Comparison of the Effects of Cold Compress and Xyla-P Cream on Stress Caused by Venipuncture among Hemodialysis Patients

Background: Stress caused by the insertion of the needle into the arteriovenous fistula is one of the main concerns of hemodialysis patients. Reducing the stress of patients during venipuncture is one of the main goals of nursing care.This study aimed to investigate and compare the effects of Xyla-P cream and cold compress on the severity of stress caused by venipuncture in hemodialysis patients.Methods: This clinical trial was conducted in 50 patients undergoing hemodialysis who were enrolled in the study using simple random sampling.The severity of stress was measured during two successivehemodialysis sessions in three stages including after the application of a placebo, Xyla-P cream, and cold compress. The visual analog scale was used to measure the severity of stress. The data collector and data analyzer were blinded. The collected data were analyzed using analysis of variance with repeated measures.Results: The stress scores were significantly different between the placebo group (6.69±1.66)and Xyla-P cream group (5.43±1.42)(P=0.000) and cold compress group (5.05±1.40)(P=0.000), and between Xyla-P cream group and cold compress group (P=0.026). Conclusions: Cold compress is more effective than Xyla-P cream in reducing the stress. Therefore, nurses are recommended to use this method, instead of medications, for reducing the stress.Conclusions: Cold compress is more effective than Xyla-P cream in reducing the stress. Therefore, nurses are recommended to use this method, instead of medications, for reducing the stress

Comparison of the Effects of Cold Compress and Xyla-P Cream on Stress Caused by Venipuncture among Hemodialysis Patients

Background: Stress caused by the insertion of the needle into the arteriovenous fistula is one of the main concerns of hemodialysis patients. Reducing the stress of patients during venipuncture is one of the main goals of nursing care.This study aimed to investigate and compare the effects of Xyla-P cream and cold compress on the severity of stress caused by venipuncture in hemodialysis patients.Methods: This clinical trial was conducted in 50 patients undergoing hemodialysis who were enrolled in the study using simple random sampling.The severity of stress was measured during two successivehemodialysis sessions in three stages including after the application of a placebo, Xyla-P cream, and cold compress. The visual analog scale was used to measure the severity of stress. The data collector and data analyzer were blinded. The collected data were analyzed using analysis of variance with repeated measures.Results: The stress scores were significantly different between the placebo group (6.69±1.66)and Xyla-P cream group (5.43±1.42)(P=0.000) and cold compress group (5.05±1.40)(P=0.000), and between Xyla-P cream group and cold compress group (P=0.026). Conclusions: Cold compress is more effective than Xyla-P cream in reducing the stress. Therefore, nurses are recommended to use this method, instead of medications, for reducing the stress.Conclusions: Cold compress is more effective than Xyla-P cream in reducing the stress. Therefore, nurses are recommended to use this method, instead of medications, for reducing the stress

The Effect of Gradual Reduction in Sodium Dialysate on Occurrence of Muscular Cramp, and the Serum Level of Calcium and Magnesium in Patients Undergoing Hemodialysis: A Cross-Over Clinical Trial

Background: The aim of study was to determine the effect of gradual reduction in sodium dialysate on occurrence of muscular cramp, and the serum level of calcium and magnesium in patients undergoing hemodialysis. Methods: This triple-blinded cross-over clinical trial was conducted on 56 hemodialysis patients. After random allocation of patients into group A by the routine method (fixed sodium dialysate) and group B with gradual reduction in sodium dialysate, they underwent a 3-session dialysis. After one week of dialysis through routine method (wash out), patients underwent 3-session dialysis in group B by routine method and in group A by gradual reduction in sodium dialysate. Occurrence of muscular cramp was recorded by using a check list. Patients, serum level of calcium and magnesium before and after intervention was measured. Descriptive statistics indices and inferential statistics tests (repeated measures Analysis of variance) were used. Results: The rate of muscular cramp in routine method was 3.8% in one muscle, 1.9% in two or more muscles, and in the method of gradual reduction of sodium dialysate was 1.9% in one muscle, and 7.5% in two or more muscles. The mean difference of plasma calcium and magnesium before and after the dialysis with routine method was 0.43 and 0.26, respectively, and in the method of gradual reduction of sodium dialysate was 0.45 and 0.34. In this study no significant difference was observed for the rate of occurrence of muscular cramp and serum level of calcium and magnesium between two methods. Conclusions: The results showed that gradual reduction of sodium dialysate, has no effect on occurrence of muscular cramp during dialysis, serum level of calcium and magnesium in hemodialysis patients. Further investigations are needed to better understand the exact effect of this method, and also eliminate the study limitations. Keywords: Calcium, Hemodialysis, Magnesium, Muscle cramp, Sodium dialysate

The Effect of Zinc Sulfate on Malnutrition in Hemodialysis Patients

Background: Malnutrition is common in hemodialysis patients and it must be controlled quickly. This study aimed to investigate the effect of zinc sulfate on malnutrition in dialysis patients. Methods: This study was a randomized controlled trial on 84 hemodialysis patients referred to Imam Hossain Hospital in Shahroud (northeastern of Iran). Patients were randomly divided into two case and control groups. For the intervention group, one tablet of zinc sulfate 220 mg was administered daily for 8 weeks. Both groups were subjected to standard dialysis three times in the week and all patients were assessed for malnutrition using a standard questionnaire, lab tests, and necessary examinations in the first stage, one month and two months after the treatment.   Results: Of 84 patients, 39 cases (46.4%) were female and rest was male. The mean age of the patients was 59.1±27.2 years. The mean total duration of dialysis was 2.9±2.3 years. The severity and extent of malnutrition at the beginning and one month after the study did not differ between the two groups, but after the second month, there was a significant decrease of malnutrition in the intervention group (Pvalue=0.015). Also, malnutrition variables were significantly associated with BMI less than 18 kg/m2 (Pvalue<0.039), and serum creatinine less than 3 mg/dl (Pvalue<0.011) and hemoglobin less than 11 g/dl (Pvalue<0.001), Conclusions: The results of this study showed that zinc sulfate consumption for at least 2 months could significantly reduce the severity of malnutrition in hemodialysis patients. Keywords: Malnutrition, Zinc sulfate, Hemodialysis

The Effect of Zinc Sulfate on Malnutrition in Hemodialysis Patients

Background: Malnutrition is common in hemodialysis patients and it must be controlled quickly. This study aimed to investigate the effect of zinc sulfate on malnutrition in dialysis patients. Methods: This study was a randomized controlled trial on 84 hemodialysis patients referred to Imam Hossain Hospital in Shahroud (northeastern of Iran). Patients were randomly divided into two case and control groups. For the intervention group, one tablet of zinc sulfate 220 mg was administered daily for 8 weeks. Both groups were subjected to standard dialysis three times in the week and all patients were assessed for malnutrition using a standard questionnaire, lab tests, and necessary examinations in the first stage, one month and two months after the treatment.   Results: Of 84 patients, 39 cases (46.4%) were female and rest was male. The mean age of the patients was 59.1±27.2 years. The mean total duration of dialysis was 2.9±2.3 years. The severity and extent of malnutrition at the beginning and one month after the study did not differ between the two groups, but after the second month, there was a significant decrease of malnutrition in the intervention group (Pvalue=0.015). Also, malnutrition variables were significantly associated with BMI less than 18 kg/m2 (Pvalue<0.039), and serum creatinine less than 3 mg/dl (Pvalue<0.011) and hemoglobin less than 11 g/dl (Pvalue<0.001), Conclusions: The results of this study showed that zinc sulfate consumption for at least 2 months could significantly reduce the severity of malnutrition in hemodialysis patients. Keywords: Malnutrition, Zinc sulfate, Hemodialysis

The Relationship between Uric Acid and Blood Glucose in Diabetic Patients

Background: some studies have shown that there is a correlation between serum uric acid and blood glucose levels so that these changes are not exactly clear. This study was conducted to determine the relationship between uric acid and blood glucose in diabetic patients. Methods: This cross-sectional study was performed on 190 type 2 diabetic (DM) patients in Shahroud by convenience sampling method. FBS, uric acid, triglyceride, and total cholesterol under standard conditions were measured. Patients were divided into four groups in terms of uric acid level. Results: In this study, 53.7% of patients were male. The average age of cases was 58.3 ± 13.5 years. There was a significant difference in uric acid between age groups (Pvalue<0.023), educational levels (Pvalue<0.041), BMI (Pvalue<0.012) and cholesterol (Pvalue<0.002) groups. Also, there was a significant reverse relationship between mean FBS (Pvalue<0.001), blood glucose two hours after feeding (Pvalue<0.001), and HbA1c (Pvalue<0.02) with different levels of uric acid. Conclusions: The results showed that there was a significant and reversal relationship between the levels of uric acid and glucose levels. In order to control the level of uric acid, the level of glucose in these patients is also to be measured and controlled. Keywords: Diabetes mellitus, Blood glucose, Uric acid.   &nbsp

The Impact of the Gradual Reduction of Sodium Dialysis Fluid on Occurrence of the Hypotension and Plasma Sodium Level in Hemodialysis Patients

Background: Dialysis is the most common method of caring end-stage kidney disease, but it has some complications despite its several advantages. The aim of study was to investigate the impact of the gradual reduction of dialysate sodium on occurrence of the hypotension and plasma sodium in hemodialysis patients. Methods: 56 hemodialysis patients participated in this randomized triple-blind crossover clinical trial. The patients were randomly divided into two groups of A and B. The routine method (Sodium Dialysis Solution) was performed on Group A, whereas the gradual reduction of sodium dialysis fluid was given to Group B for three sessions. These dialysis methods were again implemented three sessions, after one week of routine dialysis (Wash Out).The routine method (Sodium Dialysis Solution) was performed on Group B, and the gradual reduction of sodium dialysis fluid was performed on Group A, for three sessions. Patients' blood pressure was measured three separate times: 15 minutes before dialysis, during dialysis (first, second, third and fourth hours of dialysis) and 15 minutes after of it. Moreover, Patients' sodium level was also measured before and after the intervention. In this way, the descriptive statistics and inferential statistics (repeated measure analysis of covariance) were utilized to implement data analysis. Results: in the case of routine method, the percentages of the prevalence of hypotension in above mentioned different hours were declared 6.2%, 26.6%, 44.5%, 32.8%, respectively. On the other hand, in the case of the gradual reduction of sodium dialysis fluid, these corresponding percentages were  cleared 2.3%, 1.7%, 5.31%, 44.46%, respectively. The mean differences of plasma sodium before and after dialysis in the mentioned methods were obtained as 0.58 in the case of routine method, whereas it is 2.36 in the case of gradual reduction of sodium dialysis fluid method. In this research, there was no significant difference between the rate of hypotension and plasma sodium in the gradual reduction of sodium dialysis fluid by the routine method under 80% powers. Conclusions: The experimental results revealed that a gradual reduction of the sodium dialysis fluid did not play a significant role in the reduction of blood pressure during dialysis and plasma sodium in hemodialysis patients. However, either confirmation or rejection of this issue will require further studies and resolving the limitations.  Keywords: Sodium Dialysis Fluid, Hypotension, Plasma Sodium, Hemodialysis

The Impact of the Gradual Reduction of Sodium Dialysis Fluid on Occurrence of the Hypotension and Plasma Sodium Level in Hemodialysis Patients

Background: Dialysis is the most common method of caring end-stage kidney disease, but it has some complications despite its several advantages. The aim of study was to investigate the impact of the gradual reduction of dialysate sodium on occurrence of the hypotension and plasma sodium in hemodialysis patients. Methods: 56 hemodialysis patients participated in this randomized triple-blind crossover clinical trial. The patients were randomly divided into two groups of A and B. The routine method (Sodium Dialysis Solution) was performed on Group A, whereas the gradual reduction of sodium dialysis fluid was given to Group B for three sessions. These dialysis methods were again implemented three sessions, after one week of routine dialysis (Wash Out).The routine method (Sodium Dialysis Solution) was performed on Group B, and the gradual reduction of sodium dialysis fluid was performed on Group A, for three sessions. Patients' blood pressure was measured three separate times: 15 minutes before dialysis, during dialysis (first, second, third and fourth hours of dialysis) and 15 minutes after of it. Moreover, Patients' sodium level was also measured before and after the intervention. In this way, the descriptive statistics and inferential statistics (repeated measure analysis of covariance) were utilized to implement data analysis. Results: in the case of routine method, the percentages of the prevalence of hypotension in above mentioned different hours were declared 6.2%, 26.6%, 44.5%, 32.8%, respectively. On the other hand, in the case of the gradual reduction of sodium dialysis fluid, these corresponding percentages were  cleared 2.3%, 1.7%, 5.31%, 44.46%, respectively. The mean differences of plasma sodium before and after dialysis in the mentioned methods were obtained as 0.58 in the case of routine method, whereas it is 2.36 in the case of gradual reduction of sodium dialysis fluid method. In this research, there was no significant difference between the rate of hypotension and plasma sodium in the gradual reduction of sodium dialysis fluid by the routine method under 80% powers. Conclusions: The experimental results revealed that a gradual reduction of the sodium dialysis fluid did not play a significant role in the reduction of blood pressure during dialysis and plasma sodium in hemodialysis patients. However, either confirmation or rejection of this issue will require further studies and resolving the limitations.  Keywords: Sodium Dialysis Fluid, Hypotension, Plasma Sodium, Hemodialysis

The Effect of Gradual Reduction in Sodium Dialysate on Occurrence of Muscular Cramp, and the Serum Level of Calcium and Magnesium in Patients Undergoing Hemodialysis: A Cross-Over Clinical Trial: The effect of gradual reduction in sodium dialysate on occurrence of muscular cramp

Background: The aim of study was to determine the effect of gradual reduction in sodium dialysate on occurrence of muscular cramp, and the serum level of calcium and magnesium in patients undergoing hemodialysis. Methods: This triple-blinded cross-over clinical trial was conducted on 56 hemodialysis patients. After random allocation of patients into group A by the routine method (fixed sodium dialysate) and group B with gradual reduction in sodium dialysate, they underwent a 3-session dialysis. After one week of dialysis through routine method (wash out), patients underwent 3-session dialysis in group B by routine method and in group A by gradual reduction in sodium dialysate. Occurrence of muscular cramp was recorded by using a check list. Patients, serum level of calcium and magnesium before and after intervention was measured. Descriptive statistics indices and inferential statistics tests (repeated measures Analysis of variance) were used. Results: The rate of muscular cramp in routine method was 3.8% in one muscle, 1.9% in two or more muscles, and in the method of gradual reduction of sodium dialysate was 1.9% in one muscle, and 7.5% in two or more muscles. The mean difference of plasma calcium and magnesium before and after the dialysis with routine method was 0.43 and 0.26, respectively, and in the method of gradual reduction of sodium dialysate was 0.45 and 0.34. In this study no significant difference was observed for the rate of occurrence of muscular cramp and serum level of calcium and magnesium between two methods. Conclusions: The results showed that gradual reduction of sodium dialysate, has no effect on occurrence of muscular cramp during dialysis, serum level of calcium and magnesium in hemodialysis patients. Further investigations are needed to better understand the exact effect of this method, and also eliminate the study limitations. Keywords: Calcium, Hemodialysis, Magnesium, Muscle cramp, Sodium dialysate

The The Relationship between Uric Acid and Blood Glucose in Diabetic Patients

Background: some studies have shown that there is a correlation between serum uric acid and blood glucose levels so that these changes are not exactly clear. This study was conducted to determine the relationship between uric acid and blood glucose in diabetic patients. Methods: This cross-sectional study was performed on 190 type 2 diabetic (DM) patients in Shahroud by convenience sampling method. FBS, uric acid, triglyceride, and total cholesterol under standard conditions were measured. Patients were divided into four groups in terms of uric acid level. Results: In this study, 53.7% of patients were male. The average age of cases was 58.3 ± 13.5 years. There was a significant difference in uric acid between age groups (Pvalue<0.023), educational levels (Pvalue<0.041), BMI (Pvalue<0.012) and cholesterol (Pvalue<0.002) groups. Also, there was a significant reverse relationship between mean FBS (Pvalue<0.001), blood glucose two hours after feeding (Pvalue<0.001), and HbA1c (Pvalue<0.02) with different levels of uric acid. Conclusions: The results showed that there was a significant and reversal relationship between the levels of uric acid and glucose levels. In order to control the level of uric acid, the level of glucose in these patients is also to be measured and controlled. Keywords: Diabetes mellitus, Blood glucose, Uric acid.   &nbsp