The impact of mindfulness-based stress reduction training on the occupational stress and burnout experienced by nurses in geriatric wards? A randomized controlled trial.

In this clinical trial, 60 nurses from three geriatric centers were enlisted and randomly split into two groups: control (n = 30) and intervention (n = 30). Statistical analysis using SPSS version 21 employed Kolmogorov-Smirnov, Chi square, and t-test to assess results. The intervention group received eight training sessions. After the MBSR Training in the intervention groups, results showed there was a statistically significant difference between the two groups concerning the scores of the subscales of death and dying (t = 6.161, P < 0.001), conflicts with physicians (t = 7.962, P < 0.001), inadequate preparation (t = t = 6.524, P < 0.001), lack of support resources (t = 5.532, P < 0.001), conflicts with nurses (t = -6.632, P < 0.001), workload (t = 6.587, P < 0.001), uncertainty of treatment (t = 5.587, P < 0.001) as well as the scores of the subscales of burnout.

The effect of multivitamins on anxiety and depression in patients undergoing methadone maintenance treatment: A double-blind randomized controlled trial.

BACKGROUND: The prevalence of addiction is increasing in the world. Methadone Maintenance Treatment (MMT) can be associated with severe stress and mild to moderate depressive symptoms. Vitamins and minerals are commonly found in multivitamins seem to improve mood. Therefore, the aim of this study was to evaluate the effect of multivitamins on anxiety and depression in patients undergoing MMT in a double-blind randomized controlled trial. METHODS: The study was designed as a double-blind, randomized controlled trial and involved 70 male MMT patients over the age of 18. Participants were randomized to one of two groups, either those receiving multivitamins or those receiving a placebo for 12 weeks. The multivitamin capsule included vitamin E, B1, B2, B3, B5, B6, B12, C, biotin, folic acid, and zinc. Anxiety and depression were measured using standard questionnaires, before and after the intervention. RESULTS: The between-group comparison (i.e., intervention vs. placebo) indicated there was no significant difference in anxiety scores; however, there was a significant between-group difference in depression scores, favoring the intervention group. CONCLUSIONS: Multivitamin supplementation improved depression but did not have a significant impact on anxiety in patients undergoing MMT.

Treating surgical site infection by honey antibacterial wound dressing in a neonate: a case report.

Surgical site infection (SSI) increases length of treatment, delays wound healing, increases antibiotic use and causes patient death in severe cases. This case was a boy aged 38 weeks and 4 days with a birthweight of 2100 g, a height of 42 cm and a head circumference of 32 cm. Twelve days after birth, he was admitted to hospital where a surgeon removed a sacrococcygeal teratoma. The surgical site became infected, and the infection failed to improve despite him receiving routine normal saline dressings twice a day and intravenous antibiotic therapy. The authors started treatment using an antibacterial wound dressing containing honey (Medihoney) on the SSI twice a day for a month. The infant's SSI was wholly healed after 3 months, and he was discharged from the wound treatment team in good general condition. This case shows that SSIs can be treated with honey-containing antibacterial wound gel, especially in infants who have weaker immune systems.

Do the patient education program and nurse-led telephone follow-up improve treatment adherence in hemodialysis patients? A randomized controlled trial.

BACKGROUND: End-Stage Renal Disease (ESRD) is the final and permanent stage of Chronic Kidney Disease (CKD). Hemodialysis (HD) is the most common treatment for CKD. To have desirable therapeutic outcomes, patients have to adhere to a specific therapeutic regimen that reduces the hospitalization rate and side-effects of HD. The present study aimed to determine the effects of the patient education program and nurse-led telephone follow-up on adherence to the treatment in hemodialysis patients. METHODS: This is a randomized controlled trial in which a total of 66 patients were recruited using convenience sampling and then randomly assigned to two groups of control (n = 33) and intervention (n = 33). Data were collected using a demographic questionnaire, the laboratory results record sheet, and the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), which included four dimensions of HD attendance, medication use, fluid restrictions, and diet recommendations. The intervention group received a patient education program and nurse-led follow-up services through telephone communication and the Short Message Service (SMS) for 3 months. All participants filled in the questionnaire before and after the intervention. Data were analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA). RESULTS: The results showed a significant difference in the mean scores of HD attendance, medication use, fluid restrictions, and diet recommendations between the two groups immediately, 1 month, and 3 months after the intervention (p < .001). The results also indicated a significant difference in the mean scores of four dimensions during the four-time points of measurement in the intervention group (P < 0.0005). Therefore, the level of treatment adherence in the intervention group was higher than in the control group. Moreover, there was a significant difference in the mean score of laboratory values between the two groups after the intervention, except for the level of serum sodium (P = 0.130). CONCLUSION: Implementation of the patient education program and nurse-led follow-up can lead to better adherence to hemodialysis in four dimensions of HD attendance, medication use, fluid restrictions, and dietary recommendations in HD patients. TRIAL REGISTRATION: IRCT registration number: IRCT20190127042512N1 ; Registration date: 2020-09-12; Registration timing: retrospectively registered: Last update: 2020-09-12.

Effect of spiritual care on the quality of life in patients who underwent intracranial hemorrhage surgery: a randomized controlled trial.

INTRODUCTION: One of the most important complications of stroke after intracranial haemorrhage surgery is impaired quality of life. This study was conducted to determine the impact of spiritual care on the quality of life of stroke patients. METHODS: This single-blind clinical trial with a pre-test and post-test design was conducted on 100 stroke patients. Participants were recruited and randomly assigned to a control group and an intervention group. The stroke-specific quality of life (SS -QoL) scale was used to assess the quality of life of stroke patients. The intervention group received four sessions of spiritual care. RESULTS: The independent t -test showed no significant difference between the two groups in the mean quality of life score ( t =-0.120, P =0.281) and its dimensions before the intervention. However, after the intervention, the results showed a significant difference between the two groups in terms of the mean quality of life score ( t =1.984, P <0.001) and its dimensions. In addition, the results of the paired t -test showed that in the intervention group, the mean score of quality of life ( t =5.161, P <0.001) and its dimensions were significantly different before and after the intervention. Furthermore, the results showed that before and after the intervention in the control group, the mean score of quality of life ( t =1.109, P =0.614) and its dimensions were not significantly different. CONCLUSIONS: Based on this results, the authors strongly recommend the use of spiritual care as a holistic care and complementary method to improve the symptoms and quality of life of stroke patients.

Apert syndrome in a newborn with premature fusion of skull bones, a rostral nose, and cleft palate: A case report.

This case details a term neonate with Apert syndrome, featuring webbed digits, FGFR2 mutations, skull bone fusion, a rostral nose, and cleft palate. The neonate displayed acrocephaly, a flat skull back, a prominent forehead, and syndactyly, confirming Apert syndrome. It emphasizes the need for early recognition and intervention.

Surgical debridement and maggot debridement therapy can survive patient with diabetic foot ulcer after foot trauma: A case report.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers, a common issue associated with diabetes, can pose challenges in treatment, especially when they do not respond to traditional therapies. Maggot therapy, known as larval therapy, has surfaced as a substitute approach for managing stubborn wounds. CASE PRESENTATION: A 42-year-old male with a history of type 2 diabetes and peripheral neuropathy presents at the clinic with a long-lasting sore on the bottom of his right foot. The individual reveals that the ulcer has persisted for multiple months and has shown no improvement despite trying different remedies like creams and dressings. CLINICAL DISCUSSION: Diabetic foot ulcers are significant complications associated with diabetes, commonly triggered by neuropathy, peripheral artery disease, and impaired wound healing mechanisms. These ulcers can result in severe infections, amputations, and reduced quality of life for those affected. CONCLUSION: Maggot therapy arises as a valuable additional option for chronic ulcers in diabetic patients, providing a secure and efficient method for cleaning wounds and promoting healing.

Comparing the impact of acupressure and reflexology on fatigue in chronic lymphocytic leukemia patients: A randomized controlled trial with three arms.

PURPOSE: This study aimed to evaluate the effects of acupressure and reflexology on fatigue in chronic lymphocytic leukemia patients. METHOD: In this randomized controlled trial with three arms and a pretest-posttest design, 102 CLL patients were randomly allocated to acupressure (n = 34), reflexology (n = 34), or control (n = 34) groups. Pre-intervention assessments were conducted using a demographic questionnaire and a fatigue scale for cancer patients. The acupressure group received routine care with acupressure targeting the SP6 point for 10 min twice daily over four weeks. The reflexology group received daily 10-minute reflexology sessions over four consecutive weeks following the preparation and lubrication of the soles of their feet with sweet almond oil. Post-intervention assessments were administered to all groups using the same instruments. RESULTS: Results showed both acupressure and reflexology significantly reduced fatigue compared to the control group (P < 0.001). While differences were noted between acupressure, reflexology, and control groups initially, the post-intervention analysis revealed no significant variance between acupressure and reflexology in reducing fatigue (P < 0.05), suggesting similar improvement between acupressure and reflexology. CONCLUSIONS: Acupressure and reflexology are recommended as cost-effective and low risk complementary approaches for managing fatigue in chronic lymphocytic leukemia patients. These therapies offer promise in alleviating fatigue and enhancing the quality of life for cancer patients.

The devastating impact of unresectable infectious undifferentiated pleomorphic sarcoma in the gluteal region: A case report.

INTRODUCTION AND IMPORTANCE: Undifferentiated pleomorphic sarcoma (UPS), previously known as malignant fibrous histiocytoma (MFH), is a highly aggressive soft tissue sarcoma characterized by its pleomorphic histology and lack of differentiation. CASE PRESENTATION: A 35-year-old man visited our oncology department with a complaint of a growing mass in his left buttock area. The mass had been increasing in size for the past six months, affected by local and systemic infection. While it was initially painless, the patient started feeling discomfort during sitting and physical activities a few weeks, but later the complication of tumor became more aggressive. CLINICAL DISCUSSION: UPS can arise in various anatomical sites, including the extremities, trunk, retroperitoneum, and head and neck region. Clinically, UPS may present as a rapidly growing mass, often with pain and limited range of motion. However, the presentation may vary depending on the site of origin. Treatment for UPS typically involves surgical resection, aiming to remove the tumor completely. Depending on the size, location, and aggressiveness of the tumor, additional treatments such as radiation therapy or chemotherapy may be recommended. CONCLUSION: Undifferentiated pleomorphic sarcoma (UPS) represents a rare and aggressive soft tissue sarcoma requiring prompt and accurate diagnosis for appropriate management. With its non-specific clinical presentation and histological features, UPS can be challenging to differentiate from other soft tissue tumors.

Comparing the Efficacy of Acupressure and Foot Reflexology on Sleep Quality in Patients With Leukemia: A Comparative Clinical Trial.

BACKGROUND: Among leukemia patients, sleep disruptions are prevalent and can profoundly affect their overall quality of life. Acupressure and foot reflexology, modalities rooted in traditional Chinese medicine, have garnered attention for their potential to address sleep disturbances and mitigate associated symptoms. METHODS: This research utilized a randomized controlled trial with a pretest-posttest design involving 102 leukemia patients admitted to Imam Khomeini Hospital in Urmia. Participants were randomly allocated to 3 groups: acupressure (n = 34), reflexology (n = 34), or control (n = 34). Prior to the intervention, patients completed a demographic survey and the Pittsburgh Sleep Quality Index (PSQI) for baseline assessments. Acupressure involved stimulation of the SP6 point twice daily for 10 minutes over 4 weeks, while reflexology entailed daily 10-minute sessions with sweet almond oil on the soles for the same duration. The control group received standard care without additional interventions. Following the 4-week intervention period, post-intervention evaluations were conducted using identical measurement tools. RESULTS: The findings underscored the efficacy of both acupressure and foot reflexology in significantly improving sleep quality within the intervention groups (P < .001). Initially, there were no notable differences in sleep quality among the 3 groups (P > .05). Subsequently, pairwise comparisons adjusted with Bonferroni corrections revealed significant disparities in sleep quality between the acupressure and reflexology groups compared to the control group (P < .001). However, post-intervention analysis indicated no statistically significant variance in enhancing sleep quality between the acupressure and foot reflexology groups (P < .05). CONCLUSION: This study demonstrates that acupressure and foot reflexology interventions can enhance sleep quality in individuals with leukemia. These findings support the effectiveness of these complementary modalities, offering targeted relief and relaxation. While these non-invasive therapies show promise in improving well-being, further research is needed to confirm and expand upon these results due to study limitations.

Healing of a diabetic foot wound through surgical debridement using med-honey, maggot therapy, and human amniotic membrane: A case study.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers (DFUs) are a common and challenging issue for individuals with diabetes, creating difficulties in effective wound healing and requiring novel treatment methods. CASE PRESENTATION: The individual, a 46-year-old man, arrived at our clinic with a pressure wound concern. The wound had progressed to where necrotic tissue removal was necessary, accomplished through four sessions of maggot therapy. Following this initial treatment, Med-honey dressing and human amniotic membrane application were used in eight subsequent sessions, resulting in the successful closure of the wound. DISCUSSION: Treating DFUs presents a significant hurdle in medical practice due to their intricate nature and potential complications. Recent years have seen an increase in the exploration of unconventional and innovative therapies to enhance wound healing outcomes and tackle the multifaceted challenges linked with DFUs. CONCLUSION: The effective management of the pressure wound in this 46-year-old male patient with a combination of maggot therapy, Med-honey dressing, and human amniotic membrane application highlights the significance of a personalized and interdisciplinary approach in DFUs care.

Comparison of the effect of telephone follow-up with social network follow-up program on self-efficacy and depression in patients undergoing coronary artery bypass graft surgery: A randomized controlled trial.

Introduction: Coronary artery bypass graft (CABG) surgery is a common procedure to improve blood flow to the heart muscles, but patients often face challenges during the recovery period. Self-efficacy and depression play crucial roles in patient outcomes. Telephone follow-up and social network follow-up have been introduced as interventions to enhance self-efficacy. This study aims to compare the effectiveness of telephone follow-up and social network follow-up on self-efficacy and depression in CABG patients. Method: The study is a single-blinded, randomized controlled trial conducted at Shahid Rajaee Heart Hospital in Tehran, Iran. The sample size was determined to be 99 patients who met the inclusion criteria. Data were collected using a demographic questionnaire, Sullivan's cardiac self-efficacy questionnaire, and the Beck Depression Inventory (BDI). Participants were assigned to three groups: control, telephone follow-up, and WhatsApp follow-up using randomization. Data were analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA). Results: The results revealed significant improvements in self-efficacy and reductions in depression scores for both the telephone and WhatsApp follow-up groups compared to the control group following the intervention (p < 0.001). Additionally, the mean self-efficacy score was higher and the mean depression score was lower in the WhatsApp follow-up group than in the telephone follow-up group after the intervention (p < 0.001). Discussion: The findings provide valuable insights for healthcare professionals in choosing appropriate interventions to enhance patients' self-efficacy levels and improve mental health outcomes. Both telephone follow-up and social network follow-up interventions have their own advantages and can be effective in supporting patients' recovery after CABG surgery.

NSAID (nonsteroidal anti-inflammatory drugs) Induced Stevens Johnson Syndrome in a 50-year-old woman: A case study.

Stevens-Johnson Syndrome (SJS) is a severe and rare adverse drug reaction associated with significant morbidity and mortality. Although SJS is commonly triggered by multiple drugs, non-steroidal anti-inflammatory drugs (NSAIDs), including diclofenac, have been frequently implicated. A middle-aged woman, who is 50 years old, has a prior medical record of high blood pressure, type 2 diabetes, and has recently suffered from a pulmonary embolism. She was later admitted to the intensive care unit (ICU), where she was ultimately diagnosed with Steven Johnson syndrome. Careful drug selection, close monitoring of patients with predisposing factors, and prompt identification of adverse events are crucial to prevent severe drug reactions.

Traditional cheese consumption leading to hemodialysis induced by rifampin treatment: A case report.

This case report details the journey of a 51-year-old man residing in a remote Iranian village, involved in livestock rearing, who was hospitalized due to Brucellosis contracted from consuming traditional cheese and dairy products. Initially treated with doxycycline and rifampin, complications arose during antituberculosis therapy, with the patient developing symptoms of nausea, vomiting, and edema alongside renal function deterioration necessitating medication cessation. Subsequent manifestations of proteinuria, toxic hepatitis, and nephrotic syndrome prompted renal biopsy, revealing drug-induced glomerular and tubular damage. Swift cessation of rifampicin, combined with prednisolone therapy, led to symptom amelioration, resulting in the cessation of dialysis and the patient's discharge within three weeks. This case underscores the intricate relationship between traditional cheese consumption, medication-induced renal complications, and the importance of timely intervention and appropriate management in achieving a successful patient outcome.

Orchiectomy after testicular trauma in a 45-year-old man: A case report.

Testicular trauma is a rare but significant condition that can result in severe damage to the testicles. In some cases, when the trauma is extensive and irreparable, orchiectomy, which refers to the surgical removal of one or both testicles, may be necessary. A 45-year-old man experienced testicular trauma as a result of a sporting event. Upon examination, it was determined that the trauma had caused severe damage to the affected testicle, leading to compromised blood supply and persistent pain. The presence of compromised blood supply was assessed through a combination of clinical evaluation and diagnostic imaging (scrotal ultrasound). The imaging findings indicate reduced blood flow to the testicle. Considering alternative treatment options and potential complications, the medical team decided to proceed with orchiectomy. Orchiectomy is a significant surgical procedure performed as a last resort when other treatments are not viable or when complications such as infection or severe pain are present. The decision to perform orchiectomy depends on the extent of the testicular trauma and the patient's overall health. It has implications for fertility and hormone production, with the remaining testicle typically compensating for the functions of the removed testicle. Prompt medical intervention is crucial in evaluating the severity of the injury and determining the appropriate course of treatment. Orchiectomy should be considered when the testicle is extensively damaged and irreparable, making testicular trauma resulting in the need for orchiectomy a complex and challenging situation.

Hemorrhagic stroke as a rare complication of opening the permanent dialysis catheter by Reteplase: A case report study.

INTRODUCTION AND IMPORTANCE: Thrombosis of permanent hemodialysis catheters is one of the most important problems in hemodialysis centers. Drug methods such as heparin, aspirin and warfarin along with urokinase are used to keep these catheters open. CASE PRESENTATION: The present case report is of a 52-year-old Kurdish patient with a 7-year history of type 2 diabetes and hypertension leading to end-stage renal disease (ESRD). The patient has been undergoing hemodialysis for two months with two 3-h sessions per week. After several dialysis sessions, the patient is referred to Imam Khomeini Hospital in Urmia to open the catheter due to dysfunction. Because of catheter dysfunction, Reteplase (Retavase; Centocor, Malvern, PA) was administered at a dose of 3 U/lm (total dose 6 U). After administration of reteplase, the patient experienced sudden onset of headache and arterial hypertension. A computed tomography scan (CT) was immediately performed and revealed hemorrhagic stroke. Unfortunately, due to the extensive hemorrhagic stroke, the patient died one day later. CLINICAL DISCUSSION: Retavase (reteplase) is a thrombolytic drug used to dissolve blood clots. Reteplase increases your risk for bleeding, which can be severe or life-threatening. CONCLUSION: Thrombolysis with tissue plasminogen activator has been shown to be useful in some conditions. However, reteplase has a narrow therapeutic window and serious side effects, such as an increased risk of bleeding.

Nicolau syndrome after intramuscular injection of methocarbamol: A rare case report.

Background: Methocarbamol is a muscle relaxant medication that is commonly used to treat muscle spasms and musculoskeletal pain. Methocarbamol intramuscular injection can cause necrosis of the soft tissue. This rare condition can create severe adverse event with permanent disability. Case presentation: A 32-year-old woman with no significant past medical history presented to the emergency department with severe pain, redness, and swelling involving her left buttock and the surrounding back area. Clinical discussion: The necrotic changes due to methocarbamol intramuscular injection can progress rapidly, leading to the formation of deep ulcers, cellulitis, and even abscesses. Prompt recognition and intervention are crucial to prevent further tissue damage and complications. Conclusion: Comprehending the fundamental mechanisms and identifying risk factors related to this complication is imperative in enabling healthcare professionals to proficiently manage and avert its manifestation.

Gigantic undifferentiated pleomorphic sarcoma (UPS) of breast in a woman: A rare case report.

INTRODUCTION AND IMPORTANCE: Undifferentiated pleomorphic sarcoma (UPS), also known as malignant fibrous histiocytoma, is a rare mesenchymal tumor that occurs mostly in the soft tissue of the limbs and retroperitoneum. UPS of the breast is extremely rare, with less than 20 cases reported in the literature. CASE PRESENTATION: We present a case of UPS of the right breast in a 56-year-old female. The growth of tumor could not be impeded by chemotherapy and radiotherapy. Then, she underwent right modified radical mastectomy with axillary lymph node dissection. The patient died eventually due to severe respiratory failure. UPS of the breast is a rare and aggressive tumor that presents with a rapidly growing mass. It can be difficult to diagnose as it shows no specific histological features and can mimic other spindle cell tumors of the breast. CLINICAL DISCUSSION: Breast sarcomas are categorized in very rare malignancies, and the mortality of this type of cancers are significantly high as they often are not diagnosed in early stages. CONCLUSION: The treatment of UPS of the breast is mostly surgical, with adjuvant radiotherapy and chemotherapy depending on the tumor characteristics and response to neoadjuvant chemotherapy. Long-term follow-up is necessary as these tumors have a high rate of local recurrence and distant metastasis.

A cruel invasion of Ewing's sarcoma of the skull: A rare case report.

INTRODUCTION AND IMPORTANCE: Ewing's sarcoma, a highly malignant bone tumor, typically affects the pelvis and long bones of the lower extremities in children and young adults; primary involvement of the skull is rare. Primary Ewing's sarcoma arising from the skull is very rare. In most cases, this disease is fatal, although the prognosis of Ewing sarcoma improves with radiation and chemotherapy after surgery. CASE PRESENTATION: This case is about 25-year-old woman who was referred to Omid Hospital in Urmia because of frequent headaches, where a tumor mass was found according to the results of CT scan. Biopsy confirmed small round cell sarcoma as the diagnosis. Chemotherapy was ineffective and tumor growth was unstoppable, causing the patient to die after 3 months. CLINICAL DISCUSSION: Ewing's sarcoma can affect various parts of the human body, including bone and soft tissue, but rarely the skull. Ewing's sarcoma typically grows extradural and often reaches a very large size before invading the skull or being detected clinically. CONCLUSION: In most cases, Ewing's sarcoma is fatal, although the prognosis of this disease improves with radiation and chemotherapy after surgery.

Undifferentiated soft-tissue sarcoma (STS) in a 34-year-old woman: A case report.

INTRODUCTION AND IMPORTANCE: soft tissue sarcoma (STS) is a type of cancer that can affect connective tissue. Diagnosis of this malignant tumor is difficult, and complications are related to the pressure it can exert on surrounding body organs. Up to 50 % of STS patients develop metastatic disease, which greatly affects the prognosis and is challenging for the treating physician. CASE PRESENTATION: This case report is about a 34-year-old woman who was found to have significant growth of malignant tumor in her lower back due to misdiagnosis and negligence about her disease. After the cancer invaded the abdominal cavity, she died from related complications. CLINICAL DISCUSSION: STS are among the rare malignant tumors, and the mortality rate of these cancers is very high because they are often not properly diagnosed. CONCLUSION: Educating medical personnel, especially primary care physicians, about the symptoms and manifestations of STS can make a significant contribution to successful treatment. Due to the complexity of treatment, any soft-tissue swelling suspected of malignancy is best referred directly to a sarcoma center, where therapeutic management is carefully planned by an experienced multidisciplinary team.