Effects of a Self-Management Short Course Instruction on Glycemic Control in Adults with Diabetes Mellitus

Background: Education is an integral part of the treatment in diabetes mellitus. Attendance at long courses might not be convenient for many patients. Objectives: The current study was conducted to evaluate the effectiveness of self-management, short course instruction on glycemic control in adults with diabetes mellitus. Patients and Methods: A total of 60 patients with diabetes mellitus were randomly allocated into intervention (n = 30) and control (n = 30) groups. Fasting blood sugar (FBS) and blood sugar (BS) (5pm) tests were conducted. The intervention group received instructionabout self-management in diabetes mellitus for two hours, during two sessions. They were followed-up for three months with telephone calls. Patients asked any questions they had during these calls. After three months the patients’ FBS and BS were recorded again. The same process took place in the control group without training. Independent sample t-test and chi-square tests were used to analyze data using SPSS version 16.0. Results: The sample included 60 patients with a mean age of 46 ± 2.14 years. The FBS dropped from 151 mg/dL to 110 mg/dL in the intervention group (P = 0.02). While it increased from 146 mg/dL to 150 mg/dL in the control group. The BS also decreased from231 mg/dL to 196 in the intervention group. (P = 0.05), but it increased from 240 to 247 in the control group (P = 0.09). There was a significant difference in FBS and BS tests in the two groups after three months. (P = 0.002, P = 0.05), respectively. Conclusions: The results showed that a short course of instruction is effective in glycemic control. It is suggested that further research is conducted to evaluate the effectiveness of self-management long course instruction on glycemic control in adults with diabetes mellitus

Relationship of some risk factors and symptoms in patients with acute coronary syndrome

Acute coronary syndrome (ACS) is one of the major causes of death in the worldwide. Clinical manifestations are different. So it's necessary to have knowledge about the types of symptoms experienced by patients with ACS. This study was performed to assay the Relationship of some risk factors and symptoms in patients with acute coronary syndrome. This cross-sectional study, were studied 294 patients with acute coronary syndrome at least 24 hours after admission had survived. Data was collected by a questionnaire that included demographic data form and check list of some symptoms and history of risk factors. There was a significant relationship between STEMI with vomiting (OR=1.94) and anxiety (OR=1.83) and UA with vomiting (OR=0.42). Between sex with weakness (OR=2.29) and anxiety (OR=1.82), diabetes with dyspenea (OR=1.8), weakness (OR=1.02) and tinnitus (OR=2.06) and hyperlipidemia with weakness (OR=2.35) and tinnitus (OR=2.49) was available significant difference. The findings of this study indicate that the appearance of symptoms of acute coronary syndrome were different as for ECG changes and risk factors, and more focused on those symptoms that they are common with any other diseases. Since, many of the symptoms of acute coronary syndrome can be potentially dangerous and life threatening, accurate diagnosis and timely action is crucial for the patients

Comparison of Isolated Anterior Cruciate Ligament Tearing with Anterior Cruciate Ligament Tearing Associated with Displaced Lateral Femoral Condyle Fracture in Knee Arthrosis Formation

Abstract: Introduction: The etiology of posttraumatic arthritis has not been studied well. Although it has long been assumed that articular incongruity leads to post traumatic arthritis, clinical and basic sciences evidence to support such claim are not sufficient. On the other hand, the relationship of instability due to anterior cruciate ligament deficiency and Arthrosis has not been clearly defined and the relative importance of instability and incongruity is unknown. Method: ACL tearing were created in right knees of 9 rabbits (group A) and ACL tearing and displaced lateral condylar fracture with 1 mm step were created in another 9 rabbits (group B). After 6 months, osteoarthritis changes were compared between control knee and injured knee of each rabbit and between the two groups. Results: In both groups, osteoarthritis changes in injured knees were more comparing to the control knee and in whole osteoarthritis changes were significantly more in group B compared to group A. Conclusion: The unstable knee due to ACL deficiency goes toward osteoarthritis faster than normal knee. Incongruity in unstable joint increases intensity of osteoarthritis changes. It shows the importance of achieving anatomic reduction in intra articular fractures before ligament reconstruction. Keywords: Incongruity, Instability, Arthritis, Anterior cruciate ligamen

Interacting spin-2 fields in three dimensions

Using the frame formulation of multi-gravity in three dimensions, we show that demanding the presence of secondary constraints which remove the Boulware-Deser ghosts restricts the possible interaction terms of the theory and identifies invertible frame field combinations whose effective metric may consistently couple to matter. The resulting ghost-free theories can be represented by theory graphs which are trees. In the case of three frame fields, we explicitly show that the requirement of positive masses and energies for the bulk spin-2 modes in AdS$_3$ is consistent with a positive central charge for the putative dual CFT$_2$.Comment: 26 pages, 3 figures, v2: minor changes, matches published versio

A study on improving nursing clinical competencies in a surgical department: A participatory action research

Aims: The purpose of the present study was to improve clinical competencies in nursing staff in a selected surgical department in Kashan/Iran during 2016�2018. Design: This was a participatory action research. Methods: This action research was implemented in four steps of problem identification, planning, action and reflection. Interviews, focus groups and observation were used for the qualitative part. Conditions of Work Effectiveness Questionnaire-II, job satisfaction and patients' satisfaction questionnaires were completed before and after the study. Qualitative content analysis, paired and independent t test were used for data analysis. Results: Three main problems could affect the clinical competencies including professional insufficiency, basic shortages and external influences. Three changes were implemented in the surgical department including improving education, involving nursing students in patients' education and increasing the motivations by peer evaluation and selecting the nurse of the week. The changes significantly increased patients' satisfaction, nurses' job satisfaction and work effectiveness. © 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd