Oral care in trauma patients admitted to the icu: Viewpoints of ICU nurses

Background: Many patients with severe traumatic injuries are admitted to intensive care units (ICU). These patients usually require prolonged mechanical ventilation. These interventions require oral intubation and leave the mouth open which consequently impairs the natural antimicrobial activity in the mouth and airways. These patients are also prone to ventilator-associated pneumonia (VAP). Evidence shows that paying attention to oral hygiene in patients under mechanical ventilation is important in helping to prevent VAP. Objectives: The present study was conducted to assess the viewpoints and performance of ICU nurses at Birjand hospitals towards oral care of patients under mechanical ventilation. Patients and Methods: A cross-sectional study was conducted at ICUs of Imam-Reza and Vali-Asr hospitals, Birjand, Iran. Sampling was done through a census in which 53 ICU nurses participated. Descriptive statistics, Kolmogorov-Smirnov test, Mann-Whitney U tests and Kendall's correlation coefficient were used to analyze the data. Results: A total of 53 nurses participated in this study. Most of the nurses had been trained to provide oral care during their university education. According to the participants' opinions, oral care with an average score of 5.72 ranked second among the 10 nursing care domains. The most frequent oral care provided was oral suctioning, normal saline irrigation, and chlorhexidine rinse with 95, 90, and 81.3 frequency, respectively. Conclusions: Nurses participating in this study considered oral care to be of prime importance. Most of the participants although trained in this area felt the need for continuing training courses. Copyright © 2014, Kowsar Corp.; Published by Kowsar Corp

Investigation of Association Between Cardiac Dose Distribution and Strain/Tissue Doppler Echocardiographic Indices During 1-Year Post-Mastectomy Radiation Therapy Follow-Up in Breast Cancer Patients

Objective: This study aimed to determine the association between cardiac dose distribution and strain and Tissue Imaging Doppler (TDI) echocardiographic indices during 1-year follow-up after Post-Mastectomy Radiotherapy (PMRT) in breast cancer patients. Methods and Materials: In this prospective cohort study, patients with left breast cancer candidate for PMRT were included. The patients treated radiation dose of 50 Gy in 25 fractions over 5 weeks. Before the radiotherapy, and 6 and 12 months after it, the patients underwent echocardiography using strain and TDI methods. The changes in echocardiographic indices and their association with cardiac radiation dose were evaluated. Results: In this study, 31 patients with mean age of 36.6 ± 4.6 years old and the cumulative doses of doxorubicin to 237 ± 5 mg/m2 were participated. Correlation between cardiac dose during radiotherapy and changes in strain and TDI echocardiographic indices showed a significant inverse relation between minimum cardiac dose and 6-month TAPSE changes (p = 0.04, r = � 0.3), maximum cardiac dose and 6-month RV strain changes (p = 0.04, r = � 0.3) and 6 and 12-month S� changes (p = 0.02, r = � 0.4 and p = 0.05, r = � 0.3), Cardiac V30 with 6 and 12-month E velocity changes (p = 0.05, r = � 0.3 and p = 0.02, r = � 0.4, respectively) and Heart V20 with 12-month E velocity changes (p = 0.04, r = � 0.3). Normal RV strain observed before starting the study in 12 patients (38.7) was found to be abnormal after 6-month follow-up (p = 0.004). Conclusion: Results of this study showed that, PMRT was associated with left heart diastolic dysfunction and right heart systolic dysfunction especially in the first 6 months after radiotherapy. © 2020, Association of Gynecologic Oncologists of India

Ewing’s Sarcoma of Mandible: Practical Approach to a Challenging Case

As a rare entity, sarcomas of the head and neck are challenging cases. In this paper, we represent a unique case of Ewing sarcoma of mandible, serving as an example of multidisciplinary team importance in a developing country