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Recent publications have questioned the efficacy of massage. It is acknowledged that critical care environment are stressful for patients in term of invasive medical, and nursing procedures. Continuous brighting and excessive noise prohibits the potential relaxation and sleep. In this article, which is a research study, the physiologic response during and following a five minutes administration of back massage are described. This study is a semi-experimental research in which a 5 minutes back massage was offered to 25 patients as stress reduction intervention. Physiological data (Heart rate, mean arterial blood pressure, respiration and peripheral oxygen saturation) were obtained from the patient bedside monitoring system. Results indicated there was significant effect from the intervention on peripheral oxygen saturation (P<0.002). However, a significant decrease in heart rate (P<0.001), blood pressure (P<0.001) and respiration rate (P<0.001) was observed during the back massage intervention. Results indicated back massage had the potential effect of increasing relaxation as evidenced by physiological change during the intervention administration to critically ill patient in intensive care unit massage was found to be a useful therapy to enhance relaxation and sleep in critically ill patient.

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For a patient under any treatment it is very important to maintain a stable cardiovascular system (CVS) under anesthesia. The CVS can be disturbed due to many factors, and one of the factor which can later the hemodynamic system of the patient is laryngoscopy and intubation. Hence the assessment of the variations in the blood pressure (BP) and heart rate (HR) of the patient during laryngoscopy and intubation is very important. Hypertension and Tachycardia as a great disorders causing great problems. Such as cerebral hemorrhagia and myocardial infection, which are occurred during general anesthesia. Laryngoscopy and endotracheal intubation is necessary for airway management prevention of the aspiration of gastric contents. The amount of blood pressure and heart rate is measured in 1, 3, 5 after laryngoscopy and intubation. 70 patients ASA1 with the age of 16-55, undergone elective surgery and a general anesthesia were selected. Some drug pre-medication and induction were the same in rate about all patients. 35 patients are intubated orally and the rest of them nasally. The subjects were chosen among patients who did not have difficult intubation and cardiovascular disorders. Before laryngoscopy and 1, 3, 5 minutes blood pressure and HR measured. According to outcoming results, blood pressure and HR increasing after laryngoscopy in both group (Oral intubation and nasal intubation). The increase of nasotracheal intubation was more than oral one remarkably. The difference would be meaningful according to statistic point (P<0.05). According to research finding the most amount of increase in the blood pressure and HR was related to the laryngoscopy and intubation. These changes can make problems for some cardiovascular patients. So it is suggested that all anesthetists should lessen the probable complication of patients under laryngoscopy a tracheal intubation by monitoring BP and HR.

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Background and objective: To determine the effects of duration of second stage of labor on the newborn’s Apgar score in primigravida women admitted in Fatemeh Zahra Hospital. Materials and methods: Case control study on the 120 primigravide women (40 women with a duration second stage more than 2 hours and 80 women with a duration second stage less than 2 hours). The criteria such as pregnancy history, quality of prenatal care and socioeconomical status were the same for the both groups. Patients with preterm labor, cesarean section, multiple pregnancy, malpresentation, malformation and receipt sedation of narcotic less than one hours to baby’s birth were excluded. From this study statistically analysis had done by Chi-square and Z-test and person’s coefficient correlation. Results: Statistically significant relationship was observed between the age of the mothers and the duration second stage of labor, so that, the mothers with more than 30 years of age had prolonged duration in second stage of labor (P<0.05). More than half of the sample population had used oxytocin for augmentation of labor, which this difference was significant (P<0.05). Conclusion: The different studies showed that the duration of second stage of labor was significantly associated with fetal lactate and low Apgar score less than 7 at birth, but didn’t have any role in five-minute low Apgar scores and neonate morbidity.

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Background & Objective: The cuff of the endotracheal tube is securing for mechanical ventilation during anesthesia. Diffusion of N2O in the cuff results in an increase in cuff pressure. The different method was used for the control of cuff pressure, but may have difficulty and side effect. This study was to determine whether inflating the ETT cuff with air, Lidocaine 1% or N2O with O2, prevent the increase in cuff pressure during N2O anesthesia. Materials & Methods: In this randomized control trial study after obtating ethics committee 224 patients went understudy, these patients divided in 2 blocks (Sufe, Roach) and the one of the each block were randomized into 3 groups. Group, air Lidocaine 1% N2O with O2 difficult intubation and the film anesthesia with less than 30-min were excluded. All patients were similarly anesthetized and performed tracheal intubation. The pilot balloon of the endotracheal tube cuff was connected to a Japanes pressure manometer. The first pressure was measured immediately and further reading at 10-minute intervals for 70 minutes. The results were readings analyzed using T-test, paired T-test, ANOVA and the Chi-square test. A P-value of <0.05 was considered significant. Results: Cuff pressure increased gradually during anesthesia in-group air but remained stable in group’s Lidocaine and N2O with O2. The cuff pressure had significant differences between the Supa and Roach groups in all of the times during anesthesia (P<0.05). Conclusion: Inflating the ETT cuff with Lidocaine 1% or N2O/Oxygen mixtures are methods of keeping intracuff pressure stable during N2O anesthesia due to N2O diffusion the cuff tube causes increase the cuff pressure. We suggest that continuous monitoring of the UCP during anesthesia to be carried out.

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Background&Objective: The present study was designed to investigate the outcome of pregnancy and delivery in pregnant Iranian women with low and high hematocrit. Materials&Methods: In a cohort control study, 609 pregnant women attending Yahyanejad Hospital for antenatal care and delivery from Dec 2001 to Dec 2003 were randomly selected. Women with hemoglobinopathies such as thalassemia were excluded from the study. Maternal characteristics including hematocrit values were recorded at the first antenatal care and 3 cc.blood was sent to the laboratory for CBC. The main outcome measures included birth weight, gestation at delivery, Apgar scone, mode of delivery,the admitted NICU and perinatal death. X2, T-test, Anova and logistic regression models were also applied to analyze the data. Results: Anemia (hematocrit<34%) in the first trimester was associated with a significantly increased risk of low birth weight (<2500g) and preterm delievery (<37 week’s gestation). High hematocrit values (>40%) did not increase the risk of low birth weight or preterm delivery. The risk of low Apgar score, operative deliveries and admitted NICU was significantly increased in women with high and low hematocrit adjusting for maternal age, parity, weight gain, inter pregnancy, father and mother education and other confounding factors. Conclusion: Low and high maternal hematocrit in the first trimester can contribute to the adverse pregnancy outcomes, thus pregnant women with abnormal hematocrit are at high risk factor and necessary awareness should be given to them on how to prevent complication and adverse outcome by special clinical care.

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Background & Objective: We have two areas in gluteal region for intramuscular injection‚ Ventrogluteal and Dorsogluteal. This study was done to compare pain intensity and bleeding rate after injection in Ventrogluteal and Dorsogluteal area.

 

Materials & Methods: This clinical trial study was done on 67 males in 5th Azar hospital in Gorgan north of Iran. Patients had 2 injections during 24 hours. For every patient one injection was done in Dorsogluteal area and the second injection was done in Ventrogluteal area. For every patients the pain intensity and rate of bleeding for every injections recorded. Data analyzed by SPSS-11.5 software and Kolmogorov-Smirnov and Wilcoxon tests.

 

Results: In Dorsogluteal area 83.5% of patients had a low and medium pain‚ where as in Ventrogluteal area 88% of patients had a low and medium pain and 9% of them had not any pain. The Mean±SD of pain intensity in Dorsogluteal area was 50.79±1.682 and in Ventrogluteal was 40.79±1.878. The Mean±SD of bleeding in Dorsogluteal and Ventrogluteal areas were 0.73±0.102 and 0.19±0.047 respectively. There were significant differences in pain intensity and bleeding between two groups (P<0.05).

 

Conclusion: We concluded that the injection in Ventrogluteal area has a less pain and bleeding rate in comparison with Dorsogluteal area.

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Background and Objective: A common complication after general anesthesia is nausea and vomiting followed by different problems such as spasm, hypoxia and pulmonary aspiration. This complication is more common in patients with full stomach, Eye injury, head trauma, cesarean and laparoscopy. Propofol and metoclopramide are two common drugs to prevent nausea and vomiting after operation. On the other hand adding dexamethasone to the above drug, has an important effect on decreasing nausea and vomiting. In this study, the effect propofol and metoclopramide associated with dexamethasone on nausea and vomiting after operation was investigated.

Materials and Methods: In this clinical trial study, 100 patients with ASA I, II classes, aged 16-60 years with selective orthopedic surgery randomly have divided into two groups. In group one, 48 patients received metoclopramide (10mg) with dexamethasone (8mg) and in group two, 52 patients received propofol (20mg) with dexamethasone (8mg), five minutes before the end of operation. Prevalence of nausea and vomiting in both groups was considered after 4 hours and results were analyzed by Chi-Square, t-student and Fisher exact tests.

Results: The rate of nausea in group 1 and 2 was 35.4% and 11.5% respectivly (P<0.05). The rate of vomiting was 27.7% and 7.7% in group 1 and 2 respectivly (P<0.05).

Conclusion: This study showed that the antiemetic effect of propofol with dexamethasone is more effective to prevent nausea and vomiting than metoclopromide with dexamethasone.

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Background and Objective: Colorectal carcinoma accounts for nearly 10% of all incident cancers. The stage of the disease is the most important prognostic factor. The main purpose of this study was to evaluate the effect of some presumed prognostic factors on the survival rate of patients with nonmetastatic rectal adenocarcinoma.

Materials and Methods: In this retrospective cohort study, 76 patients (m/f:40/36) with nonmetastatic rectal adenocarcinoma whome were referred to oncology department of Omid Hospital between 2001-06 were evaluated. All patients underwent surgical resection and those with T3-T4 and/or lymph node involvement received adjuvant radiotherapy and chemotherapy. Disease free survival was assessed from the date of diagnosis to the date of recurrence using Kaplan-Meyer method. Log-rank test was used to compare survival curves between groups. Multivariate analysis was performed using stepwise backward Cox Proportional Regression method.

Results: Stages 1, 2 and 3 were detected in 4, 34 and 38 cases. 48 patients had well differentiated tumors. 11 cases presented with obstruction. With a median follow up time of 18 months, 17 patients experienced recurrence. For all cases 3-year survival rate was 68.2%. The 3-year survival rate was significantly better for stage 1,2 compared to stage 3, patient without obstruction compared to those presented with obstruction, cases older than 50 compared to younger patients and patients with well differentiated tumor compared to moderately or poor differentiated tumors (P<0.05). The gender and the site of tumor had not significant effects on survival. In multivariate analysis only stage of the disease remained significant predictor of survival (p<0.05).

Conclusion: This study confirmed that the stage of the disease is the most important predictor of survival. Although younger ages (<50), moderately or poorly differentiated tumor and presence of obstruction at diagnosis were associated with decreased survival in univariate calculations, they lost their significance in multivariate analysis.

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Background and Objective: Oxidative stress is known as the one of the causes of neuropathic pain, reactive oxygen species (ROS) has been reported to be involved in this process. Coenzyme Q10 acts as an antioxidant and is able to reduce resulting oxidative damage. This study was done to determine the effect of Coenzyme Q10 on neuropathic pain in CCI (Chronic Crash Injury) rat model.

Materials and Methods: In this experimental study 30 male rats (200-250g) randomizely allocated into 3 groups each 10 rat including CCI, CCI + CoQ10 and CCI + vehicle. Neuropathic pain, was induced by Chronic Crash Injury (CCI) model for sciatic nerve. IP injection of CoQ10 (200 mg/kg) or vehicle was done daily for 10 days. Behavioral tests were done before and after surgery on day 5 and 10 respectively. Paw withdrawal threshold was assessed by Randall Selitto test, Analgesy Metter and Von Frey filaments. Data was analyzed by SPSS-14, Independent T and Mean-whatney tests.

Results: Induction of nerve injury decreased pain threshold (P<0.05) and treatment with CoQ10 increased mechanical and thermal threshold in neuropathic rats compared to CCI animals (P<0.05). There was a significant difference in pain threshold between animals treated CoQ10 and vehicle injected animals (P<0.05).

Conclusion: This study indicated that coenzyme Q10 prevents deleterious effects following nerve injury in animal model.

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Background and Objective: Type II diabetes is a major globle health problem that can lead to disability and early death. This study was performed to evaluate the association of TCF7L2 (rs7903146) polymorphism with type II diabetes.
Methods: This case - control study was done on 100 patients with type II diabetes and 100 healthy subjects. Following DNA extraction, TCF7L2 (rs7903146) genotype was determined and compared between two groups by Tetra-Arms PCR method.
Results: The frequency of CT genotype was 25% and 56% in healthy subjects and patients, respectively (P<0.05). The frequency of TT genotype was 2% and 6% in control and patient groups, respectively. In the co-dominant model, rs7903146 was dependent on type II diabetes.
Conclusion: Human heterozygote for Lucos TCF7L2 (rs7903146), which contains T alleles, are high risk for developing diabetes mellitus.

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Background and Objective: Spastic diplegia cerebral palsy is a movement disorder originating from brain injury before, during, or immediately after birth. Exercise plays an important role in motor recovery. This study was performed to determine the effect of high-intensity circuit training on balance and activity daily living in children with cerebral palsy (CP).
Methods: In this clinical trial, 34 children with cerebral palsy were randomly divided into two groups of 17 including occupational therapy (control group) and circuit training group with occupational therapy as interventional group. Berg balance scale and activity scale for kids were used to assess changes in balance and activity of daily living before and after 12 weeks of exercise, respectively. High-intensity circuit training consisting of 3 rounds and each round consisting of 6,
30-second stations and a 30-second break between stations, which were performed three times a week for 12 weeks. Occupational therapy was performed one session per week.
Results: The rate of balance and activities of daily living and its components in the circuit training group with occupational therapy showed a significant improvement compared to control group (P<0.05).
Conclusion: Circuit trainings with occupational therapy can further improve the performance of balance and activity of daily living in children with Spastic diplegia cerebral palsy compared to occupational therapy.

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Background and Objective: Loneliness is one of the problems experienced by the aging population, and the lack of social communication plays a major role in the emergence of loneliness. This study was conducted to determine the effects of telenursing on the loneliness of the elderly.
Methods: This field trial was conducted on 100 elderly people over 60 years of age who were selected by convenience sampling from the clients of Gonabad (Iran) community health centers during 2017. The elderly participants were randomly assigned to 2 groups of 50 people, intervention and control. Then, the demographic information questionnaire, the Informant Questionnaire for Cognitive Decline in the Elderly, and Dehshiri et al.'s Loneliness Scale were completed. The intervention group received face-to-face training by the researcher for 2 hours. There was no intervention for the control group, and the elderly received routine care from the family health unit. After the face-to-face meeting, phone calls were made by the researcher to the intervention group for 12 weeks. One month after the end of the intervention, the questionnaires were completed again by the two groups and evaluated and compared.
Results: The mean (standard deviation) score of loneliness was 60.82±21.07 and 57.48±18.76 before the intervention in the intervention and control groups, respectively, and this value after the intervention was 35.06±14.20 and 61.40±18.72, respectively, in the intervention and control groups. After the intervention, a statistically significant difference was found in terms of a reduction in the loneliness score of the elderly in the intervention group compared to the control group (P<0.05).
Conclusion: This study showed that telenursing was effective in reducing the loneliness of the elderly.