سمیرا فتاحی

Postoperative ileus is one of the common problems of abdominal surgeries such as Cesarean section, which significantly slows down wound healing, reduces patient satisfaction and increases treatment costs. It seems that the Paula exercise method and chewing gum is likely to reduce the risk of ileus. The purpose of this study was to investigate and compare the effects of Paula exercise method and chewing gum on ileus after Cesarean section.

This random clinical trial included 90 women who were candidates for Cesarean section. Participants were divided into three groups of 30; including chewing gum, Paula technique and control groups. The first intervention group, chewed gum after the operation for 15 minutes, three times a day (45 minutes in total). The second intervention group received Paula exercise method for 5 minutes every two hours, six times a day. The control group received only routine care. Data on the evaluation indicators of the patients, including the first time of passing gas, the first stool excretion, and the time of the first postoperative patient movement and duration of hospitalization were assessed in the three groups.

The average time of the first passing gas (P <0.001), the first stool excretion (P <0.05) and duration of hospitalization (P <0.05) in the Paula and chewing gum group were less than those of the control group. However, there was no significant statistical difference in terms of the movement of the patients among the groups.

Paula and chewing gum appears to be effective in improving bowel function and duration of hospitalization after Cesarean section.

Evaluation is a way for investigating the pitfalls and problems of any system. So, based on evaluation results managers can improve the procedural affairs and efficiency of their organizations. This study aimed to evaluate Operating Room Department which is in line with the steps towards the implementation of the accreditation. This descriptive study was conducted using the accreditation pattern (internal evaluation). The study population included internal assessment committee, faculty members, head of the department, students, and graduates. Sampling method was convenience. Data were collected using a standard questionnaire and interview and were then analyzed using SPSS v.21 software. Evaluation of eight factors revealed that student factor had the best status with 4.33 points and graduates factor had the lowest status with 3.07 points. Overall, the results showed that the total score of operation room department was 3.85 which falls in the "good" category based on the Gorman scale. The internal evaluation of operating room department proved its acceptable status; however, it is essential to make the required changes and implement remedial measures based on the findings in order to improving the quality, particularly for the graduates.

: Nurses are the largest group among the health professionals and both legally and ethically they must be responsible for the quality of the cares provided. And, one of the major aspects of the quality of care is the standard. This study aims at investigating the barriers in implementing the nursing standards in caring for the patients after an abdominal surgery is done.
This is a descriptive cross-sectional study. The target population of the study, that were selected through the simple sampling method, are all the nurses working at the abdominal surgery wards of training-clinical hospitals of Kermanshah. To gather the required data, a self-made questionnaire on individual, administrative, and environmental barriers to fulfilling standards in caring for the patients after abdominal surgery. Its validity through content validity and its reliability via test-retest method and the alpha 0.80 were confirmed. SPSS software version 16 was used for the analysis of data.
The findings from 30 participants, whom 43% of which were female, showed that the greatest barriers to the implementation of standards were: 46.7% for the lack of motivation (as an individual barrier), 73% for the lack of standardized evaluation (as an administrative barrier), and 76.7% for routine-orientedness (as an environmental barrier)
The findings from 30 participants, whom 43% of which were female, showed that the greatest barriers to the implementation of standards were: 46.7% for the lack of motivation (as an individual barrier), 73% for the lack of standardized evaluation (as an administrative barrier), and 76.7% for routine-orientedness (as an environmental barrier)

Acute biliary pancreatitis is a common disease for the treatment of which antibiotics and antifungal drugs are used simultaneously. Therefore, this study was performed to examine the effects of (mortality and morbidity rates) fluconazole therapy as an antifungal drug in these patients.
This study was a random clinical trial. Participants were the hospitalized patients who were suffering from acute pancreatitis gallstones and referred to Imam Reza Kermanshah hospital. Participants were randomly assigned to two groups. In one group a conventional treatment (antibiotics) was received and in the other group conventional treatment regimens with fluconazole (200 mg orally on the first day and then 100 mg daily) was added.
87.2 % of the sample were female and 12.8 % were male. The average age of the group receiving fluconazole was 25/16 ± 97/53 and the average age in the control group was 43/16 ± 13/54. The mean duration of hospitalization in patients receiving fluconazole was 10.6 days and 13.6 days for the control group. In the group receiving fluconazole 6/2 % needed surgery and in the control group none. The average length of the stay in the intensive care unit in the control group was 1.28 and in the fluconazole group was 26.1 days.
As the results of this study showed , administration of oral fluconazole had no effects on mortality, need for surgery, cost, length of the stay in hospital and intensive care units .Therefore, because of the complications and costs of fluconazole, it is recommended that all patients with mild biliary pancreatitis should not being treated with fluconazole. This treating method can be used only for those with fungus in their upper digestive system secretions.

Hypertension with serious cardiovascular, cerebral, renal complications is an important factor of mortality in the world. Recognizing its symptoms together with its associated signs can be effective in preventing complications of hypertension. For this reason, researchers began the study aiming at surveying initial symptoms of hypertension. This study was descriptive-analytical and the participants included all patients referring to the special clinics of Kermanshah University of Medical Sciences during the study. Participants were 182 and sampling was based on the availability. A questionnaire was used to collect data. After the collected data were coded, data analysis was performed using SPSS version 16. Chi-square statistical test was used for data analysis. The findings showed that headache, nausea and sleep disorder in patients with hypertension were reported more significantly (P<0.05). Blurred vision was the major symptom observed in staffs as well as the smokers. Also, it revealed that people with family records of hypertension had experienced less blurred vision. Headache, nausea, sleep disorder and blurred vision were the symptoms observed in most hypertensive patients in the study. Therefore, further studies can reveal the symptoms felt when experiencing hypertension and that these symptoms can be introduced to medical authorities as a warning signal.