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Background and Objective: Multiple sclerosis (MS) is a chronic, progressive and degenerative myelin sheath of the central nervous system. Manifestation and side effect of this disease drastically impress patient’s body image and destruct self concept. The objective of the implementation of this study was to evaluate the effect of Orem self- care program on multiple sclerosis patients’ self concept. Materials and Methods: This quesi-experimental study was done on 34 MS patients referred to Ayatollah Kashani hospital in Shahrekord – Iran, during 2008. The patients were selected by convenience sampling. 8 sessions educational program based on patients needs and Orem self care frame work during 3 months were carried out and with self reporting sheets program was pursued. After 3 months self concept questionnaire completed and data were analyzed by using SPSS-11.5 software and paired T, will kakson and kruskal wallis tests. Results: Mean of self concept, prior and post intervention was 60.67+-4.20, 118.26+-3.53, respectively (P<0.05). No significant correlation was found between age, gender, educational level, marriage status, number of children, occupation, level of income, duration of outbreak, times of hospitalized with self esteem. Conclusion: This study showed that self care program based on the Orem frame work has positive effects on self esteem in multiple sclerosis patients. Therefore this program is recommended in MS patients.

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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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The kangaroo care method in newborn is a way of protecting the baby through skin to skin contact between newborn and their parents. This review study was done by using the keywords including kangaroo mothre care, neonatal, skin to skin contact and preterm. All related articles were published in Pubmed, Sience direct, Google scholar, SID, and Magiran were studied during 2000 to 2016. Finally, 36 articles were reviewed which were similar according to objectives, method of work, sample size, analysis method, and conclusion. Reviewing the selected articles showed that skin to skin contact among newborn and their parents regulated the body temperature of the neonate, increased the newborn's immune system, reduced infection and mortality rate, regulated heart and respiratory rate, increased the growth and weight gain in low birth weight neonates, reduced the stress and crying, increased prolong and stable periods of sleep, and also creates an emotional bond between the parents and the neonates. Kangaroo care method not only helps to care for the early stages of growth of premature neonate, but also increases the general health of the newborn and mother. This care can be used as an inexpensive and highly beneficial method for neonate's growth and health in human.

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Background and Objective: The prevention of clot formation during hemodialysis improves the effectiveness of treatment by maintaining patency in the dialyzer. This study was done to evaluate the effect of intermittent bolus of normal saline on the quality of clot formation in venous chamber and dialyzer.
Methods: In this clinical trial study, 51 eligible patients were divided into intervention (n=26) and control (n=25) groups. Patients in the control group received routine care and the intervention group received 100ml of normal saline, each hour, as an intermittent bolus, during 4 hours of dialysis beside the routine care. After three consecutive hemodialysis sessions (first round), all patients received routine care to clear the intervention effect (washout period). Then, patients crossed over from intervention group to control and vice versa. At the end of each session, the quality of clot formation in intravenous chamber and dialyzer was recorded and analyzed.
Results: The venous chamber of dialysis circuit in 74% of patient in intervention group no clot was formed, whereas in 58% of patient in control group it contained fibrous ring (P<0.05). After intervention, dialyzer of 68% of patients in intervention group, were free of clot, whereas in control group only 16% of dialyzers were free of clots (P<0.05).
Conclusion: Using intermittent bolus of normal saline during hemodialysis can reduce the risk of clot formation in venous chamber and dialyzer.

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Background and Objective: Writing about emotions and emotional disturbances, improve the performance of an autonomous system, immune system and physical and mental health. The aim of this study was to determine the effect of narrative writing on stress intensity of attendants’ patients hospitalized in intensive care units (ICUs).
Methods: This single blind clinical study was done on 106 attendants’ of adult patients hospitalized in ICUs of Babol city in northern Iran. The patients' attendants were divided into two groups of 53 controls and intervention. Data were collected using stress (DASS21) questionnaire. Intervention was writing narration about feelings, thoughts and experiences related to the hospitalized patient and ICU in a notebook as daily for seven days in the intervention group.
Results: The mean and standard deviation of overall stress intensity following intervention were significantly reduced in the intervention group in comparison with controls (P<0.05) (22.64±7.89 versus 17.15± 8.2). There was significant relationship between intervention and control groups in three areas of stress, anxiety and depression (P<0.05).
Conclusion: Narrative writing reduces the severity of stress in attendants’ patients in ICUs.

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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.