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Background & Objective: Cardiovascular disease is among important factors of mortality in hemodialysis patients. There are some reports that indicate the Carnitine concentration reduction in the tissues accelerate cardiovascular abnormalities in those patients whom regularly are hemodialysed. This research has been set up to study the effect of oral Carnitine on the heart function of hemodialysis patients from Sari and Vali-Asr Hospital in Ghaem-Shahr Fatemeh Alzahra, Imam Khomeini in during 2003. Materials & Methods: In this study 20 patients with at least 3 month duration and 3 times interval hemodialysis in each month were chosen. The sample hemogenously devided in case and control group. One Carnitine tablet with 1 gr dose was given to the case group daily. The placebo was prescribed to the control group EF and LVEDD of patients were determined by echocardiography. The ratio diameter of heart to the chest was determined by chest radiography. The plasma level of hemoglobin, Cholesterol and Triglyceride were determined simultaneously. Results: There was not any meaningful recovery in EF and LVEDD and serum Lipids, between the case and control group 6 months after treatment with 1 gr/day Carnitine. There was only a meaningful difference in EF after 6 months duration of this study. In spite of this, there was a meaningful recovery with these patients anemia (P?0.05). Conclusion: Carnitine does not have a meaningful effect of heart function and serum Lipid level, but it has an efficacy on anemia recovery of such patients.

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Background and Objective: An increased risk of invasive infections with encapsulated bacteria such as Streptococcus pneumoniae has been described among splenectomized patients. Pneumococcal vaccination has been recommended in these patients. In this study, the serum antibody response to pneumococcal polysaccharide antigens in splenectomized patients with idiopathic thrombocytopenic purpura (ITP) or trauma who immunized with Pneumovax 23 was evaluated. Materials and Methods: This case - control study was performed on two groups of patients including fifteen cases of trauma patients (11 male, 4 female) and twenty patients with ITP (10 male, 10 female) along with 40 healthy volunteers as controls who were immunized with Pneumovax 23 to prevent pneumococcal infections. All patients received the pneumococcal vaccine before splenectomy. The serum antibody response (IgG and IgG2) to pneumococcal antigens was determined by enzyme-linked immunosorbent assay (ELISA) technique prior to vaccination and 4 weeks post-vaccination. Analyzing of data was performed using student t-test and linear regression test. Results: The mean of post-vaccination IgG or IgG2 titer to the pneumococcal antigens in ITP patient group was significantly lower than those in controls or in trauma group (P<0.05). No significant differences in IgG or IgG2 antibody titer increase were found between trauma group and healthy control group. Response to immunization was poor in 9 of 20 ITP patients. Conclusion: This study indicated that 45 percent of patients suffered from ITP who have undergone splenectomy responded poorly to pneumococcal antigens.

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Background and Objective: Patients consent for medical care is a legal requirement. Consent is a document that patient must be necessary aware about all risks of surgery, treatment strategy, Substitution and the risks involved by physician. This study was done to evaluate status of filled consent form of hospitalized patients in Ardabil – Northwest of Iran. Materials and Methods: This descriptive cross sectional study was done by interview with patients and accompained patients in hospitals of Ardabil – Northwest of Iran during 2010. Patient demographics and other variables gathered by a questionnaire. Data was analyzed by Chi-Square test. Results: 86 (57%) of patients were female and 64 (43%) male. 35 (23%) were illiterate and 92 (61%) under diploma. 45% of patients get information about their illness from doctors. According to patient ideas, 13% of reception personals did not complete consent form. 65 (43.3%) of patients stated that the context of consent form was unreadable and long. Rate of completing form for patients were 87%. 40% of completed forms was not signed by witnesses. The patients and relatives were not satisfied with the form itself, and this observation statistically was significant (P<0.001). Conclusion: This study showed that validity of completed consent forms are low and it is necessary to design programs for improvement the quality of filling the consent forms.

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Background and Objective: Malnutrition in hospital increases the mortality of patients. The aim of this study was to investigate the prevalence of malnutrition and related risk factors in hospitalized patients. Materials and Methods: This descriptive study was carried out on 446 patients (217 males, 229 females) during 6 months, admitted to the Taleghani hospital in Tehran, Iran during 2005. Anthropometric measurements and previous admission to hospital in previous 6 months for each patient was recorded. Mild, moderate and severe malnutrition were considered as BMI=18-20 kg/m2 and TSF, or MAMC<10th, or weight loss<5% as BMI=16-18kg/m2 and TSF, or MAMC<5th, or weight loss 5-10% and severe as BMI<16kg/m2 and TSF, or MAMC<5th or weight loss>10% in previous 6 months respectively. Results: The prevalence rate of malnutrition as a general was 52% with following subdivision: 14%, 10% and 28% in mild, moderate and severe, respectively. The highest prevalence of malnutrition observed in gastrointestinal ward, males, those aged 18-29 year and patients with secondary and high school education. In malnourished patients, the prevalence of TSF, MAC and MAMC <5th were significantly more than of well-nourished subjects (P<0.05). Increase BMI per unit decreased the risk of malnutrition by 17% (OR: 0.83 CI: 0.79-0.87). Malnutrition was 64% higher in patients with 1≥ gastrointestinal disturbances, compared with those without it and 2.1 higher in patients with 2≥-hospitalized readmission, compared with subjects without readmission in previous 6 month. Odds ratio of at least one hospitalized admission in previous 6 month was 1.64 in patients with MAC <5th, compared with those with MAC 50-75th (P<0.017). Conclusion: This study showed that Malnutrition upon hospitalization is common in Tehran. BMI, gastrointestinal disturbances, and readmission were associated with malnutrition.

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Background and Objective: Triage is the most important and the first stage of patient’s management at the time of arrival to hospital emergency department. Emergency severity index (ESI) is a common triage system worldwide. This study was aimed to evaluate the accuracy of ESI in emergency department of Imam Hossein hospital in Tehran, Iran. Materials and Methods: In this descriptive study the result of patients’ triage based on ESI were gathered for all patients referred to emergency department of Imam Hossein Hospital from January to April 2011. A questioner was filled for each patient by the nurse and a emergency specialist independently. The l for the degree of agreement of triage between nurse and clinician was 81% (95% CI: 0.79-0.83). The sensivity of triage for step I, II, III, IV and V were 100%, 53.2%, 90.7%, 67.1% and 98% respectively. The specificity of triage for step I, II, III, IV and V were 99.8%, 97.5%, 93.7%, 98.3% and 94% respectively. There was a significant overlapping between the triage step and the patient clinical outcome. Conclusion: This study showed that five steps triage contain a high accuracy and estimation of patient outcomes.

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Background and Objective: Nasal obstruction is a common complaint leading to septoplasty as one of the most common surgical procedures in otorhinolaryngology. This study was done to determine the relationship between patients' satisfaction following septoplasty with rhinomanometry perior and after surgery. Methods: This descriptive – analytic study was done on forty-one patients, candidated for septoplasty, from Oct 2012 to Sep 2013. Rhinomanometry were tested perior and 6 months after surgery. At the time of rhinomanometry after surgery, common clinical symtomps and patient's quality of life and their satisfaction from operation were recorded by using GBI questionnaire. Results: Nasal obstruction and congestion, trouble sleeping, insufficient breath during physical activity and difficulty breathing through the nose were significantly reduced after surgery (P<0.05). In overall, patients' satisfaction after septoplasty was 90.24%. Rhinomanometry was not predictive factor for satisfaction after surgery. Conclusion: Six month follow-up after surgery showed high patients satisfaction (90.24%) following nasal septoplasty, but this was not related to rhinomanometry test results.

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Background and Objective: Hospitalization of patients in the intensive care units frequently results in anxiety of the family members. This study was performed to investigate the effect of a family-centered clinical intervention on the anxiety of family members of the patients hospitalized in intensive care units.

Methods: In this clinical trail study, eighty family members of the patients hospitalized in the intensive care units were randomly divided into interventional and control groups, respectively. In the interventional group, the family members were allowed to be present at the bedside from the second till the sixth day.The participant's level of anxiety was assessed in the second and the sixth day of patient's hospitalization using hospital anxiety and depression scale. Oral information about the equipment and the regulations and, a daily information card consisting of treatment and care activities, vital signs and patient's level of consciousness was delivered to the participants and their questions were answered.

Results: In the the sixth day, there was a significant difference between the mean anxiety scores in the intervention (11±3.22) and control group (7.05±3.44) (P<0.05). Also, the frequncey of anxiety in the interventional group (56%) was significantly higher than the control group with 15% (P<0.05). The odds ratio for anxiety in sons/daughters was lower than other family members in the sixth day (P<0.05).

Conclusion: Providing information, presence at the bedside and participation in the care of their patient increase the anxiety of family members in the first week of patient hospitalization in the intensive care unit.

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Background and Objective: Mupirocin is a secreted antibiotic inhibitor of Isoleucine-tRNA, a bacterial synthetase that is used against yellow wounds from Streptococcus pyogenic and Staphylococcus aureus. This study was carried out to determine the plasmid resistance of mupirocin in Staphylococcus aureus strains isolated from clinical specimens of the skin of hospital employees and hospitalized patients.
Methods: This descriptive study was performed on 150 strains of Staphylococcus aureus isolated from clinical specimens of the skin of patients and employees of three hospitals in Qom, Iran during
2014-15. In order to confirm the identity of Staphylococcus aureus isolates, conventional biochemical methods were used. Also, PCR of srRNA16 was used for molecular confirmation of isolates. The presence of mupA (iles-2) and mupB plasmid genes was investigated using PCR method and AluI enzyme digestion plan was performed for them. Disc diffusion method was used to demonstrate resistance to mupirocin.
Results: Seven isolated samples (4.66%) were resistant to mupirocin. All Mupirocin-resistant isolates possessed PCR-positive mupacysin mupirocidal genes (iles-2) and mupB, and all plasmid genes were resistant to all resistant specimens. Genotyping of mupB gene was able to isolate samples from patients and staff as well as male and female.
Conclusion: The prevalence of mupirocin-resistant Staphylococcus aureus isolated from skin specimens was low.

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Background and Objective: Cancer can cause many problems in all aspects of the physical, mental, social, economic and family life of the elderly patients. This study was done to determine the supportive care needs of the elderly people with cancer in north of Iran.
Methods: This descriptive- analytical study was carried out on 248 elderly patients with cancer whom referred to governmental and private medical centers in Gorgan, Northern Iran during 2018. Data were collected by a valid and reliable questionnaire "Supportive Care Needs Survey-SCNS" consisted of five domains of physical needs and daily functioning, health system and information, supportive and care, mental, and sexual chracteristics.
Results: There was a significant relationship between physical activity and daily functioning, sexual domain, support and care, health and information system with gender (P<0.05). Female seniors were more in need of assistance in the areas of physical and daily functioning, and male seniors in the areas of sex, support and care, health systems, and information.
Conclusion: This study showed that unmet needs in the elderly with cancer are particularly high in physical and functional areas.

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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.

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Background and Objective: Today, the role of family members in caring for cancer patients is becoming more important. Numerous cancer-associated problems affect both the patients and their caregivers. Little information is available about the social support and spiritual health of caregivers of cancer patients; therefore, this study was conducted to investigate the spiritual health and social support status of family caregivers of cancer patients in northeastern Iran.
Methods: This descriptive-analytical study was performed on 265 family caregivers of cancer patients. The subjects were selected by convenience sampling from inpatient wards and outpatient clinics of Babol University of Medical Sciences in 2019. Data were collected using the Social Support Questionnaire (by Vaux), the Spiritual Well-Being Scale (by Paloutzian and Ellison), and a socio-demographic questionnaire.
Results: The mean scores of social support and spiritual health of family caregivers of cancer patients were 98.86±14.58 and 91.32±11.97, respectively, which are at a desirable level. The age of caregivers and the duration of cancer had no significant relationship with the score of spiritual health and social support.
Conclusion: According to our findings, family caregivers of cancer patients have a desirable level of social support and spiritual health.
 

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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.