Vol 5 No 3 (2018): Summer


Case Report(s)

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    Background & Aim: The unsafe abortion complications may lead to mother mortality or morbidity, secondary infertility and other unwanted side effects. In some countries like ours, in many cases this kind of pregnancy termination is performed because in most cases the abortion is considered illegal by the government due to religious issues, while in some cases it may seem overly opposing the pregnancy termination. In this case report the mother was suffering from the severe psychosis symptoms, however she was not allowed to perform an abortion, and finally she decided to go to an illegal institute for abortion which results into secondary infertility. This case and similar cases bring up this question that to what extent the survival of the fetus is important in psychotic conditions of the mother.
    Case Report: This study is a case report of a 32-year-old female at week 16 of pregnancy presented to the clinic with nausea and vomiting. Following to routine workup in a gynecology department she was referred to a neurologist. Therefore, after performing various imaging studies it was revealed that she had a mass in her brain and surgical resection of the mass was performed without any complication. After few days, she showed bizarre behavior and hallucination. Due to her pregnancy, the neurologists could not prescribe some medications like carbamazepine. Neurologists took the abortion into consideration, however it is illegal in our country to terminate the pregnancy after 4months.Finally, despite her doctor’s recommendation she performed abortion in an unapproved institute and returned to our clinic to follow up and continue the treatment. She is still on drugs and in the usual state.
    Conclusion: Abortion within specific sort of diseases which might threaten the psychological condition of the mother and fetus should be legally permitted by the government. Therefore, by the availability of this opportunity for people who are suffering from psychological diseases like psychosis, they could easily approach to the well-known centers in order to terminate their pregnancy legally under appropriate observation. Useful studies must be done in this area to resolve the existing problem. This question should be answered by the government, health politicians, religious missionaries, clinical and social psychologists

Original Article(s)

  • XML | PDF | downloads: 155 | views: 484 | pages: 318-325

    Background & Aim: Self- medication is defined as consuming nonprescription medicines to treat self-diagnosed disorders or symptoms. This study was carried out to examine prevalence of self-medication during three months ago and its correlates among the elderly population in Karaj-Iran by using the HBM model.
    Materials & Methods: This cross sectional study was conducted on 189 elderlies who were covered by health care centers. The inclusion criteria were absent of cognitive disorders and being over the age of 60. The multistage sampling was used in this study. The data collection tools included: demographic characteristics and a questionnaire based on the HBM model, including knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers. Statistical analysis of the data was performed using chi-square tests, Student t-tests, ANOVAs and multiple logistic regressions. Analyses were done by SPSS 19.0.
    Results: The prevalence of self-medication was 26.5%. The most common medicine used for self-medication was Supplements (87.30%), cold drugs (40.2%), and pain killers (39.6). There was significant correlation between self-medication and health insurance coverage (P=0.01) and chronic diseases (P=0.001).There were two predictors of self -medication behavior in our study, which were having chronic disease and perceived susceptibility with OR were 1.46(95% CI:0.71-2.40) and 0.93(95%CI:0.76-1.13), respectively.
    Conclusion: Due to the study results, it is suggested that an interventional program should be considered the promoting of the perceived susceptibility of the elderly population regarding self-medication and policy makers should be noted to elderly health insurance coverage.

  • XML | PDF | downloads: 392 | views: 3035 | pages: 326-334

    Background & Aim: Communication with the patient is the basis for nursing practice in providing care for the patient. The aim of this study was to determine the barriers to nurse-patient communication from the viewpoint of nurses working in educational hospitals of Kurdistan University of Medical Sciences,
    Materials and Methods: This descriptive cross-sectional study was performed on 151 of nursing staff in educational hospitals of Kurdistan University of Medical Sciences selected by convenience sampling method. Data gathering tool was a questionnaire including demographic characteristics and “barriers to nurse-patient communication” questionnaire with four-part: common barriers between nurses and patients, nurses’ barriers, patients’ barriers and environmental barriers. The data were analyzed by SPSS software ver 16. The demographic data and the barriers to nurse-patient communication were measured, using frequency, mean, and standard deviation.
    Results: Cultural difference between nurses and patients (2.62±1.06) was the most common barriers to the nurse-patient communication. The most important barriers related to the patient included the patient's companion’s interference (3.24±0.92). Among the environmental barriers, caring for a critical patient (3.27±0.98) was the most important barriers. The most important nurses’ barriers was lack of time (3.46±0.78).
    Conclusions: Nurses and nursing managers should work to address and remove the barriers identified in relation to the nurse-patient communication. Providing care by native and same gender nurses, absence of patients' companion, creating a quiet environment and increasing the number of nursing staff could help to overcome these barriers

  • XML | PDF | downloads: 118 | views: 442 | pages: 335-346

    Background & Aim: The majority of studies on the facilitators and barriers to functioning in spinal cord injury (SCI) focussed on physical and psychosocial barriers/facilitators, with little emphasis on barriers and facilitators related to the health care system. The purpose of the present study was to explore the barriers/facilitators in the health care system to the functioning of persons with SCI.
    Methods & Materials: The present study was a qualitative descriptive design that was conducted at the Tamale Teaching Hospital in the Northern Region of Ghana. The study employed the purposive sampling technique with the Neurosurgical Unit of the Hospital as an outlet for the selection of the sample. Thirteen participants were interviewed using an interview guide. The sample was determined by saturation and the data was analysed using thematic analysis.
    Result: Treatment and management issues, health staff issues and health education issues respectively emerged as the main themes of the present study. Sub-themes such as long-term analgesic use, herbal treatment, lack of health education and high cost of treatment emerged as barriers to functioning of persons with SCI. While physiotherapy and health education were identified as facilitators to functioning, surgery emerged as both a barrier and a facilitator to functioning. 
    Conclusion: Addressing the barriers related to the health care system on the functioning of persons with SCI and improving on the few existing facilitators to functioning would help improve the general wellbeing of persons with SCI and also assist in their adjustment to the injury.

  • XML | PDF | downloads: 118 | views: 386 | pages: 347-354


     Background & Aim: Regular physical activity is a major aspect of healthy lifestyle and control and prevention of many chronic diseases. Also, perceived barriers to physical activity among various populations are different. This study aimed to determine the status of regular physical activity and perceived barriers to performing it in adolescents who studying in the junior high school.
    Materials and Methods: This cross-sectional study has used a stratified random sampling with proportional allocation on 280 subjects among the students at the city of Babol. For data collection, three questionnaires for demographic status, physical activity and perceived barriers to physical activity have been used. The data analyzed by using descriptive statistics and chi-square tests.
    Results: The results showed that most of students (61.1 %) didn’t have regular physical activity, and only 38.9 % had regular physical activity. The most common perceived barriers to physical activity of students has been listed as: lack of relatives’ supports (53.6 %), to being far from sports places (35 %), and lack of enough self-confidence (33.2 %).
    Conclusions: This study showed the majority of students during the high school years, are not engaging in regular physical activity. As well, there are many barriers to having regular physical activity. Therefore it is necessary to implement health policies about the improving physical activity at a school and community levels, increased access to places for physical activity, and eliminate perceived physical activity barriers.



  • XML | PDF | downloads: 244 | views: 1031 | pages: 355-362

    Background & Aim: Labor pain is an unpleasant experience for most women and can affect their birth satisfaction. This study investigated the effects of ice pack application on pain intensity in the active phase of labor and on birth satisfaction among primiparous women.
    Methods & Materials: This randomized controlled trial was conducted on ninety primiparous women. Participants were randomly allocated to either an intervention or a control group. In the intervention group, an ice pack was placed on the sacral area of each participant in the active phase of labor for ten minutes. This intervention was repeated every thirty minutes up to the beginning of the second stage of labor. In both groups, labor pain intensity was assessed before and every one hour after intervention onset and birth satisfaction was assessed 24 hours after delivery. Data were analyzed through the SPSS software (v. 22.0).
    Results: Groups did not significantly differ from each other respecting participants’ demographic and clinical characteristics. Throughout the study intervention, labor pain intensity increased in both groups; however, the increase in the control group was significantly greater than the intervention group (P < 0.001). Moreover, the mean score of birth satisfaction in the intervention group was slightly greater than the control group, though this difference was not statistically significant (P = 0.24).
    Conclusion: Without any significant side effects, ice pack application can significantly reduce pain intensity during the active phase of labor. Thus, this intervention is recommended for labor pain alleviation.