فهرست مطالب ladan mirmansouri

Despite a variety of strategies, propofol injection pain (PIP) is still one of the most distressing adverse effects of the drug. This study aimed to compare the effectiveness of metoclopramide, low dose of propofol, magnesium sulfate, and ondansetron in the prevention of PIP.

This double-blind clinical trial was conducted at Al-Zahra hospital an academic and referral center affiliated with Guilan University of Medical Sciences, Rasht, Iran. A total of 120 eligible women candidates for elective gynecologic surgeries were divided into four equal groups of magnesium sulfate (30 mg/kg), ondansetron (4 mg), metoclopramide (10 mg), and propofol (15 mg). The primary outcome of this study was to decrease the pain severity of propofol injection.

The participants’ demographic characteristics, including age, American Society of Anesthesiologists classification, and body mass index, had no significant differences between the four groups. A significant decrease in heart rate and mean arterial pressure were observed in four groups; however, the difference was insignificant. The mean pain intensity in the magnesium sulfate group was 1.57 ± 0.9, ondansetron 1.37 ± 0.89, metoclopramide 0.95 ± 0.93, and in propofol group was 1.25 ± 1.1 (P=0.036).

Metoclopramide could appropriately alleviate PIP. Considering some additional advantages, including antiemetic properties, preventing esophageal reflux, and less risk of postoperative ileus, this drug could be a safe and acceptable choice.

Patient safety is among the main goals in a health system. Medical errors are considered a significant threat to patient safety. An effective strategy to reduce this risk is reporting these errors even when the patient is not affected. This study investigated the main barriers to reporting medical errors and related factors.

This cross-sectional descriptive study was conducted in academic hospitals afflicted with Guilan University of Medical Sciences (GUMS) in 2020. University faculty members and residents enrolled in the survey, and a questionnaire was filled out via a face-to-face interview by the responsible resident of anesthesiology.

Overall, 366 individuals, 156 faculty members, and 210 residents completed the questionnaires. Overall, 271 (74.2%), 134 (85.9%) faculty members, and 137 (65.6%) residents, the main barrier to report medical errors was concerning legal consequences. Furthermore, the other important factors were concerning losing job credit (63.4%) and losing the patient’s trust (61.2%). Moreover, the main predisposing factors of medical errors were high workload and a large number of patients (83.3%), long work shifts, and physicians fatigue (80.8%). High job stress and the lack of feeling of support from higher authorities (70.5%), and the lack of adequate equipment and appropriate medical facilities (56%) were the most related factors based on their perspective.

According to the obtained findings, the main barrier to reporting medical errors was legal consequences. Moreover, the main predisposing factors were high workload, many patients, long working shifts, and physicians’ fatigue. Attempts should be made to plan programs to improve the current conditions

Both duloxetine (DLX) and transcutaneous electrical nerve stimulation (TENS) are recommended as safe and effective treatments for diabetic peripheral neuropathic pain. However, these methods have not been compared. This study aimed to compare the efficacy of treatment by DLX and TENS in diabetic neuropathy pain relief.

This survey was performed on 60 eligible diabetic patients randomly divided into two groups of DLX (20, 40, and 60 mg/day for weeks 1, 2, and 3-12, respectively), and TENS (20 min,80 HZ, 50 Amp, 0.2 ms Square pulses 2-3 times sensory threshold). The participants were evaluated according to the numerical rating scale (NRS) after four and twelve weeks of treatment. Moreover, adverse drug reactions were documented during the study period.

Baseline demographic data had no significant difference between the two groups (P≥0.05). The average NRS scores were significantly lower in the DLX group in both measurement times. At the end of weeks four (P=0.01) and 12 (P=0.001), the trend of changes was significant from baseline to the third month (P=0.0001). No patient in the TENS group reported any side effects, while 18% did in the DLX group.

We found that both DLX and TENS were effective and safe for the management of painful diabetic neuropathy. The DLX seemed to be better, compared to TENS. However, in some conditions, such as drug intolerance or contraindication for medications, TENS could be a proper intervention.

Meperidine is known as the gold standard drug for shivering after spinal anesthesia (SA). This drug has been used widely and safely during the Cesarean Section (CS).

This case report presents an anaphylaxis reaction to a single intravenous dose of 25 mg meperidine, aiming to control shivering during CS under SA a few minutes after surgical incision.

The condition was well managed with timely intervention. This rare fetal reaction to meperidine is worthy of reporting to make the medical team aware of the potential risks of anaphylaxis due to many routine safe drugs.

  The use of herbs which has been increasing worldwide, requires special considerations particularly in pregnant woman. The present study was conducted at Alzahra Teaching hospital (from March 2016 to August 2017) to explore the pattern of herbal use during pregnancy in Guilan province (North of Iran). Data were obtained from 836 eligible women, who were interviewed at postnatal ward, and were analyzed. The results of the study showed that 19.6% of the women consumed herbs during pregnancy. The most commonly used herbs included mint, flixweld, and cinnamon; in addition, the most prevalent indications resulted from these herbs consumption were gastrointestinal complications and cold. The rate of herbal consumption in pregnancy was related to education (P = 0.001) and resistance (P = 0.008); however, no relation was found regarding age (P = 0.203), employment (P = 0.255), or gravity (P = 0.935). Although the findings of this study were preferable to those of some other studies, due to the importance of the issue, it is vital that health care providers to be open to question the herbal use during pregnancy.