Intravenous Haloperidol versus Midazolam in Management of Conversion Disorder; a Randomized Clinical Trial

Introduction: Conversion disorder is a condition in which the patient shows psychological stress in physical ways. This study aimed to compare the effects of haloperidol versus midazolam in patients with conversion disorder.Methods: This double-blind randomized clinical trial was conducted on patients with conversion disorder who had presented to the emergency department, throughout 2015. Patients were randomly divided into two groups and were either treated with 2.5 mg of intravenous (IV) haloperidol or 2.5 mg of IV midazolam. Recovery rate, time to recovery, and side effects of both drugs 1 hour, 24 hours, and 1 week after treatment were compared using SPSS19.Results: 140 patients were divided into two groups of 70. There were no significant differences between the groups regarding the baseline characteristics. 12 (17.1%) patients who were treated with IV haloperidol experienced drug side effects within 1 hour and 12 (17.1%) within 24 hours, while only 3 (4.3%) patients in IV midazolam experienced side-effects within 1 hour after drug administration (p = 0.026).  The symptoms of the disease subsided in 45 (success rate: 64.3%) patients in midazolam and in 64 (success rate: 91.5%) participants in haloperidol group (P<0.001). Mean recovery time was 31.24 ± 7.03 minutes in IV midazolam and 30.53 ± 7.11 minutes in IV haloperidol group (p = 0.592). Absolute risk reduction (ARR) of treating patients with haloperidol compared to midazolam is about 27%.Conclusion: The response of patients to treatment with haloperidol is clearly better than midazolam. Although more transient and minor side-effects were observed in the group treated with haloperidol compared to midazolam group, serious side-effects were rare for both treatments

Competency and Cultural Similarity: Underlying Factors of an Effective Interprofessional Communication in the Emergency Ward: A Qualitative Study

Introduction: Despite its importance, interprofessional communication in emergency wards seems unfavorable. Identifying the underlying factors of an effective interprofessional communication can help care providers better design appropriate interventions. This study was designed to explore factors that influence interprofessional communication in the emergency wards. Method: A qualitative study was conducted by means of semi-structured interviews with 22 participants with a variety of jobs, positions, ages, genders, and work experiences. Data analysis was performed with content analysis method with inductive approach. Results: Data analysis revealed 4 categories of underlying effective factors of interprofessional communication in the emergency ward knowledge and skill, communication skills, the positive effect of religion on communication, similar demographic characteristics. These 4 categories revealed the 2 main themes of competency and cultural similarity. Conclusion: This study provided a better understanding of underlying factors in interprofessional communication in the emergency ward. Improving the knowledge and skills of health providers in the emergency ward, and employing personnel with common culture and demographic variables can improve interprofessional communication in the emergency ward. Interprofessional communication has a major role in the outcome of patient care and job satisfaction of staff thus, it is of great importance. Keywords: Interprofessional communication, Emergency ward, Underlying factors, Content analysi

Study on Removal of Reactive Blue 19 using PVA Electrospun Nanofibers

Textile pollutants, especially dyes are toxic compared to other pollutants and their presence is more sense in the environment. Reactive dye due to its high molecular weight and aromatic structure is more dangerous than other dyes. These dyes are highly soluble in water and are not easily removed by common treatment methods. Among the methods of wastewater treatment, application of membrane filtration via nanofibers can be more effective, since these membranes are very porous and their pores are interconnected; moreover, they can easily be functionalized. This research aimed at removal of reactive blue 19 dye from the simulated dyeing effluent using adsorbent through a membrane produced by electrospinning of the PVA solution. In this regard, the influence of different parameters on the fiber production conditions such as polymer concentration, applied voltage intensity, distance of nozzle to collector and feeding rate were investigated. In addition, effects of environmental factors including pH and temperature, contact time and nanofiber mass on the dye removal efficiency were studied. The very fine nanofiber was produced by 1.7% wt PVA at 15 kV with 1.0 ml/h feeding rate from 13 cm. The research found 91% dye removal efficiency using prepared nanofibers at pH 2.1, 35˚C and 20 mg/l nanofibers. The results indicate that the process of dye adsorption on the nanofiber mass is endothermic

Renal Angiomyolipoma Associated with Renal Vein and Inferior Vena Cava Thrombosis: A Case Report

https://jkmu.kmu.ac.ir/article_92138.html#:~:text=Abstract%0AAngiomyolipoma%20(AML,the%20best%20outcome

The Impact of Silymarin on the Symptom Severity in Pediatric Patients with Inflammatory Bowel Disease: A Randomized Clinical Trial

Background: Inflammatory Bowel Disease (IBD) is a multifactorial disease, posing significant challenges to public health. The aim of this study is to determine the effect of silymarin on the symptom severity in pediatric patients with IBD.Methods & Materials: This randomized clinical trial was conducted on children aged 5-18 diagnosed with IBD referred to the GI clinic at Akbar Children's Hospital in Mashhad. Those who met the inclusion criteria were randomly allocated into either the intervention or placebo group, each group consisting of 20 participants. In the intervention group, silymarin was administered three times daily in divided doses for three months. The control group received a placebo. To assess the efficacy of silymarin, PUCAI and PCDAI were evaluated for all patients at three different time points: before the intervention, during the first visit, and after the intervention. Data were analyzed utilizing the SPSS version 25, with a significance level set at p 0.05). However, a statistically significant difference was observed in the disease activity index score between the two groups during the second, and third evaluations (p<0.05)

Association of PAI-1 rs1799889 Polymorphism with Susceptibility to Ischemic Stroke: a Huge Meta-Analysis based on 44 Studies

Background: the PAI-1 rs1799889 polymorphism has been reported to be associated with susceptibility to ischemic stroke. However, the results of previous studies have been inconsistent or controversial. Hence, we performed a systematic review and meta-analysis to evaluate the association of PAI-1 rs1799889 polymorphism with ischemic stroke risk. Methods: A comprehensive literature search was performed on PubMed, Web of Science, Scopus, SciELO, CNKI, and CBD databases up to November 05, 2019. Pooled odds ratio (OR) with 95% confidence interval (CI) were used to access the strength of this association in fixed- or random-effects model. Results: A total of 44 case-control studies with 8,620 cases and 10,260 controls were selected. Pooled data showed a significant association between PAI-1 rs1799889 polymorphism and ischemic stroke risk in the overall populations (GG vs. AA: OR = 0.791, 95% CI 0.633-0.988, p = 0.039; GA vs. AA: OR = 0.807, 95% CI 0.683-0.953, p = 0.012; and GG+GA vs. AA: OR = 0.795, 95% CI 0.637-0.993, p = 0.043). Subgroup analysis by ethnicity revealed a significant association in Asian and Mixed populations, but not in Caucasians. Moreover, stratified analysis by country of origin revealed an increased risk of ischemic stroke in Chinese populations, but not among Dutch (Netherlands) and Swedish. Conclusions: This meta-analysis result suggested that PAI-1 rs1799889 polymorphism was associated with an increased risk of ischemic stroke, especially in Asian and Mixed populations. Keywords: PAI-1 gene; cerebrovascular accident; ischemic stroke; meta-analysis; polymorphism; rs1799889

Teacher immunity in professional identity: reflection on male ielts teachers’ homosocial fabrics in 2 iranian ethnographic institutions

As a new concept in language teacher psychology, language teacher immunity is a strong indicator of how teachers behave and respond in the face of disturbances which has a profound effect on teachers' profession. So, as it is apparent, research on language teacher immunity is in its embryonic stage and this qualitative study tried to fill the gap in the existing literature by using Retrodictive Qualitative Modeling to develop an in-depth understanding the experiences of five IELTS male teachers from two ethnographic sites. And due to research and critical studies into men and masculinity has originated as one of the most emerging areas of sociological investigation, on a macro-level of ethnography, this research study concentrated on male IELTS teachers to see the interpretations about masculinity, homosocial relations and desire to make their own professional identity and on the micro-level, the ethos varies at each institution. To achieve the research objectives and answer the questions of this ethnographic study, three data collection techniques were utilized to generate information, namely document collection, classroom observations, and interviews. The findings of this comparative ethnography revealed that in the IELTS situation, “the Visionary” and “The Spark plug” should be placed in two separate groups of immunity (productive and adaptive) to increase the categories of immunity to 5 in this context. So, by adding masculinity patterns, which changed from physicality into knowledge-discipline and socialization-patronage in this study, it was concluded that those who were in productive and adaptive immunity category were not homogeneous due to the fact that they were complicit and approached themselves to the hegemonic masculinity with slight changes that the researchers could not separate them in their immunity.Como um novo conceito na psicologia do professor de línguas, a imunidade do professor de línguas é um forte indicador de como os professores se comportam e respondem a distúrbios que têm um efeito profundo na profissão dos professores. Assim, como é aparente, a pesquisa sobre imunidade de professores de línguas está em seu estágio embrionário e este estudo qualitativo tentou preencher a lacuna na literatura existente usando Modelagem Qualitativa Retroditiva para desenvolver uma compreensão profunda das experiências de cinco professores do IELTS de dois sites etnográficos. E devido à pesquisa e estudos críticos sobre homens e masculinidade tem se originado como uma das áreas mais emergentes da investigação sociológica, em um nível macro da etnografia, esta pesquisa concentrou-se em professores do IELTS para ver as interpretações sobre masculinidade, relações homossociais e desejo de fazer a própria identidade profissional e no nível micro, o ethos varia em cada instituição. Para atingir os objetivos da pesquisa e responder às questões deste estudo etnográfico, três técnicas de coleta de dados foram utilizadas para gerar informações, a saber, coleta dedocumentos, observações em sala de aula e entrevistas. Os resultados desta etnografia comparativa revelaram que na situação do IELTS, “o Visionário” e “A vela de ignição” devem ser colocados em dois grupos separados de imunidade (produtiva e adaptativa) para aumentar as categorias de imunidade para 5 neste contexto. Assim, ao adicionar padrões de masculinidade, que passaram de fisicalidade para conhecimento-disciplina e socialização-patrocínio neste estudo, concluiu-se que aqueles que se encontravam na categoria de imunidade produtiva e adaptativa não eram homogêneos pelo fato de serem cúmplices e se aproximarem à masculinidade hegemônica com ligeiras modificações que os pesquisadores não conseguiram separar em sua imunidade.Como nuevo concepto en la psicología del profesor de idiomas, la inmunidad del profesor de idiomas es un fuerte indicador de cómo se comportan y responden los profesores ante las perturbaciones, lo que tiene un efecto profundo en la profesión docente. Entonces, como es evidente, la investigación sobre la inmunidad de los profesores de idiomas se encuentra en su etapa embrionaria y este estudio cualitativo trató dellenar el vacío en la literatura existente mediante el uso de modelos cualitativos retrodictivos para desarrollar una comprensión profunda de las experiencias de cinco profesores de IELTS de dos sitios etnográficos. Y debido a la investigación y los estudios críticos sobre los hombres y la masculinidad se ha originado como una de las áreas más emergentes de la investigación sociológica, en un macro-nivel de etnografía, este estudio de investigación se concentró en profesores de IELTS masculinos para ver las interpretaciones sobre masculinidad, relaciones homosociales y deseo de hacer su propia identidad profesional y, a nivel micro, el ethos varía en cada institución. Para lograr los objetivos de la investigación y responder a las preguntas de este estudio etnográfico, se utilizaron tres técnicas de recolección de datos para generar información, a saber, recolección de documentos, observaciones en el aula y entrevistas. Los hallazgos de esta etnografía comparativa revelaron que en la situación del IELTS, “elVisionario” y “La bujía” deben colocarse en dos grupos separados de inmunidad (productiva y adaptativa) para aumentar las categorías de inmunidad a 5 en este contexto. Entonces, al agregar patrones de masculinidad, que cambiaron de fisicalidad a conocimiento-disciplina y socialización-mecenazgo en este estudio, se concluyó que aquellos que estaban en la categoría de inmunidad productiva y adaptativa no eran homogéneos por el hecho de que eran cómplices y se acercaban a sí mismos. a la masculinidad hegemónica con ligeros cambios que los investigadores no pudieron separarlos en su inmunidad

Factors behind moral distress among Iranian emergency medical services staff: A qualitative study into their experiences

Background: The unique characteristics of each emergency situation and the necessity to make prompt decisions cause emergency medical services (EMS) staff's ethical conflicts and moral distress. Objectives:This study aimed to explore EMS staff's experiences of the factors behind their moral distress. Methods: This qualitative study was conducted on 14 EMS staff using the conventional content analysis. Data were collected through unstructured and semi-structured interviews. Each interview was started using general questions about moral issues at workplace and barriers to professional practice. The five-step content analysis approach proposed by Graneheim and Lundman was used for data analysis. Results: The factors behind EMS staff's moral distress were categorized into 13 subcategories and 5 main categories. The main categories were staff's lack of knowledge and competence, inability to adhere to EMS protocols, restraints on care provision, ineffective interprofessional communications, and conflicts in value systems. The subcategories were, respectively, inadequate knowledge and experience, working with incompetent colleagues, artificial services, working in unpredictable situations, lay people's interference in care provision, resource and equipment shortages, barriers to early arrival at the scene, obligatory obedience to the system, poor interprofessional interactions, inadequate interprofessional trust, refusal of care, challenges in obtaining consent, and challenges in telling the truth. Conclusion: EMS staff experience moral distress at work due to a wide range of factors. Given the negative effects of moral distress on EMS staff's physical and mental health and the quality of their care services, strategies are needed to prevent or reduce it through managing its contributing factors

Ingested Foreign Bodies Removed by Lexible Endoscopy in Pediatric Patients: A 10-year Retrospective Study

Introduction: Determination of type and location of trapped objects and endoscopic observations among children with foreign-body ingestion.   Materials and Methods: We evaluated 105 endoscopic records of patients presenting with foreign-body ingestion from 2001–2011.   Results: Button batteries were the most common objects removed (41%). The lower segment of the esophagus was the most common trapping site. There was significant correlation between type of foreign body and its location of trapping. Abnormal endoscopic observations were reported in 33% patients. There was significant correlation between the type of foreign body and endoscopic observations. There was also a significant correlation between the location of the foreign body and endoscopic observation.   Conclusion:  The pattern of foreign-body ingestion is somewhat different in our center compared with other studies. Awareness among parents about the prevention of this accident is an important step in decreasing the incidence of foreign-body ingestion.

Ingested Foreign Bodies Removed by Flexible Endoscopy in Pediatric Patients: A 10-year Retrospective Study

Introduction: Determination of type and location of trapped objects and endoscopic observations among children with foreign-body ingestion. Materials and Methods: We evaluated 105 endoscopic records of patients presenting with foreign-body ingestion from 2001–2011. Results: Button batteries were the most common objects removed (41%). The lower segment of the esophagus was the most common trapping site. There was significant correlation between type of foreign body and its location of trapping. Abnormal endoscopic observations were reported in 33% patients. There was significant correlation between the type of foreign body and endoscopic observations. There was also a significant correlation between the location of the foreign body and endoscopic observation. Conclusion: The pattern of foreign-body ingestion is somewhat different in our center compared with other studies. Awareness among parents about the prevention of this accident is an important step in decreasing the incidence of foreign-body ingestion