ASSESSMENT OF THE EFFICACY OF PROPRANOLOL AND DILTIAZEM ON THE INTENSITY, DURATION AND PERIODS OF PAIN IN THE ANGINA PATIENTS REFERRED TO THE HEART CLINIC OF THE SHAHREKORED UNIVERSITY OF MEDICAL SCIENCES

ASSESSMENT OF THE EFFICACY OF PROPRANOLOL AND DILTIAZEM ON THE INTENSITY, DURATION AND PERIODS OF PAIN IN THE ANGINA PATIENTS REFERRED TO THE HEART CLINIC OF THE SHAHREKORED UNIVERSITY OF MEDICAL SCIENCES KHaledi A1, Elahei N2,Moradi M3, Salehi SH4* Received: 7 Sep , 2013 Accepted: 16 Nov , 2013 Abstract Background & Aims: Ischemic heart disease is one of the most common, chronic and deadly diseases in the world. Ischemic heart disease treatment consists of ensuring the patient, its identification, eliminating risk factors, lifestyle changes and drug therapy. The study tries to compare the efficacy of propranolol and diltiazem on the intensity, duration and periods of pain in the angina patients referred to the heart clinic of Shahrekored University of Medical Sciences. Materials & Methods: In a cross sectional study 60 patients with stable angina were selected with convenience sampling. Initially after receiving exercise testing, and completing the questionnaire to determine angina class, the patients were randomly divided into A and B groups by using the questionnaire and related chart recording of physiological variables. Demographic characteristics, types of drugs, the number of angina attacks and the results of the stress test were registered. The patients were treated with 20 mg propranolol every 8 hours daily, and with 30 mg diltiazem for 6 weeks, and they were considered as Group A, and Group B respectively. The patients were examined by a cardiologist for 6 weeks. Inclusion criteria to the survey were typical angina pain, positive exercise test, patient satisfaction, and dwelling in the provincial capital. Exclusion criteria were negative exercise test, treated with cardiac drugs, drug complications, diabetes, severe ischemic attacks, and cutting off medication. Hospitalization data were recorded by a questionnaire, and the collected papers were analyzed by using SPSS statistical software. Results: The results showed that from the 60 stable angina patients in both groups of A, and B, 68.3 % were male, and 31.7 % were females. The most abundant minor pain, was angina pain, with 50% , and the least pain, was terrified angina pain with 10%. The most abundant Angina class was class 2 with 80%, and lowest was class 3 with 8.3%. There was a significant differences between the two groups of treatment concerning the drug’s effectiveness, number of attacks of pain, and the effect of pain. Fisher's exact test indicated that there was a significant difference between negative exercise test in the two groups. Conclusion: Although both Ayndral and diltiazem had an effective role on the quality of pain, number of attacks, period of pain in patients with stable angina, but this effect was more effective in diltiazem group. More investigations with bigger sample size are needed

The comparison of the effects of education provided by nurses on the quality of life in patients with congestive heart failure (CHF) in usual and home-visit cares in Iran.

Quality of life (QOL) can be considered as a quality indicator of health care systems and nurses can play an important role to improve QOL in patients with congestive heart failure (CHF). The aim of this study was to determine the effects of education provided by nurses on the QOL in patients with CHF in home-visit care compared to usual care. In a single-blind randomized controlled trial conducted from September 2011 to June 2012, 110 patients with CHF were randomly assigned into two groups. While patients in group I were received usual education at the time of hospital discharge, patients in Group II, in addition to usual education, were received special education regards to their illness by nurses who visited patients in their homes. The 36-item short-form (SF-36) questionnaire was used to evaluate the patient's QOL at the time of discharge and also six months after hospital discharge. At the time of hospital discharge, mean score of all 8 sub-score of SF-36 questionnaire was 63.4±7.8 in patients of group II and 61.1±6.4 in patients of group I, respectively (P> 0.05). QOL was decreased in group I and increased in group II compared to the time of hospital discharge. After six months, mean score of QOL was higher in group II than in group I. QOL of patients with CHF were decreased after hospital discharge. Education provided by nurses in home-visit care could improve the QOL in patients with CHF, based on the findings of this study

Effect of continuous caring and educational intervention (home visit) on quality of life in the congestive heart failure patients.

Background and aim: Quality of life in congestive heart failure (CHF) patient’s comrade with declines mortality, psychosocial, physical and social restriction due to inability effect of the disease. So, the aim of this study was the assessment effected continuous caring and educational intervention (home visit) on quality of life in the CHF patients. Methods: In a clinical trial study, a total of 110 patients were selected and accidentally were put in two groups (experimental and control). Each group was equalized based on sex, age, education, living place, heart failure and ejection fraction. Then, experimental group was educated about heart failure disease, drugs being used, self care plan and life style that this educational plan followed by three home visits. In all of the patients, quality of life questionnaire (SF-36) was filled in two steps, in first study and six months after discharge. Data were analyzed using independent and pair t-tests. Results: Before intervention, the results indicated that there was no difference in two groups base on six, age, education, living place, cardiac failure degree, ejection fraction and quality of life main score (P<0.05). But after the intervention, quality of life main score in domains physical function, limitations in usual role activities because of physical health problems, vitality, social function, body pain and general health in intervention group were greater than control group (P<0.05). Pair t-test was detected quality of life main score after six months was increased in the intervention group and decreased in the control group (P<0.05). Conclusion: Our results show that, nursing intervention and education in congestive heart failure patients base on need and life style improve physical status and quality of life of these patients

The effect of local infiltration of morphine in reducing the post operative pain in soft tissue injury

زمینه و هدف: آسیب های بافت نرم از جمله آسیب تاندون ها و لیگامان ها از مشکلات شایع بوده که باعث ایجاد درد و اختلال در عملکرد فرد می شود. در این مطالعه تأثیر تزریق موضعی مورفین در کاهش شدت درد پس از اعمال جراحی بافت نرم اندام ها مورد بررسی قرار گرفت. روش بررسی: در این مطالعه کارآزمایی بالینی دو سوکور 80 نفر از بیمارانی که با آسیب بافت نرم اندام ها به بیمارستان کاشانی شهرکرد مراجعه کرده بودند به صورت تصادفی ساده، به دو گروه مورد و شاهد تقسیم شدند. در گروه شاهد 1 سی سی نرمال سالین و در گروه مورد 1 میلی گرم مورفین به ازای هر یک سانتی متر برش با آب مقطر رقیق و به صورت موضعی تزریق شد. سپس شدت درد با استفاده از مقیاس سنجش درد (VAS) در ساعات 3، 10 و 24 پس از عمل جراحی اندازه گیری گردید. داده ها با استفاده از تست های تی مستقل، تحلیلی کای دو و تست دقیق فیشر مورد تجزیه و تحلیل قرار گرفت. یافته ها: میانگین سنی بیماران در گروه شاهد 34/6±5/32 و در گروه مورد 70/7±6/30 سال بود. میانگین طول برش در گروه شاهد 06/1±5/5 سانتی متر و در گروه مورد 8/1±57/5 سانتی متر بود (05/0P>). شدت درد در گروه شاهد در همه زمان های بررسی شده به طور معنی داری کمتر از گروه مورد بود (01/0

The Experiences of Iranian Nurses in Critical Events and Natural Disasters: A Qualitative Study

Medical staff and healthcare providers are always involved in earthquakes; therefore, the aim of this study was to explore the experience of nurses in dealing with critical events and natural disasters. A qualitative study was conducted by semi-structured interviews with 12 medical staff. Data were analyzed by qualitative analysis hermeneutic approach. Four categories were developed as follows: “confusion,” “coercion,” “psychological disturbance,” and “wasting of resources.” The categories led to the development of the main theme of “miss management.” Earthquakes are considered serious challenges for nurses and health professionals involved in such disasters. It will culminate in dire consequences including physical, mental, and psychological damage as well as high mortality rate among people and healthcare providers

The effect of CPR training on performance of nurses in selected hospitals of Shahrekord University of Medical Sciences, 2010

زمینه و هدف: با توجه به نقش حیاتی پرستاران در احیای قلبی-عروقی بیماران دچار ایست قلبی تنفسی، این پژوهش با هدف تعیین تاثیر آموزش احیای قلبی- ریوی بر عملکرد پرسنل پرستاری بخشهای منتخب بیمارستانهای دانشگاه علوم پزشکی شهرکرد در سال 1389 انجام گردید. روش بررسی: این پژوهش مطالعه‌ای نیمه‌تجربی است که در آن کلیه پرستاران شاغل در بخشهای ICU،CCU ، اورژانس، فوریت‌ها، لیبر و ریکاوری بیمارستان‌های دانشگاه علوم پزشکی شهرکرد به روش سرشماری انتخاب و قبل و پس از برگزاری کارگاه‌های آموزشی، عملکرد آنان توسط چک لیست استاندارد شده ارزیابی و مقایسه گردید داده ها با استفاده از آمار توصیفی و استنباطی و نرم افزار SPSS مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: میانگین سابقه اشتغال در اورژانس 2/2 سال و در سایر بخش‌ها 5/4 سال بود. در بخش سئوالات پژوهش نیز عملکرد واحدهای مورد پژوهش در ارزیابی سطح هوشیاری 6/11±8/81 درصد و در تماس با تیم احیاء4/11±53/81 درصد بود که پس از آموزش عملی به 100 درصد ارتقاء یافت و در مواردی چون استفاده از ماسک اکسیژن از 8/7± 9/42 درصد به3/8 ±25/56 درصد رسید و درخصوص کلیه سوالات در کلیه مراکز درمانی مورد بررسی، بین نمرات اخذ شده قبل و بعد از آموزش اختلاف معنی‌داری آماری وجود داشت (05/0

Comparison of the effects of lecture and booklet methods on awareness and attention of parents of children with Thalassemia major

چکیده: زمینه و هدف: تالاسمی از مهمترین بیماریهای ژنتیک است که مشکلات زیادی برای بیماران مبتلا ایجاد کرده است. با آموزش والدین می توان از بروز مشکلات جبران ناپذیر و عوارض خطرناک این بیماری پیشگیری و یا آنها را به حداقل رساند. این مطالعه با هدف مقایسه تاثیر روش سخنرانی و خود آموزی بر میزان آگاهی والدین کودکان مبتلا به تالاسمی ماژور بر نحوه مراقبت از کودکان خود انجام شده است. روش بررسی: در این مطالعه مداخله ای والدین 90 نفر از بیماران مبتلا به تالاسمی ماژور که به منظور گرفتن خدمات پزشکی به بیمارستان هاجر شهرکرد مراجعه نموده بودند بصورت نمونه گیری آسان انتخاب و بصورت تصادفی به سه گروه آموزش سخنرانی، خود آموزی و شاهد تقسیم شدند. در گروه آموزش سخنرانی چهار جلسه کلاس به مدت 30 دقیقه و در فاصله 3 هفته برای والدین برگزار شد. در گروه آموزش خود آموزی جزوه ای که حاوی همان مطالب در روش سخنرانی بود به زبان ساده در اختیار والدین قرارداده شد و در گروه شاهد هیچگونه مداخله ای انجام نشد. آگاهی والدین نسبت به بیماری در هر سه گروه، قبل و بعد از مداخله با استفاده از پرسشنامه محقق ساخته جمع آوری گردید. جهت تجزیه و تحلیل داده ها از آزمون های t زوجی وضریب همبستگی اسپیرمن و آنالیز واریانس یکراهه استفاده شد. یافته ها: بین سه گروه از نظر میانگین سنی، جنس، مدرک تحصیلی، شغل، تعداد فرزندان مبتلا، سن کودک مبتلا و میزان آگاهی قبل از آموزش اختلاف معنی دار وجود نداشت. یافته ها نشان داد که میانگین میزان آگاهی به ترتیب قبل و پس از آموزش در گروه سخنرانی 73/4±53/10 و 14/4±5/16 (05/0

The effect of progressive muscle relaxation on anxiety and stress in nursing students at the beginning of the internship program

Background and aims: Anxiety is a complicated process appearing from low to high which may reduce the learning ability. It is common among nurses as they struggle to cope with increasingly complicated stressors such as examinations, article preparation and practical experiences. The aim of this study was to evaluate the effect of muscle relaxation on reduction of anxiety in nursing students before starting the internship program. Methods: In this study, 40 nursing students who were going to start their internship program were randomly divided into two equal groups. Before starting the internship program, all students were asked to fill a questionnaire (Spielberger Test Anxiety) to measure their anxiety. In addition, physiological parameters (blood pressure, pulse, respiration, temperature) were collected before and after the study in both groups. During a 45-min session, muscle relaxation training was given to the test group. Muscle relaxation practice was continued three times per day for two weeks. Two weeks after starting the internship, Spiel Berger Test Anxiety and physiological parameters were collected again in both groups. Data were analyzed using Chi-square and t tests. Results: The average age of the students in both groups was 22.7±2 (range=21 to 25 years) and the majority of the students were female (75%). No significant difference was observed between two groups for willingness to the nursing profession, birth rank and the average scores of the students from the previous years. The average anxiety score in control group before and after the study was 27.5±10.2 and 28.3±8.8 respectively (P>0.05). Average anxiety score in test group before and after the study was 25.4±19.5 and 29.2±14.1 respectively (P<0.05). Conclusion: To alleviate stressors associated with practical practice and create a healthy work environment for practice, it is recommended that nursing students have some progressive muscle relaxation before entering practical environments

A comparison of life style with body mass index (BMI) of loss and more than 25 in individuals between 20-65 years in Shahrekord city

Background and aim: The present study aimed to compare the habits and features of obese (BMI>25) and normal (BM25 kg/m2 then it was designated in the case group (obese). Samples with BMI between 20-25 kg/m2 were assigned into the control (normal) group. The Miller-Smith life style questionnaires were used for both groups. Data were analyzed using Chi-square and t-tests. Results: No significant differences were found between the two groups tested in terms of the mean age, gender, level of education, marital status insurance, the length of sleep during 24 h, cigarette smoking and losing job or spouse. However, a significant relation was found in using vegetables, sausage, fried potatoes, enriched breads, low fat milk, low salt, candies and chocolates (P<0.05). Conclusion: The present study suggests that one way to control obesity and prevent diseases is to ameliorate the life styles with education to people

Victim of situation: experience familial caregiver with hemodialysis patient. A qualitative study

Background and Aims Today, 60% to 85% of chronic patients are cared by home caregivers and prolong care causes bitter experiences for the caregivers. This study aimed to assess the burden of care for patients undergoing hemodialysis from the point of family caregivers’ views. Methods In this qualitative study, we used content analysis approach for data collection and analysis. The study participants were 17 family caregivers selected through purposive sampling method from four medical education centers affiliated to Ahvaz Jundishapur University of Medical Sciences, Iran. The relevant data were collected by quasi-structured interviews. Results The following categories were emerged from interviews as follow: "care challenges", "the nature of long-term care", and ‘care in the shade". The categories share the main theme of "victim of the situation" experienced by the family caregivers of the patients undergoing hemodialysis. Conclusion Monitoring the mental status of the caregivers, which reflects their experiences and attitudes is an appropriate tool for assessing the physical, mental, social, and functional aspects of care burden on caregivers and reflects their needs in the care process