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BACKGROUND: In patients living with chronic obstructive pulmonary disease (COPD), cognitive impairment and reduced activities of daily living (ADLs) are associated with poor clinical outcomes. AIM: The aim of the present study was to determine the effect of rosemary hydroalcoholic extract on cognitive function and ADLs in patients with COPD. METHODS: A total of 77 COPD patients aged 40-80 years were assigned to two intervention and control groups by random stratified block method in the current tripleblind clinical trial. The intervention group received 500 mg rosemary capsules and the control group received oral capsules containing corn powder twice a day, one to two hours before breakfast and dinner, for two months. The Montreal Cognitive Assessment-Basic (MoCA-B), London Chest Activity of Daily Living scale (LCADL) and Lawton Instrumental Activities of Daily Living (IADL) were used to measure cognitive function and the measure of basic and instrumental daily life activities, before and after the intervention, respectively. RESULTS: The mean total score of cognitive function (P = 0.022) and the two subscales of abstraction (P = 0.003) and naming (P = 0.034) significantly increased after the intervention in the intervention group. There was no significant difference between the intervention and control groups in terms of changes in the mean scores of IADL and LCADL (P < 0.05). The final statistical model showed that the changes in the total mean score of cognitive function (P = 0.014) and IADL (P = 0.047) in intervention group patients are significantly higher than in the control group after adjusting the effect of obstructive sleep apnea (OSA). CONCLUSION: The rosemary hydroalcoholic extract can be effective in improving cognitive function and IADL in patients with COPD, but not LCADL. CLINICAL TRIALS REGISTRATION NUMBER: IRCT20150919024080N16.
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Background: Sumac fruit is an antioxidant and reduces serum triglyceride (TG) and cholesterol (CHOL) levels. Therefore, this study aimed to investigate the effect of sumac fruit on serum lipids and body mass index (BMI) of hemodialysis (HD) patients. Materials and Methods: This triple-blind randomized clinical trial study was conducted for 12 weeks on HD patients. Participants were randomly divided into three groups of 2-gram sumac (N = 40), 3-gram sumac (N = 40), and placebo (N = 40) by nonprobability consecutive sampling and stratified block randomization method based on inclusion criteria. Serum lipids and BMI were measured at the beginning of the study and also at the end of the sixth and the twelfth weeks. The physical activity and 24-hour dietary recall questionnaires were used to collect data. Results: No significant difference was found between the level of nutrient and micronutrient intake (P > 0.05), physical activity (P=0.159), and BMI (P=0.718) of patients in the three groups before and after the intervention. However, the difference in serum low-density lipoprotein (LDL) levels in each studied group was significant over time (P < 0.001). The difference was not statistically significant between the groups before the intervention, 6 and 12 weeks after the intervention (group effect), and between the study groups over time (time-group interaction). No statistically significant difference was observed between the mean levels of TG (P=0.875), CHOL level (P=0.969), LDL level (P=0.998), high-density lipoprotein (HDL) level (P=0.136), and BMI (P=0.608) in the groups over time. Conclusion: Consumption of sumac fruit significantly changed the LDL level over time. Although BMI and serum lipids changed in HD patients, these changes were not significant. Future studies are needed to determine the effective dose of sumac and any dose increase should take toxicity into account and consider a larger sample size and longer intervention and follow-up times.
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The purpose of this study was to explore the experiences of undergraduate nursing students of the implementation of case-based learning in an emergency nursing course. The present qualitative study was conducted using the qualitative content analysis method. Participants consisted of 18 third year undergraduate nursing students selected through purposive sampling, which continued until the saturation of the data. Data were collected using semistructured interviews and were analyzed concurrently with their collection through the constant comparison method. The process of data analysis led to the emergence of 4 main themes, including "the continuum of knowledge from production to transfer competence," "a positive atmosphere of interaction," "the process of stress relieving," "the sense of role-playing in professional life," and the emergence of 12 subthemes signifying participants' experiences and perceptions with regard to the implementation of case-based learning (CBL) in teaching the emergency nursing course. The results of the present study showed that CBL is a stressful but pleasant and empowering experience for Iranian nursing students that develops critical thinking and stress management skills, reinforces peers' potentials, improves diagnostic abilities, and helps acquire professional competencies for use in future practices through the creation of a positive environment.