Pharmacutical effects of ephedrine, atropine and mucosal phenilephrin on hemodynamic alterations of women during spinal anesthesia in cesarean section

Background and Objective: Hemodynamic alteration and hypotension due to spinal anesthesia can reduce tissue perfusion and increase ischemic risk, myocardial infraction, renal failures spinal damages and even deep veins thrombosis. This study was designed to compare pharmaceutical effects of ephedrine, atropine and mucosal phenilephrin on hemodynamic alteration of women during spinal anesthesia in cesarean section. Materials and Methods: This randomized clinical and double blind study was done on 90 singleton pregnant women with ASA I and II class .the subjects gone elective cesarean section and allocated into three groups. subjects were received 500 ml ringer lactate before spinal anesthesia. Subjects in group I, II and III first received 0.1 mg/kg atropine (IV) 0.01mg/kg ephedrine and 100µgr phenilephrin (mucosal) prior spinal anesthesia, respectively. Hemodaynamic indexes including blood pressure, heart Rate, oxygen saturation and drug side effects were determined every 5 minutes interval through the surgery. Data was analyzed by using SPSS-11.5, Chi-Square and ANOVA tests. Results: Hemodaynamic indexes were changed during study, but three medicine showed similar effect on heart Rate, blood pressure and changes of oxygen saturation (P<0.05). There was a significant differences among three groups for dosage of extra ephedrine to control of blood pressure (P<0.05). This increase dosage of extra ephedrine was 56.7%,20% and in ephedrine, phenilephrin and atropine groups,respectively. Nosia rate was 6.7%, 50% and 46.7% in phenilephrin, atropine and ephedrine groups, respectively (P<0.05). Conclusion: This study showed that to prevent of blood pressure drop following spinal anestasia atropine, phenilephrin and ephedrine can be prescribed, but ephedrine is recommended for lowering the rate of nosi

National guidelines for cognitive assessment and rehabilitation of Iranian traumatic brain injury patients

Background: Individuals with moderate to severe traumatic brain injury (TBI) often have prolonged cognitive impairments, resulting in long-term problems with their real-life activities. Given the urgent need for evidence-based recommendations for neuropsychological management of Iranian TBI patients, the current work aimed to adapt eligible international guidelines for cognitive assessment and rehabilitation of the TBI patients in Iran. Methods: The project was led by an executive committee, under the supervision of the Iranian Ministry of Health and Medical Education (MOHME). Following a systematic literature search and selection process, four guidelines were included for adaptation. Clinical recommendations of the source guidelines were tabulated as possible clinical scenarios for 90 PICO clinical questions covering all relevant phases of care. After summing up the scenarios, our initial list of recommendations was drafted according to the Iranian patients� conditions. The final decision-making, with the contribution of a national interdisciplinary panel of 37 experts from across the country, was conducted in two rounds using online and offline survey forms (Round 1), and face-to-face and telephone meetings (Round 2). Results: A total of 63 recommendations in six sections were included in the final list of recommendations, among which 24 were considered as key recommendations. In addition, some of the recommendations were identified as fundamental, meaning that proper implementation of the other recommendations is largely dependent on their implementation. Conclusion: Iranian health policy makers and rehabilitation program managers are recommended to address some fundamental issues to provide the necessary infrastructure to set up an efficient cognitive rehabilitation service system. © 2020 Academy of Medical Sciences of I.R. Iran. All rights reserved

Do wool carpets ‘clean’ the air or not? A study on the sorption effects of wool carpets by sensory evaluation

Indoor air quality (IAQ) is an important aspect of maintaining human health and well-being, particularly since people spend most of their time indoors. Carpets, with their large surface area and dense fibre piles, have the potential to significantly impact IAQ by emitting and absorbing volatile organic compounds (VOC) from building materials and human activities. The cleaning effect of wool carpets regarding the sorption of odours from two sources of pollution: hardboard and sweaty underwear (as a proxy for bio-effluents), was investigated with an untrained panel of subjects assessing the odour intensity and the acceptability. Tests were performed in three different test environments, including a sniffing table, CLIMPAQs, and full-scale test chambers. The outcome showed that wool carpets can potentially clean the air of odours in small-scale environments, where the wool carpet covers the floor and walls of the test environment, and the odour sources are in contact with the wool carpet. However, the results were less conclusive in on scale scenarios where wool carpets only covered the floor. Overall, wool carpets have the potential to ad(b)sorb odorous emissions, but only when these emissions are near the wool carpet, and thus can have the opportunity to be ad(b)sorbed.ChemE/Catalysis EngineeringEnvironmental & Climate DesignUrban Data Scienc

Healthcare Utilization Among Patients Hospitalized With Gastrointestinal Diseases in the United States

Background and Aims: Gastrointestinal (GI) disorders represent a significant burden on United States healthcare, but research assessing the relative contribution of individual GI disorders is lacking. We aimed to determine the relative impact of various GI conditions, as compared to non-GI conditions, on US hospital-related healthcare utilization. Methods: Hospitalization data from 2016 to 2018 were obtained from the Nationwide Readmissions Database. Outcomes included length of stay, hospital charges, 30-day readmissions, and death. Multivariable regression models evaluated each outcome, while adjusting for patient and hospital characteristics. Patients hospitalized for each GI indication were compared to individuals hospitalized for non-GI conditions. Results: 5,344,145 patients with GI and 68,901,595 patients with non-GI indications for hospitalization were included in our study. All GI indications were associated with increased odds for 30-day readmission compared to non-GI indications, with the highest being gastroparesis (adjusted odds ratio, 2.15; 95% confidence interval [CI], 2.09–2.22). Upper GI cancer had the highest relative increase in length of stay (2.31 days, 95% CI 2.20–2.42) and total charges ($23,441, 95$21,296–25,587). Upper GI cancer, pancreatic cancer, and gallbladder/biliary cancer were associated with the highest odds of death. Conclusion: GI malignancies contributed significantly to utilization and death, possibly from advanced stage at hospitalization and systemic effects of malignancy. The high GI-specific readmission rates highlight the chronicity of GI conditions and the importance of optimizing digestive health to prevent recurrent admission