جستجوی مقالات مرتبط با کلیدواژه "level of consciousness" در نشریات گروه "پزشکی"

Traumatic brain injury (TBI) is an acquired brain tissue injury with different severities that leads to a change in the patient’s level of consciousness.

The present study aimed to compare the impact of foot reflexology massage and familiar sensory stimulation on the level of consciousness of trauma patients admitted to the intensive care units (ICUs) of Khatam Al-Anbia Hospital in Zahedan in 2021.

This quasi-experimental study was conducted with a pretest-posttest design on 135 trauma patients with an altered level of consciousness admitted to the ICUs of Khatam Al-Anbia Hospital in Zahedan in 2021. The participants were selected using convenience sampling from the patients who met the inclusion criteria and were randomly assigned to 3 groups: Foot reflexology massage, familiar sensory stimulation, and control groups (each with 45 patients). The foot reflexology massage group received reflex massage on both feet for 30 minutes, the familiar sensory stimulation group received familiar sensory stimulation for 45 minutes, and the control group received ICU routine care. The interventions were carried out for 1 week in 2 morning and evening shifts. The patient’s consciousness level was measured and recorded using the Glasgow Coma Scale (GCS) 5 minutes before and 30 minutes after the intervention. The data were analyzed using SPSS version 22, as well as using analysis of variance (ANOVA), paired samples t-test, independent samples t-test, and analysis of covariance (ANCOVA) at a significance level of 0.05 (P < 0.05).

The data showed that the average consciousness score for the patients in both foot reflexology massage and familiar sensory stimulation groups increased significantly after the intervention compared to the control group (P = 0.001), but the 2 interventions were not significantly different in improving the level of consciousness of the patients.

Foot reflexology massage and familiar sensory stimulation were both equally effective in increasing the level of consciousness of trauma patients with an altered level of consciousness, and none of them was superior to the other. Thus, nurses can use these 2 complementary medicine methods to speed up the improvement of consciousness of patients with TBI.

Coma is one of the severe complications of traumatic brain injury. The study aimed to determine the effect of auditory sensory stimulation on the level of consciousness and cognitive function of patients with traumatic brain injury.

Methods & Materials:

 This study is a triple-blind randomized controlled clinical trial on 60 patients with traumatic brain injury selected using consecutive sampling. They were then randomly assigned to control and intervention groups. The patients in the intervention group received auditory sensory stimulation (twice a day for 15 minutes), while those in the control group only received the routine sounds of the ward (through headphones) for six days. The data were measured using the Glasgow Coma Scale and the Rancho Los Amigos Scale daily. SPSS software version 22 and descriptive and inferential statistics were used for data analysis.

According to the independent samples t-test, there was a significant increase in the level of consciousness on the third, fifth, and sixth days after the intervention among the patients in the intervention group compared to the control group (P=0.001). The findings of two-way repeated measures ANOVA revealed that auditory sensory stimulation could lead to a statistically significant improvement in the cognitive function of patients in the intervention group compared to the control group (P= 0.003).

Because of the improvement of the level of consciousness and cognitive function resulting from auditory sensory stimulation, this method is recommended to improve consciousness and cognitive function in patients with traumatic brain injury.

Patients with traumatic brain injury (TBI) experience changes in their level of consciousness (LOC). Royal Jelly is used in the treatment of neurological diseases.

This study aimed to examine the effect of royal jelly on the LOC of patients with TBI.

This double‑blind randomized trial was performed in 2020 on 61 patients with TBI admitted to the intensive care unit. The patients were recruited consecutively and randomly assigned to an intervention (n = 33) and a control (n = 28) group. Patients in the intervention group received 3000 mg of royal jelly orally each day for 14 days, while those in the control group received routine care. The LOC was evaluated using the Glasgow Coma Scale (GCS) and Full Outline of Unresponsiveness (FOUR) score from day 1 to day 14. Data were analyzed using the repeated measures analysis and analysis of covariance.

The mean baseline GCS scores of the intervention and the control group were 4.39 ± 0.61and 4.82 ± 0.77, respectively, and changed to 11.93 ± 2.41 and 7.60 ± 2.51 at the end of the 14th day (P < 0.001). Furthermore, the mean baseline FOUR scores of the intervention and the control groups were 6.06±0.93 and 6.42 ± 1.16, respectively, and changed to 13.88 ± 2.57 and 9.71 ± 2.40 at the end of the study (P < 0.001).

Using royal jelly for 2 weeks could improve the LOC of patients with TBI. However, further studies are recommended to determine the dose and duration of the usage.

With regards to the importance of traumatic brain injury (TBI) and its high incidence rate in Iran as well as its severe consequences, it is important to determine the safety and efficiency of modafinil to increase the level of consciousness in hospitalized TBI patients.

This double-blind randomized controlled trial was done during 2016. Sixty patients with TBI and moderate GCS score between 9 and 13 had the inclusion criteria and entered the study and were divided into two groups. Patients in the treatment group received 200 mg of modafinil once a day and the control group received the placebo. Overall, 24 hours after admission, defined as base day, modafinil was prescribed for 196 hours after admission and GCS scores were recorded: this period was defined as the last day. Level of consciousness in both treatment and control groups was assessed by the GCS score. Data were analyzed by SPSS version 21 software using the independent t-test with intention-to-treat approach.

Among 60 patients, there were 34 (56.66%) males and 26 (43%) females; 45 (75%) survived. The ITT analysis was employed to assess changes in the level of consciousness (LOC) after prescribing modafinil and placebo. Based on the findings, modafinil prescription was not associated with significant differences in LoC in the first time period (24 hours after) and the last day (196 hours) (P > 0.05).

Prescribing modafinil was not associated with significant changes in LoC in comparison with the placebo.

A large number of stroke patients are not the perfect candidate for craniotomy and invasive procedures, so providing an alternative and noninvasive method, which is applicable in terms of costs and facilities, is necessary. Thus, the present study aimed to determine the effects of mannitol 20% on outcome of the patients with nontraumatic intracerebral hemorrhage (ICH) in patients admitted to Isfahan’s Al-Zahra Hospital during 2012 and 2013.

This is a clinical trial study which is conducted during 2012–2013 in Isfahan’s Al-Zahra Hospital. In this study, 41 patients suffering from ICH received mannitol 20% for 3 days, and volume of hemorrhage and Glasgow Coma Scale (GCS) of patients were controlled every 12 h. The collected data were analyzed via SPSS software.

The mean ICH volume was 22.1 ± 6.3 ml in pre intervention and 38.4 ± 19.3 ml in post intervention, and according to the t-paired test, before and after treatment the difference was signifi cant (P < 0.001). Hemorrhage volume was stable in nine patients (22%), it increased in 25 patients (61%), and decreased in seven patients (17.1%). The mean index of GCS before and after treatment was 11.85 ± 1.6 and 9.37 ± 2.65, respectively. Moreover according to t-paired test, the difference was signifi cant before and after treatment (P < 0.001). During using mannitol, the GCS index was stable in eight patients (19.5%), it increased in eight patients (19.5%) and decreased in 25 patients (61%).

Mannitol injection was not effective in reducing hemorrhage size, and its use is not recommended, also, further studies in this fi eld have been proposed.

Coma is one of the most important complications of brain injury. Comatose patients in the intensive care units are exposed to sensory deprivation. This study aims to survey the effect of family members' voice on level of consciousness of comatose patients hospitalized in the intensive care units.

In this single-blind randomized controlled trial, 40 comatose patients with brain injury with acute subdural hematoma in intensive care units were randomly assigned into two groups. The intervention group was stimulated twice a day each time 5-15 min with a recorded MP3 from family members' voice for 10 days. The patients' level of consciousness was measured with Glasgow Coma Scale before and after auditory stimulations. In the control group, GCS was measured without auditory stimulation with the same time duration like intervention group. Data analysis in software SPSS version 15 and using Chi-square test, independent t-test, paired t- test and analysis of variance with repeated measures was done.

On the first day before the intervention, there was no a statistically significant difference between the mean of GCS in both groups (P = 0.89), but on the tenth day after the intervention, there was a significant difference (P = 0.0001) between the mean GCS in both control and intervention groups. Also, there was a significant difference between the mean daily GCS scores in two groups (P = 0.003). The findings during ten days showed the changes in the level of consciousness in the intervention group from the 4 rd day of the study were more in the mean daily GCS scores than control group.

This study indicated that family members' voice can increase level of consciousness of comatose patients with acute subdural hematoma.

The relation between serum osmolality, glucose, sodium, bicarbonate, arterial pH, BUN and level of consciousness was studied in 189 patients with diabetic ketoacidosis (DKA). There was much overlap between all laboratory values among various groups, even when there was a statistically significant difference. To find a better predictor, we defined a new factor as serum osmolality/arterial pH. This factor was significantly higher in drowsy and stuporous compared with alert and drowsy patients (p=0.007 and p=0.03 respectively), but not different between stuporous and comatose patients (p= 0.46). Again much overlap could be seen between groups. There was at least one other problem, either as a coexisting or a precipitating factor, in 18 (23.3%) of the alert, 24 (29.2%) of the drowsy, 11 (43.4%) of the stuporous and 4 (57.1 %) of the comatose group. We conclude that none of these clinico-biochemical parameters can be a reliable predictor of the level of consciousness in patients with DKA, and consideration and exclusion of other conditions associated with altered consciousness that may occur in diabetics should be routine.