---

This is a double - blind clinical trial to evaluate the safety and efficacy of topical nitroglycerin ointment on venous catheterization in patients referred to emergency ward of Baghiyatollah hospital in 1997.The units under investigation consisting of 70 patients, 40 women and 30 men ranging in age from 20 to 69.The samples were randomly assigned into two equal groups, 35 patients in case group and 35 patients in experimental group. The experimental group received 2% nitroglycerin ointment and the case group received the placebo ointment that was applied prior to venus catheterization on the skin of the dorsum of the hand, wrist or front part of forearm.To collect data, an observational checklist was used in which demographic characteristics, and efficacy and immunity of the ointment were recorded.The findings revealed that the vein diameter in case group was not increased after applying the ointment, while it was considerably increased in experimental group from 4 mm to 6.6 mm. Although the method of catheterization in two groups was the same, catheterization in case group was more difficult than experimental group. Using T.test, the findings revealed that there was statistically significant relationship between vein diameter before and after applying the ointment in experimental group and after applying it in case and experimental groups (PO.001). Moreover, tachycardia and hypotension was not observed in both groups during 15, 30, 45 minutes and one and two hours immediately after applying the ointment, however in both groups, a sort of mild headache was observed. The findings also showed that there was significant relationship in observing the vein after catheterization in two groups (P<0.2). However, before applying the ointment, there was significant relationship in observing the vein in the experimental group. Furthermore, after applying the ointment, arhythmia appeared, but it was not significant.The results showed that applying nitroglycerin ointment was a useful method in expanding the peripheral veins, therefore, it resulted in easy venous catheterization.

---

Background & Aim: Recognizing and modifying organizational commitment and its related factors is important. It seems that nurses&apos attitudes towards learning organizations influence their organizational commitment. This study aimed to determine the relationship between nurses&apos attitudes towards learning organizations and organizational commitment.

Methods & Materials: In this descriptive-correlative study, 719 nurses working in Rasht educational hospitals were recruited to the study. We gathered data using the Porter organizational commitment questionnaire and the Jeong learning organization questionnaire. Data were analyzed using descriptive statistics and the Spearman and t-tests in the SPSS-18.

Results: Most of the nurses were female (94.7%) and registered (35.3%). The mean (SD) age of the nurses was 32.13 (6.98). The mean (SD) of the organizational commitment was 27.10 (42.50). The mean (SD) of the learning organization was 92.72 (10.04). The relationship between the organizational commitment and nurses&apos attitudes towards learning organizations was statistically significant (r=0.482 P<0.0001).

Conclusion: It seems improving nurses&apos attitudes towards learning organizations may result in better organizational commitments.

---

Background & Aim: Self-care plays an important role in the management of care for patients with chronic renal failure. In order to provide effective education, it is necessary to identify problems, concerns and challenges in this group of patients. The aim of this study was to explore the challenges of self-care in the patients undergoing hemodialysis.
Methods & Materials: This study is part of a research project on adherence to treatment regimen in hemodialysis patients referred to hospitals affiliated to Tehran University of Medical Sciences in 2019. Patients with the highest and lowest mean (SD) scores of self-care were selected by the purposeful sampling method and finally, 22 in-depth semi-structured interviews were performed with 18 interviewees. All data were recorded, transcribed and analyzed using the conventional content analysis approach proposed by Graneheim and Lundman.
Results: Findings from the data analysis included four categories: "the mismatch between the view of patient and the view of nurse", "missing loop training", "culture: a double sword ", and "dual role of religious beliefs".
Conclusion: The results of the present study showed that patients undergoing hemodialysis faced many challenges in self-care. They had difficulty in understanding the meaning of self-care and its implications. There is a need to plan for educating these patients and also changing their religious and cultural beliefs.
 

---

Background & Aim: Osteoporosis is a common condition in the elderly, contributing to fracture incidence and associated pain. This study aims to analyze trends in osteoporosis-related fractures within the elderly population from 2017 to 2021.
Methods & Materials: A descriptive cross-sectional study was conducted in 2024 involving 448 elderly people over 60 who experienced pelvic, hip, distal hand, or spinal injuries during 2017-2021 in Kashan. Data were extracted from the National Trauma Registry of Iran, including demographic information, injury severity, and frequency of fractures. The data were analyzed using analysis of variance and chi-square tests, with a significance level set at P<0.05.
Results: Among the 448 participants, 244 were female (54.5%), with an average age exceeding 75 years among those diagnosed with osteoporosis. The most common fracture types included hip and pelvic fractures, affecting 331 individuals (73.9%), followed by distal hand fractures in 71 individuals (15.8%), and spinal fractures in 65 individuals (14.5%). The average injury severity score increased from 8.43±2.80 in 2017 to 8.96±2.77 in 2021. No significant changes were observed in the age distribution of the elderly population during this period; however, the proportion of males increased by approximately 6%.
Conclusion: The study results indicate a rising trend in hip fractures among the elderly in Kashan. To reduce fracture incidence, it is recommended to implement proactive screening for osteoporosis risk factors in this population.