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Introduction: While elderly people enter the hospital in biological crisis, family caregivers enter the hospital in psychological crisis. But professional caregivers haven’t adequate knowledge of family caregivers' experiences. Therefore they forget that family caregivers are in suffering equally. Since suffering is a significant concept in nursing science and knowing and comprehending sources of suffering in family caregivers by professional caregivers is very important, this study is done to describe the nature and structure of sources of suffering in family caregivers of hospitalized elderly patients. Materials and Methods: This is a qualitative study with phenomenological method. Population of the research is all elderly patients' families that were hospitalized in one of the hospitals of Isfahan University of medical sciences. Sampling method was purposive and continued until data saturation. The numbers of participants are 12. Data were gathered through in-dept interview and data analysis done by “Parse” method that was not used in Iran. Results: The finding of this research is summarized in these core concepts: Patients and therapeutic interventions as source of suffering, hospital as source of suffering, disturbance in family and social life as source of suffering, self neglect as source of suffering. These concepts will be discussed in the full article. Conclusion: Participants' experiences reflect the need for planning interventions such as developing supportive groups, providing facility and instruments and continuous support for family caregivers during hospital stay. Also results show that educational programs are necessary for effective adaptation in family caregivers.

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Introduction: The objective of this study is to clarify the opinions of scientific board members of Sina university hospital about medical research and the ways of promoting these researches. Materials and Methods: This is a grounded theory study in which we used in-depth interviews and focus group discussions. Scientific board members and different authorities of the hospital such as the chief of hospital and the deputy of education were participated in the study. We used three different FGDs. Each group included about 5 people. We also interviewed the chief, the deputy of education and the head of clinical research center of the hospital. Results: Most of the participants in our FGDs believed that the most important factor for research promotion in the hospital was preparation of a data base of patients. They also mentioned that, different research workshops are important for empowering scientific board members in research. Conclusion: According to our study the most important strategies for research promotion in Sina hospital are data bank preparation, providing repeated research workshops, revising the bureaucratic process of proposal approvals, revising the manner of evaluation of scientific board members and more participation of the department of epidemiology in clinical researches

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Introduction: Quality of life (QOL) has become an important concept in medical research. Some research has shown a curvilinear relationship between QOL and glycemic control, but some did not so. The aim of this study is to investigate different aspects of QOL and also assess the hypothesis in diabetic patients. Materials and Methods: In a cross-sectional study, a random sample of adult diabetic outpatients (n=110) were selected and completed the WHO-QOL assessment instruments. In addition HbA1c was measured in these patients by calorimetric method. Patients were divided in to 3 groups: 1-good control (HbA1c<7), 2-fair control (7≥HbA1c<9) and 3-poor control (HbA1c≥9). QOL was assessed by measuring physical, psychological, social and environmental domains. Data were analyzed with one way ANOVA (Tukey as post hoc), Chi2 and Mann-Whitney, and correlation tests. Results: A significant correlation was seen between BMI and glycemic control, physical and social aspects, physical and environmental aspects, psychological and environmental aspects, and social and psychological aspects. No significant difference was seen between mean score of different dimensions of QOL in relation to HbA1c changes. The mean score of each dimension in relation to glycemic control showed that, better score of psychological, environmental and social dimensions is seen in patients with fair glycemic control. But regarding the overall score of QOL this is completely reverse. The mean score of physical dimension is decreased with increasing HbA1c. There was no correlation between other domains of QOL and glycemic control. Conclusion: In this survey higher quality of life was seen in fair glycemic control in social, environmental and psychological dimensions, but physical dimension in patients was decreased when HbA1c was increased. Regarding the overall score of QOL it can be seen that the lowest score of QOL is in patients with fair glycemic control which is in contrast with curvilinear hypothesis.

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Background: The face the main channel through which the individual communicates. It is the site of beauty and attractiveness. Physical attractiveness has stereotyping nature. Because the precise content of the stereotype depends on cultural values. The aim of this study was described the range of psychosocial issues burned disfigurement people that psychosocial support programmes may need to address after hospitaization. Methods and Materials: Part of data from a larger study grounded theory approach was reported by this Paper. In this qualitative study, individual in depths interview performed with 21 participants. Interviews were analyzed using a content analysis. Results: After data analyzed five axial category emerging from this qualitative study included social behaviors and beliefs (reproach, retirement, wrong thoughts and beliefs, stigmatize, pity) emotional problems (grief, shame, fear of expulsion, aversion, hopelessness) reactions assessment (positive assessment, Negative assessment) strategy (hidden, separation, self-presentation) and weariness. Conclusion: Findings indicated negative behaviors' and beliefs' of people cause emotional problems in disfigured people. Thise persons perform inappropriate strategy against behaviors' and beliefs' of people. Therefore This persons need to appropriate supportive programs for community, family and person instruction to knowledge, attitude and practice promotion.

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Background: Hospital readmission rate as a global health problem has increased over the last few decades. Congestive heart failure (CHF) is one of the most common causes of hospital readmission. Little is known about barriers of readmission rate control. The aim of this study was used for data exploring the barriers of readmission rate control. Methods and Materials: A qualitative study was designed with grounded theory approach. Data were gathered with interview. This study was started with proposly sampling and continues with theoretical sampling during 6 months. A convenience sample of 42 people was recruited from two public educational hospitals in Tehran during 6 month. The data were analyzed using constant comparative analysis. Results: Data analysis demonstrated lake of sensitivity on barriers of readmission incorrect patient’s health believes and expectations insufficient patient education, drug and diet adherence, and incorrect life style lack of active medical system , distrust on physicians and lack of communication psychological issues and patient - family challenges, were as the barriers of readmission control. Conclusion: This research had shown that the barriers of readmission control recognized by applying Qualitative research method with source triangulation better than the biomedical approach with single source. On the other hand, lack of sensitivity of partcipants on barriers of readmission control is a new finding. So, for controlling the barriers of readmission despite of exploring the barriers, making sensitive of involved people to readmission, is also proposed

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Background: Breast Cancer is the most common malignancy and is the second largest cause of death among 35-55 years old women. The aim of this study is explore and to describe women's experiences with breast cancer for achieving a deeper comprehension of their individual experiences. Methods and Materials: This is a qualitative study with a phenomenological approach. Sampling method was purposive and continued till data saturation. Twenty two participants (patients,families and treatment team) attended in the study.Data were collected by using in-depth interviewing and were analyzed by “Parse”method. We tried to analyze qualitative data based on valid criteria. Results: The findings of this research were summarized into four core concepts:delay in diagnosis and treatment, treatment rejection, drowning in suffering (reaction to disease,facing with outcome of treatment,exposure to treatment system, ineffective care and disturbance in daily life of the family) and moving toward normal life. Conclusion: Knowledge of treatment team from the expriences of women suffering from breast cancer helps them to play a better role in their treatment. It seems, this is essential for make a shift from terminal treatment to early diagnosis. Also it emphasise to use of source for support of patients.

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Background: Colorectal cancer is one of the most important and most common fatal types of cancer in the world. Identifying new agents which individually or in combination with other agents induce apoptosis in tumor cells is surely of great significance in treatment of colon cancer. The aim of the present study was to assess the effectiveness of applying lovastatin and α-tocopherol individually or in combination with each other in the induction of apoptosis in human colorectal cancer cells. Materials and Methods: In this trial, HT29 cells were exposed to various concenterations of lovastatin (5, 10, and 20 μmol) and/or alpha tocopherol (10, 20, and 25, and 30 μmol). After cell count, these cells were examined through trypan blue method and DNA fragmentation technique. Results: The findings of DNA fragmentation technique showed that each of the two drugs could induce apoptosis at all of the given concentrations. In the combination of 10 μmol concentration of lovastatin and 5 and 10 μmol concentrations of α-tocopherol, induction of apoptosis was not observed. Conclusion: Based on the extensive effects of statins, the concentration of lovastatin is seen as determining in its apoptosis function, and its combination with tocopheroles in high concentrations, by inducing apoptosis, can provide novel effective strategies for prevention of human colorectal cancer.

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Background: Inappropriate feeding is one of the major causes of malnutrition in children. This study was carried out to get an insight into mothers’ views and beliefs about the role of complementary feeding in children under the age of two. Materials and Methods: In this qualitative study, data were collected through 11 focus-group discussions (FGDs) with mothers, who had children under the age of two, in urban and rural areas of Damavand in 2007. Each FGD was held in the presence of a moderator, two note takers, and an observer. At the end of field work, all notes were collected and coded according to the objectives of the study. Then the subgroups for each objective were obtained, and emerging themes were extracted and reported. Results: In the study, six general themes were identified:(1) The mothers viewed complementary feeding as simple, soft, light foods which are especially made for children (2) the best time for introducing complementary feeding was 6 months of age (3) there were no complementary local foods in Damavand (4) for children under the age of one, a different type of food was separately prepared (5) home-made complementary food was preferred over the ready made type, and (6) children were fed with table food from the first year of life. Conclusion: Despite their sufficient knowledge about the advantages of complementary feeding, the majority of mothers, due to some socio-cultural limitations, had a weak performance. In this regard, in addition to making revisions in current training programs and protocols, providing effective and goal-oriented educational programs for mothers and others who take care of children is strongly recommended.

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Background: Allah descended the holy Quran to guide the human and for instructing him the principles of life. The holy Quran always guides the human in the best of ways. Accordingly, the aim of this study was to explore the manifestation of Quran reading in the life of faculty members, students, and clerks’ at Arak University of Medical Sciences (AUMS). Materials and Methods: This qualitative study was done through content analysis method, and the data were collected through interviews. The study was initiated with purposive sampling and continued by theoretical sampling 30 individuals were interviewed over a 2 month period at AUMS. The data were analyzed based on the content analysis method. Continuous-comparative analysis was utilized for data analysis. Results: Data analysis showed the manifestation of miracles in life, achieving internal peace, having humanistic communication, decision making based on Quran instructions, being patient and tolerant, behaving based on Quran instructions, and saving as secondary codes of the effect of Quran reading on participants’ life, and “the effect of holly Quran on the whole dimensions of life” as the main code or theme. Conclusion: In this qualitative study, using triangulation sources, the effects of Quran reading on the faculty members, students, and clerks’ life at AUMS were identified more profoundly than the quantitative methods. On the other hand, the effect of Quran reading on all dimensions of the participants’ life, as the theme of this study, is a very important finding which is completely in accordance with Allah’s words in Quran. Therefore, in order to achieve more divine benefits from Quran, reading the holy Quran is recommended to academians and all people, in general, so as to compete for using Quran more.

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Background: Every year over 150 million pregnancies occur in developing countries however, delivery is not satisfactory for some mothers and, in fact, it is a painful and frightening experience. One solution for pain relief is using En2nox gas. Because of opposite stances of people and society on En2onox, this study was done to highlight the real experiences of people and describe mothers' experiences of pain relief using En2nox. Materials and Methods: In this qualitative, phenomenological study, deep interview is conducted with 30 pregnant women who chose painless delivery using En2nox at Taamin Ejtemaee Hospital. Data analysis was done via Collaizzi method. Validity and reliability were obtained noticing such measures as real value, applicability, continuity, and authenticity. Results: The reasons for choosing En2nox were being easy-to-use and having minimal side effects. Most mothers had a positive attitude towards self-administration of the method and their main satisfaction was with the reduction in pain without severe side effects following withdrawal from usage of the method. The mothers’ major complaint was with dizziness following the method. Conclusion: Based on the mothers’ positive experience of En2nox painless delivery, using this method with the aim of decreasing labor pain and elective cesarean is recommended. Furthermore, the use of this type of analgesia at other centers, with larger sample sizes, and in comparison with other analgesia methods is recommended.

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Background: Male involvement in maternal health is one of the policies promoted by international reproductive health bodies. To better understand male involvement issues in maternal health, this study was done to explore midwives’ experiences toward the promotion of male involvement in maternal health and barriers to such programs. Materials and Methods: In this qualitative study, sampling was conducted by means of focus group discussions (FGDs) and in-depth interviews through a semi-constructed questionnaire. The experiences of all midwives at health centers were surveyed through 2 group interviews and the views of 8 midwives employed in Maternity Hospital of Sabzevar, Iran, were considered as well. Content analysis was applied to data analysis. Results: Results of this study can be divided into three categories: Arguments in favor of, obstacles to, and outcomes of male involvement in maternal health. Based on midwives’ experiences, the provision of couple-friendly health services would enhance the quality of care, better understanding of health information provided to pregnant women and easier acceptance of tasks like taking a sonogram. Midwives indicated some obstacles like manpower and work space deficiency and cultural barriers like husbands and midwives uneasiness while communicating and giving information. Disagreements between partners and higher likelihood of partner interventions in affairs were found to be possible negative outcomes of such programs. Conclusion: Midwives’ attitudes towards male involvement in maternal health were positive and indicate that the introduction of such programs would be accepted. However, attention should be paid to midwives’ concerns and cultural obstacles and they should be trained for such programs.

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Background: Prevalence and incidence of end stage renal diseases requiring renal replacement therapies such as dialysis and kidney transplantation is on the rise. However, no qualitative research studies have been done to explore the experiences of people living with dialysis and kidney transplant in depth. Therefore, this qualitative study was done to explore the experiences of patients living with dialysis and those with kidney transplant. Materials and Methods: This qualitative study was carried out through content analysis approach. Sampling was done from the beginning and continued until data saturation. Semi-structured interviews were tools of data collection. A total of 18 participants were interviewed. The interviews were analyzed through Graham and Landman content analysis method. Results: After analyzing the data, two main themes including, dialysis, a grueling event, and renal transplantation, a normal life with healthy kidney transplant, were reported. Conclusion: Compared with hemodialysis, receiving a kidney through transplantation provides a significantly more pleasant quality of life for patients. However, there are certain obstacles in transplantation and graft survival in the views of transplantation patients. Hence, it is suggested that health officials design programs to provide support and instruction to facilitate the process of kidney transplantation for eligible patients even before entering the dialysis stage.

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Background: Leukemia, due to its widespread prevalence, high mortality rate, high treatment expenses, and long hospital stay, influences the families and their children to a great extent. This study was done to explore the experiences of parents whose children suffer from leukemia. Materials and Methods: Using qualitative research approach with applying content analysis method, 22 participants were interviewed in two teaching hospitals during 2 months. The study started by purposive sampling and continued by a theoretical one till data saturation. The obtained data were constantly analyzed through content analysis method. Results: Data analysis showed that “finding no solution in life, having a lot of problems, errors in treatment, concealing the illness, faith in God, parents’ devotion, hospital facilities, and consistency were the level 3 codes of parents’ experiences and “parents’ reaching a dead-end in life” was the main theme or core category of this study. Conclusion: Using a qualitative approach for exploring the experiences of parents with a child suffering from blood cancer helped recognize them more profoundly than quantitative methods. On the other hand, “parents’ reaching a dead-end in life” as the theme shows the importance of attention to parents’ problems. Using these experiences can increase hope among parents and help conduct the treatment more effectively.

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Background: There is abundant evidence indicating that inflammatory mechanisms within the central nervous system contribute to cognitive impairment via cytokine-mediated interactions between neurons and glial cells. BAT1, a member of the DEAD-box family of RNA helicases, appears to regulate the production of inflammatory cytokines associated with AD pathology. In the current study BAT1 -22 promoter polymorphism was analyzed in AD and control subjects.

Materials and Methods: In this case-control study, genomic DNA from peripheral blood samples of 153 Alzheimer’s patients and 153 healthy controls was extracted using salting-out method. DNA analysis was performed by PCR-RFLP method and p<0.05 was considered statistically significant.

Results: After genotyping and statistical analysis the results failed to show any association between BAT1 -22 promoter polymorphism and sporadic Alzheimer’s disease.

Conclusion: BAT1 -22 is not associated with Alzheimer’s disease in Iranian population and so has no effect on predisposition to sporadic Alzheimer’s disease.

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Background: Prostate cancer is one of the most prevalent type of cancer and the second cause of death among American men. Its prevalence has a direct relationship with increasing age. The present study was carried out to determine the level of prostate specific antigen (PSA) and calcium level in blood in men with prostate cancer and BPH in Arak.

Materials and Methods: In this prospective study, out of 400 Arak males, were selected from different inner-city areas through cluster sampling during a period of two years (august 2011-august 2012). After the population was approved to have the necessary criteria to be included in the study, their PSA and calcium level was measured and its mean in over 40 years. In order to determine mean difference among the seven groups T-test analysis and to determine "PSA", PSA Assay and Tandem-R kits were utilized and for measurement of serum calcium, pars azmoon kit was used.

Results: In this study, there was a markedly relationship between age and serum calcium and serum PSA in both groups.in this way that there was a negative relationship between age and serum calcium and a positive relationship between age and serum PSA.

Conclusion: With respect to the findings of the study, it could be confirmed that was a markedly relationship between serum PSA and serum calcium only in prostatic cancer patients,according to this study in future maybe we used serum calcium as a tumor-marker for screening for prostate cancer.

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Background: Radiocephalic arteriovenous fistula (AVF) at wrist is the vascular choice for dialysis. In the absence of a suitable vein in the wrist, elbow brachiocephalic fistula is the next choice. In this study to create an arteriovenous fistula in antecubital area, we turned to the proximal radial artery in comparison to brachial artery in antecobital area for dialysis.

Materials and Methods: We reviewed 124patients in clinical trial study that candidated for placement of AVF for dialysis in antecubital area .To create AVF ,proximal radial artery in 62 patients and brachial artery in 62 other patients selected as the artery of choice,then patients followed based on complications ,steal syndrome ,primary failure and mean time to prepare for dialysis.

Results: The mean time of maturation of AVF in brachial group was 41 days and in radial group was 43 days. Primary dysfunction in brachial group was 6 cases (10%) and in radial group was 5 cases (8%). Steal syndrome in radial group was not seen but in brachial group 2 cases (3%) were seen.

Conclusion: According to the primary success, steal syndrome and mean time of maturation of these two arteries had no significant statistic differences, but like other previous studies, this study emphasizes on usefulness and less complications. On the other hand, due to the anterior anatomical position and allowing the release of the artery, it causes easy technique for creating AVF anastomosis to the antecubital arteries and its branches.. Therefore, this study recommends use of this artery in creation of AVF in antecubital area.

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Background: Hematopoietic stem cell transplants are routinely used to treat patients with cancers and other disorders of blood and immune systems. Osteoblasts constitute part of the stromal cell support system in marrow for hematopoiesis by participating in the formation of the HSC niche. It is believed that interaction between hematopoietic cells and bone forming osteoblasts regulate each other’s function. It is established that acute blood loss in animal models activates bone formation and niche development because of EPO stimulation. In this experimental study we have examined the co-culture of HSCs derived from cord blood which treated with EPO in vitro, on osteoblastic differentiation of mesenchymal stem cells.

Materials and Methods: In this experimental study MSCs isolated from bone marrow and co-cultured with CD 34+ CD38- HSCs isolated from cord blood. These co-cultured cells were treated with different doses of erythropoietin for 14 days, after that RNA were extracted from MSCs and analysed with RT-PCR to evaluate the expression of osteopontin and osteocalcin. Alizarin red and alkaline phosphatase staining were done for osteoblastic differentiation.

Results: Osteopontin and osteocalcin were expressed in MSCs. Cellular staining were positive for osteoblastic differentiation. Differentiated cells expressed osteoblastic markers.

Conclusion: These data suggest that EPO regulates the osteoblastic differentiation from bone marrow MSCs in vitro.

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Background: Upper gastrointestinal bleeding is a common medical emergency condition which can be very costly with potential risks. Prompt evaluation of the patients’ status and determination of the risks involved are of utmost significance. Rockall score is one of the Methods determining the risk of bleeding. The aim of the present study was to determine sensitivity, specificity and negative and positive predictive values of Rockall scoring system during a 3-month follow-up period in patients with upper gestronintestinal bleeding.

Materials and Methods: 340 hospitalized patients with acute upper gastrointestinal bleeding in Imam Reza hospital were studied from December 2013 to September 2014. The full and clinical Rockall scores, sensitivity, specificity and negative and positive predictive values were specified for all the subjects who were followed for 3 months in relation to complications and mortality.

Results: Of all patients, 204 were males and 136 were females who 15.6% of the subjects had a clinical Rockall score under 3, with 84.4% having a score over 3. In relation to endoscopic Rockall score, 15.6%, 66.8% and 17.6% of the subjects had a score under 3, between 3-8 and over 8, respectively. During the 3-month follow-up period, in the low-risk group, 92.5% did not exhibit hemorrhage again, 3.8% had one recurrent episode of hemorrhage, 1.9% exhibited 2 hemorrhage episodes, with 1.9% having 3 hemorrhage episodes. In the moderate-risk group, 90.9% experienced no recurrence and 9.1% exhibited 1 case of recurrent hemorrhage (p=0.4). There was no mortality in the low-risk group. In the moderate-risk and high-risk groups, the mortality rates were 8.07% and 22.7%, respectively (p<0.001). The sensitivity and specificity of the test were calculated at 11.1% and 81.1%, respectively. The positive and negative predictive values were 5% and 91.4%, respectively.

Conclusion: With due attention to the specificity of 81.8% and negative predictive value of 91.4% for the Rockall score, it might be guaranteed the patient will not suffer from the complications resulting from recurrence of hemorrhage. Given the low sensitivity of the test, the test is not appropriate to rule out disease.

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