Palliative care is the science of promoting the patient's quality of life. It can improve the quality of life of a patient, which is effective not only in patient's late-life but also useful in dealing with a chronic illness over many years. In this regard, nurses, as the largest providers of health care services, play an important role in palliative care.Objective: This study aimed to investigate the palliative care knowledge of nurses and its contributing factors. Materials and Methods:This cross-sectional study was conducted on 280 nurses working in different departments of hospitals affiliated to Guilan University of Medical Sciences (GUMS). They were recruited using the stratified random sampling technique. Their data were collected by a demographic form and the Palliative Care Quiz for Nursing (PCQN) instrument. The collected data were analyzed by Kruskal-Wallis and Mann-Whitney U tests. Results:The Mean±SD score of palliative care knowledge of study nurses was reported as 7.86±2.16 indicating their imperfect knowledge. Among studied factors, only the personal study about palliative care had a significant association with the nurses' knowledge (P=0.038). Conclusion:Nurses had poor knowledge of palliative care and its subscales that is one of the main obstacles in providing optimal palliative care. So, increasing their quality of palliative care services by improving their knowledge through in-service education and on the job retraining could promote the quality of palliative care services for the patients.

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Defatting techniques have no effect on reducing tip and supratip skin thickness after rhinoplasty in moderate to thick skins.

Objective:The purpose of this study was to evaluate the disability in patients with spondylolisthesis who assigned either to posterolateral fusion (PLF) or posterior lumbar interbody fusion (PLIF) and to compare it between two groups.Methods:In a prospective observational study, 102 surgical candidates with low-grade degenerative and isthmic spondylolisthesis enrolled from 2012 to 2014, and randomly assigned into two groups: PLF and PLIF. Evaluation of disability has been done by a questionnaire using Oswestry Disability Index (ODI). The questionnaire was completed by all patients before the surgery, the day after surgery, after 6 months and after 1-year.Results:There were no statistically significant differences in terms of age and sex distribution and pre-operation ODI between groups (P > 0.05). Comparison of the mean ODI scores of two groups over the whole study period showed no significant statistical difference (P = 0.074). ODIs also showed no significant differences between two groups the day after surgery, 6th months and 1-year after surgery (P = 0.385, P = 0.093, P = 0.122 and P = 433) respectively. Analyzing the course of ODI over the study period, showed a significant descending pattern for either of groups (P < 0.0001).Conclusion:Both surgical fusion techniques (PLF and PLIF) were efficient to lessen the disability of patients with spondylolisthesis, and none of the fusion techniques were related to a better outcome in terms of disability.

Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism is associated with functional and cognitive outcomes of stroke and plays a key role in preventing neuronal death. This study aimed to answer the following question: does BDNF Val66Met polymorphism prognosticate survival status and risk of post-stroke dementia (PSD)? In a retrospective cohort study, 206 patients with ischemic stroke (IS) entered the study. They were consecutively being admitted to the neurology clinic in Poursina Hospital (northern Iran) from 2012 to 2014. The diagnosis of PSD was based on DSM-5 criteria. The current and the premorbid cognitive statuses of the patients were respectively assessed through the third edition of Addenbrooke's Cognitive Examination and the Informant Questionnaire on Cognitive Decline in the Elderly. BDNF Val66Met gene polymorphism was determined by PCR-RFLP. On average, 48 patients (23.3 %) developed PSD 6 months after IS. Log-rank test showed that the survival rate of at least one Val-allele carriers was significantly lower than that of Met/Met homozygotes (P = 0.0005), and the former developed PSD sooner than the latter (375, 492 days, respectively). Cox model showed that heterozygous carriers of Val/Met were at greater risk of PSD over time (HR 2.280, 95 % CI 1.566-4.106, P = 0.006). However, the risk ratio of patients with PSD among different BDNF genotypes decreased after adjusting demographic, clinical, and vascular risk factors, and was no longer statistically significant (AHR 2.434, 95 % CI 0.597-9.926, P = 0.215). Val-allele carriers or Val/Met genotypes were more quickly diagnosed as having dementia after IS. However, this genetic vulnerability became more destructive when it was added to demographic, clinical, and vascular risk factors.

Background and objective: Arthroplasty is the main treatment in patients with advanced knee osteoarthritis. In bilateral lesions, it is frequently performed in two simultaneous or separate surgical procedures. In this regard, the present study aimed to compare the results of knee arthroplasty in two joints simultaneously at two different times. Method: In general, all 40e70 years old patients in need of complete bilateral total knee arthroplasty (BTKA) were enrolled in this descriptive cross-sectional study during 2009e2016. They were included in three groups of BTKA as simultaneously (n ¼ 272), staging in the same hospitalization ( 146), and staging in different hospitalizations (245). To assess the quantitative and qualitative function of the knees, patients' knees were evaluated before the surgery, and one month, three months, and two years after the surgery using the Knee Society Score (KSS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC). Finally, hospitalization time, anesthesia duration, and medical costs were compared between the three groups. Results: Based on the results, knee function improved based on WOMAC and KSS scales in all groups after arthroplasty although no significant differences were observed between the three groups. Patients' satisfaction in simultaneous BTKA was significantly higher compared to the other two groups (P ¼ 0.013). Eventually, complications demonstrated no significant differences between the three groups except for pulmonary and cerebral embolism which were more prevalent in old patients with a high body mass index in the simultaneous BTKA group (P ¼ 0.035 and P ¼ 0.043, respectively). Conclusion: Overall, simultaneous BTKA is a useful approach for reducing costs while increasing patients' function and satisfaction although it has certain complications such as embolism in older overweight patients.

Abstract- We aimed to define Metabolic Syndrome (METs) from different viewpoints to determine the most appropriate method that could be used for early METs' diagnosis in general population and treat them immediately. This study was an analytic cross-sectional study which was conducted on 725, twelve year-old-girls and boys from Rasht city in Iran. METs was defined based on 7 different methods. Data were reported by descriptive statistics (number, percent, mean, and standard deviation) and analyzed by Cohen's kappa coefficient correlation and chi-square in SPSS version 19. The highest and lowest percentages of METs were obtained by DE Ferranti (17.5%) and viner et al., (0.8%) methods, respectively. Results showed that viner et al., had the highest degree of agreement with NCEP ATPIII and the lowest with DE Ferranti. Furthermore, De Ferranti showed the highest degree of agreement with NHANESIII and the lowest with Viner et al., According to results, the identification of the cut off points of obesity could help to promote public health care.

Introduction Planned pregnancy is an important indicator of improving the health status of mothers and newborns, as today unplanned pregnancy is a public health indicator (1). There are 2 types of unplanned pregnancies; first, the pregnancy which happens sooner than intended pregnancy time called mistimed pregnancy. And the second type which is unintended pregnancy, when a woman has no decision to have a baby in the future (2-4). Pregnancy and childbirth are joyful experiences for women (4). This event raises pleasure and satisfaction as well as concerns about accepting pregnancy and changes in family and social roles (5). In planned pregnancy, the couple feels stronger; however, women need to get ready for a healthy pregnancy, childbirth, and childcare. On the contrary, unplanned and forced pregnancy makes mothers fearful and anxious (5,6). During this period, mothers may face high risk factors (7) including delayed or no referral to health care centers for receiving pregnancy health care, lack of self-care behaviors (taking no folic acid and iron tablets, no tetanus injection), and increased risk of medical complications and surgery (anemia and increased risk of preeclampsia) (8). Unplanned pregnancy and its consequences is a global problem which affects women, children, as well as families, and the society (9,10). It often leads to induced abortions and preterm labor, and sometimes its complications can cause mother's death (11). In developing countries, 20%-40% of births are unplanned or mistimed, posing problems for families and jeopardizing the health of millions of women and children, which lead to an estimated number of 50 million induced abortions(12). In the United States, 45% of the pregnancies are unplanned, from which 85% belong to the women who use no contraceptive methods. Forty-five percent of these women are 15-44 years old from which 22% choose abortion (13). In Iran, annually 400 000-500 000 unplanned pregnancies (constituting 40% of total pregnancies) are reported. In a meta-analysis performed in Iran, the total prevalence of unplanned pregnancy was 30.6%. Despite success in Iran's family planning program, one third of pregnancies are unintended and it is increasing 3.2 times per year, and 75% of these unintended pregnancies are among the couples using the contraceptive methods (1). The most important causes of this problem can be traced back to failure of contraceptive Abstract Objectives: The present study aimed at comparing the physical health and maternal-fetal attachment in the women with planned and unplanned pregnancies. Materials and Methods: This was a descriptive-comparative study including 300 pregnant women (165 planned and 135 unplanned pregnancies) with mean age of 29.8±5.8 (age range of 16-50 years old) who had referred to the prenatal clinic of a hospital from September to October, 2016. The maternal-fetal attachment was analyzed using frequency distribution of attachment scores which did not follow the normal distribution of the subscale totally and specifically. Therefore, to...