Background: Non-adherence to treatment regimens can bring about negative effects on the quality of life of hemodialysis patients. Objectives: The present study was conducted to explore the relationship between compliance with treatment regimens and the quality of life in these patients. Methods: This descriptive-analytic study investigated 68 hemodialysis patients who had referred to Imam Khomeini Hospital of Zabol, Southeast of Iran. The subjects were chosen via convenience sampling. Data were collected using a demographic questionnaire, a self-constructed scale for treatment regimen compliance, and the kidney disease quality of life short form (KDQOL-SF). Descriptive statistics, Pearson correlation coefficient, and t-test were used to analyze the data by SPSS 22. Results: The results showed that 77% of patients moderately adhered to treatment regimens, and the mean quality of life in hemodialysis patients was 56.36 ± 17.41. Pearson correlation coefficient revealed a positive significant relationship between the quality of life and compliance with treatment regimens in the study population (P = 0.02). Conclusions: According to the findings of this study, it is recommended that appropriate educational programs should be designed to improve the quality of life in hemodialysis patients by encouraging their adherence to treatment regimens.

Background: Diabetes is a serious chronic disease that can damage the heart, arteries, eyes, kidneys and nerves, leading to death and early disability. Before the discovery of insulin as well as common anti-diabetes drugs, patients with diabetes were treated with medicinal herbs and traditional treatments. One of these effective medicinal herbs is Rhubarb. Rhubarb is prescribed in traditional medicine for various patients, including patients with diabetes. But its effect has not been scientifically reported so far.Purpose: This study was conducted with the aim to determine the effectiveness of Rhubarb stem extract on HbA1C and fasting blood glucose in patients with type II diabetes.Method: In this experimental study, 80 patients with type II diabetes mellitus in Zabol diabetes center, aged 30-60 years old with fasting blood glucose greater than 140 mg/d/ were selected. Patients were randomly assigned into two groups (n = 40) of treatment with capsules of Rhubarb stem and placebo after matching the oral medications. The patients in both groups were studied for fasting blood glucose and HbA1C before and after 1 month of conducting the study.Results: The mean FBS and HbA1C in rhubarb group before the intervention were 288.80 ± 94.49 and 9.62 ± 1.58, respectively, and after the intervention were 226.42 ± 88.89 and 7.83 ± 1.50, respectively. According to the statistical paired f-test and Wilcoxon test a significant reduction was found in FBS and HbA1C with rhubarb intervention (p < 0.05).Conclusion: In diabetes mellitus, as many factors affect the level of blood glucose, they also contribute to reducing blood glucose level and preventing complications. Therefore, considering the positive effects of rhubarb, it can be recommended to use rhubarb extract as an additional treatment to reduce blood glucose level.

This study suggests that a high percentage of patients experienced acute postoperative pain despite routine nursing care, while evidence-based nursing practices could significantly alleviate pain.

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Dialysis should be a safe procedure with less complications. It should improve physical state of the patients. High dialysis adequacy should also be taken into account in dialysis procedure. Thereby, the present study recommended dialysis with increased blood flow rate with higher adequacy and less complications compared to routine dialysis despite insignificant difference in dialysis adequacy and complications between increased blood flow intervention and high-flux hemodialysis. Nevertheless, increased blood flow intervention increased dialysis adequacy. For this purpose, this intervention was preferred over high-flux hemodialysis. Introduction: Various parameters such as increased blood flow and high flux filter increase dialysis adequacy. Each parameter is associated with specific complications. Objective: The aim of this study was comparison of two interventions of increased blood flow rate and high-flux filter on hemodialysis adequacy and complications. Please cite this paper as: Patients and Methods:This was a single-group quasi-experimental before-and-after intervention study. Twenty-two patients undergoing dialysis three times a week in the last 6 months consented to participate in the study. The participants were selected using random sampling method. They were reevaluated prior to dialysis and every 30 minutes until the end of each hemodialysis session using dialysis complication checklist. Dialysis adequacy was measured at the end of the fourth session for each patient. Results: The paired t test results showed a significant increase in dialysis adequacy in dialysis with increased blood flow and dialysis with high flux filter (high-flux hemodialysis) compared to routine dialysis (P = 0.01). A significant increase was found in incidence of muscular cramp in dialysis with increased blood flow compared to routine dialysis based on McNemar's statistical test (P = 0.02). Conclusion: Dialysis adequacy improved in both increased blood flow intervention and highflux hemodialysis compared to routine dialysis. On the other hand, increased blood flow intervention was associated with less complications than high-flux hemodialysis. In addition, increased blood flow intervention was more efficient and safer than high-flux hemodialysis.

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Background: Hemodialysis, as one of the most commonly used chronic renal failure treatments, increases the level of blood toxins, complications of illness, hospitalized days, imposed costs, and mortality if it does not have the required quality. One of the factors that can be effective in increasing dialysis adequacy in case of patient tolerance and lack of complications is an increasing blood flow, the stepwise profile of dialysis fluid flow. The present study intends to compare these methods in terms of efficiency in increasing the dialysis adequacy against their complications. Materials and methods: In this semi-experimental single-group study, before and after-intervention trials, 22 patients with hemodialysis under the coverage of Special Patients Center in Zabol, who had the criteria to be included in the study were selected by random sampling method and underwent dialysis for 4 sessions using routine methods, increasing blood flow, stepwise profile of dialysis fluid flow, while maintaining all parameters (such as the type of fluid, type and concentration of dialysis fluid, shifts, etc.). At the beginning and the end of the each dialysis session in two methods, the BUN sample was taken before and after dialysis to study the adequacy of dialysis. During the 12 sessions of dialysis, patients were examined before dialysis in terms of lack of hypertension and some symptoms including nausea, vomiting, muscle cramps and other symptoms and then they were monitored directly every 30 min for hypertension, nausea, vomiting, muscle cramps, headaches, and so on. Results: The mean score of adequacy of dialysis was 0.834 ± 0.22 in the routine session, 1.19 ± 0.45 in the method of increasing blood flow and 1.07 ± 0.35 in the stepwise profile of dialysis fluid flow, and there was a significant difference between the mean score of dialysis adequacy in routine session and each method of increasing blood flow and stepwise profiles of dialysis fluid flow using paired t-test (p=0.001). The results from Cochran statistical test showed that there is a significant difference between the routine methods, an increase in blood flow, stepwise profile of dialysis fluid flow profile in terms of the frequency of muscle cramp during hemodialysis (p<0.05) and this difference was statistically significant between the routine session and an increase in blood flow based on McNemar test (p=0.021). Based on the McNamar statistical test, the difference in headache frequency during hemodialysis was significant between the routine session and the stepwise profile of fluid flow (p=0.039). Conclusion: Although the increase in blood flow and dialysis fluid flow in the stepwise method leads to an increase in the adequacy of dialysis, but they are not safe due to their complications and side effects.

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