Morphine Suppository versus Indomethacin Suppository in the Management of Renal Colic: Randomized Clinical Trial

Background. Renal colic is a medical emergency due to the rapid onset and devastating nature of its pain. Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are both used as first-line choices in its management. Aim. This study aimed to compare the efficacy and safety of opioids and NSAIDs in the management of acute renal colic. Methods. One hundred and fifty-eight patients were divided into two groups (n=79) and received either 10 mg morphine or 100 mg indomethacin suppositories. The severity of pain was measured using verbal numeric rating scale at baseline and 20, 40, 60, and 90 minutes after the administration of analgesics. Drug side effects as well as patients' vital signs were also recorded. Results. The mean decrease in the pain score during the first 20 minutes was significantly higher among those who received morphine suppository. However, no significant difference was observed between the two groups regarding the mean decrease in pain score during the first 40, 60, and 90 minutes after the admission. Prevalence of drug side effects or changes in the vital signs was not significantly different between the two groups. Conclusions. Morphine suppositories seem to be more efficient in achieving rapid pain relief comparing to indomethacin. © 2016 Forough Zamanian et al

Pelvic floor dysfunction and polycystic ovary syndrome

Objectives: To compare the prevalence of pelvic floor muscle dysfunction (PFMD) in patients with and without polycystic ovary syndrome (PCOS); to test PFMD in women with different PCOS phenotypes. Methods: This was a case-control study of 202 women who were recruited in an infertility clinic in Hormozgan, Iran: PCOS (n=103) and control groups who were healthy women whose husbands were diagnosed with male infertility (n=99). According to the presence or absence of menstrual dysfunction (M), hyperandrogenism (HA) and polycystic ovaries on ultrasonoghraphy (PCO), patients with PCOS were divided into three phenotypes: HA+PCO, M+PCO and M+HA+PCO. PFMD was assessed by the Pelvic Floor Distress Inventory-20 (PFDI-20. Results: The reported PFMD symptoms were higher in PCOS (P=0.05) than the non-PCOS group. The mean PFDI score in the HA+M+PCO was higher compared to other phenotypes, although the difference did not reach significance level (P>0.05). The mean LH level was higher in HA+M+PCO than the two other phenotypes. There was a significant positive correlation between LH level and PFDI score (P<0.04). Conclusion: The findings suggest that a high level of LH may cause PFMD. Further studies are needed to determine the precise role of LH levels and potential treatment options in women with PCOS and PFMD. Keywords: polycystic ovary syndrome, pelvic floor distress inventory, pelvic floor muscle dysfunctio

Rocker outsole shoes and margin of stability during walking: a preliminary study

Rocker outsole shoes are commonly prescribed to diabetic patients to redistribute peak plantar pressures at high risk areas such as forefoot thereby decreasing risks of plantar ulceration. However, there are evidences of postural destabilizing effect of the rocker outsole shoes. Patients with diabetes, particularly those suffering from neuropathy, are at a higher risk of falling. Then, beside primary role of rocker outsole in offloading, it is essential to explore the effect of the rocker outsole on postural stability of these patients. The smaller base of support (BOS) of the rocker outsoles due to their specific geometry has been previously mentioned as a threat to postural stability. Margin of stability (MOS) appeared to be an appropriate method for measuring postural stability during walking by considering the dynamicity of BOS in its equation. MOS is defined as the distance between the velocity adjusted position of the centre of mass (COM) and the boundaries of the BOS which constantly changes during walking. Then, this study proposes how we can use MOS concept to investigate the impact of the rocker outsoles on dynamic stability. In this study the kinematic data from a single subject with diabetic neuropathy was used to explain the efficiency of the methodology. Conclusive results are expected after carrying out systematic tests using a statistically representative sample size.This project is funded by Iran University of Medical Sciences (IR.IUMS.REC. 1395.9211503202).info:eu-repo/semantics/publishedVersio

Randomized planning of dynamic motions avoiding forward singularities

The final publication is available at link.springer.comForward singularities, also known as direct, or actuator singularities, cause many problems to the planning and control of robot motions. They yield position errors and rigidity losses of the robot, and generate unbounded actions in typical control laws. To circumvent these issues, this paper proposes a randomized kinodynamic planner for computing trajectories avoiding such singularities. Given initial and final states for the robot, the planner attempts to connect them by means of a dynamically-feasible, singularity-free trajectory that also respects the force limits of the actuators. The performance of the strategy is illustrated in simulation by means of a parallel robot performing a highly- dynamic task.Peer ReviewedPostprint (author's final draft

Hospital managers' skills required and onward challenges: A qualitative study

Introduction: The qualification of managers in terms of management skills is one of the most important factors in the continuous success of each organization, and utilizing such skills can have a positive contribution in the effectiveness of the organization while improving the performance of the employees in line with the objectives and goals of the organization. The study's primary objective was to examine the necessary skills of the hospital managers and their capabilities to manage the challenges in providing health care facilities to their patients and employees. Materials and Methods: This study is a qualitative that deep interviews were performed with 22 managers (senior and middle managers) of educational hospitals of Kermanshah city, and the sample size was 22 individuals. The interviews were analyzed by a MAXQDA software application after transcription. Results: This study includes 8 themes and 23 subthemes. The strategic skill, the perceptive skill, the human relations skill, work experience, and personal characteristics were among the skills necessary for hospital managers. Some of the challenges facing the hospital managers included rapid changes in the policies, the limitations of financial resources, and lack of proportion between the educational and occupational spheres. Conclusion: Because of their existential philosophy and differences with other service sectors, managing hospitals poses a particular sensitivity. In this regard, the role of the hospital manager is very important. Therefore, in order to meet the satisfaction of those receiving services, decision.makers and policy.makers must think twice when selecting and appointing hospital managers and evaluate and appraise this group in terms of abilities and skills necessary for managing such an important service section. © 2020 Journal of Education and Health Promotion

Incidence, mortality, and burden of acute watery diarrhea and its geographical distribution in Iran during 2009-2016

Background: Diarrhea is a major cause of public health burden, especially in children under 5 yr of age. This study aimed at estimating the incidence, mortality, burden, and geographical distribution of Acute Watery Diarrhea (AWD) in Iran from 2009 to 2016. Methods: This study was conducted in 2018. The data on the incidence and mortality from 2009 to 2016 was obtained from AWD surveillance system of the Centre for Communicable Diseases Control (CCDC), Ministry of Health and Medical Education (MOHME) of Iran. Disability Adjusted Life Years (DALYs) was used to estimate the burden of AWD. The DALYs-related AWD was calculated using a method developed by WHO. The average duration of the disease and its disability weight, respectively, were set at 5 d (0.0137 years) and 0.093 for all age groups. Results: The incidence of AWD had an ascending trend over the studied period. Forty cases of deaths from AWD were reported. The lowest and highest burdens of AWD, respectively, were 436.1 DALYs in 2010 and 975.9 DALYs in 2015. The incidence and burden of AWD did not have an equal distribution across the country, between the provinces. Conclusion: The incidence of AWD had an ascending trend over the studied period that can be attributed to the improvements in the disease surveillance system. Moreover, the incidence, mortality, and burden of AWD did not have an equal distribution in Iran. Hence, it is recommended to strengthen AWD surveillance system. In addition, it is suggested to adopt proper interventions for controlling the disease in areas with a high burden of AWD. © 2019, Iranian Journal of Public Health. All rights reserved

Study forming of growth rings in the Caspian bony fishes (Step 1: Common carp Cyprinus carpio Linnaeus, 1758)

The ichthyology studies at fish tagging was referred to more than 100 years ago. Tagging is utilized for the estimation of stock amount, population frequency and project or calculating of survival and growth value. There are many various methods for fish tagging are used for juvenile to adult fish. The current study was carried out at Ghare-su research station during 2011-2013. 250 of carp fingerlings (Cyprinus carpio) were tagged by bath with tetracycline manner (pH=6, 500mg/l). The fork length and weight of fish were 10-12 mm and 2-4 g, respectively. Also, fish were fed twice a day. The second and third tagging stages were performed at November 2012 and July 2014, respectively. After otolith was extracted, it was washed water and dry at lab room air. The tagged rings or loops (annuali) were observed by lab loupe with 10X and 40 X magnifications. The results showed that a narrow band was formed after the first tagging of carp fingerlings, as it was seen at the end of otolith edge. It was demonstrated that tetracycline was absorbed and the tagged ring or loop (annuli) was newly formed at external or out of othlith edge. There was not observed any fish death, when carp fingerlings were tagged by OTC bath manner. It said that the first OTC band will be seen, the first sign of the formed OTC band was observed at external margin of otoilith after 6th month , of course , from 4th month, this sign was formed at the most external of otoilth edge but with added the following region, it can be hardly distinguished. The formed band in relative to second tagging was similar to the first band but there was no discrepancy or difference with together

Ecological study on fisheries important rivers and bays in the south part of the Caspian Sea 2nd phase: Gorgan Bay

In this study ichthyoplankton, phytoplankton, zooplankton, benthic and hydrochemistry parameters were studied. 9 out of 11 sampling stations were in the Gorgan Bay area and 2 of them were in the mouth of the Bay. Ichthyoplankton survey were carried out in 6 stations and the other surveys such as phytoplankton, etc were done in 11 stations in 2009. Gorgan Bay map and position of sampling sites are given at the end of material and methods section. Biomass and frequency of phytoplankton at different stations, months and seasons were calculated that are presented in Tables 1 to 3. Hydro-chemical parameters such as water temperature, air temperature, visibility, DO, BOD5, pH, Alkalinity (bicarbonate, carbonate and total), Hardness (calcium, magnesium), CL,EC, Salinity, N (nitrate, nitrite, NH_3), Phosphate were measured and results are shown Table 11. Biomass (mgr/m^3) and numbers (ind./m^3) of 47 genus of different phylum of phytoplanktons such as Cyanophyta, Chlorophyta, Pyrophyta, Chrysophyta and Euglenaphyta as well as different phylum of zooplanktons consist of Protozoa, Arthropoda, Rotifera and Cyliophora were estimated. Frequency of phytoplanktons (ind/m^3) was 131.2, 1.6, 65.3, 18.9 and 23.8 million respectively. Furthermore, their biomass was 308.4, 1.9, 1358.9, 295.1 and 124.7 mg/m^3, respectively. The maximum and minimum numbers were observed in Leptolingbaya belonged to Cyanophyta and Diatoms of Chrysophyta 84.3 and 0.025 million (ind/ m^3) respectively. The maximum and minimum biomass was observed in Gyrosigma (Chrysophyta) and Tetradron (Chloropyta), 12317.3 and 0.014 mg/m3 respectively. The average biomass of zooplankton was measured 531.74, 30.77, 225.07, and 96.26 mg/m^3 respectively and the total was attained 883.83 mg/m3 Table 5. The maximum and minimum biomass of all zooplanktons was estimated in November and July, 3446.23 and 6 mg/m^3 respectively. Furthermore, the maximum and minimum numbers of zooplanktons were found in September and July which were 48.4 and 0.002 millions respectively and the average number was 8.4 ind/m^3 Table 4. Also numbers and biomass (gr/m^2) of 11 families of benthos which inhabit Gorgan Bay such as Annelida, Mollusca and Arthropoda were investigated in separated stations and distinctive months. The maximum and minimum biomass of benthos was observed in January (42.91 gr/m^2) and March (0.6428 gr/m^2). The biomass was considerable in April, February, August and December (Tables: 4, 5 and 6)