نشریه مراقبت امروز
پیاپی 10-11 (بهار و تابستان 1387)

Striae gravidarum is the most common change in connective tissue of pregnant women and may cause cosmetic concerns. This study was made to determine the effects of Saj cream on the occurrence of striae gravidarum in the second trimester of pregnancy. This study was carried out by random clinical experience method or control group method in the second trimester of pregnancy on 70 nulliparous women in their 18th-20th week of pregnancy presenting to health and treatment centers of Tehran. 30 subjects were studied within each group. In the intervention group the samples taking use of Saj Cream. In control group use no substance for the treatment. Personal particulars questionnaires were completed early in the study in the form of interviews and the same were completed for each study subject after observation by researcher. Data analysis was made by taking use of descriptive statistics and Chi-Square test. Striae had emerged among 16.7% of those using Saj cream and 56% of those in the control group. There was a significant difference between the intervention group and the control group (P<0.001). The findings of this study indicated that using Saj cream within a period from the beginning to the end of the second trimester in pregnancy had been effective in reduction of emergence of striae gravidarum. Suggestion is also given here that some studies must be made on the effects of the other herbal oils for preventing of striae.

Overweight and obesity is one of the major health problems among children and adolescents. 13-19 year olds are at higher risk of obesity in adulthood and physiological and internal problems. This study was done to determine the effect of habits and nutritional education on the knowledge of obese high school students and their parents in Khorramabad. In this quasi - experimental study, 152 obese students and their parents were selected from 12 high schools of Khorram Abad in 2006 which had been identified in the previous study, and they were randomly assigned to either the intervention or the control groups. The educational program consisted of nutritional education and modifying dietary habits were implemented by a skilled nurse through face-to-face method and an educational booklet. Students and parent's nutritional knowledge were evaluated with twelve 4-item questions (with 1.5 points given to each correct answer) before and after implementing the educational program. Knowledge scores of <7, 7-12, and 13-18 were considered poor, fair and good, respectively. The collected data were analyzed by T-test and Chi-square test. Difference in adolescent's dietary habits and nutritional knowledge between the two groups at the baseline was not statistically significant, but the difference in scores was statistically significant between the intervention and control group after the intervention (p = 0.003), so that good knowledge level was found to be more frequent in the case group (47.4%). Parent's dietary habits and nutritional knowledge was not statistically significant different between two groups at the baseline, but this difference was statistically significant after intervention (p = 0.046), so that good knowledge level was found to be more frequent in the case group (46.1%). The dietary habits and nutritional education is effective in enhancement of obese students and their parents Knowledge, and could change the condition of obese students and affect the view and behavior of them and their parents in the program of controlling the obesity.

Depression is the most prevalent mental disorder with the 4-20% prevalence during pregnancy. The evaluation of stress causing situations and social support and their relation with depression can be used as evidence for diagnosis of depression and cause to necessary background to preventive and effective work. The aim of this study was to assess the relation of depression during pregnancy with social support and negative life events. This is a cross sectional study that was carried out on a group of 200 pregnant women in Aran- Bidgol. The data collection instruments were demographic are, Beck inventory, Social support and Negative life events questionnaires. The data were analyzed with descriptive and analytical tests. The prevalence of depression was 41% Mild, moderate and severe levels were 27.5%, 11% and 2.5% respectively. There was a significant relation between depression and social support(r=-0.37, p<0.001) and negative life events(r=0.42, p<0.001).There was a significant difference in social support (p<0.05) and negative life events (p<0.05) between depressed and non depressed groups. With regard to the high prevalence of depression in this study in companion to some other studies in Iran and significant relation between depression during pregnancy and social support and negative life events, necessity of patient finding during pregnancy is suggested. Increase of social support and decrease of negative life events may be effective to prevention of depression during pregnancy.

Blood cultures are one of the most important laboratory tests in diagnosis serious infections. Like any other test false- positive results is a limitation to this method. Contaminated blood culture can cause diagnostic dilemmas for clinicians. The aim of this study was to evaluate the effect of teaching correct sampling method on decreasing contamination of blood culture of the patients who are admitted in Khorram abad’s Ayat-ollah Madani hospital. This study was a semi experiment trial which historical control group describes the differences between the blood samples withdrawal for blood culturing in the first half of 2007, which were collected only alcohol for disinfection the first half of the year 2008 with using alcohol-providone - iodine and needle replacements after proper staff training for contamination in blood culturing at the Ayatollah Madani Hospital's wards. Our results showed that, coagulase -negative staphylococci were the most common microorganisms blood culture contamination before (71.53%) and after (65.85%) of education, and (5.17%) contamination rate after education was significantly lower than before (14.97%) (p<0.001). The current study suggests that use of this method (alcohol - povidone-iodine and changed needle) reduces blood culture contamination and will lead to better isolation of microbial pathogens and consequently easier diagnosis and treatment.

Diabetes mellitus is a metabolic disorder also, is the most important endocrine disease, which leads to an increase in the rate of complications and mortality. Plant medicines (phytotherapies) have a long history as control and treatments for many diseases such as diabetes and up to now, more than 800 kinds of plant medicines have been used as blood glucose reducers. The World Health Organization has also recommended the use of safer and cheaper plants as an alternative to modern drugs for the control and treatment of diseases. In Iranian and some other country’s traditional medicine, the plant Citrullus colocynthis was used to treat many diseases such as diabetes. The aim of this study was to collect the enough scientific information about the effect of Citrullus colocynthis on control and treatment of diabetes mellitus. The methodology of this study was to search in the international and Iranian scientific sites such as pub med, Iran medex, www.inlm.org and Iranian traditional medicine books in order to collect enough scientific information about the diabetes mellitus and effect of Citrullus colocynthis on reduction of blood glucose and diabetes complications. Then, the results of 31 related papers and books were concluded as a review article. Many studies worldwide, Iran, Pakistan, Morocco, England, Nigeria, China, Egypt, India and Saudi Arabia, have indicated a significant antihyperglycemic effect with petroleum ether extract of Citrullus Colocynthis fruits. Results of these studies have shown that extract of this fruit can significantly reduce fasting blood glucose, glycosidase hemoglobin, and oxidative stress markers in laboratory animals and otherwise in patients. Also, following treatment of the diabetic rats with Citrullus colocynthis pulp extract, their livers showed an improvement in the histological architecture with persistence of the cytoplasmic vacuoles in some hepatocytes. According to results of many studies that reviewed, it can be concluded that oral administration of Citrullus Colocynthis extract might reduced blood glucose and improve hepatic functions.

Ostomy surgery is done, sometimes for patient survival and sometimes to improve his quality of life. In both cases, patients are faced with great stress. This study was done to assess quality of life in Ostomy patients. In this cross sectional- descriptive study, 300 patients with ostomy were selected by conveince sampling from Sanandaj teaching hospitals. Data were investigated by using of Standard questionnaire ostomy Patients quality of life index)SQLI) Patrick, Alexia and Bernard in seven dimension: sexual concern, nutrition, mental, physical and social health, body image and pain. Data analysis was performed and frequency distribution tables, calculating mean and standard deviation, pearson correlation and unilateral variance a analysis. In this study the mean score patients’ quality of life was relatively good (15.43). The lowest mean score of quality of life was dedicated in dimensions of sexual concern and physical health (5.67, 8.67) and the highest mean score of quality of life in dimensions of pain and body image (20, 25).There was a Significant correlation between quality of life and age, (p> 0.005), education (p> 0.01), after surgery treatment type (p> 0.04) and ostomy type (p> 0.01). In this study there was a significant relationship between quality of life and some variables such as age, education, after surgery treatment type and ostomy type. According to this results nurses in evaluating quality of life should consider profile as the unique and by identify groups with high risk in physical health and sexual concerns dimensions of quality of life, prevent isolation from in this group of patients in the community.

The importance of quick access to emergency medical system by telephone is obvious. This is obtained in our country by dialing 115. However, studies show an insufficient use of it in the urgency time and this study was planned to evaluate the use of the emergency medical services in patients suffering from heart attack. In this descriptive-cross sectional study 300 suspected heart attack patients were selected by continuity method, from hospitals related to Iran University of medical sciences. A two part questionnaire was employed for data collection, part A related collection demographic characteristics and part B related to the frequency of the heart attack patients using of the 115 emergency system. Validity by content validity and reliability by test re test(r=0/75) were done. The questionnaire was completed by the self reporting method. Then the collected data were analyzed by using descriptive statistics as well as analytical statistics, such as qui square test. The research findings showed that 70% of the cases were transmitted to cure centers by their private cars, 17% transmitted by taxi and only 13% of heart attack patient, called the emergency medical service. 59% of cases who called the emergency medical service were female with 25 years mean age. There was no correlative between level of education, age and sex of the patients. who suffering from heart attack and the using rate of calling the emergency medical service. The results of this study clearly indicate that the rate of calling the emergency medical services is very low that through training plan to target patients, families and health professionals the rate of using the emergency medical services can be elevated.

Hand scrub is used preoperative and invasive procedures. It is the most important way for preventing of surgical wound infection. But the frequent use of scrub contributes to skin problems, colonization by bacteria and change in normal flora presented on health care workers hands. That will increase rate of infection. The aim of this study was to determine surgical hand scrub duration on microorganism growth in operation room. This is a quasi experimental research. Sample consisted of 38 male and female fifth semesters and up baccalaureate nursing students that have been selected by simple sampling method. Al participants scrubbed for two minutes in the one stage and five minutes in the second stage. Then after scrubbing microbial specimens were collected immediately and one hour after scrub of their dominated hand. The instrument was a questionnaire and a data sheet for recording results of microbial cultures. The analytical methods Frequency, Means, Standard deviation, Chi –square, Fisher exact and Paired T- test. There was a statistically significant difference between means of colonies count immediate and one hour after two minutes scrub and five minute. Surgical hand times (p<0.01). But no significant difference were found between means difference variation colonies count after two and five minutes surgical hand scrub (p>0.05). The findings indicate that two minutes surgical hand scrub is as effective as five minutes surgical hand scrub. So, two minutes scrub based on clinical usefulness is more effective than five minutes scrub.