Journal of Kermanshah University of Medical Sciences
Volume:18 Issue: 4, 2014

Current therapies for diabetic neuropathy have not been satisfactory despite the frequent attempts made and various medications introduced. Given the lower level of vitamin D in diabetic patients than in normal population, the present study evaluated the role of vitamin D in the treatment of diabetic neuropathy. A total of 90 type II diabetic patients with a history of neuropathy for at least one month based on Toronto clinical score system and low level of vitamin D, who had referred to Kermanshah Diabetes Research Center, Iran, were included in this clinical study. The patients underwent treatment with 50000 U vitamin D for three months, once per week. The level of vitamin D, HbA1C and the score of neuropathy were measured before and after three months treatment and the results were analyzed. After treatment, vitamin D level significantly increased which was favorable in 85% of the patients. Also, neuropathy level decreased from 9.5±2.5 (before treatment) to 7.0±2.5 (after treatment), which was statistically significant. Moreover, the HbA1C level significantly decreased from 8.6±1.6 to 7.4±1.4. However, no significant correlation was reported between neuropathy level reduction, changes of vitamin D level and HBA1C level. The results of the current study indicated that vitamin D has no therapeutic effect on diabetic neuropathy and increase of pain threshold level may be non-specifically due to the placebo effect of vitamin D.

Ethical leadership appeared as a new approach in the leadership perspective and provided the ground for promoting individual and organizational efficiency by giving priorities to ethics in organizations. In this regard, the present study was conducted with the aim of modeling the relations of ethical leadership and clinical governance with psychological empowerment among nurses of public hospitals in Kermanshah in 2014. the research method was descriptive survey. The study sample consisted of all nurses (n=550) working in public hospitals of Kermanshah University of Medical Science for whom 163 nurses were selected using simple random sampling. The tools for data collection were ethical leadership, clinical governance and psychology empowerment questionnaires whose validity and reliability were confirmed. The structural equation modeling was used to analyze the data. The results showed a significant relationship between ethical leadership and clinical governance (P<0.01) and psychological empowerment (P<0.01). Moreover, there was a significant correlation between clinical governance and psychological empowerment (P<0.05). Based on the results of the research, ethical leadership directly and through clinical governance affected the nurses’ psychological empowerment (P<0.05). reliance on ethics and ethical leadership in hospitals, in addition to providing the space and ground for improving the effectiveness of clinical governance approach, can promote the feeling of psychological empowerment in nurses. Accordingly, the ethical issues are required to be taken into consideration in hospitals.

Low adherence to the treatment regimen in tuberculosis patients has been recognized as a major threat for tuberculosis (TB) control program. Thus, the present study was conducted to assess the factors affecting adherence to the treatment regimen of TB patients via Health Belief Model (HBM). In this cross-sectional study,110 tuberculosis patients attending anti-TB center in Zabol were selected and included in the study using census method. Data were collected using Health Belief Model (HBM) questionnaire and reviewing the patient's medical files. The collected data were analyzed by SPSS software using t-test, ANOVA and multiple regression analysis with 95 % confidence level. The mean age of the participants was 55.7±18.6 years. 89% of the patients had pulmonary tuberculosis and 11% had extra-pulmonary tuberculosis. The multiple regression analysis showed knowledge, self-efficacy, perceived benefits and perceived threat were significant predictors of adherence to the treatment regimen. The HBM constructs accounted for 29% of the variance observed in adherence to the treatment regimen. The findings of the study highlight the need to increase awareness and change the patients’ beliefs about the risks of low adherence to the treatment regimen in patients.

Bed sore is a major problem for inpatients in the hospital. This study was aimed to determine the predictive factors of bedsore in Intensive Care Unit (ICU). A descriptive – analytical study was conducted on 673 Intensive Care Unit (ICU) inpatients of 6 selected hospitals in a period of 6 months in Guilan. The participants were selected via simple random sampling. Data were collected by the Braden Scale whose reliability and validity had breen confirmed in previous studies. Data were fed into SPSS software and analyzed using t-test, chi-square and Logistic regression. The mean age of the subjects was 45.35±16.7. Incidence of bedsore was 3.6%. Dietary patterns, wear and tension were identified as predictors of bed sore after adjustment of odds ratio. We can properly manage the bed sore and its complications, in addition to predicting the parameters of the given model, through attention to proper nutrition, stretching the muscles and tissues of the patients in ICU. Retraining the personnel of the intensive care unit and training the patients are recommended.

Quality of life is a complex multi-dimensional concept influenced by factors such as time, location and personal and social values. Quality of life for chronic patients is related to their individual characteristics and adaptation skills in different situations. This study was conducted to compare the quality of life in patients undergoing coronary artery bypass surgery in the rural and urban communities. A cross-sectional analytical study was conducted using Mac New questionnaire (specific to patients with heart disease). The quality of life in 126 patients after coronary artery bypass graft surgery (CABG) (56 rural patients and 70 urban patients) was compared by independent t-test. the mean scores for quality of life in urban and rural patients were 64.01±1.72 and 76.17±11.3, respectively, which showed a statistically significant difference (P<0.001). Also, there was a significant difference between groups in terms of the physical domain (P<0.001), social domain (P<0.001) and emotional domain (P<0.03), more favorable, however, in rural patients. the individuals’ environment and its components have impact on their quality of life after CABG. The rural people’s lifestyle and activity can be a good example for urban patients.

Detection of various environmental allergens is the major challenge in allergic diseases and the only treatment is avoiding these allergens. The aim of this study was to determine the prevalence of food and airborne allergens in allergic patients using Skin Prick Test (SPT). A cross-sectional study was done on clinically confirmed patients of atopic-dermatitis (n=54), allergenic-rhinitis (n=64) and chronic-urticaria (n=39) who referred to asthma and allergy clinic at Afzali-Pour hospital in Kerman during 2008-2010. Skin prick test was done using allergen extracts to determine the patient's sensitivity to food and airborne antigens. Fifty-nine percent of patients responded to at least one allergen. Allergy to airborne and food allergens was 55.9 % and 21.7%, respectively. Chenopodiaceae (22.9%) and egg white (10.2%) were most prevalent airborne and food allergens. Allergy to cockroach, egg white, egg yolk and tomato was significantly higher in males than in females (P<0.05). The results indicated that allergy to food and airborne allergens is different depending on the nutrition and environmental conditions.

Metabolic syndrome (MetS) is a complex of risk factors which increase the risk of cardiovascular diseases, type 2 diabetes, morbidity and mortality in people. The aim of this study was to analyze the prevalence of MetS in Iran using a meta-analysis study. The SID, Magiran, Irandoc, Medlib, Google Scholar and PubMed databases were searched for MetS prevalence. 26 articles conducted between 2003 and 2013 in Iran were selected and the obtained data were analyzed by a meta-analysis using random-effects model. Heterogeneity was assessed using I2 statistics. Data were analyzed by R software and STATA (Ver. 11.2). The total sample size was 60635 people with the age range of 3-90 years. The metabolic syndrome prevalence based on IDF definition was 36% (95% CI: 0.32-0.40) and based to ATPIII was 27% (95% CI: 0.22-0.32). Based on IDF definition, the MetS prevalence rates in women and men were0.39 (95% CI: 0.19-0.59) and 0.20 (95% CI: 0.10-0.29), respectively. The findings showed a high prevalence of metabolic syndrome in Iran, especially in women, which increases with age in both sexes. Health care providers and policy makers need to find solutions to reduce MetS risk in the society.

The purpose of this cross-sectional study was to assess the urology patient's perspective about the patient privacy "Importance" and "Compliance". 210 patients were selected by cluster random sampling method. The tool for data collection was an 18-item questionnaire about the patient privacy that was completed through interview. The validity and reliability of the questionnaire were calculated by content validity and Cronbach's alpha. From the viewpoint of the patients, immediate treatment action (100%), providing a clean and safe environment (100%) and covering non-essential areas (93%) were the most important elements, respectively. The patient's privacy "Compliance" was observed only in 34% of patients. The patient privacy compliance is very low; therefore, it needs to be taken into account more seriously.