The effect of aromatherapy with Pelargonium graveolens on postoperative pain intensity in hospitalized children: A clinical randomized trial

زمینه و هدف: درد یکی از شکایات شایع بعد از عمل جراحی کودکان است و علی رغم پیشرفت های وسیع در زمینه پزشکی همچنان یافتن روش های درمانی بدون عارضه برای کاهش شدت درد بعد از عمل احساس می شود؛ لذا این مطالعه با هدف بررسی تأثیر رایحه درمانی بر شدت درد بعد از عمل جراحی کودکان صورت گرفته است. روش بررسی: در این مطالعه کارآزمایی بالینی دو سویه کور، 64 کودک 6-3 ساله بستری در بخش جراحی به روش آسان انتخاب و در دو گروه 32 نفره تصادفی سازی شدند. در کنار درمان های معمول کنترل درد، رایحه درمانی استنشاقی با یکی از دو نوع رایحه شمعدانی معطر و روغن بادام شیرین (پلاسبو)، در زمان های بدو ورود کودک به بخش و سپس3،6،9 و 12 ساعت بعد از آن انجام و 30 دقیقه بعد از هر مرحله نمره شدت درد به وسیله چک لیست بررسی درد بعد از عمل جراحی در کودکان اندازه گیری و ارزیابی شد. یافته ها: نمره شدت درد کودکان، قبل از دریافت هر گونه مداخله در دو گروه، تفاوت معنی داری نداشت (05/0P). نتیجه گیری: رایحه درمانی با شمعدانی معطر می تواند در تسکین درد بعد از عمل جراحی کودکان در کنار سایر مراقبت ها مؤثر باشد

Dysregulation of Survivin-Targeting microRNAs in Autoimmune Diseases: New Perspectives for Novel Therapies

It has been well established that the etiopathogenesis of diverse autoimmune diseases is rooted in the autoreactive immune cells’ excessively proliferative state and impaired apoptotic machinery. Survivin is an anti-apoptotic and mitotic factor that has sparked a considerable research interest in this field. Survivin overexpression has been shown to contribute significantly to the development of autoimmune diseases via autoreactive immune cell overproliferation and apoptotic dysregulation. Several microRNAs (miRNAs/miRs) have been discovered to be involved in survivin regulation, rendering the survivin-miRNA axis a perspective target for autoimmune disease therapy. In this review, we discuss the role of survivin as an immune regulator and a highly implicated protein in the pathogenesis of autoimmune diseases, the significance of survivin-targeting miRNAs in autoimmunity, and the feasibility of targeting the survivin-miRNA axis as a promising therapeutic option for autoimmune diseases

Effect of a supportive training program on anxiety in children with chronic kidney problems and their mothers' caregiver Burden

Background: Chronic problems have a long course of treatment and are one of the important causes of the childhood hospitalization. The aim of this study was to determine the effect of a supportive training program on the children's anxiety and their mothers' caregiver burden. Materials and Methods: This study was a randomized controlled clinical trial, performed on two groups in three stages in the autumn of 2017 on 112 individuals. The study population consisted of all children with chronic kidney problems who hospitalized in Emam Hossein Hospital (Isfahan, Iran) and their mothers. Sampling selection method was convenient. Participants were randomly assigned to experimental (n = 56) and control (n = 56) groups and the supportive training program, that was a self-regulating program, was done for the experimental group. The Face Anxiety Scale and the Zarit Caregiver Burden Scale were completed by both groups before, after and 1 month after the intervention. Statistical significance was set at 5%. Results: There was a significant difference in the mean scores of anxiety and caregiver burden in the experimental group preintervention [anxiety: (t54= 0.31, p = 0.75); caregiver burden: (t54= 1.34, p = 0.18)], postintervention [anxiety: (t54= 5.30, p < 0.001); caregiver burden: (t54= 2.72, p = 0.009)], and follow-up [anxiety: (t54= 2.39, p = 0.01); caregiver burden: (t54= 3.06, p = 0.003)], whereas there was no significant difference in the mean scores of anxiety and caregiver burden in the control group. In order to controlling for pretest scores, the repeated measure analysis of covariance was adopted. Conclusions: The results showed that the supportive training program can reduce children's anxiety and their mothers' caregiver burden and suggesting to nurses, an effective program to reduce the negative effects of hospitalization on children and their mothers

Effect of environmental and behavioral interventions on pain intensity in preterm infants for heel prick blood sampling in the neonatal intensive care unit

Background: Recent researches suggest that preterm infants understand pain and stress. Because of the wide range of effects of pain on infants, the present study was conducted on the effect of environmental and behavioral interventions on pain due to heel-prick blood sampling in preterm infants. Materials and Methods: A clinical trial was conducted among 32 infants with gestational age of 32–37 weeks in the intervention and control groups. The effects of noise reduction by earplugs, light reduction by blindfolds, reduction of nursing manipulation, and creation of intrauterine position for neonates, 30 minutes before taking blood samples until 30 minutes after it, were measured during the intervention stage. Data were collected using the Neonatal Infant Pain Scale (NIPS) in 5 stages (before intervention, 2 minutes before sampling, during the sampling, and 5 minutes and 30 minutes after the sampling). The data were analyzed using analysis of variance (ANOVA) and paired t-test in SPSS software. Results: The paired t-test results showed no significant differences between the control and intervention stages in terms of pain scores at base time (P = 0.42) and 2 minutes before sampling (P = 0.12). However, at the sampling time (P = 0.0), and 5 minutes (P = 0.001) and 30 minutes after the sampling (P = 0.001), mean pain score in the intervention stage was significantly less than that in the control stage. Conclusions: Based on the findings, environmental and behavioral interventions reduced pain and facilitated heel-prick blood sampling in preterm infants

Evaluation of the effect of individual and group tour on the anxiety scores of 4–7-year-old hospitalized children and their mothers

Background: Anxiety is a human response to any unknown situation. Hospitalization and encountering an unfamiliar environment could lead to anxiety and its complications. Therefore, the aim of the present study was to evaluate the effect of individual and group tours on anxiety in children and their mothers. Materials and Methods: This quasi-experimental study was conducted on the three groups of individual tour, group tour, and control in two stages. The study was performed on 84 children. The self-report image anxiety scale and State-Trait Anxiety Inventory (STAI) (Spielberger et al.) were used for the assessment of anxiety among children and their mothers, respectively. Data were analyzed using Statistical Package for the Social Sciences software. Results: The results showed that the mean score of children's anxiety differed significantly between the three groups after the intervention (F = 40.58, p < 0.001). In addition, the three groups were significantly different in terms of the mothers' anxiety after the intervention (F = 4.12, p < 0.02). No significant difference was observed between the group tour and individual tour groups regarding the children's anxiety score (F = 0.02, p = 0.980) and mothers' state anxiety scores (F = 0.054, p = 0.950). Conclusions: The hospital visiting tours decreased the hospitalized children's anxiety and their mother's anxiety. This might be due to their greater familiarity with the ward's nurses, hospital environment, and facilities, familiarization with the unfamiliar new places and the location of different places, and speaking to and finding a sense of empathy and sympathy with their peers

Effect of palady and cup feeding on premature neonates′ weight gain and reaching full oral feeding time interval

Background: Premature neonates′ feeding is of great importance due to its effective role in their growth. These neonates should reach an independent oral nutrition stage before being discharged from the Neonatal Intensive care Unit. Therefore, the researcher decided to conduct a study on the effect of palady and cup feeding on premature neonates′ weight gain and their reaching full oral feeding time interval. Materials and Methods: This is a clinical trial with a quantitative design conducted on 69 premature infants (gestational age between 29 and 32 weeks) who were assigned to cup (n = 34) and palady (n = 35) feeding groups through random allocation. The first feeding was administrated either by cup or palady method in each shift within seven sequential days (total of 21 cup and palady feedings). Then, the rest of feeding was administrated by gavage. Results: Mean hospitalization time (cup = 39.01 and palady = 30.4; P < 0.001) and mean time interval to reach full oral feeding (cup = 33.7 and palady = 24.1; P < 0.001) were significantly lower in palady group compared to cup group. Mean weight changes of neonates 7 weeks after the intervention compared to those in the beginning of the intervention were significantly more in palady group compared to the cup group (cup = 146.7 and palady = 198.8; P < 0.001). Conclusions: The neonates in palady group reached full oral feeding earlier than those of cup group. Subjects′ weight gain was also higher in palady group compared to the cup group. Premature neonates with over 30 weeks of gestational age and physiological stability can be fed by palady

The impact of an educational program regarding total parenteral nutrition on infection indicators in neonates admitted to the neonatal intensive care unit

Background: One of the basic care measures for preterm infants is providing nutrition through total parenteral nutrition (TPN) and one of the most important complications of it is infection. Because prevention of nosocomial infections is an important issue for neonate's safety, this study aimed to determine the effects of a continuing medical education (CME) course on TPN for neonatal intensive care unit (NICU) nurses on indicators of infection in newborns. Materials and Methods: This quasi-experimental study was conducted on 127 neonates who fulfilled the inclusion criteria. They were selected through simple convenience sampling method at two stages of before and after the CME program. The inclusion criteria were prescription of TPN by the physician and lack of clinical evidences for infection in newborns before the beginning of TPN. Death of the infant during each stage of the study was considered as the exclusion criteria. The data gathering tool was a data record sheet including clinical signs of infection in the infants and their demographic characteristics. Data were analyzed using Chi-square test, Fisher's exact test, and student's t-test in SPSS software. Results: The results showed the frequency of clinical markers for infection in newborns at the pre-intervention stage (n = 41; 65.10%) was significantly less than at the post-intervention stage (n = 30; 46.90%) (p = 0.04). Conclusions: Nursing educational programs on TPN reduce infection rates among neonates in NICUs

Validation of the Early Feeding Skills Assessment Scale for the Evaluation of Oral Feeding in Premature Infants

Background: Feeding difficulties are common and important in premature infants. In order to identify neonatal feeding difficulties, clinicians and nurses require assessment tools to conduct an objective evaluation of infant oral feeding (breast/bottle-feeding). Early identification of infants with feeding difficulty is critical to implement appropriate therapies and optimize the infant’s nutrition and oral feeding skill development. The aim of this study was to validate the Early Feeding Skills (EFS) Instrument for the Evaluation of Oral Feeding in Premature Infants. Methods: In this descriptive cross-sectional study, the researcher initially got permission from the designer of the tool through email. Then, the main version of this tool was translated into Persian using the standard backward/forward method. Subsequently, the formal and content validity of the questionnaire was confirmed. After visiting a neonatal specialist, the assessment of preterm infants' oral feeding skills was performed using the EFS Instrument by observing the infants (n=180) during feeding. The exploratory factor analysis and Cronbach’s alpha were utilized to determine the construct validity and assess the reliability of the instrument, respectively. Results: All items of the EFS Instrument had formal validity. Two items were removed from the instrument, based on content validity. On the basis of factor analysis, the items with a minimum factor load of 0.4 were evaluated and according to the factor load of all items (above 0.4), EFS Instrument had the appropriate construct validity. The Cronbach's coefficient of the instrument was obtained 0.88. Conclusion: The EFS Instrument obtained the required reliability and validity for the evaluation of preterm infants oral feeding

The effect of melody on the physiological responses of heel sticks pain in neonate

Background: During health care in the neonatal intensive care unit (NICU), infants undergo extremely painful procedures, which may cause problems, if not controlled, such as changes in the pattern of respiratory rate, heart rate, and blood oxygen saturation. The present study aimed to find the effect of melody on the physiological responses of neonates′ heel stick pain. Materials and Methods: This quasi-experimental study was conducted in Alzahra Hospital (Isfahan, Iran) for 5 months. Fifty infants were selected through convenient sampling method and were randomly assigned in equal numbers to two groups ( n = 25). In the melody group (intervention), a selected melody was played for the infants at a distance of 1 m from them, with a sound intensity of 65 dB, from 3 minutes before, during, and after the heel stick procedure, respectively, and their physiological responses were observed with a monitoring system and recorded at the afore-mentioned time periods. Physiological responses were also recorded in the control group (no intervention) 3 min before, during, and after the heel stick procedure, respectively. Results: Means of respiratory and pulse rates in the melody and control groups showed a significant difference at different time points. But the mean blood oxygen saturation in the melody group showed no significant difference at different time points, although the difference was significant in the control group. Conclusions: The results showed that melody could maintain more balance in some physiological responses of infants, such as the respiratory rate and pulse rate during the Guthrie test. Therefore, melody is recommended to be used to prevent the destructive effects of pain in infants during painful procedures

Effect of the Sound of the Holy Quran on the Physiological Responses and Pain Caused by Blood Sampling from the Heels of Hospitalized Neonates at the Neonatal Intensive Care Unit

Background: Invasive procedures could change the physiological responses of neonates. The present study aimed to evaluate the effect of the sound of the Holy Quran on the physiological responses and pain caused by heel stick blood sampling in neonates. Methods: This three-stage, two-group, clinical trial was conducted on 72 hospitalized term neonates at the neonatal intensive care unit (NICU) of Al-Zahra Hospital  in Isfahan, Iran during 2013-2014. Subjects were selected via simple random sampling and allocated to two groups of intervention and control. Data were collected using a questionnaire consisting of the demographic characteristics, physiological responses, and pain of the neonates. Data analysis was performed in SPSS version 18. Results: Post-hoc LSD test indicated that the mean respiratory and heart rates were significantly higher in the intervention group (sound of the Holy Quran) during blood sampling compared to before and three minutes after the procedure (