Development and psychometric evaluation of data collection tools for Iranian integrated road traffic injury registry: Registrar-station data collection tool

Background: Comprehensive and accurate data are fundamentally needed for effective management of road traffic injuries (RTIs). Existing sources of RTI reports have a huge underestimation and inaccuracy at some levels. The aim of this study was to develop and validate the registrar-station data collection tool as a part of the Iranian Integrated Road Traffic Injury Registry (IRTIR). Materials and Methods: This study was conducted in Tabriz University of Medical Sciences in 2018. A data collection tool was developed to be used by the registrar for inpatient section of IRTIR by information retrieved from the literature review and road traffic experts' need assessment. The content validity of the preliminary tool was assessed. The feasibility of the tool was tested in two regional referral injury hospitals. Intra- and inter-rater reliability of the tool was evaluated using the individual/absolute intra-class correlation coefficient (ICC) and Kappa. Validity was revisited after 1 year of the pilot study. Results: The registrar-station data collection tool of IRTIR included 53 items, in five categories. Content validity was approved (modified content validity index was 0.8-1 and content validity ratio was one for all items). ICC was >0.6 for all items, and kappa index ranged between 0.69 and 0.92. The nurse data collection tool of IRTIR was applicable in the pilot phase. Conclusions: The Registrar-Station data collection tool of IRTIR was confirmed as a valid and reliable tool for inpatient traffic injuries as a part of the Iranian IRTIR

The Effectiveness of Intravenous lidocaine in Burn Pain Relief: A Randomized Double-Blind Controlled Trial

Objectives: Poor pain control in burn patients as a great public health problem disrupts the healing and rehabilitation process and results in several adverse outcomes. The aim of this study was to investigate the efficacy and safety of intravenous lidocaine in reducing the pain of burn injuries. Materials and Methods: From August 2014 to March 2015, 66 eligible burn patients participated in the study and were randomly divided into two groups of lidocaine (L) and placebo (P). In group L, lidocaine 2% was injected at a bolus dose of 1.5 mg/kg followed by infusion at the dosage of 1.5 mg/kg/h, and in group P, saline was administrated. Pain severity was measured during 24 hours at baseline and 1, 2, 4, 8, 12, 16, 20, 24 hours after intervention based on Numerical Rating Scale (NRS-11). Morphine consumption, Ramsay score, and side effects were also documented. Results: Finally the data from 60 patients were analyzed. Comparing baseline with 24 hours after intervention, NRS-11 scores decreased from 7.12±1.42 to 3.33±0.76 (P<0.001) in group P and from 6.45±1.02 to 2.50±0.72 (P<0.001) in group L. Moreover, the mean of NRS scores during 24 hours in the lidocaine group was significantly lower compared to the placebo group, 3.93±0.72 vs 4.73 ±1.14, (P=0.03). The mean amounts of morphine consumption in group L were significantly lower compared to group P, 14.41 ± 4.86 vs 21.07±6.86, (P=0.001). The mean of Ramsay score in group L was significantly lower compared to group P, 1.38±0.59 vs 1.45±0.6, (P=0.014). Conclusions: This study revealed that intravenous lidocaine was an effective and safe drug for pain reduction in burn patients

Actual Preoperative Fasting Time; A Report From Guilan Academic Hospitals: A Cross-sectional Study

Objectives: Traditional guidelines for preoperative fasting (POF) time lead to several complications in surgery patients. However, not enough attention has been paid to the issue. This aimed of this study was to investigate the management of fasting times in Guilan academic hospitals. Materials and Methods: In this descriptive cross-sectional study, individuals from five academic referral centers enrolled the survey and questionnaires including demographic characteristics, fasting hours for liquids and solids, POF recommenders, and patient’s knowledge regarding the definition of clear liquids were completed. Results: A total of 390 individuals candidate for elective surgeries enrolled in the study, the mean age of our cases were 46.61 years. The average POF time for solids and liquids was 11.43 and 9.70 hours, respectively. 95.38% of the participants did not know a correct definition of clear liquids, which was not related to their level of education (P=0.314). A positive association was observed between age and POF times for liquids and American Society of Anesthesiologists Classification for both solids (P=0.010) and liquids (P=0.0001). Conclusions: It was found that the real POF time in our hospitals was significantly longer than the modern guidelines, and needs to be corrected

Investigation of the effects of intranasal desmopressin on the bleeding of the patients during open septorhinoplasty: A randomized double-blind clinical trial

Objectives: Rhinoplasty is one of the most common cosmetic surgeries in the world. Lack of adequate local homeostasis may lead to excessive bleeding during the operation, which increases the time of operation and recovery period, and the prevalence of complications. This study investigated the effects of nasal desmopressin on the quality of the surgical field and the volume of bleeding during rhinoplasty. Materials and methods: This double-blind randomized clinical trial was performed on 120 patients aged 18–40 years who were candidates for rhinoplasty. Patients were randomly divided into three groups: low-dose desmopressin group and high-dose desmopressin group and placebo group. Hemodynamic changes and surgical field based on BOEZAART criteria, and the volume of bleeding were calculated. Results: In this study 115 women (95.8%) and 5 men (4.2%) participated. The mean age of patients was (27 ± 6.8). Bleeding volume in high dose desmopressin group was (21.7 cc ± 12.3), (27.7 cc ± 12.3) in low dose group, and (38.3 cc ± 12.3) in the placebo group, The difference in blood volume among the three groups was statistically significant with p < 0.005. Clean surgical field according to BOEZAART classification was marginally significant in both desmopressin groups. The differences in blood pressure, heart rate, blood and urine sodium, and hemoglobin before and after surgery between groups there not statistically significant. Conclusion: Based on the results of the present study topical nasal spray desmopressin can reduce surgical field bleeding during rhinoplasty. To generalize the results to other surgeries in the ENT field it is recommended to conduct studies