Diabetes mellitus is considered a silent disease with possible late chronic complications such as diabetic foot ulcer. This condition is managed by surgical debridement. To improve surgical outcome, some surgeons use proteolytic agents after surgery. Kiwifruit contains a type of proteolytic enzyme called actinidin that may play a role in the treatment of such complication. In the current study, we evaluate the role of kiwifruit extract in the treatment of diabetic foot ulcer. Eighteen diabetic foot ulcer patients were included in a randomized, double-blind clinical trial. The patients were divided randomly to control and experimental groups. Patients in the control group underwent daily wound dressing using base ointment (Eucerin). In the experimental group, we added kiwifruit extract to the standard wound dressing. Clinical data including general appearance of wound (according to recorded photographs before and after medical intervention) were analyzed using SPSS version 22. The mean wound area of the experimental group was significantly less than in the control group ( P = .005) after 4 weeks of treatment. Comparison of the average of size difference, before and after the treatment in the experimental group and the control group, shows that kiwifruit can have a good impact on wound healing ( P = .0001). In patients with diabetic foot ulcer, wound dressing using kiwifruit extract may help reduce time of treatment and may replace surgical debridement for some selected cases.

Background: Death anxiety and obsession are human tensions that routinely present in nursing. The sense of humor is also associated with obsession and anxiety. Objectives: Therefore, the present study aimed to determine the level of death anxiety, death obsession, and sense of humor among nurses working in medical-surgical wards and intensive care units in Iran. This is a descriptive-analytical study. Methods: The research population comprised 240 nurses working in intensive care units and medical-surgical departments in Kerman. The research instrument was composed of a demographic questionnaire, death obsession scale (DOS), Templer death anxiety scale (TDAS), and humor styles questionnaire (HSQ). Results:The mean scores of nurse's death anxiety in intensive care units and medical-surgical wards were 7.46 ± 3.43 and 5.46 ± 2.84, respectively. The mean scores of death obsession in intensive care units and medical-surgical wards were 30.47 ± 11.17 and 26.38 ± 11.67, respectively. The mean scores of the sense of humor in the two groups were 117.37 ± 21.31 and 109.56 ± 23.47, respectively. The mean scores of death anxiety, death obsession, and sense of humor among nurses were significantly higher in intensive care units than in medical-surgical wards (P < 0.05). Conclusions: It is necessary to determine the sources of death anxiety and obsession and strengthen the sense of humor in nurses to provide better healthcare.

Background: Burnout, a phenomenon that is of interest for both individuals and organizations, is characterized by decreasing energy, power and resources in the presence of excessive demands. Nurses are more prone to develop burnout due to both the emotional nature of their jobs as well as patients' demand. The present study was aimed to assess burnout among nurses working in the Iranian hospital of Ali-ebn Abitaleb Rafsanjan, Iran 2010. Material and Methods: in this descriptive study, 134 nurses (working in Med-Surge, ER, ICU, CCU, and Neurology units) were randomly recruited. The data were collected in two sections. Demographic variables including age, sex, diet, work experience, marital and employment status and academic degree were asked in the first section. Maslach burnout tool was applied for measuring burnout in nurses, in the second section. Results: Most nurses (63%) were women and married (74.8%). Mean age of nurses was 33.84 ± 8.7 years with a minimum of 24 and maximum of 53 years. Mean score of burnout was 78.43 ± 15 with a minimum of 26 and maximum of 132. There was a significant association, between gender and degree of burnout (p <0.05). Higher score of burnout was reported among those with shorter duration of working in their job (0-5 years) comparing to nurses with a longer duration (more than 20 years) of working in their job (p <0.05). Conclusions: Our findings showed that burnout affected nurses significantly. Therefore, it seems that this problem must be studied and related factors should be recognized, in order to reduce burnout among nurses. Many aspects of nurse's job should be noticed and appropriate intervention should be conducted. These aspects include their salary, job security, their lesure and their dayly working hours.

Major depressive disorder (MDD) is a severe mood disorder that may lead to use of drugs, alcohol, and even suicide in acute cases. It has been shown that neurotransmitters and hormones have the same receptors and pathways in the mood area of the brain. Therefore, metabolic and biochemical changes are expected in MDD and, in such diseases, understanding the hormonal alterations would be extremely helpful in the management or treatment with hormone replacement therapy. We evaluated levels of cortisol, adrenocorticotropic hormone (ACTH), testosterone, thyroid‐stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroxine index (FT4I), T3 resin uptake (T3RU), and dehydroepiandrosterone sulfate (DHEA‐S) in 79 patients suffering from MDD and 71 healthy controls. The existence of MDD was confirmed by a face‐to‐face structured clinical interview. We started the investigation by taking a blood sample from the study population. Then, hormone levels were measured by enzyme‐linked immunosorbent assay. Significant differences were found between TSH, FT4I, DHEA‐S, ACTH, testosterone, and cortisol/DHEA‐S ratio in MDD patients compared to the healthy controls. We also demonstrated a correlation between MDD recurrence and FT4I index and TSH, respectively. Regarding some hormonal changes in patients with MDD, hormonal shifts should be considered in the treatment or management of MDD patients.

The potential effects of opium consumption on lipid profile remain unquantified. We considered the association between opium use and dyslipidemia. In this cross-sectional study, we used data obtained from the Rafsanjan cohort study, as a part of the prospective epidemiological research studies in IrAN (PERSIAN) with detailed and validated data on opium consumption and selected other exposures. A total of 9932 adults were included in the study. Logistic regression models were used to assess the relationships of opium consumption with the prevalence of dyslipidemia and lipid disorders. In this population, 73.33% had dyslipidemia and the prevalence rates of high TC, high TG, high LDL and low HDL were 54.24%, 47.45%, 34.43% and 11.91% respectively. After adjustment for all confounders, opium users compared with non-users had lower odds ratios (OR) of high TC and high LDL [0.81 (95% confidence interval, CI 0.71–0.92) and 0.80 (95% CI 0.69–0.93) respectively] and greater OR of low HDL [1.30 (95% CI 1.04–1.62)]. Longer duration of opium consumption resulted in lower ORs of high TC, 0.68 (95% CI 0.55–0.84) and high LDL, 0.82 (95% CI 0.67–0.99), and shorter duration of opium consumption resulted in increased odds of low HDL, 1.30 (95% CI 1.02–1.66). High dose of opium consumption was associated with an OR of dyslipidemia of 0.80 (95% CI 0.65–0.97), high TC of 0.80 (95% CI 0.67–0.95), and high LDL of 0.78 (95% CI 0.64–0.96) and low dose of opium consumption, with an OR of low HDL of 1.30 (95% CI 1.02–1.65). In relation to route of consumption, opium smoking was a risk factor for low HDL with an adjusted odds ratio of 1.31 (1.04–1.63). Opium use was associated with selected changes on serum lipid levels, but opium users had higher frequency of cardiovascular disease history.