فهرست مطالب
Journal of Clinical Care and Skills
Volume:5 Issue: 3, Summer 2024
- تاریخ انتشار: 1403/06/11
- تعداد عناوین: 8
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Pages 111-116Aims
In the field of infertility treatments, intrauterine insemination (IUI), with or without ovulation stimulation, is considered the first line of intervention. This study aimed to assess the relationship between various factors and the rates of biochemical and clinical pregnancy following IUI treatment over a five-year period.
Instrument & MethodsThis cross-sectional study was conducted at Kashan, Iran, 2023. The medical records of patients diagnosed with infertility and treated with IUI at the infertility center in Kashan were reviewed. The primary outcomes were biochemical and clinical pregnancy rates, along with associated factors. Data were analyzed using the Chi-square test and independent t-tests, with statistical significance set at p≤0.05.
FindingsA total of 334 patients were included in the study. The mean age of those with positive biochemical (p<0.006) and clinical pregnancy outcomes (p<0.008) was significantly lower compared to those who did not achieve pregnancy. A significant correlation was found between endometrial thickness and both biochemical (p<0.002) and clinical pregnancy rates (p<0.007). However, no significant associations were observed between the other variables and pregnancy outcomes.
ConclusionIncreasing maternal age is associated with a decline in biochemical and clinical pregnancy rates. In contrast, an increase in endometrial thickness positively correlates with higher biochemical and clinical pregnancy rates.
Keywords: Ovarian Stimulation, Pregnancy Rate, Infertility, Clinical Pregnancy -
Pages 117-123Aims
One of the frequent problems in hemodialysis patients is sleep disorders. The aim of this study was to assess the effect of Thai massage therapy on the sleep quality of hemodialysis patients.
Materials & MethodsThis was a randomized controlled trial conducted in Kashan in 2020. For this randomized single-blinded clinical trial study, 80 hemodialysis patients in Kashan Hemodialysis Center, Iran, were selected. Using the block randomization method, these patients were randomly assigned to intervention (n=40) and control (n=40) groups. In the intervention group, in addition to routine care for hemodialysis patients, 60-minute Thai massages were performed three times a week for a month based on the participants’ convenience for morning or afternoon massages. For the control group, only routine care was done. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the quality of sleep. Data was analyzed using the independent t-test, Chi-square, and two-way analysis of variance with repeated measures.
FindingsThe total sleep quality score one month after the intervention was 8.15±2.52 in the intervention group and 10.09±3.01 in the control group. The independent t-test showed a statistically significant difference between the two groups (p=0.004).
ConclusionThai massage therapy effectively improved the participants’ quality of sleep.
Keywords: Hemodialysis, Sleep Quality, Thai Massage -
Pages 121-135Aims
Cesarean section is one of the most common surgeries worldwide. Pain management and the acceleration of cesarean wound healing are important and necessary for the mother, baby, and breastfeeding. Herbal medicines with anti-inflammatory and antibacterial effects have been used in wound management and care in traditional medicine. This systematic review assessed the efficacy of herbal products used in clinical trials for cesarean wound healing.
Information & MethodsIn this systematic review, keywords, including “cesarean section,” “wound healing,” “herbal medicine,” “complementary medicine,” and “alternative care” were searched in PubMed, Scopus, Web of Science, Cochrane Library, and ProQuest databases. The Persian equivalents of these terms were searched in the SID and Magiran databases. The search was conducted with no time limit until April 2024. Studies published in Persian and English that investigated herbal products for the healing of cesarean section wounds were included in this study. The quality assessment of the articles was conducted using the CONSORT 2018 checklist. Data analysis was performed qualitatively and reported.
FindingsAmong 471 articles, eight articles assessing seven plants were investigated. Most of the studied plants improved cesarean wound healing. The results of two studies on the effect of turmeric on cesarean wound healing were consistent.
ConclusionThe medicinal products prepared in all the studies are effective in cesarean wound treatment.
Keywords: Cesarean Section, Wound Healing, Systematic Review, Herbal Medicine -
Pages 137-144Aims
Pain and fatigue are common in women with breast cancer. Mindfulness-based stress reduction training has shown varying results regarding pain and fatigue scores. Therefore, this study was conducted to determine the effect of mindfulness-based stress reduction intervention on pain and fatigue in women with breast cancer in Yazd, Iran.
Materials & MethodsThis quasi-experimental study was conducted on 56 women with breast cancer in Yazd City, Iran. Using a simple randomization method, participants were assigned to the intervention and control groups (28 patients per group). Mindfulness-based stress reduction training was conducted via WhatsApp in eight virtual sessions for the intervention group. Data were collected using an electronic demographic form and the Fatigue Severity Scale Questionnaire (FSS) and Brief Pain Inventory (BPI) before the intervention, immediately after the intervention (week eight), and four weeks after the intervention (week 12). Descriptive statistics and both parametric and nonparametric analyses were performed using SPSS 16 software.
FindingsThere was no significant difference in demographic and clinical characteristics between the groups. The mean fatigue score of the intervention group improved at week eight compared to the control group (p<0.001). However, there was no significant difference between the two groups in the average pain score after the intervention, although a decreasing trend was observed (p>0.05).
ConclusionMBSR training reduces fatigue in women with breast cancer, and although it decreases pain, this reduction is not significant.
Keywords: Mindfulness, Stress, Physiological, Pain, Fatigue -
Pages 145-150Aims
Concomitant Helicobacter pylori (H. pylori) infection in patients with chronic kidney disease (CKD) may increase the risk of CKD progression. Maybe the eradication of Helicobacter pylori improves the Glomerular Filtration Rate (GFR), however, there is a challenge between studies. Therefore, this study aimed to demonstrate whether eradication of this infection improves GFR in CKD patients.
Materials & MethodsThis is an interventional study on 270 CKD patients with GFR between 30 to 60 mL/min who were evaluated for H. pylori infection. A total of 79 patients were eligible for inclusion in the study. The patients underwent an early eradication treatment for H. pylori infection. The trend of changes in GFR was evaluated and compared in CKD patients in whom H. pylori infection was successfully eradicated (group A) to those whose infection had not been eradicated (group B) in a six-month follow-up period.
FindingsA total of 49 patients with chronic kidney disease (CKD) and a positive stool antigen test for H. pylori completed the study. In Group A, which received treatment for H. pylori infection, the mean glomerular filtration rate (GFR) showed an upward trend, rising from 48.54 ± 8.66 mL/min at baseline to 49.5±14.4 mL/min at six months. However, this increase was not statistically significant (P=0.18). In contrast, Group B exhibited a downward trend in GFR over the study period, decreasing from 45.77±7.92 mL/min at baseline to 45.48±14.33 mL/min at six months, with this change also not reaching statistical significance (p=0.48).
ConclusionThere is no significant difference in GFR between groups, however GFR in CKD patients with H. pylori infection eradication is increased.
Keywords: Helicobacter Pylori, Chronic Kidney Disease, Glomerular Filtration Rate, Infection, Disease Eradication -
Pages 151-156Aims
Klebsiella pneumoniae is a common cause of urinary tract infections (UTIs), especially in hospitals. Quinolones work by blocking bacterial DNA gyrase and topoisomerase IV, but the presence of qnr genes enables bacteria to survive despite these drugs. This study aimed to evaluate antibiotic susceptibility and the prevalence of plasmid-mediated quinolone resistance genes (qnrA, qnrB, qnrS) in these isolates.
Instruments & MethodsIn this descriptive, cross-sectional study, 142 K. pneumoniae isolates were collected from UTI patients at Imam Sajjad and Kosar hospitals in Yasuj and Shiraz, Iran, during 2020-2021. The disk diffusion method assessed resistance to various antibiotics, with a focus on quinolones. Multiplex PCR was used to detect qnrA, qnrB, and qnrS genes in quinolone-resistant isolates.
FindingsCiprofloxacin showed the highest resistance rate (60.6%). Sensitivity was comparatively higher for sulfamethoxazole-trimethoprim (39.4%) and nalidixic acid (39.7%). The qnrA, qnrB, and qnrS genes were found in 31.4%, 55.8%, and 10.5% of isolates, respectively. Coexistence of qnrA and qnrB occurred in 11 isolates, while qnrB and qnrS coexisted in 5 isolates. One isolate exhibited all three genes.
ConclusionThe study reveals a substantial prevalence of plasmid-mediated quinolone resistance genes in K. pneumoniae isolates from UTIs in these hospitals.
Keywords: Klebsiella Pneumoniae, Antibiotic, Drug Resistance, Quinolones, Genes -
Pages 157-163Aims
Every year around the world, hospital infections and resistance to antibiotics lead to many complications in hospitalized patients. This study aimed to determine and compare the antibacterial effect of hydroalcoholic extract of Rosa canina plant (Rosa canina L) on Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus bacteria isolated from surgical wounds in Yasuj hospitals.
Materials & MethodsIn this cross-sectional study, the effect of Rosa canina L hydroalcoholic extract on 20 samples of Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus was investigated. The Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) and zone of inhibition (ZOI) of each clinical sample were investigated and compared with the standard sample. The results were statistically analyzed by SPSS 16 software.
FindingsRosa canina L hydroalcoholic extract had no antibacterial effect on Pseudomonas aeruginosa. The lowest inhibitory concentration was related to Staphylococcus aureus 125 µg/ml, Escherichia coli 325 µg/ml and Klebsiella pneumoniae 350 µg/ml, respectively. The difference in minimum MIC, MBC and ZOI between clinical and standard samples was not statistically significant. The ZOI diameter of Klebsiella pneumoniae and Escherichia coli clinical samples were equal (9.8 mm).
ConclusionThe hydroalcoholic extract of Rosa canina L has a better antimicrobial effect on Staphylococcus aureus than the other 3 investigated bacteria and has no effect on Pseudomonas aeruginosa. There is no difference between the effect of the examined extract on clinical and standard samples, and the effect of this extract on different bacteria is different.
Keywords: Plant Extracts, Rosa, Anti-Bacterial Agents, Bacteria -
Pages 165-171Aims
We aimed to evaluate the effect of treatment with testosterone with and without bisphosphonates on bone density in patients with thalassemia major.
MethodsThis Quasi-experimental study was performed on patients with thalassemia major. Four groups were included in the study 1: patients with hypogonadism who were treated with testosterone and alendronate (HTA group, n=11), 2: patients with hypogonadism who were treated with testosterone (HT group, n=12), 3: patients with hypogonadism who did not receive any treatment (H group, n=5), and 4: patients without hypogonadism who were treated with alendronate (NHA group, n=10). The status of bone density was assessed before and after interventions and compared across the study groups.
FindingsA total of 38 subjects with mean age of 22.46 ± 4.64 years were investigated.The mean difference of Z score of the lumbar region before and after the intervention in the four groups was -1.65±0.65, -26±0.48, 0.00±0.00 and -0.32±0.21 respectively, that there was a significant difference between the four groups (P < 0.001). The mean difference of Z score of the hip region before and after the intervention in the four groups were -1.35±0.58, -57±0.37, 0.00±0.00 and -0.32±0.21 respectively, that there was a significant difference between the four groups (P < 0.001).
ConclusionAdding bisphosphonates to testosterone in thalassemia patients with hypogonadism will improve bone density as well as reduce pain intensity in these patients. Also, administration of bisphosphonates in thalassemia patients without hypogonadism can be very effective in improving bone density and bone pain in these patients.
Keywords: Beta-Thalassemia, Testosterone, Bone Density, Pediatrics