نسرین سرابی

Diabetes is a significant health problem that can lead to death and serious complications. To prevent these outcomes, patients need to adopt specific self-care behaviors. Patients' knowledge about the disease and self-care methods is crucial for achieving desired treatment outcomes. Therefore, this study aimed to determine the state of awareness and self-care performance in patients with type II diabetes.

This cross-sectional study included 299 patients with type 2 diabetes referred to the diabetes clinic of Dezful City in 2022, selected through convenience sampling. Data were collected using a questionnaire related to self-care knowledge and practice and analyzed using SPSS 16 software with a 95% confidence level.

The results showed that 88.6% of participants were under 60 years old, 67.2% were male, 57.9% lived in urban areas, 54.2% were single, 56.2% were illiterate, and 34.1% had been diagnosed with diabetes for 1 to 5 years. It was found that 93% and 99.3% of participants did not achieve high self-care knowledge and performance scores, respectively. The highest average score was for knowledge about diabetes (3.87 ± 1.35), while the lowest average score was for foot care practice (12.70 ± 3.6).

This study showed that patients with type 2 diabetes have low self-care knowledge and performance. Therefore, it is necessary to modify and improve the self-care programs for these patients.

Knowledge, positive attitude, and proper practice are the most important factors in controlling cardiovascular complications in chronic diseases such as diabetes. So, this study investigated the knowledge, attitude, and practice of cardiovascular disease prevention in patients with type 2 diabetes.

In this descriptive-cross-sectional study, 385 patients with type 2 diabetes who visited the Diabetes Clinic of Ganjavian Dezful Hospital from January 2023 to April 2024 were selected by convenience sampling method. To collect data, the demographic information questionnaire and the questionnaire by Koohi et al. (2021) related to the knowledge, attitude and practice of prevention of cardiovascular diseases were used. The Cronbach's alpha of the questionnaire was >0/6 for all dimensions of the questionnaire, and its CVR and CVI in this study were 0/90 and 0/85. Data were analyzed using SPSS version 16 software and p-value of less than 0.05. Descriptive statistics including frequency, mean, and standard deviation as well as inferential statistics such as Pearson correlation, independent t test, and ANOVA were used to analyze the data.

This study showed that 57.1 percent of the participants were in the age range of 40 to 60 67/5 percent of whom were women. Patients had a high level of knowledge and attitude toward preventing cardiovascular disease (20/06 ± 5/42) and (46/80 ± 4/99), respectively); however, their performance level was not high (8.65 ± 5.03). A significant positive relationship was also observed between knowledge and attitude (r = 0/6, P= 0/001).

Despite patients’ high level knowledge and attitude toward the prevention of cardiovascular diseases, their performance in this field is not appropriate, and this issue requires planning by hospital managers

One of the goals of managers in the health system is to improve staff performance and the quality of services provided to clients. Many factors can improve these services, including the amount of stress and quality of work-life of nurses are important factors affecting the quality of services are important.

In this study, 350 nursing staff of Ganjavian Hospital in Dezful were selected. The main data collection tool consists of two parts: nurses 'job stress questionnaire and nurses' quality of life questionnaire and the data using SPSS 24 software with the help of descriptive statistics including: frequency, mean and standard deviation and analytical statistics Including: Independent t-test and analysis of variance were analyzed.

A total of 350 nurses in the present study had a mean age of 41.62 ± 15.56 years (range = 20-63 years). The mean of job stress in the present study was 131.34 ± 8.98. Of the 350 nurses who completed the questionnaire, 57 experienced low-stress levels, and 22 experienced severe stress. Moderate stress was observed in 271 patients or 77.42% of nurses. The mean physical dimension of quality of life (PCS) in nurses was 49.17 ± 9.04. the mean psychological dimension of quality of life (MCS) was 40.69 ±7.68. Also, a statistically significant correlation was observed between PCS (r = 0.32) and MCS (r = 0.55) with job stress in nurses (p = 0.01). Discussion and

Job stress is one of the factors affecting the quality of work-life and health of nurses, which requires further study to determine other influential factors and pave the way for changes in the quality of work-life of nurses.

Reconstruction of hard dental tissue after endodontic treatment is a difficult and important duty of the dentist. According to the general opinion, endodontically treated teeth are inferior in quality, more brittle, predisposed to fractures and crackings. The aim of the present study was to compare the fracture resistance of endodontically treated maxillary premolars including MOD cavities with different restoration methods Ninety intact extracted human maxillary premolars were assigned to six different restoration methods. After endodontic treatment, MOD cavities with 2/3 inter cuspal distance was prepared and restoration was carried out by one of the following Group I: Buccal and palatal cusps were reduced 2mm and were restored with indirect composite onlay. Group II: The cavity preparation was same as group I, and then were restored with porcelain onlay. Group III: Reduction of palatal cusp was done as much as 2mm. One semihorizontal threaded pin was placed in buccal cusp and then was restored with amalgam. Group IV: The cavities were prepared same as group III and were restored with posterior resin composite.Group V: The MOD cavities were restored with amalgam. Group VI: The cavities were restored with posterior composite. The teeth in all groups were subjected to thermocycling and mechanical loading. Then all specimens were loaded to failure with static force in a universal testing machine at 0.5 mm/min. The mode of fracture was determined using a stereomicroscope and classified according to 3 categories, cohesive failure of tooth, and cohesive failure of restoration and mixed. Data were analyzed with ANOVA and Tukey test (=0.05). ANOVA showed significant differences among groups (P<0.001) Tukey test found that the highest fracture resistance were in groups I, II IV. The most unfavorable fracture site was occurred in group 1. Endodontically treated maxillary premolars with wide MOD cavities could be successfully restored by indirect composite and porcelain onlay and semihorizontal threaded pin plus composite.

Effective steps towards prevention of dissatisfaction and promotion of care could be operationalized by assessing consumers’ satisfaction and studying the reasons of their dissatisfaction. Regarding the special needs of ostomy patients this study has been done with the aim of determining the ostomy patient’s satisfaction with nursing care. In this cross- sectional study, 300 ostomy patients were recruited by convenience sampling from Educational Hospitals of Iran, Tehran & Shahied Beheshti University. Data was collected by Modified Quality from Patient perspective and was analyzed using SPSS –PC (ver.16) The mean for Items related to respect by nurse during care, good relationship during information giving, and information regarding bathing with ostomy were respectively high. The mean for items of information related to ostomy association, types of appliances and how to provide them and provision of time to talk to patients were respectively low. although total satisfaction with ostomy nursing care was high, but some aspects of nursing care should be revised to promote satisfaction with care.

Prefabricated posts have recently become more popular due to their satisfactory results while saving time and reducing costs. Glass-fiber prefabricated posts were paid more attention because of reducing the risk of root fracture as well as minimal allergic hypersensitivity and corrosion with satisfactory cosmetic results. Surface treatment is one of the various factors that might affect retention of a post. The purpose of this study was to evaluate the effect of surface treatment on the retention of an Iranian E-glass fiber post. Thirty two intact central maxillary incisors were selected. The coronal aspect of each tooth was removed and the remaining root received endodontic therapy. The specimens were then divided into 4 groups (n=8). Post spaces were prepared to a depth of 10mm. The posts (HtCo، Iran) received one of the surface treatments including cleaning with alcohol (Alc)، air borne-particle abrasion and cleaning with alcohol (Air-Alc)، cleaning with alcohol and conditioning with silane treatment (Alc-Sil) or airborne- particle abrasion، cleaning with alcohol and conditioning with silane treatment (Air-Sil). All the posts were luted with Panavia F after conditioning the canal dentin primer (ED-primer) according to the manufacturer's instructions. After cementation، the specimens were stored at 37°C for 30 days and subjected to simulated aging conditions، consisting of 7500 thermal cycles (5°C/55°C). Retention of the posts was measured with a universal testing machine with a crosshead speed of 2mm/min. The data were analyzed using one-way ANOVA and Duncan tests (α=0. 05). The mean retentive values (N) of the test groups were as follows: Alc=157. 63±39. 91، Air-Alc=171. 53±47. 80، Alc-Sil= 167. 87±42. 49، Air-Sil= 166. 53±40. 32. There was no significant difference between the mean values of the four groups. Treating the surface of HtCo Iranian post produced no significant improvement in the retention of the posts.

Sandwich technique with glass ionomer (GI) has been recommended to overcome gingival microleakage. The study objectives were to compare open and closed sandwich techniques and evaluate GI injection in sandwich restorations. Sixty extracted sound premolar teeth were divided into 4 groups (n=15). A Class II cavity with gingival margin below CEJ was prepared on each tooth. Teeth were restored using glass ionomer (Fuji II LC), adhesive (Single Bond) and resin composite (Z250) as follows: Group 1, Open sandwich, GI injection; Group 2, Open sandwich, placing GI by a probe; Group 3, Closed sandwich, GI injection; Group 4, Closed sandwich technique, placing GI by a probe. Dye penetration was performed by using fushin after thermocycling. Teeth were sectioned then dye penetration was evaluated (0-3 scores) under a stereomicroscope. Statistical analysis was conducted using Kruskal Wallis and Mann-Whitney U tests. The least microleakage was observed in closed sandwich technique with GI injection and the most microleakage was observed in open sandwich using GI by a probe. When comparing the handling techniques, it was shown that using a syringe was significantly better than using a probe (P<0.05). There was no statistical difference between open and closed sandwich techniques although the mean dye penetration happened less in closed technique. According to the results of this study, injection of GI into cavity is recommended because of better access and superior adaptation of GI with cavity walls.

Ostomy surgery is done, sometimes for patient survival and sometimes to improve his quality of life. In both cases, patients are faced with great stress. This study was done to assess quality of life in Ostomy patients. In this cross sectional- descriptive study, 300 patients with ostomy were selected by conveince sampling from Sanandaj teaching hospitals. Data were investigated by using of Standard questionnaire ostomy Patients quality of life index)SQLI) Patrick, Alexia and Bernard in seven dimension: sexual concern, nutrition, mental, physical and social health, body image and pain. Data analysis was performed and frequency distribution tables, calculating mean and standard deviation, pearson correlation and unilateral variance a analysis. In this study the mean score patients’ quality of life was relatively good (15.43). The lowest mean score of quality of life was dedicated in dimensions of sexual concern and physical health (5.67, 8.67) and the highest mean score of quality of life in dimensions of pain and body image (20, 25).There was a Significant correlation between quality of life and age, (p> 0.005), education (p> 0.01), after surgery treatment type (p> 0.04) and ostomy type (p> 0.01). In this study there was a significant relationship between quality of life and some variables such as age, education, after surgery treatment type and ostomy type. According to this results nurses in evaluating quality of life should consider profile as the unique and by identify groups with high risk in physical health and sexual concerns dimensions of quality of life, prevent isolation from in this group of patients in the community.

In order to improve the aesthetics and functional quality of restorations, the combined amalgam-composite restorations have been introduced. The aim of this study was to compare different reinforcement methods, in weakened buccal walls of premolar teeth.

In this in vitro study, 70 similar and intact premolar teeth were used. The specimens were divided into seven groups of ten. In six groups, the three reinforcing materials composite (A), Compoglass F (B) and glass ionomer (C) with two

I: buccal and distal wall reinforcement. II: buccal, distal and pulpal floor reinforcement was used. In the seventh group (D), the Scotchbond M.P.P adhesive as a control group was applied. Then specimens were restored conventionally with amalgam and submitted to 500 thermal cycles (5°C-55°C). The specimens were loaded through Instron testing machine at a crosshead speed of 1 mm/min with angle of 45 degree. Statistical analyzes of ANOVA, Duncan and chi- square tests were used to analyse fracture strength, location and type of fracture.

The highest strength was detected in group with composite reinforcement on buccal and distal walls and pulpal floor. The highest failure mode was adhesion type and observed in composite reinforcement and control group. The highest cohesive and mixed failure mode was respectively observed in Compoglass and glass ionomer groups.

This study showed that composite resin was the best material for reinforcement of weakened walls with favourable aesthetic property.

The adhesives type and placement application technique may be important in long term stability and function of composite veneers. This study was conducted to evaluate the influence of dentin adhesive application techniques (pre-curing vs. non-curing) on micro leakage and marginal adaptation of indirect composite veneer restorations. A total etch bonding system, Excite/Variolink II (EXV), and a self-etching primer system, Panavia F 2.0 (PF2) were used in this in-vitro investigation. Forty-eight human central incisors were prepared for composite veneer restoration. These teeth were then divided into two groups (n=24). Pre-cure adhesive (PC) with light cure technique as well as no pre-cure (NPC) prior to resin cement insertion in half of specimens in each group. By using these methods, we worked with four experimental subgroups (PC+EXV, NPC+EXV, PC+PF2, NPC+PF2). Composite veneers (Tetric Ceram resin) were cemented using a dual-cured resin luting agents. All specimens were then stored in distilled water at 37oC for 24 hours before checking for marginal leakage. By random sampling, two specimens were selected from each group for SEM observations and evaluation of marginal adaptation at 1050 time magnifications. Data was analyzed by ordinal regression and link function of probit type at α ≤0.05. The highest and lowest micro leakage values were observed in dentinal margins of NPC+EXV and PC+EXV subgroups respectively. A significant difference was observed between dentinal and enamel margins on micro leakage values of PC and NPC groups (P<0.05), meaning that, pre-cure adhesive was more effective than resin cements alone. No adhesive layer was observed in non pre-cured adhesive specimens. The effect of pre-curing adhesive was not material specific. The pre-cured adhesives showed the best resistance to dye penetration, although the film thickness of luting agent was slightly increased.

Statement of problem: The polymerization of light cured composite resins is initiated fromsurface layer and the rate of polymerization reduces from surface to depth. The difference in hardness is in correlation with different factors such as the intensity of unit and the distance between composite and light tip.

The aim of this study was to compare the effect of four different methods of filling and two light direction on microhardness of class I composite resin restorations.

In this parallel interventional study, 40 intact human premolarteeth were selected. Class I cavities were prepared (4×4×4 mm). After etching and applying Excite as a dentin adhesive, the specimens were divided into four groups (n=10) based on the filling

Group 1)one bulk, group 2)horizontal incremental and occlusal light curing, group 3)horizontal incremental and three directional light curing, Group 4)oblique and three directional light curing. Z100 was used for restoration of cavities. Microhardness of specimens was measured by kicker's microhardness tester in 0, 1.5, 2.5 and 3.5 mm distance from surface. Data were analyzed using ANOVA and Duncan tests (=0.05).

The mean value of microhardness in groups 1 and 2 showed significant differencefrom that of groups 3 and 4 (p<0.05). Within each group, the subsurface layer showed the highest value of hardness (P<0.05) except for group 2 that all surfaces showed a similar hardness value (p>0.05).

Based on the results of this study, incremental technique (oblique or horizontal) with three dimensional light curing is the most suitable procedure for obtaining a maximum hardness in Class I composite resin restoration.

The polishing and finishing procedures may cause topographical changes and introduce subsurface micro-cracks in dental composite restorations. The effect of Occlusal Index on the amount of wear in the posterior composite restorations was evaluated. Likewise, a comparison was made between the wear rates of Tetric Ceram and Ideal Makoo composite resin products. A total of 40 premolars were collected and randomly divided into four groups. Occlusal Indices were prepared with a transparent acrylic resin (Duralay). Class I cavities were prepared in all specimens. In two groups, teeth were restored with Occlusal Index. However, the restorations were completed without any Occlusal Index in the other two groups. Wear on the surfaces of these restorations were made by an oral cavity simulator and a tooth-brush machine. The vertical sections of the “pre-wear “and “post-wear “replicas were compared with a Projector Profilometer and the differences between the two sections were analyzed using two way ANOVA test at α=0.5. The results showed that the mean-wear in index groups was higher. The findings did not show any significant difference between the wear rates of the two materials used in this experimental evaluation. The uses of occlusal index dose not decrease the wear of posterior composite restorations.