Clinical and radiographic findings of foreign body aspiration in children admitted to 17- Shahrivar hospital in Rasht during 1996-2008

Background: Foreign body aspiration (FBA), as a life-threatening emergency, is a common problem in children especially in 1-3 year old age group. FBA is one of the leading causes of death in the 7 of children under 4 years. The purpose of this study was to evaluate the clinical and radiographic findings of foreign body aspiration in children admitted to 17- Shahrivar hospital in Rash.Materials and Methods: In this study, the required data were collected from the medical records of all children with FBA hospitalized in 17- Shahrivar hospital (Rasht, Iran).Results: Fifty-one percent of the children were 1-3 years and the most common complaints of patients were cough (34) and respiratory distress (34). In patients' history records, initial suspicion to aspiration was 78, respiratory distress, 65 and choking, 63. Common physical examination findings were unilateral decreased pulmonary sound (65) and rales (45). The most common findings in CXR were consolidation (34) and unilateral air trapping (32).The most frequent foreign body was sunflower seed (34.5). The ratio of foreign body in the right and left bronchi was equal in children under 1 year old (40) and was more in right bronchi in older children. Conclusion: Considering the high prevalence of aspiration and choking, initial suspicion to them and history records can be helpful in diagnosis

Effects of Distraction on Physiologic Indices and Pain Intensity in children aged 3-6 Undergoing IV Injection

Background & Objective: Illness, hospitalization and pain are often first crisis children faced with in their early life. Performing painful procedures such as IV injections for medical purposes are inevitable and stressful events in pediatric wards. Distraction is an inexpensive, practical, and nonpharmacological nursing intervention for pain relief. This study aimed to determine the effects of distraction on some physiological indices (heart rate and O2 saturation (and intensity of pain in the hospitalized children aged 3-6 years undergoing IV injection. Methods & Materials: In this clinical trial, 72 children aged 3-6 years who were undergoing IV insertion were recruited for the study. The participants were randomly allocated into two groups of intervention and control. Distraction technique was applied using bubble-maker in the intervention group. After 10 minutes, pain intensity was measured using OUCHER scale. Moreover, heart rate and blood oxygen saturation were measured for three minutes in both groups using Pulse Oxymeter pre- and post-intervention. Results: The findings showed statistically significant differences in the average heart rate (P<0.01) and the amount of saturated oxygen (P<0.009) and the pain intensity (P<0.001) between two groups after the intervention. The pain decreased significantly in the intervention group in comparison with the control group. Conclusion: According to the research findings, distraction with bubble-maker resulted in decreasing the physiological responses and intensity of pain in children aged 3- 6 years. This method can be useful in reliving the pain in preschool children undergoing IV insertion. &nbsp

Comparison of the Effect of the Routine Bowel Preparation and Use of Oral Sodium Phosphate on Acceptance and Bowel Cleansing in Patients Undergoing Colonoscopy: A Randomize Clinical Trial

Background and Objectives: Treatment team perform a variety of practices in the fields of treatment and caring. The main domain of nursing practice is to prepare patients for diagnostic tests. Colonoscopy is a method of endoscopy of lower gastrointestinal system which needs proper colon preparation that allows proper assessment, diagnosis and positive treatment. Currently, there are different methods of bowel preparation. Therefore more research by a clinical nurse on this can result in better care. This study was aimed at comparing the routine method (caster oil and bisacodyl tablet) and oral sodium phosphate on the level of patients’ acceptance and bowel cleansing in patients undergoing colonoscopy.Methods: The study was a one-blind controlled randomized clinical trial done on 90 outpatient candidates for colonoscopy referring to Razi Training Center in Rasht city. Samples were randomly chosen on the visit day and divided to 2 groups of experiment and control. Data collection instrument included a demographic questionnaire and checklist to assess the level of patients’ acceptance and bowel preparation. Primarily demographic data form for each patient was filled, and then intervention was done for two groups with 45 samples. During the process the acceptance form was filled by the researcher by asking the patient and also the check list on the residual stool score and global preparation assessment left was marked by colonoscopist and the nurse.Results: The findings indicated that patients’ acceptance (p<0.000) and the level of bowel preparation (p<0.000) was better with oral sodium phosphate. Conclusion: According to the results result oral sodium phosphate has better acceptance and is more effective on colon cleansing prior to colonoscopy when compared with routine regime (caster oil and bisacodyl tablet).Keywords: Oral Sodium Phosphate; Colonoscopy; Bowel Preparation; Colonic Diseases; Intestines; A Randomize Clinical Trial

Report of Giardia assemblages and giardiasis in residents of Guilan province-Iran

Giardia duodenalis is considered a highly diverse organism that infects a variety of mammalian hosts. Giardiasis is a significant public health problem in Iran. The purpose of this study was to investigate the occurrence of Giardia duodenalis (G. lamblia, G. intestinalis) infections in humans residing in the Guilan province of Iran. Stool samples were collected during 12 months from 8356 individuals that had been referred to certain hospitals in the capital city of Rasht in the Guilan province, of which 4126 were males and 4230 were females. The samples were separated into three groups according to patient age: group A 1-9 years old (n = 483); group B 10-19 years old (n = 491); and group C greater than 20 years old (n = 7382). The wet mount technique was performed directly on 8356 fecal samples for microscopy. Samples were examined using a saline and iodine direct smear technique in order to confirm the presence of G. duodenalis. The results indicated that 2.5% (206/8356) of the samples were identified as positive for G. duodenalis. A total of 30% of the infected patients (n = 62) had no symptoms. In symptomatic cases, the most common symptoms (46%, n = 95) were abdominal cramps and bloating. Twenty-four percent of patients (n = 50) had cramps, bloating, nausea, and diarrhea. Sixty positive samples were sent for G. duodenalis genotyping based on the amplification of the gdh gene. Forty-one PCR products were successfully selected and sequenced, where 38 (92.6%) samples were identified as genotype A/subgenotype II and in three samples (7.4%) genotype B/subgenotype IV. Genotype A-II had a dominant prevalence as compared to the genotype B-IV samples that were identified in the study. Based on the samples provided by the regional teaching hospitals and subsequent sample analysis, the authors concluded that assemblage A-II is most likely the most common Giardia subgroup infection in the Guilan region. Assemblages have been reported in both humans and animals; however, further studies need to investigate the role of domestic animals and water reservoirs as potential sources of Giardia infection in the Guilan region