فهرست مطالب masoum khosh fetrat

Disorders of consciousness, including the vegetative state (VS) and the minimally conscious state (MCS) following brain damage and various complications for the patient, also have economic and social consequences. However, there is still no definitive or effective treatment for this condition. However, there is still no definitive or effective treatment for this condition. Therefore, this study aims to investigate the effectiveness of zolpidem in improving consciousness in patients with acute brain injury.

The present quasi-experimental study was performed from 2020 to 2021 after obtaining the necessary permissions from Zahedan University of Medical Sciences, Iran. Eighty patients with acute brain injury who met the study inclusion criteria were recruited and randomized into zolpidem and placebo groups. In the zolpidem group, 10 mg zolpidem tablets were gavage twice daily. In the placebo group, a placebo tablet with the same appearance as zolpidem was gavage twice daily for 14 days. The consciousness level of patients was measured daily until the outcome (ICU discharge or expiration) was established. Eventually, a comparative data analysis was conducted to determine zolpidem's efficacy in enhancing consciousness, reducing mechanical ventilation duration, and improving patient outcomes.

The mean GCS score in the zolpidem group was 6.1±2.4 on admission and 11.6±3.8 at the end of the study, compared to 5.9±1.7 on admission and 11.3±2.8 at the end of the study, for the placebo group (p=0.154 and p=0.211, respectively). The mean duration of mechanical ventilation was 24.41±9.14 days in the zolpidem group and 23.16±10.72 days in the placebo group (P=0.529). Twenty-eight patients in the zolpidem group were discharged from ICU, and 12 expired. For the placebo group, 26 patients were discharged from ICU, while 14 were expired (p=0.87). No statistically significant difference was found in any of the measured variables between the two groups.

The results have shown that zolpidem administration had no statistically significant effect on improving the level of consciousness and reducing mechanical ventilation duration and clinical outcomes in acute brain injury patients.

The improved consciousness level reflects the patient’s recovery following acute brain injury. The medications that can regulate neurotransmitter levels, neural synaptic plasticity, and functional connectivity of consciousness networks might play a crucial role in improving the consciousness status of the patients. Thus, this study aims to evaluate the effectiveness of amantadine in improving consciousness in acute brain injury patients.

The present quasi-experimental study was performed from 2021 to 2022 after obtaining the necessary permissions from Zahedan University of Medical Sciences, Iran. Eighty patients with acute brain injury who met the study inclusion criteria were recruited and randomized into amantadine and placebo groups. The amantadine group was given a daily dose of 100 mg amantadine tablets, while the placebo group received a gavage of amantadine-like placebo tablets twice daily for 14 days. The consciousness level of patients was measured daily until the outcome (ICU discharge or expiration) was established. Eventually, a comparative data analysis was conducted to determine amantadine's efficacy in enhancing consciousness, reducing mechanical ventilation time, and improving patient outcomes.

The mean GCS score in the amantadine group was 5.5±1.4 on admission and 11.9±3.7 at the end of the study, compared to 6.6±1.5 on admission and 11.8±3 at the end of the study, for the placebo group (p=0.154 and p=0.211, respectively). The mean duration of mechanical was 28.87±11.34 days in the amantadine group and 24.13±14.93 days in the placebo group (P=0.329). Twenty-four patients in the amantadine group were discharged from ICU, and 16 were expired. For the placebo group, 21 patients were discharged from ICU, while 16 were expired (p=0.221). No statistically significant difference was found in any of the measured variables between the two groups.

The results demonstrate that amantadine administration had no statistically significant impact on improving consciousness status and clinical outcomes and reducing mechanical ventilation time in acute brain injury patients.

The intensive care unit is one of the most specialized hospital units that need nurses with a high level of skill and experience. The leave of experienced nurses from this unit reduces the quality of nursing care and imposes heavy costs on the health care system. This study aimed to investigate the reasons for nurses' intention to leave the ICU.

This cross-sectional study was performed on 247 nurses in the ICU affiliated with Zahedan, Tehran, and Mashhad University of Medical Sciences, Iran, from 2018 to 2021. Nurses were included in the study by Census sampling method based on inclusion criteria. They completed a four-part questionnaire including demographic variables, Job Satisfaction Survey (JSS), intention to leave, and reasons for intention to leave the ICU. Data were analyzed with SPSS software using descriptive-analytic statistics, Chi-square, independent t-test, one-way ANOVA, and Pearson correlation. The significance level was considered less than 0.05.

Out of 247 nurses studied, 183 (74.1%) were female and 64 (25.9%) were male. The mean age of participants was 32.47± 6.68 years. The mean score of job satisfaction was 115.45±58.20 and the mean score of intention to leave was 15.98±3.76. The mean score of the three areas of reasons for intention to leave had a negative correlation with job satisfaction and a positive correlation with the intention to leave the ICU, which was statistically significant in all cases (p= 0/001). The mismatch between the workload and legal benefits, shortage of nurses, forced overtime, the disproportion of nurse-patient ratio, and lack of welfare facilities had the greatest effect on nurses' intention to leave the ICU.

The results of the study showed that the most common reasons for the increase the intention to leave of nurses are related to the mismanagement of nursing managers and authorities of ICU. Therefore, reforming old management styles, observing justice among employees, involving nurses in decisions and the process of patient's treatment are among the things that can increase nurses' self-esteem, job satisfaction and reduce the leave of ICU without providing additional funding for the organization.

Predicting the final outcome of patients with traumatic brain injury is crucial for making the right clinical decision and determining the course of treatment. The aim of this study was to compare the ability of Marshall and Rotterdam scoring systems to determine the prognosis in patients with traumatic brain injury.

The present study is cross-sectional. The statistical population of the study consisted of patients with traumatic brain injury admitted to the intensive care unit of Khatam al-Anbia Hospital in Zahedan from 2021 to 2022. 287 patients were selected by convenience sampling method based on inclusion criteria. Patients were first evaluated by an intensive care physician to determine the prognosis with the APACH II Scale. The Marshall and Rotterdam scores of each patient were then determined by a radiologist based on a brain CT scan, and the patients were evaluated for the entire period of hospitalization until the final outcome (discharge or death) was determined. Finally, the data were compared to determine the ability of the two scales to predict outcomes.

Out of 287 patients, 33(11.5%) died and 254 (88.5%) survived. The mean score of the Marshall Scale in deceased patients was 4.69±1.01 and in survived patients was 2.03±1.3. The mean score of the Rotterdam Scale in deceased patients was 5.33±0.95 and in survived patients was 2.14±0.89. In both cases, this difference was statistically significant (P=0.001). The mean score of APACH II scale was 24.04±8.2 in deceased patients and 16.08±7.3 in survived patients. The correlation between Rotterdam and Marshall Scales in determining the outcome of patients, with APACH II was positive and high. The agreement between the APACH II and Rotterdam scales was greater in predicting mortality. The results of regression model showed that gender with (OR=2.91), head injury due to accident with (OR=3.04), Marshall Score above 4 (OR=1.97), Rotterdam score above 4 (OR=2.84) and Apache II score above 15 (OR=1.97) have a significant relationship with patient mortality.

Both the Marshall and Rotterdam scales can determine the prognosis of patients with traumatic brain injury.

The study of neuromuscular blocking agents (NMBAs) in the management of acute respiratory distress syndrome (ARDS) has provided conflicting results in terms of their effect on mortality.

The main purpose of this study was to evaluate mortality in ARDS patients who underwent NMBA.

A retrospective secondary analysis of 4,200 patients with ARDS was collected from two academic medical centers, Tehran, Iran. This study was performed to assess the impact of NMBAs use in ARDS patients with different subgroups including mild and moderate-to-severe ARDS, age more and less than 65 years, having medical turnover vs. not-having, and high acute nursing care vs. moderate to low nursing care. The primary outcome was the ICU mortality

In the subjects without medical turnover, the moderate dose of NMBAs significantly reduces the mortality of patients (P=0.044). In patients who need high acute nursing care, increasing the NMBAs dose significantly reduces patients' mortality (P=0.010). In addition, increasing the NMBAs doses significantly reduces ICU LOS (p <0.001). Logistic regression analysis revealed that the high dose vs. low dose of NMBAs was increased the risk of mortality among patients between 80 to 84 years old (OR: 3.142, 95% CI: 1.461-6.756, P=0.003). However, higher doses of NMBA than low doses reduce the risk of death in patients between 50 and 54 years of age (OR: 0.432, 95% CI: 0.267-0.798, P=0.006).

this study provides evidence that the administration of different doses of NMBAs had no effect on patients’ mortality with mild or moderate-to-severe ARDS.

Endotracheal intubation (EI) associated with mechanical ventilation (MV) is frequently performed in critically ill patients admitted to intensive care unit (ICU) with sepsis.

This study aimed to assess the impact of important factors on the duration of tracheal intubation in patients with sepsis at the ICU admission.

Adult patients admitted to the mixed medical–surgical ICUs with sepsis at the ICU admission who needs prolonged mechanical ventilation (PMV) (≥ 21 days) were included in this retrospective secondary analysis study. The primary outcome was ICU mortality. Baseline demographic and clinical characteristics of all patients were assessed as risk factors associated with the duration of MV by univariate and multivariate Binary logistic regression.

Eighty-five patients required more than 21 days of MV. Out of the 85 patients, 52 (61.2%) patients were intubated within 30 to 34.50 days and 33 (38.8%) patients had intubation within 34.51 to 65 days, and categorized as PMV and very prolonged MV groups, respectively. Two parameters were significantly associated with very prolonged MV which are as follows: older age 1.229 (95% CI: 1.002-1.507, P = 0.048) and long hospital stay (LOS) 2.996 (95% CI: 1.676-5.356, P < 0.001). No significant survival difference was observed between the two groups of study. (33.3% vs. 25%, P = 0.406).

Our observations showed that the older age and LOS as pre-ICU stay in patients with positive sepsis at the ICU admission can prolong the duration of intubation. In addition, no significant survival difference was observed between patients with PMV and very prolonged MV.

The disease related to the coronavirus disease 2019 (COVID-19) has now been a pandemic throughout the world. Although the epidemiological studies and clinical trials are utilized to find standard measures and medicines to prevent and control COVID-19, addressing the mental health and psychology of the people who may be at risk of the disease may also be effective to find comprehensive methods to better overcome this pandemic. This study aimed at investigating the mental status of both the general population and healthcare personnel during this pandemic in Iran.

Using a cross-sectional design, a sample of 296 medical staff and 532 people living in Tehran city of Iran were included in the study. The assessment was performed by Depression, Anxiety, and Stress scale short-form (DASS-21). Two groups were matched in terms of some demographical factors such as age, gender, and marital status. Analysis of covariance (ANCOVA) was utilized to perform comparisons between the two groups.

Both samples of the general population and medical staff had high levels of stress, anxiety, and depression. The mean score of anxiety and depression among medical staff was higher than that of the general population (P < 0.001). There was no significant difference between the two groups in terms of stress level.

It seems both the Iranian general population and healthcare personnel are under mental pressure caused by COVID-19, indicating an urgent need for intervention and using preventive measures to control the negative impacts of the diseases on the psychological well-being of these people. Further studies in other regions affected by the disease may provide more evidence in this regard.

Retraction of articles occurs as a result of scientific misconducts or honest errors.

This study aimed to identify the frequency of retracted Iranian publications, compared to those of other countries and adjust them with influential parameters.

All publications that were indexed on the Scopus database from 2008 to 2017 and then retracted, due to scientific misconduct were extracted through the Retraction Watch database and selected as the research community. To calculate the growth of retraction for each proposed country (or region), first, the rate of an absolute number of retracted papers for the years 2013-2017 was divided by the similar number for years 2008-2012, then this rate was adjusted to the retracted rate which is similarly computed for the total retracted statistics of the world.

Overall, 545 Iranian retracted publications from 2008 to 2017 were identified, of which 240 and 305 retracted articles were related to the first five years and the second five years of the study, respectively. The results showed that less than 1% (0.82) of all scientific articles published by Iranian researchers were retracted. However, the rate of retracted scientific articles in Iran compared to this rate in the world was significantly higher.

Although retracted Iranian publications make up a small percentage of all Iranian publications, the number of retracted publications is increasing. It is important to recognize the reasons for scientific misconducts and to provide researchers with proper education.

Sepsis is a very common serious medical condition among patients admitted to the intensive care units (ICUs) that increases with age and ICU length of stay (LOS).

The primary goal of this study was to estimate the mortality rate due to sepsis among adult patients admitted to the mixed medical–surgical ICUs for a long time. The secondary goal was to identify factors associated with predicting ICU mortality in individuals with long-term ICU LOS.

Adult patients admitted to the medical ICU for a long time (≥75 days) were included in this retrospective secondary analysis study. Baseline demographic, clinical, and laboratory data were recorded upon inclusion in the study.

ICU mortality occurred in 78 (43.1%) patients, out of 188 participants. A greater portion of patients with sepsis at admission (62.7%) were observed in the death group (59.2% vs. 30.8%, P < 0.001), than the survivor group. Additionally, survived patients differed significantly in terms of age, family engagement, baseline cognitive impairment, activity, nurse anticipated turnover scale (ATS), duration of a mechanical ventilator (MV), and ICU LOS. The results of multivariate binary logistic regression showed that the older age and low family intervention can increase the risk of mortality in patients with sepsis at the time of admission, with a long ICU LOS.

Our findings are crucially important to increase the awareness of the impact of sepsis, highlight the need for continued research into potential preventive and therapeutic interventions, and help guide resource allocation.

As the coronavirus disease 2019 (COVID-19) pandemic rapidly sweeps across the world, it is inducing a considerable degree of psychological problems, which can affect everyone in the community. This study aimed to compare the severity of the psychological distress in the general population and patients during the COVID-19 epidemic in an Iranian population. In this cross-sectional study, the mental health status of 221 COVID-19 infected patients and 241 participants from general population were investigated by the self-report questionnaire of Depression, Anxiety, and Stress Scale (DASS). The DASS-21 questionnaire and sociodemographic data sheet were filled out by the participants. All statistical analyses were performed using SPSS software version 21. The results indicated higher scores of DASS in patients than the population simultaneously (Wilks Lambda = 0.934, F (3, 440) = 10.44, p <0.001) and individually (Mean difference [MD] = 2.55, 95% CI = 1.48 to 3.62 for depression, MD = 1.48, 95% CI = 0.39 to 2.57 for anxiety, and MD = 1.41, 95% CI = 0.32 to 2.49 for depression score). The present study revealed a high prevalence of mental health problems among patients with COVID-19 and gaps in providing them with mental health services. We call for systematic screening of mental health status for all patients and developing specific psychological interventions for this vulnerable population. Psychosocial assessment and monitoring should be developed in the community to support aspects of COVID-19.

It is widely accepted that increased prevalence of antibiotic resistance of pathogens grown in the respiratory system in intensive care unit (ICU) patients is a very serious problem causing expansion of mortality. The most important strategy to prevent the occurrence and appropriate solution to control the antibiotic resistance is to thoroughly investigate the pattern of resistance in the studied ward. Therefore, the purpose of this study was to determine the antibiotic resistance pattern of organisms isolated from endotracheal tube secretions of patients admitted to ICU of Khatam-Al-Anbia Hospital at Zahedan in Iran.

In the present retrospective and descriptive cross-sectional study, the medical records of patients hospitalized during 2013-2018 were included by census method and then selected based on inclusion criteria (n=1387). The required data, including age, gender, type of microorganism isolated from endotracheal tube cultures, antibiotic resistance and sensitivity, duration of intubation and cause of hospitalization, were recorded for each patient. Finally, the data were analyzed by descriptive statistics using SPSS 16 software.

Mean age of patients was 44.66 ± 21.39 years and mean duration of intubation was 17.96 ± 10.99 days. Stroke was the most common cause of hospitalization with a prevalence of 553 patients (49%). The prevalence of positive culture of endotracheal tube secretions was 1128 (81.3%) of which 71.5% were male (n=807) and 28.5% were female (n=321). The cultures of endotracheal tube secretions resulted in 933 (82.7%) gram-negative bacteria, 191 (16.9%) gram-positive bacteria and 4 (0.4%) mixed isolates. The most prevalent gram-negative bacterium was Acinetobacter baumannii (37.2%) with the highest and lowest antibiotic resistance to Meropenem (95.1% resistance) and colistin (99.5% sensitivity), respectively. In addition, the most prevalent gram-positive bacterium was Staphylococcus epidermidis (50.3%) with the highest and lowest antibiotic resistance to Meropenem (85.7% resistance) and Vancomycin (92.2% sensitivity).

The findings of the present study illustrate that there was widespread bacterial resistance to respiratory tract infections in our ICU patients. Due to the high sensitivity of gram-negative bacteria to colistin, the use of antibiotic combination with colistin in the control of pulmonary infections caused by these organisms can be a good choice. In addition, in the case of gram-positive bacteria, the highest sensitivity was to vancomycin; therefore, it can be the selective antibiotic to control infections caused by these bacteria.

The use of subcutaneous enoxaparin is a usual method for preventing venous thromboembolism (VTE) in the intensive care unit (ICU) patients, but adequate absorption of the drug is not reliable due to the illness intensity, existing edema and hypoperfusion in these patients. The aim of this study was to compare the effect of intravenous enoxaparin with subcutaneous enoxaparin to prevent VTE in ICU patients.

The current double-blind Randomized clinical trial was performed on 64 patients admitted to the ICU at Khatam- Al- Anbia Hospital in Zahedan, southeast of Iran. The patients were randomly assigned into each of the subcutaneous enoxaparin and the intravenous enoxaparin groups. The blood sampling was performed aseptically and then active factor Xa level was measured. Next, the intervention group received 0.5 mg/kg of intravenous enoxaparin for 10 days and the control group was injected subcutaneously the same dosage of drug. Four hours after the first injection and 12 hours after the last injection on the tenth day, the factor Xa level and the frequency of VTE incidence was measured again.

In all three measurement times, the active factor Xa level in the intravenous enoxaparin group was lower than that of the subcutaneous group, but no significant difference was observed between the two groups and different times (P> 0.05).

The results of this study showed that the use of intravenous enoxaparin is an effective way to prevent the VTE development in the ICU patients.

For patients with prolonged bed rest and immobilization because of motor or consciousness disorders, many factors may contribute to the development of pressure ulcers. To this end, the present study aimed to investigate the frequency of pressure ulcers and the factors affecting the development of this condition in intensive care units (ICUs).

In this descriptive cross-sectional study, the case files and records of patients hospitalized between March 2017 and March 2018 entered the study using the census method. The necessary information including age, gender, location of pressure ulcers, number of ulcers on each part of the body, length of stay in ICU, and underlying diseases was extracted from the files and recorded in the data checklist. In the end, the extracted data were analyzed with SPSS 25.

Of the 781 patients studied, 71 (9.1%) had pressure ulcers, of whom 34 were men and 37 were women. A statistically significant difference was found between men and women in terms of the incidence of pressure ulcer (p = 0.0013). The most common sites of pressure ulcers were buttock with 34 cases (47.9%) and sacrum with 21 cases (29.6%).

Old age and prolonged stay in ICU are important determinants of the development of pressure ulcers.

Cardiovascular diseases are the most common cause of death in the most countries and Iran, and are the main disability cause, those induced stress, anxiety and changes in vital signs in patients under coronary artery bypass graft (CABG) surgery. This study was conducted to determine the effect of progressive muscle relaxation on the vital signs and oxygenation indexes of patients under CABG. In the randomized triple-blind clinical trial, 80 patients under CABG surgery after sampling by convenience method, randomly selected and assigned by random allocation method to 40 patients either the control or intervention groups. An orientation session was held to explain the research goals and intervention. The intervention group did the progressive muscle relaxation technique, two 20-30 minutes' sessions daily for 2 months (120 sessions). Correspondingly, data collection tools were demographic information questionnaire, vital signs, oxygenation indexes, and self-report checklists. Systolic blood pressure and respiratory rate within intervention group and main arterial pressure, pain and cardiac rhythm between two intervention and control groups had significant differences (P<0.05). Interaction effects time and group of systolic blood pressure and pain variables were significant (P<0.05). From oxygenation indexes perspective, PaO2/FiO2 and SPO2/FiO2 indexes within intervention group, PALVO2/FiO2 within control group, and PALVO2/ PaO2 within both intervention and control groups had significant differences (P<0.05). Except SPO2/FiO2 index, other oxygenation indexes had interaction effects of time and group (P<0.05). Applying progressive muscle relaxation technique on the various aspects of vital signs and oxygenation indexes of coronary artery bypass graft surgery was effective and using the technique to improve and stabilize of those is applicable and practical.

Prevention is a necessary and urgent task due to the widespread prevalence of various acute and chronic diseases. Nurses, in order to play their professional role and responsibility, need to know the choices, needs and abilities of patients in reality, their communication and their social context. The present review was conducted with two 1. determining the effect of a continuous care model on the outcomes of acute and chronic diseases, and, 2. describing and assessing the quality of methodology of published papers in this field.
This is a systematic review conducted on 2017. A systematic search was conducted using PRISMA guidelines to retrieve all national and international studies using a Continuous Care Model.
In the initial search, 3074 papers were retrieved, and following PRISMA screening guide, 51 relevant articles were identified. The final studies were classified and reviewed based on the authors, year, type of research with the number of studied groups, the aim of the research, the sampling method, the characteristics of the research samples in terms of the number of people and the type of disease, the method of data collection and final conclusion.
According to the review of the studies carried out with the continuous care model and the effectiveness of all of them on the different outcomes of the study, it can be stated with certainty that this indigenous model corresponds with the culture of Iran is an effective, simple, efficient and reliable model and can be used in promoting and improving the various aspects of acute and chronic diseases. The quality of conducting intervention studies using this Continuous Care Model was relatively good, but the reporting style and quality of the studies are inadequate.

The weaning process from mechanical ventilation in chronic obstructive pulmonary diseases (COPD) is a time-consuming process required for the care of these patients. This study aimed to: 1. decide cut-off points of combined and common indices RSBI, P0.1, NIF, CROP, and IWI in the population of COPD patients; and 2. compare different weaning factors from the mechanical ventilator of combined, RSBI, P0.1, NIF, CROP, and IWI indices in the population of COPD patients.
This observational, prospective multi-center triple-blinded study was conducted from January 2013 to March 2014 in the population of hospitalized COPD patients in the critical care units of selected Military hospitals in Tehran, Iran. Patients were divided into two groups with cut-off points determining the first group (n = 90) and different predictive weaning factors from the mechanical ventilator determining the second group (n = 90). The process of weaning from the mechanical ventilator was performed in the same way in both groups and was based on the defined protocol. ROC analysis was used to determine cut off points in the first group and predictive factors in the second group.
Six indices combined, RSBI, IWI, P0.1, NIF, and CROP were compared from different predicting weaning factor's view. Generally, RSBI, combined, IWI, P0.1, NIF, and CROP indices were devoted the most favorably factors to itself, respectively. The highest area under the curves were devoted to RSBI (0.927) and combined (0.891) indices.
Although the proposed index has more components than other common indices in weaning process from mechanical ventilator, the RSBI index in addition to simplicity, provided the most desirable characteristics of predictive weaning from mechanical ventilator. It is also suggested that corrected RSBI index (RSBI application alongside tight subjective and objective signs and symptoms of respiratory distress) be used in the population of chronic obstructive pulmonary patients.

Cardiopulmonary resuscitation (CPR) procedure consists of measures taken to restore the acts of the heart and the brain in a person who has lost their own consciousness. Thus, the purpose of the present study was to investigate the success rate of Cardiopulmonary Resuscitation, survival rate in patients, and their related factors in order to assist in improving effective conditions and measures within hospitals to increase the success rate of CPR.
This cross-sectional analytic study was conducted in 2016. To this end, a total number of 199 patients affected with cardiopulmonary arrest and undergoing the CPR procedure in the emergency wards and other hospitals units in Iran were recruited using a convenience sampling method. Then, patient information was collected through a researcher-designed checklist as well as a review of clinical records. The data were also analyzed via the SPSS.16 software. Data analysis was similarly performed using descriptive statistics and Chi-square and t-test.
The mean age of patients was 44 years. The result of 36.7% of CPR procedures conducted was reported successful, however, only 4% of patients finally survived. In general, the findings revealed that factors such as age, gender, hospital, history of prior diseases, checked initial rhythm, work shift, time of work shift change, pre-resuscitation intubation status, and underlying cause of cardiopulmonary arrest had no effects on the success rate of CPR procedure. However, location of the occurrence of cardiopulmonary arrest (P = 0.03) and specialty of physicians in charge of resuscitation teams (P = 0.01) were among the factors affecting the success rate of CPR procedure. Furthermore, checked initial cardiac rhythm (P Given the simplicity and teachability of the principles of basic life support (BLS), health status, and survival rate in patients can be easily and significantly promoted through the public education of the initial resuscitation measures. Moreover, according to the investigations made in this respect, post-resuscitation measures can dramatically affect the survival rate of individuals. Therefore, it is suggested to investigate post-resuscitation measures in other studies of prospective type in order to propose strategies to improve the survival rate of patients.

Weaning decision for the patients undergoing mechanical ventilation (MV) is often made based on personal judgments and experiences, which results in longer MV length of stay and higher costs. Therefore, the present study aimed to evaluate the effect of Burn’s wean assessment program on the success rate of weaning from ventilator in patients admitted to the Intensive care unit (ICU).
The present experimental study was carried out on 100 patients undergoing MV for more than 72 hours. The patients were selected by convenience sampling and randomly divided into two groups of 50 subjects. Burn’s wean assessment program was applied to the intervention group, while weaning was assessed by a physician in the control group.
35 patients in the intervention group were male and 15 were female. In the control group, 36 were male and 14 were female. Chi-square test showed no statistically significant difference between the two groups (P Using Burn’s scale for assessing patient readiness for weaning from mechanical ventilation is more useful.

The pain induced by intravenous injection of propofol is controlled using a variety of methods, but there is no consensus in choosing the best effective method. Therefore, this study was conducted to compare premedication injections of magnesium sulfate, ketamine and lidocaine on pain induced by intravenous injection of propofol.
The present double-blind clinical trial was conducted on 150 patients with elective orthopedic surgery under general anesthesia. The patients were randomly assigned into three groups of 50; Group I: 2 cc magnesium sulfate 20%, Group II: 2 cc Ketamine at a dose of 0.1mg/kg and Group III: 2 cc lidocaine 2% at a dose of 0.05mg/kg. One minute after injecting the drugs, 2mg/kg intravenous propofol was injected in all groups and then a trained unaware expert evaluated the severity of subsequent pain using a Numeric Pain Rating Scale.
The mean age of the patients was 39.3±12.3 years, and the mean weight was 67.4±11.5 kg. The patients consisted of 98 (65.4%) males and 52 (34.6%) females. Ten in the Group magnesium sulfate, eight in the Group ketamine and seven in the Group lidocaine complained of pain. The mean pain severity was 0.85±0.38 in the Group magnesium sulfate, 0.66±0.26 in the Group ketamine and 0.62±0.22 in the Group lidocaine (P=0.513).
The Group lidocaine showed further pain relief compared to other two groups, but there was no statistically significant difference.

The process of cardio-pulmonary resuscitation (CPR) is an immediate action toprevent or delay cardiopulmonary arrest. This study was done to find out the success rate of CPR and its relationship with the working shift of the personnel in emergency unit and the wards.
Material and In this analytical and cross-sectional study in 2016, 199 patients whom with cardio-pulmonary arrest in emergency unit and wards of Ali-ibn-AbiTalib and Khatam-al-anbia hospitals of Zahedan undergone (CPR), were investigated. Then, patient's information was collected through researcher-made checklist and eventually, SPSS software was used for data analysis. Data analysis was done by using descriptive statistics and Chi-square and T-tests.
36.7 percent of CPRs was successful. According to the findings, the average of patient's age was 43.6 years old. Also 50.3% of the subjects were male. 41.2% of CPR cases were done in the morning shift which didnt have a significant relationship with the outcome of CPR (P=0.72). Also, 28.6% of total number of patients before CPR were intubed and 69.9% of the patients who undergone unsuccessful CPR were not intubed before resuscitation.
The results of this study show that the success rate of CPR is almost higher than other studies. Although it was expected that the patient's intubation condition prior to CPR and the time interval between cardio-pulmonary arrest and the start of CPR would have an important impact on the outcome of CPR, but there was no significant relationship between them, it might have been because of the inaccurate registration of the available information in the projects; it is suggested that the related officials, should come up with the essential ideas to make sure that the personnel register the information accurately in the hospital to be used in further studies.

Cardiopulmonary resuscitation consists of the measures taken to restore the functions of brain and heart in a person who has lost his consciousness. The present study was performed with the objective of investigating the relationship between the underlying cause of cardiopulmonary arrest and the successful cardiopulmonary resuscitation and to help to improve the conditions and effective measures in the hospitals so that the successful cardio-pulmonary resuscitations would increase.
In this descriptive and cross-sectional study from September 2016 to March 2017, 199 patients who suffered cardiopulmonary arrest in emergency and wards of Ali-ibn-Abi-Talib and Khatam-al-anbia hospitals of Zahedan and undergone CPR, were investigated Then, the information of the patients was collected through researcher-made checklist and eventually, SPSS software was used for data analysis. Descriptive statistics were used to analyze the demographic data. Then, chi-square and t-test were used for the correlation between variables.
patient's average age was 43 years. The underlying cases which were related to internal diseases were at the top of the table of cardiopulmonary arrest with the frequency of 23.6. Also, 36.7% of performed resuscitations were successful. It was observed that there is a significant relationship between the underlying causes of heart arrest and the result of CPR. Eventually, 4% of studied subjects were discharged from the hospital alive.
There was not a significant relationship between the underlying causes of heart arrest and the result of CPR. The obtained results from this study suggest that the percentage of successful resuscitations in the studied hospitals, comparing to the other studies performed in the country, is high. But in this study, a noticeable percentage of patients died.

Weaning from mechanical ventilation is one of the main stages of treatment as well as applying a tool that can predict the success in weaning is very important. This study aimed to evaluate the success rate of weaning from ventilator in patients admitted at the Intensive Care Unit (ICU) using Burn’s Wean Assessment Program (BWAP) checklist.
The present analytical cross-sectional study was carried out on 100 mechanical ventilation-dependent patients connected to the ventilator for more than 72 hours. All patients were selected by simple available sampling based on purposive sampling method and examined by BWAP checklist and were weaned from ventilator by obtaining scores over 18.
The total number of patients participating in the study was 100, 71 males and 29 females. There was no significant relationship between gender and success or failure of weaning process based on chi-square test (p Investigating preparation for weaning using Burn’s Scale is more useful for patients who had no prolonged hospitalization at ICU and ventilated through an endotracheal tube.

One of the more infrequent congenital diseases with a wide spectrum of symptoms and more complications of the right side of pulmonary artery (63% according to Ten Harkel) is unilateral pulmonary artery agenesis (UPAA). The clinical presentation is variable, and many patients can be asymptomatic for many years and even throughout their lives. Although the disease more frequently appears in childhood with moderate to severe respiratory symptoms, some patients continue living with the disease up to adulthood. The abnormality is sometimes concurrent with cardiac anomalies. Patients with UAPA may be asymptomatic or may present with recurrent pulmonary infections. In a report, a 25-year old woman who had inductional termination of pregnancy at 35 week last menstrual period (LMP) in a rural hospital due to preeclampsia reported as the UAPA patient.

One of the major problems in pediatric surgery is anxiety and fear of separation from parents.
We studied the efficacy of different doses of oral midazolam for pre operation sedation of children.
Patients and In this randomized, double-blinded clinical trial, 120 children aged 1 - 8 years were enrolled in the study .The children were randomly assigned to one of 4 groups and received orally 0.5 mg/kg (group A), 0.8 mg/kg (group B), 1 mg/kg (group C), 0mg/kg (group D) of injectable midazolam mixed with 10 - 15 mL apple juice 45 minutes before separation from parents. Sedation score, changes in MAP, HR, SPO2, respiratory rate, time of recovery and frequency of nightmares evaluated and analyzed with Kruskal-Wallis and ANOVA tests.
The mean age of children was 4.46 ± 2.17 years. Sedation levels in 26 patients in group A and 21 patients in group C were desirable qualified. MAP changes increased in group D and decreased in the other groups. Most changes were observed in group C equals -3 ± 2.5 mmHg. Most changes in heart rate were observed in group D (increased to 11.5 ± 7.41 beat). Most decrease of SPO2 was in group A (-0.86 ± 0.93%). Maximum decrease of RR was in group C (-3.36 ± 2.88%). Maximum of recovery time was observed in group C (76.3 ± 12.67 minutes). Group D had the highest frequency of nightmares (10 children, 58.8%).
Oral midazolam with 0.8 mg/kg, as premedication, reduces recovery time and hemodynamic disturbances .We can use that as appropriate premedication dose in children for reducing children anxiety and fear of separation from parents.

Acute pain intensity after surgical operation is an important predictor of the chronic post-operation pain. Thus, controlling acute pain can play an important role during the convalescence of the patient after surgery. Preemptive analgesia indicates that if controlling the pain process starts before onset of the painful process, it will be more effective than after onset of the painful process. This study was designated with regard to the importance of controlling pain and special properties of celecoxibs. As a double-blind clinical trial, the study was conducted on 80 people who have undergone leg surgery. Patients were divided into two 40-member groups and were treated with 200 mg celecoxib or placebo two hours before surgery. The statistical blocks were used for randomization purposes. Both the patient and the person who was responsible for checking the pain intensity and opioid intake were not informed on the prescribed medicine. After the surgery was wrapped up, the patient’s pain intensity was estimated based on Visual Analog Scale (VAS) 2, 6, 12 and 24 hours after surgery. After 24 hours, the uptake amount of the consumed opoid was recorded in the information form. The difference in VAS of patents two hours after surgery was not significant statistically (p=0.2); while in celecoxib group it became significantly lower than placebo group in the hours 6 (p=0.038), 12 (p=0.037) and 24 (p=0.038) after surgery. Also pethidine intake has been significantly decreased (p=0.042) in celecoxib group compared to the placebo group. Taking 200 mg celecoxib two hours before operation will decrease significantly pain intensity and opoid intake after surgery.