سمانه غضنفر طهران

Assessing maternal satisfaction with spinal anesthesia is important for determining changes that is needed to improve the overall quality of patient care delivery. In this study, the aim of this study was to investigate the main complaints of mothers after cesarean surgery with spinal anesthesia.

This cross-sectional analytical study was performed on pregnant women undergoing caesarean section with spinal anesthesia in 2022 in Alzahra Hospital, Rasht. First, the purpose and method of the research was explained to the patients and informed consent was obtained. Then a questionnaire containing demographic data and patients complaints of spinal anesthesia was filled out.

The results of this study showed that 92 (38.5%) of the total 239 pregnant women mentioned complaints after the anesthesia procedure, while most of them 147 (61.5%) had no complaints. Nausea-vomiting (37.7%), shivering (23.9%) and repeated needling (16.7%) were the most common complaints mentioned by mothers. Based on the results of this study, there was no statistically significant relationship between complaints of spinal anesthesia and the variables of age, education, employment status, place of residency, number of pregnancies, BMI, time of termination of the pregnancy and history of spinal anesthesia (All P < 0.05).

Pregnant women who underwent cesarean section with spinal anesthesia in this center, reported limited and preventable complaints from this procedure. The mentioned complications did not lead to lasting and serious injury in mothers and were often controlled with routine therapeutic interventions without adverse consequences.

The COVID-19 pandemic caused changes in daily life and disrupted hospital performance and the provision of medical services, especially in the organ transplant departments.

This study aims to compare the frequency of organ donation and transplantation before and after the COVID-19 outbreak in the transplant centers of northern Iran.

This cross-sectional study was conducted on 75 donors with brain death from 2018 to 2021 in Rasht. Demographic data, underlying diseases, history of smoking and drug use, causes of brain death, type of donated organ, number of donated organs per patient, type of transplanted organ, and the location of transplantation (in or out of the province) were recorded. Then, these factors were compared between two time periods: Before the pandemic (from July 2018 to February 2020) and during the pandemic (from February 2020 to August 2021). The recorded data was analyzed in SPSS software, version 21. The significance level was set at 0.05.

The mean age of donors during the pandemic was significantly higher than that of patients before the pandemic (P<0.001). The most common cause of brain death in donors before the pandemic was trauma; after the pandemic, cerebrovascular causes were more common (P=0.01). The frequency of organ donation and the mean number of donated organs per donor during the pandemic were significantly lower than before the pandemic (P<0.001).

The COVID-19 pandemic has significant impact on the process of organ donation and transplantation in northern Iran.

Today, with the spread of the tendency to non-invasive methods, laparoscopic surgery has been used progressively and with acceptable results. The aim of this study was to investigate the effects of carbon dioxide insufflation on hemodynamic parameters in laparoscopic gynecological surgery.

This cross-sectional analytical study was performed on patients undergoing laparoscopic surgery in Al-Zahra Hospital during 2021. Hemodynamic parameters were recorded before the gas insufflation, after 5, 15, and 30 minutes and immediately and 15 minutes after the gas exsufflation, the data were entered into SPSS software version 19.

The trend of changes in hemodynamic parameters including mean SBP, DBP and HR from T0 to T5, was statistically significant which was ascending following gas insufflation and the highest mean SBP, DBP and HR were observed within 15 minutes after gas insufflation (P &lt; 0.0001). In addition, following the gas insufflation the trend of changes in ET-CO2 values and SaO2 was statistically significant (P &lt; 0.0001), No adverse events were reported in any of the patients.

According to the standard protocols of anesthesia and surgery in this center, laparoscopic surgery was associated with some degree of hemodynamic fluctuation including increased systolic blood pressure, diastolic blood pressure, heart rate and end-expiratory carbon dioxide which was well tolerated by our study population who were in good medical condition.

 Various drugs are used as adjuvants to improve the quality of supraclavicular block method. 

 This study aims to investigate the effect of adding dexmedetomidine to lidocaine in the supraclavicular block method in patients candidate for upper extremity surgery.

 This double-blind randomized controlled clinical trial was conducted on 61 patients candidate for upper extremity fracture surgery receiving the supraclavicular block method from 2017 to 2018. They were randomly divided into two groups of lidocaine-normal saline (30 mL of 1.5% lidocaine plus normal saline) and lidocaine-dexmedetomidine (30 mL of 1.5% lidocaine plus 1 μg/kg of dexmedetomidine). The supraclavicular block characteristics and intraoperative hemodynamic changes were measured.

 There was no statistically significant difference between the two groups regarding the demographic factors. The mean age of patients was 43.09±10.92 years, and most of them were male. The mean onset time of sensory-motor blockade was faster and the duration of sensory-motor blockade and analgesia were longer in the lidocaine-dexmedetomidine group than in the other group. These differences were statistically significant. There was significant differences in hemodynamic parameters among nine assessment times in each group and between the two groups.

 Adding dexmedetomidine to lidocaine in the supraclavicular block method accelerates the blockade onset and increases the duration of blockade and analgesia after surgery without causing any considerable side effects.

Electroconvulsive therapy (ECT) is a safe and practical treatment method for patients with severe, refractory or emergency psychiatric disorders. However, it is often associated with hemodynamic fluctuations. 

The purpose of this study was to investigate the pattern of hemodynamic changes in patients undergoing ECT.

This longitudinal study was conducted at Shafa hospital, a referral and academic center in Rasht, Iran, during 2020. Hemodynamic parameters including heart rate (HR) systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded before induction of anesthesia (T0), one minute after induction of anesthesia (T1), one minute after seizure (T2), and 15 minutes after wakefulness (T3). The trend of changes of these parameters was determined during the mentioned time intervals.

Finally, the data from total 126 patients were analyzed. Most of the cases were diagnosed with psychotic disorder of Schizophrenia (59.5%) and the least of them had Major depression (14.3%) and 15.9% of them suffered from comorbidities. In terms of SBP, DBP and MAP, the trend of changes was significant (P=0.0001) at four measurement point times, but not about HR (P= 0.74). However, all the changes in hemodynamic parameters were kept in the normal range.

Our study showed that despite the fluctuations in hemodynamic parameters during ECT, patient management was acceptable as a result of teamwork and apropriate interaction of psychiatric and anesthesia teams.

Obtaining informed consent (IC) is essential for any diagnostic or therapeutic procedure. IC is an important legal communication process between the patient and physician.

This study was performed to evaluate the quality of IC process in patients undergoing spinal anesthesia (SA) in gynecological surgeries.

During 2021 this cross-sectional study was performed in Alzahra Hospital.
Eligible patients over 18 years old, who were candidates for elective gynecological surgeries under SA, enrolled the survey. A questionnaire containing demographic data and 20 specific questions divided in to 4 areas; providing information, Comprehensibility of the consent form, Voluntary of informed consent, Communication with the doctor, was filled out via a direct interview.

Finally the data from 259 eligible patients were analyzed. In terms of providing information to the patient, comprehensibility of the consent form, and the voluntary of obtaining consent were in poor conditions .But, in terms of communication with the physician, 46.3% of the patients were in a good state and 20.1% excellent. It was also found that there was significant relationship between the level of education and the quality of obtaining IC (P= 0.034).

It was concluded that the IC process was not acceptable in this academic center, and effort should be made to improve the current conditions.

 Considering the high prevalence of Coronavirus Disease 2019 (COVID-19) and the medical resource constraints, a better understanding of the characteristics of the disease and identifying the factors indicating the severity of the disease‎ can help decide on the allocation of important and limited resources. The current study aimed to investigate the demographic, clinical, laboratory characteristics, and imaging features of critically-ill patients with COVID-19 who were admitted to the Intensive Care Unit )ICU) of 3 hospitals in Rash City, Iran.

 This retrospective study was performed on 138 patients with COVID-19 who were admitted to the ICU. The study patients’ data, including demographic characteristics, underlying disease, laboratory, imaging findings, and disease outcome were extracted from their records.

 This retrospective study was performed on 138 patients with COVID-19 who were admitted to ICU. Patient data, including demographic characteristics, underlying disease, laboratory and imaging findings, and disease outcomes, were extracted from patient records.

 In this study, the majority of patients were male and in the age range of 55-69 years.  Diabetes mellitus, hypertension, and chronic heart disease were the most common underlying diseases; shortness of breath, fever, and cough were the most common symptoms. Ground glass opacities were the most common sign in lung Computer Tomography (CT) scan and an increase in the level of LDH, ESR, CRP, neutrophil percentage, and lymphopenia were the most common laboratory findings in the study subjects. The mortality rate was equal to 90.58%. 

 This study revealed that most patients with severe manifestations of the disease were older, had a history of underlying disease, symptoms of shortness of breath, cough, and fever, and extensive lung involvement in imaging and changes in laboratory results. Mortality remained high despite medical therapy and mechanical ventilation.