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Abstract Introduction The quality of care and patient satisfaction is closely linked with dignity, which is a crucial component of therapy and care. However, there is very little study on dignity in the context of mental health care. Planning for ongoing patient care might benefit from an understanding of the notion of dignity by exploring the experiences of patients, caregivers and companions of patients who have a history of hospitalization in mental health institutions. To retain patients' dignity while they were being treated in mental wards, this study sought to understand the experiences of patients, caregivers and companions of patients. Materials and Methods This investigation was qualitative. Semistructured interviews and focus groups were utilized to collect the data. The purposeful sampling method was employed for participant recruitment, which continued until data saturation. Two focus group discussions and 27 interviews were conducted. Participants included 8 patients, 2 patients' family members (companions), 3 psychologists, 4 nurses and 11 psychiatrists. Two focus group discussions were held with seven family members or companions of patients. Thematic analysis was used for data analysis. Results The primary theme that emerged was the infringement of patients' dignity, through negative guardianship, dehumanization and violations of their rights. Subthemes included dehumanization, worthlessness and namelessness, patient rights violations and stripping patients of authority. Conclusion Our results suggest that, regardless of the severity of the illness, the nature of psychiatric illness significantly compromises patients' dignity. Mental health practitioners, due to their sense of guardianship, may unintentionally treat patients with mental health disorders, thus compromising the patient's dignity. Patient or Public Contribution The research team's experiences as a psychiatrist, doctor and nurse informed the study's objectives. Nurses and psychiatrists who work in the healthcare industry designed and conducted the study. The primary authors, who are healthcare providers, collected and analysed the required data. Furthermore, the entire study team contributed to the writing of the manuscript. Study participants were involved in the data collection and analysis.

Introduction: Leishmaniasis caused by Leishmania spp. is observed in most parts of the world. Although, glucantime, a pentavalent antimony compound, and other synthetic drugs are broadly applied for leishmaniasis therapy; however, the use of these synthetic agents has some limitations. Hence, this study was designed to assess the inhibiting effects of 7-hydroxy4′-methoxyisoflavone (7HMI) against promastigote and amastigote stages of Leishmania major in vitro. Methods: The MTT assay was applied to study the antileishmanial activity of 7HMI against promastigotes and its cytotoxicity effects on macrophage cells. The nitric oxide (NO) produced by the treated macrophage cells with 7HMI was also assessed. Results: 7HMI considerably (P

Introduction: Recent studies have reported that Astragalus spp. can display various biological effects, e.g., anticancer, antioxidant, antimicrobial, neuroprotective, and hepatoprotective activities. Here we decided to assess the ameliorating effects of Astragalus maximus methanolic extract (AMME) on inflammation and oxidative stress in streptozotocin-induced diabetic rats. Methods: The dried aerial parts were extracted by maceration technique with 70% methanol. Diabetes was induced in rats via intraperitoneal injection of streptozotocin at 65 mg/kg. Diabetic rats orally received AMME at 75-30 mg/kg for 28 days. The serum levels of glucose, insulin, liver enzymes, bilirubin, creatinine (Cr), urea (Ur), triglyceride, and cholesterol, as well as the tissue levels of oxidant/antioxidant enzymes and pro-inflammatory cytokines were evaluated by the diagnostic kits. The level of α-amylase inhibition by AMME was also determined. Results: AMME (150 and 300 mg/kg) treatment significantly reduced (P

Background: The current coronavirus pandemic has profoundly impacted healthcare services across all dimensions. Patient safety culture stands as a pivotal element in enhancing safety and the quality of patient care. This study aimed to compare the patient safety culture in the COVID-19 ward with that in other inpatient wards. Methods: In this cross-sectional study, 418 nurses were selected through a quota sampling method from an educational hospital in Western Iran. For data collection, the Hospital Survey on Patient Safety Culture (HSOPSC), developed by AHRQ, was utilized. Data were analyzed using descriptive statistics, including mean and standard deviation (SD), as well as analytical statistics such as independent-samples t-test, Mann-Whitney test, Spearman's correlation test, and Kruskal-Wallis test. SPSS 25 was used for analysis, and the significance level was set at p ≤ 0.05. Results: There was no statistically significant difference between the two groups (p > 0.05), but there were variations in the mean scores within different dimensions. The overall mean score of patient safety culture in the coronavirus ward was 117 ± 20.91, indicating a moderate to low level of patient safety culture in this group. In contrast, in other inpatient wards, the mean score was 122.66 ± 23.47. Conclusion: In the coronavirus department, due to the heightened patient severity and increased nursing workload, the patient safety culture was rated as weak. Therefore, it demands specific attention from management to provide additional training for healthcare staff, aiming to enhance their performance in coping with stressful and unpredictable conditions.

Objective: To assess the effect of oral treatment of methanolic extract of the aerial parts of Astragalus adscendens in streptozotocin-induced diabetic rats. Methods: In order to induce diabetes, rats intraperitoneally received streptozotocin at 65 mg/kg. Sixty adult male Wistar rats were allocated into six groups (10 rats per each) including the healthy control group, the diabetic group as well as the diabetic group treated with Astragalus adscendens methanolic extract at 50, 100, and 200 mg/kg per day or glibenclamide (0.6 mg/kg/day) for 28 d. The effects of Astragalus adscendens methanolic extract on the levels of glucose, insulin, alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, creatinine, urea, uric acid, total protein, albumin, triglyceride, cholesterol, α-amylase, oxidant/antioxidant enzymes, and inflammatory cytokines were evaluated. Real time-PCR was also used for measuring the gene expression of caspase-3, Bcl2, and Bax. Results: The levels of glucose, cholesterol, triglyceride, creatinine, urea, uric acid, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, bilirubin, and malondialdehyde considerably declined (P

Abstract Objective Today, smoking is considered a pressing global health issue. The present study aimed to estimate the total prevalence of hookah smoking among pupils and university students in Iran. Materials and Methods This systematic review and meta‐analysis were conducted via searching in databases such as Scientific Information Database (SID), MagIran, Scopus, PubMed and Web of Sciences from inception to October 2021. We targeted observational studies evaluating the prevalence or frequency of hookah smoking among Iranian pupils and university students. Data analysis was performed using a random‐effects model, and the heterogeneity of the articles was assessed using Cochran's Q test and the I2 statistic. Results In total, 124 studies conducted on 155 115 subjects were reviewed. The lifetime prevalence of hookah smoking among high school students and university students was estimated at 34.4% and 32.3%, respectively. In addition, the frequency of hookah smoking within the past month/week (point prevalence) was estimated at 21.5% and 16.6% in university students and pupils, respectively. The frequency of hookah smoking within the past year (period prevalence) was also reported to be 22.5% and 20.8% in these groups, respectively. No significant correlation was observed between the prevalence of hookah smoking, sample size, year of publication and the mean age of the participants. Region 5 had the highest lifetime prevalence (41.7%) and period prevalence (27.1%). However, Region 1 had the highest point prevalence of hookah smoking (27.2%). Conclusions According to the results, hookah smoking is highly prevalent among Iranian pupils and university students. Therefore, proper educational interventions are required in the form of workshops and curricula to raise awareness regarding the hazardous effects of this unhealthy habit on the young generation.

Abstract Aim We developed and psychometrically tested the Nursing Presence Scale. Background Nursing presence is a foundation for professional nursing practice; therefore, it is critical to measure this concept. Introduction This instrument development study was designed to generate an itemized scale and psychometric testing using a sample of Iranian patients. Methods Based on both a concept development and literature review, and finally face and content validity 44-item draft scale was generated. During November 2018–2019, 774 patients were surveyed. Exploratory and confirmatory factor analyses were used to evaluate the scale’s construct validity; concurrent and predictive reliability of the nursing presence scale were also evaluated. We also examine the weighting to scale items. Results The analyses yielded a 36-item, 4-factor scale that adequately fit the data. Cronbach’s alpha coefficient for the whole instrument was 0.94. The intra class correlation coefficient was 0.91. Nursing Presence Scale scores were positively correlated with Revised Humane Caring Scale and predicted 25% of missed nursing care. Conclusion This 36-item has good reliability and validity, making it useful for measuring the current condition of nursing presence. Implications for Nursing and Health Policy Measuring the frequency of nursing presence allows for data-driven planning and upgrading the inpatient care services.

This study examined the synthesis of magnetic iron oxide nanoparticles coated with PO (FOMNPsP) and assessed their in vitro, ex vivo, and in vivo effects against cystic echinococcosis. The FOMNPsP was synthesized through the alkalization of iron ions in a deoxygenated form. In vitro and ex vivo protoscolicidal effects of FOMNPsP (100–400 μg/mL) were evaluated on hydatid cyst protoscoleces by the eosin exclusion test for 10–60 min. The effect of FOMNPsP on caspase-3 gene expression and exterior ultra-structural of protoscoleces was assessed by real-time PCR and scanning electron microscopy (SEM), respectively. In vivo effects were assessed by evaluating the number, size, and weight of hydatid cysts among infected mice. The FOMNPsP size was

BackgroundChemotherapy with synthetic drugs is the principal approach for toxoplasmosis treatment; however, recent studies reported the limitations and adverse side effects of these chemical drugs.ObjectiveThis study aimed to examine the in vitro and in vivo effects of Curcuma longa essential oil (CLE) against the Toxoplasma gondii RH strain.MethodsThe in vitro effect of different concentrations of CLE on T. gondii tachyzoites was assessed by cell viability assay. Flow cytometry and apoptosis analysis were performed, and nitric oxide production by CLE was also evaluated in tachyzoites. BALB/c mice were orally treated with various doses (1.25, 2.5, and 5 mg·kg−1·day−1) of CLE for 2 weeks. After the induction of acute toxoplasmosis in the mice, their survival rate and the mean number of peritoneal parasites were checked. The hepatic level of antioxidant enzymes and oxidative stress markers was evaluated by commercial kits. The mRNA expression level of proinflammatory cytokines such as interleukin 1-beta (IL-1β) and interferon-gamma (IFN-γ) was evaluated by quantitative real-time PCR.ResultsCLE, especially at 50 µg/ml, showed potent inhibitory effects on T. gondii tachyzoites. It increased the survival rate (ninth day) and reduced the mean number of peritoneal tachyzoites in the infected mice. CLE dependently increased (p < 0.01) the number of necrotic and apoptotic cells as well as NO production. CLE significantly (p < 0.05) reduced the hepatic level of oxidative stress markers but increased (p < 0.001) the antioxidant enzymes and proinflammatory cytokines in the infected mice, with no important toxicity for vital organs.ConclusionThe findings of this survey revealed the significant in vitro inhibitory effects of CLE on T. gondii tachyzoites. The results also exhibited promising in vivo effects of CLE. CLE improved the survival rate of infected mice and reduced the parasite number in them. Although the mechanisms of action of CLE are not clear, our study demonstrated its beneficial effects on acute toxoplasmosis by strengthening the immune system and reducing inflammation and oxidative stress. Still, more studies are required to confirm these results.

Most studies have shown the positive effects of lavender inhalation in decreasing anxiety in patients with cardiovascular diseases. We aimed to systematically review the role of aromatherapy with lavender in these patients. By PRISMA standards, we explored the studies on the role of aromatherapy with lavender in reducing the anxiety of patients with cardiovascular diseases in English databases through the words and terms "aromatherapy", "lavender", "lavandula", "anxiety", "cardiovascular diseases". Out of 16 647 papers, 12 papers up to January 2022 encountered the inclusion criteria for involving in this systematic review. The majority of studies (7 studies, 70%) were used Spielberger Standard Questionnaire as a measurement scale for their studies. Lavender aromatherapy was mostly used for myocardial infarction (3 studies, 30%) and coronary artery bypass graft (CABG) surgery (3 studies, 30%) patients. We concluded that aromatherapy with lavender essential oil significantly ameliorated the anxiety signs in some cardiovascular diseases, e.g., CABG surgery, myocardial infarction, and cardiac ischemia; however, more studies are required in this field to obtain more specific evidence.

Background: Gouty arthritis is widespread throughout the globe. This disorder leaves the patient with severe pain so that none of the usual pain remedies can help it. The present study was undertaken to investigate the therapeutic effect of Citrullus colocynthis on it to introduce a simple, effective, and economical approach to treatment. Method: In this randomized clinical trial, 60 patients diagnosed with gout were included, and divided into control and experimental groups. A purine diet was applied for both groups; the treatment was a capsule containing 300 mg grounded dried Citrullus colocynthis, and the placebo was an identical capsule containing starch; both were given for one month, three times a day. Data were collected by demographic questionnaire, health history form, the visual analog scale of pain, and laboratory assessment of serum uric acid. Independent t-test, paired t-test, and repeated measures analysis of variance were used to analyze the data. Results: There was a significant difference in the mean scores of pain intensity in the experimental group before and after intervention (P

Echinococcosis, or hydatidosis, is one of the most important zoonotic diseases, which is initiated by the larval stage in the clasts of Echinococcus granulosus. For the treatment of hydatidosis, surgery is still the preferred method and the first line of treatment for symptomatic patients. Unfortunately, most of the scolicidal agents that are injected inside cysts during hydatid cyst surgery have side effects, including leaking out of the cyst and adverse effects on the living tissue of the host, such as necrosis of liver cells, which limits their use. This work was carried out to study the lethal effect of green synthesized gold nanoparticles (Au-NCs) against hydatid cyst protoscoleces. Au-NCs were green synthesized using the Saturja khuzestanica extract. Au-NCs were characterized by UV-visible absorbance assay, electron microscopy analysis, X-ray diffraction (XRD), and Fourier transform infrared (FTIR) spectroscopy. Scolicidal properties of Au-NCs (1–5 mg/mL) were studied against protoscoleces for 10–60 min. The effect of Au-NCs on the expression level of the caspase-3 gene as well as the ultrastructural examination was studied by real-time PCR and scanning electron microscopy (SEM). The cytotoxicity of Au-NCs on hepatocellular carcinoma (HepG2) and normal embryonic kidney (HEK293) cell lines was also studied by the cell viability assay. The obtained Au-NCs are cubes and have an average size of 20–30 nm. The highest scolicidal efficacy was observed at 5 mg/mL with 100% mortality after 20 min of treatment for hydatid cyst protoscoleces. In ex vivo, Au-NCs required more incubation time, indicating more protoscolicidal effects. Au-NCs markedly upregulated the gene level of caspase-3 in protoscoleces; whereas they changed the ultra-structure of protoscoleces by weakening and disintegrating the cell wall, wrinkles, and protrusions due to the formation of blebs. We showed the effective in vitro and ex vivo scolicidal effects of Au-NCs against hydatid cyst protoscoleces by provoking the apoptosis process of caspase-3 activation and changing the ultrastructure of protoscoleces with no significant cytotoxicity against human normal cells. However, additional studies should be conducted to determine the possible harmful side effects and accurate efficacy.

Background: Objective Structured Clinical Examinations (OSCEs) are widely applied in health communities to provide constructive feedback to students on their clinical skills. Despite the fact that OSCE offers a comprehensive, consistent, and standardized method for evaluating students’ clinical learning skills, students are commonly unable to project their real knowledge that they are equipped with resulting in scoring errors. Objective: Investigating nursing students' views towards OSCE to reach a higher standard of clinical evaluation. Design: A qualitative, exploratory study. Methods: Final year nursing students who experienced OSCE was the target population, data were collected with semi-structured interviews. After 25 interviews, data saturation was achieved. The interviews were verbatim transcribed and analyzed according to qualitative content analysis based on Graneheim and Lundman method. To achieve trustworthiness, the methods proposed by Lincoln and Guba were used. Results: Two main themes emerged during data analysis were: 1- management problems, that includes 3 categories: 1) supervisor’s behavior, 2) time management,3) facilities, and 2- educational problems including three categories of 1) simulation, 2) educational background, 3) question design which are key factors in conducting a more rational evaluation. Conclusion: Although OSCE is an accepted method of clinical evaluation, there are some drawbacks in both management and education that require attention. These results could be effective in improving clinical evaluation and educational programs. Using more student-centered methods in teaching and providing facilities to bring students to the real world of the profession can help them to improve their ability in clinical decision making.

The primary aim of this prospective randomized trial is to determine the effect of clobetasol ointment with nitroglycerin ointment on the prevention of phlebitis caused by cannulation. The target sample is 144 patients admitted to surgical ward, randomized to 3 groups. the data collection tools included demographic information, information about intravenous treatment and phlebitis measurement scale. In the intervention groups, after venipuncture, 1.5 cm of ointments (clobetasol and nitroglycerin) was applied n three time periods of 24, 48 and 72 hours from the time of venipuncture. In the first 24 hours after cannulation, there was no significant difference between the three groups. But at 48 and 72 hours after placement, the difference between intervention and control groups was significant (P