مجله دانشکده پرستاری و مامایی مشهد
پیاپی 20 (بهار 1388)

The presence of necrotic tissue is an important problem in patients with deep burns. To remove these tissues surgical procedures are usually used which are problematic and with limited indications. This study was designed to compare topical effectiveness of kiwifruit versus Elase ointment on removal of necrotic tissue of full-thickness burns. This experimental study was accomplished on 0 Vistar rats that assigned to three groups. Full thickness burns with cm diameter were produced in all rats. One side of the first group was treated by Elase ointment and the other side by topical kiwifruit. In second group one side was treated by Elase ointment or topical kiwifruit and the other side was considered as control group. All wounds in group three were considered as control group. In each group the time of removing necrotic tissues, the instant of infection occurrence and forming granulate tissue were recorded in a check list and then were analyzed using non-parametric statistics. Findings showed that debridement time of kiwifruit (5.7days) was significantly shorter than Elase ointment group (8.5 days) (p<0.09). Surprisingly in the kiwifruit groups no infection was observed. Using kiwifruit not only causes no injury to healthy tissues but also resulted in shorter debridement time. Findings of this study can open new horizons and provide a new treatment modality for patients with deep burns.

Elevated serum cholesterol and, particularly, low density lipoprotein (LDL) cholesterol is significant risk factors associated with development and progression of atherosclerosis and consequently CHD. Wet cupping has been known as a complementary medicine to reduce cholesterol. Thus with attention to peoples demand to these complementary methods, the present study was conducted to investigate the effects of wet cupping on serum lipoprotein concentrations. In this clinical trial, 7 men and women with high blood cholesterol were randomly assigned into treated (N=8) and control (N=6) groups. Participants in treated group were subjected to wet cupping, whereas those in control group remained untreated. Then, the serum concentrations of lipoproteins were measured after weeks. Data were analyzed using statistical methods including Chi-square, Mann-Whitney, Independent t-test, paired t-test. A significant difference was found in the amount of LDL-C and LDL/HDL ratio before and after wet cupping (p<0.005), as the amount of LDL-C and LDL/HDL ratio was lower in treated group compared to control (p<0.00). Although HDL-C reduction in control group was observed (p<0.0), but comparing two group differences did not show any significant changes at the end of study (p=0.6). Wet cupping may be an effective method to reduce LDL cholesterol and consequently may have a preventive effect against atherosclerosis.

Episiotomy and perineal lacerations are common perineal trauma in primiparous vaginal birth. Problems after episiotomy include perineal pain, inflammation, edema, dysparonia and dehiscence, of which perineal pain is more popular. For this reason, this study aimed to compare the perineal pain and wound healing in primiparous women in two groups of women who were administered lavender cream or placebo at Modarres hospital in kashmar. In this double-blind randomized clinical trial, 90 primiparous women aged between 7-5 years old, with gestational age between 7- weeks, -5 cm dilation of cervix and spontaneous delivery of a singleton fetus with vertex presentation were allocated. Subjects were allocated randomly into two groups of lavender cream or placebo. Data were collected using interview schedule, Visual Analogue Scale and REEDA scale. There was no significant difference in perineal pain at first hours postpartum between two group (P=0.78), but perineal pain at the rd (P<0.05), 5th (P<0.009) and 0th (P<0.07) day postpartum was less in experimental group. In terms of wound healing there was no significant difference between two group at rd day post partum (P=0.7), whereas at the 5th (P<0.00) and 0th day (P<0.009) a significant difference between two groups was seen. Topical application of lavender cream is effective in relieving perineal pain and episiotomy wound healing.

One of the most important problems of nursing process method is lack of student's capability in implementing nursing process in actual fields to conduct professional tasks. Thus, teaching methods such as simulation could be used for teaching of nursing process. It seems that it can involve students actively and therefore help them to apply their taught skills in actual conditions. In this one–grouped quasi-experimental study which conducted in 00-005, student nurses were included in the study. Data were collected using a questionnaire, Gordon College Student Evaluation Form and Nursing Process Evaluation Form in three intervals including before, immediately and one month after teaching. The data analyzed using Mann-whitney test, paired t-test as well as repeated measures analysis. The results showed that study subjects achieved higher score in two posttests which were carried out immediately (5.±.97) and one month after teaching (6.±.6) in comparison with pretest (6.6±.89). Also significant differences were observed between means of student's practice skills before and immediately after teaching, before and one month later, immediately after teaching and one month later as well as before, immediately and month after teaching using paired t-test and repeated measures analysis. It is suggested to use active styles of training including simulation for the nursing process teaching. It seems that such training methods involve students in a situation which is similar to natural fields and make student nurses to be able to implement nursing process as a standard method of caring.

Hemodialysis is the most prevalent therapeutic procedure for end stage renal disease patients. During dialysis patients have to lie in supine position for at least four hours. Putting the patients in other positions may enhance patient's comfort. So, this research was accomplished to investigate the effect of semi-Fowler's position on the hemodialysis complications. In this cross-over study 5 patients who were under hemodialysis in Zabol city were conveniently selected and then assigned to two groups. In each group patients were randomly put in one of the supine or semi-Fowlers positions in two sessions of dialysis. Hemodialysis complications including hypertension, nausea, vomiting and muscular cramps were recorded and compared in each position using relevant instruments. There was no significant difference between supine and semi-Fowler's position in terms of systolic and diastolic blood pressure mean, the occurrence of hypertension, nausea, vomiting and cramp, also the frequency and intensity of vomiting and cramp. However, the frequency, duration and intensity of nausea were significantly less in semi- Fowler's position comparing supine position. Considering that most of the hemodialysis complications had no differences in two positions, and just some of the complications decreased in semi- Fowler's position, it seems in order to preserve the patient's comfort, nurses can suggest them to choose either supine or semi- Fowler's position. Nevertheless, it is recommended to investigate carefully the other hemodialysis complications in semi- Fowler's position as well.

Delivery has an extensive effect in women's health and it is one of the most important indexes in public health. In recent years, interventions in delivery are common, that fundal pressure is one of them. The use of this procedure is poorly described in the medical literature and controversy exists about its safety in the second stage. Therefore, aim of this study is detect and compare the outcome of delivery by fundal pressure in second stage of labor with spontaneous delivery. This was cross-sectional study that women were included. Seventy two deliveries in which fundal pressure was used to expedite birth were matched with 7 deliveries that occurred spontaneously. Delivery outcome was evaluated in two groups. A questionnaire was used for data gathering. Data were analyzed using statistical methods including Chi-square, Independent t-test, Z-Ratio and Fisher Exact test. Spreadind of episiotomy, tear (p<0.05), APGAR scores on the first minute (p<0.00) and median of duration of the second stage of labor (p<0.000) were statistically different. Fundal pressure is associated with an increased rate of maternal and neonatal accidents. Thus, if there is any requirement to such intervention, its benefit should be considered in comparison with operational delivery.

High sensitive C-reactive protein (HS-CRP) has prognostic utility in patients with acute coronary syndromes and is a strong independent predictor of future coronary events in apparently healthy subjects. In this study, the prognostic value of the HS-CRP was evaluated in detection of coronary artery events when combined with serum LDL–C/HDL–C ratio. Three hundred male patients who suffered from the symptoms of coronary artery diseases were divided into three subgroups according to the number of diseased vessels (66 with one diseased vessel, 87 with two diseased vessels, and 0 with three diseased vessels). Control group consisted of 7 males who seemed to be healthy individuals (without diseased vessesl). Serum levels of HS-CRP were measured by ELISA method and those of lipid parameters by standard methods using Cobas Mira autoanalizor. The relationships between the measured variables were analyzed by Pearson tests. Comparing with the control group significant elevation were noticed in serum levels of HS-CRP in patients with coronary artery diseases in all cases (P<0.05). Also there was a significant correlation between the serum levels of HS-CRP, LDL-C, HDL-C and LDL-C/HDL-C ratio (P<0.05). A significant correlation between the number of diseased vessels and the elevated level of HS-CRP was also found (p<0.00). The direct correlation between serum levels of HS-CRP and LDL–C/HDL-C ratio and number of diseased vessels suggests that predictive value of HS-CRP in men is considerably increased when it is combined with serum LDL–C/HDL–C ratio.

Adoption is considered as a therapeutic alternative to reduce the emotional burden of infertile couples. However, it is virtually unknown and with a limited acceptance amongst infertile couples. This study was designed to investigate the factors which affect acknowledgment of adoption in couples with and without adopted child in Aran-Bidgol town. In this comparative study, 50 infertile couples without and 50 with an adopted-child were selected using stratified sampling. All infertile couples were interviewed in order to take their psychosocial and medical history. Couple's socioeconomic and demographic data were also obtained using a self-administered questionnaire. Subject's attitude towards adoption was measured using a self-measured Likert scale. General health, self-esteem and social support were respectively measured by GHQ8, Cooper Smith and Cassidy scales. Two groups had no significant difference in terms of medical history and socioeconomic status. The score of attitude (p<0.009), general health (p<0.00), self-esteem (p<0.00) and social support (p<0.0) was significantly different in couples with and without adopted child. The highest score of attitude was seen in females with adopted child. The highest score of general health was seen in males with adopted child. Whereas its lowest score was seen in females without adopted-child. Also females with adopted child had the highest score of self esteem and social support. Infertile couples with adopted-child had a positive attitude towards adoption and also improved psychosocial status. It is therefore recommend establishing support organizations to assist infertile women to adopt children to overcome infertility crisis.

Nutrition plays a major role in cancer development and treatment. Weight loss is a common problem in patients with cancer that has been identified as an indicator of increased mortality and morbidity in cancer patients. The purpose of this study was to determinate the relationship of body mass index with severity of fatigue and quality of life in cancer patients undergoing chemotherapy.Methods and Materials: This study was a descriptive correlational study which utilized a purposeful sampling to select one hundred and twenty one outpatients with cancer. Data were collected by face-to-face interview using a questionnaire. The severity of fatigue and quality of life were respectively measured by fatigue severity scale and quality o life scale (EORTC QLQ-0).The analysis of data was carried out using Paired t-test. The findings showed a significant difference between mean of fatigue severity (P<0.00), quality of life (P<0.0) and BMI (p<0.00) before and after three cycles of chemotherapy. Also the scores of fatigue severity (P<0.008), quality of life (P<0.00) were significantly different during the three cycles of chemotherapy. In cancer patients undergoing chemotherapy weight loss leads to increased severity of fatigue and impaired quality of life. The nurses could help to reduce severity of fatigue and improve quality of life by appropriate interventions such as patient's self care education and also careful monitoring of patient's nutritional status.