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Pain is a symptom of disease and most diseases accompanied with pain, specially among hospitalized post-operative patients. Several drugs and routes of administrations have used for post operative pain control. We compared post op analgesic effects of Diclofenac suppository to intramuscular Pethedine in post op inguinal herniorrhaphy patients. This study is a clinical trial on 40 patients who were operated due to unilateral inguinal herniorrhaphy. They divided into two groups incidentally. In Diclofenac Na group each patient received 100 mg Diclofenac Na supp every 8 hours. In Pethedine group each patient received 0.5 mg/kg Pethedine, intramuscularly. Pain severity of the patients controlled for 24 hours with visual comparation method and mean pain severity compared among 2 groups in the first 24 hours. Mean pain severity difference of Pethedine groups patients compared to Diclofenac Na group was 6.10 with standard error of 3.57 with (P<0.212) had no meaningful difference during first post operative phase. We concluded that Diclofenac Na is a suitable substitute of 24 hours intramuscular Pethedine for post op pain relief.

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Recent publications have questioned the efficacy of massage. It is acknowledged that critical care environment are stressful for patients in term of invasive medical, and nursing procedures. Continuous brighting and excessive noise prohibits the potential relaxation and sleep. In this article, which is a research study, the physiologic response during and following a five minutes administration of back massage are described. This study is a semi-experimental research in which a 5 minutes back massage was offered to 25 patients as stress reduction intervention. Physiological data (Heart rate, mean arterial blood pressure, respiration and peripheral oxygen saturation) were obtained from the patient bedside monitoring system. Results indicated there was significant effect from the intervention on peripheral oxygen saturation (P<0.002). However, a significant decrease in heart rate (P<0.001), blood pressure (P<0.001) and respiration rate (P<0.001) was observed during the back massage intervention. Results indicated back massage had the potential effect of increasing relaxation as evidenced by physiological change during the intervention administration to critically ill patient in intensive care unit massage was found to be a useful therapy to enhance relaxation and sleep in critically ill patient.

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It is generally recognized diabetes in more prevalent in women than men, besides that there is a close relationship between diabet, type of obesity and body fat distribution. In a descriptive-analytical study, 100 diabetic women aged 30-60 years old referring to diabetic clinic compared with 100 healthy subjects who were similar to the sample group with respect to age and sex. The results showed that BMI of majority women on both groups were in the range of 24.9-29.9, on the other hand 33% of women in control group and 26% patients suffered from the grade one obesity. Minimum ratio of waist-to-hip ratio (WHR) in patients was 0.72 and in healthy women was 0.47. In control group 90% and in healthy subjects 74% of women suffered from upper-truncal obesity (WHR>0.8). A significant difference was found (P=0.04) between the WHR ratio in women control and healthy group. To prevent the fat distribution in the area of stomach and upper truncal, increasing activity and dietary control are suggested.

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Background and objective: Nosocomial infections are the important problems in health care centers in the world. Incidence rate in different countries is very variable and has been reported about 5% to 15%. This research was done for ascertainment of level of knowledge, attitude and practice of employed nurses to nosocomial infection in teaching hospitals of Golestan University of Medical Sciences. Materials and methods: This is a descriptive and analytical study, total number of employed nurses (518), 189 male and 328 female. The research carried out using a questionnaire. The data was used to analyze the data SPSS software. Results: Results of research showed that 26.5% of nurses had very low knowledge, 63.9% medium knowledge and 9.6% good knowledge. About attitude 52.4% had negative attitude, 36.4% medium and 11.2% positive attitude. About practice 37.1% had poor practice, 49% medium and 15.9% good practice. In this research between attitude and knowledge, knowledge and practice there was not any meaningful correlation but difference between attitude and practice was statistically significant. Conclusions: The nurses are playing important role in prevention and control of nosocomial infection. So, it is necessary for nurses to have enough knowledge about how to control the infection and to have positive attitude, if they want to do their job property.

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Background&Objective: Considering the high prevalence of Tricomonas vaginalis (TV) in women and the known side effects of metronidazol, herbal drug therapy in order to reduce drug side effects has been considered increasingly in recent decades. This study was done to determine the effect of Artemisia aucheri Boiss, Zataria multiflora Boiss and Myrtus communis L. on Trichomonas vaginalis. Materials&Methods: This study was done on samples extracted from 100 patients with vaginitis due to Trichomona. The parasite was isolated from vagina and determined directly. Identification was done through direct smear preparation. Parasite was added to the 5 test tubes containing Dorse medium, metronidazole. dimethyl sulfoxaide (DMSO), Artemisia, Zataria and Myrtus extraction with concentration of 0.1, 0.01 ml in order to determine the effect of these concentrations within 72 hour. Results: Trichomonas could be alived in Dorse medium for 72 hours, in presence of metronidazole for one hour and in Dorse medium for 6 hours. Also, methonolic extracts of Artemisia are effective at concentration of 0.1 after one hour and 0,01 after 4 hours of the inoculation. Methanolic extracts of Zataria at concentrations of 0.1 and 0.01 and the Myrtus extract at concentration of 0.1 are effective at beginning of inoculation but the Myrtus extract at concentration of 0.01 is effective after one hour. Conclusion: Considering the acceptable effect of metanolic extracts of these plants on trichomonas in in-vitro conditions, it is recommended that , the therapeutic effects of the substances from these plants to be studied in in vivo conditions and in case of having positive effect to be used as a drug.

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Background & Objective: We have two areas in gluteal region for intramuscular injection‚ Ventrogluteal and Dorsogluteal. This study was done to compare pain intensity and bleeding rate after injection in Ventrogluteal and Dorsogluteal area.

 

Materials & Methods: This clinical trial study was done on 67 males in 5th Azar hospital in Gorgan north of Iran. Patients had 2 injections during 24 hours. For every patient one injection was done in Dorsogluteal area and the second injection was done in Ventrogluteal area. For every patients the pain intensity and rate of bleeding for every injections recorded. Data analyzed by SPSS-11.5 software and Kolmogorov-Smirnov and Wilcoxon tests.

 

Results: In Dorsogluteal area 83.5% of patients had a low and medium pain‚ where as in Ventrogluteal area 88% of patients had a low and medium pain and 9% of them had not any pain. The Mean±SD of pain intensity in Dorsogluteal area was 50.79±1.682 and in Ventrogluteal was 40.79±1.878. The Mean±SD of bleeding in Dorsogluteal and Ventrogluteal areas were 0.73±0.102 and 0.19±0.047 respectively. There were significant differences in pain intensity and bleeding between two groups (P<0.05).

 

Conclusion: We concluded that the injection in Ventrogluteal area has a less pain and bleeding rate in comparison with Dorsogluteal area.

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Background and Objective: Ageing is a bio-cognitive which can be described as a progressive and degenerating process in human. One of the major changes in the elderly is loss of teeth, which can affect on dietary intake and nutritional status. This study was designed to assess the dental health in elderly people in Gorgan, North of Iran. Materials and Methods: This descriptive and cross-sectional study was conducted on 400 subjects (211 female and 189 male) aged 60 years and above in two selected health centers in Gorgan-Iran. Data were collected by questionnaire and oral and dental examination. Data was analyzed by using SPSS-13 software and chi-square test. Results: The mean age of the subjects were 66.7+-6.7 Sixty percent of the participants were without natural teeth and forty percent had natural teeth. only 10.5 percent of subjects had complete natural teeth. 19.7 participants had decayed teeth. The mean of decayed teeth was 9.2 (rang 1-28) and filled teeth was 4.8 (rang 1-16) in 12.5 percent of participants. Age, level of education and level of income were significantly associated with the number of existed teeth (P<0.05). Conclusion: In regard to high prevalence of without natural and decay teeth in the elderly population, this study, it is recommended the serial assessment of dental health to be screened on routine bases.

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Background and Objective: Cardiovascular diseases is the first cause of mortality in developed and developing countries. This study was done to determine findings of coronary arteries angiography of subjects referring to Kosar angiography center in Golestan province, Iran.

Materials and Methods: In this descriptive study 5444 patients whome referred to the Kosar angiography center in Golestan province, Northern Iran undervent in this study during 2008-09. Gender, age, ethnicity, body mass index (BMI), cigarette smoking, opium, hypertension and coronary arteries angiography findings were completed for each subjects. Coronary arteries angiography was performed on 5400 of subjects. Data was analyzed by using SPSS-13, ANOVA, Chi-Square and Kruskal-Wallis tests.

Results: In this study 52% of subjects were men. 72% of patients were Native Fars. 49.5% of subjects were found to be illiterate. While 92.6% of clients did not reported any history of smoking, 22.5% of subjects were addicted to different opium. The mean BMI was 27.48 and 38.2% of clients reported a history of hypertension. Coronary arteries angiography was performed on 5400 of subjects. Coronary arteries disorders were determined in 3142 of subjects (58.8% males, 41.2% females). Left anterior descending, right coronary artery, circumflex and obtuse marginal were the most involved coronary arterial branches in positive angiograms, respectively.The most severe failure (47.7%) has been found in left anterior descending artery.

Conclusion: Due to high incidence of coronary arteries disease in this region of Iran, it is suggested to design a project to investigate the preventive mearsures of cardiovascular disorders.

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Background and Objective: Coronary angiography is a routine and gold standard cardiac diagnostic procedure. Patients are restricted to bed rest after the procedure due to potential vascular complications using a femoral approach. Many patients are required to remain on bed rest for up to 24 hours after the procedure. The aim of this study was to assess the effect of changing position and early ambulation on the amount of bleeding, hematoma and urinary retention in patients with coronary angiography. Materials and Methods: In this clinical trial study 140 patients, which referred to coronary angiography center in Dezfoul-Iran, were randomly divided into four 35-individual groups. The patients in the control group were in supine position for 6 hours without movement. Position change was applied to the first interventional group based on a specific protocol, early discharge was applied to the second interventional group and both early discharge and position changes were applied to the third interventional group. The level of bleeding, hematoma and urinary retention were measured at zero, 1, 2, 4, 6 and 24 hours after angiography. The findings were collected using the individual data questionnaire and Kristin Swain’s checklist in order to evaluate the level of bleeding and hematoma. Results: There were no significant differences between the four groups in terms of occurrence of vascular hematoma and bleeding. The incidence of urinary retention was non significantly higher in the control group in compare to others. Conclusion: Changing position following angiography speed up patient discharge from hospital.

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Background and Objective: Dissection of the axillary lymph nodes is considered as one of the common measures in management of breast cancer. Edema and limitation in hand movement are accompanied with dissection of axillary lymph nodes. Sentinel lymph node biopsy can be used to evaluate axillary metastasis. This study was carried out to evaluate the diagnostic value of sentinel lymph node biopsy in patients with breast cancer. Materials and Methods: This descriptive study was performed on 30 selected patients with breast cancer less than 5 cm without any involvement of axillary lymph nodes in Ghaem Hospital in Mashhad, North-East of Iran during 2009 -10. Initially, the lymphoscintigraphy was performed. Subsequently, prior, to the surgery, the blue dye as a marker was injected for detecting sentinel lymph node and with the use of probe gamma counter and observing blue color on lymph nodes, the sentinel node was determined and separated. Finally, axillary dissection was performed for removing the lymph nodes of I and II level in all patients. Results: Among 30 patients who were evaluated for sentinel lymph nodes and axillary dissection, false negative were observed only in two cases (6.6 %). The sensitivity rate was determined to be 84.6%. Conclusion: Considering the high success rate of detection of sentinel lymph node and limited false negative cases, sentinel lymph node biopsy is recommended in cases of breast cancer without axillary involvement.

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Background and Objective: Bunium percicum is often used in Iranian traditional medicine for the treatment of gastrointestinal disorders particularly gastric ulcer.This study was done to evaluate the antiulcerogenic effect of Bunium percicum Boiss.essential oil against indomethacin and ethanol – induced ulcer models in Wistar rats. Methods: This experimental study was carried out on rats weighing 200-220 g in veterinary college of Urmia University, Iran. LD₅₀ was calculated based on Lorke’s method. To evaluate the short term oral toxicity, animals were allocated into four group of six each. In groups 1-3 animals were received orally 250, 125, 80 mg/kg/bw of Bunium percicum Boiss.essential oil, respectively. Controls were received Tween 80 (2%) orally for 14 consecutive days and monitored daily. Bunium percicum Boiss. essential oil was administered orally at doses of 20, 40 and 80 mg/kg/bw and cimetedin (10 mg/kg/bw) and omopirazol (30 mg/kg/bw) in indomethacin and ethanol–induced ulcer models. Results: The LD₅₀ was 375 mg/kg/bw. Daily single oral doses of Bunium percicum Boiss.essential oil tolerated behaviorally after 14 days without any alterations in body and organs weight, food, water consumption and serum total protein, alanine and aspartate aminotransferase activity. The preventive index in doses of 40 and 80 mg/kg/BW of Bunium percicum Boiss.essential oil was 37.98% and 59.21%, respectively in the indomethacin -induced ulcer model (P<0.05). In the model of ethanol -induced ulcer, the preventive index in doses of 40 and 80 mg/kg of Bunium percicum Boiss. essential oil was 12.40% and 22.05%, respectively (P<0.05). Conclusion: The essential oil of Bunium percicum Boiss is completely ‘‘safe’’ and at the doses of 40 and 80mg/kg/bw significantly prevent gastric ulcers in animal model.

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Background and Objective: Methicillin-resistant Staphylococcus aureus is a common pathogen responsible for health-care-related infections. This study was done to determine the prevalence of Meticilin - resistant Staphylococcus isolated from hand and nasal of hospital health worker. Methods: This descriptive study was conducted on 148 health workers in teaching hospitals in Sari, northern Iran during 2011-12. Samples were collected from fingers and noses and were cultured on mannitol salt agar immediately. Suspected colonies were identified using Gram staining, catalase and coagulase tests. Susceptibility testing was performed by disk diffusion method. Methicillin resistant strains were determined using micro dilution broth method. Results: Staphylococcus aureus was observed in 24 (16.2%) of individuals. 9.5% of population was resistant to Methicillin. The high portions of Staphylococcus aureus carreier were in the operation room, angiography and internal pediatric ward health worker. Methicillin Staphylococcus aureus resistanat were more common in nasal samples of the operation room personal and angiography ward health worker. All strains were sensitive to Vancomycin and Chloramphenicol and resistant to Penicillin and Amoxicillin. Conclusion: In this study the prevalence of the Staphylococcus.aureus in teaching hospitals health worker was low while Staphylococcus aureus resistant to methicillin was higher than other reports in Iran.

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Background and Objective: Pregnancy can not only protect mothers against intimate partner violence but even it may increase the rate and severity of intimate partner violence. This study was done to determine the intimate partner violence during pregnancy in the Northern Iran. Method: This cross-sectional - analytical study was done on 1500 mothers whom attended the primary health centers of Mazandaran province, Northern Iran from Feb to Sep 2010. Mothers screened using modified standard world health organization intimate partner violence questionnaire via interview. The questionnaire included physical, emotional and sexual intimate partner violence. Intimate partner violence was categorized to severe, moderate and mild. A multivariate logistic regression analysis was used to identify predictor of intimate partner violence. Results: The most common intimate partner violence was restriction of mothers in terms of money, food, and clothing (88.8%). The prevalence of physical, psychological and sexual intimate partner violence was 14.1%, 69.9% and 10.8%, respectively. The adjusted odds ratio for physical intimate partner violence in mothers with low education and low socio-economic status were significantly higher in those mothers with high education and fair socio-economic status (P<0.05). Conclusion: Mild psychological intimate partner violence is prevalent in Mazandran province, North of Iran.

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Background and Objective: Lower back pain is one of the common discomforts of the occupational-musculoskeletal system, and the scope of motion measurement is important for assessing the effectiveness of therapeutic interventions. This study was carried out to evaluate the reproducibility of the modified-modified Shober's technique (MMST) in measuring the range of motion of lumbar in patients with non-specific chronic low back pain.
Methods: In this descriptive-analytic study, the range of motion of lumbar (flexion and extension) of 15 patients with non-specific chronic low back pain was measured in three times with modified – modified Shober's technique by two physiotherapists. To achieve this, the correlation coefficient (ICC) was used. Two measurements with an interval of one hour and one week were run to evaluate the reproducibility within-days and between-day, respectively.
Results: Flexion and extension were measured by the first assessor in within-day that showed a high reproducibility for flexion (ICC=0.88) and extension (ICC=0.71), findings also revealed an acceptable ICC for flexion (ICC=0.85) and extension (ICC=0.68) in between-days. The second assessor measurements of flexion and extension in whiten-day also presented high reproducibility for flexion (ICC=0.85) and extension (ICC=0.76); moreover, in between-days evaluation, correlation was found for flexion (ICC=0.81) and for extension (ICC=0.71).
Conclusion: This study showed that the modified-modified Shober's technique is applicable for measuring the reproducibility of range of lumbar motion in patients with non-specific chronic lumbar pain.

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Background and Objective: Coronary disease is the most common life-threatening among chronic diseases. Coronary angiography is one of the most important diagnostic procedures that have complications similar to other invasive procedures. This study was performed to determine the effect of changing sandbag weight on complications of femoral artery catheterization and patient comfort.
Methods: This single-blind clinical trial was performed on 140 patients who were referred to Amir Al-Mo'menin Kordkoy hospital in northern Iran. Patients were randomly assigned into four groups consisting 35 patients. After angiography, sandbags with different weights (control group, first intervention, and second intervention, third intervention with weights of 4, 3.5, 3 and 2.3 kg) were placed on the angiography site for 6 hours. Bleeding, hematoma, pain and comfort of patients were recorded and compared immediately, 2, 4, 6, 8 and 24 hours after angiography.
Results: Bleeding and hematoma were not observed in any of the patients. There was a significant difference in pain and patients comfort between groups (P<0.05). The third intervention group had the lowest pain and highest comfort at 6 and 8 hours after angiography. Also, the control group had the highest pain and the lowest comfort.
Conclusion: Reducing sandbag weight leads to decrease back pain and improves patient comfort without increasing vascular complications.

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Background and Objective: Stroke has a high prevalence and is associated with a high premature mortality rate. Thus, it is important to identify the effective factors in increasing the incidence of stroke. The aim of this study was to investigate the role of seasonal changes and environmental factors in the occurrence of stroke.
Methods: This descriptive-analytical study was done on 3,639 patients including 3,102 (85.3%) with ischemic stroke, 472 (12.9%) with intracerebral hemorrhage and 65 (1.9%) with subarachnoid hemorrhage patients. After measuring environmental factors such as air temperature, air pressure, humidity and geomagnetic field, admission data of stroke patients between 2015-2019 were extracted from the Sayyad Shirazi Hospital information system.
Results: The mean occurrence of intracerebral hemorrhage was highest in winter, especially in January and March, and lowest in summer, especially in July and August. Intracerebral hemorrhage had a positive significant correlation with air pressure (P=0.001, r=0.452) and a negative correlation with ambient temperature (P<0.001, r= - 0.457). Subarachnoid hemorrhage and ischemia were not related to the season or the month. It was also found that ischemic stroke had a significant positive correlation with geomagnetic field fluctuations. Subarachnoid hemorrhage was not associated with any of the variables, but intracerebral hemorrhage was significantly positively associated with air pressure and inversely associated with temperature.
Conclusion: This study illustrated that winter, low temperature, high air pressure and high geomagnetic fluctuations are associated with a higher risk of stroke. Therefore, the underlying physiopathological causes of this relationship should be carefully investigated in future studies.
 

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Background and Objective: Micro-ribonucleic acids (microRNAs) have introduced a new field in the molecular diagnosis of cancer. However, the role of circulating microRNAs in the plasma/serum of colorectal cancer patients is still unclear. This study was conducted to determine the expression of let-7d microRNA in patients with colorectal cancer.
Methods: This case-control study was conducted on 40 patients with colorectal cancer and 40 healthy people. In this study, 7 mL blood samples were collected from patients with colorectal cancer (both before and after tumor resection) and healthy individuals (only once). The serum samples were isolated and stored at - 80°C until molecular analysis. MicroRNAs were extracted from serum samples, and cDNA was synthesized. Let-7d expression was examined using the RT-qPCR method. Data were analyzed using GraphPad Prism v. 9 software. The receiver operating characteristic (ROC) curve analysis, sensitivity, and specificity were also calculated for the let-7d microRNA data to introduce a diagnostic biomarker between the preoperative patient group and the control group.
Results: In the preoperative samples of the patients, the expression of let-7d microRNA was significantly lower than that of the control group (P˂0.05). The expression of let-7d microRNA significantly increased after tumor resection compared to before. The ROC analysis for let-7d microRNA in the preoperative patient group with the control group showed that the sensitivity was 33.3%, specificity was 92.3%, and the area under the curve (AUC) was 0.622.
Conclusion: Let-7d microRNA could potentially serve as a new noninvasive diagnostic biomarker for the early detection of colorectal cancer. However, further studies are required on this subject.

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Background and Objective: Non-adherence to treatment regimens is a significant factor contributing to the persistence of cardiovascular diseases and their complications. This study aimed to compare the effects of two educational methods, with and without short message service (SMS) reminder, on adherence to treatment regimens among patients with acute coronary syndrome (ACS).
Methods: This clinical trial was conducted on 111 patients with ACS divided into three 37-people groups: A control group (receiving routine education), the first intervention group (receiving education and a booklet), and the second intervention group (receiving education, a booklet, and SMS reminders). The study was conducted in patients at the coronary care units (CCUs) and post-CCUs of the following educational therapeutic centers: Shahid Sayyad Shirazi in Gorgan, the Fifth Azar in Gorgan, Amir Al-Momenin in Kordkuy, and Al-E-Jalil in Aqqala, Iran, during 2019. The research instrument consisted of the Treatment Adherence Perception Questionnaire (TAPQ) in three domains, including dietary regimen, medication regimen, and exercise and activity, which was completed at the time of discharge and two months later.
Results: The mean scores of adherence to treatment dietary in patients with ACS two months after discharge in the three domains of dietary regimen, medication regimen, and exercise and activity were significantly higher in the group receiving education and SMS reminders (105.54±75.8, 16.00±2.71, and 23.67±3.85, respectively) compared to the education group (84.73±5.02, 11.05±1.69, and 17.45±2.48, respectively) (P<0.05). Moreover, the scores in the three investigated domains were significantly higher in both intervention groups compared to the control group (82.68±13.54, 11.40±1.96, and 17.67±5.04, respectively) (P<0.05).
Conclusion: The use of education and a booklet along with SMS reminders to patients with ACS discharged from the hospital increased adherence to treatment. This adherence was higher in the intervention group receiving SMS reminders.