Hamad Hospital Research Articles

Status of social capital and its relationship with the success rate of smoking cessation in patients referred to the smoking cessation clinic of Farshchian Cardiovascular Hospital in Hamadan

ABSTRACT Background and Objective Several studies showed the effect of social capital on smoking cessation. The present study examined this issue. Materials and Methods One hundred eleven smokers admitted to the smoking cessation clinic were consecutively included in a cross-sectional study in 2019. The data were collected using a checklist of demographic characteristics, nicotine dependency (Fagerström questionnaire) and social capital scale (Bullen). The success rate for smoking cessation was determined for smokers at 1-, 3- and 6-month intervals. Data were analyzed by SPSS 22 software. Result Of the 111 participants, 107 were males. The mean age of participants was 47.42 ± 12.66 years. The minimum score of social capital was 63 and the maximum was 172. Of all the patients admitted to the clinic, only 43 (38.7%) completed the cessation sessions (at least 4 sessions), with the mean score of social capital having no significant differences between the two groups (107.97 ± 17.93, 107.58 ± 19.95, respectively, p: NS) Conclusion Given the lack of a significant relationship between social capital and successful smoking cessation in the study, studying other factors like socioeconomic conditions and social norms that affect social capital and smoking cessation seems to be advisable to consider in future studies.

The role of Bordetella pertussis in the development of multiple sclerosis

BackgroundMultiple sclerosis (MS) is one of the most common neurological disorders which main cause is not identified yet. Some studies mentioned the possible role of infectious agents such as chlamydia pneumonia, mycoplasma and also, B. pertussis via asymptomatic nasopharyngeal colonization. The current study aimed to investigate and compared the serum level of B. pertussis antibody and the rate of nasopharyngeal colonization by this pathogen in subjects with and without MS.MethodsIn this case-control study, 109 patients with MS and 114 subjects without MS referred to Sina Hospital in Hamadan in 2019 are studied and compared in terms of serum titer of B. pertussis antibody and nasopharyngeal colonization by this bacterium. Colonization was evaluated using culture and real-time PCR techniques. Data were analyzed using SPSS version 16 with a 95% confidence interval.ResultsThe serum titer of B. pertussis antibody in case and control groups was 37.8 and 35.1%, respectively (P = 0.74). Culture and real-time PCR techniques revealed no case of nasopharyngeal colonization by B. pertussis.ConclusionThere was no difference between B. pertussis antibody titer and the rate of nasopharyngeal colonization between both MS patients and the healthy control group. Therefore, it seems that probably B. pertussis has not a role in MS development.

Epidemiology of Mortality From Cerebrovascular Accident in Patients Admitted to Sina (Farshchian) Educational-Medical Hospital of Hamadan in 2018-2019

Background and aims: Cerebrovascular accidents are a major cause of death and disability in many countries. Therefore, the epidemiological indicators are highly important in the case of these patients’ mortality. The present study aimed to determine the epidemiology of mortality due to cerebrovascular accidents in patients admitted to Sina (Farshchian) hospital of Hamadan within 2018-2019. Methods: In this descriptive cross-sectional study, data of deceased patients were collected from one-year medical records in the neurology wards of Sina (Farshchian) hospital in Hamadan using the census method and a researcher-made checklist. The exclusion criteria were the cause of death except for cerebrovascular accident and incompleteness of data in patient’s medical record. Data were analyzed by descriptive statistical methods and SPSS 21. Results: Out of the 1196 patients admitted to the neurology wards, 159 cases died, and this rate was nearly equal between men and women. The highest mortality frequency belonged to ischemic type (83%), people over 60 years old (83%), illiterate (77.4%), urban (69.2%), self-employed (42.8%) individuals, and those with a history of underlying disease (73.6%), no history of smoking (90.6%), previous stroke (78.6%), and family history of stroke (99.4%). Conclusion: The findings of the present study showed that certain groups such as the elderly, illiterates, urban residents, self-employed, and people with underlying diseases had a higher mortality rate due to cerebrovascular accidents. Thus, special attention to these groups in health planning can be efficient in reducing the mortality of these accidents.

Incidence and Risk Factors of Ventilator-Associated Pneumonia among Patients with Delirium in the Intensive Care Unit: A Prospective Observational Study.

Introduction The incidence and risk factors for ventilator-related pneumonia (VAP) in patients with delirium are deficient, and there is a lack of in-depth knowledge of the impact of VAP on outcomes in this population. We investigated the incidence, risk factors, and outcomes of VAP in patients with delirium. Materials and Methods This prospective observational study was performed in a surgical ICU at Be'sat Hospital in Hamadan, Iran, between 2018 and 2019. A total of 108 patients with delirium were identified using the Confusion Assessment Method (CAM) for the ICU and Intensive Care Delirium Screening Checklist (ICDSC) and enrolled in this study. The association between VAP and delirium, risk factors, and outcomes (ICU length of stay and ICU mortality) for VAP were investigated using the Cox proportional hazards model and logistic and simple linear regression analyses with a 95% confidence interval. Results Of 108 delirium patients, 86 patients (79.6%) underwent mechanical ventilation (MV) and 16 patients (18.6%) experienced VAP during ICU stay. The median onset of VAP was 6.5 (IQR 4.2–7.7) days after intubation. Delirium patients with VAP stayed longer in the ICU (21.68 ± 4.26 vs.12.93 ± 1.71, P < 0.001) and also had higher ICU mortality (31.25% vs. 0%, P < 0.001) than subjects without VAP. According to multivariate cox regression, the expected HR for VAP was 53.5% lower for patients with early-onset delirium than in patients with late-onset delirium (HR: 0.465, 95% CI: 0.241–0.894, P=0.022). However, the expected hazard for VAP was 1.854 times and 4.604 times higher in patients with longer ICU stay (HR: 1.854, 95% CI: 1.689–3.059, P=0.032) and in patients with a prolonged MV duration (HR: 4.604, 95%CI: 1.567–6.708, P=0.023). Conclusion According to the results, there seems to be an inverse relationship between early onset of delirium and VAP. This finding cannot be conclusively cited, and more studies in this filed should be conducted with a larger sample size. Furthermore, VAP in delirium patients is associated with increases in poor outcomes (higher ICU mortality) and the use of medical resources (longer stay in the ICU and MV duration).

Investigation of Effort-Reward Imbalance Model as predictor of Counterproductive Work Behaviors

Introduction: Nowadays, counterproductive behaviors have become a common and costly position for many organizations, and Managers of organizations are always looking for a suitable and practical solution to reduce this type of behavior in their organization. Due to the importance of the subject, the present study aims to investigate the imbalance of effort and reward as a predictor of counterproductive behaviors. Materials and Methods: The present study is a cross-sectional study. The target population was all nurses working in hospitals in Hamadan, and according to the simple random sampling method, 320 people were selected as the research sample. The tools used in this study were the Imbalance of Effort-Reward questionnaire and the counterproductive questionnaire. Data analysis was performed using the Pearson correlation method using SPSS18. Results: The results showed that the effort-reward imbalance model at a significance level of 0.05 is able to predict individual counterproductive behaviors in nurses (P = 0.036). Among the studied variables, the reward variable is able to predict individual counterproductive behaviors (β = -0.179 and P = 0.006) and organizational (β=-0.171 and P = 0.009) and the over-commitment variable is able to predict individual counterproductive behaviors. (β= 0.145 and P = 0.05). According to the results, the effort-reward imbalance model could not predict organizational counterproductive behaviors. Conclusion: Based on the results, it can be concluded that job stress is an important factor in creating Counterproductive behaviors in personnel and the components of the model used in this study can be used to reduce the incidence of these behaviors among nurses.

Effectiveness of prophylaxis treatment in the acute febrile stage of febrile seizure in children under five years old.

ObjectivesIn children suffering from febrile seizure, the likelihood of recurrence seems to be high in the early hours following the first episodes in the absence of proper interventions. The present study was aimed at assessing and comparing the outcomes of different preventive interventions in the acute stage after febrile seizure in children.Materials & Methods This randomized clinical trial study was performed between September 2015 and September 2016. We enrolled patients aged between 6 and 60 months suffered from febrile seizure and referred to the Pediatric Emergency Department at Besat Hospital in Hamadan. The eligible patients were randomly assigned to the following four receive one of the following groups: group 1 (not receiving any anti-seizure drugs), group 2 (receiving a single dose of phenobarbital) on admission, group 3 (receiving a single dose of phenobarbital on admission continued until the fever is resolved), and group 4 (receiving diazepam until the disappearance of fever). Results:The study population consisted of 248 children. The recurrence rate of seizure in the acute stage was 4.84%. Also, the impact of diazepam and phenobarbital (either as a single dose or as continuous) on the prevention of febrile seizure recurrence in the acute stage has been established. None of the patients had febrile status epilepticus. Conclusion:Controlling seizures without prescribing anti-seizure drugs increases the risk for the recurrence of febrile seizure in the acute stage. Different drug regimens for controlling seizure, including diazepam and phenobarbital (as stat or maintenance), may play a similar role in preventing the occurrence of febrile seizure.

Comparison of Vitamin D Deficiency in Patients with Bladder Cancer and Healthy Individuals Referring to Shahid Beheshti Hospital in Hamadan, Iran, from 2018 to 2019

Background and Objective: Bladder cancer is one of the most common cancers in the world. In some studies, vitamin D deficiency has been reported in patients with bladder cancer. Vitamin D deficiency may increase the risk of bladder cancer by disrupting the responses of bladder wall cells to abnormal cells. Materials and Methods: This case-control study included 226 patients with gross hematuria who were referred to the urology clinic of Shahid Beheshti Hospital in Hamadan. The patients were divided into two groups of patients (n=76) with bladder cancer (case group) and those (n=150) without bladder cancer (Control group). The data were analyzed using SPSS software (Version 16) and at a confidence level of 95%. Results: The mean serum level of vitamin D in the case and control groups was obtained at 23.78 and 27.20 ng /mL, respectively (P=0.69). In total, 50% and 34% of patients had moderate and severe vitamin D deficiency in the case and control groups, respectively (P=0.020). The mean tumor size was 2.66 cm and 4 cm in moderate and severe cases of vitamin D deficiency, respectively (P=0.007). Conclusion: Vitamin D deficiency is also associated with increased tumor size in patients with bladder cancer, other than increasing the chance of developing bladder cancer.

Effects of Relationship Enrichment Training on Improving Marital Satisfaction of Infertile Couples: A Randomized Clinical Trial

Background: Infertility can cause low marital satisfaction. Marital satisfaction has an important effect on infertile couples’ health. Objective: This study aimed to assess the effect of relationship enrichment training on improving the marital satisfaction of infertile couples. Methods: This randomized clinical trial was conducted on 50 infertile couples in the infertility center of Fatemiyeh Hospital in Hamadan, Iran in 2018. Participants were matched for demographic characteristics and randomly assigned to intervention and control groups (each group had 25 couples). Informed consent was obtained from all participants. The Enrich Marital Satisfaction questionnaire and demographic information were used to collect data before the study and two months after the intervention. Two trained midwifery students taught only the intervention group about the relationship enrichment topics in seven sessions (each session = 90 minutes). The data were analyzed by SPSS Statistics version 21 using analysis of covariance, independent t-test, chi-square, and Mann–Whitney. The significance level was set at p ≤ 0.05. Results: There was no significant difference in demographic and obstetric information between the two groups (p &gt;0.05). The mean of marital satisfaction in the intervention group significantly increased among women and men from 151.00 ±28.61 to 154.88 ±22.62 and from 152.56 ±27.33 to 159.24 ±22.14, respectively, (p &lt;0.001). Conversely, the mean of marital satisfaction decreased among women and men from 158.13 ±13.86 to 146.25 ±19.53 and from 164.25 ±17.00 to 153.17 ±27.50 in the control group (p=0.02). Conclusion: Relationship enrichment training can be effective in promoting the marital satisfaction of infertile couples.

Effects of Lifestyle and Environmental Factors on the Risk of Acute Myeloid Leukemia: Result of a Hospital-based Case-Control Study

Background: Acute myeloid leukemia (AML) is a common malignancy in adults. A vast variety of environmental and lifestyle factors play a role in AML incidence. This study aimed to assess the factors related to AML. Study design: A case-control study. Methods: This case-control study was performed on 137 AML cases during 2018-2021 at Beheshti Hospital in Hamadan, Iran, and 137 gender/age-matched controls. A questionnaire including 12 items was used to obtain information about lifestyle and environmental factors. A univariate and multiple variate logistic regression was used to estimate the odds ratios (OR), and a 95% confidence interval (CI) was used to investigate the relationship between the studied variables and the incidence of AML. Results: Based on findings, 62 (45.3%) out of the 137 leukemic cases were male and 75 (4.7%) were females. A statistically significant increased risk for AML was found with regard to prior usage of cytotoxic agents (OR: 8.00, 95% CI 1.01, 63.9, P =0.050), family history of malignancies (OR: 3.62, 95% CI: 1.65, 7.92, P =0.001), exposure to electrical power (OR: 3.22, 95% CI: 1.52, 6.81, P =0.002), and history of mental diseases (OR: 8.50, 95% CI: 3.64, 19.80, P =0.001). It was found that the AML incidence had no association with age, gender, radiation therapy, cigarette smoking, prior chemotherapy, congenital disorders, exposure to chemical agents, history of infectious mononucleosis, exercise, and blood transfusion ( P >0.05). Conclusion: The current results suggested that cytotoxic agents, family history of malignancy, mental disorders, and exposure to electrical power could play a role in AML incidence.

Causes and results of non-cardiac surgeries in newborns admitted to the NICU

Background and aims: Surgery is an important and life-saving health service that can treat many of the congenital anomalies. This study aimed to investigate the possible causes and outcomes of non-cardiac surgeries in newborns admitted to the neonatal invasive care unit (NICU) department of Be’sat Hospital in Hamadan during the period 2011 to 2017. Methods: This study included all neonates (482 newborns) who were admitted to the NICU department of Be’sat hospital during the period 2011-2017 due to non-cardiac surgery, and had hospital records. The required information was extracted from their hospital records and the surgical outcomes and complications were analyzed with respect to other variables such as the gender, type of delivery, gestational age, birth weight, and disease. Results: According to our study results, 80.5% of the newborns had the gastrointestinal disease which was the most common cause of surgery found in this study. Moreover, imperforated anus (20.8%) and esophageal atresia (17.1%) were among the most common disorders. Esophageal atresia (33.9%) was detected to be the most common disease among the newborns who died during the course of the study. The results from the study showed that the outcome of surgery had statistically significant relationship with gender (P=0.011), type of breastfeeding/feeding (P&lt;0.001), gestational age (P&lt;0.001), and birth weight (P&lt;0.001). Conclusion: Fetal examinations during pregnancy and neonatal care immediately after birth were recommended for early diagnosis of esophageal atresia, diaphragmatic hernia, and imperforated anus. Since gender (male), breastfeeding, normal gestational age, and normal birth weight had a significantly positive effect on surgery outcome, higher quality care was also recommended for infants lacking these characteristics.

Molecular Detection of blaOXA -type Carbapenemase Genes and Antimicrobial Resistance Patterns among Clinical Isolates of Acinetobacter baumannii.

Acinetobacter baumannii is a bacterium found in most places, especially in clinics and hospitals, and an important agent of nosocomial infections. The presence of class D enzymes such as OXA-type carbapenemases in A. baumannii is proven to have a key function in resistance to carbapenem. The aim of the current study is to determine the blaOXA -type carbapenemase genes and antimicrobial resistance among clinically isolated samples of A. baumannii. We assessed 100 clinically isolated specimens of A. baumannii from patients in intensive care units of educational hospitals of Hamadan, West of Iran. The A. baumannii isolates' susceptibility to antibiotics was performed employing disk diffusion method. Multiplex polymerase chain reaction was used to identify the bla OXA-24-like , bla OXA-23-like , bla OXA-58-like , and bla OXA-51-like genes. The bla OXA-23-like , bla OXA-24-like , and bla OXA-58-like genes' prevalence were found to be 84, 58, and 3%, respectively. The highest coexistence of the genes was for bla OXA-51/23 (84%) followed by bla OXA-51/24-like (58%). The bla OXA-51/23- like pattern of genes is a sort of dominant gene in resistance in A. baumannii from Hamadan hospitals. The highest resistance to piperacillin (83%) and ciprofloxacin (81%) has been observed in positive isolates of bla OXA-23-like . The A. baumannii isolates with bla OXA-58-like genes did not show much resistance to antibiotics. Based on the results of the phylogenetic tree analysis, all isolates have shown a high degree of similarity. This study showed the high frequency of OXA -type carbapenemase genes among A. baumannii isolates from Hamadan hospitals, Iran. Thus, applying an appropriate strategy to limit the spreading of these strains and also performing new treatment regimens are necessary.

Relationship between D-dimer Levels and the Glomerular Filtration Rate in Patients with Chronic Kidney Disease

Background: Given the high sensitivity of the D-dimer assessment when ruling out pulmonary embolism, the present study was conducted to investigate the D-dimer levels in patients with CKD based on their related GFR. Methods: The present cross-sectional study included 98 patients with CKD who presented to the nephrology clinic of the Shahid Beheshti Hospital in Hamadan, Iran. The patients gave informed consent before enrollment. The data of each patient was recorded in the form of a checklist. The data analysis was performed using the SPSS software at a significance level of 0.05%. Results: There was found to be a negative correlation between GFR and D-dimer levels in the study participants. However, there was no evidence of thromboembolic events during the 1-year follow-up. Moreover, we found a direct relationship between patient age and the serum levels of the D-dimer, in that the D-dimer levels were higher in the participants who were older. Conclusion: We concluded that serum D-dimer level has a positive correlation with age, while it has a negative correlation with GFR in CKD patients. However, no evidence of thromboembolic events was found. &nbsp;

Prevalence of psychiatric disorders in multiple sclerosis patients: A cross-sectional study

Introduction and Objective: The incidence risk of psychiatric disorders is higher in patients with multiple sclerosis (MS) than in the general population. This cross-sectional study aimed to evaluate the frequency of psychiatric disorders in patients with MS referring to Sina Hospital in Hamadan, western Iran, from 2016 to 2019. Materials and Methods: This cross-sectional study was performed on 95 patients with MS referring to Sina Hospital in Hamadan, 2016-2019. Demographic information, illness duration, and psychiatric disorders were collected using the Symptom Checklist-90-Revised (SCL-90-R) questionnaire in 2016-2017. Data were analyzed in SPSS software (version 16) using the Chi-square test and Spearman correlation coefficient. Results: The most common psychiatric disorders in these patients were found to be depression in 36 (39.1%) cases, phobic anxiety in 33 (34.7%) subjects, and somatization in 33 (34.7%) patients. The least prevalence rates of the disorders were reported for psychoticism in 17 (17.9%) cases and paranoid ideations in 18 (18.9%) cases. In all psychiatric disorders, except obsessive-compulsive disorder, the frequency of psychiatric disorders was higher in women than in men (27.1% vs. 13.8%), and the only significant difference between the two groups was observed in the anxiety dimension (P=0.002). There was a significant positive correlation between the mean scores of the global severity index and the Expanded Disability Status Scale (r=0.41, P =0.001). Conclusion: The findings of this study showed that in patients with MS, depression, somatization, and phobic anxiety were the most common psychiatric disorders that were associated with increased severity of the disability.

Cardiopulmonary Resuscitation Outcomes of Patients with COVID-19; a One-Year Survey.

Introduction:Assessing cardiopulmonary resuscitation (CPR) outcomes of patients with COVID-19 and employing effective strategies for their improvement are essential. This study is designed in this regard. Methods:This cross-sectional study was conducted between January 20, 2020 and January 20, 2021 in the emergency departments of two hospitals in Hamadan and Kermanshah, Iran. Participants were 487 patients with confirmed COVID-19 and cardiac arrest (CA) who had undergone CPR during the study period. Data were collected using the available CPR documentation forms developed based on the Utstein Style and analyses were performed using Chi-square, Fisher’s exact, and Mann-Whitney U tests and the logistic regression analysis.Results:Participants’ mean age was 69.31±14.73 years and most of them were male (61.8%) and suffered from at least one underlying disease (58.1%). The rate of total and in-hospital CA was 9.67% and 9.39%, respectively. The most prevalent first documented rhythm was asystole (67.9%) and the highest responsivity to CPR was for shockable rhythms. The rate of the return of spontaneous circulation (ROSC) was 9% and the rate of survival to hospital discharge was 2%. The significant predictors of CPR success were age (p = 0.035), epinephrine administration time interval (p = 0.00), CPR duration (p = 0.00), and First documented rhythm (p = 0.009).Conclusion:The rate of in-hospital CA among studied COVID-19 cases was 9.39% with 9% ROSC and 2% survival to hospital discharge rates after CPR. Primary CPR success among patients with COVID-19 was poor, particularly among those with asystole and bradycardia. It seems that old age and improper doses of epinephrine can reduce CPR success.

Comparison of the Effect of Foot and Palm Reflexology Massage on Respiratory Distress Syndrome in Premature Infants under Noninvasive Ventilation

Introduction: Respiratory distress is one of the life-threatening conditions in preterm infants. Sensory deprivation in preterm infants hospitalized in the intensive care units affects their physiological and psychological development. Therefore, this study is an attempt to compare the effects of foot and palm reflexology on respiratory distress in infants subjected to noninvasive ventilation. Methods: In this clinical study, 150 infants hospitalized at Fatemieh Hospital in Hamadan were randomly assigned to 3 groups. In the intervention groups, the reflexology massage to foot and palm was performed for 10 min within 3 days in 6 rounds. In the control group, leg warming was performed. In each group, the personal information checklist, the respiratory distress score, oxygen saturation percentage, and respiratory rate before and after the daily intervention were examined. Data analysis was performed using the standard statistical tests in SPSS. Results: The results mirrored the statistically significant difference between the intervention and control groups 3 days into the intervention with regard to the average oxygen saturation percentage, respiratory rate, and the respiratory distress score (p < 0.05). When eliminating the effect of confounding variables, therapeutic intervention applied to palm compared to foot had a greater effect on reducing respiratory distress score in the studied infants. Conclusion: The reflexology massage method, especially palm reflexology massage, contributes to the mitigation of respiratory distress in preterm infants subjected to noninvasive ventilation. Hence, this low-cost and efficient intervention program can be recommended as a complementary method for preterm infants with respiratory distress.

The Effect of Teaching Patients’ Rights to Midwifery Students on Their Compliance with Patients’ Rights at Fatemieh Hospital, Hamadan, Iran

Background: Medical ethics has emphasized the necessity of respecting patients’ rights. Objectives: This study aimed to determine the effect of teaching patients’ rights to midwifery students on their compliance with patients’ rights in Fatemieh Maternity Hospital in Hamadan. Methods: This quasi-experimental study was performed on all of the midwifery students in the last academic year in 2018. Also, a sample population of 300 pregnant women who were hospitalized for normal vaginal delivery (150 cases in the control group and 150 in the intervention group) was included. A researcher-made checklist was used for assessing compliance with patients’ rights, which was completed for midwifery students before and after training. Also, pregnant women's satisfaction was assessed using a questionnaire. A workshop in two days was implemented for the midwifery students group about the patients' rights charter. Data were analyzed with SPSS 16 software. Results: There was no significant difference between the two groups of pregnant women in terms of education, age, gravida, and para (P &gt; 0.05). The mean score of the adequate services had a significant difference between the before and after training (P &lt; 0.01). The other dimension of patients’ rights was not statistically significant (P &gt; 0.05). There was a significant difference in pregnant women’s satisfaction in psychological domain (P &lt; 0.05). Conclusions: The patients’ rights charter workshop for midwifery students is recommended to improve awareness of them and patient satisfaction.

Effect of Regular Nursing Rounds Based on Ethical Care on Patient Satisfaction with Nursing Care Quality and Patient Anxiety: a Quasi-Experimental Study

Background and Objective: Considering the importance of respecting the rights and satisfaction of patients, as well as the destructive role of anxiety in patients' recovery processes, the present study aimed to evaluate the effect of regular nursing rounds based on ethical care on the level of satisfaction and anxiety of hospitalized patients. Materials and Methods: This quasi-experimental study was conducted based on a pre-test-post-test design in Fatemieh Hospital in Hamadan, Iran. A total of 100 hospitalized patients were assigned to two groups of control and intervention (n=50 in each group), and patients in the intervention group received a clinical round based on ethical care, in addition to routine care. The control group also received routine care. Finally, the difference between the mean scores of satisfaction of nursing services and the anxiety of the two groups before and after the intervention was analyzed in SPSS V.20 software using descriptive and inferential tests. Results: The two groups of intervention and control were not statistically significant in terms of underlying variables and disease and were homogeneous. In the intervention group after receiving the relevant training, anxiety decreased and the level of patients' satisfaction with the quality of nursing care increased significantly, as compared to patients in the control group; therefore, the intervention was effective (P&lt;0.001). Conclusion: Considering the effect of clinical rounds based on ethical care on anxiety and patients' satisfaction with the quality of nursing care, it is recommended to be used as an intervention in therapeutic wards

Adherence and Related Factors in Pregnant Women With Gestational Diabetes

Gestational diabetes is a metabolic disease that can have multiple maternal and fetal complications. Therapeutic adherence can help controlling blood sugar and reducing its complications. This study investigates the medication adherence among pregnant women and the effective factors on it. This cross-sectional study was conducted on 104 pregnant women with gestational diabetes who were referred to the endocrinology clinic of Shahid Beheshti hospital in Hamadan, Iran, in 2018. Input criteria were those over 18 years of age, and output criteria included heart, kidney, and thyroid disorders. Medication adherence was evaluated using Morisky's 6-question questionnaire (MMAS-6). Analyzes were conducted using SPSS version 21 at the significance level of less than 0.05. Based on the results, 77.9% of the women lived in the city, 65.4% had a college education, and 73.1% were housewives. 58.7% of them had good medication adherence. There was a significant relationship between adherence and glycemic control. Address and level of education had a significant relationship with medication adherence. People with higher levels of health literacy had significantly higher medication adherence. Low education level, rural residence, and low health literacy level are determinants of poor medication adherence in pregnant women with gestational diabetes, which indicates the need for more training for these people.

Transit-Oriented Development in Doha: The Case of the Al Sadd Neighborhood and Hamad Hospital Metro Station

Over the last two decades, transit-oriented development (TOD) has been widely implemented as an integrated strategy to enhance urban livability. Doha, the capital of the State of Qatar, has faced urban challenges such as excessive reliance on private vehicles, absence of a well-established public transportation system, and issues with integration of last-mile connectivity. This research study explores Al Sadd, a mixed-use neighborhood in Doha, in order to investigate key factors to be addressed for enhancing urban livability within this neighborhood. These factors were analyzed through a combination of qualitative and quantitative methods incorporating: (1) a literature review focusing on sustainability, smart growth, and transit-oriented development; (2) data collection and analysis utilizing oral and visual data from the Qatari Ministry of Municipality and Environment (MME), Qatar Rail, and private engineering and consulting companies; and (3) analytical and applied study through site analysis, observation, photographs, and field notes. A regeneration master plan for the study area proposes the creation of avenues for urban interaction through the introduction of community open spaces, pedestrian-friendly streets, and other measures promoting city compactness. The outcome of this research study illustrates how the enactment of a TOD model can lead to smart growth and eco-friendly urban living by emphasizing TOD principles which promote a pedestrian-oriented neighborhood.

Epidemiologic and Pathologic Study of Pancreatic Cancer in Hamadan, Iran (2008 to 2018)

Pancreatic cancer is the seventh leading cause of cancer death in cases. The study was conducted to determine the epidemiologic and pathologic of pancreatic cancer METHODS: A case series study was conducted retrospectively at Beheshti Hospital in Hamadan, Iran. A total of 409 cases that had been diagnosed with pancreatic cancer from 2008 to 2018 were reviewed. The variables included age, gender, occupation, pathological type, location involved, early symptoms, metastasis status, prognosis, and treatments were extracted from the files and recorded in checklist. Data were analyzed by using SPSS/20 software. Pancreatic cancer has been increasing trend in terms of time (2008-2018). Pancreatic cancer was most common age in the sixth decade of life and is more common in men than women. There was a significant relationship between aging and the incidence of pancreatic cancers (P < 0.05). Most of the subjects were urban (50.4%). The frequencies of smoking, alcohol, and drugs were 34.5, 15.6, and 14.0%, respectively. Also, there was no statistically significant relationship between smoking, alcohol, and drugs and pancreatic cancer (P > 0.05). The frequency of pancreatic cancers included adenocarcinomas (66.7%), unknown (25.2%), mucinous adenocarcinomas (4.2%), and carcinoma (3.9%), respectively. Pancreatic cancer has been increasing trend in terms of time. Pancreatic cancer was most common age in the sixth decade of life and is more common in men than women. The most common type of pancreatic cancer was adenocarcinoma. Diagnosis usually occurs at higher stages. More preventive considerations were found to be beneficial among this population.