فهرست مطالب رسول کاویان نژاد

 Pain is frequently reported as an unpleasant feeling during diagnostic and therapeutic procedures. Using local anaesthetics is one of the common ways to reduce pain. The present study was conducted to determine and compare the effects of Transcutaneous Electrical Nerve Stimulation (TENS) with a combined anaesthetic ointment of lidocaine and prilocaine on pain level.

 This randomized clinical trial study was conducted on 240 chronic obstructive pulmonary disease patients at Imam Reza Hospital in Kermanshah, in 2020. These patients required three procedures including arterial-venous blood sampling and intravenous catheter placement. In each clinical procedure, 80 patients were divided into groups receiving electrical stimulation and anaesthetic ointment in the needle or catheter insertion area. The pain level assessment was done by the visual analogue scale and after the procedures and in 1st, 3rd, and 5th minutes. The time and attempt frequency were also recorded. Independent t-test and two-way repeated measures ANOVA were used for data analysis.

 The pain level in venous and arterial sampling and catheter placement was not statistically significant (p>0.05). The attempt frequency was not statistically significant across different procedures (p>0.05), but the time to perform the procedures was significantly higher in the stimulation group (p<0.05).

 Electrical stimulation can reduce local pain caused by the insertion of a needle or catheter, similar to anaesthetic ointment. Therefore, it is proposed that this method be further investigated in non-pharmacological pain reduction guidelines.

Ventilator-associated pneumonia is a common, serious and costly complication in patients of intensive care units. Oral hygiene is one of the important clinical measures to reduce the amount of pulmonary infection in these patients. Therefore, this study compares the effects of chlorhexidine and orthodontal mouthwashes on prevention of pulmonary infection in patients with endotracheal tracheal intubation under mechanical ventilation in intensive care units.

This double-blind clinical trial study was performed on 60 patients undergoing mechanical ventilation in two groups of intervention (n = 30) and control (n = 30) in ICU department of Imam Reza hospital in Kermanshah. In the control group, chlorhexidine (0.2%) mouthwash and in the intervention group, Ortodontol mouthwash was used three times a day. Data on the rate of early and late pneumonia were compared based on CPIS criteria applying t-test and Chi-square.

The incidence of early and delay pneumonia in the intervention group was lower than that of control, but no significant difference was observed (P >0.05). The overall frequency of pulmonary infection in the intervention group was significantly lower than the control group (P = 0.03). The frequency of pneumonia causes was lower in the intervention group, but this decrease was statistically significant in Staphylococcus aureus (P = 0.03).

According to the results of this study, orthodontol mouthwash can be effective in reducing the incidence of pulmonary infection associated with mechanical ventilation.

Ventilator-associated pneumonia is a common, serious and costly disorder in intensive care units (ICUs) that rank first in hospital infections. So, appropriate interventions are needed to prevent this condition. Eucalyptus is a plant with antibiotic properties, therefore, current study aimed at investigating its effects on prevention of endotracheal tube-associated pneumonia in ICU. A double-blind clinical trial was performed in 100 patients with endotracheal tube and on ventilator in ICU in Kermanshah Imam Reza Hospital, Iran. The patients were divided into two groups. In intervention group (n=50) 4 cc of 2% eucalyptus solution was mixed with 6 cc distilled water and in control group (n=50) 10 cc distilled water was given three times daily through a nebulizer kit connected to mechanical ventilation devices. Data on the rate of early and late pneumonia were compared based on CPIS criteria applying t-test and Chi-square. The incidence of early and late pneumonia was lower in intervention group compared to that of the controls. The decrease was significantly more in onset of late pneumonia (P=0.01). The onset of pneumonia due to mechanical ventilation was significantly higher in intervention group than that of the control group (P=0.01). Eucalyptus was found to be an effective prophylaxis that could delay the development of pulmonary infection in patients on ventilation. Therefore, it is suggested in ICUs in patients with tracheal tubes.

Natural and abnormal disasters and accidents have great influence on people's lifestyle and their health. Main object of hospitals is providing fast and timely health care to reduce mortality and complications by the disaster. The aim of this study is to evaluate preparedness crisis and disasters in centers of trauma of Kermanshah University of Medical Sciences.
The present descriptive, cross-sectional study was conducted in three hospitals (A,B,C) of Kermanshah university of medical sciences, Iran, 2016. The study data were collected using a self-administered checklist and questioner through observation and interview. The checklist included 220 yes/no questions in 10 domains of emergency (30 questions), admission (24 questions), evacuation and transfer (30 questions), traffic (15 questions), communication (16 questions), security (17 questions), education (17 questions), support (28 questions), human workforce (21 questions), and leadership and management (22 items). Scores 0 and 1 were given to “No” and “Yes” choices, respectively. Data were analyzed using SPSS and descriptive statistics.
Overall, the relative mean of disaster preparedness in the study hospitals A, B and C was 99.1%, 43.4%and 84.7%, respectively. Generally, the average readiness score for all hospitals was 75%. The most and lowest preparedness was related to the management and traffic, respectively.
According to the results, preparedness of hospitals was in the suitable level. Officials of medical centers have the necessary programs and educations in all areas of disaster preparedness for quick reaction and timely in hospitals.

Handicapped child in the family is a source of stress which can affect physical and mental health of the parents, especially mothers. Increase in resiliency increases ability to manage stressors. The aim of this study was to determine the effect of stress coping skills training on the resiliency of mothers with handicapped children.
Material and This semi experimental study with pre-test, post-test design and control group included 60 mothers with handicapped children who had been referring to the Kermanshah welfare center in 2013. They were selected by using convenient method and then divided randomly into two groups. In this study we used a coping skill training package and Connor and Davidson Resiliency Scale (CD-RISC). SPSS 20 software was used for data analysis.
The results showed that coping skills training resulted in a significant increase in resiliency level in the mothers with disabled children (P In most of the coping skills training programs, handicapped children were the center of attention and their families that take care of them had been ignored. Therefore, training programs for parents with handicapped children is at the forefront of planning policies.

Background and Hemodialysis adequacy is one of the key factors in evaluating the health services provided for hemodialysis patients. This study was performed to determine the adequacy of dialysis with low-flux membrane in Hamadan Shahid Beheshti Hospital at 2011.
In a cross sectional descriptive study, 40 patients were put on low-flux membrane (FR6). Blood samples were taken before and at the end of dialysis (30 second after decreasing the blood flow rate to 80ml/min). KT/V and URR were used to determine the hemodialysis adequacy. Data was analyzed in SPSS ver. 19.
The patients were 67.5% male and 32.5% female (mean age: 48.37±10.38 years). The mean KT/V and URR were 1.10± 0.32 and 0.61±0.14, respectively.
Periodic assessment of hemodialysis adequacy is necessary to achieve international standards.

Hemodialysis is the most common method of treatment in patients with end-stage renal diseases (ESRD). Given the importance and the role of permeability of hemodialysis membranes in removing the materials and particles, they were divided into two categories Low and High Flux.This study aimed to compare the effects of membranes in removing electrolytes and particles in ESRD patients.
In a crossover clinical trial, blood sampling from 30 patients undergoing hemodialysis was done in two sessions of hemodialysis using a Low Flux and High Flux membrane from arterial lines before and after hemodialysis in order to assess and compare the amounts of sodium, potassium, phosphorus, urea and creatinine was taken. Data were analyzed by SPSS 16 software.
The mean age of samples was 47.46±10.74 years and 70% were men and 30% were women. Urea and phosphorus uptake was significantly higher in the high flux membrane (p=0.017)(p=0.006) respectively. Other parameters did not show significant differences between the two filters (p>0.05).
According to the results of research and high flux membrane features, we propose a high flux filter regularly be used in hemodialysis in the absence of specific ban.

Hemodialysis is the most common method of treatment for end stage renal disease. The hemodialysis dialyzers are divided into low-flux and high-flux. This study aimed to compare the effects of these two dialyzers on patient’s comfort and hemodialysis complications in end-stage renal dialysis patients. In a clinical trial, convenience and complications (variations of blood pressure, nausea, vomiting, itching, headache, and fever and chills) of 30 eligible patients were assessed during hemodialysis in two groups with low- and high-flux dialyzers. Data were analyzed using ANOVA, paired t-test, and Chi-square were analyzed. The significance level was considered to be p<0.05. In this study, 70% of the patients were male and 30% were female, and the mean age of the samples was 47.4±10.7 years. The blood pressure significantly decreased in dialyzers (p<0.001), but there was no statistical difference between the dialyzers (p>0.05). The incidence and severity of hemodialysis complications did not show any statistically significant changes between the two dialyzers, (p>0.05). The patient’s comfort was higher with high-flux dialyzer, but it was not significant (p>0.05). According to the results of this study, in the case of no statistically significant differences in the incidence and severity of complications and also the importance of dialyzers in hemodialysis patients, it is recommended that high-flux filter be used in dialysis wards.

Postoperative nausea and vomiting (PONV) is the commonest consequence after surgery which can lead to multiple difficulties on different body systems. The aim of this study was to compare Dexamethasone and Metoclopramide effect in preventing PONV and pain. In a clinical trial, 60 ASA 1-2 patients who were candidate for elective inguinal surgery were randomly divided into two equal groups. One group (M) received the intravenous 10mg Metoclopramide and the other group (D) received 8mg Dexamethasone 10 min before extubation and 6 hours after the end of the surgery. The indication of PONV, the time to the first request for analgesic and the amount of analgesic in the course was recorded 24 hours after surgery. Data was analyzed using SPSS version 16. The indication of PONV had no significant difference in both groups (P>0.05). The time to the first request for analgesic in group (M) was less than group (D) (p=0.063) and the amount of used analgesic in group (D) was less than group (M) (p=0.177) but had no significant difference. Prescription frequency of analgesic was significantly lower in dexamethasone group (P=0.033). There was no statistically significant difference between two groups in the rate of PONV, but due to the analgesia effects of Dexamethasone, using this drug after surgery is recommended.

Hemodialysis is the most common treatment for end stage renal disease (ESRD). Inadequate dialysis is a risk factor for morbidity and mortality of this group، so it is necessary to determine the adequacy of dialysis. This study was performed to determine the adequacy of dialysis with High Flux membrane in hemodialysis at Shahid Beheshti hospital in Hamedan.

in this cross sectional descriptive study، 40 hemodialysis patients in Shahid Beheshti Hospital of Hamadan city participated. In second dialysis session with High Flux membrane (FR60) before and 30 seconds after decreasing blood flow rate to 80mg/min at the end of dialysis، blood samples were taken in order to assess BUN. KT/V and URR indexes used to determine hemodialysis adequacy. Data analyzed by SPSS 16 software.

in the present study 67. 5% of participants were male and 32. 5% were female. The mean of their age were 47. 56 ± 10. 79 years. The mean of kt/v was 1. 27± 0. 28 with the minimum of 0. 71 and the maximum of 2. 12. The mean of URR was 0. 65±0. 09 with the minimum of 0. 45 and the maximum of 0. 92.

According to the results of our study، we suggest the use of High Flux membrane dialysis and increase of blood flow rate doing hemodialysis to increase dialysis efficiency and to achieve international standards.

Electromagnutic field of cell Phones may affect the biological systems. This study was done to evaluate the effect of electromagnutic field of mobile phones on blood pressure, heart rate and arytmia on students of Kurdistan University of Medical Science, in West of Iran. In a randomized, double-blind clinical Trial, 56 young healthy volunteers with 20-30 years age were divided in two groups: expousure (n=27) and control (n=29). Cell phone was kept in front of the heart. Non functional cell phone was used in the control group. Systolic and diastolic blood pressure, heart rate and basic ECG were recorded. The Parameters were recorded in stage one (before set on cell phone), stage two (the first 5minutes), stage three (6minutes,with silent ringing), stage four (after 17min conection) and stage five (after 35 min conection). In all Stages, it was evaluated by cardiac monitoring (Lead2) for the presence of (sinus arryhthmia, sinus bradycardia, SA block, AV block, PAC and PVC). Systolic and diastolic blood pressure and heart rate did not show to have any significant differences between two groups in any stages. Rate of sinus arryhthmia was higher in expousure group at stages four and five, but only in stage four, this difference was shown to be significant (P<0.05). The findings of this study showed that, electromagnetic of cellular phone cause sinus arryhthmia after 17 minute connection, to prevent the side effect of cell phone, we suggest that, cell phone set distant away from heart and reduce the connection time.