Journal of Clinical Research in Paramedical Sciences
Volume:4 Issue: 3, 2016

Pseudomonas aeruginosa is one of the most common Gram negative bacteria involved in nosocomial infections. Presence of Extended-spectrum Beta-lactamases (ESBLs) genes, play an important role in induction of resistance in beta-lactamase producing species to beta lactam antibiotics. Frequency of resistance to these antibiotics is increasing. In this study, antibiotic sensitivity and frequency of ESBLs in Pseudomonas aeruginosa which had been isolated from clinical specimens, was assessed by phenotypic methods. This study was performed on 200 isolated Pseudomonas aeruginosa from clinical specimens in Imam Khomeini and Imam Reza hospitals, Kermanshah during 2013. Specimens were determined and cultured by standard conventional methods. Antibiotic sensitivity test on 14 antibacterial agents was performed according to CLSI criteria. Then, frequency of ESBLs producing isolates was determined by Combined Disk Test (CDT) and Double Disk Synergy Test (DDST) methods. This study revealed that the highest and lowest resistance rate were against to cefpodoxime (100%) and piperacilin-tazobactam (34%), respectively. Using CDT and DDST methods, 41% of isolates were ESBL positive. Considering high resistance rate of Pseudomonas aeruginosa to majority of antibiotics and increasing frequency of ESBLs producing isolates, we need for infection control criteria and use of appropriate therapeutic protocols according to antibiogram test patterns.

Type 2 diabetes mellitus is one of the psychosomatic disorders that stress playing an important role in causing, severity, and long term situation. The present study conducted to determine the association of personality type A and B to type 2 diabetes mellitus in patients’ referring to diabetes center. In the descriptive correlation study, 50 diabetic type 2 patients were assigned spontaneously and after matching with healthy persons, the personality type A and B Bortner was completed. SPSS-18 software was used and data analyzed using Pearson correlation and t student. The result showed that there are a significant relationship between personality type A, B and diabetes type 2. However, there was not significant relationship between personality type B and diabetes type 2, but there was a significant relationship between personality type A and diabetes type 2, P<0.05. The result showed that there are a significant relationship between personality type A and diabetes type 2, and the type A personality have a more chance to get diabetes. While with screening by the simple questionnaire we can prevent diabetes type 2.

The brain laterality is meant to make a difference in the function of both brain hemisphere and may be associated with some components of mental health. Therefore, the aim of this study was to evaluate of empathy, stress, anxiety, and depression in lefthanded and right-handed medical and paramedical students. The study design is a causal-comparative. The study population included all students of Kermanshah University of Medical Sciences in 2013-2014. The sampling was conducted on a stratified random procedure and 168 people were studied. The research instruments were including Edinburgh handedness inventory, Baron- Cohen scale for empathy quotient, and depression, anxiety, and stress Scale (DASS). Finally, SPSS 20 was utilized to analyze the data using multivariate analysis of variance. The results showed there is only significant differences between the groups in term of emotional reactivity subscale and levels of emotional reactivity is higher in the left-handed group. Similarly, there is significant difference between the left-handed and right-handed groups in term of the rate of anxiety and anxiety levels were significantly higher in the right-handed people. However, there was no difference between the groups in terms of stress and depression. The laterality of the brain hemispheres is a determining factor in the emotional and psychological state of individuals; So that increased emotional reactivity in left-handed people is justified due to the fundamental role of the right hemisphere in expressing emotions. The findings related to anxiety are debatable.

Today, using the chemical materials in X-ray films processing has caused some Occupational concerns associated with the darkroom disease all around the world. The darkroom disease is considered as complications triggered by exposure to chemicals which are used for the processing of the X-ray films by the radiographers. So for this purpose, the present research aims to compare the prevalence of the darkroom diseases syndrome between the radiographers and special care nurses in the selected hospitals of Kermanshah University of Medical Sciences, in 2014. In this case-control study, related data with the darkroom diseases syndrome of 100 radiographers and nurses were collected by using simple sampling and the questionnaire. 50 participants were selected from both the case group and the control group. Then collected data were analyzed by using the SPSS statistical software version 21 and the Chi-square test at a significance level of <0.05. Most of the research units (%71) were female. The radiographer's age mean was 34.4±9.4 and nurses were 29.9±5.8. There was found a significant relationship between the headache (P=0.04), eye irritation (P=0.02) and eye pain (P=0.01) and the type of occupation. In this study, the prevalence of the eye irritation and eye pain were reported higher among the radiographers as compared with the nurses. So the Solutions of personnel safety and awareness improvement to the darkroom disease should be put on the agenda.

Iron deficiency anemia is the most common nutritional problem in the world is a complicated and multifaceted economic and social consequence to the community to impose. This study aimed is to determine the prevalence of anemia, iron deficiency and factors that effect on it among female students The study population was 310 female students of medical science university of Kermanshah that samples were selected randomly from it. The tools of data collection were demographic; Beck, FFQ and WHOQOL-BREEF.5 ml blood was gathered from pioneer samples for determination of blood parameters and was investigated by standard laboratory methods. 44% of students had ferritin < 20 (iron deficiency), 9.8% hemoglobin <12 (anemia) and 6.8% of them had hemoglobin <12 and ferritin < 20 (iron deficiency anemia). 26.3% of students were depression. Iron deficiency was significantly associated with the consumption of meat, this is the increase per unit of meat, the chances of an iron deficiency 2.4 times decreased (OR=0.976, CI=0.65-0.94). Ferritin levels were significantly associated with academic success (P=0.04). High prevalence of iron deficiency and iron deficiency anemia in this study can show the imbalance between girl's intake of iron and their needs required further attention to this group.

Fear, anxiety and pain of delivery have the important role in the passing way of the delivery process. Some clear-sighted people believ that threshold of pain differs among ethnic groups. Therefore, this study was conducted to compare primipara’s women perception of pain, fear and anxiety of vaginal delivery among Persian, Kurdish and Turkish women. In this descriptive-analytical study, 450 primipara’s women selected from general hospitals of Shiraz, Tabriz and Kermanshah city using multistep random-sampling method were assessed. Data collection was done using questionnaire and visual analogue scale of pain (VAS). Data were analyzed using descriptive and analytic statistics (mann-withneyu, Kruskal-wallis) and SPSS.16 software. In this study statistically P<0.05 was significant. The mean of pain severity in primipara’s Persian, Kurdish and Turkish women were (8.24±1.21), (7.01 ±1.98) and (7.82 ±0.79) respectively. Kruskal-wallis test showed that severity of pain was significant amonge three groups. The mean of fear and anxiety in primipara’s Persian, Kurdish and Turkish women were (55.64±14.66), (42.11 ±8.81) and (40.11 ±14.56) respectively and was significantly different amonge three groups. Significant relationship was found between maternal education with childbirth pain perception among Turkish women (P<0.001).Significant relationship was found between maternal jobs with childbirth pain perception among three groups of women. perception of pain severity, fear and anxiety of vaginal delivery was significantly different amonge Persian, Kurdish and Turkish women. It seems that different issues such as cultural, social, mental, environmental and psychological factors affect woman’s perception of labor pain.

Mammography is the most sensitive and specific test that is requested for early diagnosis of breast cancer. Psychological disorders during mammography can have adverse effects on women and cause that they have not shown much interest in doing mammography. Therefore, the purpose of present study was to determine the relationship between anxiety and depression with breast cancer screening in women referring to the mammography clinic. This descriptive analytical (cross–sectional) study was performed on 275 women referring to some of the mammography clinics of Kermanshah city. The data was collected using a questionnaire consisting of a demographic section and a "Beck" anxiety and depression scale. Data analysis was performed using the software SPSS 20. The meaningless level of tests considered as P<0.05. According to the scores obtained by Beck questionnaire, 20% of subjects had moderate anxiety and 21.8% of them had low depression. There was no statistically significant correlation between the history of doing mammography and anxiety and/or depression in women (P >0.05) and other factors such as age, marital status, residency, education. The occupation of women are the most influential parameters on psychological disorders (P <0.05). The results show that the information transfer, notification about breast diseases and the applications of screening mammography are the most effective methods to reduce anxiety and depression, especially in elderly, married, urbanite, low literacy women, and housewives. Thus, providing adequate information to improve the health of patients referring to the mammography clinic is recommended by the medical team.

Nurses must stay awake during the night to provide nursing cares that can causes Sleepiness disorders. It has been shown that Transcutaneous Electrical Acupoint Stimulation (TEAS) as a new method of acupuncture with low side effect and invasion has an appropriate effect to improve the Sleep disorders. The aim of this study was to determine the efficacy of TEAS on Sleepiness disorder of nurses who works in afternoon and night shifts. in this study 60 nurses (38 female 22 male) who work in afternoon and night shifts in were studied. Sleepiness disorder evaluated by Epworth Sleepiness Scale (ESS). If a person had ESS≥9 was qualify for entrance to study. Patients divided in three groups including acupressure points (Electrical acupoint sstimulation in SP6, H7 and Li4), Sham points and control group with no intervention. For these patients, TEAS was done in 10 sessions (5 minute). Finally, data were analyzed by SPSS 16. Of 60 nurses, 36 nurses (60%) had ESS≥9. There wasn’t any significant difference between ages, sex, marriage and experience with ESS (P>0.05). Also, there is no significant difference in ESS between three groups before intervention (P>0.05). After intervention, there is significant improvement in the all of ESS in the acupressure points group, while in the Sham points and control group there isn’t significant improvement. According to the results of this study, the prevalence of Sleepiness disorder in shift worker nurses is high and screening and treatment of this disorder should be done. The results of this study showed TEAS is an effective, non-invasive and easy method for treatment of Sleepiness disorder in these patients.

Hypertension with serious cardiovascular, cerebral, renal complications is an important factor of mortality in the world. Recognizing its symptoms together with its associated signs can be effective in preventing complications of hypertension. For this reason, researchers began the study aiming at surveying initial symptoms of hypertension. This study was descriptive-analytical and the participants included all patients referring to the special clinics of Kermanshah University of Medical Sciences during the study. Participants were 182 and sampling was based on the availability. A questionnaire was used to collect data. After the collected data were coded, data analysis was performed using SPSS version 16. Chi-square statistical test was used for data analysis. The findings showed that headache, nausea and sleep disorder in patients with hypertension were reported more significantly (P<0.05). Blurred vision was the major symptom observed in staffs as well as the smokers. Also, it revealed that people with family records of hypertension had experienced less blurred vision. Headache, nausea, sleep disorder and blurred vision were the symptoms observed in most hypertensive patients in the study. Therefore, further studies can reveal the symptoms felt when experiencing hypertension and that these symptoms can be introduced to medical authorities as a warning signal.

Urinary infections is one of the most prevalent complains among elderly patients. The aim of this study was to assess prevalence and antibiotic susceptibility pattern of bacterial agents isolated from urinary tract infections in hospitalized elderly patients in Imam Khomeini hospital, Kermanshah (2009-2013). In this cross sectional descriptive study the information of elderly patients who have been admitted to Imam Khomeini hospital were collected from January 2009 to December 2013.The patients were in the age group≥65 year. The study included all the patients who were admitted in the hospital with or missing symptoms of UTI (fever, dysuria…) and urine culture during the study period. 154 out of 262 admitted subjects had inclusive criteria. Demographic data collected using questionnaires and SPSS15 was used for statistical analysis. The prevalence of urinary infection was 19.5%. The most common clinical symptoms were fever and trembling (43.3%). Escherichia coli (70%) was the most frequently isolated organism. The highest resistance were seen against Nalidiclic acid (90%), Ceftriaxon and Cefexime (83.4%). The lowest resistance were seen against Amikacin and nitrofurantoin (16.7%). Our results showed that the most appropriate antibiotic to be used for empirical therapy are Amikacin and nitrofurantoin.

Nosocomial pneumonia is the most common type of infection in intensive care units. This study aimed to compare the efficacy of Chlorhexidine mouthwash 0.2%, 1% sodium bicarbonate and normal saline 0.9% on bacterial colonization of endotracheal tube cuff and the incidence of pneumonia in patients undergoing open heart surgery. In this clinical trial study, 165 patients undergoing open heart surgery were enrolled and randomly divided into three groups: Chlorhexidine, sodium bicarbonate and normal saline. In each group twice a day, rinsing with mouthwash was given. To determine bacterial colonization, the tube was removed and the number of colonies was counted. At discharge time, patients were evaluated for pneumonia. Data was analyzed by descriptive and inferential statistics using SPSS-20. Mean and standard deviation of bacterial colonization in the Chlorhexidine group was 305×103 ±97 × 103, in the sodium bicarbonate group 330×103 ±110 × 103 and in normal saline Group 358×103 ±104 × 103. The incidence of pneumonia was 3.6% (2 cases) in Chlorhexidine group, 5.5% (3 cases) in group bicarbonate sodium and 9.1 %(5 cases) normal saline group. There were no significant differences among the three groups in term of bacterial colonization and incidence of pneumonia. Every three mouthwashes, have similar effect in reduction of bacterial accumulation around the tracheal tube cuff and rate of pneumonia too. Therefore mouthwash with each of these solutions in cardiac surgical patients is recommended.

Clients that be hospitalized in intensive care units were not able to protected cornea and eye dry due to keratopathy. The aim of study was to Comparing the effectiveness of three methods of eye care in health of cornea in critically ill patients in Kermanshah intensive care unites 2013. These clinical trials were done with 96 samples in three. Three methods Care (Polyethylene cover, Artificial tears and liposic gel) randomly performed on one eye of each patient and compared with the opposite eye as control, the other two groups was compared, Whilst the routine care was performed on both eyes of samples. Interventions during the study eyes of patients every day for 5 days by ocular surface disorders and keratopathy tool was created. Analyzed the data using SPSS-16 and chi-square test, ANOVA and Kruskal-Wallis tests were performed. There was no statistical differences between groups in age, gender, case of admit ion, integrity of cornea and level of conciseness. The use of polyethylene cover was significantly more effective than other methods in health of cornea (P=0.001) and general, the results showed that each of the three methods are more effective than routine care intervention wash eyes with normal saline control group (P<0.05). Finding of study suggested the use of nursing and polyethylene cover in patients hospitalized in intensive care with low of conciseness and impaired self-eye care were been able to maintain health of cornea and saline alone is not sufficient to prevent keratopathy.

Infertility and the reactions of people towards it can lead to psychological disorders which have negative effects on the life of young couples. Therefore, this study aims to comparatively analyze the level of mental health, happiness, inferiority feelings, sexual satisfaction and marital conflict in fertile and infertile women in Kermanshah. This cross-sectional study was done on 100 infertile and 100 fertile women using convenient sampling. The questionnaires used in this study were Scaled-General Health Questionaire-28 (GHQ-28), happiness, inferiority feelings, Enrich Marital Satisfaction Scale (EMS) and Kansas Marital Conflict Scale (KMCS). Running Chi-squared and independent t-tests, the data was analyzed using SPSS-16. The results of this study revealed that there is a significant difference between the studied variables in the fertile and the infertile women (P<0/05). The level of mental health, happiness and marital satisfaction were higher in the fertile women (P<0/001) whereas inferiority feelings and marital conflict were stronger in the infertile women (P<0/05). Infertile women are exposed to more psychological disorders in comparison to fertile ones. Considering such problems of infertile women, it seems necessary for fertility clinics to have some psychologists.

So far, few studies investigate the correlation of amount of sleep and blood glucose control among diabetic patients. The aim of this study was to determine the correlation of amount of sleep with hemoglobin A1C and fasting blood sugar in diabetic patients. In this study, 101 patients with type 2 diabetes were studied. Demographic data and amount of sleep were collected by questionnaires and hemoglobin A1C and fasting blood sugar (FBS) tests were done by standard methods. In this study, there isn’t significant correlation between amount of sleep and tests including hemoglobin A1C and FBS; but, too much sleeping can increase both tests, however these increasing is not significant. Results of this study shows that too much sleeping can increase hemoglobin A1C and FBS in diabetic patients but in the cases of insufficient sleep cannot be state definitively.