The Effect of Gradual Reduction in Sodium Dialysate on Occurrence of Muscular Cramp, and the Serum Level of Calcium and Magnesium in Patients Undergoing Hemodialysis: A Cross-Over Clinical Trial

Background: The aim of study was to determine the effect of gradual reduction in sodium dialysate on occurrence of muscular cramp, and the serum level of calcium and magnesium in patients undergoing hemodialysis. Methods: This triple-blinded cross-over clinical trial was conducted on 56 hemodialysis patients. After random allocation of patients into group A by the routine method (fixed sodium dialysate) and group B with gradual reduction in sodium dialysate, they underwent a 3-session dialysis. After one week of dialysis through routine method (wash out), patients underwent 3-session dialysis in group B by routine method and in group A by gradual reduction in sodium dialysate. Occurrence of muscular cramp was recorded by using a check list. Patients, serum level of calcium and magnesium before and after intervention was measured. Descriptive statistics indices and inferential statistics tests (repeated measures Analysis of variance) were used. Results: The rate of muscular cramp in routine method was 3.8% in one muscle, 1.9% in two or more muscles, and in the method of gradual reduction of sodium dialysate was 1.9% in one muscle, and 7.5% in two or more muscles. The mean difference of plasma calcium and magnesium before and after the dialysis with routine method was 0.43 and 0.26, respectively, and in the method of gradual reduction of sodium dialysate was 0.45 and 0.34. In this study no significant difference was observed for the rate of occurrence of muscular cramp and serum level of calcium and magnesium between two methods. Conclusions: The results showed that gradual reduction of sodium dialysate, has no effect on occurrence of muscular cramp during dialysis, serum level of calcium and magnesium in hemodialysis patients. Further investigations are needed to better understand the exact effect of this method, and also eliminate the study limitations. Keywords: Calcium, Hemodialysis, Magnesium, Muscle cramp, Sodium dialysate

The Effect of Moderating Noise Pollution on Premature Infants' Behavioral and Physiological Responses in Neonatal Intensive Care Unit

Background: The aim of the study was to determine the effect of moderating noise pollution on premature infants' behavioral and physiological responses in a neonatal intensive care unit (NICU). Methods: 110 premature infants hospitalized in the NICU ward of hospitals in Tehran were selected. All the infants who met the research criteria were allocated and assigned to the experimental and control group (n = 55). The sampling method was non-probability and convenient. In the first section of time, each infant with inclusion criteria, inserted in the control group and then in the second section of time, infant with inclusion criteria placed in the experiment group. In the first section, the educated nurse measured the LAeq, LC, LA, infants’ behavioral responses, and physiological responses. In the second section, noise modifying interventions were implemented in the experimental group for 6 weeks, and then LAeq, LC, LA, infants’ behavioral responses and physiological responses were measured with the same methods. Results: Infants' heart rate in the experimental group was significantly lower than the control group (Pvalue<0.05), and atrial blood O2 Saturation was significantly higher than the control group (Pvalue<0.05). There was no statistically significant difference in the mean number of crying, sleeping, and Moro reflex of premature infants in the two groups. Also, the sound-pressure level in the C-weighted network in the experimental group was lower than the control group (Pvalue=0.021). The sound-pressure level of the C-weighted network was obtained in the same way (Pvalue=0.008). Conclusions: Based on the results, moderating noise pollution in NICU can lead to heart rate deceleration and atrial blood O2 Saturation acceleration in premature infants. Keywords: Noise pollution, Premature infants, Behavioral responses, Physiological responses, Neonatal Intensive care unit

The Effect of Moderating Noise Pollution on Premature Infants' Behavioral and Physiological Responses in Neonatal Intensive Care Unit

Background: The aim of the study was to determine the effect of moderating noise pollution on premature infants' behavioral and physiological responses in a neonatal intensive care unit (NICU). Methods: 110 premature infants hospitalized in the NICU ward of hospitals in Tehran were selected. All the infants who met the research criteria were allocated and assigned to the experimental and control group (n = 55). The sampling method was non-probability and convenient. In the first section of time, each infant with inclusion criteria, inserted in the control group and then in the second section of time, infant with inclusion criteria placed in the experiment group. In the first section, the educated nurse measured the LAeq, LC, LA, infants’ behavioral responses, and physiological responses. In the second section, noise modifying interventions were implemented in the experimental group for 6 weeks, and then LAeq, LC, LA, infants’ behavioral responses and physiological responses were measured with the same methods. Results: Infants' heart rate in the experimental group was significantly lower than the control group (Pvalue<0.05), and atrial blood O2 Saturation was significantly higher than the control group (Pvalue<0.05). There was no statistically significant difference in the mean number of crying, sleeping, and Moro reflex of premature infants in the two groups. Also, the sound-pressure level in the C-weighted network in the experimental group was lower than the control group (Pvalue=0.021). The sound-pressure level of the C-weighted network was obtained in the same way (Pvalue=0.008). Conclusions: Based on the results, moderating noise pollution in NICU can lead to heart rate deceleration and atrial blood O2 Saturation acceleration in premature infants. Keywords: Noise pollution, Premature infants, Behavioral responses, Physiological responses, Neonatal Intensive care unit

The Effect of Gradual Reduction in Sodium Dialysate on Occurrence of Muscular Cramp, and the Serum Level of Calcium and Magnesium in Patients Undergoing Hemodialysis: A Cross-Over Clinical Trial: The effect of gradual reduction in sodium dialysate on occurrence of muscular cramp

Background: The aim of study was to determine the effect of gradual reduction in sodium dialysate on occurrence of muscular cramp, and the serum level of calcium and magnesium in patients undergoing hemodialysis. Methods: This triple-blinded cross-over clinical trial was conducted on 56 hemodialysis patients. After random allocation of patients into group A by the routine method (fixed sodium dialysate) and group B with gradual reduction in sodium dialysate, they underwent a 3-session dialysis. After one week of dialysis through routine method (wash out), patients underwent 3-session dialysis in group B by routine method and in group A by gradual reduction in sodium dialysate. Occurrence of muscular cramp was recorded by using a check list. Patients, serum level of calcium and magnesium before and after intervention was measured. Descriptive statistics indices and inferential statistics tests (repeated measures Analysis of variance) were used. Results: The rate of muscular cramp in routine method was 3.8% in one muscle, 1.9% in two or more muscles, and in the method of gradual reduction of sodium dialysate was 1.9% in one muscle, and 7.5% in two or more muscles. The mean difference of plasma calcium and magnesium before and after the dialysis with routine method was 0.43 and 0.26, respectively, and in the method of gradual reduction of sodium dialysate was 0.45 and 0.34. In this study no significant difference was observed for the rate of occurrence of muscular cramp and serum level of calcium and magnesium between two methods. Conclusions: The results showed that gradual reduction of sodium dialysate, has no effect on occurrence of muscular cramp during dialysis, serum level of calcium and magnesium in hemodialysis patients. Further investigations are needed to better understand the exact effect of this method, and also eliminate the study limitations. Keywords: Calcium, Hemodialysis, Magnesium, Muscle cramp, Sodium dialysate