Effect of booklet and combined method on parents' awareness of children with β-thalassemia major disorder

OBJECTIVE: To assess the effects of booklet and combining methods (lecture, video, etc.) on parents' awareness of children with beta-thalassemia major disorder. METHODS: Two groups of parents (n=30 each) of children with thalassemia were selected randomly. Among educational programmes, in one group booklet and in the other group combined method were used. A questionnaire was designed to gather information about the disease from parents of the two groups. The data were analysed using student's t-test and Pearson's correlation, significance was considered at p < 0.05. RESULTS: There was no significant difference between the two groups in terms of the mean age, gender, level of education, job, number of affected children, and age of the child. However, in both methods of education (lecture and combined), knowledge of parents about the disease significantly increased (p < 0.001). CONCLUSION: The education whether through booklet or combined method has a significant positive effect on increasing knowledge of the investigated groups. It is recommended that increased knowledge levels of parents can decrease the burden of beta-thalassemia

Vitamin D and population health; a nephrology viewpoint

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The effect of family training and support on the quality of life and cost of hospital readmissions in congestive heart failure patients in Iran

Background: This study was conducted to investigate the effects of family training and support on quality of life and cost of hospital readmissions in congestive heart failure patients. Methods: In this single-blinded, randomized, controlled trial, the participants were heart failure patients hospitalized in an Iranian hospital. Data were collected from available hospitalized patients. The participants were enrolled through randomized sampling and were divided randomly into two groups, an intervention group and a control group. The intervention group received extra training package for the disease. Training was provided at discharge and three months after. A standard questionnaire to assess the QoL was filled out by both groups at discharge and six months after. Results: Mean scores of QoL domains at the beginning of the study decreased in control group and increased in intervention in comparison with six months after (p < 0.01). Conclusion: Nursing care follow-up according to heart failure patients' needs promoted their QoL

The prevalence of kidney scarring due to urinary tract infection in Iranian children: a systematic review and meta-analysis

INTRODUCTION: Urinary tract infection is one of the most common diseases in childhood, and can lead to severe complications such as renal scarring in case of lack of diagnosis and timely treatment. OBJECTIVE: The aim of this study was to investigate the prevalence of kidney scarring caused by urinary tract infection in Iranian children by meta-analysis. STUDY DESIGN: English -language databases including Science Direct, PubMed, Scopus, Web of Science, and Springer, and Persian -language sites including SID, Magiran, Iranmedex, and Medlib, and the Google Scholar search engine were searched by in March 2018 using MeSH keywords. The heterogeneity of studies was studied using the I2 index. Data were analyzed using STATA software, version 15.1. RESULTS: In 18 studies, the prevalence of kidney scarring from urinary tract infections in Iranian children was 31% (95% confidence intervalCI: 22%-39%), (which was 14% in girls and 23% in boys. Also, the prevalence of kidney scar in children with urinary reflux was 47% and in children without urinary reflux was 12%. The most common symptom of the renal scar was fever in 61%, followed by urinary reflux in 45% (unilateral in 42% and bilateral in 30%). Also, the prevalence of mild, moderate, and severe reflux, respectively, was 31%, 27%, and 13%. Meta-regression also showed that the prevalence of kidney scar due to urinary tract infections had no significant relationship with the number of samples and years of research (P > 0.05). DISCUSSION AND CONCLUSION: About one-third of Iranian children suffering from urinary tract infections had kidney scarring, so that the prevalence is lower in girls than in boys. Also, the prevalence of renal scarring in children with urinary reflux is about four times higher than that in children without urinary reflux

Frequency of celiac disease in children with type 1 diabetes

Background and aims: Occurrence of celiac and diabetes is accompanied by numerous complications in children and if diagnoses do not occur promptly, celiac disease complications including gastrointestinal disorders, loss of appetite and damage caused by hypoproteinemia, and most importantly, growth disorder occurs in diabetic children. This study was aimed to compare the frequency of celiac disease in children with diabetes aged under 15 years and the controls of the same age referring to the clinics affiliated with Shahrekord University of Medical Sciences. Methods: In this case-control study, using convenience sampling, 42 patients with diabetes and 43 patients without diabetes admitted for gastrointestinal diseases were assigned as cases and controls, respectively. The description of all patients was provided, and physical examinations and serologic tests were conducted on them. If the serologic tests tTGA-IgA and tTGA-IgG were positive, the intestinal biopsy was taken. The data were analyzed by descriptive statistics and t-test, chi-square, and Mann–Whitney test in SPSS. Results: The mean serum levels of tTGA-IgA and tTGA-IgG were significantly higher in the case group than the control group (P<0.05). There were significant differences in weight gain between the cases and the controls (P=0.017). The frequency of celiac disease was 15% (n: 6) in children with diabetes with a significant difference from the controls (P=0.02). Conclusion: In this study, the frequency of celiac disease was higher in children with diabetes than children without. Therefore, in the study area, routine screening for celiac disease is helpful in reducing possible disorders and complications in diabetic children

Self-care concept analysis in cancer patients: An evolutionary concept analysis

Self-care is a frequently used concept in both the theory and the clinical practice of nursing and is considered an element of nursing theory by Orem. The aim of this paper is to identify the core attributes of the self-care concept in cancer patients. Materials and Methods: We used Rodgers' evolutionary method of concept analysis. The articles published in English language from 1980 to 2015 on nursing and non-nursing disciplines were analyzed. Finally, 85 articles, an MSc thesis, and a PhD thesis were selected, examined, and analyzed in-depth. Two experts checked the process of analysis and monitored and reviewed the articles. Results: The analysis showed that self-care concept is determined by four attributes of education, interaction, self-control, and self-reliance. Three types of antecedents in the present study were client-related (self-efficacy, self-esteem), system-related (adequate sources, social networks, and cultural factors), and healthcare professionals-related (participation). Conclusion: The self-care concept has considerably evolved among patients with chronic diseases, particularly cancer, over the past 35 years, and nurses have managed to enhance their knowledge about self-care remarkably for the clients so that the nurses in healthcare teams have become highly efficient and able to assume the responsibility for self-care teams

Nursing Instructor and Students' Perspectives on Clinical Education Apprenticeship Problems

Introduction: Different problems might lead to reduction in the efficiency of nursing students' apprenticeship education and solving those problems. Aim: This study was conducted to determine nursing internship problems from the perspective of trainers and students. Materials and Methods: In this descriptive cross-sectional study, 20 trainers and 43 senior students of nursing were selected using census method. A researcher-made questionnaire was used to collect data. Total internal consistency (a) of the questionnaire was 0.88 and had proper convergent validity. SPSS was used to analyse data with applying descriptive and inferential statistics. Results: More than 50 considered their course relatively weak or weak in helping intern nurses to acquire comprehensive view of the nursing profession that takes a social perspective into account, skills required for the processes of nursing and instructing patients. Problems such as insufficient access to welfare and educational facilities, lack of co-operation among clinical team and scattering of internship sessions during a course were mentioned by nurses and their trainers. They believed that changes must take place in the way internship courses are carried out. Conclusion: Although the internship courses seem to achieve their aim of improving students' skills and independence in providing different nursing services to students and their trainers generally have a positive attitude towards such courses, there are still problems in effective exercise of the training

Comparison of the effects of methylphenidate and the combination of methylphenidate and risperidone in preschool children with attention-deficit hyperactivity disorder

Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder among preschool children but the number of controlled clinical trials regarding psychopharmacological treatment in this age group is limited. The aim of this study was to compare methylphenidate with the combination of methylphenidate and risperidone in preschool children with ADHD. Forty-two preschool children, aged 3-6 years, diagnosed with ADHD by a child and adolescent psychiatrist according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-Text Revision criteria, were enrolled in a 6-week, single-blind clinical trial and administered with methylphenidate (5-30 mg/dl) or the combination of methylphenidate and risperidone (0.25-2 mg/dl) in Iran. Treatment outcomes were assessed using the Conners' Rating Scale and Clinical Global Impression (CGI) Scale at baseline and 3 and 6 weeks after starting the drugs administration. Side effects were rated by a checklist and body weight was measured at each visit. There were no significant differences between the two protocols in Parent Conners' Rating Scale scores (P > 0.05) and CGI scores (P > 0.05). Both groups showed a significant improvement in ADHD symptoms over the 6 weeks of treatment for Parent Conners' Rating Scale (P < 0.001). The combination group used significantly lower doses of methylphenidate compared to the other group (P = 0.002). The most common adverse effects were anorexia (21.7%) and daytime drowsiness (17.4%) in combination treatment group and insomnia (33.3%) and anorexia (25%) in methylphenidate group. Risperidone and methylphenidate may be effective and well tolerated in preschool children with ADHD, and adding risperidone to methylphenidate may decrease the occurrence of some side effects of methylphenidate such as insomnia and anorexia and lower the dose of methylphenidate may be needed to control symptoms. © 2016 Journal of Advanced Pharmaceutical Technology & Research

Comparison of risperidone and aripiprazole in the treatment of preschool children with disruptive behavior disorder and attention deficit-hyperactivity disorder: A randomized clinical trial

Although pharmacotherapy with atypical antipsychotics is common in child psychiatry, there has been little research on this issue. To compare the efficacy and safety of risperidone and aripiprazole in the treatment of preschool children with disruptive behavior disorders comorbid with attention deficit-hyperactivity disorder (ADHD). Randomized clinical trial conducted in a university-affiliated child psychiatry clinic in southwest Iran. Forty 3-6-year-old children, diagnosed with oppositional defiant disorder comorbid with ADHD, were randomized to an 8-week trial of treatment with risperidone or aripiprazole (20 patients in each group). Assessment was performed by Conners' rating scale-revised and clinical global impressions scale, before treatment, and at weeks 2, 4, and 8 of treatment. The data were analyzed by SPSS version 16. Mean scores between the two groups were compared by analysis of variance and independent and paired t-test. Mean scores of Conners rating scales were not different between two groups in any steps of evaluation. Both groups had significantly reduced scores in week 2 of treatment (P = 0.00), with no significant change in subsequent measurements. Rates of improvement, mean increase in weight (P = 0.894), and mean change in fasting blood sugar (P = 0.671) were not significantly different between two groups. Mean serum prolactin showed a significant increase in risperidone group (P = 0.00). Both risperidone and aripiprazole were equally effective in reducing symptoms of ADHD and oppositional defiant disorder, and relatively safe, but high rates of side effects suggest the cautious use of these drugs in children. © 2016 Journal of Advanced Pharmaceutical Technology & Research