Background: Depression, anxiety, and stress are very common among hemodialysis patients. The aim of this study was to investigate effects of aromatherapy using the damask rose oil on depression, anxiety, and stress in these patients. Methods: In a clinical trial that was performed in 2015, 60 patients under hemodialysis treatment were randomly allocated to two groups of control and intervention each consisting of 30 subjects. The DASS21 scale was used to measure the rates of depression, anxiety, and stress before and four weeks after intervention. In the intervention group, the patients were asked to inhale the damask rose oil with a constant density of 2% from a piece of cloth smeared with three drops for an hour. In the control group, only the usual, standard care was applied. Results: The comparison of the mean scores before and after the intervention in the two groups showed that after intervention, the

BackgroundOne of the most prevalent problems in hemodialysis patients is sleep disturbance. Poor sleep quality has unpleasant bio-psycho-social outcomes. The positive effects of implementing the continuous care model (CCM) were verified with different variables, including sleep quality. This study was done with different populations, using two groups.ObjectivesThis study aims to identify the sleep quality of hemodialysis patients in the city of Ilam and determine the effects of CCM on sleep quality.Patients and MethodsWe performed a quasi-experimental research study with 56 hemodialysis patients at the Shahid Mostafa Hospital in Ilam during 2014 and 2015. Pretests and posttests were conducted with the study groups and the control groups. Pretests were conducted over a one-month period, then repeated immediately before the study. Posttests were conducted immediately after the study and then repeated one month later. Participants were selected by census method and randomly divided into two groups. Ethical considerations were observed. Based on the continuous care model, interventions were performed through educational sessions over a three-week period. Consultations for continuous sleep monitoring, controls, and evaluations were conducted with the study group over the next nine weeks. Data were gathered from patient demographics questionnaires and PQSI, then introduced in SPSS 22 and analyzed with descriptive and analytic statistics (t-paired, ANOVA with repeated measures, follow-up tests such as S-N-K, Duncan, Sheffe and Tukey).ResultsOne month prior to the study, 94.6% of the participants suffered from poor sleep quality. Immediately before and after the study, 91% complained of poor sleep quality. And one month after intervention, the figure dropped to 82%. Applying the CCM positively affected the sleep quality of hemodialysis patients in Ilam, and was statistically meaningful one month after intervention (P = 0.001).ConclusionsHemodialysis patients need a consistent care plan to manage poor sleep quality. This research has proven the effectiveness of implementing CCM as an intervention for improving the sleep quality of hemodialysis patients. CCM provides a comprehensive model for caring for hemodialysis patients, and its executive stages are congruent with the many stages of the nursing process. Practitioners in different domains of nursing care, education, and management can derive great benefit from this valuable care model

Background:Despite regular treatment by hemodialysis, patients on hemodialysis are affected by uremic syndrome, which is marked by fatigue. Fatigue is supposed as the most common and the most severe symptom ever reported by patients with chronic kidney disease.Objectives:This controlled study aimed to evaluate the effect of intradialytic physical and mental exercises on fatigue in patients on hemodialysis.Patients and Methods:A total of 66 patients on long-term hemodialysis were selected via purposive sampling and were assigned to two groups, namely, control and experimental groups. The experimental group participated in a intradialytic training program twice a week for two months. The program was designed by a senior expert in physical education. Their fatigue was measured via a fatigue severity scale questionnaire before as well as one and two months after the intervention in both groups.Results:The mean of the fatigue score within the research units was 42.37. Overall, 42.2% and 56.1% of the participants experienced medium and severe fatigue, respectively. The scores of fatigue decreased significantly from the beginning through two months after intervention in the experiment group.Conclusions:With respect to the findings of the study, this method of treatment is recommended due to being cost efficient, easy, applicable, and flexible for alleviating the effect of fatigue on the personal, psychological, and social aspects of life quality in patients on hemodialysis.

Background:Chronic inflammation is the most important cause of cardiovascular disease in patients undergoing hemodialysis, and vitamin C as a major antioxidant which could be effective to suppress inflammation.Objectives:This study was performed to evaluate the effect of vitamin C supplementation on C-reactive protein levels in patients undergoing hemodialysis.Patients and Methods:This randomized, placebo-controlled and double-blind trial was conducted on 151 patients on hemodialysis who were divided randomly by lottery method to three identical groups. In the intervention group, 250 mg of vitamin C was injected intravenously immediately at the end of each hemodialysis session three times a week for 8 weeks in a row. In the control group 1, same term of placebo saline was injected, and in the control group 2, no intervention was performed.Results:A total of 86 (61%) male and 55 female patients with mean hemodialysis duration of 39.74 ± 45.5 months, and a mean age of 61.36 ± 11.46 years-old, participated in this study. Hypertension and diabetes were the most common underlying diseases (79.4%). Median baseline CRP in the intervention, control 1 and control 2 groups were 16.8, 17.8, and 19.4 mg/L respectively. After 2 months, median CRP reduced significantly in the vitamin C group to 10.7 (P = 0.04) vs. 22.6, and 30.6 mg/L in control groups.Conclusions:Our findings demonstrated that vitamin C supplementation modifies the levels of CRP in patients on hemodialysis.

BackgroundThis study aimed to assess the effect of surface preparation with sandblasting and diamond bur along with the use of three primers on shear bond strength (SBS) of metal brackets to aged composite.Material and MethodsIn this in vitro, experimental study, 60 Filtek Z250 composite discs were fabricated (10×2mm), immersed in distilled water for 24 hours and subjected to 5000 thermal cycles. They were randomly divided into two groups (n=30) of sandblasting with aluminum oxide particles for 10 seconds and surface roughening with bur. Each group was randomly divided into three subgroups (n=10) for use of Transbond XT, Assure Plus and Composite Primer. Metal brackets were bonded and the samples were stored in distilled water for 24 hours followed by 2000 thermal cycles. The SBS of brackets was measured and the adhesive remnant index (ARI) score was calculated. The data were analyzed by one-way ANOVA, t-test and Chi square test.ResultsThe difference in the mean SBS was not significant among the six subgroups. ConclusionsAll combinations of primers and surface preparation methods provided adequately high SBS between brackets and aged composite surfaces. Considering the ARI scores, surface roughening by bur is superior to sandblasting. Key words:Shear strength, composite resins, orthodontic brackets, aged composite, surface preparation.