THE EFFECT OF AROMATHERAPY WITH ORANGE ESSENTIAL OIL ON ANXIETY AND PAIN IN PATIENTS WITH FRACTURED LIMBS ADMITTED TO AN EMERGENCY WARD: A RANDOMIZED CLINICAL TRIAL

Aim: Pain and anxiety are unpleasant feelings associated with actual or potential tissue damage. The goal of this study is to determine the effect of aromatherapy with orange oil on the pain and anxiety of patients with limb fractures hospitalized in an emergency ward. Design: Randomized Clinical Trial. Methods: 60 patients in an emergency ward were allocated to one of two groups: an experimental and a control group, using a randomized blocking sampling method. Four drops of orange oil were poured onto a pad, which was attached to his/her collar by a plastic safety pin (posing no risk to patients), so that the distance from the patient’s head was not more than 20 cm. To prevent loss of aroma from the impregnated pad, the fragrance was replaced every hour. Pain was measured every hour for six hours, and the patients’ anxiety rate was measured before and after the intervention. All data were analysed using SPSS 21. Results: Mean age of participants was 37.93 ± 18.19 years. Most fractures were in the scapula area (11 patients – 18.3%). The results indicated a significant difference between the mean of anxiety in the intervention group (p < 0.001) compared to the control group (p = 0.339). Regarding pain, a Friedman test showed significant differences between the mean of pain in the intervention group (p < 0.001) compared to the control group (p = 0.339). Conclusion: Aromatherapy with orange essential oil reduced pain and anxiety in patients with limb fractures. Therefore, the application of aromatherapy with orange essential oil as a complementary therapy is recommended for these patients. Keywords: aromatherapy, anxiety, limb fracture, orange oil, pain, relief

Case Report of a Large Fibrosarcoma

Fibrosarcoma is a rare neoplasm associated with locally-recurring and highly metastatic malignant mesenchymal fibroblast. This type of neoplasm is more prevalent among young adults and children. Fibrosarcoma can be treated by surgery for excision of the healthy marginal tissues alone or in combination with radiotherapy. This study presents the case of a 22-year-old female patient in Arak Vali-e-Asr Hospital, Iran 2018, complaining of hemorrhage and thoracic pain between her two scapula bones. On examination, a hemorrhagic tumor necrosis was observed. Cranial nerve examination showed normal results, no tenderness was detected in cervical and lumbar vertebrae, while thoracic vertebrae were tender. The limb force was 5/5 . CT scan and MRI imaging showed a well-defined soft tissue tumor measuring 140 *126*140 mm3. It did not involve the vertebrae and spinal canals. The patient underwent surgery three days post-admission and a 2600-gram mass was excised. Pathological results indicated a fibrosarcoma (grade of 2-3) with mitosis but no necrosis

Supplemental Material - Pre-Hospital and Post-Hospital Quality of Care in Traumatic Spinal Column and Cord Injuries in Iran

Supplemental Material for Pre-Hospital and Post-Hospital Quality of Care in Traumatic Spinal Column and Cord Injuries in Iran by Arman Zeinaddini-Meymand, Vali Baigi, Mehdi Mousavi-Nasab, Sina Shool, Mohsen Sadeghi-Naini, Zahra Azadmanjir, Seyed Behnam Jazayeri, Samuel Berchi Kankam, Mohammad Dashtkoohi, Aidin Shakeri, Esmail Fakharian, Leila Kouchakinejad-Eramsadati, Habibollah Pirnejad, Homayoun Sadeghi-Bazargani, Laleh Bagheri, Yasaman Pourandish, Malihe Amiri, Ahmad Pour-Rashidi, James Harrop, and Vafa Rahimi-Movaghar in Global Spine Journal</p

Quality of in-hospital care in traumatic spinal column and cord injuries (TSC/SCI) in I.R Iran

PURPOSE: This study aimed to implement the Quality of Care (QoC) Assessment Tool from the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to map the current state of in-hospital QoC of individuals with Traumatic Spinal Column and Cord Injuries (TSCCI).METHODS: The QoC Assessment Tool, developed from a scoping review of the literature, was implemented in NSCIR-IR. We collected the required data from two primary sources. Questions regarding health system structures and care processes were completed by the registrar nurse reviewing the hospital records. Questions regarding patient outcomes were gathered through patient interviews.RESULTS: We registered 2812 patients with TSCCI over six years from eight referral hospitals in NSCIR-IR. The median length of stay in the general hospital and intensive care unit was four and five days, respectively. During hospitalization 4.2% of patients developed pressure ulcers, 83.5% of patients reported satisfactory pain control and none had symptomatic urinary tract infections. 100%, 80%, and 90% of SCI registration centers had 24/7 access to CT scans, MRI scans, and operating rooms, respectively. Only 18.8% of patients who needed surgery underwent a surgical operation in the first 24 h after admission. In-hospital mortality rate for patients with SCI was 19.3%.CONCLUSION: Our study showed that the current in-hospital care of our patients with TSCCI is acceptable in terms of pain control, structure and length of stay and poor regarding in-hospital mortality rate and timeliness. We must continue to work on lowering rates of pressure sores, as well as delays in decompression surgery and fatalities.</p