Negative pressure pulmonary oedema: A rare case report of two brothers

Negative Pressure Pulmonary O/Edema (NPPE) is potentially life-threatening and it is a general anaesthesia side effect. We are mentioning a rare case report of two brothers who were referred to our hospital for elective surgeries (varicocele and septoplasty) in a 3 years period. Both of them were athletes and their coagulation factors were disturbed after surgeries. Pulmonary oedema was healed after treating it by reintubation, mechanical ventilation by Positive End-Expiratory Pressure (PEEP), diuretics, morphine, Fresh Frozen Plasma (FFP) and liquid bounding

Differentiation of definitive endoderm from human induced pluripotent stem cells on hMSCs feeder in a defined medium

Background: The Definitive Endoderm (DE) differentiation using the undefined media and non-human feeders can cause contaminations in the generated cells for therapeutic applications. Therefore, generating safer and more appropriate DE cells is needed. This study compared five different methods to establish an appropriate method for inducing an efficient DE differentiation from Human Induced Pluripotent Stem Cells (hiPSCs) on an appropriate feeder in a more defined medium. Methods: Human Induced Pluripotent Stem Cells (hiPSCs) were cultured on inactivated feeders. Passaged hiPSCs, without feeder, were incubated for three days with Activin-A and different endodermal differentiation media including 1-FBS, 2-B27, 3- ITS and albumin fraction-V, 4-B27 and ITS and 5-like the third medium. The feeder cells in the first four methods were Mouse Embryonic Fibroblasts (MEFs) and in the fifth method were human adult bone marrow Mesenchymal Stem Cells (hMSCs). DE markers FOXA2, SOX17 and CXCR4 and also pluripotency marker OCT4 were evaluated using qRT-PCR, as well as FOXA2 by the immunocytochemistry. Results: QRT-PCR analysis showed that after three days, the expression levels of DE and pluripotency markers in the differentiated hiPSCs among all five groups did not have any significant differences. Similarly, the immunocytochemistry analysis demonstrated that the differentiated hiPSCs expressed FOXA2, with no significant differences. Conclusion: Despite this similarity in the results, the third differentiation medium has more defined and cost effective components. Furthermore, hMSC, a human feeder, is safer than MEF. Therefore, the fifth method is preferable among other DE differentiation methods and can serve as a fundamental method helping the development of regenerative medicine. © 2016, Avicenna Journal of Medical Biotechnology. All rights reserved

The Effect of Dexamethasone on the incidence of laryngospasm in pediatric patients after Tonsillectomy

Background and Aims: Laryngospasm and vomiting occurring after tracheal extubation in children is potentially dangerous. The aim of this study was to investigate the effects of preoperative 0.5 mg/kg i.v. Dexamethasone on the incidence of postextubation laryngospasm, and vomiting in children after tonsillectomy. Material and Methods : This study was performed at the Ilam Imam Khomeini hospital, IR, during the year 2009. In a randomized, double-blind trial, 66 pediatric patients 4-12 years (Dexamethasone group, n=33- placebo group , n=33) undergoing tonsillectomy received IV placebo (saline) or Dexamethasone , 0.5mg/kg IV after the induction of anesthesia before surgery. The incidence of postextubation laryngospasm and vomiting was recorded by the an investigator. All collected data were analyzed with using the statistical software (SPSS, Ver.16). Results : Mean age in Dexamethasone group 6.4±2.2, placebo group 6.1±2.8. Mean weight in Dexamethasone group 19.2±5.3, placebo group 20.3± 6.8 (p>0.05). Mean duration of anesthesia in Dexamethasone group 57.4 ±7.4 min, placebo group 55.6±4.6min. Mean duration of surgery in Dexamethasone group 40.7±6.7min , placebo group 42.3 ±8.4min (p>0.05). The incidence of postextubation laryngospasm in Dexamethasone group (6) was lower than that in the placebo group (30) (

Evaluation of the quality of nursing work life and its association with job burnout in Isfahan University of Medical Sciences

Background and aims: Nurses are particularly susceptible to burnout. Nursing staffs are in face to a relatively stressful work environment, high mental and physical pressure, irregular scheduling or shifting, limited job promotion, and socio-emotional pressures in connection with the patients and partners. This study aimed to assess the quality of work life (QWL) and its association wit

Comparison effect of oral propranolol and oxytocin versus oxytocin only on induction of labour in nulliparous women (a double blind randomized trial)

BACKGROUND AND AIM: Today, research on new methods for preventing caesarean sections owing to labour induction, have been requested in obstetric practice, because of the increased morbidity related to caesarean section. Therefore, the aim of this study was to compare the effect of Oral Propranolol and Oxytocin versus Oxytocin only on induction of labour in nulliparous women. MATERIAL AND METHODS: A double blind randomized controlled trial was performed at the Ilam Mostafa Hospital, Ilam, Iran, from March 2010 to March 2011 on 146 nulliparous pregnant women who had gestational age of 40-42 weeks of pregnancy and a Bishop score of .05) DISCUSSION AND CONCLUSION: Our study showed that oral Propranolol was effective for labour induction and that it could decrease the frequency of caesarean deliveries without producing any adverse effects on mothers or neonates

The participation of nurses in decision making

Background and Aim: Staff nurse decisional involvement is associated with positive patient outcomes including a higher nurseperceived quality of patient care, lower patient mortality, fewer complications and lower levels of job strain and burnout. The aim of this study was to investigate the actual and preferred levels of the decisional involvement of nurses in the Iranian state. Material and Methods: This was a descriptive study that was performed at the ILAM general hospitals, IR, during the year 2010. The research instrument which was used was the decisional involvement scale (DIS). A sample of 96 registered nurses (RN) were enrolled in the study by using a simple random sampling method. Descriptive and inferential statistical analyses were performed by using the Statistical Package for Social Sciences Program, Version 11.5 (SPSS). Results: The nurses reported the actual involvement in their work environment to be only somewhat (M = 2, SD = 0.75) and also reported high levels of preferred involvement (M = 4, SD = 0.65). Collaboration/liaison activities were the most actual involvement aspect in the work environments of the nurses (M = 3.1, SD = 0.69) and unit governance and leadership were the most preferred forms of involvement (M= 4.2, SD= 0.56).Discussion and Conclusion: The results provide support for decisional involvement in the population of Iranian nurses. Therefore, efforts to improve the quality of the nursing work environments into decisional involvement are critically important to sustaining a strong nursing work force in the future. These findings have important implications for nursing leadership

Evaluation of the nurses' job satisfaction, and its association with their moral sensitivities and well-being

Background and Aim: Several researchers have described the nurses' work as stressful and that the incidence of the occupational stress-related burnout in the profession was high. The aim of this study was to establish the relationship between the nurses' satisfaction, their psychosocial work environment, the levels of their reported moral sensitivities and their well - being in Iran. Material and Methods: This descriptive-correlation study was performed at the ILAM general hospitals, IR, during the year 2011. The research instruments which were used were the Psychosocial Work Environment (PWE), the Moral Sensitivity (MS) and the well-being profile of the nurses. A sample of 120 Registered Nurses (RN) were enrolled in the study by using a simple random sampling method. The descriptive statistics and the Pearson's correlation test were performed by using SPSS. Result: The relationship of the nurses' satisfaction and their psychosocial work environment was moderate (M=106.5, SD= 7.2). The nurses' moral sensitivity was moderate (M=112.3, SD= 11.2).This study found that there were significant correlations between the PWE factors score and the MS subscale (P< 0.05, p<0.01). In addition, significant correlations were found between the nurses' well-being and the PWE factors (P< 0.05, p<0.01). Discussion and Conclusion: These findings proved that the nurses perceived their PWE as stressful. The supporting nurses may have a positive effect on their perceptions of well-being. The attending nurses reported less physical symptoms, reduced anxiety and fewer feelings of not being in control

The prevalence of sleep disorder and associated factors in haemodialysis patients: An Iranian study

Background and Aim: Sleep is one of the most basic of the human needs that in addition to maintaining the physical and the mental health, causes stress reduction and helps in focussing on the daily activities. The aim of this study was to investigate sleep disorders and their related factors in patients with end stage renal disease, who were treated with haemodialysis. Methods: This was a descriptive-analytical study that was performed at the Kermanshah Emam Reza Hospital, Iran, during the year 2011. The research instruments which were used were a data recording sheet and a questionnaire. A sample of 148 patients was enrolled in the study by using a simple random sampling method. Descriptive and inferential statistical analysis were performed by using the Statistical Package for Social Sciences Program, version 16 (SPSS). Results: The prevalence of sleep disorders among these patients was 75. The prevalence of the types of sleep disorders were RLS (29.7), SAS (34) and insomnia (70.3) respectively and also the sleep disorders had significant correlations with age higher than 60 years (p= 0.04, r = 0.21), evening dialysis shift (p = 0.03, r = 0.16), lower than normal haemoglobin (p = 0.02, r = 0.17) and higher than normal blood pressure (p = 0.04, r = 0.19). Discussion and Concluding: The general prevalence of sleep disorders among the studied samples was high and insomnia had the highest prevalence. So, appropriate planning in the treatment of sleep disorders is essential in order to improve the quality of life of the patients

A multimodal analgesia of cyclooxygenase-2 for postoperative pain

Recently, Interest to multimodal analgesia, using of two or more analgesics and modalities to treatment of postoperative pain is rising. The aim of this study was to assess the effect of celecoxib on pain and associated complications after lumbar disc surgery. In a randomized, double- blind, placebo- controlled trial, 76 patients scheduled for elective laminectomy divided into two groups. Group A : celecoxib group ( n=38, received celecoxib 400 mg 2hrs before surgery and 200 mg 6 hrs after surgery, along with morphine), Group B : control group ( n=38, received placebo tablets at the same time along with morphine). Visual Analog Scale (VAS) was used to determine the severity of pain. Complications after surgery, anxiety scores before surgery and patient's satisfaction 24 h after surgery were recorded. The mean pain severity score and morphine consumption in the celecoxib group were less compared to the control group at various intervals (P 0.05). In the celecoxib group patient satisfaction was significantly higher compared to the control group (p< 0.001). Celecoxib 400 mg 2 hrs before surgery and 200 mg 6 hrs after surgery is a good alternative in multimodal analgesia, effective in pain control with lesser side effects seen with morphine alone in patients' pain management following lumbar disc surgery

Female sexual dysfunction: Prevalence and risk factors

Background and Aim: Sexual dysfunction adversely affects quality of life, self esteem and interpersonal relationships and it may often be responsible for psychopathological disturbances. The purpose of this study was to explore the prevalence and associated risk factors for Female Sexual Dysfunction (FSD) in women with Kurdish culture from western Iran. Material and Methods: This was a cross-sectional descriptive survey which included 400 women aged 18-50 years old, married, from Ilam-IR, who were interviewed as per the Iranian version of Female Sexual Function Index (FSFI). The subjects were randomly selected from 4 primary health centres. Results: According to the findings, 185 (46.2) women reported FSD. Prevalence of FSD increased with age, from 22 in women aged 0.05). Conclusion: FSD needs to be recognized as a significant public health problem in Kurd women. Further research, particularly studies on awareness and competency of physicians in the management of FSD, is required