Background and Objective : Anemia is one of the most common complications of end stage renal diseases. Inadequate production of erythropoietin is the main cause of anemia in these patients, and iron deficiency is the other important factor. We designed this study to survey the prevalence of iron deficiency anemia in hemodialysis patients referred to hemodialysis ward of Panje Azar hospital in Gorgan, Iran.

  Material and Methods: The subjects of this descriptive and cross-sectional study were all 97 patients undergone permanent hemodialysis. Hemoglobin, Serum Iron, Ferritin, Transferrin saturation and Hemoglobin index were measured to assess iron deficiency anemia. We did data analysis by using chi square, fisher exact test and independent T test in spss 13 environment.

  Results: The prevalence of anemia and iron deficiency anemia were 57.6 and 31.1 percent, respectively. Tranferrin saturation in 29.16 percent of the patients is less than 20%. There was no significant correlation between signs of anemia and variables such as, duration of dialysis, causes of the disease and iron- deficiency anemia (p=0.06). But signs of anemia were significantly correlated (p<0.0001) with erythropoietin. In comparison with patients consumed iron orally, those who used injectable iron had higher serum iron, Hemoglobin and Transferrin saturation (p<0.001).

  Conclusion: Because of high frequency of iron- deficiency that may results in resistance to erythropoietin therapy and leads to inappropriate treatment of iron deficiency. We recommend first treating of ID to prevent from useless administering of erythropoietin.

  Background and Objective : Neurologic patients' care givers are faced with many challenges and stresses, affecting on their health if they cope with an inappropriate style. The awareness of the care givers about coping strategies is necessary to prevent from their psychological problems, therefore the present study was conducted to determine the coping strategies of men and women care givers of Neurologic patients at home.

  Material and Methods : This descriptive-Analytical study was conducted on 200 subjects selected by convenience sampling method. The instrument was Jawiloice coping strategy scale­ having two dimensions of problem-focused­ part (15 ­questions) and
emotion-focused (24 questions). The data analysis was performed using estimates of central tendency, Chi-Square, Kruskal-Wallis, Mann-Whitney test and Anova (P<0.05) by spss 16.

  Results: The participants were men (N=120) and women (N=80). The problem-focused subscale in men is 51.86 ± 6.3 and in women 52.86 ± 7.63, whereas in emotional-focused the result is 72.86 ± 13.89 in men and 69.68 ± 11.65 in women. In latter dimension, the difference is not statistically significant. ­In problem-focused between men and women, the difference is significant (p≤0.05). Considering coping levels to low, moderate, and high, there is no meaningful difference between males and females. Duration of involvement with patients is significantly correlated with emotional-focused (p≤ 0.05) and income status with problem-focused (p≤ 0.03).

  Conclusion: According to the findings, the care givers must be educated about effective coping strategies skills to decrease stresses due to care of the patients and to improve mental health.

  Background and Objective: Injection-site pain and bruising associated with subcutaneous injection of Heparin is one of the physical and psychological discomforts in patients. This study aimed at determining the effect of injection duration on the size of bruising and the severity of injection pain.

  Material and Methods: This quasi-experimental study was designed on 119 patients hospitalized in Panje Azar teaching center in Gorgan, 2009. For each patient, two subcutaneous injections of 10 and 30 seconds were performed with a 12-hour interval. Data collection was carried out using a researcher-made checklist that consists of two sections, demographic characteristics and a section to record the extent of bruising and pain intensity. The Extent of bruising was measured using clear flexible ruler within 48-72 hours and pain intensity by visual analog scale (VAS) immediately after Heparin injection. Data were analyzed using SPSS- 16 by central tendency and statistical tests.

  Results: The Findings show that 10-second injection in comparison to 30-second injection is more effective in increasing the exent of bruising and pain intensity. There is significant difference between the two methods (P<0.05).

  Conclusion: The duration of subcutaneous injection has an effect on bruising extent and the pain following the administration of Heparin in hospitalized patients. The findings can be used in clinical setting and nursing education.

  Background and Objective : Because of special life condition, martyrs and veterans students have unique status in comparison with other university students. The aim of this study was determination of relationship of perceived social support, mental health, and life satisfaction in martyrs and veterans students of state universities in Gorgan,Iran.

  Material and Methods: In this descriptive and analytical study, 102 martyrs and veterans students were selected via census sampling. Demographic data sheet, perceived social support scale, general health questionnaire (GHQ-12) and satisfaction with life scale were used.­ Descriptive statistics, liner regression analysis, spearman correlation coefficient and Mann-Whitney test in spss 16 software environment were used for data analysis­(P<0.05).

Results: According to GHQ-12, 21.4 percent of participants have unfavorite mental health (score less than 14). Findings show perceived social support is correlated with 23 percent of mental health changes (P=0.032) and 42 percent of life satisfaction changes (P=0.000). There is no significant relationship between perceived social support from friends and significant others and mental health and life satisfaction (P>0.05). There is significant correlation between mental health and life satisfaction (r= -0.534, P=0.000).

  Conclusion: According to our findings, availability of perceived social support from family leads to promotion of mental health and life satisfaction of students.

  Background and Objective: Chronic neurologic diseases due to associated disabilities and high cost of ­their medical services are considered as a crisis for patients and family. The stress caused by these problems can jeopardize the health of the caregivers. Thus, the aim of this study was to determine the general health status of neurologic patients’ caregivers and the related factors.

  Material and Methods: In this cross-sectional study conducted in 2009, the caregivers of the patients with neurological disorders (n=200) were selected via convenience sampling.­ The data was gathered by a demographic checklist and general health questionnaire (GHQ-28) completed by caregivers and analyzed by descriptive statistic­, Pearson correlation coefficient and chi square, using SPSS-16.

  Results: The mean age is 31.78±9.94 and 59.5% of the subjects are males. The caregivers (72.5%) general health is disturbed (Score more than 23 based on GHQ-28 cut of point). General health of male and female caregivers is significantly different (P<0.05). Between the subscales of GHQ-28, female caregivers compared to males have higher depression score, which is significant (P<0.05).­ ­The caregivers’ general health are correlated with (P<0.05) the patient’s care dependency and the income of family. ­There is no significant relationship between general health and demographic variables such as marital status, history of the disease and educational level.

  Conclusion: Based on the results, significant percent of caregivers of the patients with neurological disorders suffer from disrupted general health. Thus, the presence of supportive resources and effective coping skills can be effective in improving the health.

  Background and Objective: ­ With the development of human societies,­ the needs for different types of health services are increasing. Because of limitations and shortage of national resources, the awareness of health administrators about appropriate allocation of resources leads to efficient use of assets. The aim of this study was to measure the workload and efficacy of nursing staff in internal ward.

  Material and Methods: ­ This descriptive and cross sectional study was conducted on, via census sampling, all nursing activities performed by 10 nurses for 94 patients in Panje-Azar Hospital of Gorgan. ­To determine the efficacy, we asked the subjects to fill out a researcher made, validated questionnaire and measured the time of their presence in the ward. Data analysis was performed by analysis variance, using SPSS-16 software.

  Results: Of ­­total time of presence,­ ­20.3% is spent for documentary activities whereas only 0.49% for patient education. Overall, the spent time for direct and indirect nursing activities is 46.46% and 53.54%, respectively. The efficacy of nursing staff is 62%, ­the highest (66.6­ %) for morning shift and the lowest for night shift (58.34­ %). There is no significant difference, using analysis variance, in efficacy rates of work shifts­ (morning, evening and night).

  Conclusion : In spit of efficacy of over 50 percent in different shifts, the educational programs related to time management, human resource development and electronic nursing are necessary to increase the efficacy.

  Background and Objective: anemia is one of the main problems of chronic renal failure patients undergone Hemodialysis and erythropoietin is not effective for these patients. Since Vitamin C deficiency in Hemodialysis patients is common, this study was performed to compare the effect of intravenous and oral ascorbic acid consumption on anemia in Hemodialysis patients.

  Material and Methods: this clinical trial was conducted on 75 patients, selected via convenience sampling and including criteria (hemoglobin, 11mg/dl ferritin, 100ug/L transferring saturation, < 20%). The subjects were randomly assigned to three equal groups of control , oral ascorbic acid (POAA) and intravenous ascorbic acid (IVAA) After each every-other-day dialysis performed for eight weeks, the patients of IVAA group were given 300mg intravenous vitamin C and the ones of POAA group given 500mg vitamin C orally. The Plasma iron with chemical method, total iron-binding capacity (TIBC) and ferritin level with indirect method, hemoglobin with cell counter and transferring saturation (TSAT) with related formula were measured. Using a checklist, the data of demographic, laboratory results and side effects were recorded and analyzed by SPSS-13, using ANOVA and scheffe post-hoc test (p≤ 0.05).

  Results: the baseline hemoglobin, serum iron, ferritin, TIBC and TSAT in three groups were not different significantly. After intervention, the hemoglobin level of IVAA group( 20.1g/dl ) and in POAA group (0.99g/dl) were increased compared to control group(P>0.001). the mean of hemoglobin in IVAA was significantly more than POAA (P>0.05).

  Conclusion: based on the results, the use of oral and intravenous vitamin C can be effective in the anemia caused by iron deficiency, especially vitamin C injection that is more beneficial.

Background: Receiving Oxygen during Cesarean section under spinal anesthesia can be a good way to prevent from nausea and vomiting of mothers and hypoxemia of fetus. This study aimed to compare the effect of two treatment methods of Oxygen therapy with facemask and nasal catheter on vomiting and nausea and patient's comfort during Cesarean section under spinal anesthesia.

Methods: This clinical trial study was conducted  on 50 candidate patients for elective cesarean section, recruited via convenience sampling , were divided into two groups. For the first group, 8 liters of Oxygen per minute with face mask and for the second one, 4 liters of Oxygen per minute with nasal catheter was administered during cesarean section and after that in recovery unit. Nausea, vomiting and comfort were recorded during the first 30 min of surgery and in recovery unit. Data were analyzed by Mann-Whitney test, independent t test, Fisher's exact test and Chi-square tests.

 Results: No significant difference was observed between two groups in terms of nausea and vomiting during surgery and after that.  Moreover, there was no significant difference between two groups in terms of comfort during (p=0.14) and after surgery (p=0.12).  In terms of clinical treatment, patients who received Oxygen through nasal catheter felt more comfort.

Conclusion: Nasal catheter by administering lower dose of oxygen had a similar effect to face mask on nausea and vomiting. Therefore, since patients feel more comfort when using nasal catheter, it is preferable in preventing the nausea and vomiting in Cesarean section during spinal anesthesia.