فهرست مطالب

Shiraz Emedical Journal - Volume:19 Issue: 6, 2018
  • Volume:19 Issue: 6, 2018
  • تاریخ انتشار: 1397/04/04
  • تعداد عناوین: 7
|
  • Mohammadreza Mobinizadeh, Alireza Olyaeemanesh, Sanaz Zargar, Hesam Ghiasvand, Ali Akbarisari * Page 1
    Context: The mitral valve conducts blood flow from the left atrium to the left ventricle. Mitral regurgitation occurs when the valve couldn’t be closed properly at the end of ventricular filling. Mitraclip, a catheter-based device that can reduce mitral regurgitation without requiring open surgery, is routinely used for patients with unacceptable risk of conventional mitral valve repair or replacement. The purpose of this study is assessing the safety, efficacy, and economic aspects of Mitraclip treatment for mitral regurgitation.
    Evidence Acquisition: The Cochrane Library, the TRIP database, and Google Scholar have been searched through appropriate strategies. Seven studies were included in the final phase based on the inclusion and exclusion criteria. Data collected from these studies were analyzed based on four main themes; applications, safety, efficacy, and economic evaluation.
    Results
    The most potential side effects were related to an improper transfer of catheters and low durability of the device. One of the included studies showed that improved outcomes of the New York Heart Association (NYHA) was more in the clip group with better quality of life that were observed after 1 to 12 months in 192 patients and also one-year mortality rate after using clip ranged between 10% and 24%. This included study found that 72% to 100% of patients with Mitraclip have been successfully treated and the duration of hospital stays in these patients was between 5 to 10 days. The cost-effectiveness of the procedure still needs more robust evidence.
    Conclusions
    Given the lack of high quality evidence and relatively high cost of Mitraclip, it seems that until further robust evidence is produced; it should be used in research and in high risk patients selected after detailed examination with strict indications and appropriate opinions of cardiologists.
    Keywords: Mitral Valve Insufficiency, Heart Ventricles, Heart Valve Diseases, Aortic Valve Stenosis
  • Ramin Shiraly, Vahid Keshtkar * Page 2
    Background
    Walking is the most common type of physical activity among older people. A few studies have specifically investigated factors associated with walking behavior of elderly. The purpose of this study was to determine correlates of regular outdoor walking among Iranian males aged 65 to 75 years, living in Shiraz, Iran.
    Methods
    This was a cross - sectional study with a control group matched by age and gender, carried out during June to August 2016 in Shiraz, Southern Iran. Interviews with more than 900 elderly people from 11 municipal divisions of Shiraz city were carried out, and 531 eligible males aged 65 to 75 years, including 127 subjects with regular outdoor walking and 404 controls without this activity during the previous year were identified. Using a checklist, socio - demographic and environmental data were collected. Binary logistic regression was used to identify factors associated with regular outdoor walking. Statistical analyses were performed using SPSS version 19. Statistical significance was set at 0.05.
    Results
    Higher educational level (Adjusted Odds Ratio [AOR] = 2.15, 95% Confidence Interval [CI]: 1.28 - 3.59, P value = 0.004), married status (AOR = 4.10, 95%CI: 1.92 to 8.73, P
    Conclusions
    Being married, having higher education and family support could predict regular outdoor walking among older people. Access to walkable and safe environments are notable environmental factors. Strategies to promote physical activity in older adults should be focused on encouraging regular walking in this age group.
    Keywords: Older Adults, Physical Activity, Walking
  • Sepide Biyari, Leila Fozouni * Page 3
    Background
    Candidiasis includes a range of opportunistic fungal diseases that appear in various forms such as oral thrush and stomatitis in the elderly. Recently, the resistance of Candida species to antibiotics selected to treat oral infections has increased significantly.
    Objectives
    This study aimed to determine the antagonistic effects of probiotics on oral candidiasis in the elderly.
    Patients and
    Methods
    Swab samples from the saliva and mouth of 72 elders residing in the elderly care centers in Gorgan were cultured in Sabouraud dextrose agar (SDA). The Candida spp. and Candida albicans were identified by culturing in CHROMagar Candida medium and using a PCR identification kit and API 20CAUX system. The broth microdilution method was used to determine the minimum inhibitory concentration (MIC) of nystatin and itraconazole based on the CLSI document. The well - diffusion method and the modified agar method were applied to separate dairy - isolated probiotics from cultures in MRS and M17 media and to study their antimicrobial effect.
    Results
    Overall, 47 Candia isolates in seven different species were diagnosed. The MICs of itraconazole and nystatin were within the range of 0.03 - 16 and 0.03 - 8 µg/mL and the rates of resistance were 87.23% and 74.46%, respectively. The study on dairies showed that most isolated strains belonged to Lactobacilli. It was also revealed that the probiotic bacteria were able to prevent the growth of Candida species. The highest inhibitory effect was seen in Lactobacillus plantarum. Moreover, desirable antifungal effects were observed in preventing the growth of C. albicans as well as non - albicans species, particularly C. glabrata.
    Conclusions
    Concerning the high resistance of Candida isolates to antifungal agents and the inhibitory effects of lactic bacteria, especially Lactobacillus plantarum, it is recommended to use its metabolites directly in the diet of the elderly or to use them in the form of supplements in order to control oral candidiasis.
    Keywords: Candida, Elderly, Drug Resistance, Probiotic
  • Elmira Janavi, Mostafa Ansari, Shahzad Pashaeypoor * Page 4
    Background
    Considering the importance of information literacy in achieving well-documented and reliable information, it is evident that nurses must achieve a high level of information literacy through evidence-based performance. With regards to this, the present study was conducted to determine the association between information literacy and evidence-based practice.
    Methods
    The present research was a descriptive-correlation study. The subjects of the study were 244 nurses working at critical care units of Tehran University of Medical Sciences hospitals. The tool used comprised of three parts: demographic information, information literacy, and evidence-based practice. The questionnaires were completed through the self-report method, and the data obtained were analyzed using the SPSS software 16.
    Results
    The results of the study indicated that scores of information literacy and evidence-based practice were 78.72 ± 16.64 (of 170) and 102.17 ± 20.40 (of 130), respectively. Also, a significant and direct correlation was observed between the researched subjects’ information literacy and evidence-based practice (r = 0.596, P
    Conclusion
    The findings showed that the subjects’ level of information literacy and evidence-based practice is not desirable and can only be considered average. Thus, it can be concluded that through improvement of nurses’ information literacy, who are working at hospitals’ critical care units, one can improve the attitude towards and acceptance of evidence-based practice. This will improve nurses’ clinical practice and will eventually lead to an improvement in community health.
    Keywords: Nurses, information Literacy, Evidence, Based Practice
  • Esmail Soltani *, Zohreh Hosseini, Paria Naghizadeh Page 5
    Background
    The current study aimed at assessing the relationship between experiential avoidance (EA) and cognitive fusion to the level of anxiety in students experiencing such problems in their social interactions.
    Methods
    The sample consisted of 324 college students who were randomly selected by cluster sampling method. They completed acceptance and action questionnaire (AAQ-II), social anxiety-acceptance and action questionnaire (SA-AAQ), cognitive fusion questionnaire (CFQ), believability of anxious feelings and thoughts questionnaire (BAFT), and social interaction anxiety scale (SIAS). Pearson correlation coefficient and multiple regression analysis were used to analyze the data.
    Results
    The results showed a positive correlation between EA (r = 0.45; P
    Conclusions
    The results of the current study showed a correlation between EA and cognitive fusion and students anxiety in social interactions.
    Keywords: Experiential Avoidance, Cognitive Fusion, Social Interaction Anxiety, Acceptance, Commitment Based Therapy
  • Mohsen Mardani-Kivi *, Ehsan Kazemnejad, Keyvan Hashemi-Motlagh, Khashayar Saheb-Ekhtiari Page 6
    Background
    Elbow arthroscopy is increasingly applied to diagnose and treat elbow pathologies. Although evidence about its efficacy is rising, it is still not sufficient to prove it as the preferred technique for the treatment of elbow diseases.
    Methods
    Since this method is very new and only a few studies have been carried out on this technique, the current researchers decided to undertake a study at an academic referral hospital to determine the functional outcome of this method. Data were provided using review of records, applying questionnaires before and after operation, and at final visit (one-year postop).
    Results
    In this analytical case-series study, eighteen patients, who underwent elbow arthroscopy with mean age of 36.11 ± 6.14 years were enrolled during year 2013 to 2015. Between 32 indications of elbow arthroscopy, most indications were arthrolysis (12 cases) and removal of osteophyte and debridement in elbow arthritis (9 cases). Based on the Visual Analogue Scale (VAS), the mean scores of elbow pain intensity were 5.22 ± 1.7 before the surgery and 2.94 ± 1.73 at final follow up. Also, mean scores provided by Quick Dash questionnaire were 41.2 ± 16.5 before the surgery and 20.8 ± 12.9 at one-year postop visit (P
    Conclusions
    Although arthroscopic treatment of elbow lesions may possess few complications, it has favorable functional outcome, and it is a reliable method in the hands of expert orthopedists. Attaining favorable results may require paying attention to contraindications, technical considerations, careful patient selection, and proper general care of the patient.
    Keywords: Complication, Elbow, Arthroscopy, Indication, Outcome
  • Farhad Lotfi, Mohsen Bayati, Ali Reza Yusefi, Shekoufeh Ghaderi, Omid Barati * Page 8
    Background
    One of the most important goals of health systems is equality in access to health services and one of the important dimensions of health equality in relation to resources distribution in this sector.
    Objectives
    This study was done to examine the equality in resource distribution between provinces of Iran in 2014.
    Methods
    In the present retrospective study, the population included the public health sector human resources, hospital beds, and health centers in Iran. The data were collected from the Iran statistics center and ministry of health and Medical education. The inequality was estimated by Lorenz curve, Gini coefficient, Hoover index, and by using Excel and Stata 12 software.
    Results
    The Gini coefficients were 0.13797, 0.19980, and 0.1499 for the manpower, health care centers, and hospital beds, respectively. Thus, they were significant. In addition, the Hoover index was 7, 8.60, and 6.70 for the three studied resources, respectively.
    Conclusions
    The distribution of the health sector resources between Iran provinces was relatively equal. Therefore, health policy makers should be focused on the other aspects of accessibility such as distribution of resources according to health needs, resources distribution within provinces, and quality of provided services.
    Keywords: Health Care Inequality, Resource Allocation, Health Resources, Health Manpower, Health Centers, Hospital Bed