Physicians' and Nurses' Opinions about the Impact of a Computerized Provider Order Entry System on Their Workflow

INTRODUCTION: In clinical practices, the use of information technology, especially computerized provider order entry (CPOE) systems, has been found to be an effective strategy to improve patient care. This study aimed to compare physicians' and nurses' views about the impact of CPOE on their workflow. METHODS: This case study was conducted in 2012. The potential participants included all physicians (n = 28) and nurses (n = 145) who worked in a teaching hospital. Data were collected using a five-point Likert-scale questionnaire and were analyzed using SPSS version 18.0. RESULTS: The results showed a significant difference between physicians' and nurses' views about the impact of the system on interorganizational workflow (p = .001) and working relationships between physicians and nurses (p = .017). CONCLUSION: Interorganizational workflow and working relationships between care providers are important issues that require more attention. Before a CPOE system is designed, it is necessary to identify workflow patterns and hidden structures to avoid compromising quality of care and patient safety

Age-associated changes on axonal regeneration and functional outcome after spinal cord injury in rats

This study was conducted to evaluate the association between aging and regenerative potential of spinal cord injury. Three groups of male Sprague�Dawley rats, including young (40 days), mature (5-6 months) and old (28-29 months) were spinally hemisected at the L1 level. The locomotor performance was assessed weekly for eight weeks after lesion using locomotors� rating scale developed by Basso, Bresnahan and Beattie (BBB). In the tracing study, retrograde labeled neuron was counted in the lateral vestibular nucleus for axonal regeneration. From 4-8 weeks, the functional recovery of the young and mature age rats was significantly increased in comparison to the old age group. At 8 weeks, young and mature animals achieved a plateau score of (mean ± SD), 17 ± 1.47 and 16.8 ± 0.70 respectively, and the old rats reached an average score of 13.8±1.63 (P<0.05). The mean number of labeled neurons in the vestibular nucleus in the young group (mean ± SD): 32.05 ± 1.03 increase significantly compared to the older age group 5.01 ± 1.31 (P<0.05). Current findings suggest that axonal repair and functional improvement decrease in aged animals after partial spinal cord injury. Thus, the aging process may affect the regenerative capacity of the injured central nervous system, and axonal regeneration is age dependent. © 2015 Tehran University of Medical Sciences. All rights reserved

Effects of Ginger (Zingiberaceae) on Diabetes Mellitus Induced Changes in the Small Intestine of Rat

Introduction & Objective: Diabetes mellitus is the most common endocrine disorder and causes gastrointestinal complications .The aim of this study was to investigate the effects of ginger on the small intestine of diabetic rats. Materials & Methods: This experimental study was done in the anatomy department of Uremia Medical University in 1385. 24 adult male rats, weighing 250±20 gr were randomly selected and divided into 3 following groups: control, diabetic (induced by 60mg/kg STZ) and treatment groups. The treatment group was given ginger powder (5% of their consumed food weight during day/night period). After 8 weeks, all rats were anaesthetized and their small intestines were removed and measured for their weight and length. For histological assessment, samples from each part of duodenum, jejunum and ileum was fixed in 10% formalin and slides with hematoxilin & eosin staining were prepared. Villi length, crypt depth and muscular layer thickness were assessed by graticule eye piece of light microscope. Statistical analysis, one- way analysis of variance and Tukey’s SPSS software was used for data analysis. Results: The results showed that mean of intestinal length and weight, villi length and muscular layer thickness in all three parts and crypts depth in duodenum and jejunum in diabetic group increased significantly in comparison with control and treatment groups, but there was no significant difference between control and treatment groups. Conclusion: The results of this study demonstrate that ginger as an antioxidant, through decreasing oxidative stress, can prevent pathologic alterations induced by diabetes in small intestine

Effect of hydro-alcoholic extract of Carum copticum on withdrawal syndrome in adult rats addicted to morphine

Background & Aim: Long-term useofopioidcreates toleranceandphysical and psychologicaldependence. Discontinuation of the drug, creating ashortageofendogenousopioidsandwithdrawal syndromeemerges.Addictiontreatmentin traditional medicine isusing ofherbssuch asCarumcopticumthathas manytherapeutic effects. The purpose of thisstudy was to evaluatethe effects of hydro-alcoholic extractof Carumcopticum onwithdrawalsyndromein adult ratsaddictedto morphine. Material & Method: In this study70male Wistarratsdividedinto seven groups of 10, six groups were addicted by morphinesulfateinjection (the first 5days10 mg/kg, the second 5days15 mg/kg andon the dayfrom11 to21, 20mg/kg) subcutaneouslyfor 21 days.Groups three, four and five were fed respectively 10%, 20% Carumcopticum extract and methadone (mg/kg 5) after addiction of animals until the end of period. Groups sixandseven were given respectively10%and 20% of Carumcopticumextractfrom the beginning to the end of treatment period orally.Group one(control) andGrouptwo (morphine) were fed daily 0.5 mL of saline orally to the end of the treatment period (day 21to 35).Datacollected from body weight, jumping, itchingand diarrhea ofanimals wereanalyzedby SPSS software, using Unpaired T test, ANOVA and LSD as post-hoc statistical tests. Finding: Comparing the mean of weight loose ofthe animals in different treatmentgroupson day21with 35showed statistical significant reduction in the group that received extract of Carumcopticum 10%. On the day 21,itchingand jumping, in the group that received extract of Carumcopticum 10%,and the diarrhea, in the group that receivedthe extract ofCarumcopticum20%compared withthe control groupshoweda significant decrease(P<0.05).On day35,Jumping and diarrheain thegroupsreceived theextract ofCarumcopticum10 and 20percent comparedwith the control groupshoweda significant decrease(P<0.05). Conclusion: According to the results, hydro-alcoholic extract of carumcopticum inconcentration of 10and 20percent are effectivein reducingwithdrawal syndromeofmorphine as like as methadone.Perhapsitcan be usedas an alternative tomethadoneinaddictiontoreducepainfulwithdrawalsyndromeand freed from the side effects ofmethadone.This suggestionneeds a widerinvestigation

The Effect of Various Types of Surgical Repair of Sciatic Nerve Transection on Number of Dorsal Root Ganglion Neurons

Background: Considering the need for appropriate maintenance of function and survival of neurons after nerve injury, and inadequacy of information about the number of sensory neurons in dorsal root ganglion after nerve trauma, this study was carried out on mice ganglia after their sciatic nerve cut. Materials and Methods: In this experimental study 12 adult, 200-250 gram weight, Wistar rats were randomly assigned into four groups of axotomy, epineurial suture repair, nerve guidance channel repair, and sham. Left sciatic nerve was transected in mid-thigh level and then in axotomy group, it left without repair in epineurial suture group it was repaired end to end and in nerve guidance channel repair it was repaird by PVDF (Polyvinilidine Flouride) tube containing collagen gel. The right side sciatic nerve spared intact. After 12 weeks, the 5th left and right dorsal root ganglia were excised and flouroscent Hoescht staining of prepared frozen sections performed and their neurons counted. Data were analysed with one way Anova, and Tuki tests. Results: The average number of neurons in axotomy group was 144.2±11.2 (P ≤0. 001), in epineurial repair group 189.8±15.5 (P<0.04), and in nerve guidance channel group 163.9±5.6 (p<0.001). Conclusion: Primary surgical nerve repair decreased sensory neuronal loss after nerve transection, but could not prevent it completely. Further studies on the causes of sensory neuron death after nerve injury and repair is recommended at molecular level

Hepatoprotective effects of Bupleurum exalatum extracts against carbon tetrachloride induced liver injury in rats

Background & aim: Some of natural and synthetic products have antioxidant properties which protect the liver against the destructive factors. This study aimed to investigate the effect of Bupleurum exelatum (B. exalatum) extracts on rat liver. Material and method: This experimental study was conducted at Yasouj University of Medical Sciences in 2013 on 50 healthy adult male Wistar rats. Animals were randomly divided into five equal groups: the normal group (receiving, olive oil), control and experiment groups receiving different dose of carbon tetrachloride and olive oil. The experiment group was given daily doses of 75, 150 and 300 mg per Kg of B. exalatum extract by gavage respectively. After two months, the liver enzymes, total protein, albumin and bilirubin in animal’s sera were measured. Data were analyzed by the SPSS software, using ANOVA and tuky-test. Result: The toxicant significantly (P < 0.05) increased the levels of ALT, AST, ALP, TB, DB, and decrease the level of TP and ALB. Oral administration of B. exalatum extracts showed a significant (P < 0.05) decrease in all the elevated serum and significant increase (P < 0.05) in TP and ALB levels at all usage doses. These results indicate the maximum recovery was observed in 300 mg/kg/day. The histopathological changes i.e. fatty changes, necrosis etc were partly or fully prevented in animals treated with the extracts. Conclusion: These findings suggest that the extract of B. exalatum possessed hepatoprotective activity, which could be linked to their phytochemical constituents and antioxidant activity this therefore requires further in-depth studies

Protective effects of arginine on fetal brain under maternal immobilization stress

Background & aim: Arginine by regulating the biological activity of the brain plays an important role in reducing stress. Today's, stress is one of the century disease that created many problem.  This study conducted to determine the protective effect of arginine on nitric oxide levels in maternal fetal brain tissue under stress. Methods: Twenty pregnant Wistar rats (200-250 gr) were randomly divided into four groups. With and without stress groups received arginine (200 mg/kg) intraperitoneal from 5 – 20 days of pregnancies. Control with and sham without stress received 2 ml of normal saline. The pregnant rats were anesthetized by ketamine (100 mg/kg) on the day 20 then the fetuses removed and weighed. Twenty five brain of fetal brain rat from each group were chosen for measuring of forebrain thickness and brain volume. Another 25 brain were chosen for measuring of nitric oxide. Data were analyzed by one way ANOVA. Results: Nitric oxide Levels reduced in stress rats treated with arginine compared to control group (P<0.05). The mean thickness of forebrain and hippicampal formation decreased in stress rats versus unstressed, but was not significant. The mean weight decreased significantly in stress group compared to the unstressed group (P<0.05). Conclusions: Arginine could protect the brain tissue and fetal weight by reducing the level of oxidative stress in the pregnant rats