The relationship between fear of falling and frailty in older adults undergoing hemodialysis

Background: Frailty and fear of falling (FOF) are highly prevalent in older adults undergoing hemodialysis (HD). However, there is no reliable evidence of the association between FOF and frailty in older adults undergoing HD.Objectives: This study aimed to determine the association between FOF and frailty in older adults undergoing HD.Methods: This cross-sectional study was conducted on 194 older adults undergoing HD in the east of Mazandaran province, Iran. Data were collected using of demographic and clinical characteristics questionnaire, Edmonton Frail Scale (EFS), and Falls Efficacy Scale–International (FES-I). Independent t-test, analysis of variance, Pearson’s correlation coefficient, and stepwise multiple regression were used to analyze the data.Results: The mean score of the FOF was 34.41±12.20, and most of the participants (38.4%) had moderate FOF. The mean score of the frailty was 6.91±3.12 and most of older adults (34.3%) were vulnerable to frailty. There was a positive and significant association between FOF and frailty in older adults undergoing HD (r=0.802, P<0.001).Conclusion: The majority of older adults receiving chronic HD have moderate to high FOF and are prone to frailty. Therefore, it is necessary to perform appropriate educational, behavioral, and cognitive interventions to reduce the FOF in these patients

The effects of education on nurses' ability to recognize elder abuse induced by family members

Background: Nurses' lack of knowledge about domestic elder abuse and their limited ability to recognize it can result in negative consequences. Education has the potential to improve nurses' ability to recognize elder abuse. Yet, there is no conclusive result about its effectiveness. Objectives: The main objective of the present study was to assess the effects of education on nurses' ability to recognize elder abuse. Methods: This randomized controlled trial was conducted in two public hospitals in Ramsar and Tonekabon, Iran. Participants were 120 nurses who were randomly recruited and allocated to an intervention (n= 60) and a control (n= 60) group. The study intervention was an educational program implemented in two successive 2-h sessions in 1 day. Data were collected using a demographic questionnaire and The Nurses' Recognition of Elder Abuse by Family Caregiver Questionnaire. The possible total score of the latter questionnaire was 67-335. The data were analyzed using the Chi-square, the Fisher's exact, and the paired- and the independent-samples t-tests as well as the one-way and the repeated-measures analyses of variance. Results: The mean score of elder abuse recognition ability significantly increased in the intervention group (P < 0.001), while it did not significantly change in the control group (P = 0.85). Participants had a good ability to recognize physical elder abuse and limited ability to recognize sexual abuse. Conclusion: In-service education about elder abuse for nurses not only improves their elder abuse recognition ability but also can help them take appropriate measures for its management

The effects of telephone-based telenursing on perceived stressors among older adults receiving hemodialysis

Background: Older adults who receive hemodialysis face different physiological and psychosocial stressors. Management of physiological and psychosocial stressors is among their basic needs for a desirable life. Objectives: This study aimed to evaluate the effects of telephone-based telenursing on perceived stressors among older adults receiving hemodialysis. Methods: This quasi-experimental study was conducted in 2018 on sixty older adults who were receiving hemodialysis. Participants were conveniently recruited from the hemodialysis centers of Shahid Beheshti and Imam Khomeini hospitals, Babol and Behshahr, Iran, and were randomly allocated to a control and an intervention group. A 3-month telephone-based telenursing program was implemented for participants in the intervention group. Physiological and psychosocial stressors were assessed before and after the study intervention. Data were analyzed using the Chi-square, paired-samples t, and independent-samples t-tests. Results: The mean score of physiological stressors in the intervention group statistically significantly reduced from 17.33 ± 1.74 at pretest to 11.96 ± 3.16 at posttest (P 0.05), there were significant between-group differences respecting the posttest mean scores and the pretest-posttest mean differences of both physiological and psychosocial stressors (P < 0.05). Conclusion: Telenursing is effective in significantly reducing perceived stressors among older adults receiving hemodialysis. Nurses can use telenursing to reduce stressors among this patient population

The effects of telephone-based telenursing on perceived stressors among older adults receiving hemodialysis

Background: Older adults who receive hemodialysis face different physiological and psychosocial stressors. Management of physiological and psychosocial stressors is among their basic needs for a desirable life.Objectives: This study aimed to evaluate the effects of telephone-based telenursing on perceived stressors among older adults receiving hemodialysis. Methods: This quasi-experimental study was conducted in 2018 on sixty older adults who were receiving hemodialysis. Participants were conveniently recruited from the hemodialysis centers of Shahid Beheshti and Imam Khomeini hospitals, Babol and Behshahr, Iran, and were randomly allocated to a control and an intervention group. A 3-month telephone-based telenursing program was implemented for participants in the intervention group. Physiological and psychosocial stressors were assessed before and after the study intervention. Data were analyzed using the Chi-square, paired-samples t, and independent-samples t-tests. Results: The mean score of physiological stressors in the intervention group statistically significantly reduced from 17.33 ± 1.74 at pretest to 11.96 ± 3.16 at posttest (P 0.05), there were significant between-group differences respecting the posttest mean scores and the pretest-posttest mean differences of both physiological and psychosocial stressors (P < 0.05). Conclusion: Telenursing is effective in significantly reducing perceived stressors among older adults receiving hemodialysis. Nurses can use telenursing to reduce stressors among this patient population

The effectiveness of ibuprofen and lorazepam combination therapy in treating the symptoms of acute Migraine: A randomized clinical trial

Background: Migraine is a common, episodic and debilitating disease. The migraineur not only suffers from pain, but also lives with a diminished to poor quality of life. Several medicinal therapies are used to abate the debilitating symptoms of this disease. Objective: The present study was conducted to determine the effectiveness of Ibuprofen and Lorazepam combination therapy in treating the symptoms of acute migraine. Methods: The present randomized clinical trial study used the pretest-posttest design with three comparison treatments, to examine 90 patients with an average of two to six attacks per month and an initial diagnosis of migraine based on the International Headache Society (HIS) criteria. The study was conducted on patients during the first half of 2014 with a diagnosis of acute migraine attack who were referred to Babol Ayatollah Rouhani Hospital in Iran. The patients were randomly divided into three groups of 30. The first group was administered 200 mg Ibuprofen capsules, the second group 400 mg Ibuprofen capsules and the third group a combination of 200 mg Ibuprofen capsules and 1 mg Lorazepam tablets. The medications were taken in the presence of the researcher. A checklist was used to assess the severity of headache and other migraine symptoms such as nausea, vomiting, photophobia and phonophobia in the patients, before and two hours after the intervention. Data were analyzed in SPSS-18 using the Mann-Whitney test, the McNemar test, Wilcoxon’s test, the NOVA and the Chi- squared test at the significance level of p<0.05, and power analysis with 30 patients in each group to perform this study was 0.8(1-β). Results: The mean age of participants was reported as 52±8 years and the condition was more frequent in women (56%). All three treatment regimens reduced the severity of headache significantly in the patients (p<0.001); nevertheless, the combination therapy used, produced the lowest mean severity of headache (p<0.001). The highest reduction in nausea and vomiting was (3.3%). None of the patients in either of the three groups reported phonophobia after the intervention, but only the patients in the combination therapy group reported no instance of photophobia. Conclusions: Given the greater effectiveness of combination therapy with Ibuprofen and Lorazepam in alleviating the symptoms of acute migraine compared to single-drug treatments with Ibuprofen, Lorazepam is recommended to be used as a first line treatment for acute migraine. Clinical trial registration: The trial was registered at the Thai Clinical Trials Registry (TCTR) (http://www.clinicaltrials.in.th/) with the ID: TCTR20160927003. Funding: The authors received no financial support for the research, authorship, and/or publication of this articl

Megaloblastic Anemia in a Patient with Addison’s Disease: A Case Report

&quot;nAbstract &quot;nPrimary adrenal insufficiency (Addison&amp;rsquo;s disease) is due to adrenocortical disease. This study is about a 40 year old man who had been referred to a hematologist who assessed him for anemia. He had been affected by a periodic paresthesia one month prior to his visit to the physician. According to the clinical presentation, macrocytic anemia and hypersegmentation of PMN in PBS, BMA/B was performed, which reported &amp;ldquo;megaloblastic anemia&amp;rdquo;. &quot;nIn 2001, his skin became mildly hyperpigmented, on the elbows, hands, groin and knees. In 2002, he felt weakness, had the sweats, arthralgia and myalgia. The patient was refered to a clinic and then to a hospital. But, his symptoms did not abate, therefore he was refered to the Imam-khomeini Hospital located in Tehran, and was admitted. At the hospital, new signs were detected: hypotension, hyponatremia (Na=100), raised ALT and TSH levels, and macrocytic anemia.The physician suspected primary adrenal insufficiency. More tests were performed and the diagnosis of Addison&amp;rsquo;s disease was confirmed. Noticing one of the rare features in Addison&amp;rsquo;s disease is megaloblastic anemia. &quot;n&amp;nbsp; &quot;nKeywords: Primary Adrenal Insufficiency, Addison&amp;rsquo;s Disease, Megaloblastic Anemi

The Perspective of Nursing Students and Clinical Instructors from Logbook-based Evaluation

Introduction: Instructors and students have many challenges in completing and presenting logbooks. This study endeavored to investigate the views of nursing students and instructors of Ramsar School of Nursing on logbook-based evaluation. Methods: This cross-sectional descriptive study was performed in the second semester of the academic year 2020-2021. The study population was all nursing students studying and clinical instructors working in Ramsar School of Nursing. Seventy-five individuals (65 nursing students and 10 nursing instructors of the internal medicine-surgery internship unit) were included in the study by census method. The researcher-made questionnaire on the perspective of nursing students of logbook-based and traditional method evaluation were used for data gathering. Data analysis was performed using paired and independent t-test and Chi-square. Results: The perspective of nursing students and clinical instructors about the use of logbooks showed a significant difference concerning order, evaluation, satisfaction, and clinical skills. The mean scores of the perspective of instructors in the dimensions of order and evaluation were higher than students (t=-4/38, p=0.001; t=-5/36, p=0/001). The instructors’ mean score of satisfaction and clinical performance with logbook evaluation was more than students (t=-4/06, P=0.001 vs. t=-3/27, P=0.002). Students believed that the use of logbooks led to more supervision of instructors over their work (t=4/17, P =0.001), but it did not affect their clinical performance (t=-1/8, P= 0.077). Conclusion: The clinical Instructors evaluated the priority of the logbook over the traditional method to achieve the expected outcomes more positively towards the students. Because the logbook should meet the learning needs of students, using students' opinions in compiling the logbook can be effective in improving student satisfaction and performance

Comparison the efficacy of ceftazidime and imipenem in treatment of neutropenic febrile due to chemotherapy in cancer patients

Introduction: In cancer patients various infections were developed due to severe neutropeniaresulted from chemotherapy. There is controversy between initial monotherapy or multidrugprescription. The purpose of this study was to compare the efficacy of ceftazidime and imipenem incontrol of fever in cancer patients with febrile neutropenia.Materials ands Methods: 40 patients with cancer, fever and neutropenia (PMN<500), withoutrecognized source of infection, were selected using the convenience and consecutive method. Using arandom sampling, twenty patients were treated with imipenem (500mg Iv/Q8hr) and others withceftazidime (2mg Iv/Q8hr). The criteria for positive response to the drugs were: fever disappearanceduring maximally 72 hours lasted for up to 24 hours, and increased neutrophil counts more than500/ml.Results: Our results show that 60% and 55% patients with ceftazidime and imipenem were cured,respectively. 40% patients treated with ceftazidime and 45% patients treated with imipenem neededanother antibiotic therapy at the same time. No significant relationship was found between differenttypes of drug regime among the groups.Conclusion: Findings of this study indicate that ceftazidime and imipenem have similar efficacy intreatment of febrile neutropenic patients. Due to more availability and lower cost of ceftazidime thanimipenem, ceftazidime is suggested as first line treatment in febrile neutropenia

Incidence of chemotherapy-induced amenorrhea in non-menopausal women with breast cancer

, , 2, , (Received 14 January, 2009; Accepted 17 June, 2009)AbstractBackground and purpose: Although adjunct chemotherapy may increase life in non-menopausal breast cancer patients, however, it may cause short-term complications such as nausea, vomiting, alopecia, as well as long-term complications in ovarian failure and premature menopausal. The objective of this study was to investigate chemotherapy-induced secondary amenorrhea in non-menopausal women with breast cancer.Materials and methods: A descriptive design (case series) was preformed on fifty breast cancer patients, non-menopausal (normal mense) and chemotherapy in Ramsar Emam Sajad Hospital Oncology unit from 2007 to 2008. Sampling was consecutive. Data gathering method was questionnaire & blood sampling (FSH & Progesterone) for prior and 12 months after the end of chemotherapy. Data was analyzed by paired-t, independent-t and one-way ANOVA tests.Results: Results showed that 62% of patients were amenorrhea 12 months after the end of chemotherapy. Results showed that there was no meaningful relationship between age, hormone therapy, disease stage, node-positive and ER & PR status to amenorrhea; however, there was a meaningful relationship between duration of treatment, type and dose of chemotherapy to amenorrhea.Conclusion: In pre-menopausal patients with breast cancer, receiving cytotoxic chemotherapy against tumor cells, amenorrhea may occur do to ovarian failure.J Mazand Univ Med Sci 2009; 19(70): 9-17 (Persian