Zahedan Journal of Research in Medical Sciences
Volume:26 Issue: 4, Oct 2024

The neurological assessment plays a crucial role in evaluating stroke patients and is a skill that has been practiced by physicians for a long time, and further refined by practitioners. The purpose of the current study was to systematically review and synthesize the evidence-based neurological assessment of the different methods of treadmill-related training protocols in stroke patients.

Evidence Acquisition:

 In this study, the appropriate studies were documented (N = 1270) using PubMed as the sole electronic database. Moreover, subgroup studies were provided based on training intensity and duration, categorized as low intensity-low duration, low intensity-high duration, high intensity-low duration, and high intensity-high duration. Training intensities were standardized to meters per second (m/s), and the training duration was calculated in terms of minutes per session, the number of sessions per week, and the total number of training weeks, which were then converted into minutes. The assessment of neurological recovery following stroke was conducted using standard neurological assessment scales.

This meta-analysis in humans found a notably positive standardized mean difference in protocols with high intensity and high duration (1.792; 95% CI = 0.566 to 3.02).

In conclusion, the current meta-analysis suggests that practitioners using the high intensity-high duration protocol should regularly monitor the neurological outcomes, as they may be negatively impacted by the intensity and duration of the protocol.

Context:

 In recent years, there has been a growing emphasis on ensuring the accuracy and reliability of research findings. However, the reporting of reliability and validity measures in nursing research articles (RAs) remains underexplored.

This study aimed to investigate the current trends in reliability and validity reporting within nursing RAs and explore the implications of these practices.

The study analyzed 42 RAs published between 2021 and 2022 from seven key nursing journals. The inclusion criteria were defined to incorporate empirical studies that employed tests and/or questionnaires. To maintain consistency and homogeneity, we exclusively included studies that relied on data collected through these methods. Title and abstract screening were performed by two independent reviewers, followed by a full-text review.

The study revealed a concerning lack of attention to reliability and validity reporting. A significant portion of the reviewed articles (19.05%) did not explicitly report reliability measures, and an even larger proportion (38.10%) failed to report validity measures.

Our findings highlight the need for a significant change in how nursing research reports reliability and validity measures. By improving the clarity of these reports, researchers can enhance the trustworthiness of their findings and ensure that they can be applied more broadly in nursing practice.

Nosocomial sepsis is a leading cause of morbidity and mortality worldwide. Understanding the antibiotic susceptibility patterns of pathogens specific to each geographic region is essential for effective patient management.

This cross-sectional study aimed to investigate the microorganisms causing nosocomial sepsis and their antibiotic sensitivity in patients admitted to three referral hospitals in Isfahan, Iran. Clinical information and blood culture results were obtained from hospital records. Results from patients without signs of sepsis, as well as contaminants and community-acquired isolates, were excluded. Stratification was conducted based on sex and age (< 20 and > 20 years) categories.

In this study, 267 patients with hospital-acquired sepsis were identified, with gram-negative bacteria accounting for 77.2% of infections. The most common pathogens included Klebsiella spp. (35.2%), Acinetobacter spp. (21.7%), Enterococcus spp. (13.5%), Escherichia coli (8.6%), Pseudomonas aeruginosa (8.6%), and Staphylococcus aureus (8.2%). The highest resistance among gram-negative bacteria was observed with cefepime (80.3%), ceftazidime (76.5%), cefotaxime/ceftriaxone (70.0%), trimethoprim-sulfamethoxazole (68.6%), ciprofloxacin (68.2%), meropenem (60.0%), and amikacin (50.3%). All gram-negative isolates were sensitive to colistin. Among gram-positive bacteria, the highest resistance was to ciprofloxacin (77.3%), ampicillin (75.7%), clindamycin (74.4%), vancomycin (64.9%), and gentamicin (30.0%). All gram-positive isolates in this study were sensitive to linezolid.

The study indicates a high level of resistance among bacterial agents causing nosocomial sepsis in the studied area. Consequently, treatment may necessitate the use of last-line antibiotics, such as linezolid and colistin.

Identifying risk factors that predict mortality in the intensive care unit (ICU) can lead to improved management of critically ill patients and help reduce mortality rates.

This study aimed to identify the prevalence and risk factors that potentially contribute to predicting mortality in the ICU.

This cross-sectional study was conducted in the general ICU of an academic hospital in northeastern Iran from April 2019 to March 2023. Demographic and clinical data were retrieved from medical records, including age, gender, marital status, residency, length of stay in the ICU, level of consciousness, duration of mechanical ventilation (MV), and co-morbidities. The outcomes were categorized as death or discharge.

Out of 8,650 admitted patients, 62.8% were discharged, and 37.2% died. The factors significantly associated with death included age (59.24 ± 21.9 years vs. 49.63 ± 23.32 years, P < 0.0001), female gender (42.7% vs. 57.3%, P < 0.0001), marital status (41.1% married vs. 58.9% unmarried, P < 0.0001), length of stay in the ICU (5.99 ± 9.09 days vs. 4.13 ± 6.55 days, P < 0.0001), Glasgow Coma Scale (GCS) of 3 - 5 (87.9% vs. 12.1%, P < 0.0001), duration of MV (4.86 ± 8.69 days vs. 1.09 ± 4.85 days, P < 0.0001), and co-morbidities (44.7% vs. 55.3%, P < 0.0001), which were confirmed by logistic regression analysis.

The prevalence of death in the ICU was 37.2%. Age, co-morbidities, cerebral vascular accident (CVA), GCS, duration of MV, and marital status were significantly associated with mortality.

Cigarette smoke causes inflammation of the alveoli, leading to airflow restriction and potentially irreversible changes in lung architecture, including pulmonary emphysema. This study investigates the effects of a six-week aerobic interval training regimen on elastin activity in a rat model of cigarette smoke-induced COPD (CS-COPD).

Specifically, we observe the variables matrix metalloproteinase-12 (MMP12) and transforming growth factor-beta (TGF-β1).

Twenty male Wistar rats, aged eight weeks, were divided into four groups (n = 5 per group): Control, aerobic interval training (Exe), cigarette smoke extract (CSE), and CSE + Exe. The aerobic interval training (Exe) was performed for 49 min/day, five days per week for six weeks in interval form. The CSE group received an intraperitoneal (IP) injection of 150 µL of CSE, one day per week for six weeks.

The CSE and CSE + Exe groups showed a significant decrease in elastin gene expression in lung tissue compared to the healthy control group (P = 0.0002 and P = 0.0057, respectively) and the Exe group (P = 0.0002 and P = 0.0042, respectively). Additionally, the CSE group exhibited a significant increase in lung MMP12 gene expression compared to the healthy control and Exe groups (P = 0.0008 and P = 0.0013, respectively). Notably, the CSE + Exe group showed a significant decrease in MMP12 gene expression in lung tissue compared to the CSE group (P = 0.0015). Furthermore, the CSE and CSE + Exe groups demonstrated a significant increase in TGFB1 gene expression in lung tissue compared to the healthy control group (P < 0.0001 and P = 0.0022, respectively) and the Exe group (P < 0.0001 for both).

Our findings indicate that the group exposed to cigarette smoke experienced a significant decrease in elastin levels, accompanied by an increase in MMP12 and TGF-β1 expression. Although aerobic interval training provided some protection against the detrimental effects of cigarette smoke exposure, it was not sufficient to fully reverse the harmful impacts of the disease.

Thyme is widely recognized for its antimicrobial properties, attributed to the effective compounds present in its extract that inhibit and destroy pathogenic bacteria.

This study explores the impact of combining thyme extract with biosurfactants on pathogenic bacteria and biofilm. The biosurfactants 12B and SG have inherent antimicrobial effects, and their combination with thyme extract demonstrated synergistic effects.

The experiments involved preparing methanolic thyme extract in combination with biosurfactants 12B and SG. Disk diffusion and well diffusion tests were conducted to assess the antimicrobial activity of this combination. The inhibition zones for Acinetobacter baumannii , Bacillus cereus , Escherichia coli , and methicillin-resistant Staphylococcus aureus (MRSA) were measured. Further tests determined the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) for these bacteria. To evaluate synergistic effects, the fractional inhibitory concentration (FIC) and fractional inhibitory concentration index (FICI) were calculated.

The anti-biofilm effects of the biosurfactants combined with thyme extract were analyzed by testing biofilm formation inhibition, biofilm destruction, and inhibition of dehydrogenase enzyme activity within the biofilm. Biofilm assays were conducted using microplates, with readings taken at 490 nm using an ELISA reader.

The biofilm tests demonstrated the effectiveness of thyme extract combined with biosurfactants. The results indicated that this combination exhibits antibacterial, anti-biofilm, and synergistic effects, making it effective against both antibiotic-resistant and non-resistant pathogenic bacteria.

General and spinal anesthesia are commonly used for cesarean sections, each with implications for both the mother and the fetus. The choice of anesthesia technique depends on various factors. While spinal anesthesia is often preferred for cesarean surgeries due to its well-known benefits, general anesthesia may be chosen in emergency situations. The decision is ultimately based on the safety profile and benefits for both the mother and the fetus.

This clinical trial was conducted at Fatemieh Hospital in Hamadan and involved 60 patients undergoing elective cesarean section. The patients were randomly divided into two groups of 30: One group received spinal anesthesia, and the other group received general anesthesia. Variables such as intraoperative bleeding, the Apgar score of the newborn, postoperative pain, and postoperative systolic and diastolic blood pressure were analyzed and compared between the two groups using SPSS software version 16.

The mean age of participants in the spinal and general anesthesia groups was 32 ± 3.5 years and 34 ± 3.4 years, respectively. The results showed that the amount of intraoperative bleeding in the general anesthesia group was higher than in the spinal anesthesia group, but this difference was not statistically significant (P = 0.85, P < 0.05). The Apgar scores at the first and fifth minutes in the spinal anesthesia group were higher than those in the general anesthesia group, but this difference was also not statistically significant (P = 0.32, P < 0.05). Postoperative pain in the spinal anesthesia group was significantly lower than in the general anesthesia group (P = 0.001, P < 0.05). Regarding hemodynamic parameters, systolic blood pressure after the operation was higher in the spinal anesthesia group compared to the general anesthesia group (P < 0.05). Conversely, diastolic blood pressure in the general anesthesia group was higher than in the spinal anesthesia group at all measurement stages, though not statistically significant in some measurements (P > 0.05).

The results of our study indicate that spinal anesthesia is a preferable and safer method compared to general anesthesia, based on the parameters examined, particularly in emergency cesarean sections.