Comparison of complications of spinal and general anesthasia in percutaneous kidney stone removal

While the complications of spinal anesthesia are much less than general anesthesia, percutaneous nephrolithotomy (PCNL) is still performed under general anesthesia in most centers. Therefore, in this study spinal anesthesia is compared with general anesthesia in patients undergoing PCNL. This research was a double-blind clinical trial study which was conducted on 130 patients with inclusion criteria. Patients were nonrandomly assigned into two general anesthesia (n=65) and spinal anesthesia (n=65) groups and underwent PCNL surgery.In group A, patients were given intravenously midazolam (2 mg), fentanyl (100 μg), atracurium (0.5 mg/kg), propofol (2 mg/kg) and morphine (10 mg) and then were incubated. In group B, Marcaine 0.5% (15 mg) was injected into the L3-L4 or L4-L5 lumbar spinal space in a sitting position. Patient’s blood pressure was measured and recorded at various times and in recovery as well as in the surgery room. Intra-operative bleeding, pain in the surgery area, nausea and vomiting, shortness of breath and sore throat were recorded for the two groups in the ward and during hospitalization.Changes of blood pressure were the same in both groups. In the general anesthesia group, intra-operative bleeding, pain at the site of the surgery, nausea and vomiting, shortness of breath and sore throat and duration of hospitalization were significantly higher. Changes in other tests were equal in both groups. Spinal anesthesia might be a safer method than general anesthesia for PCNL surgery.Keywords: Complication, Spinal Anesthesia, General Anesthesia, Kidney Stone Removal, Percutaneou

The knowledge and the use of psychological skills of anger management skills at the bedside by the physicians and nurses of Jahrom University of Medical Sciences in 2013

Although all individuals could be exposed to the outburst of anger, a group of them are more at risk than others because of the nature of their work and responsibilities, that the physicians and nurses are placed in this group. In the field of psychology, different skills such as social protection systems, problem-solving skills, self-relaxation system, use of humor skills and communication and negotiation skills have been proposed to control anger. Given the importance of anger management in the prevention of job violence in the health environment and its impact on psychological health of psychiatrists and nurses and also the lack of information and research on the topic, this study aimed to study the knowledge and the use of psychological skills of anger management at the bedside by the physicians and nurses of Jahrom University of Medical Sciences.Methodology: This study is a cross-sectional and descriptive research, its studied sample included 259 general practitioners, specialists and nurses working in two general hospitals affiliated to Jahrom University of Medical Sciences. They were included in the study by the census method. The data was collected by the self-report method and two researcher-made questionnaires: a questionnaire of the knowledge of the psychological skills of anger management and a questionnaire of the use of anger management skills at the bedside and their validity (face and content) and reliability were examined before performing the research. Data analysis was performed with descriptive statistics (mean, frequency, percentage) using SPSS software.Results: The mean of the knowledge of the physicians and nurses of Jahrom University of Medical Sciences from the psychological skills of anger management was 30.2 (standard deviation is equal to 1.53) that based on the classification of the scores of related questionnaire, it was at a good level. Also, the results showed that the mean of the use of psychological skills of anger management at the bedside by the physicians and nurses working in Jahrom University of Medical Sciences was 39.54 (standard deviation is equal to 1.28) that based on the classification of the scores of related questionnaire, it was at a good level.Conclusion: According to the results, the knowledge and the use of psychological skills of anger management skills at the bedside by the physicians and nurses of Jahrom University of Medical Sciences were at the desired level, however, it is proposed to use other evaluation and assessment methods which have no limitations of self-report method in future studies.Keywords: anger management skill, nurses, physician

The Science Performance of JWST as Characterized in Commissioning

This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies