The effect of gabapentin versus intrathecal fentanyl on postoperative pain and morphine consumption in cesarean delivery: a prospective, randomized, double‑blind study

Pain after cesarean delivery is a leading cause of chronic pain and there are many attempts to reduce it without total success. Gabapentin is effective in reducing acute and chronic pain with little experience in parturient. The purpose of this study is to compare the effect of pre-emptive gabapentin with intrathecal fentanyl on reducing postoperative pain and morphine consumption in cesarean surgery. METHODS: Seventy-eight primiparous women who scheduled for non-emergency cesarean delivery were enrolled in the study and separated into two groups. The control group received 12.5 mg of heavy bupivacaine 0.5 % plus 10 μg of fentanyl intrathecally and the case group received 300 mg of gabapentin orally 2 h before surgery and 12.5 mg of heavy bupivacaine 0.5 % intrathecally. Data collection including blood pressure, heart rate, neonate sedation, Apgar score, visual analogous scale at several hours, at first, need to analgesic postoperatively. RESULTS: In the fentanyl group, the need for analgesic drug was earlier, total dose of morphine in 24 h and patient satisfaction was higher than the gabapentin group. The mean visual analogous scale at several hours postoperatively in the fentanyl groups was significantly higher than the gabapentin groups (P = 0.001). CONCLUSION: Preemptive use of gabapentin is a safe and effective way to reduce postoperative pain and morphine consumption in parturients after cesarean surgery

Comparison the effects of oxytocin and methylergonovine in elective caesarean section under spinal anesthesia

Purpose In order to prevent postpartum hemorrhage in caesarean section under spinal anesthesia, patients routinely receive oxytocin. In this study we compared the efficacy of Methylergonovine and Oxytocin on hemodynamic stability and bleeding amount in caesarean section. Materials and methods In this randomised controlled trial study, 80 patients candidate for elective caesarean section under spinal anesthesia divided to two groups: 40 patients in control group received oxytocin and 40 ones in case group received methylergonovine. Results There was no differences between groups in Mean age, baseline hemodynamic values, after spinal anesthesia and recovery (except diastolic blood pressure min 20), time of uterine atony, dizziness; nausea and vomiting. After drug administration (oxytocin and methylergonovine), systolic blood pressure in minutes 1, 10, 15 and diastolic blood pressure in minutes 1, 3, 20 increased in case group statistically more than control group. In control group, heart rate in minutes 1, 5 increased significantly more than the other group. Mean arterial blood pressure in minutes 1, 3, 5, 10, 15 reduced significantly more than in control group. Need to vasoconstrictor drug statistically was less in case group (p\0.0001). Conclusion Methylergonovine induced significantly more hemodynamic stability. Adverse effects were similar between two groups. We recommend the use of methylergonovine in patients with caesarean section under spinal anesthesia because of its hemodynamic stability and low need to vasoconstrictor drugs

Compare Clinical Competence and Job Satisfaction Among Nurses Working in Both University and Non-University Hospital in Bushehr 2015

Background: Nurses are the biggest component of the health care system in the world and their job satisfaction and clinical competence affect performance and success of the organization. This study aimed to determine and compare the clinical competence and job satisfaction of nurses in both academic and nonacademic hospitals in Bushehr in 2015. Materials & Methods: In this cross-sectional study, 257 nurses were studied in two hospitals of Bushehr city selected by census method. Data was collected by using valid and reliable Nurse Clinical Competence and Job Satisfaction Inventory questionnaires. Data analyzed by using SPSS- 21, and descriptive statistics, t-test, and ANOVA and Pearson correlation coefficient. Statistical significance was set at P< 0.05. Results: Findings showed that there were no significant diffrences between academic hospital nurses' job satisfaction with 126.96±29.34 and non-academic hospital with 128.31±23.26. Also, there were a significant diffrences between total score of nurses' clinical competence in academic hospital 62.18±18.09 and in nonacademic hospital 67.78±17.64. There were a significant and direct association between the clinical competence and job satisfaction of nurses in both hospitals (p≤0.05). Conclusion: Although nurses clinical competence and job satisfaction in both hospitals were assessed at desirable level but both criteria were higher in non-university hospital nurses. It is nessessary that Nurse Manager’s of academic hospitals should pay attention to assessment and improvement of nurse clinical competence and job satisfactio

Comparison of Power Hierarchy, Cohesion and Structure in Families with and Without a Disabled Child From the Perspective of their Mothers, Bushehr 2015

Background: Power hierarchy, cohesion and family structure are the main component of every family. Families with disabled children may be affected with this structure and function. The aim of this study was to comparison of the power hierarchy, cohesion and family structure with disabled and non-disabled children in Bushehr from the perspective of their mothers (2015). Materials & Methods: In this Cross-sectional study, 150 mothers of disabled and non-disabled children in Bushehr city were selected by census and clusters method, respectively. Family structure, cohesion and hierarchy of mothers was assessed by using the Family System Test (FAST). Data were analyzed by using SPSS software (Version 18) and statistical tests carried out such as (Independent t-test, ANOVA and chisquare test. Results: Based on this results, there was no significant difference between the families in terms of power (p=0.22) but the cohesion of families with children with physical disabilities (p=0.0001, 1/90 ± 0.54) and mentally (p=0.0001, 1.56 ± 0.73) is less than the natural family (p=0.0001, 2.26 ± 0.52), Also in terms of structure, there was no significant difference between families with healthy children and physical disability and mentally (p=0.05). Conclusion: Findings showed that the cohesion of families with disabled children are more vulnerable than healthy family. In the first step, awareness of young couples about the outcome of the birth of a disabled child is necessary and inevitable and in second step, providing training and adequate support to families with disabled child

Renal Artery Stenosis and Its Predictors in Hypertensive Patients Undergoing Coronary Artery Angiography

Background: Renal artery stenosis (RAS) has been increasingly recognized in the recent years, especially in patients with coronary artery disease (CAD). RAS affects the patients with hypertension (HTN), but the exact prevalence is not known. Objectives: This study was performed to determine the prevalence and to identify the predictors of RAS in hypertensive patients undergoing coronary artery angiography. Patients and Methods: In a cross-sectional study from August 2008 to August 2009, 481 patients with HTN and suspected CAD underwent selective coronary and renal angiography for screening and predicting RAS. RAS was defined as a higher than 50% stenosis in the renal artery lumen. Multivariate analysis of factors associated with the presence of RAS were examined using a logistic regression model. Results: The mean ± standard deviation of age was 59.25 ± 10.81 years and 50.3% were men. According to angiographic data, 425 patients (88.4%) had CAD, while 56 (11.6%) had normal coronary arteries. RAS was seen in 94 (22%) patients with CAD. The multivariate logistic regression analysis identified only age (P < 0.001) and the number of significant coronary lesions (P < 0.001) as independent predictors of RAS. Gender, smoking, congestive heart failure, diabetes mellitus (DM), hyperlipidemia (HLP) and body mass index (BMI) were not independent predictors. Conclusions: This study suggests that in the management of patients with RAS, risk factors should most likely be considered as beneficial. In addition, the clinical and angiographic features are helpful in predicting its presence in elderly patients with CAD

Effect of vitamin supplementation on serum oxidized low-density lipoprotein levels in male subjects with cardiovascular disease risk factors.

Objective(s):Oxidized low-density lipoproteins (ox-LDLs) appear to play a significant role in atherogenesis. In fact, circulating ox-LDL concentrations have been recognized as a risk factor for cardiovascular disease (CVD). The main objectives of this study were to assess the effects of antioxidant vitamins on ox-LDL as a biomarker of CVD in male subjects with CVD risk factors. Materials and Methods:The effect of antioxidant vitamins on ox-LDL as a biomarker of CVD in male subjects with CVD in male subjects with CVD risk factors at baseline and after 12 weeks of supplementation with vitamin E (400 IU), C (500 mg), ß-carotene (15 mg), and the combined supplements (E, C, and ß-carotene) respectively defined as group E, C, B and control group was considered as group P. Results:The mean values for ox-LDL at the baseline were 86.93 ± 26.30 U/l in group C, 94.52 ± 38.40 U/l in group E, 79.73±2.07 U/l in group B, 85.97±23.07 U/l in combined group, and 84.90± 14.66 U/l in group P. After 12 weeks of intervention the percentage of changes for group C, group E, group B, COM group, and group P were (-18.32), (-2286), (-17.31), (-19.01) and (-2.0), respectively. Using Wilcoxon method, significant differences were detected in the mean ox-LDL concentrations of baseline and after intervention, values in the C, E, B and combined groups (P< 005). Conclusion:This study illustrated that diet supplemented with vitamin C (500 mg), vitamin E (400 IU), ß-carotene (15 mg), and the combination of these vitamins was associated with lower serum ox-LDL levels

The Effect of Group Counseling on the Quality of Life in Patients with Major Thalassemia Referred to the Thalassemia Treatment Center in Bushehr

Background and Objective: Major Thalassemia is the most common hereditary disease in the world and in Iran. The chronic nature of the disease and complications associated with clinical signs and protests of the disease and its treatment make multiple physical, psychological and social problems and effects on the quality of life in these patients. The aim of this study was to determine the effect of group counseling on quality of life in patients with thalassemia major. Materials and Methods: This study was a randomized controlled clinical trial. The total number of subjects included 62 patients with thalassemia major from thalassemia treatment center in the Bushehr in 2016, were randomly divided into two groups of 31 people of intervention and control. For intervention group, four sessions of group counseling in behavioral cognitive approach held in two weeks. The quality of life in patients in both groups evaluated before the intervention and one month after the intervention, using the SF-36 questionnaire. The results were analyzed by SPSS software version 23 at a significant level of 0.05. Results: The results of analytical tests showed that there was no statistically significant difference between the two groups in demographic variables (P > 0.05). However, the intervention group gained a significant increase in total score of quality of life and its sub-domains after counseling. (P < 0/001). Also, the difference between the mean total scores of quality of life and its sub-domains in the intervention and control groups was statistically significant (P < 0.001). Conclusion: This study showed that the treatment group counseling with cognitive behavioral approach significantly improves the quality of life in patients with Thalassemia major. Therefore it is recommended that this treatment helped to improve the quality of life in these patients. m

Alterations in metabolic pathways: a bridge between aging and weaker innate immune response

Aging is a time-dependent progressive physiological process, which results in impaired immune system function. Age-related changes in immune function increase the susceptibility to many diseases such as infections, autoimmune diseases, and cancer. Different metabolic pathways including glycolysis, tricarboxylic acid cycle, amino acid metabolism, pentose phosphate pathway, fatty acid oxidation and fatty acid synthesis regulate the development, differentiation, and response of adaptive and innate immune cells. During aging all these pathways change in the immune cells. In addition to the changes in metabolic pathways, the function and structure of mitochondria also have changed in the immune cells. Thereby, we will review changes in the metabolism of different innate immune cells during the aging process

Evaluation of HIV-Related Cardiomyopathy in HIV-Positive Patients in Bushehr, Iran

Objectives In 2020, according to the UNAIDS (Joint United Nations Programme on HIV/AIDS), more than 37 million people lived with human immunodeficiency virus (HIV) infection worldwide. The disease is known to affect several organs, and one of the most affected organs is the heart. Cardiac diseases are highly prevalent among HIV-infected individuals, and recent findings suggest that this could be due to the damage caused by the virus. HIV patients are subject to advanced immunosuppression, which may lead to cardiac muscle damage and, in turn, cardiomyopathy. We aimed to study the incidence of HIV-related cardiomyopathy