Incidence and risk factors of sternal wound infection at site of incision after open-heart surgery

Objective: To identify the incidence of sternal wound infection and the risk factors before, during and after open-heart surgery in an Iranian critical care unit. Method:A descriptive, analytic study investigating all open-heart surgery patients from March 2010 to March 2011,in terms of the incidence of sternal wound infection and the risk factors before, during, and after surgery. Patients were examined for signs of infection at the site of surgical incision on presentation to the ward, daily during their stay, and on discharge. The same investigator reviewed all wounds, every day. Results:The incidence of sternal wound infection was found to be 10%. Multivariate regression analysis identified the following risk factors: diabetes (OR: 0.439; 95%CI: 0.21-0.95; p=0.04), age (OR: 1.033; 95%CI: 1.003-1.064; p=0.03), hyperlipidaemia (OR: 1.008; 95%CI: 1.005-1.011; p < 0.001), history of respiratory disorders (COPED] OR: 2.952; 95%CI: 1.3-6.4; p=0.007), female gender (OR: 2.06; 95%CI: 1.40-3.03; p < 0.008), and history of addiction to opiates (OR: 2.33; 95%CI: 1.56-3.49; p < 0.006). Conclusion: This study found a high rate of surgical sternal wound infection in open-heart surgery patients in an Iranian critical care unit, suggesting that the medical and care-giving team in the cardiac intensive care unit need further education

Complementary and alternative therapies to relieve labor pain: A comparative study between music therapy and Hoku point ice massage.

BACKGROUND & AIM Pain is a common experience for women during labor. In the present study, we compared the effect of two types of non-pharmacological pain relief methods "music therapy" and "Hoku point ice massage" on the severity of labor pain. METHODS This prospective, randomized, controlled trial was conducted in Shahrekord, Iran, from September 2013 to June 2014. We randomly assigned 90 primiparous women who expected a normal childbirth into three groups: group "A" received music therapy, group "B" received Hoku point ice massage, and group "C" received usual labor care. At the beginning of the active phase (4 cm cervical dilation) and before and after each intervention (at dilations 4, 6, and 8 cm), the intensities of labor pain were measured using Visual Analogue Scale (VAS). RESULTS At the beginning of the active phase, the mean VAS scores were 5.58 ± 1.29, 5.42 ± 1.31, and 6.13 ± 1.37 in the women in groups "A," "B," and "C," respectively (P > 0.05). After the intervention, the mean pain scores were significantly lower at all of the time points in groups "A" and "B" than in group "C" women (P  0.05). CONCLUSIONS Music therapy and Hoku point ice massage are easily available and inexpensive methods and have a similar effect in relieving labor pain

The study of harmful and beneficial drug interactions in intensive care, Kerman, Iran

Since multidrug therapy is common in the intensive care unit (ICU), the risk of drug interactions is high. This study aimed to examine the prevalence of drug interactions and risk factors in patients who were admitted to ICUs. In a crosssectional study, the medication flow sheet of 101 patients was investigated in terms of the number and the type of drug interactions. The Drug Interaction Facts reference text book (2010 edition) was used to determine the type and the number of drug interactions. In total, 609 potential drug interactions were found. The mean number of drug interactions per patient was 6.1 (SD=5.6). Of all observed drug interactions, 66.9 were classified as harmful and 33.1 beneficial. In terms of the nature of interactions, delayed, moderate, and possible were the most common types. The most frequent harmful interaction was between phenytoin and omeprazole (63 occasions). Critically ill patients are at a higher risk of drug interactions. Although 33.1 of the drug interactions were considered beneficial, medical teams should be awarethat even beneficial interactions can have undesirable side-effects in the critically ill. © The Intensive Care Society 2013