Effects of Patient Educational Programs on the Headache Caused by Spinal Anesthesia

Background: Headache is the most common complication caused by spinal anesthesia. Systematic educational programs about conservative treatments could be effective in the reduction of headache after spinal anesthesiz. Aim: This study aimed to evaluate the effects of training programs on the headache of patients after spinal anesthesia. Method: This empirical study was conducted on 120 patients within the age range of 16-40 years who were candidates for general, orthopedic and urology surgeries in Dr. Shahidzadeh Hospital of Behbahan, Iran in 2015. Patients were randomly divided into two groups of intervention and control. Scheduled training was provided for the intervention group, and the control group received routine training. Intensity of headache was recorded using the visual analogue scale (VAS). Data analysis was performed in SPSS V.14 using Chi-square and independent T-test. Results: In this study, Chi-square test showed a statistically significant difference between the groups in terms of incidence and time of occurrence of headaches. In total, eight patients (25.8%) in the intervention group and 23 patients (74.2%) in the control group had headaches (P=0.001). In the first 48 hours after anesthesia, all patients in the intervention group and 11 patients (47.8%) in the control group had headaches (P=0.03). Moreover, independent T-test revealed a significant difference between the mean of pain intensity in patients of the intervention (5.0±1.8) and control groups (7.1±2.1) (P=0.01). Implications for Practice: According to the results of this study, systematic education of patients could effectively reduce the occurrence and intensity of headaches after spinal anesthesia. Therefore, it is recommended that patient training be included in the preoperative preparation program in order to prevent headaches after surgery

Investigating the effect of implementing a sensory stimulation program by family members on delirium status of brain injury patients hospitalized in the intensive care unit: A randomized clinical trial

BACKGROUND: Delirium is the most common psychological disorder in brain injury patients hospitalized in the intensive care unit (ICU), one of the leading causes of which can be sensory deprivation or sensory overload. This study aimed to determine the effect of implementing a sensory stimulation program by family members on the delirium status of ICU-hospitalized brain injury patients. MATERIALS AND METHODS: In this randomized controlled clinical trial, 66 brain injury patients hospitalized in the ICUs were assigned to intervention and control groups using stratified random sampling. For the intervention group, a sensory stimulation program was implemented by family members for 1 h a day during the ICU stay. The control group received routine care. Patients' delirium status was assessed daily using the confusion assessment method for the intensive care unit (CAM-ICU). Data were analyzed by the SPSS software version 22, using Chi-square, independent t-test, and Binary logistic regression model tests, at a significance level of 0.05. RESULTS: Odds of delirium Incidence in the intervention group was 94% lower than in the control group (OR = 0.057, 95% CI 0.017, 0.19, P = 0.001). There is a significant difference between the two groups in terms of length of delirium (P = 0.001), stay in ICU (P = 0.001) and mechanical ventilation (P = 0.001). The mean of all three variables in the intervention group was lower than the control group. CONCLUSIONS: Implementing of sensory stimulation program by the family members, as a non-pharmacological method, can reduce the incidence of delirium in brain injury patients admitted to ICU

The evaluation of effect of ivermectin in addition to standard COVID-19 treatment in intubated patients

Introduction: Since the introduction of the Corona pandemic, the use of appropriate antivirals with minimal side effects has been the most important research topic. Laboratory evidence has shown that ivermectin, which has long been available as an anti-parasitic drug market, has anti-COVID19 properties. Therefore, in this study, we investigated the outcomes of this agent administration in patients undergoing mechanical ventilation. Material and method: Intubated patients with Covid 19 who were eligible for the study were randomly divided into two groups: 1) ivermectin recipient (n = 31) and 2) placebo group (n = 29). This study was performed in Center Corona hospitals in Ahvaz from March 2020 to September 2021. Mortality event was Primary outcome; vital signs and pulmonary Compliance were as secondary outcomes of the study. Results: The results of the study did not show a significant difference between the two groups in demographic data including: age, sex, and time of intubation after the onset of symptoms, plasma levels of LDH, ESR, CRP, D-Dimer and IL-6. Survival analysis did not show a significant difference between the mortality event in the two groups.&nbsp

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes