Perspectives of cardiac care unit nursing staff about developing hospice services in Iran for terminally ill cardiovascular patients: A qualitative study

Introduction: The present study was conducted aiming to determine the points of view of cardiac care units' nursing staff about designing and providing Hospice services in Iran for cardiovascular patients in the final stages of life. Materials and Methods: In this qualitative study, the perspectives of 16 Cardiac Care Unit (CCU) nurses selected purposefully among hospitals of Tabriz-Iran University of Medical Sciences were investigated using semi-structured interviews and were analyzed in content analysis method. Results: 33 themes were finally extracted. Some nurses were for and some were against designing and providing Hospice services in Iran. The main reasons identified for supporting this plan included: Possibility of designing and providing these services consistent with high ethical values of Iranian society; approval of authorities due to increasing the load of chronic diseases and aged population; need of families due to the problems in taking care of patients and life concerns; better pain relief and respectful death; decrease of costs as a result of lower usage of diagnostic-therapeutic services, less use of expensive facilities and drugs, and better usage of hospital beds. Conclusion: Growing load of chronic diseases has made the need for Hospice as a necessary issue in Iran. In order to provide these services, studying the viewpoints of health service providers is inevitable. Therefore using and applying the results of this study in planning and policy making about designing and providing these services in Iran for cardiovascular patients in their final stages of lives could be helpful. © 2015, Medknow Publications. All rights reserved

Cardiovascular patients� experiences of living with pacemaker: Qualitative study

BACKGROUND: A pacemaker implantation is considered major life event for cardiovascular patients, so they will probably have very interesting experiences of living with this device. The aim of this study was to explore the experiences of cardiovascular patients living with the pacemaker. METHODS: In this qualitative study, 27 patients were chosen through purposive sampling to achieve data saturation, and their experiences were examined using semi-structured interviews. The patients� statements were recorded with their consent and analyzed using content analysis method. RESULTS: Participants� experiences included three main themes: �Problems and limitations,� �feeling and dealing with pacemaker�, and �sources of comfort� and 10 sub-themes including: physical problems, financial problems, social problems, the first encounter, the feeling of living with the pacemaker, how to cope with pacemaker, satisfaction with pacemaker, good family support, hospital and hospital staff performance, and role of religious beliefs. CONCLUSION: Planning to solve social problems, identifying and changing feelings of patients using pacemakers, reinforcing the resources of comfort especially family support seem to be necessary steps for improving quality of life and impact of using pacemaker. © 2015 Isfahan University of Medical Sciences(IUMS). All rights reserved

Perspectives of faculty members toward Iranian National Olympiad for medical students: A qualitative study

Objective - Regarding to the status of medical science Olympiads in medical science pedagogy, the views of beneficiaries are needed to be examined on them, in particular, faculty members who are the most interested group in the given issue. As such, the purpose of this study is the evaluation of views of the faculty members on the mission and performance of medical science Olympiads in Iran. Material and Methods - The data for this qualitative study were collected through semi-structured interviews and then were analyzed using the content-analysis method. Finally, 95 members of faculty board were selected from universities of medical sciences in Iran and data collection continued till data saturation. Results - Four themes including: points of strength in Olympiads, points of weakness in Olympiads, attitudes of faculty members to Olympiads, and suggestions for better performance of the Olympiads were extracted. The points of strength consisted of: mission, the performing procedures, and the scientific level of the competitions. The points of weakness included: mission, the performing procedures, and the scientific level of the competitions. Most of the participants (79) had positive attitude toward the Olympiads. Participants presented 8 strategies in order to manage the competitions better. Conclusion - It necessary to do more researches to identify the related problems and to use the required. Applying instructor's points and views on the strengths, weakness, and suggestions can be efficient in policy making, designing and performing medical Olympiads. © 2016, Azami-Aghdash S., Ghojazadeh M., Nazavar R., Yaghoubi S., Vahedi L

Breast cancer screening barriers from the womans perspective: A meta-synthesis

Background: The principal aim of health service providers in the field of breast cancer is to detect and treat lesions at an appropriate time. Therefore, identification of barriers to screening can be very helpful. The present study aimed to systematically review the qualitative studies for extracting and reporting the barriers of screening for breast cancer from the womans perspective. Materials and Methods: In this systematic review; Pubmed, Google Scholar, Ovid Scopus, Cochrane Library, Iranmedex, and SID were searched using the keywords: screening barriers, cancer, qualitative studies, breast and their Persian equivalents, and the needed data were extracted and analyzed using an extraction table. To assess the quality of the studies, the Critical Appraisal Skills Programme (CASP) tool was used. Results: From 2,134 related articles that were found, 21 articles were eventually included in the study. The most important barriers from the point of view of 1,084 women were lack of knowledge, access barriers (financial, geographical, cultural), fear (of results and pain), performance of service providers, women's beliefs, procrastination of screening, embarrassment, long wait for getting an appointment, language problems, and previous negative experiences. Articles' assessment score was 68.9. Conclusions: Increasing women's knowledge, reducing the costs of screening services, cultural promotion for screening, presenting less painful methods, changing beliefs of health service providers, provision of privacy for giving service, decreasing the waiting time, and providing high quality services in a respectful manner can be effective ways to increase breast cancer screening

Complications and carcinogenic effects of mustard gas - A systematic review and meta-analysis in Iran

Background: Catastrophic effects of mustard gas as a chemical warfare agent have always been a major problem for those exposed to this agent. In this meta-analysis it was tried to evaluate carcinogenesis, ocular, cutaneous and respiratory complications of mustard gas exposure among Iranians who had been exposed to this agent during the Iran-Iraq war. Materials and Methods: In this meta-analysis, the required data were collected using keywords "mustard gas", "sulfur mustard", "cancer", "neoplasm", "respiratory complications", "ocular complications", "lung disease", "chronic complication", "eye", "skin", "cutaneous complication", "carcinogenesis" and their combination with keywords "Iran", "Iranian", "prevalence", "mortality" and their Farsi equivalent terms from the databases of SID, Iranmedex, Magiran, Pubmed, Science Direct, Google Search engine, Gray Literature and Reference of References. To determine the prevalence of each complication and perform meta-analysis, CMA: 2 (Comprehensive Meta-Analysis) software with a randomized model was used. Results: Of the 542 articles found, 7 national articles, consistent with the aims of this study were selected. Metaanalysis of seven papers revealed that cancer risk, especially cancer of the respiratory system was elevated, so that the relative risk (RR) of cancer role of mustard gas was inconsistent from 2/1 to 4 in this survey. Also prevalence of delayed skin disorders due to sulfur mustard was 94.6, pulmonary complications 94.5 and ocular complications 89.9. The incidence of various cancers in victims exposed to mustard gas was 1.7 worldwide where the rate was 2.2 in Iranian victims of the Iraq-Iran war. Conclusions: Based on present study the prevalence of delayed mustard gas related cutaneous, pulmonary and ocular complications is above 90 and risk of carcinogenesis is higher in comparison to worldwide statistics. This may suggest need for long-term and persistent follow-up and rehabilitation procedures es for populations exposed to this agent

Epidemiology of oral cancer in Iran: A systematic review

Background: Oral cancer stands among the 10 top causes of cancer death in the world. Considering the role of epidemiologic information on planning and effective interventions, the present study aimed to investigate the epidemiology of oral cancer in Iran. Materials and Methods: The required information for this systematic review study was obtained from PubMed, Google Scholar, CINAHL,SID, Medlib, Magiran and Iranmedex databases, using key words "cancer", "oral cancer", "squamous cell carcinoma", "oral cavity carcinoma" and their Persian equivalents in combination with keywords of epidemiology, prevalence, etiology, frequency, and Iran from 1990 to 2014. From 1,065 related studies found, finally 25 were included to the study. Results: The mean age of 8,248 patients in 25 studies was 54.0±15.1 years. The male/female ratio for oral cancer was 1.91. Tongue with average percentage of 29.9 was the most involved site. Regarding microscopic grade, 65.7 of cases were grade 1. SCCs, accounting for an average of 70.0, was the most common among all types of oral cancer. In the majority of studies, smoking including cigarette, hookah, and tobacco consumption was found to be a risk factor. Conclusions: The epidemiological pattern of oral cancer in Iran is somewhat similar to that of other countries. Yet the information on hand in this field is limited and considering the role of epidemiological data we suggest conducting more accurate studies to catch data that is required for effective programs and interventions

Prevalence, risk factors, and outcome of myocardial infarction with angiographically normal and near-normal coronary arteries: A systematic review and meta-analysis

Context: Coronary artery diseases are mostly detected using angiographic methods demonstrating arteries status. Nevertheless, Myocardial Infarction (MI) may occur in the presence of angiographically normal coronary arteries. Therefore, this study aimed to investigate the prevalence of MI with normal angiography and its possible etiologies in a systematic review. Evidence Acquisition: In this meta-analysis, the required data were collected from PubMed, Science Direct, Google Scholar, Scopus, Magiran, Scientific Information Database, and Medlib databases using the following keywords: �coronary angiograph�, �normal coronary arteries�, �near-normal coronary arteries�, �heart diseases�, �coronary artery disease�, �coronary disease�, �cardiac troponin I�, �Myocardial infarction�, �risk factor�, �prevalence�, �outcome�, and their Persian equivalents. Then, Comprehensive Meta-Analysis software, version 2 using randomized model was employed to determine the prevalence of each complication and perform the meta-analysis. P values less than 0.05 were considered to be statistically significant. Results: Totally, 20 studies including 139957 patients were entered into the analysis. The patients� mean age was 47.62 � 6.63 years and 64.4 of the patients were male. The prevalence of MI with normal or near-normal coronary arteries was 3.5 (CI = 95, min = 2.2, and max = 5.7). Additionally, smoking and family history of cardiovascular diseases were the most important risk factors. The results showed no significant difference between MIs with normal angiography and 1- or 2-vessel involvement regarding the frequency of major adverse cardiac events (5.4 vs. 7.3, P = 0.32). However, a significant difference was found between the patients with normal angiography and those with 3-vessel involvement in this regard (5.4 vs. 20.2, P < 0.001). Conclusions: Although angiographic studies are required to assess the underlying etiology of MI, physicians facing patients presenting with the clinical features of MI in presence of normal or near-normal coronary arteries should consider the prevalence and risk factors of MI with normal or near-normal coronary arteries. � 2016, Iranian Cardiovascular Research Journal. All rights reserved

Success rate of two different methods of ilioinguinal-iliohypogastric nerve block in children inguinal surgery

Background: The ilioinguinal-iliohypogastric (ILIH) nerve block is a safe, effective, and easy to perform in order to provide analgesia for a variety of inguinal surgical procedures in pediatric patients. A relatively high failure rate of 10%-25% has been reported, even in experienced hands. It is assumed that this high failure rate of the ILIH nerve block in this age group could be due to lack of special knowledge of the anatomy of these nerves in infants and neonates. There are two main techniques for landmark-based ILIH nerve block with regard to determining the best insertion point. This study compared the sucess rate and outcomes of these two techniques in children undergoing surgery in inguinal region. Patients and Methods: In a double-blind randomized clinical trial, 120 children were candidated for surgery in inguinal region, and ILIH nerve block was recruited in Tabriz Children Teaching Hospital in a 12-month period. They were randomly clustered in two groups and underwent two different methods of ILIH nerve block. In the fi rst group, needle was inserted in a point placed between outer 1/4 and inner 3/4 of a line connecting anterior-superior iliac spine to umbilicus (n = 58), and in the second group, this point was 1 cm medial and 1 cm superior to anterior-superior iliac spine. Block failure was defi ned as the need for analgesia during operation. Results: There were 50 males (86.2%) and 8 females (13.8%) with a mean age of 5.55 ± 2.32 (3-11) years in the fi rst group and 48 males (87.3%) and 7 females (12.7%) with a mean age of 5.32 ± 2.18 (3-11) years in the second group (P &gt; 0.05). The success rate of ILIH block was 94.8% in the fi rst group and 94.5% in the second group with no signifi cant difference between the two groups (P = 0.64). Changes of vital signs including heart rate, systolic blood pressure, and diastolic blood pressure, as well as the SPO2 were not signifi cantly different between the two groups during the study period. Change of pain severity after recovery was also comparable between the two groups. Time of the fi rst dose of postoperative analgesic was not signifi cantly different between the two groups. Conclusion: Based on our fi ndings, success rate and outcomes of the two techniques of landmark-based ILIH block are similar in children undergoing surgery in inguinal area.Key words: Children, ilioinguinal-iliohypogastric nerve block technique, inguinal herni