The association between waist-to-hip ratio (WHR) with diabetes in the PERSIAN Guilan cohort study population.

BACKGROUND: Waist circumference (WC), or waist-to-hip ratio (WHR), potentially offers a more accurate reflection of intra-abdominal fat accumulation and could serve as a superior predictor of type 2 diabetes mellitus (T2DM) risk compared to BMI. The current study investigated the relationship between WHR and its influencing factors among diabetes patients enrolled in the Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan Cohort study (PGCS). METHOD: In this cross-sectional study of 10,520 participants, 2,531 had T2DM. Waist and hip circumference, body mass index (BMI), underlying diseases, and demographical data of participants were recorded. Also, fasting blood sugar (FBS), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides (TG) were assessed. All data was analyzed using SPSS version 16; the significant level was < 0.05. RESULTS: The mean age of participants was 51.52 ± 8.90 years, and 39.9% had a BMI between 25 and 30 kg/m2. The prevalence of diabetes was 24.1% (n = 2531). About 7628 (72.5%) individuals had abnormal WHR, and 2072 (19.7%) were diabetics. Among patients with diabetes, abnormal WHR was significantly associated with age over 50, female gender, higher BMI, and lower LDL (P < 0.05). CONCLUSION: The study showed a higher prevalence of abnormal WHR in diabetic patients. Abnormal WHR in patients with diabetes was significantly associated with age, gender, and BMI.

Wounded healer nurses: a qualitative content analysis of the positive traits of nurses affected by chronic cardiovascular disease.

BACKGROUND: The wounded healer concept refers to healthcare providers who, in the past, have had similar experiences to those of their clients and now draw on these challenging experiences to assist their clients. This study explored the positive traits of nurses with chronic cardiovascular diseases who transitioned to wounded healers. METHODS: A qualitative content analysis study was conducted within hospitals in Tehran, Iran, between November 2023 and March 2024. Sampling was conducted using a purposive sampling method in accordance with the study objectives and inclusion criteria. The data were collected through semi-structured face-to-face interviews. Twenty-three participants, comprising 16 females and 7 males, participated in the interviews. Data analysis was conducted by employing a qualitative content analysis approach, including creating codes, subcategories, generic categories, and main categories. MAXQDA v20 software was utilized to facilitate the analysis process. RESULTS: The data analysis revealed one main category that aligned with the research question: the positive traits of a wounded healer nurse, consisting of three generic categories: (1) traits related to interpersonal and professional relationships; (2) traits related to the professional dimension; and (3) traits related to the personal dimension. wounded healer nurses demonstrate positive traits that enhance patient care. CONCLUSIONS: The findings of this study have important implications for nursing practice and education. By identifying the positive traits exhibited by nurses as wounded healers affected by chronic cardiovascular diseases, nursing programs can emphasize and strengthen these qualities to convert challenges into opportunities and bridge the theory-practice gap.

Evaluation of a New Method of Leukocyte Extractions from the Leukoreduction Filter.

This study's purpose was to optimize the leukocyte extraction protocol and evaluate the efficacy of this new protocol. 12BioR blood filters were collected from Tehran Blood Transfusion Center. A twosyringe system and Multi-step rinsing were designed for cell extraction. The final purpose of this optimization was: (1) removed the residual RBCs, (2) reversed the leukocyte trapping process, and (3) remove the microparticles to obtain the high yield of target cells. Finally, Extracted cells were evaluated by Automated Cell count; Samples smear differential cell count, Trypan blue, and Annexin-PI staining. The results showed that on average 11.88 × 108 ± 3.32 leukocytes recovered after indirect washing and that the mean count of granulocytes, lymphocytes, and Monocyte in this sample was 5.24 ± 2.18 × 108, 5.57 ± 1.74 × 108, and 0.56 ± 0.38 × 108 respectively. Also, the mean percent of manual differential cell count after concentration was 42.81%, 41.80%, and 15.82% for granulocytes, lymphocytes, and monocytes respectively. Moreover, viability and apoptosis assay showed > 95% viability in mononuclear cells recovered from LRFs. It is concluded that the use of a double-syringe system and RBC and microparticles removal from leukoreduction filters lead to acceptable viable leukocyte count that can be used in in vitro and in vivo studies.

Subfoveal choroidal thickness following pars plana vitrectomy in tractional diabetic macular edema.

PURPOSE: To evaluate changes in subfoveal choroidal thickness (SCT) in cases of tractional diabetic macular edema (DME) after pars plana vitrectomy (PPV). METHODS: This prospective study included 31 eyes of 31 patients who underwent PPV for the management of tractional DME. Best-corrected visual acuity (BCVA), SCT, and central macular thickness (CMT) were measured before the operation, as well as one, three, and six months following the surgery in the operated eyes and at baseline, as well as six months in the fellow eyes. RESULTS: The SCT decline in eyes with tractional DME was statistically significant six months postoperatively (P = 0.009). A statistically significant decline was observed in the CMT values one, three, and six months postoperatively in eyes with tractional DME (P = 0.02, P < 0.001, and P < 0.001, respectively). There was a statistically significant improvement in the visual acuity of the affected eyes three (P = 0.047) and six months (P = 0.017) postoperatively. CONCLUSION: After PPV for the treatment of tractional DME, a statistically significant decrease in the CMT values is detectable from the first month after surgery, followed by the improvement of BCVA from the third month. It is worth mentioning that a decrease was found in the SCT six months postoperatively.

Combination of Dental-Capping Agents with Low Level Laser Therapy Promotes Proliferation of Stem Cells from Apical Papilla.

Background: Direct pulp capping is a vital pulp therapy, which stimulates differentiation of stem cells from apical papilla (SCAPs). SCAPs have multipotential capacity to differentiate into types of cells, contributing to the regeneration of tissues. Objective: Considering the promising effects of dental-capping materials, we aim to investigate the effect of dental dressing materials combined with laser therapy on the percentage of SCAP viability and the consequent dental regeneration capacity. Methods: We collected two immature third molar teeth and isolated SCAPs through collagenase type I enzymatic activity. Isolated SCAPs were then cultured with Dulbecco's modified Eagle's medium and α-minimum essential medium enriched with 15% and 10% fetal bovine serum, respectively. After reaching 70-80% confluency, cells were seeded in a 96-well plate and then treated with mineral trioxide aggregate (MTA), enamel matrix derivative (EMD), biodentine, and low level laser therapy (LLLT) alone and in combination for 24, 48, and 168 h. After that, cell survival rate was assessed using (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) (MTT) assay. Results: We found that combination of MTA, EMD, and LLLT as well as that of biodentine, EMD, and LLLT could lead to significant increase of SCAP viability as compared with other treatment groups. Combination of MTA and biodentine with EMD could also show increased level of SCAP proliferation and viability. However, MTA and biodentine alone reduced SCAP survival rate in all time points. Conclusions: Our conclusion is that LLLT can serve as an enhancer of SCAP proliferation and differentiation rate when added to dental-capping agents such as MTA, EMD, and biodentine. Thus, LLLT combination with effective capping materials will serve as a promising option for dental tissue repair.

Relationship between the status of occupational health management and job satisfaction among farmers: A health promotion approach.

BACKGROUND: Job satisfaction is one of the most important issues related to human resources in the organization which can reduce organizational productivity. In this regard, occupational health is an important science related to the health of the workforce in any organization, paying attention to it will help health promotion. The aim of the present study was to determine the relationship between the status of occupational health management and job satisfaction among farmers with a health promotion approach. MATERIALS AND METHODS: This cross-sectional study was conducted in 2020. The number of 209 farmers from all villages of Zabol was included by census method. Data were collected using a researcher-made questionnaire that consisting of three sections of demographic information, occupational safety and health status, and standard job satisfaction questionnaire. At first, the validity and reliability of the questionnaire were evaluated. In addition, 5-10 staff working in Agricultural Jihad Organization were asked about the content, clarity, and simplicity of the questionnaire terms. Content validity index and content validity ratio indexes were calculated as 0.68 and 0.83 for occupational health management and 0.69 and 0.83 for job satisfaction questionnaires, respectively. Instrument reliability was also assessed using the Cronbach's alpha coefficient, which was 0.872. Finally, after verifying the validity and reliability of the instrument, a questionnaire was used to collect the research data. Shapiro-Wilk, Wilcoxon, and Spearman correlation tests were used to analyze the findings. The collected data were analyzed using SPSS software version 19. Armonk; NY, USA: IBM Corp. RESULTS: The results of the study indicate that occupational health management was at a moderate to a high level (3.701) and job satisfaction (3.381) was at a moderate to a high level. The standard regression coefficient between occupational health management and job satisfaction was obtained as 0.571. With a confidence of 95%, it can be stated that occupational health management in Zabol city under the supervision of jihad-e-agriculture organization has a significant impact on farmers' job satisfaction. In addition, the research findings confirmed a positive and significant relationship between occupational health management and job satisfaction of employed farmers and showed that the implementation of occupational safety and health programs in the jihad-e-agriculture organization can affect the job satisfaction of farmers. CONCLUSION: According to the evaluation of research findings, job satisfaction and occupational health management in the Agricultural Jihad Organization are relatively favorable among farmers in Zabol city. It was argued that there is a relationship between occupational health management and job satisfaction, that the implementation of programs related to occupational safety and health management system such as Health and Safety Executive will promote health.

The impact of education through nurse-led telephone follow-up (telenursing) on the quality of life of COVID-19 patients.

BACKGROUND: The widespread prevalence of COVID-19 has disrupted the social life, physical function, and daily activities of patients, leading to reduced quality of their lives. Because of the nature of this disease and its comprehensive impact on patients' lives, a follow-up based on the conditions of these patients is necessary. This study was conducted to determine the impact of nurse education and telephone follow-up (telenursing) on the quality of life of COVID-19 patients. METHODS: This quasi-experimental study included 120 COVID-19 patients discharged from 22nd-Bahman Hospital in Khaf city and was conducted over 6 months from July 20, 2020, to December 20, 2020. The participants were selected by convenience sampling method and were assigned into two matching groups. The training was delivered through telenursing based on the quality of life criteria for 1 month in the intervention group. The controls did not receive any intervention. Both groups completed the 36-item SF health survey before and 1 month after the intervention. RESULTS: The two groups were not significantly different regarding the quality of life mean scores at baseline (p = 0.61). However, after the intervention, the mean and standard deviation of the total life quality score was significantly different between the control and intervention groups (63.62 ± 3.93 versus 72.62 ± 3.51, p <0.001). CONCLUSIONS: Telenursing improves the life quality of COVID-19 patients. Through appropriate policies, health managers may put on the agenda the implementation of telenursing for COVID-19 patients.

Nursing empowerment by simulation in percutaneous endoscopic gastrostomy short-time complication control: Protocol study.

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is one of the most suitable methods for long-term nutritional support. In this study, the empowerment of intensive care nurses is examined by a simulation technique to control the short-term complications of PEG. METHODS: A two-group clinical trial study will be conducted on eighty intensive care nurses in a teaching hospital in Tehran. The study participants will be randomly assigned to one of the two control and intervention groups based on the inclusion criteria. A pretest will be given to both groups using a researcher-made tool. Then, the empowerment package developed by the researcher will be provided to the intervention group in two stages. Next, a posttest will be administered. After this stage, patients' complications with PEG will be observed using a researcher-made checklist. Nurses' performances in both control and intervention groups will be evaluated in terms of preventing and controlling short-term complications up to 1 week after PEG insertion. All of the data collected in this research will be analyzed with statistic tests such as independent t-test, standard deviation, T pair, ANOVA, and mean based on the SPSS 16 software. RESULTS: At present, the research team is designing an empowerment package for nurses and tools needed to evaluate the nurses' empowerment. CONCLUSION: This study will attempt to design and evaluate the empowerment package of graduate nurses with a cognitive empowerment approach and using a simulation technique to care for patients with PEG and to control their short-term complications.

Waist Circumference and Spirometric Measurements in Chronic Obstructive Pulmonary Disease.

OBJECTIVES: The aim of this study was to evaluate whether the waist circumference of patients with chronic obstructive pulmonary disease (COPD), had an impact on lung function. METHODS: There were 180 patients with COPD recruited into this prospective cross-sectional study. The age, weight, body mass index and waist circumference (WC) were measured. Spirometry parameters including forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), were measured and FEV1/FVC calculated. RESULTS: The mean FEV1/FVC in both normal weight and overweight patients, did not statistically significantly correlate with WC. The COPD assessment test, positively correlated with WC ( p = 0.031). A positive correlation with body mass index ( p < 0.001), smoking ( p = 0.027), and global initiative for chronic obstructive lung disease score ( p = 0.009), were observed to positively associate with WC. WC, age, C-reactive protein, duration of disease, and gender (male), were observed to be statistically significant risk factors for the severity of COPD. CONCLUSION: WC was not observed to impact upon lung function in this study but it was a predictive factor for COPD severity in patients.

Waist Circumference and Spirometric Measurements in Chronic Obstructive Pulmonary Disease

OBJECTIVES: The aim of this study was to evaluate whether the waist circumference of patients with chronic obstructive pulmonary disease (COPD), had an impact on lung function. METHODS: There were 180 patients with COPD recruited into this prospective cross-sectional study. The age, weight, body mass index and waist circumference (WC) were measured. Spirometry parameters including forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), were measured and FEV1/FVC calculated. RESULTS: The mean FEV1/FVC in both normal weight and overweight patients, did not statistically significantly correlate with WC. The COPD assessment test, positively correlated with WC ( p = 0.031). A positive correlation with body mass index ( p < 0.001), smoking ( p = 0.027), and global initiative for chronic obstructive lung disease score ( p = 0.009), were observed to positively associate with WC. WC, age, C-reactive protein, duration of disease, and gender (male), were observed to be statistically significant risk factors for the severity of COPD. CONCLUSION: WC was not observed to impact upon lung function in this study but it was a predictive factor for COPD severity in patients.

Mothers' preferences toward breaking bad news about their children cancer.

BACKGROUND: The responsibility of breaking bad news (BBN) to patients is one of the most difficult tasks of a medical profession. AIM: The current study aimed to investigate the preferences of mothers of children with cancer about BBN. MATERIALS AND METHODS: In this cross-sectional study was conducted in Mashhad during years of 2016, 62 mothers of children with cancer at Dr-Sheikh hospital were recruited by convenience sampling and completed a questionnaire including demographic data and 20 questions about the mothers' preferences to BBN. Data displayed as percent by SPSS V20 software. RESULTS: Mothers preferred that BBN conducted by their child's doctor (93.5%), with an emotional and compassionate way (83.9%), and in a private setting (90.3%). Be told completely about the process of diagnosis (98.4%), meet people with similar conditions (83.9%), receive psychological (85.5%), and religious (79%) support after getting bad news, being in touch with a close relative (82.3%) and applying another term-like malignancy instead of cancer (95.5%). CONCLUSION: We tried providing helpful information for developing national guidelines about how to breaking news in Iran, by doing this study.

Evaluation of physicians' skills in breaking bad news to cancer patients.

BACKGROUND: Delivering bad news to patients is one of the most difficult tasks of physicians that play a big role in the process of treatment and cooperation of patients. The objective of this study is to evaluate the ability and skills of physicians in delivery bad news to cancer patients. METHODS: This study is a cross-sectional study performed on 70 specialist physicians in two hospitals of Mashhad in 2016. Data were collected by Persian questionnaire of SPIKES included 16 questions and were analyzed by SPSS software. RESULTS: In this study, among the questionnaire items, the most prevalent item was not giving the bad news by phone (100%) and the least prevalent item was putting the hand on the shoulder (24.3%). This study showed that 81.4% of doctors agreed on giving the bad news in private, 72.9% agreed on giving relative hope to patients and 67.1% agreed on evaluating patients knowledge of his/her disease when giving bad news. CONCLUSION: The results of this study show that the ability of physicians in giving bad news is not enough in some aspects. Therefore, holding educational courses during physicians' education and after graduation are recommended to increase patients' trust and decreasing worries and inconvenience of physicians in difficult situations of delivering bad news.

Cluster analytical approach to Lifestyle characteristics: A population based study in Shiraz, Iran.

INTRODUCTION: A limited number of risky behaviors cause most morbidity and mortality. The aim of this study was to determine the possible clustering of lifestyle behaviors, including transportation behaviors, diet, physical activity, and smoking in Shiraz, Iran. METHODS: There were 776 representative Shirazi adults who participated in this cross-sectional study. The questionnaires were completed via person-to-person interviews. The datasets were searched for any clustering patterns. Cluster analysis was used for statistical analysis, and the data were analyzed using SPSS version 11.5. RESULTS: Three distinct clusters were identified. Cluster 1 was named "Healthy," and it included non-smokers, safe drivers, appropriate or acceptable fruit, vegetable, and fast-food consumers, and physically-active people. Cluster 2, "Moderately Healthy," was relatively risky drivers who had appropriate behaviors on the rest of the health-related behaviors. Cluster 3, "Unhealthy," was smokers, risky drivers, inappropriate or unacceptable fruit, vegetable & fast-food consumers, and a sedentary lifestyle. CONCLUSIONS: It was obvious that health-related behaviors were clustered together and unhealthy behaviors were not established in isolation.

Health System's Responsiveness of Inpatients: Hospitals of Iran.

INTRODUCTION: Additional to improving health and ensuring equitable financing that are two predominant goals of health system, another important goal of health systems is responsiveness to people's non-medical expectations. In this study we try to assess the health system's responsiveness in academic and non-academic hospitals. METHODS: This is a cross sectional study done in summer 2014 in Mashhad-Iran, we surveyed a total number of 403 inpatients by multi-stage sampling. A questionnaire of responsiveness and a check list included demographic variables and characteristics of hospitalization were completed by trained interviewers. Scales from 0 to 10 was applied for each questionnaire at the end of assessment of questions. RESULT: 403 participants Took part in this survey from 10 hospitals (6 academic and 4 non-academic hospitals). 124(30.8%) were from non-academic and 279(69.2%) from academic hospitals 140(34.7%) of patients were male and 263(65.3%) were female. mean age of participants was 36.77±1.52 years. The mean total score of responsiveness was 7.12±1.31 in academic hospitals and 6.99±1.38 in non-academic hospitals, considered as good performance. There was no significant difference between total scores of these two groups (p=0.38). Health care responsiveness score was higher in private (8.35±0.95) than other kinds of hospitals and charity hospitals had the lowest score (5.98±0.51). CONCLUSION: Responsiveness of health care system at hospitals is an important parameter for measuring patients' perception of quality of health care. Although responsiveness rate of our hospitals are good but some components such as: choice health care providers, respect to autonomy of individuals, clear communication and confidentiality received lower responsiveness scores, therefore they require more attention and these domains can be the more significant choices that should be considered while designing improvement programs.

Effects of Sesame Oil on the Reproductive Parameters of Diabetes Mellitus-Induced Male Rats

PURPOSE: The purpose of the present study was to investigate the effect of sesame oil on the reproductive parameters of diabetic male Wistar rats. MATERIALS AND METHODS: The adult male rats in a split plot design were divided into normal (n=10), normal 5% (n=5; 5% sesame oil enriched diet), diabetic (Streptozocin induced diabetes; n=9), diabetic 5% (n=9; 5% sesame oil enriched diet), and diabetic 10% (n=9; 10% sesame oil enriched diet) groups. Diet supplementation continued for 56 days. RESULTS: Sesame oil supplementation did not reduce the plasma glucose concentration of rats in the diabetic groups (p>0.05). The total spermatogonia, spermatocytes, Leydig cells/tubule, and the germ cell to Sertoli cell ratio were lower in the diabetic rats than the normal ones (p<0.05), and with the exception of spermatogonia counts, these values improved by the addition of sesame oil to the diet (p<0.05). The sperm progressive motility and viability were lower in the diabetic rats (p<0.05) and sesame oil supplementation did not improve them. Incorporation of sesame oil into the diet improved the plasma testosterone concentration of the diabetic rats in a dose-dependent manner (p<0.05). CONCLUSIONS: In summary, sesame oil supplementation improved the reproductive parameters of diabetic rats at the levels of the testicular microstructure and function, but was not effective in protecting the epididymal sperm.