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Introduction: A variety of maladies, sometimes disabling, beset many ovulatory women in a recurrent manner during the luteal phase of each ovarian cycle. These problems can deteriorate interpersonal relationships and/or interfere with normal activities of life. Present research was performed to evaluate effects of hypericum perforatum for treatment of physical symptoms of premenstrual syndrome.

Materials and Methods: This study was a randomized, double-blind, placebo-controlled, parallel group compassion study performed over two menstrual cycles on student of Tehran University of Medical Sciences and Tehran University. Volunteers underwent a preliminary screening interview, completed Beck questionnaire as a screening test for depression and attended a medical screening visit before being diagnosed as having premenstrual syndrome. Participants administrated hypericum or placebo, 30 drops BD, for two complete cycles. Premenstrual symptoms were evaluated by a daily symptom report form. Data analysis performed by Chi square, Fisher exact, Wilcoxon and t tests.

Results: Premenstrual daily hypericum caused a significant improvement in mean daily score of severity of premenstrual problems compared to placebo (p<0.05). Premenstrual administration of hypericum, 30 drop BD, showed significant advantage over placebo for physical disorders (%49, p=000).

Conclusion: Daily premenstrual administration of hypericum perforatum treats physical symptoms of premenstrual syndrome. It seems that hypericum perforatum can improve symptoms of premenstrual syndrome.

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Introduction: The delivery of placenta and membranes (third stage of labor) is an important stage of delivery. Complications of this stage can increase maternal mortality rate. There is controversy regarding the routine use of oxytocic drugs in this stage of labor. These drugs may shorten duration of third stage but have side effects. Furthermore, management of delivery in physiologic way causes minimum damage to the mother and newborn.

Materials and Methods: The present research is a clinical trial study. A total of 94 subjects were divided into two groups. All subjects in active group received 10 units of Syntocinon in 500 cc serum. The cord was clamped and cut after cessation of pulsation and the placenta was delivered by Brandt–Andrews maneuver. Women in the physiologic group received 1cc of placebo in 500 cc serum, no clamping of the cord was attempted until pulsation had ceased and the placenta was delivered by minimal traction on the cord and with maternal effort without any maneuver.

Results: Two groups were matched in the subjects’ characteristics. The rate of postpartum hemorrhage in physiologic group (14.58%) was higher than active group (10.64%) but the statistical tests showed no significant differences between two groups (p=0.2945). The mean duration of the third stage of labor in the physiologic group (13 minutes) was longer than active group (9 minutes) but the statistical test showed no significant differences between two groups. The statistical tests also showed no significant differences between rate of retained placenta (p=0.5) or piece of the placenta and membranes (0.2428) in two groups.

Conclusion: Statistical tests showed no significant differences between duration and complications of the third stage of labor in two groups. The routine use of Syntocinon in management of third stage of labor can not be recommended.

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Introduction: Anemia is a common finding among pregnant women, and it could cause a number of complications for both mother and fetus.             

Materials and Methods: In this case - control study, 302 pregnant women among patients referred to prenatal clinic of Mirza Kochak Khan Hospital were randomly chosen and were divided into anemic and normal groups based on their hemoglobin (Hb) level. Patients with Hb<11g/dl during the first or third trimester as well as those with Hb<10.5g/dl in the second trimester were considered anemic. Anemic patients were treated and pregnancy outcomes of two groups, including birth weight of the newborns, prematurity, stillbirth and abortion, were compared.

Results: Overall prevalence of anemia during pregnancy was 8.6%. The prevalence of anemia in the first, second, and third trimesters of pregnancy were 10.3%, 3.5% and 12.7%, respectively. The frequency of anemia had a positive correlation with maternal age, gravidity and parity however it was less frequent in patients taking iron supplements. There was no significant difference in pregnancy outcome of normal and treated anemic woman. Growth retardation was more frequent in treated anemic patients but only in women who were diagnosed in third trimester.

Discussion: The prevalence of anemia among pregnant women is noticeable, and with the iron deficiency as the most common cause, we recommend administration of iron supplements for prevention of anemia and its maternal and fetal consequences. Treatment of anemia in early stages of pregnancy results in normal pregnancy outcome, a finding emphasizing the importance of treatment.

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Background & Aim: Performance appraisal is one of the most important duties for nursing managers. This will improve the quality of nursing care, and it needs suitable approaches and effective strategies in nursing services. The aim of this study is to determine the impact of performance appraisal using management by objective approach on nursing care quality.

Methods & Materials: This was a quasi-experimental and single-blind study that was carried out in two surgical units of an affiliated hospital of Tehran University of Medical Sciences. 80 patients were selected using a randomized sampling. The quality of nursing care were controlled in both experiment and control units before and after the performance appraisal procedure. The procedure was programmed on the basis of management by objective approach for six months in the experiment unit. In the intervention unit, nursing performance appraisal was done three times and in every time head nurse and supervisors participated in giving feedbacks and recommendations for the nurses. At the end of the intervention, quality of nursing care was assessed in both groups blindly. The results were compared and statistically analyzed.

Results: Significant difference was found between quality of nursing care in the experiment and control units (P<0.001). Quality of nursing care was significantly different before and after intervention in the experiment unit (P=0.009).

Conclusion: Performance appraisal using management by objective approach could increase the quality of nursing care. As a result, using nursing performance appraisal plans according to the basis of MBO could be an effective evaluation way to access the quality of nursing care.

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Background & Aim: Labor refers to a chain of physiologic events that allows a fetus to undertake its journey from the uterus to the outside. Friedman (1954) described a sigmoid pattern for labor. This study was carried out to compare the pattern of labor progression in nullipara women of Fasa with the Friedman&aposs labor curve.

Methods & Materials: This cross-sectional study was conducted among 619 nulliparous women aged 18-35 who had term delivery and had no serious disease. In order to data analysis, we used one way ANOVA for comparing the means, and fixed effect of regression models in reverse method for curves drawings.

Results: In all of the subgroups, effacement rate increased by increasing the cervical dilatation. Mean of dilatation rate was significantly higher in induced group than the other groups. Duration of the active phase was longer in the group that had sedation than the other two groups. Means of the duration of active phase and second stage were significantly lower in our study than the durations in the Freidman&aposs study (P<0.001) (3.87 hours vs. 4.9 hours and 52 minutes vs. 57 minutes, respectively). We did not observe the deceleration phase in our study.

Conclusion: The pattern of labor progression differed from the Freidman&aposs curve and had not sigmoid shape. The most important factor in latent phase was the time of admission to the labor ward.

 

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Background & Aim: Despite the advancement of medical science, readmission of the heart failure patient remains a serous problem. The aim of this study was to assess the effect of continuous care and educational intervention on the rate of readmissions, refers to physician, and health costs in patients discharged from hospital.
Methods & Materials: This study was a randomized clinical trial in which 110 patients were studied. The participants were allocated in two experimental and control groups. Data were gathered using questionnaires. Home visits were carried out in the experimental group during six months. At the end of the intervention, the rate of readmissions, referrals, and health care costs were compared in the two groups. Data were analyzed using independent t-test, Fisher&aposs exact test, and Chi-square test.
Results: Results indicated that the rate of readmissions (1.65±1.01 vs. 2.74±1.07, respectively), and refers to physicians (2.73±1.24 vs. 3.32±0.94, respectively) were lower in the experiment group than the control group (P<0.05) after the intervention. The average health care cost in the intervention group (2494000±172150 Rials) did not differ significantly with the control group (2736800±167360 Rials) (P>0.05).
Conclusion: The results of this study indicated that the nursing interventions such as home visits are effective in lowering readmissions and refers to physicians in patients with heart failure. It seems that home visits are necessary in promoting the patients health. 

 

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Background & Aim: Job stress can interfere with endocrine function and result in dysfunctional menstrual bleeding patterns. The aim of this study was to assess the relationship between job stress with menstrual bleeding pattern among midwives.

Methods & Materials: In this cross-sectional study, we recruited 150 midwives working in hospitals and health centers of Mashhad using two-stage sampling. Data were collected using a questionnaire including demographic characteristics, Karazek Job Content, a daily diary for menstrual periods to record duration and interval of periods, and the Higham Chart for recording the bleeding amount. The diary was completed for three menstrual periods. Collected data were analyzed using independent t-student, one way ANOVA, Mann-Whitney U, Chi-squared test, correlation test and linear regression in the SPSS-14.

Results: The findings showed that 21.3% of the midwives reported mild job stress, 19.3% had moderate stress and 59.3% reported severe job stress. Mean of the duration of the periods was 7.06 days, the mean interval of the periods was 27.9 days and the mean amount of bleeding was 79.72 cc. There was a significant relationship between job stress and the duration and interval of periods (P<0.001). There was not any significant relationship between job stress with the amount of bleeding.

Conclusion: Our study showed that job stress was related to menstrual bleeding patterns among midwives. It is necessary introduce strategies to decrease job stress and provide professional support for midwives.

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The harlequin fetus is the most severe type of congenital ichtyosis in which fetus suffers from chapped thick skin, abnormal face appearance, increased or decreased body temperature, respiratory distress, malnutrition, decreased sodium level, convulsion and infection. It happens once every 300 000 births in both genders. Premature birth and death are among consequences of this disorder. The woman was 31 years old. No abnormalities were reported in sonography. The fetus was delivered via normal vaginal delivery. The infant had a harlequin face appearance. The infant was discharged with consent of the parents after two days and passed away 24 hours after discharge.

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Background & Aim: Previous studies have shown lack of appropriate inter-professional relationships between nurses and doctors and its negative impact on quality of provided care. This study aimed to determine nurses' attitudes on professional relationships between doctors and nurses.
Methods & Materials: In this cross-sectional study, 228 nurses were selected from the internal-surgical and intensive care units of educational hospitals in Zanjan. Data were collected through the Jefferson scale of attitude toward physician- nurse collaboration. Descriptive (mean, median, standard deviation) and inferential statistics (independent t-test, ANOVA) were used to analyze data in the SPSS version 16.
Results: The situation of the inter-professional relationship between nurses and doctors was “high”. The maximum score belonged to the "care versus curing"; and the lowest score belonged to the "medical authority". There was a significant relationship between the mean score of the inter-professional relationship with nurses’ employment status (r=0.69, P<0.01).
Conclusion: Perspectives of nurses on nurse-doctor relationship was high. Efforts should be made to achieve the ideal situation by paying more attention to nurses' professional roles and their autonomy, including inter-professional relationship subjects in Medicine and Nursing educational curriculum and creating team spirit between nurses and doctors.

 

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Background & Aim: The role of caffeine as a cerebral stimulant for improving respiratory indicators in the mechanically ventilated patients is unclear. The purpose of this study was to evaluate the effect of coffee consumption on respiratory indicators among the mechanically ventilated patients in the Intensive Care Unit (ICU).
Methods & Materials: A double blind, randomized clinical trial (IRCT2013122915972N1) was performed on 80 patients who were selected by convenience sampling and randomly allocated into two groups (intervention and control). For the intervention group was administered 3.5 grams of espresso coffee powder dissolved in 80 cc water, then 20 cc water through gavage about an hour after breakfast. The control group received 100 cc distilled water. Respiratory parameters were recorded and compared in the two groups 2 minutes before the intervention and 30 minutes and 60 minutes after the intervention. Chi-square test, t-test and the repeated measures analysis of variance were used to analyze the data.
Results: There was no difference between the two groups in the baseline variables. After the intervention, the spontaneous respiratory rate, tidal volume, the minute ventilation rate and arterial O2 saturation increased in the intervention group compared to the control group, but the increase was statistically significant only for the spontaneous respiratory rate and tidal volume.
Conclusion: Espresso coffee consumption through gastric tube in the mechanically ventilated patients increases the spontaneous respiratory rate and tidal volume but does not significantly affect other respiratory indicators.
 

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Background & Aim: Given the importance of the physical and mental health of pregnant women and the negative effects of worry on maternal and fetal health, identifying the factors affecting the reduction of worries is necessary. Therefore, the present study was performed to determine maternal worries and their relationship with coping strategies.
Methods & Materials: This analytical, cross-sectional study was performed on 465 pregnant women 14-40 weeks referred to health centres in Hamadan in 2015-2016. Data were collected using the obstetric and socio-demographic characteristics questionnaires, the Billings and Moos Coping Strategy and the Cambridge Worry Scale (CWS). Descriptive and inferential statistics including Spearman correlation and One-way analysis of variance were used to determine relationship between worries and coping strategies. A p-value <0.05 was considered significant.
Results: The mean (SD) of worry score was 25.8 (15.1), with achievable scores of 0 to 80. Thus, 67.3% were not worried, 30.1% expressed a small amount of concern and 2.6% had a great deal of concern. The comparison of the total score of coping strategies and the two subscales of problem-focused and emotion-focused coping strategies in the three groups indicated that only the emotion-focused strategy score was different in these groups (P<0.005).
Conclusion: The findings of the study indicate that there is a direct correlation between maternal worries and use of emotion-focused strategy. Therefore, it is suggested that midwives help pregnant women to reduce worry by training coping strategies in order to increase the use of problem-focused strategy.