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

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

The Effect of Gabapentin Plus Celecoxib on Pain and Associated Complications After Laminectomy

Introduction: Prevention and treatment of postoperative pain is a major challenge in postoperative care and well-being of the surgical patient. The multimodal analgesic method has been recommended as an alternative treatment for the management of postoperative pain. Aim: To assess the comparative effect of gabapentin versus gabapentin plus celecoxib on pain and associated complications after laminectomy. Materials and Methods: In this randomized double-blind clinical trial, 114 patients scheduled for elective laminectomy received gabapentin (n=38, 900 mg daily), gabapentin plus celecoxib (n=38, 200 mg celecoxib plus 300mg gabapentin twice a day), and placebo (n=38, capsule containing starch). Visual Analog Scale (VAS) was used to determine the severity of pain. Complications after surgery, anxiety scores before surgery and patient's satisfaction 24 hour after surgery were recorded. Results: The mean pain sevenity score and morphine consumption in the gabapentin plus celecoxib group were less compared to the placebo and gabapentin group respectively at various intervals (p < 0.001). The mean anxiety score, shivering, nausea, vomiting and pruritus in the gabapentin group were significantly lower compared to the placebo and gabapentin plus celecoxib groups respectively (p < 0.001, p < 0.05). The frequencies of drowsiness (42.1) in the gabapentin group were significantly high compared to the placebo and gabapentin plus celecoxib group respectively (p < 0.001, p < 0.05). In the gabapentin plus celecoxib group patient satisfaction was significantly higher compared to the placebo and gabapentin group (p< 0.05). Conclusion: Combination of 300 mg gabapentin plus 200 mg celecoxib twice a day is a good alternative in multimodal analgesia, effective in pain control with lesser side effects seen with gabapentin alone

Effects of oral propranolol on duration of labor and type of delivery in nulliparus women with prolonged pregnancy

Introduction: Since duration of labor is an effective factor on outcome of pregnancy, the study was conducted to evaluate the effect of oral propranolol and oxytocin with oxytocin alone on duration of labor and type of delivery in nulliparous women with prolonged pregnancy. Methods: A double blind randomized controlled trial was performed on 146 nulliparous women with gestational age 40-42 weeks, cephalic presentation, bishop score ≥5, normal body mass index, intact of membrane, estimated fetal weight ≤4kg who referred to Khomeyni hospital of Ilam in 2009. Participants were classified into two groups, case group (propranolol and oxytocin) and control group (oxytocin alone).Before induction, the case group received 20 mg propranolol and control group received placebo with similar capsules orally TDS. Then induction was started initially with 2 mIU/min oxytocin in both groups and increased until obtain well contractions (3 contractions per 10 min) or 30 mIU/min. Data analyzes using SPSS software version 16, t-test and x2 test. p&lt;0.05 was considered significant. Results: All participants were matched for factors affecting duration of labor. Mean± SD duration of active phase and second stages of labor in first and second days after induction was significantly shorter in case group than control group. Cesarean rate had significantly decreased in the control group but no significant difference of third stage and Apgar was found between both groups (p=0.987). Conclusion: Propranolol decreases the labor duration and the number of cesarean delivery