Effect of midazolam on reducing awareness during surgery

Background and aims: Intra operative awareness is one of the unpleasant complications of anesthesia. This complication must be decreased because of psychological and physiological consequences. This study was aimed aims to determine the effect of midazolam on reducing intra-operative awareness during general anesthesia. Methods: This double-blind clinical trial study was conducted on 154 patients candidate for elective surgery, 15-45 years old, in class I or II of American Society of Anesthesiologists )ASA), with mean surgery duration of an hour, no hearing problem, history of neurological illness, or taking effective medications in psychological and neurological terms were assigned randomly into two groups: intervention group receiving intravenous midazolam (2.5 mg/l), for general anesthesia 15 minutes prior to operation, and control group. Necessity to increase depth of anesthesia or sedative use and post operative symptom was analyzed. Data were analyzed using SPSS and K2. Results: The symptoms of intraoperative awareness including lacrimation, requiring additional analgesia, and increased depth of anesthesia as well as post operative symptoms in terms of comfortable feeling in recovery were significantly lower in the intervention group compared to the control. Conclusion: Regarding the findings of the present study midazolam used as a premedication is effective on reducing the complications resulted from awareness during general anesthesia

The effects of improvement plan on the emergency services in Kashani & Hajar Hospitals of Shahrekord

زمینه و هدف: به دلیل نقش و اهمیت بخش اورژانس، وزارت بهداشت درمان و آموزش پزشکی از مدتها پیش به دنبال ساماندهی بخش های اورژانس بوده است. طرح بهینه سازی اورژانس ها از سال 1381 در دو مرکز آموزشی درمانی کاشانی و هاجر شهرکرد به مرحله اجرا در آمد. مطالعه حاضر با هدف بررسی تأثیرات اجرای این طرح انجام شد تا ضمن مشخص نمودن نقاط قوت و ضعف اجرای طرح، جهت توسعه آن در سایر بخش های اورژانس استان برنامه ریزی لازم بعمل آید. روش بررسی: این مطالعه از نوع مطالعات مداخله ای و با روش مطالعه قبل و بعد در جامعه مورد مطالعه صورت گرفته است. با توجه به اهداف پژوهش بخش های اورژانس دو مرکز درمانی آیت اله کاشانی و هاجر شهرکرد به عنوان جامعه پژوهش انتخاب و مورد ارزیابی قرار گرفتند. بدین منظور 264 نفر در قبل و بعد از اجرای طرح بر حسب نوع بیماری در مراکز مذکور به روش غیر احتمالی آسان انتخاب و به منظور زمان سنجی ارائه خدمات از حداقل 35 تا حداکثر 60 مورد بر حسب واحد خدمت دهنده و جنبه های مورد ارزیابی در واحدهای مختلف چون آزمایشگاه رادیولوژی و سی سی یو انتخاب و مورد بررسی قرار گرفتند. اطلاعات به روش استفاده از پرونده و سوابق بیماران، روش مشاهده به منظور ارزیابی ساختار، فرآیند و عملکرد اورژانسها و با استفاده از سه نوع پرسشنامه در 6 ماهه اول سال 81 و 82 جمع آوری و با استفاده از آزمون آماری t-test مورد تجزیه و تحلیل قرار گرفت. یافته ها: با توجه به ارزیابی ساختار نیروی انسانی، اجرای طرح موجب ارتقاء وضعیت ساختار با شرح وظایف و عملکرد به میزان 98/13 و 67/16 به ترتیب در اورژانس کاشانی و هاجر گردیده همچنین وضعیت آموزش بخش های مذکور نسبت به قبل، بیمارستان کاشانی با 29/14 و بیمارستان هاجر با 72/10 و هر دو به وضعیت متوسط بهبود یافته است. میانگین فاصله زمانی بین ورود تا اولین ویزیت بیماران با ایسکمی مغزی به میزان 9 دقیقه افزایش یافت که معنی دار نبود. همچنین میانگین فاصله زمانی ورود بیماران با سکته مغزی و انجام سی تی اسکن به میزان 56 دقیقه کاهش یافته که معنی دار نیست. میانگین فاصله زمانی ورود بیماران جراحی مغز و اعصاب تا اولین ویزیت 9 دقیقه کاهش یافته است (01/0

Impact of garlic tablets on nosocomial infections in hospitalized patients in intensive care units.

BACKGROUND Nosocomial infections are one of the main causes of mortality and morbidity in hospitals, especially in intensive care units (ICUs). OBJECTIVE The aim of this study was to examine the impact of garlic tablets on nosocomial infections in hospitalized patients in intensive care units. METHODS This clinical trial was carried out on 94 patients, admitted to the intensive care units in Kashani and Al-Zahra hospitals from January 21, 2014 to December 20, 2014. Firstly, the patients were randomly selected by simple sampling, then they were assigned into case and control groups. The case group administered one 400 mg garlic tablet daily for 6 days and the control group received placebo. During the study, inflammatory blood factors and infection occurrence in the two groups were compared. The Data were analyzed by SPSS software version 22 through descriptive tests such as independent t-test, Chi-square test, ANOVA and exact Fisher test for the analyses of primary and secondary outcomes. RESULTS During the study period, 78 cases of intravenous catheter tip were sent to laboratory for culture, of which, 37 cases were in the intervention group and 41 in the control group. Culture results of Catheter tips was positive in 5 cases and all five cases were in the control group. Frequency distribution of catheter tip culture was significantly higher in the control group than that of the intervention group (p=0.03). CONCLUSION Based on the results of our study, in people with weakened immune systems and in people with high incidence of opportunistic infections, it is necessary to strengthen their body's immune system stimulants before dealing with these infectious agents, and cause decrease in the diseases insusceptible people. It was suggested that garlic supplementation has shown to be effective in patients admitted to ICU, who are highly susceptible to nosocomial infection, and it can be used for the prevention of septicemia and urinary tract infections. However, further research with larger sample size is needed. TRIAL REGISTRATION The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT207406156480N6. FUNDING Shahrekord University of Medical Sciences financially supported this research

Effects of transcutaneous electrical nerve stimulation (TENS) on labor pain

Based on the gate theory of pain, an apparatus was manufactured for transcutaneous electrical nerve stimulation (TENS) that relieves some pains. Since this method inflicts no harm to the patients and due to cultural and environmental effects on the intensity and tolerance of pain, this study was performed to determine the effectiveness of the method on alleviating of labor pain in the province of Chaharmahal & Bakhtiary. TENS was used in 50 nulliparous patients and reduction of pain intensity, duration of delivery as well as patients’ inclination for future use of TENS, were compared to those of a control group that used placebo. Our results showed that there was a marked reduction in the duration of active phase of labor and a higher tolerance of labor pain and a higher inclination for reuse of the method in the case group compared to those of the control group. 52% of the case group inclined to reuse TENS for future labor. Also there was no significant reduction of labor pain in the case group. It can be concluded that due to the effectiveness of this method, its usage is advisable

Lazer Navigating System: A New System for Finding and Removing Forigner Bodies

Finding Foreign Bodies (FB) inside different parts of the body have been difficult for all of the surgeons. Although at first it seems easy to remove these FB but during operation many problem for their removing can occurs, the most important of them is that they can not be find. Many orthopedists, general surgeons and neurosurgeons had experienced with this problem. In this study we are trying to show the efficacy of Lazer Navigating System (LNS) a new system that we have designed for finding and removing FB inside different parts of ..