فهرست مطالب

Clinical Research in Paramedical Sciences - Volume:10 Issue: 1, Jun 2021
  • Volume:10 Issue: 1, Jun 2021
  • تاریخ انتشار: 1400/04/12
  • تعداد عناوین: 12
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  • Akram Ahmadi Barati, Leila Farhadi, Mozhgan Khalily* Page 1
    Background

     Primary dysmenorrhea is chronic pain during menstruation without the presence of a pelvic pathologic complication.

    Objectives

     The aim this research was comparison of the effect of stretching exercises and combination of massage - stretching exercises on primary dysmenorrhea of female students of Razi University of Kermanshah.

    Methods

     This semi-experimental study was statistical population all female students of Razi University of Kermanshah. 90 students were selected through purposive and convenient sampling method. After obtaining consent and justification of the subjects from the research stages, they were randomly divided into three groups of 30 to practice the protocol. The research instrument consisted of two primary dysmenorrhea and McGill pain questionnaires as well as stretching exercise and massage protocol. The validity of the questionnaires was obtained formally using Cronbach's test. Exercise program for groups was performed in 8 sessions for 3 weeks. Data were analyzed by dependent t-test, one-way ANOVA and Kolmogorov-Smirnov test, to check the normality of the data distribution.

    Results

     The results showed that there were significant differences between the three methods of exercise (stretching, massage and massage- stretching movements) on pain severity (P = 0.938), duration of pain (P = 0.095) and the nature of pain (P = 0.664) There was no significant difference.

    Conclusions

     According to the results of the present study, massage and stretching exercise and massage-stretching combinations are almost as effective and effective as noninvasive methods in reducing the symptoms of sensory pain caused by primary dysmenorrhea. Assistance to girls with dysmenorrhea Selection and application of one of these methods will depend on the individual's abilities and circumstances.

    Keywords: Massage, Dysmenorrhea, Stretching Exercises, Primary Dysmenorrhea
  • Farhad Towhidi, Khalid Mohammadzadeh Salamat *, Ali Soroush, Ali Pourmotabbed Page 2
    Background

     Obesity is known as one of the most important cardiovascular risk factors.

    Objectives

     This quasi-experimental study was conducted to investigate the effect of an eight-week aerobic exercise and garlic extract use on the blood pressure, fat percentage, and lipid profile of patients with hypertension.

    Methods

     A total of 50 men with a mean age of 53 ± 7.6 years were recruited from among obese patients with blood pressure. They were randomly divided into five groups of aerobic exercise, garlic extract, aerobic exercise plus garlic extract, placebo, and control. The experimental groups underwent aerobic exercise (3 sessions per week, each session for 35 - 60 min with a maximum heart rate of 50 - 75) or garlic extract supplementation (daily use of 6 g) for eight weeks. Blood samples were collected before interventions and 48 h after the last exercise session. Statistical analysis was done by the dependent t-test and ANCOVA.

    Results

     Body weight, body fat percentage, systolic and diastolic blood pressures, and serum LDL significantly reduced in the aerobic exercise, garlic extract, and aerobic exercise plus garlic extract groups compared to the control group (P ≤ 0.05). Aerobic exercise and aerobic exercise plus garlic extract groups showed a significant decrease in total cholesterol level and serum triglyceride and an increase in serum HDL compared to the control group (P ≤ 0.05). Aerobic exercise plus garlic extract group indicated a higher increase in serum HDL and a higher decrease in the body weight, body fat percentage, and serum LDL compared with the control group (P ≤ 0.05). Aerobic exercise plus garlic extract group indicated a higher serum LDL decrease compared to the aerobic exercise group (P ≤ 0.01).

    Conclusions

     Both aerobic exercise and garlic extract seem to be able to improve obesity, lipid profile, and hypertension. However, their concurrent use has no additional effects on the blood pressure control although it mostly influences lipid profile and body composition.

    Keywords: Blood Pressure, Aerobic Exercise L, ipid Profile G, arlic Extract, Fat Percentage
  • Seyed Mansour Razavi, Fatemeh Mousavi, Termeh Tarjoman, Marjan Mohammadnouri, Parisa Shojaei * Page 3
    Objectives

     Main goal in this study was to design and introduce a standard checklist that medical interns to be able to apply it to assess the medication safety status in clinical settings and learn the facts related to this issue simultaneously.

    Methods

     We performed the following steps to conduct the study: (1) using brainstorming and fishbone method for collecting problems in six domains including: demographic and risk factors, prescribing, transcribing, usage, storage and management; (2) collecting the medication standards and indicators; (3) designing a problem oriented checklist, including 85 questions; (4) verifying the validity and reliability of designed checklist by Delphi method and conducting a pilot study. The Cronbach's alpha co efficient were good (more than0.7); (5) to perform of pretest; (6) teaching and introducing of 10 valid evidences to answer the checklist questions in three day workshop to 41 medical interns; (7) after the workshop, students applied the mentioned checklist for assessment of drug safety status on 151 hospitalized patients with the aim of learning during assessment; (8) monitoring of patient’s medication safety status by the interns and self -learning simultaneously; and finally (9) we used Student self-assessment of medication safety education goals, before and after self-training with our checklists.

    Results

     A standard checklist with dual functions (self-learning during assessment) was developed. Difference between pre-test and post test scores was statistical significant (P ≤ 0.001) and 92% of participants were satisfied with this type of training.

    Conclusions

     We recommend our designed checklist to all clinical educators who are engaged in medication safety domain.
     

    Keywords: Medication Errors, Adverse Drug Events, Medication Safety, Rational Drug Administration Use
  • Ailin Alishahi, Kamal Azizbeigi *, Khalid Mohammadzadeh Salamat, Mozafar Yektayar Page 4
    Objectives

     The aim of this research was to study the influence of consuming ascorbic acid during high -intensity endurance training on catalase (CAT), nitric oxide (NO) concentration, and blood pressure (BP) in hypertensive male.

    Methods

     36 hypertensive male voluntary participated in the present study and randomly assigned into endurance training-ascorbic acid (HTC; n = 9), endurance training-placebo (HTP; n = 9), ascorbic acid (AA; n = 9) and control (n = 9). The exercise protocol was including continuous running exercise training with gradually increasing of duration and intensity, 3 times a week for 10 weeks. The supplement groups consumed daily 500 mg of ascorbic acid, and the placebo group consumed the same amount of maltodextrin. Fasting blood samples was gathered before the beginning exercise protocol and one day after last session for analyzing CAT and NO.

    Results

     Results showed that activity of CAT and NO concentration were significantly increased only in the HTC and HTP (P ≤ 0.05). Also, in the HTP and HTC, a significant decrease observed in the systolic and diastolic (P ≤ 0.05). Nevertheless, there was no significant difference between HTC and HTP in SBP and DBP (P > 0.05).

    Conclusions

     Finally, we concluded that, continuous running exercise training has positive effect on the catalase and oxide nitric activity, and can improve blood pressure in the hypertensive men. Anyway, combined the high -intensity aerobic training with ascorbic acid may have not more efficacy.
     

    Keywords: Blood Pressure, Nitric Oxide, Endurance Training, Catalase
  • Kheironessa Naderi, Hamid Taher NeshatDoost *, Hooshang Talebi Page 5
    Objectives

     This study was carried with the purpose of evaluating the effectiveness of self-regulation strategy training on procrastination, academic achievement, and happiness of 1st grade high school male and female students.

    Methods

     It is a quasi-experimental research with a pretest-posttest design involving a control group. Sixty students were selected by means of multistage cluster sampling plan and randomly grouped in 4 groups of 15. Research instrument consisted of Solomon and Rothblum Academic Delay, Oxford Happiness, and Standard Academic Achievement Questionnaire. Test group received 8 self-regulation training sessions of 45-minute duration each.

    Results

     Results revealed that self-regulation training has a meaningful effect on dependent variables (P < 0.001). In the presented model, "gender", "time and group", "interactive effect of gender and group", and "interactive effect of group and time" were meaningful, as opposed to the "interactive effect of gender and time" and "interactive effect of gender, group, and time" which lacked any significance.

    Conclusions

     Results of LSD post hoc test showed no meaningful difference between the mean happiness, procrastination, and academic achievement scores of experimental and control groups in the pretest stage. However, in the posttest and follow-up stage, the mean scores of the two groups differed significantly.
     

    Keywords: Happiness, Academic Achievement, Procrastination, Self-regulation Strategies
  • MohammadJavad Jamshidi *, Mahdi Hosseinpour, Hamed Heshmati, Bahareh Fathi Zolmabadi Page 6
    Background

     Performance improvement in hospitals requires an appropriate model for performance evaluation. Because organizational goals cannot be achieved without a comprehensive model for evaluating and reviewing programs, organizations cannot apply effective management of programs without regard to the results of their activities.

    Objectives

     The purpose of this study is to introduce a new model for improving the performance of hospital information systems using Six Sigma method in Kermanshah province hospitals.

    Methods

     This is a qualitative research based on content analysis and Delphi method. The data are collected through semi-structured interviews and the participants are 19 experts in hospital performance systems which were selected by snowball sampling. After transcribing the interviews, three steps were done using content analysis: firstly, using line-by-line coding (or open coding) words and segments of interviews were coded, secondly, each code was conceptualized and categorized into some axial codes based on focused coding, and finally, selective coding was done in which categories were identified based on axial codes’ similarity, conceptual relationship and common characteristics.

    Results

     The results of the coding of the interviews showed that variables such as reduction of medical errors, improvement of hospital quality of services, promotion of hospital efficiency and productivity, quick and easy access to information, increased patient satisfaction and safety, management and cost reduction, and time management and control influences the performance of hospital information systems.

    Conclusions

     For improving hospital information systems, hospital managers and system developers should not only pay attention to variables which are controlled by the software and are least affected by the human resources of the organization; such as: cost control, quality control, information control and time control but also human based variables such as specialization of the staffs, their motivation, reduce errors and etc., which are sometimes neglected.

    Keywords: Hospitals, Health Information Systems, Quality Improvement, Systems Analysis
  • Abdolhamid Zokaei, Mehran Ghahramani * Page 7
    Background

     The creatine phosphokinase-MB (CPK-MB) isoenzyme level is useful in determining the myocardial infarction (MI) extent and time. Evidence indicates the possible effect of exercise training on reducing the amount of CPK-MB, but the proper intensity of exercise is still unclear.

    Objectives

     In this study the effect of intensity of exercise training on creatinine kinas after a myocardial infarction in plasma levels of male Wistar rats was comparing.

    Methods

     Thirty two male Wistar rats at 10 weeks of age were divided in to four groups [low (N = 8), moderate (N = 8), and high (N = 8) intensity interval training and a control (N = 8) group (no exercise)]. Six weeks later, rats became MI patients through surgery. CPK-MB plasma levels were investigated before training, immediately after training for six weeks as well as 12 hours after MI. The data were analyzed by ANOVA with repeated measure and Tukey (α ≥ 0.05).

    Results

     The results showed that changes in CK enzyme at 12 hours after MI in LIIT (113.88 ± 19.25), MIIT (135.88 ± 35.58) and HIIT (105.75 ± 19.05) were statistically significant compared to the control group (124.62 ± 23.41) only in 12 hours after MI and this reduction in the low-intensity interval training group was significant than the other two groups (P = 0.0001).

    Conclusions

     In this study, six weeks of interval training with each intensity was likely to make cardiac cells resistant to necrosis resulting in low levels of the CPK-MB enzyme compared to the control group after the myocardial infarction event.

    Keywords: Myocardial Infarction, Creatine Kinase MB, Excercise
  • Sadegh Mohamadi, Neda Khaledian *, Ali Karbasfrushan, Seyed Sajad Hosseini, Ebrahim Ezzati ‎ Page 8
    Background

     Anesthesia is widely used to manage pain and anxiety during oocyte retrieval in vitro fertilization (IVF), but there is probable interference with the results and success rate of IVF.

    Objectives

     The present study compares the effects of general anesthesia (GA) and monitored anesthesia care (MAC) applied in oocyte retrieval.

    Methods

     The general anesthesia used in this study comprised a fentanyl-propofol mixture to reach hypnotic concentrations. Intravenous ketamine-midazolam were used for MAC before procedures according to prescribed doses. In sum, 180 women were recruited for research while 90 women selected for general and 90 for MAC methods.

    Results

     The collected oocytes were higher in number in general group (11.25 ± 4.39) than MAC group (7.03 ± 3.84, P < 0.001), meanwhile, the analyses did not show difference between groups regarding the number of fertilized oocytes (4.52 ± 3.18 vs. 4.15 ± 3.02). The differences in successful pregnancy was not significant.

    Conclusions

     Thus, it seems from findings that fentanyl-propofol GA without nitrous oxide is an appropriate alternative to ketamine-midazolam MAC and can be used for IVF oocyte retrieval if GA is demanded.

    Keywords: IVF, Anesthesia, Propofol, Fentanyl, Oocyte Retrieval
  • Roghayeh Sajedi, Abbas Khorshidi *, Fatemeh Hamidifar, Hamid Moghaddasi, AmirHossain Mahmoodi Page 9
    Background

     Over the last number of decades there has been a shift in medical education practice from traditional forms of teaching to other media which employ online, distance or electronic learning. E-learning can provide students with easier and more effective access to a wider variety and greater quantity of information.

    Objectives

     The present study aimed to design a conceptual pattern of e- learning for Iran’s universities of Medical Sciences.

    Methods

     This study was applied in terms of objective and qualitative in terms of data collection. The population of the study was the e-learning experts and faculty members of universities who sampled purposefully, after 30 interviews, saturation was achieved. A semi-structured questionnaire was used to interview. The qualitative data was analyzed using three- stage codings.

    Results

     the electronic learning pattern of Iran’s universities of Medical Sciences was categorized in the following dimensions, including: "academic dimension" including components of synergogy and instructional design, human resources, infrastructure, management, organization, financial resources, ethics & culture, support, monitoring & coordination, and legal factor; The "spatial planning regions dimension" includes the components of the educational activities, research and information technology- related activities; the "national-macro dimension" includes the government’s structural and managerial supports, the government’s cultural and social supports, the government’s economic supports, the government’s scientific and technical supports, supports from the higher medical education, and supports from the private sector; the "regional – international dimension" including scientific and educational interactions, cultural and social interactions, political, and economic interactions.

    Conclusions

     This study suggested that policy-makers, top managers of higher medical education, and those in charge of e-learning exploit the pattern proposed in this study for developing policies and programs for creating/developing e-learning centers, and sufficiently address the dimensions, categories, and indicators mentioned here, so that the long-term effects of operationalizing each category of the pattern can be demonstrated more optimally and quickly. In this way, costs can be reduced, repeat work can be avoided (especially in the face of environmental crises), and Iranian universities can progress in line with world universities and thereby take a big step towards the successful implementation of e-learning in Iran.

    Keywords: Learning, Universities, Educational Technology, Education Medical, Education Distance
  • HamidReza Samzadeh, Mohadeseh Iranpour *, Fatemeh Shekari, Ali Soltaninejad, Mahin Eslami Page 10
    Background

     Stuttering as a communication disorder can lead to serious problems in interpersonal communication and affect the quality of life of the affected person.

    Objectives

     The aim of this study was to investigate the effectiveness of telehealth in improving its treatment and its effect on maintenance phase of stuttering children.

    Methods

     In this study, all 6 - 12 year-old stuttering children referred to the Speech Therapy Center of Shahid Beheshti Hospital in 2018 were selected by purposeful sampling method and divided into two groups of experiment and control. Children were healthy and without any disorder. All 12 children received a three-month course of treatment with a speech and language pathologist (SLP) weekly one session. Maintenance phase included 8 sessions of 30 minutes over a period of six months.

    Results

     Six children in the experimental group received maintenance phase training exercises by the SLP in the form of audio and video files through the WhatsApp software. Average total satisfaction rating (4.22) the lowest satisfaction score (3.16) highest score (5). According to the total score of the questionnaire,17% of the parents were satisfied at a low rate, 33% of parents were satisfied with the average and 50% of parents were very satisfied.

    Conclusions

     In this study, the efficacy of telehealth on the maintenance phase of stuttering children has been evaluated. Results showed that telemedicine, with its ability to completely remove distance and travel as barriers for both patients and health care professionals is one option. Telemedicine can be a viable alternative to traditional in-person physician-based care for stuttering.
     

    Keywords: Telemedicine, Stuttering Children, Maintenance Phase
  • Fatemeh Taghlili *, Fatemeh Barzegar, Fatemeh Mirahmadi Page 11
    Background

     Inflammatory pain is the spontaneous hypersensitivity to pain that occurs in response to tissue damage and inflammation. Recently herbal remedies have been considered for less complications. The two topical products of Capsicum (Capex Topical cream) Apium graveolens and Mentha (CM lotion) can reduce the inflammatory. Since Capex Topical cream causes skin irritation, it seems that its composition with the other product could probably reduce this complication.

    Methods

     This experimental study was performed on 60 patients referred to orthopedic clinic of Shahid Yahyanejad Hospital, Babol in 2018. Patients were randomly divided into three treatment groups. Data collection was done by a researcher-made questionnaire, which included two parts of individual characteristics and the severity of pain. The severity of pain was measured by visual analogue scale (VAS) before intervention and two and four weeks after the intervention. Data were analyzed using SPSS-16 software and P < 0.05 was considered as significant.

    Results

     The results showed that the intensity of pain after use of each of the products decreased in all three groups. In addition, our results demonstrated that application of Capex Topical Cream was more effective that use of CM lotion in decreasing the pain intensity (P < 0.05). Moreover, the intensity of pain after topical application of the combined lotion of CM and Capex Topical cream significantly decreased (P < 0.05), however the decrease in pain intensity using combined solution was not significant compared to application of Capex Topical cream or CM lotion alone.

    Conclusions

     The present study showed that the use of all topical products reduces the severity of pain and due to the less side effects and complications such as skin irritation in application of combined solution and better acceptance by patients, it could be suggested the use of combined solution as a better alternative to reduce inflammatory pains.

    Keywords: Capex Topical Cream, CM lotion, Inflammatory pain
  • Fereshteh Jalalvandi, Mohammad Rostami *, Sohrab Nosrati, Reza Feyzi, Amir Koshki Page 12
    Background

     Although surgery is done for improving the patient’s condition, it can put every individual that undergoes surgery at risk of irreparable postoperative complications. One way to decrease the post-surgery complications is apply of surgical safety checklist.

    Objectives

     This study aimed to evaluate the implementation of surgical safety checklist in operating rooms of the selected hospital of Kermanshah University of Medical Sciences in 2018.

    Methods

     This cross sectional descriptive study was done by a checklist designed based on the surgical safety checklist on randomly selected 150 operations, in the selected hospital of Kermanshah University of Medical Sciences between January and May 2018.

    Results

     According to the findings, 77.1% of the safe surgery standards are observed in the operating rooms of the selected hospital. 77.48% of the safe surgery standards are observed before anesthesia, 74.8% of the standards are observed after anesthesia and before incision, and 79.33% of the standards are observed after suturing the wound until getting the patient out of the operating room. The results of t-test showed that there is a significant difference between different operating rooms in terms of the implementation of surgical safety checklist (P ˂ 0.05).

    Conclusions

     The findings show that implementation level of safe surgery standards was low. So, it's necessary to take specific measures for explain the importance of the items of this checklist and developing educational programs to explain the importance of the patients’ safety in operating rooms for the surgical staff.
     

    Keywords: Operating Room, Surgery, Patient Safety, Surgical Safety Checklist