A Comparative Study on the Efficacy of Ibuprofen and Celecoxib on the Intensity of Perineal Pain Following Episiotomy: A Randomized Clinical Trial

Background: Pain is a worldwide problem that often originates from disease process, and diagnostic and treatment procedures such as surgical operations. Objectives: This trial was performed to compare the effectiveness of two analgesics for the management of perineal pain caused by episiotomy. Materials and Methods: A total of 170 nulliparous women who gave birth vaginally with episiotomy between March 2009 and November 2010 were randomly assigned to receive either ibuprofen or celecoxib which were given orally every 6 or 12 hours, respectively. Pain levels were measured before the intervention, and at 1, 2, 4, 8 and 12 hours after providing the first dose on a 10-cm visual analogue scale. Results: The results showed that the two groups had no significant differences regarding demographic characteristics, maternal, neonatal, and post-delivery factors, and mean premedication pain severity. Means of pain severity were different between the two groups as patients in the celecoxib group had lower means than the other group at 1,2,4,8 and 12 hours (4.01 +/- 1.8 vs. 4.46 +/- 1.9, 3.17 +/- 1.9 vs. 3.79 +/- 1.7, 2.89 +/- 1.3 vs. 2.96 +/- 1.5, 2.19 +/- 1.8 vs. 2.55 +/- 1.4, and 1.98 +/- 1.1 vs. 2.45 +/- 1.2, respectively) after administration of analgesics. Conclusions: Patients who received celecoxib had lower VAS in comparison with others. Although these differences were not significant, as celecoxib has longer half-life, fewer upper GI symptoms, and is better tolerated based on the previous studies, and this study is in favor of using it

STUDY OF THE STATUS OF SPIRITUAL HEALTH OF THE ELDERLY ADULTS

Aims: spirituality as one of the important dimensions of the healthy concept, and is an effective factor on human consistency with the malady. This investigation has been done in order to determine the spiritual health status and its relationship with the demographic characteristics of the elderly adults. Materials and the methods: this investigation was done in a sampling method available on 360 individual adults of 65 years old and upper in Ilam city. Questionnaire of the spiritual healthy from Islam view point was used in order to collecting of the this tool data including four items of the belief system, thought moral system, and life style which its reliability and validity has been confirmed in previous studies. Data have been analyzed by SPSS software using correlation coefficient. Results: findings showed that spiritual health of the most of participants in above investigation, and also spiritual health has had a significant relationship with age, status of the disease addiction, status of the elderly adult life with his/her family and low education. But it had no significant correlation to gender. Concluding: according to the spiritual health role in the individuals' consistency, necessity of the more attention for elderly adults' health and its promotion is necessitate for health care providers

The Effect of Oxygen Inhalation Plus Oxytocin Compared with Oxytocin Only on Postpartum Haemorrhage: A Randomized Clinical Trial

Introduction: Post Partum Haemorrhage (PPH) is the leading cause of maternal mortality across the world, mainly in the developing countries. Aim: The present study was conducted with the aim to investigate effect of oxygen inhalation plus oxytocin compared with oxytocin only on PPH. Materials and Methods: This study was a clinical trial which was performed in Shahid Mustafa Khomieni Teaching Hospital of Ilam (western Iran) from April 2012 to Nov 2013. One hundred and twenty pregnant women who were referred to delivery ward for normal vaginal delivery were selected with convenience sampling method and they were randomly assigned into two groups. For both groups management of the third stage of labour was done using 1000CC Ringer and 20 units of Oxytocin. In the intervention group, in addition to the routine administration, 8 liters of oxygen via face mask was used continuously until 2 hours after delivery. Blood loss was determined by regular weighing of the buttocks that were previously weighted. The difference was calculated before and after weighing (1 gram increasing of weight was considered to be equivalent to 1CC blood loss). Data were analysed by SPSS 16 version using Student-t and Chi-square tests. Results: The two groups were homogenous in regard to all the base line variables. The study results indicated that the mean of blood loss were (256.16+/-97) ml at two hours after delivery in the control group and (149.5+/-46.49) ml in the intervention group. There was a significant difference between PPH of the two groups (p<0.006). Conclusion: Research findings showed that the use of inspired oxygen during the third stage of labour and oxytocin infusion during 2hours later resulted in a significant decreasing in the amount of bleeding after normal vaginal delivery

Effect of acupressure (UB32) on pain intensity in intramuscular injections

BACKGROUND: Pain originating from intramuscular (IM) injection should not be underestimated, because it can damage the nurse-patient relationship. This research aimed at answering two main questions, whether acupressure is effective on pain severity due to IM injection or not and whether pain severity in two groups is different or not. MATERIALS AND METHODS: This research was performed in government-affiliated hospitals of Ilam. The patients were 15-55 years old. Subjects were individually asked to participate in the research, and an informed consent was obtained from them. Before injection, the patients were asked to lie in prone position and the acupressure point UB32 was found. It was pressed for 1 min circularly. Then, the acupressure point was pressed directly (pressure equal to 4.5 kg/cm(2)) by thumb three times sequentially. After acupressure, 3 ml penicillin 6.3.3 was injected to buttock muscle. In the control group was injected only penicillin 6.3.3 by the conventional method. Collected data were analyzed by SPSS 16 version. RESULTS: Means of pain intensity in the acupressure group according to body mass index values (BMIs) were 1.50 +/- 0.75 in thin, 1.64 +/- 0.72 in normal, 1.38 +/- 0.60 in overweight, 1.40 +/- 0.54 in obese, and 1 +/- 0.0 in severely obese subjects, with a total score of 1.53 +/- 0.68. Analysis of variance (ANOVA) showed no significant difference between mean pain intensities based on BMI. There was no significant difference in the two groups concerning BMI and age (age: 30.24 +/- 10.98 vs. 29.26 +/- 10.07; BMI: 23.74 +/- 4.45 vs. 23.88 +/- 5.74), but the difference between them in terms of pain intensity mean was statistically significant. CONCLUSION: It is concluded that acupressure in UB32 is effective on reducing the pain severity. Pain severity mean in the acupressure group was lesser than in the other group, and t-test showed a significant difference between the two groups

Female sexual dysfunction: Prevalence and risk factors

Background and Aim: Sexual dysfunction adversely affects quality of life, self esteem and interpersonal relationships and it may often be responsible for psychopathological disturbances. The purpose of this study was to explore the prevalence and associated risk factors for Female Sexual Dysfunction (FSD) in women with Kurdish culture from western Iran. Material and Methods: This was a cross-sectional descriptive survey which included 400 women aged 18-50 years old, married, from Ilam-IR, who were interviewed as per the Iranian version of Female Sexual Function Index (FSFI). The subjects were randomly selected from 4 primary health centres. Results: According to the findings, 185 (46.2) women reported FSD. Prevalence of FSD increased with age, from 22 in women aged 0.05). Conclusion: FSD needs to be recognized as a significant public health problem in Kurd women. Further research, particularly studies on awareness and competency of physicians in the management of FSD, is required

What is missed in self-immolated patients' care?: a grounded theory study

Aims and objectives To explore rehabilitation care process in patients who commit self-immolation. Background Self-immolation is not only a type of burn injury, but it is also a suicidal method. It is placed in burn injury category that requires long-term rehabilitation and treatment measures. As a suicidal method, among all forms of suicidal attempts, it is the most dramatic, violent and often difficult one to understand. Unfortunately, there are few reported studies investigating experiences and perceptions of nurses about burn care and with qualitative study about the patients' experiences and perceptions. Design On the basis of the research question, the grounded theory method was used. Methods Considering ethical codes of Belmont and Helsinki statements, purposive sampling was used to select the participants. The patients were deliberately selected, based on the research needs. They were self-immolated patients being referred to Talaghani hospital of Ilam (western Iran) or discharged previously (time of interview and observation ranged from immediately later the burn till 5 years after), in Ilam, where self-immolation rate is very high. The main methods for data collection were deep, open ended, semi-structured interviews, dairies and observations. The interviews were audio taped in Persian, and verbatim transcriptions were made. By doing so, semantic meaning is preserved, and misinterpretation of data due to translation into English is minimised. Data analysis was conducted using the Strauss and Corbin method. Results Five main categories were emerged: situation of crisis unprofessional care, prolongation and formidability of the journey, self-immolation as paralyse, and attempt for self-management. Finally, by constant, comparison of collected data and emerged categories, central variable entitled unintegrated care emerged as the main problem of self-immolated patients' care. Conclusion The study comes to the conclusion that we need to focus on specific considerations to provide integrated care for the burned patients as it is a decisive component of care that is missed. Relevance to clinical practice Although self-immolation requires long-term treatment and social, emotional rehabilitation, such a rehabilitation care process is not clear

Evaluation of Risk Management Knowledge among Nurses in Medical Training Hospital of Ilam

Introduction: Risk management is one of the most important concepts of clinical administration in health care system. It includes different interventions planned and performed to improve and provide safety of services for the clients. Aim: To evaluate the status of risk management in the three state hospitals of medical education in Ilam (western Iran). Materials and Methods: In the present descriptive analytic study, 112 registered nurses were randomly selected. The necessary data was gained through the risk management questionnaire as follows: nurses knowledge about risk management (8 items) organising how to manage risks (8 items), policies and procedures (6 items), risk management training (8 items), organisational status of risk management (6 items), monitoring, analysis, evaluation and control of risk (9 items). The questionnaire of 45 items was provided in 5-choice format in accordance to the Likert Scale. The least score was 45, while the most was 225, divided into 4 levels of weak, average descending, average ascending and good sections. The data analysis was done using SPSS V.19. Results: The results showed that 56 people (50) of the staff were male and 56 (50) were female. Totally, the average score of risk management was 115.53, while the staff's knowledge about of risk management was 22.62 +/- 5.32 (the highest score), policies and procedures on risk management was 20.48 +/- 5.7 (the lowest score). Conclusion: A total of 57.14 of the investigated cases showed an average descending score of 90-134. A finding that necessitates an educational program on risk management dimensions as an essential measure. Accordingly, determination of educational programs on risk management dimensions, application of appropriate executive procedures and approaches besides establishment of supervising programs at hospitals are suggested

Comparison between massage and music therapies to relieve the severity of labor pain

BACKGROUND: During labor, women experience a high level of intense, stressful and steady pain that may negatively affect both mothers and neonates. Painkillers have previously been used for childbearing women, but nowadays, owing to some well-known limitations and serious side effects, nonpharmacologic methods such as massage and music therapies are being broadly recommended. The present clinical trial was conducted to compare the effects of massage and music therapies on the severity of labor pain in the Ilam province of western Iran. MATERIALS & METHODS: Overall, 101 primigravidae who were hospitalized for vaginal delivery were recruited and randomly stratified into two groups of either massage (n = 51) or music (n = 50) therapies. Pain was measured using the visual analog scale and the two groups were compared in terms of pain severity before and after the interventions. RESULTS: Mothers in the massage therapy group had a lower level of pain compared with those in the music therapy group (p = 0.009). A significant difference was observed between the two groups in terms of pain severity after intervention (p = 0.01). Agonizing, or most severe, labor pain was significantly relieved after massage therapy (p = 0.001). CONCLUSION: Massage therapy was an effective method for reducing and relieving labor pain compared with music therapy and can be clinically recommended as an alternative, safe and affordable method of pain relief where using either pharmacological or nonpharmacological methods are optional

Tragedy of women's self-immolation in Iran and developing communities: a review

Committing Suicide is an awful way to die as well as a historical psycho-social problem of human community worldwide. Suicide is an action deliberately initiated and performed by a person with complete awareness of its fatal outcome, prevalence of which is very rare in developed countries, but it is reported with more frequency in Baltic region, Africa (including Egypt), The Middle East (including Iran), The Far East, particularly India and Vietnam. Its rate has ranged from10 per 100,000 people/year in Egypt, and up to 35 per 100,000 people/year in Baltic region (including Lithuania, Finland, and Russia). Categorically Iran is the 93th country of the world in terms of suicide Rate, but self immolation in the reported suicides is very high. There are many different approaches of suicides based on culture, symbols, religion, geographical regions, genders and socioeconomic factors. Self-inflicted burn or self immolation is a common suicidal method. According to the American Burn Association, self- immolation is placed in burn injury category that required long-term treatment as well as social and emotional rehabilitations. Deliberative burn injuries are classified into self- inflicted (self-immolation) or else-inflicted burn (assault burn). In this review study, we try to focus on self- inflicted burn or self- immolation as the most dramatic and violent method of suicide. The present review article was aimed to assess the epidemiology of self immolation phenomenon and its associated factors as a worldwide problem, particularly in Iran and other developing communities. The main victims of this awful way of death are women who are considered the most vulnerable group in such societies

Effect of herbaceous medicines effective in hot flashes of menopause women: A systematic review and meta-analysis in Iran

Introduction: The most common phenomenon of menopause period is hot Flashes. nowadays using herbaceous medicines in hot Flashes treatment has gained much attention. The aim of this study is to investigate the effect of herbaceous medicines in hot Flashes treatment. Methods: Current study is a systematic and Meta-analysis review. Information about the effect of herbaceous medicines on hot Flashes in menopause period collected from Google scholar, IranMedex, Magiran, MedLib, PubMed, SID, IranDoc databases. 16 articles published between 2000 and 2009 worldwide were selected. Data were analysed by STATA software (version12.2) using Meta-analysis method (random selection model). Results: of 16 articles, 15 one were evaluated the reduction of hot Flashes. In herbaceous medicines group, the average of reduction of hot Flashes was 0.85 (CI 95: 1.83-0.12) lower than the control group which was significant, statistically. The intensity of hot Flashes also significantly reduced. The severe and medium hot Flashes was 0.81(CI 95: 1.86-0.23) and 0.85 (CI 95: 1.83-0.12) lower than control group, respectively which was statistically significant. Conclusion: Herbaceous Medicines contain phytoestrogens, have a positive effect on reducing the frequency and severity of hot Flashes and They are the best choise for the treatment of hot Flashes in menopausal women and in hormone replacement therapy