Fall-Related Injuries in Community-Dwelling Older Adults in Qom Province, Iran, 2010-2012

Background: Falls and related injuries are common health problems in the elderly. Fractures, brain and internal organ injuries and death are the common consequences of the falls, which result in dependence, decreased self-efficacy, fear of falling, depression, restricted daily activities, hospitalization and admission to the nursing home and impose costs on the individual and the society. Objectives: The purpose of this study was to determine the types of fall-related injuries and the related risk factors in the elderly population of Qom province, Iran. Patients and Methods: This retrospective study was performed on 424 elderly people (65 years and over) referred to Shahid Beheshti Hospital, Qom, Iran, due to falls between 2010 and 2012. The ICD-10 codes of external causes of injury from w00 to w19 related to falls were selected from the health information system of the hospital and demographic variables of the patients and external causes of falls were extracted after accessing the files of the patients. Data were analyzed using SPSS version 18 (SPSS Inc., USA). The duration of hospital stay and its relationship with underlying variables were investigated using t test and ANOVA. The level of significance was considered P < 0.05. Results: Among 424 elderly people, 180 cases (42.45%) were male and the mean age of the patients was 78.65 ± 7.70 years. Fall on the same level from slipping, tripping, and stumbling was the most common external cause with 291 victims (68.60%), and hip fracture in 121 patients (29.00%), intertrochanteric fracture in 112 patients (26.90%), and traumatic brain injury in 51 patients (12.20%) were the most common causes of hospital stay. The mean hospital stay was 7.33 ± 3.63 days. Conclusions: Lower limb fracture and traumatic brain injury were the most common causes of hospitalization, which resulted in the longest hospital stay and highest hospitalization costs in the elderly

Prevalence of metallo-beta-lactamase enzyme and patern of antibiotic resistance in Klebsiella pnomoniae isolated from patients with urinary tract infection in Qom city during 2013-2014

Bachground: Klebsiella pnomoniae is one of the most important etiologic agents of urinary tract infection (UTI). An increasing occurrence of antimicrobial resistance among uropathogenic bacterial isolates has complicated the treatment process. The aim of this study was to determine antibiotic susceptibility patterns and prevalence of the metallo-beta-lactamase enzyme of K. pneumoniae isolates collected from UTI. Materials and Methods: This cross-sectional study was conducted on patients with complicated UTI reffered to hospitals in Qom city, Iran. A total of 1807 culture positive samples of pathogens were collected from the patients, among which 457 isolates were K. pneumoniae. The isolates were tested for antimicrobial susceptibility by the disc-diffusion method recommended by the guidelines of Clinical and Laboratory Standards Institute (CLSI 2013). In addition, the dubble disk synergy test was used to detect the K. pneumoniae isolates of metallo-beta-lactamase enzyme. Results: The prevalence of UTI infection due to K. pneumoniae was 25.3. Among 1807 positive urine cultures, 62.4 were from females and 37.6 from males. Results of antimicrobial susceptibility showed that the highest antibiotic resistance was seen for trimetoprium-sulfametoxazole (98.5) and the lowest resistance levels were seen for amikacin (9.4), meropenem (22.8) and imipenem (25.6). The results of the imipenem-EDTA combined disk showed that 93.2 imipenem resistance isolates were positive for the metallo-beta- lactamase enzyme. Conclusion: Carbapenem resistance and production of the metallo-beta-lactamase enzyme in K. pneumoniae uropathogenic are increasing. However, amikacin is still effective against these bacterial infections and its effectiveness should be maintained

Effect of educational program on milk consumption based on the theory of planned behavior among girl students

Background An adequate level of calcium intake during growth years can extensively help to stabilize calcium level and increase bone density. However, calcium intake in female school-age students is low. This study aimed to determine effect of educational programs on milk consumption based on the theory of planned behavior among 7th grade girl students in Kashan city, Iran. Materials and Methods: This studywas interventional quasi‑experimentalresearch. 220 girl students (110 for interventional group and 110 for control group), were selected by simple random sampling from schools in Kashan city, Iran. The researcher-made questionnaire based on theory of planned behavior used for data collection. Interventional programs were performed using lectures, poster, and pamphlet. The questionnaire was completed by the students twice, before and two months after the implementation of educational program. Data were analyzed by SPSS version 20.0 using descriptive statistics and independent t-test. Results: After the implementation of the educational programs, the rate of milk consumption at home significantly increased among the interventional group (P<0.05). Also, there was a significantly increase in the mean scores of attitude (P < 0.05), subjective norms (P< 0.05), perceived behavioral control (P< 0.05), and intention of milk consumption (P < 0.001) in the interventional group. Conclusion Educational programs based on the theory of planned behavior led to an increase in the scores of attitude, subjective norm, perceived behavioral control, and milk consumption intention among girl students. Thus, educational interventions and programs should be designed and implemented based on the theories of health education

Professionalism among medical residents in a young second-level university in Iran: A cross-sectional study

Professionalism is a set of behaviors that build trust in physicians� relationships with patients and the public. The aim of this study was to assess professionalism among residents in Kashan University of Medical Sciences, Kashan, Iran. This cross-sectional study was conducted on 139 residents recruited through the census method. Data were collected using the American Board of Internal Medicine Professionalism Questionnaire. The first part of the questionnaire was on residents� personal characteristics, and the second part contained fifteen items in the three domains of professionalism, namely excellence, honor/integrity, and altruism/respect. The mean scores of the questionnaire and its domains were calculated and their relationships with residents� personal characteristics were evaluated. The mean scores (± SD) of professionalism and its excellence, honor/integrity, and altruism/respect domains were 4.93 ± 2.4, 5.92 ± 1.85, 4.94 ± 3.39, and 4.35 ± 3.27, respectively (in a range of 0-10). Professionalism had significant relationships only with residents� specialty and gender. The level of professionalism in residents was low, which requires the attention of educational authorities. Moreover, the mean score of professionalism among residents in surgical specialties was significantly lower than non-surgical specialties. Various factors can be considered in this regard and it cannot be concluded that the lower score means worse professional behavior. © 2019 Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences. All rights reserved

Emerging Carbapenem-Resistant Pseudomonas aeruginosa Isolates Carrying bla_IMP Among Burn Patients in Isfahan, Iran

Background: Metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa is a significant pathogen in burn patients. Objectives: The aim of this study was to determine the prevalence of carbapenem-resistant P. aeruginosa isolates, including those resistant to imipenemase (IMP), in a burn unit in Isfahan, Iran. Patients and Methods: One hundred and fifty P. aeruginosa isolates from burn patients were tested for antibiotic susceptibility by the disc diffusion method in accordance with CLSI guidelines. Production of MBL was identified with the EDTA disk method. DNA was purified from the MBL-positive isolates, and detection of the blaIMP gene was performed with PCR. Results: Fifty-seven out of 150 (38%) isolates were multi-drug resistant (MDR), and 93 (62%) were extensively-drug resistant (XDR). Among all isolates, the resistance rate to ciprofloxacin, tobramycin, imipenem, meropenem, amikacin, ceftazidime, and cefepime was higher than 90%, while the resistance rates to piperacillin/tazobactam and aztreonam were 70.7% and 86%, respectively. Colistin and polymyxin B remained the most effective studied antibiotics. All of the imipenem-resistant P. aeruginosa isolates were MBL-positive, and 107 out of 144 (74.3%) of the MBL isolates were positive for the blaIMP gene. Conclusions: The results of this study show that the rate of P. aeruginosa-caused burn wound infections was very high, and many of the isolates were resistant to three or more classes of antimicrobials. Such extensive resistance to antimicrobial classes is important because few treatment options remain for patients with burn wound infections. blaIMP-producing P. aeruginosa isolates are a rising threat in burn-care units, and should be controlled by conducting infection-control assessments

The effect of tactile-kinesthetic stimulation on growth indices of healthy neonates

Abstract Therapeutic touch is emphasized by healthcare professionals for improvement of neonates' growth and development. However, inconsistencies exist regarding effects and methods of massage in neonates. The purpose of this clinical trial is to assess and comprise intervention and control groups regarding the effects of tactile-kinesthetic stimulation (TKS) by mothers on growth indices of healthy term neonates. Sixty healthy term neonates were randomly assigned into intervention and control groups. Mothers of neonates in the experimental group were trained to perform TKS for their newborns at home before feeding for at least 28 consecutive days, two times a day, and 15 min each time. Neonates in the control group were not required to receive this intervention. The neonates’ growth indices were measured within 24 h after birth, and then at days 14 and 28. During the study and the three consecutive measurements, no significant difference was found between the mean weights, heights, and head circumferences of the neonates in the two groups (p > 0.05). Keywords: Tactile-kinesthetic stimulation Growth indices Neonates Mother's touc

The effects of omega-3 and vitamin E co-supplementation on carotid intimamedia thickness and inflammatory factors in patients with polycystic ovary syndrome

Objectives: We sought to evaluate the effects of omega-3 and vitamin E cosupplementation on carotid intima-media thickness (CIMT) and inflammatory factors in patients with polycystic ovary syndrome (PCOS). Methods: This randomized, doubleblind, placebo-controlled trial was done among 60 women with PCOS. Participants were randomly assigned into two groups (n = 30 each group) and assigned to take either 1000 mg omega-3 plus 400 IU vitamin E supplements or a placebo for 12 weeks. Results: Compared with placebo, omega-3 and vitamin E co-supplementation led to significant decreases in maximum levels of left CIMT (-0.006±0.006 vs. +0.002±0.007 mm, p < 0.001), mean levels of left CIMT (-0.005±0.006 vs. +0.002±0.010 mm, p = 0.010), maximum levels of right CIMT (-0.006±0.010 vs. +0.006±0.010 mm, p = 0.010), and mean levels of right CIMT (-0.005±0.005 vs. +0.001±0.010 mm, p = 0.020). Change in high-sensitivity C-reactive protein (hs-CRP) (-390.6±942.9 vs. +237.0±754.3 ng/mL, p = 0.006) was significantly different between the supplemented patients and placebo group. We did not observe any significant effect in plasma nitric oxide (NO) values following supplementation with omega-3 plus vitamin E compared with the placebo. Conclusions: Co-supplementation with omega-3 and vitamin E for 12 weeks among patients with PCOS had beneficial effects on CIMT and serum hs-CRP values, but unchanged NO values. © 2018, Oman Medical Specialty Board. All rights reserved

Developing a Tool for Evaluating Ageism in Nursing Care of Older People in Kashan/Iran

Ageism implies negative views and attitudes towards older people. These unconscious behaviors could make the elderly feel as if they were no longer useful for the family and community. Ageism is common in healthcare services. The objective of this study was to develop a tool to assess ageism in nursing care in Kashan/Iran 2015. This psychometric study was carried out in four stages: literature review for item generation; content validity testing; exploratory factor analysis (EFA) for evaluation of construct validity; and reliability assessment. The data analyzed with SPSS version 16. The final questionnaire had 24 items. The total CVI and CVR were 0.88 and 0.57. Explanatory factor analysis identified 3 factors of respecting older adult in nursing care (14 items); age discrimination and negative views towards older adults (5 items); attention to older adult and their basic caring needs (5 items). The three factors could explain 49.54 of variance. The test-re-test correlation stood at 0.9. The internal consistency of the questionnaire was Cronbach�s alpha =0.85. A valid and reliable instrument for the evaluation of ageism in nursing care was developed in this study. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

The effect of acupressure on anxiety and dysrhythmia in patients undergoing cardiac catheterization

One of the ways to diagnose heart diseases is catheterization that most often causes stress and anxiety in patients. Acupressure is one of the effective non-pharmacological interventions to reduce patients' anxiety. The present study was aimed at investigating the effect of acupressure on the level of anxiety in patients undergoing coronary angiography. Method: The study was a double-blind clinical trial in which 70 patients who had referred to Kashan's Shahid Beheshti Hospital and undergone coronary angiography were studied. The participants were randomly assigned to an acupressure group and a pseudo points group. For the experimental group, acupressure was applied in correct third eye and shenmen points while the control group patients received acupressure in 1.5 cm away from the main points. Anxiety was measured through VAS anxiety questionnaire (0-10) and the dysrhythmia through a checklist. In the both groups, VAS anxiety and dysrhythmia in angiography blade were measured right away after the participants entered the angiography ward and before they were injected medication in three phases. Data analysis was carried out through independent t-test, paired t-test, covariance analysis, and chi square test. Results: There was a significant difference between the level of VAS anxiety of angiography blade and its level immediately after the patients entered the angiography ward and before they were injected medication (p<0.001). However, there was no significant difference between the two groups regarding dysrhythmia (angiography blade and immediately after entering the angiography ward, p=0.2) and (angiography blade and before injecting medication, p=0.6). Discussion and Conclusion: Acupressure had positive effect on reduction of anxiety and tachycardia. Therefore, acupressure can be utilized before conducting critical procedures

Relationship Between Ischemic Heart Disease and Sexual Satisfaction

AIM: Ischemic heart disease is a life-threatening condition. Considerable doubts exist over the effects of this disease on patients' sexual activity and satisfaction. The aim of this study was to evaluate the relationship between ischemic heart disease and sexual satisfaction. METHODS: In a retrospective cohort study, the convenience sample of 150 patients exposure with ischemic heart disease and 150 people without exposure it was drawn from Shahid Beheshti hospital, Kashan, Iran. Sampling was performed from March to September 2014. We employed the Larson's Sexual Satisfaction Questionnaire for gathering the data. Data were analyzed using descriptive statistics and Chi-square, t-test and linear regression analysis. RESULTS: The means of sexual satisfaction in patients exposure with ischemic heart disease and among the subjects without exposure it were 101.47±13.42 and 100.91±16.52, respectively. There was no significant difference between the two groups regarding sexual satisfaction. However, sexual satisfaction was significantly correlated with gender and the use of cardiac medications (P value<0.05). CONCLUSION: The level of sexual satisfaction in patients with exposure ischemic heart disease is similar to the people without exposure it. Moreover, the men and the patients who do not receive cardiac medications have higher levels of sexual satisfaction. Nurses who are providing care to patients with ischemic heart disease need to pay closer attention to patient education about sexual issues