akvan paymard

Pain is the most common post-tonsillectomy complaint in children, whose insufficient relief can result in a number of complications. The present study aimed to determine and compare the effects of the local injection of bupivacaine and lidocaine-epinephrine mixture on post-tonsillectomy pain.

In this double-blind randomized clinical trial, 87 candidate children for tonsillectomy aged 4-10 years were selected through non-probability convenience sampling. The subjects were randomly assigned to 3 groups. All patients in the three groups underwent identical general anesthesia and cold knife dissection procedures. Five minutes before incision, children in the intervention groups received 2 mL of bupivacaine 0.125% and 2 mL of a mixture of lidocaine 1% and epinephrine (1:200,000), respectively, through tonsillar and peritonsillar local injection. Pain intensity was assessed 2, 4, 6, and 8 hours after surgery using the Wong-Baker Faces Pain Rating Scale. Data were analyzed in SPSS 21 using descriptive and inferential statistics at a 95% confidence interval and 0.05 significance level.

The postoperative pain intensity ranged from 4 to 8 in the bupivacaine-receiving group, from 5 to 8 in the lidocaine-epinephrine mixture-receiving group, and from 6 to 10 in the control group. A statistically significant difference was observed in the median pain intensity among the three groups of children participating in the study (p=0.001). Although the pain intensity in the bupivacaine-receiving children was lower than lidocaine-epinephrine mixture-receiving children 2, 4, 6, and 8 hours after surgery, the difference was only statistically significant 2 and 4 hours postoperatively (p=0.001) and no statistically significant difference was observed in other times (p>0.05). There was a significant difference in the pain intensity between the two intervention groups and the control group at all times (2, 4, 6, and 8 hours after surgery) (p=0.001).

Although local injection of bupivacaine and lidocaine-epinephrine mixture reduced post-tonsillectomy pain in children, there was no difference in their effect on pain reduction except 2 and 4 hours postoperatively.

There is little consensus about type of the maintenance fluid therapy and it’s effect on serum sodium in adults. Thus, this study was conducted to assess the effect of maintenance fluid therapy on serum sodium of hospitalized patients in intensive care unit. This randomized clinical trial was carried out on 64 patients aged 18-90 years hospitalized in intensive care unit (ICU) of Imam Sadjad and Shahid Beheshti hospitals, Yasuj, Iran in 2017. These patients were randomly allocated to take 2500-3000 milliliter of intravenous maintenance isotonic (0.9% saline) or hypotonic (0.45% saline) fluids daily. Blood and urine samples were taken to measure biochemical parameters before and 48 hours after intervention.  Data analyses were done by using SPSS 16 software via descriptive and analytic statistics. Twenty eight patients in 0.9% saline group (19 male and 9 female) and 32 patients in 0.45% saline (20 male and 12 female) completed the study. There was no significant difference between two groups in sodium (P=0.94), potassium (P=0.21), sugar (P=0.91), creatinine (P=0.21), Blood Urea Nitrogen (P=0.99), systolic (P=0.81) and diastolic (P=0.73) blood pressure, PH(P=0.27), bicarbonate(P=0.8), and urine specific gravity(P=0.73). Based on the results of this study, it was shown that administration of maintenance hypotonic fluids has been appropriate for the patients and will not face them with the risk of hyponautremia.

improving academic performance in students is one of the main objectives in the educational centers. Since the nursing students during their educational period are facing with a large volume of material, failure to select the correct study method, causing confusion, disgust of educate and loss of energy and time among them. According to the importance of study habits in academic performance, this study aimed to identify nursing student’s study habits and its relationship with academic performance was performed.
In this cross-sectional study, 220 nursing students were selected by random sampling method in Hamadan University of Medical Sciences (2016). Data was collected using study habits questionnaire (PSSHI) that has 45 questions in eight areas. In order to measure academic performance, the mean of total score was used. Data were analyzed by descriptive and inferential statistics.
The results showed that the mean and standard deviation for score of student’s study habits was 45.04 ± 9.37. Study habits in 86.9% of students were relatively good, in6.8% favorable, and in 4.5% of them were poor. The mean of student's Academic grade was 15.61 ± 1.27 and the majority of students (81.9%) had a moderate performance. Between mean score study habits and academic performance there was a significant positive correlation (P In general, student’s study habits are in moderate grade and can say that the study method in students have not a good quality. On the other hand, due to the significant relationship between study habits and academic performance, pay attention to this issue is considered necessary by the faculty education authorities. Holding training courses, in this regard can be effective in improving student learning process.

artificial airway lead to weakened cough reflex and the loss of ciliated cells eventually that finaly lead to accumulation of secretions so patients need periodic suction. This study aimed to compare the effect of open suction endotracheal tube using two different size suction catheter on the arterial blood oxygen saturation in critical care patients were admitted.
In this clinical trial 36 patients in one group and under suction catheter with two size 12 and 14, respectively. Changes in blood oxygen saturation before, during, after 5 minutes and 20 minutes after suctioning was recorded. For Oxygen saturation suction compare changes in different stages, analysis with variance and repeated measures was used.
The results showed that oxygen saturation during small suction catheter is a significant difference (p=0/000). In addition to suction the blood oxygen saturation rate in the first episode there is a significant difference (p=0/000). 5 minutes after suctioning blood oxygen saturation in compare of 5 minutes before the suction has no significant difference (p=0/597) but blood oxygen saturation 20 minutes after suction in compare of 5 minutes prior to suctioning and suctioning episodes were significantly different(p=0/050).
Since the fall endotracheal suctioning of arterial blood oxygen saturation and the reduction in the episodes become more frequent suctioning, it is recommended to reduce the duration of suction.

Stroke is a rare complication of myocardial infarction (AMI). Aspirin, plavix, and enoxaparin are among drug treatments for myocardial infarction, which lead to stroke. The present study is a case report of stroke after myocardial infarction, which discusses patient’s records and clinical history along with paraclinical findings.
Case Report: The patient was a 60-year-old man with a history of heart disease and diabetes, presented with severe chest pain and dyspnea to the Emergency Department of Yasuj Sajad Hospital on January 29, 2015, and after taking ECG, it was found that there was no signs of myocardial infarction, but troponin test was positive two times. The diagnosis was myocardial infarction without ST segment elevation. The patient took aspirin and plavix, and after subcutaneous injection of enoxaparin at the dose of 80 mg, his level of consciousness decreased, which caused GCS:5, right-side mydriasis, and motor paralysis in the left half of the body, therefore, CT was performed, and the patient that had about 90 ml hemorrhage in temporoparietal lobe. The patient was transformed to the operating room and 60 ml blood was removed using partial lobectomy and a microscope. After hospitalization in ICU for several days, the patient was extubated under the SIMV mode.
Considering the high prevalence of heart disease, especially increasing rate of myocardial infarction in the country, anticoagulants should be more carefully used and after administration of this group of drugs, patients be regularly monitored for side effects.

Nursing ethics is a branch of professional ethics which applies ethics and ethical decision-making in the realm of nursing. The aim of this study was the assessment of the relationship between awareness on ethical codes and nursing errors reported by the staff in Persian Gulf hospitals of Bushehr University of Medical Sciences in 2014.
This study had a descriptive cross-sectional design. The study population included all the nurses in Persian Gulf hospitals of Bushehr in 2014, of which finally 160 patients were enrolled. The sampling method was census and for data analysis, Pearson’s correlation coefficient, t-test and ANOVA were used.
Nurses’ awareness of ethical codes comprised %57 poor, %19 moderate and %24 strong recognition. The average nursing error was 15.38 ± 16.82. The relationship between the knowledge and the average nursing error was statistically significant (P It is recommended to implement professional ethics education, in order to enhance professional ethics and reduce nursing errors. This program must be a top priorityfor nursing students and staff.

Background and Pain after amputation have several outcomes including disability, reduced quality of life and reduces the ability of communication with others. The aim of this study was to evaluate the effect of foot reflexology on pain in patients after lower limb amputation.
A clinical trial was conducted in patients undergoing amputation in Isfahan Al-Zahra Hospital who were divided into a control and an experimental group (n= 25 per group). To assess the pain intensity the Numeric Rating Scale (NRS) was used. The patients in experimental group received 30 minutes foot reflexology while simple massage was done for the control group for 30 minutes. Both techniques were carried out 8 to 10 times. To analyze the data Chi-square test, T-test, and ANOVA were used.
Foot reflexology massage significantly reduced pain intensity in the experimental group compared with the control group (P= 0.009). The T-test showed no significant difference in pain intensity between intervention group and controls before the operation (P= 0.52). There was a significant difference between the two groups in mean pain intensity (P Foot reflexology in patients undergoing amputation reduces post-operation pain and is suggested for pain relief.

Aims and Prevention of bedsore is considered as a priority in acute and long-term care in intensive care units (ICU).This study aimed to determine the effect of olive oil on prevention of pressure ulcers in patients hospitalized in the ICU of Shahid Beheshti Hospital in Yasuj.
In this double-blind randomized clinical trial 70 patients18-74 years old were investigated from 2013 to 2015. Patients were selected by purposive sampling method and were divided into two groups. During two weeks, patients of the control group received their usual skin care including changing positions every two hours and flow mattress while the patients of the intervention group received usual care in addition to daily use of 15 ml olive oil on special areas of body without massage. Data about pressure ulcers was collected using a questionnaire and was analyzed by chi-square test, Fisher’s exact test and t-test in SPSS software version 20.
Findings: In the intervention group 11.4 % had a grade 1 pressure ulcer, and 8.2 % had second grade decubitus ulcers while 85.7 % had no pressure ulcer. In the control group, 8.5 % had a grade 1 pressure ulcer, and 25.7% had second grade decubitus ulcers while 65.7 % had no pressure ulcer. The results of this study showed that the incidence of pressure ulcers in the intervention group was lower than the control group (p˂0.03).
According to our data, it can be concluded that the use of local olive oil is effective in prevention of pressure ulcers.

Aim and More than 50% of patients suffer from phantom limb pain after amputation. This study was conducted to identify the effect of eye movement desensitization and reprocessing on phantom limb pain in patients with amputation.
Methods and Materials: This quasi experimental study was performed in Yasuj City between 2012 to 2014. A total of forty (40) patients suffering from phantom limb pain, were selected using sampling and randomly divided into experimental and control groups. In the experimental group, eye movement desensitization and reprocessing therapy was performed in twelve (12) sessions. The control group received no intervention. Data were gathered on phantom limb pain at pretreatment and post-treatment and analyzed using descriptive statistics, T test, Paired T test and Chi- square.
Findings: The results showed that there is a significant difference between the mean of phantom limb pain before and after intervention in the experimental group (P0.05).
Eye movement desensitization and reprocessing reduced phantom limb pain in patients with amputation. Therefore, its use as a therapeutic and alleviative method could be suggested for patients suffering from phantom limb pain.