiotherapy treatment planning CT scans.

In the present study, radiation doses and cancer risks resulting from abdominopelvic radiotherapy planning computed tomography (RP-CT) and abdominopelvic diagnostic CT (DG-CT) examinations are compared. Two groups of patients who underwent abdominopelvic CT scans with RP-CT (n = 50) and DG-CT (n = 50) voluntarily participated in this study. The two groups of patients had approximately similar demographic features including mass, height, body mass index, sex, and age. Radiation dose parameters included CTDIvol, dose-length product, scan length, effective tube current, and pitch factor, all taken from the CT scanner console. The ImPACT software was used to calculate the patient-specific radiation doses. The risks of cancer incidence and mortality were estimated based on the BEIR VII report of the US National Research Council. In the RP-CT group, the mean ± standard deviation of cancer incidence risk for all cancers, leukemia, and all solid cancers was 621.58 ± 214.76, 101.59 ± 27.15, and 516.60 ± 189.01 cancers per 100,000 individuals, respectively, for male patients. For female patients, the corresponding risks were 742.71 ± 292.35, 74.26 ± 20.26, and 667.03 ± 275.67 cancers per 100,000 individuals, respectively. In contrast, for DG-CT cancer incidence risks were 470.22 ± 170.07, 78.23 ± 18.22, and 390.25 ± 152.82 cancers per 100,000 individuals for male patients, while they were 638.65 ± 232.93, 62.14 ± 13.74, and 575.73 ± 221.21 cancers per 100,000 individuals for female patients. Cancer incidence and mortality risks were greater for RP-CT than for DG-CT scans. It is concluded that the various protocols of abdominopelvic CT scans, especially the RP-CT scans, should be optimized with respect to the radiation doses associated with these scans.

Comparing the Effect of Heat and Cold Therapy on the Intensity of Nitrate Induced Migraine Type Headache in Cardiac Inpatients: A Randomized Controlled Trial.

OBJECTIVE: This study aimed to compare the effect of heat and cold therapy on the intensity of nitroglycerine induced migraine type headache in cardiac inpatients. METHODS: This randomized controlled trial was conducted on a total of 75 cardiac inpatients in three groups design (heat or cold therapy,and control group) as pre-test and post-test. Patients in the intervention group received heat or cold therapy for25 minutes, two times (at 1-hour interval), Patients in the control group did not receive any heat or cold therapy. Headache intensity was measured by the numeric rating scale for pain (NRS Pain), in three groups of study for 3 times (just before the study, at the end of applying the first therapy, and at the end of applying the second therapy). RESULTS: No baseline differences existed among the three groups for the mean pain scale score (P=0.781) just before the study; but the difference between three groups after applying heat and cold therapy was statistically significant (p=0.000). CONCLUSION: This study demonstrated applying heat and cold therapy may reduce the intensity of nitrate induced migraine type headache in cardiac inpatients. Considering this fact that approximately 10% of patients cannot tolerate nitrate therapies due to unbearable headache, applying heat or cold therapy in patients with nitrate induced migraine type headache is recommended to improve patient's adherence to treatment.

Prediction of Breast Cancer Survival by Machine Learning Methods: An Application of Multiple Imputation.

BACKGROUND: The low breast cancer survival rates in less developed countries are critical. The machine learning techniques predict cancers survival with high accuracy. Missing data are the most important limitation for using the highest potential of these techniques to predict cancers survival. Multiple imputation (MI) was implemented and analyzed in detail to impute the missing data of a breast cancer dataset. METHODS: The dataset was from The Omid Treatment and Research Center Urmia, Iran between Jan 2006 and Dec 2012 and had information from 856 women. The algorithms such as C5 and repeated incremental pruning to produce error reduction were applied on the imputed versions of the original dataset and the non-imputed dataset to predict and extract clinical rules, respectively. RESULTS: The findings showed the performance of C5 in all the evaluation criteria including accuracy (84.42%), sensitivity (92.21%), specificity (64%), Kappa statistic (59.06%), and the area under the receiver operator characteristic (ROC) curve (0.84), was improved after imputation. CONCLUSION: The dataset of the present study met the requirements for using the multiple imputation method. The extracted rules after the application of MI were more comprehensive and contained knowledge that is more clinical. However, the clinical value of the extracted rules after filling in the missing data did not noticeably increase.

Serum Selenium Status and Its Interrelationship with Serum Biomarkers of Thyroid Function and Antioxidant Defense in Hashimoto's Thyroiditis.

Selenium (Se) deficiency has been implicated in the pathogenesis of Hashimoto's thyroiditis (HT), although the available evidence is limited. The present study aimed to explore the interrelationships between serum Se status with measures of thyroid function and antioxidant defense in new cases of HT patients with hypoechogenic thyroid. HT patients (n = 49) and matched controls (n = 50) were recruited. Selenium, thyroid hormone panel, thyroid volume (TVol), glutathione (GSH), glutathione peroxidase3 (GPx3) activity, urinary iodine concentration (UIC), and urinary creatinine (Cr) were assessed. HT patients exhibited lower Se levels compared to controls (p < 0.001) with the rates of Se-deficient (<0.85 µmol/L) participants being 58.8% and 34%, respectively. Se-deficient patients exhibited higher thyroid stimulating hormone (TSH), Thyroid volume (TVol), thyroglobulin, antibody-titers, GPx3 activity and UIC/Cr compared to Se-sufficient patients (all p < 0.001). In the Se-deficient patients, inverse correlations were seen between Se-levels with TSH, TVol, and Thyroid peroxidase antibody (TPO-Ab) (all p < 0.001). This study is the first to uncover that coexisting Se-deficiency and elevated iodine in HT may enhance autoimmune reactions and accelerate the deterioration of thyroid function through oxidative stress. Our study also highlights the importance of optimal Se status in this disease, thus providing a rationale for the execution of intervention trials for the evaluation of the clinical benefits of antioxidant-status improvement in HT.

Serum levels of bone sialoprotein, osteopontin, and ß2-microglobulin in stage I of multiple myeloma.

CONTEXT: The fluctuations of proteins in multiple myeloma (MM) are well-known markers for checking the status of the patients. AIMS: The objective of this study was to examine three proteins that have an important role in disease progression. SUBJECTS AND METHODS: The study was performed with two groups: 30 MM stage I patients' (14 females/16 males; aged 60.83 ± 12.38 years) as case group and 40 healthy individuals (18 females/22 males; aged 57.65 ± 6.43 years) as control group. Both groups have been matched in gender and age. Bone sialoprotein (BSP), osteopontin (OPN), and ß2-microglobulin (ß2M) were measured with an enzyme-linked immunosorbent assay. RESULTS: Serum BSP levels of MM-I patients was significantly higher than that of healthy controls (29.24 ± 5.57 vs. 20.89 ± 3.67, P = 0.001). OPN levels of MM-I patients were significantly lower than that of healthy individuals (12.03 ± 3.45 vs. 19.35 ± 4.67, P = 0.001). ß2M levels of patients and controls were similar (1.49 ± 0.67 vs. 1.29 ± 0.55, P = 0.193). CONCLUSIONS: The results suggested that myeloma cells may affect the production of BSP and OPN, which possibly contributes to osteoclastic bone resorption in MM-I patients. Their levels may be a useful biomarker for assessing bone destruction in MM-I patients and distinguishing MM-I from healthy individuals.

The Effect of Expressive Writing on Postpartum Depression and Stress of Mothers with a Preterm Infant in NICU.

This study was conducted to investigate the effects of expressive writing on postpartum depression and stress of mothers with a preterm infant in NICU. This clinical trial was carried out on 91 mothers whose infants were in NICU. Subjects were assigned to intervention and control groups. In the intervention group, subjects were asked to start expressive writing from the third day of hospitalization in NICU and continue it until the tenth day. EPDS, PSS: NICU, and PSS-14 COHEN were completed by all the mothers on days 3 and 10, and 1-3 months after the admittance. Mean EPDS score was obtained as 9.65 ± 5.28, 9.23 ± 5.41, 8.19 ± 4.45, and 7.60 ± 4.65, respectively, for control group at days 3 and 10, and 1-3 months after hospitalization, and it was also obtained as 9.62 ± 5.89, 6.04 ± 3.39, 2.95 ± 2.41, and 2.44 ± 2.01, respectively, for the intervention group at days 3 and 10, and 1-3 months after hospitalization (p < 0.001). Mean PSS-14 COHEN score was lower for intervention group similar to the control group (p < 0.005). Results of the independent samples T-test showed higher stress scores for the control group before and after the intervention, but the difference was not statistically significant (p = 0.08). Mothers with an infant in NICU experienced a high level of postpartum depression and stress. Thus, according to findings of this study, expressive writing is proposed as a convenient and inexpensive means to reduce levels of postpartum depression and stress.

Impact of hot stone massage therapy on sleep quality in patients on maintenance hemodialysis: A randomized controlled trial.

BACKGROUND: Many patients on maintenance hemodialysis experience sleep disorders. This problem is related to depression, anxiety, hospitalizations, chronic medical conditions, decreased quality of life, and increasing mortality rate in patients on maintenance hemodialysis. The objective of this research is to determine the impact of massage therapy by hot stone on quality of sleep in patients on maintenance hemodialysis. MATERIALS AND METHODS: This was a randomized controlled trial conducted on 60 patients on maintenance hemodialysis. They were assigned via random allocation process into two groups of study: intervention group (n = 30), or control group (n = 30). Patients in the experimental group received massage therapy by hot basalt stone for 12 séances. During the massage therapy, each of five basalt stones were placed at the sites of the fifth, fourth, third, second, and first chakra. Control group received their treatment as usual without any massage therapy. Using Pittsburgh Sleep Quality Index (PSQI), the global score and its components were computed in both groups of study, two times (before the intervention and 1 month after the intervention). RESULTS: Although there were not any baseline differences between the two groups of study for the mean of global PSQI score (P = 0.92) before the study, the mean of global PSQI score in the intervention group, after the intervention decreased to 5.7 ± 3.06, but in the control group sleep quality increased to 10.7 ± 3.6. The difference between the mean of global score of PSQI among two groups of study after the massage therapy was statistically significant (P < 0.001). CONCLUSION: Applying massage therapy by hot stone in hemodialysis patients may contribute in enhancing their quality of sleep.

Ten Years' Survival in Patients with Cervical Cancer and Related Factors in West Azerbaijan Province: Using of Cox Proportion Hazard Model

Objective: There are two basic ways to analyze survival data including nonparametric and parametric methods. Considering that cervical cancer is the fourth most common cancer among women, this study was conducted using a suitable regression model for survival data for patients with cervical cancer in Urmia. Material and Methods: In this historical retrospective study, all patients with cervical cancer who referred to Motahhari Hospital of Urmia during 2004 and 2015 were included in the study and consisted of 109 women with cervical cancer. The data were collected using checklist which filled with records of patients. The data were described with percent, mean and standard deviation. The survival function was computed with the Kaplan-Meier method. The adjusted Hazard Ratio for variables were estimated after fitting the Cox proportion hazard model using Forward Stepwise Likelihood Ratio method with PE=0.1, PR=0.15. Results: Of the 109 patients, the mean (SD) time of diagnosis was 50.1% (11.7) years. The mean (SD) and median of follow-up time was 38.23 (32.50) and 27.1 months (Mim:2 months and Max:132 months). Ninty-Three of patients (88.7%) were in urban area. Using Log-Rank test, the mean score of survival in patients with recurrence of 38.8 months was significantly lower than those without recurrence (102.5 months) (P <0.001). The results of the COX model showed that the adjusted relative risk of mortality with a diagnostic age of 50 years or more compared to those under 50 years of age was 1.978. The risk for marriage under age 20 was 3.189 compared to the marriage age of 20 years or more. Conclusion: According to results, the low age of marriage increases the occurrence of advanced stages of cancer in older ages and as a social and cultural factor has a significant effect on the survival of patients with cervical cancer.

A multicenter study of ß-lactamase-producing Klebsiella pneumoniae isolated from university teaching hospitals of Urmia, Iran.

INTRODUCTION: Klebsiella pneumoniae is an opportunistic pathogen accounting for 5-7% of hospital acquired infections. The emergence of carbapenem-resistant Klebsiella pneumoniae has been increasing rapidly over recent years causing many therapeutic problems worldwide. This study aimed to research the antimicrobial resistance profile, detect ß-lactamase genes among clinical isolates of K. pneumoniae, and determine their clonal relatedness. METHODOLOGY: All Klebsiella pneumoniae isolates were obtained from teaching hospitals in Urmia, Iran. Antimicrobial susceptibility testing was done by the disk diffusion method. Furthermore, minimum inhibitory concentrations of imipenem were determined by applying Etest strips. Screening of ß-lactamase-producing isolates was performed by the combined disk method and modified Hodge test. The detection of ß-lactamase genes was conducted by polymerase chain reaction (PCR), and isolates' clonal relatedness was evaluated by random amplified polymorphic DNA (RAPD)-PCR. RESULTS: Overall, 45 out of 182 (24.7%) K. pneumoniae isolates were non-susceptible to imipenem. The combined disk method and modified Hodge test revealed that 93.3% and 71.1% of the imipenem non-susceptible isolates were ß-lactamase producers, respectively. The presence of blaVIM, blaNDM, blaKPC, and blaIMP genes was confirmed in 48.9%, 15.6%, 11.1%, and 6.7% of the ß-lactamase-producing isolates, respectively. RAPD-PCR revealed that 73% of these isolates were classified into six different clusters. CONCLUSIONS: A relatively high prevalence of ß-lactamase genes was seen among multidrug-resistant isolates of K. pneumoniae. Most patients infected with ß-lactamase-producing isolates had a history of long-term hospitalization and nosocomial infections. The predominance of ß-lactamase genes in intensive care unit and internal units alarm clinicians to the growth of hospitalization and mortality rates.

Effect of lifestyle interventions on diabetic peripheral neuropathy in patients with type 2 diabetes, result of a randomized clinical trial.

OBJECTIVES: Diabetic peripheral neuropathy (DPN) is the most common and troublesome complication of diabetes leading to great morbidity and resulting in a huge economic burden for diabetes care. Over half of people with diabetes develop neuropathy. Also, DPN is a major cause of reduced quality of life due to pain, sensory loss, gait instability, fall-related injury, and foot ulceration and amputation. The aim of this study was evaluating the effects of lifestyle interventions on diabetic neuropathy severity in diabetes type 2 outpatients. METHODS: This clinical trial conducted on 74 patients with DPN that divided with random allocation into intervention or control group. The lifestyle interventions applied in the intervention group beginning four educational sessions on lifestyle that emphasize strategies for lowering blood sugar, increasing physical activity, promoting weight loss, prudent diet, and foot caring. Each session was lasted for1.5 hour. Then patients followed for 12 weeks. During this period, they received counseling on mentioned lifestyle interventions. DPN severity in both groups measured using modified Toronto Clinical Neuropathy Score (mTCNS) at the beginning of study and at the end of counseling for 12 weeks. RESULTS: Comparing differences of mean of DNP severity before and after lifestyle intervention between two groups of study, there was a significant difference (p<0.001). DNP severity in control group had not any change or it increased in some participants, but DNP decreased in intervention group, after applying lifestyle intervention. CONCLUSION: Lifestyle interventions can contribute to reducing DPN severity, and consequently decreasing neuropathic pain.

Effect of applying reflexology massage on nitroglycerin-induced migraine-type headache: A placebo-controlled clinical trial.

OBJECTIVES: Nitroglycerin (NTG)-induced migraine-type headache is the most prominent side effect of nitrate therapy. Therefore, the aim of this study was to clarify the effectiveness of reflexology massage on intravenous NTG-induced headache in coronary care unit (CCU) inpatients. METHODS: This was a randomized clinical trial. The study sample included 75 patients that were randomly divided into three groups: control, intervention, and placebo groups. The intensity of baseline headache in patients who received NTG was measured by the numeric rating scale for pain (NRS Pain). Patients in the intervention group received reflexology massage two times for 20 min (at 3-h interval), wherein the upper part of patient's both foot thumbs, which is the reflection point of the head, was massaged. In the placebo group, an unspecified point on the foot (heel), which was not related to the head, was massaged. Patients in the control group did not receive any massage. RESULTS: No baseline differences existed among the three groups for the mean pain scale score (p=0.66) before the study; but the difference between the groups after the application was statistically significant (p=0.000). CONCLUSION: Reflexology massage can reduce the intensity of NTG-induced headache.

Estimation of lifetime attributable risks (LARs) of cancer associated with abdominopelvic radiotherapy treatment planning computed tomography (CT) simulations.

PURPOSE: The present study attempts to calculate organ-absorbed and effective doses for cancer patients to estimate the possible cancer induction and cancer mortality risks resulting from 64-slice abdominopelvic computed tomography (CT) simulations for radiotherapy treatment planning (RTTP). MATERIAL AND METHODS: A group of 70 patients, who underwent 64-slice abdominopelvic CT scan for RTTP, voluntarily participated in the present study. To calculate organ and effective doses in a standard phantom of 70 kg, the collected dosimetric parameters were used with the ImPACT CT Patient Dosimetry Calculator. Patient-specific organ dose and effective dose were calculated by applying related correction factors. For the estimation of lifetime attributable risks (LARs) of cancer incidence and cancer-related mortality, doses in radiosensitive organs were converted to risks based on the data published in Biological Effects of Ionizing Radiation VII (BEIR VII). RESULTS: The mean ± standard deviation (SD) of the effective dose for males and females were 13.87 ± 2.37 mSv (range: 9.25-18.82 mSv) and 13.04 ± 3.42 mSv (range: 6.99-18.37 mSv), respectively. The mean ± SD of LAR of cancer incidence was 35.34 ± 13.82 cases in males and 34.49 ± 9.63 cases in females per 100,000 persons. The LAR of cancer mortality had the mean ± SD value of 15.38 ± 4.25 and 16.72 ± 3.87 cases per 100,000 persons in males and females respectively. CONCLUSION: Increase in the LAR of cancer occurrence and mortality due to abdominopelvic treatment planning CT simulation is noticeable and should be considered.

Determinant of successful implementation of Computerized Provider Order Entry (CPOE) system from physicians' perspective: Feasibility study prior to implementation.

BACKGROUND: Health information technology is a solution for medical error reduction through the implementation of Computerized Provider Order Entry (CPOE). OBJECTIVE: The aim of this study was to determine physicians' attitudes toward the implementation of CPOE. METHODS: This cross-sectional study was started in March 2017 and completed in June 2017. The study used a questionnaire to collect data from physicians in hospitals affiliated to Urmia University of Medical Sciences. We invited 200 physicians who were not using a CPOE system. Questionnaires were randomly distributed among physicians. In order to understand the physicians' attitude about implementation the CPOE system, we used the Diffusion of Innovation Theory, developed by E.M. Rogers. Data were analyzed by SPSS version 16.0, using descriptive statistics and one-way ANOVA. A p value <0.05 was considered to be statistically significant. RESULTS: Most of the physicians were women (n=54, 60%) and the average age of the physicians was 36.39±8.42 years. About three-quarters of the physicians (76.66%) reported that they found the CPOE system adapted to their specific professional practice. The relative advantage of the CPOE system was estimated to be 42.22% for physicians and the complexity of that was 13.33%. There was no significant relationship between Compatibility, Relative advantages and Complexity with physicians' experience in HIS use and physicians' degree of education (p>0.05). CONCLUSION: Since the role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care, our results can be used to assist the planning and introduction of CPOE systems.

Does coffee affect the bowel function after caesarean section?

OBJECTIVES: Postoperative ileus is a common consequence of abdominal surgery, which tends to prolong the duration of hospital stay and imposes considerable economic costs on healthcare system. Coffee is proved to have positive effects on gastrointestinal motility index in healthy young adults. Thus, the present study aims to examine effects of coffee on bowel function after caesarean section. MATERIAL AND METHOD: A total number 100 patients after elective caesarean section were randomly assigned before surgery into control and intervention groups. The intervention group received 100cc coffee at 8, 12 and 20h after the surgery, while the control group received 100cc hot water at the same intervals. First bowel sound, first passage of flatus, first defecation, and length of stay after surgery were compared in the two groups. FINDINGS: Mean time to first flatus passage was recorded in the control (22.54±5.09h) and intervention (17.28±4.44h) groups and showed to be statistically significant (p=-0.000). However, average time of first defecation (intervention 37.22±16.31h; control 36.82±16.5h; p=0.647) and mean time of hospital stay of patients (intervention 30.08±9.50h; control 32.16±11.82h; p=0.518) and first bowel sound (intervention 5.84±1.41h; control 6.16±1.33h; p=-0.326) were not statistically significant. DISCUSSION: Drinking coffee after a caesarean section reduces time to first flatus in patients. Nevertheless, further studies are needed to examine effects of coffee on ileus after elective caesarean section.