Hospital In Zahedan Research Articles

Key Performance Indicators Related to the Quality of Life in Patients with Celiac Disease: A Descriptive-Analytical Study

Background: Celiac disease (CD) is a chronic, systemic immune disorder that can affect one’s quality of life. Objectives: The aim of this study was to explore the key performance indicators (KPIs) related to the quality of life of patients with CD admitted to the Celiac Association of Bouali Hospital in Zahedan. Methods: This descriptive-analytical study was performed on 60 patients with CD who referred to the Celiac Association of Bouali Hospital in Zahedan in 2018. Data collection tools included a demographic questionnaire (age, gender, marital status, duration of illness, education, ethnicity, economic status, occupation, breastfeeding history, family history of CD, as well as vitamin D and iron supplementation) and the Quality of Life Questionnaire for patients with CD. Data were analyzed in SPSS 21 using descriptive statistics. All values less than 0.05 were considered statistically significant. Results: Sixty participants completed the study, 66.7% of whom were female, 76.7% were married, and 85.3% reported a family history of CD. The total score of patients’ quality of life was 81.66 ± 18.33, and the lowest score of quality of life was associated with patients’ concerns (51.81 ± 3.85). The findings also showed that, among various KPIs, vitamin D had a particularly significant relationship with patients’ quality of life. Conclusions: There was a significant relationship between the quality of life and vitamin D supplementation in the participants. Besides, considering the effect of physical health on improving the quality of life and the chronic nature of CD, it is necessary to enhance the quality of life of these individuals by raising their awareness about micronutrient intakes while respecting their dietary restrictions.

The Effect of Pulmonary Rehabilitation on Fatigue and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease: A Quasi-Experimental Study

Background: Chronic obstructive pulmonary disease (COPD) is a debilitating condition. Those with COPD often complain about fatigue, which can negatively affect activities of daily living, and consequently, the quality of life (QoL). Objectives: This study aimed at determining the effect of pulmonary rehabilitation on fatigue and QoL in patients with COPD. Methods: This quasi-experimental study was performed on 40 eligible patients with COPD admitted to two teaching hospitals in Zahedan in 2018 - 2019. The subjects were randomized into the experimental (n = 20) and control (n = 20) groups based on convenience sampling. Data collection tools included a demographic questionnaire, St George’s Respiratory questionnaire (SGRQ), and the Multidimensional Fatigue inventory (MFI). The QoL and fatigue in both groups were initially measured through interviews. For three consecutive days, patients in the experimental group received three 30-45-min face-to-face training sessions. The pulmonary rehabilitation program was conducted on patients’ bedsides and included theoretical and practical dimensions. Additionally, after necessary coordination with the patients and their families, a summary session was held at patients’ homes. The control group received no training, except for routine care. At the end of the eighth week, the researchers made telephone contact with the two groups (patients or their families) and visited them at their home to complete the SGRQ and MFI. Data were analyzed using SPSS and descriptive and analytical tests (independent t-test, paired t-test, and chi-squared test) at the significance level of less than 0.05. Results: The mean score of changes in QoL was 21.75 ± 7.06 in the experimental group and -1.93 ± 4.70 in the control group. The results of the paired t-test indicated that the mean score of QoL in the experimental group in the post-test was significantly different compared with the baseline (P = 0.001). Moreover, the mean score of changes in fatigue was 35.65 ± 7.12 in the experimental group and 3.25 ± 144 in the control group. In this regard, the paired t-test results showed that the mean fatigue score of patients in the experimental group in the post-test was significantly different compared with the baseline (P = 0.001). Conclusions: Pulmonary rehabilitation program reduced fatigue and improved QoL in patients with COPD. Therefore, it is suggested to consider this program in the care plan of these people.

Comparison of Intravenous Enoxaparin with Subcutaneous Enoxaparin in Preventing Venous Thromboembolism in Patients Admitted to Intensive Care Unit

Background: The use of subcutaneous enoxaparin is a usual method for preventing venous thromboembolism (VTE) in the intensive care unit (ICU) patients, but adequate absorption of the drug is not reliable due to the illness intensity, existing edema and hypoperfusion in these patients. The aim of this study was to compare the effect of intravenous enoxaparin with subcutaneous enoxaparin to prevent VTE in ICU patients. Methods: The current double-blind Randomized clinical trial was performed on 64 patients admitted to the ICU at Khatam- Al- Anbia Hospital in Zahedan, southeast of Iran. The patients were randomly assigned into each of the subcutaneous enoxaparin and the intravenous enoxaparin groups. The blood sampling was performed aseptically and then active factor Xa level was measured. Next, the intervention group received 0.5 mg/kg of intravenous enoxaparin for 10 days and the control group was injected subcutaneously the same dosage of drug. Four hours after the first injection and 12 hours after the last injection on the tenth day, the factor Xa level and the frequency of VTE incidence was measured again. Results: In all three measurement times, the active factor Xa level in the intravenous enoxaparin group was lower than that of the subcutaneous group, but no significant difference was observed between the two groups and different times (P> 0.05). Conclusion: The results of this study showed that the use of intravenous enoxaparin is an effective way to prevent the VTE development in the ICU patients.

Diagnosis Performance of Cerebral Venous Thrombosis with Magnetic Resonance Imaging and Magnetic Resonance Venography in Zahedan (Southeast of Iran): A Series of 57 Patients

BACKGROUND: Cerebral venous sinus thrombosis (CVST) is a scarce disease with poor prognosis and its diagnosis often challenges physicians due to nonspecific symptoms and widespread clinical manifestations.
 AIM: To investigate the findings of magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) of patients with CVST diagnosis in Ali Ebne Abitaleb Hospital in Zahedan during 2013–2016 and to evaluate imaging pitfalls involving in late diagnosis, complications, and even death.
 METHODS: This retrospective descriptive study was done on 57 patients with confirmed CVST during 2013–2016 in Ali Ebne Abitaleb Hospital in Southeast of Iran (Zahedan). The MRI and MRV findings and related diagnostic pitfalls were evaluated. Twenty-one patients are pediatrics and 33 patients are adults.
 RESULTS: Of 57 patients, evidences of cerebral edema were found in 33 patients, among whom 2 patients showed parenchymal edema (cerebral edema) without infarction, and 31 patients exhibited parenchymal edema with infarction. The frequency of involvement in descending order was as followed; transverse sinus (96.49%), sigmoid sinus (49.12%), superior sagittal sinus (29.82%), jugular vein (19.29%), internal cerebral veins (7.01%), straight sinus (5.2%), and cortical veins (5.2%). Diagnostic pitfalls were also found in 8 patients. Seven patients exhibited acute and subacute thrombosis mimicked normal sinus flow void in T2-weighted images. No filling defect was seen on gadolinium-enhanced T1-weighted image in the other patient due to the sub-acute phase of thrombosis.
 CONCLUSION: The delayed diagnosis of CVST originating from nonspecific clinical features and diagnostic imaging pitfalls can result in poor outcomes in patients. To prevent the diagnostic pitfalls, the clinician should give a brief history and clinical data and radiologist(s) should interpret the findings in addition to the use of advanced MR sequences.

The Effect of Regular Family Appointments on Hope of Hospitalized Depressed Patients: a Randomized Clinical Trial.

Introduction: Depression is one of the most common psychological disorders in the world. Many depressed patients are being hospitalized in psychiatric centers every year, which can lead to hopelessness and indifference. Considering the role of family as a support system in caring for depressed patients, the goal of the present study is to assess the effects of regular family appointments on the hope of hospitalized depressed patients.Methods: This was a randomized clinical trial on 70 hospitalized depressed patients in the Baharan psychiatric hospital of Zahedan. Block Randomization was used to categorize the participants continuously into two groups intervention (n=35) and control groups (n=35). The data collection tools were demographic characteristics questionnaire and Schneider hope scale. The patients in the interventions group received 6 sessions of regular family appointments with first- degree relatives. The control group received freely and without any planning appointments. Hope level was measured and compared before and after the intervention for two groups. The data were analyzed by SPSS using the chi-square test, the independent t-test and the paired t-test.Results: The results showed that both groups were homogeneous in terms of socio- demographic differences. The hope scores of patients in the intervention group significantly increased compared to those of the control group.Conclusion: Encouraging family cooperation and using patient's choice in selecting visitors is recommended.

Electrocardiography Findings in Children with Febrile Convulsion

AbstractFebrile convulsion (FC) is a seizure associated with body temperature that leads to electrocardiography changes. This article aimed to study electrocardiographic changes in children with FC as compared with healthy children. In this case–control study, 90 children aged 6 to 60 months were matched with equal healthy ones in “Ali Ebne Abi Talib” hospital in Zahedan, Iran. FC was confirmed by a neurologist based on its definition by the International League Against Epilepsy. Electrocardiogram (ECG) was captured by a pediatric cardiologist. Data were analyzed using SPSS 19. Sex distribution in groups was similar (p = 0.232). QT correction (QTc) was normal in 97.8 and 76.7% of controls and FC children, respectively (p < 0.001). QT dispersion (QTd) was normal in all controls when it was prolonged in 0.6% of children (p< 0.316). Calculated QT (QTcd) prolonged in controls and FC of 4.4 and 27.8% of children, respectively (p < 0.001). RR interval (p = 0.001), heart rate (p< 0.001), S in V1 (p = 0.004), R in aVL (p = 0.007), S in V3(p< 0.001), left ventricular mass (LVM) (p< 0.001), QTd (p< 0.001), QTc max (p< 0.001), and QTcd (p< 0.001) were significant. Means of LVM were 46.00 ± 1.86, 47.22 ± 2.24, and 51.45 ± 2.41 for age groups of <12, 12–24, and >24 months, respectively (p < 0.001). We conclude that QTd, QTc, and QTcd were higher in FC compared with those of healthy children. The rate of FC in children with higher level of QTcd increased compared with controls.

Prevalence of the blaCTX-M and antibiotic resistance pattern among clinical isolates of Acinetobacter baumannii isolated from Zahedan, Southeast Iran

BackgroundAcinetobacter baumannii is a common opportunistic pathogen that causes major nosocomial infections. This study aimed at determining the antimicrobial resistance pattern and the prevalence of blaCTX-M among A. baumannii isolated from the different wards of a teaching hospital in Zahedan, in southeast Iran. Materials and methodsIn this cross-sectional study, 141 A. baumannii isolates were identified and confirmed using standard microbial tests from January to September 2018. The susceptibility profile was performed by disk diffusion and broth microdilution methods. The blaCTX-M (CTX-M groups 1, 2, 8, 9, and 25) genes were also identified using polymerase chain reaction (PCR). ResultsThe results showed a high prevalence of antimicrobial resistance in A. baumannii isolates. More than 95% of the isolates were resistant to piperacillin-tazobactam, ceftizoxime, cefotaxime, ceftazidime, imipenem, aztreonam, and cefazolin. Among 141 A. baumannii isolates, 97.2% and 41.1% of the isolates were multidrug-resistant (MDR) and extensively drug-resistant (XDR) isolates, respectively. The results also indicated that 61.3% of the isolates were positive for blaCTX-M genes with the rate of 22%, 22.7%, 15.6%, and 11.3% for CTX-M-1, 2, 8 and 9, respectively. None of the isolates carried blaCTX-M-25. ConclusionThe present study showed a high prevalence of blaCTX-M genes and MDR strains among A. baumannii isolates. Moreover, the high level of resistance to antibiotics related to the blaCTX-M genes can be a risk factor and emphasizes the need for rapid identification of ESBL-producing strains and antimicrobial susceptibility testing for selecting suitable antimicrobial therapy and preventing further spread of their encoding genes.

The Effect of Spiritual Care on the Spiritual Health of Adolescents with Cancer: A Pre-Experimental Study

Background: Spiritual health is considered one of the most important components of health and palliative care that facilitates harmonious and integrated communication among one's inner forces. One of the basic principles of holistic nursing care is to pay attention to the spirituality and spiritual care of patients. Spiritual care is an important source of adaptation in refractory and chronic patients such as cancer. Objectives: The aim of this study was to determine the effect of spiritual care on the spiritual health of adolescents with cancer. Methods: This pre-experimental, single-group, pre-post study was performed on 35 adolescents with cancer admitted to Imam Ali Teaching Hospital in Zahedan from May to September 2019. Convenient sampling technique was performed to carry out the study based on inclusion criteria. Data collection tools included demographic information questionnaire and Paloutzian and Ellison Spiritual Health questionnaire. Before and after the spiritual care intervention, the required data were collected by interviewing adolescents and using questionnaires. The data were analyzed using Shapiro-Wilk test and paired t-test. Results: Adolescents’ overall spiritual health score increased from 52 ± 7.34 before the intervention to 102 ± 6.57 after the intervention and the difference was significant (P = 0.001). Conclusions: According to the findings of the present study, spiritual care is effective in the spiritual health of adolescents with cancer and can promote adolescent spiritual health. Therefore, it is suggested that nurses incorporate spiritual care into their patient care plans as a simple, accessible, safe and affordable way to promote their spiritual health.

Experiences of Young Girls with Psoriasis: A Descriptive Phenomenological Study

Background: Psoriasis is an inflammatory skin disease with detrimental effects on patients’ physical, mental, and social health. Living with this physical skin disorder can pose a threat to patients’ identity and bring about unwanted changes to their role, mental image, and lifestyle. Hence, the analysis of different experiences and perceptions of people living with psoriasis can help healthcare managers and policymakers in adopting the most efficient coping strategies. Objectives: The study aimed to explain the experiences of young girls with psoriasis. Methods: This qualitative descriptive phenomenological study was conducted using in-depth, semi-structured interviews with 10 young girls with psoriasis who referred to the Dermatology Clinics of Zahedan hospitals in 2018 - 2019. The participants were selected using purposive sampling and the data were analyzed by Colaizzi’s method. Results: The themes describing the experiences of young girls with psoriasis included the challenging emergence of disease, indefatigability in pursuit of ineffective treatment, social stigma as a community gift to the patients, and fear of uncertain future. Conclusions: The challenges of the incidence of disease at a young age and insistence on ineffective treatments were highly evident in the experiences of patients. The patients were also concerned about the social stigma associated with the disease, which could pose further challenges to their uncertain future. According to the findings, increasing public awareness of the disease and applying psychological strategies can be effective in addressing the problems of psoriasis patients. Elevating the awareness of families to accompany the patients in treatments can also be another effective measure.

INVESTIGATING THE FREQUENCY OF NORMAL VAGINAL DELIVERY AND CESAREAN SECTION AND CAUSES OF CESAREAN SECTION IN PUBLIC AND PRIVATE CENTERS AND COMPARING IT WITH EDUCATIONAL CENTERS IN ZAHEDAN

Introduction. Cesarean section plays an important role in decreasing the mortality and complications of childbirth in the mother and fetus. But the worrying issue in modern midwifery is the high rate of cesarean section. The current study was done to evaluate the frequency of normal vaginal delivery and cesarean section and the causes of cesarean section in public-private centers and compare it with educational centers in Zahedan in 2016-2017. Materials and methods. This is a descriptive cross-sectional study and a total of 792 deliveries were studied, 300 cases were from university hospitals and 492 from non-university hospitals in Zahedan. SPSS22 software was used for data analysis. Findings. The results disclosed that in university hospitals, 65.3 of the deliveries were normal vaginal delivery and 34.7 were cesarean, and in the non-university hospitals, 44.5 and 55.5 of the deliveries were normal and cesarean deliveries, respectively. There was a significant relationship between the type of delivery and the hospital where the delivery was done (P < 0.001). The most common causes of cesarean section in this study were: previous cesarean section (33.7), fetal distress (14.9), cesarean delivery on maternal request (CDMR) (11.7), delivery failure (11.4), mother's disease (7.4), abnormal fetal placement (6.6), multiparous pregnancy (4.5), problems with the placenta and umbilical cord (4), cephalopelvic disproportion (3.2) and embryonic diseases (2.7). There was no cesarean delivery on maternal request (CDMR) in university hospitals while in non-university hospitals it was 16.1. Conclusion. Generally, the percentage of normal vaginal delivery was higher than that of the cesarean section, but the number of cesarean sections was higher in non-university hospitals than in university hospitals. Also, ethnicity, number of pregnancy, job, education, history of infertility, and awareness of complications were significantly related to the type of delivery.

The Effect of Oral Care with Miswak Versus Chlorhexidine on the Incidence of Ventilator-Associated Pneumonia: A Clinical Trial Study

Background: Inadequate oral care in ICU patients can lead to lethal complications such as ventilator-associated pneumonia (VAP). Objectives: The purpose of this study was to compare the effect of oral care using miswak and chlorhexidine mouthwash on the incidence of VAP in ICU patients. Methods: This single-blind randomized clinical trial was carried out in 2018 on 70 patients undergoing mechanical ventilation in the intensive care units of Khatam-al-Anbia Hospital in Zahedan, Iran. The inclusion criteria were the insertion of endotracheal tube, scoring 10 or below based on Beck oral assessment scale (BOAS), scoring below 5 based on the modified clinical pulmonary infection score (MCPIS) at the beginning of the study, absence of chronic pulmonary disease, and no history of pulmonary aspiration. The subjects were selected through convenience sampling and randomly divided into the intervention (n: 35) and control (n: 35) groups. For five days, oral care was administered using miswak in the intervention group and chlorhexidine mouthwash in the control group. Data were collected through a demographic and clinical information questionnaire, MCPIS, and BOAS. After normality tests, the obtained data were analyzed in SPSS 22 using independent t-test, chi-square test, and Fisher’s exact test at the significance level of P < 0.05. Results: The two groups were similar in terms of age, gender, cause of hospitalization, level of consciousness, administered antibiotics, history of ICU admission, and smoking. After oral care with miswak, none of the patients in the intervention group developed VAP, but 6 patients in the control group (17.1%) were diagnosed with this condition. The results of Fisher’s exact test showed a significant difference between the two groups in terms of VAP incidence (P = 0.01). Conclusions: In addition to promoting the oral health of ICU patients, miswak can mitigate the incidence of ventilator-associated pneumonia. Therefore, because of its availability, cost-effectiveness, and fewer side effects compared to chlorhexidine mouthwash, it is strongly recommended to be administered to ICU patients.

Nurses Experiences in the Burn Unit: A Qualitative Research.

Background:Nurses form the largest group of burn care treatment team. They have valuable experiences regarding the care of burned patients that needs to be explored. Therefore, the present study was aimed to explain the experiences of nurses who work in the burn unit.Materials and Methods:This qualitative study was conducted in the burn units of Zabol and Zahedan Hospitals in 2018. Accordingly, the data were collected through a semi-structured deep interview with 16 nurses. Purposeful sampling method was used for data collection. The data were analyzed using a thematic analysis approach.Results:The data analysis ultimately led to the development of 4 themes and 16 sub-themes. The extracted themes included burden of burn unit, toil of burn unit as a deal with God, need for continuing the education program, and work-life imbalance.Conclusions:Nurses in burn unit experience many challenges that can affect their job and life, which require special attention of the authorities, their families, and other colleagues. For better patient care, there is a need for up-to-date facilities and training. The hospital managers should pay more attention to the nursing staff of the burn units through increasing staff number, changing the working units, and offering financial and motivational vacations.

Effect of Eye Masks, Earplugs, and Quiet Time Protocol on Sleep Quality of Patients Admitted to the Cardiac Care Unit: A Clinical Trial Study

Background: There are several factors such as noise and light, which affect the sleep quality of patients admitted to the cardiac care unit (CCU) and cause sleep disorders in these individuals. Objectives: The purpose of this study was to compare the impact of applying eye masks and earplugs as well as implementing the quiet time (QT) protocol on the sleep quality of patients hospitalized in the CCU of Ali Ibn Abi Talib Hospital in Zahedan. Methods: This clinical trial was performed on 135 CCU patients. Subjects meeting the inclusion criteria were chosen through convenience sampling. The patients were divided into three groups (control, eye mask and earplugs, and QT protocol) and were matched in terms of background variables. The subjects were studied over three days after admission. On the first night, the patients’ sleep quality was determined by the Verran and Snyder-Halpern Sleep Scale (VSH), and on the second and third nights, the interventions (eye mask and earplugs and QT protocol) were administered. The next day, as the post-test, patients’ sleep quality was measured again. ANOVA test was used to determine and compare the mean sleep quality of the three groups, and the chi-square test was employed to compare the qualitative variables in the three groups. Results: After the intervention, the mean score of sleep disturbance was significantly different between the control and the two experimental groups. Also, the mean score of sleep efficacy was higher in the eye mask and earplugs group than the other two groups, indicating a better sleep quality in this group. Conclusions: As low-cost devices with no side effects, eye masks and earplugs can improve the quality of sleep in [CCU] patients, and nurses could utilize them to help reduce environmental factors, which disturb patients’ sleep.

The Effect of Self-Care Training on Spirometric Indices in Patients with Chronic Obstructive Pulmonary Disease: A Clinical Trial Study

Background: Pulmonary changes and their respiratory consequences in patients with chronic obstructive pulmonary disease (COPD) could lead to many physical complications and are one of the major causes of hospitalization. Objectives: In this regard, the present study explores the efficacy of self-care training on spirometric indices of COPD patients. Methods: This clinical trial was performed on 70 patients with COPD who had been admitted in 2017 to Ali Ibn Abi Talib Hospital in Zahedan, Southeast Iran. The subjects were recruited through convenience sampling based on the inclusion criteria and were subsequently randomized to the intervention and control groups. The self-care program was administered to the intervention group during eight 30-minute sessions organized within 4 weeks. Data collection tools included a demographic questionnaire and Vitalograph Alpha Spirometer. Data were analyzed in SPSS V. 21 using chi-square, Independent t-test, and Paired t-test at the significance level of 0.05. Results: The results of 8 sessions of self-care training revealed that the mean FVC index of patients before self-care education was 43.40 ± 8.54 in the intervention group and 46.54 ± 10.73 in the control group. After the educational program, the mean score of this index changed significantly in the intervention group (48.62 ± 9.30) (P = 0.01), but no such alteration occurred in the control group (47.11 ± 10.27) (P = 0.16). Furthermore, the mean FEV1 index of the two groups differed significantly after the self-care program (P = 0.01). Conclusions: Given the impact of self-care training on improving spirometric indices in patients with COPD, it is recommended that nurses help ameliorate breathing status of these patients and relieve their symptoms by providing them with self-care instructions.

Seasonal variations of 25-OH vitamin D serum levels in Multiple Sclerosis patients with relapse using MRI.

An increasing body of evidence suggests that low vitamin D (25-[OH]-D) concentrations is linked to increased activity in multiple sclerosis (MS) patients and MS relapse. Therefore, the current study was aimed to evaluate vitamin D serum concentrations and its possible seasonal variations among MS patients with relapse. This prospective, descriptive study was conducted on patients with MS relapse who referred to the neurology center of Ali ibn Abi Talib Hospital in Zahedan during one year. Magnetic Resonance Imaging (MRI)-Spine was performed for 90 patients and serum samples were collected from patient to measure serum vitamin D levels using RIA KIT. Furthermore, the plaques in each patient's MRI were counted and then recorded. Descriptive and inductive statistics were conducted using statistical software. Our findings indicated a significant correlation between serum vitamin D level and cervical spinal cord plaques (p = 0.007, r = 0.28), while no association was revealed between serum vitamin D level and number of brain plaque. Furthermore, a significant association was also observed between number of cervical spinal cord plaques and serum vitamin D levels. In addition, a reverse correlation was observed between number of cervical spinal cord plaques and serum vitamin D levels in spring. In autumn, there was a statistically significant relationship between number of brain plaque and serum vitamin D level. Additionally, a statistically significant relationship was found between serum vitamin D levels and number of plaques in winter. Our findings are in agreement with some previous studies that reported conflicting result, where the association of season with the prevalence of relapse cases cannot be verified. Although the mean serum levels of vitamin D are inversely correlated with the incidence of relapses in winter. However, the values obtained in the spring do not confirm such an inverse relationship.

Electrocardiography Findings in Children with Epilepsy Compared with Healthy Children

Background Epilepsy is one of the most common neurological diseases. Over the last decades the hypothesis of cardiovascular effects from sudden seizure has been raised, and cardiac rhythm and ECG changes in these patients have been highlighted. The study aimed to evaluate the electrocardiography findings in children with epilepsy compared with healthy children. Materials and Methods In this case-control study, 90 patients aged between 6 months and 18 years who were matched with equal number of healthy children who referred to pediatric ward the of 'Ali Ebne Abi Talib' hospital in Zahedan, Iran. The study was performed in multicenter of Neurology and Cardiology centers. In the patients, the epilepsy was confirmed by a unique pediatric neurologist based on the definition of having at least two unprovoked seizures in 24 hours. ECG was captured from all participants by a pediatric cardiologist. Results In patients, 45.6% (n= 41) were females and in healthy 51.1% (n= 46) were females. Mean age of participants was similar in patients and healthy children (p=0.060). ECG findings such as QT min (p=0.001), R-R interval (p<0.001), Heart rate (p<0.001), S in V1 (p=0.002), R in aVL (p<0.001), S in V3 (p=0.003), QTd (p<0.001), QTcd (p<0.001), QTc max (p<0.001), and LV mass (p=0.007) were different in patients compared to controls. In patients, from ECG parameters, R in V5 was higher in male patients (p=0.043). Conclusion Based on the results, QTc, QTd, QTcd were prolonged in patients with epilepsy and, R in V5 was higher in male patients. To prevent abnormality rhythm in epilepsy, it is needed to evaluate QT to recognize the autonomic changes.

Comparison of Induction Abortion in the First Trimester Using Misoprostol Alone and Misoprostol With Estrogen Priming

Objectives: Miscarriage is defined as the loss of pregnancy before the 20 weeks of gestational age. This study was conducted to compare the induction abortion in the first trimester using misoprostol alone and misoprostol with estrogen priming. Materials and Methods: This clinical trial was conducted in Ali ibn-e Abitalib hospital of Zahedan in 2017. A total of 100 women with missed abortions under 14 weeks of gestational age were evaluated. The women were randomly assigned into the misoprostol alone and misoprostol with estrogen priming groups. Ultrasound was done to evaluate the presence of remnants 4 hours after the abortion. If it was less than 10 mm, the abortion was considered successful. Results: The success rate was 38% in the misoprostol group and 86% in the misoprostol with estrogen priming group. Conclusions: Overall, this study showed that estrogen increases the success rate of abortion and reduces the time to abortion.

Investigation of informal payments and related factors in Iran state hospitals after health system reform plan implementation

Background: Informal payments in many developing countries, are a serious obstacle towards to improving healthcare system and has negative effects on the function of healthcare system. In order to reduce the unofficial payments and direct payments from patient's pocket, the health reform plan executed. This study was conducted to assess the Informal payments in the hospital related to government. Methods: This study was a survey based on descriptive analytic method in Zahedan University of medical science in 2017. The study population included all patients hospitalization to the two genera) hospitals of Zahedan in 2017, in which 500 patients were selected by multistage cluster sampling. The data collection tool was a standard questionnaire that was conducted by interview method. Data were analyzed by using spss v22 and descriptive statistics and chi-square test. Results: in this study,98% patients were male, 484(96.8%) lived in the urban area, about 2% had informal payment, the average informal payment to nurses were 300 thousand tomans.The highest number of informal payment was in the maternity ward with 50%.The doctors didn't have any informal payment, and all of people disagreed this type of payments. Conclusion: The results of the study showed that the rate of informal payments in the hospitals related to government in Southeast of Iran after execution of health reform plan, Is minimal. Poor economic status of the patients and well executed health reform plan are the reasons for minimal informal payments. Solutions including constant supervision on employees and realization of the health costs and proportion of insurance companies are effective steps towards elimination of informal payments.

The Relationship Between Endometrial Thickness and Endometrial Pattern With Pregnancy Rate Based on Positive Serum Beta-Human Chorionic Gonadotropin

Objectives: Infertility is defined as the lack of pregnancy after one year of sexual contact without using any contraception. The aim of this study was to investigate the association between endometrial thickness (ET) and endometrial pattern with beta-human chorionic gonadotropin (B-HCG) test in women undergoing the induction of ovulation who referred to the infertility clinic of Ali ibn-e Abitalib hospital in Zahedan. Materials and Methods: This cross-sectional study was conducted at Ali ibn-e Abitaleb hospital in Zahedan (Iran) in 2017. The ET and endometrial pattern were estimated using transvaginal sonography and the pregnancy rate was determined based on B-HCG test. Finally, the data were analyzed by SPSS using the Chi-square test and independent t-test. Results: A total of 200 individuals with a mean age of 29.6 ± 5.6 years were evaluated in this study. The negative or positive B-HCG distribution was significantly different in terms of the endometrial pattern (P=0.001) so that 35.3% of women had B-HCG positive cases in the three-line pattern of ET while in the homogenous pattern, 3.3% had B-HCG positive cases. In addition, the pregnancy rate in women with ET greater than 7 mm was significantly higher compared to those women with ET less than 7 mm thickness (35.1% vs. 12.8%, P&lt;0.001). Conclusions: Overall, the results of this study showed a significant correlation between the endometrial pattern and ET and pregnancy rate based on positive B-HCG test.

Effect of Peer Education on the Resilience of Mothers of Children with Leukemia: A Clinical Trial

Background: Resilience has become a basic construct in theories and studies of welfare and mental health. The mother is the one most involved emotionally in the child’s cancer and its treatment and hence, she requires the most degree of resilience. Therefore, it is crucial to deploy effective methods to enhance the resilience of mothers. Objectives: The purpose of this study was to determine the impact of peer education on the resilience of mothers of children with leukemia. Methods: This clinical trial was performed on 74 mothers of children with leukemia who had been hospitalized in the hematology ward of Ali ibn Abi Talib Hospital in Zahedan in 2017. Convenience sampling was used to recruit the participants in accordance with the inclusion criteria. The subjects were randomly assigned to the control and experimental groups. Peer group training was then conducted for the experimental group for five days. The Connor-Davidson Resilience Scale (CD-RISC) was completed for both groups before and immediately after the intervention, as well as two months later. The data were then analyzed using the chi-square test (Fisher’s exact test), independent t-test, repeated measures ANOVA, and Bonferroni post hoc test at the significance level of P 0.05). Meanwhile, two months post-intervention, a significant difference was observed in this regard between the control and experimental groups, with the latter featuring a higher mean score (P < 0.001). Besides, the results suggested a significant increase in the total score of resilience and all its subscales over time in the experimental group (P < 0.001). Conclusions: Peer education could be implemented as an inexpensive easy method to improve the resilience of mothers of children with leukemia.