Pars Journal of Medical Sciences
Year:2023 | Volume:20 | Issue:4|Papers Count:8

Introduction: One of the basic features of a successful anesthesia is reversible loss of consciousness with immobility, lack of awareness, not responding to painful stimulation and not remembering surgical interventions. The present study was conducted with the aim of comparing ketamine and dexmedetomidine in maintaining hemodynamic stability in laparoscopic head cystectomy surgery with general anesthesia. Materials & Methods: This study is a double-blind randomized clinical trial Study. 90 patients aged 18 to 44 (in three groups of 30) were evaluated during general anesthesia. Inclusion criteria included anesthesia class (ASA I, II) and consent to participate in the study. Patients were randomly divided into three groups: 1) control and 2) intervention with ketamine, intervention and 3) intervention with dexmedetomidine. Patients' hemodynamic symptoms (systolic blood pressure, diastolic blood pressure, mean arterial pressure, blood oxygen saturation percentage and heart rate) were evaluated. Data analysis was done using descriptive statistics (mean, percentage and standard deviation) and inferential statistical tests (Mann-Whitney and Kruskal-Wallis) using SPSS version 21 software. Result: The findings of the research showed that between the three groups of ketamine, dexmedetomidine and control in the times before induction, after induction, 5 minutes after, 15 minutes after, 30 minutes after, 60 minutes after, in recovery and outside of recovery, from There is a significant difference in mean systolic and diastolic blood pressure and mean arterial blood pressure (P<0. 05). But there was no significant difference in heart rate between the three groups at these times (P<0. 05). The average percentage of blood oxygen saturation in the ketamine group was lower than the dexmedetomidine and control groups (P<0. 05). Conclusion: Based on the results of the present study, the use of dexmedetomidine in laparoscopic cholecystectomy surgery compared to ketamine causes hemodynamic stability in laparoscopic cholecystectomy surgery with general anesthesia.

Introduction: Organizational health and flexibility enable organizations to manage complex challenges in the organization such as the occurrence of crises such as Covid-19. The purpose of this research was to determine the relationship between organizational health and organizational flexibility with the mediating role of stress of contracting Covid-19 in medical personnel of Shohdai Anohmim Yasuj Hospital in 2022. Methodology: In a cross-sectional descriptive study, 160 medical staff working in Shahada Anhomesh Yasouj Hospital were selected by simple random sampling. The treatment staff responded to the Organizational Health Scale (OHI) of Hoy and Fidman, the Organizational Flexibility Questionnaire of Mofabi et al., and the standard Covid-19 stress questionnaire. Data analysis was done using structural equation modeling and SPSS20 and SMART PLS software at a significance level of 0. 05. Result: The results showed that the average age of the participants was 32. 18±, 1. 62, and 98 people (61. 25 percent) were women and 62 people (38. 75 percent) were men. The findings showed that organizational health has a positive and significant relationship with organizational flexibility and a negative and significant relationship with the stress of contracting Covid-19 (p<0. 001). The stress of contracting Covid-19 has a negative and significant relationship with organizational flexibility (p<0. 001). The stress of contracting covid-19 significantly plays a mediating role between the relationship between organizational health and organizational flexibility (p<0. 001). Conclusion: The results show that organizational health and organizational flexibility have a positive and strong relationship, also the stress of contracting Covid-19 has a mediating role with its inverse and significant relationship between these two variables, so it seems that by controlling the stress of contracting Covid-19 Organizational health and organizational flexibility can be improved.

Introduction: Covid-19 patients perceive a lot of stress and suffer from psychological symptoms including depression, stress and anxiety. Because these patients are required to comply with quarantine conditions, remote training can be used for these patients. Therefore, this study was conducted with the aim of investigating the effect of remote training of stress management in a cognitive-behavioral way on the psychological symptoms of covid-19 patients. Materials and Methods: In this randomized clinical trial, the research population was all the patients with Covid-19 referred to the Dr. Garazi hospital in Isfahan city in the winter of 1400. 70 people were selected by available sampling method and divided into two intervention and control groups (35 people) by limited randomization method. For the intervention group, remote training program on stress management was implemented in five sessions of 60 minutes in two weeks. The control group did not receive training. Psychological symptoms were measured before and after the training sessions using the DASS-21 questionnaire. The data were analyzed with SPSS21 software and at two levels of descriptive and inferential statistics and by performing chi-square tests, analysis of variance, independent and paired t-test, and analysis of covariance. Results: Remote training of stress management in a cognitive-behavioral way has had a significant effect on all dimensions of psychological symptoms of covid-19 patients in the intervention group and has reduced them in the intervention group. (p≤, 0. 05). Conclusion: Based on the results, this method of training can improve the psychological symptoms of covid-19 patients. Considering the possibility of easy and comprehensive use of distance education, it is recommended to use this method of teaching patients in similar pandemic conditions.

Introduction: Patient participation in treatment decisions has been associated with improved treatment results. By checking the level of knowledge of patients and informing patients about the risks and benefits of treatment methods, the level of participation of patients in treatment can be checked. This study was conducted with the aim of determining the participation rate in the treatment of breast cancer patients. Materials and Methods: The current cross-sectional study was conducted in descriptive and analytical form in 2019. The statistical population includes 15 doctors who worked in the field of breast diseases and 300 patients with breast cancer who visited clinics and doctor's offices in the cities of Shiraz, Kerman, Rasht and Tabriz, who were selected by cluster random sampling. In order to measure the level of participation, a researcher-made questionnaire was used after validity and reliability. The data were analyzed using SPSS 20 software with the help of descriptive statistics and chi-square inferential tests. Results: The findings of the research showed that patients' participation in treatment has a significant and direct relationship with age, education, duration of illness and income of patients (P value < 0. 05). Based on the findings of this study, patient participation was reported in three areas (decision-making process (53%), doctor's practical behavior (67. 6) and patient preferences (66. 2)) and in general, the level of participation in the treatment of patients with Breast cancer was estimated at 52%. Conclusion: Empowering patients by increasing awareness about diagnosis and treatment, as well as covering breast cancer as a special disease and receiving treatment allowances, can help increase patient participation.

Introduction: In recent decades, many high-level policy documents of the country have emphasized the need for mission-oriented focus and differentiation of scientific institutions to achieve scientific authority. The aim of this study was to quantify the scientific authority of the best evidence-based indicators and the desirable model in Jahrom University of Medical Sciences. Materials and Methods: In this research, which was conducted through expert decision-making and the hierarchical group decision-making model to design. Initially, nominal groups from various departments provided their prominent indicators and reviewed their current status in terms of weaknesses, strengths, opportunities, and threats. In multiple expert panels with 5 specialized sessions, the current situation was analyzed by combining the 4 components of the strategic plan, the prominent indicators were quantified, and then the main priorities were explained in order of priority by weighting the indicators from the Group Analytic Hierarchical Process. Results: The results of the hierarchical group decision-making model in determining the prominent indicators of the university showed that the fields of education, research, infrastructure/human resources, and medical services are identifiable. Each indicator has many sub indicators and model design as an authority in university. Conclusion: Based on the research findings, universities can establish scientific authority, along with the available evidence, can provide a basis for the development of universities in line with the country's scientific development plan. It is crucial to clarify the identities of universities and develop suitable operational programs to facilitate the realization of these goals.

Introduction: The most common method of choice for orthopedic lower extremity surgery is intrathecal anesthesia. Despite the benefits of using spinal anesthesia, this method has complications such as headache in the acute postoperative period. Therefore, this study aims to compare Madin and Parmadin methods. The incidence of PDPH (Post-Dural-puncture headache) in patients undergoing orthopedic lower limb surgery was performed by spinal anesthesia. Materials and Methods: This double-blind clinical trial was performed on 60 orthopedic surgery patients referred to Pimayeh Hospital in Jahrom. Inclusion criteria included expressing consent to participate in the study, ASA class 1 and 2, no migraine and chronic headaches, no cardiovascular disease, no coagulation disease. Patients accidentally throwing coins into two groups 1) Medin And 2) paramedins were divided. Vital signs were recorded before and after spinal anesthesia at 5, 15, 30, 45, 60, and 90 minutes during surgery and in recovery. PDPH was collected in patients after surgery for 7 days and once a day by an uninformed person in the form of a questionnaire. After collecting data, the data were statistically analyzed using SPSS software version 21. To report descriptive statistics, qualitative variables were reported using frequency and percentage, and quantitative data were reported using mean and standard deviation. Analysis of variance with repeated measures and Chi-square test were used. P <0. 05 will be considered as a significant level. Results: A total of 60 patients undergoing orthopedic surgery were evaluated by spinal anesthesia in the age range of 16 to 90 years (in two groups of 30). In pre-spinal anesthesia, immediately after spinal anesthesia, 5 minutes, 15 minutes and 30 minutes after spinal anesthesia, and in recovery, there was no significant difference between median and paramedic groups in mean systolic and diastolic blood pressure. (05/0> P). In the periods before spinal anesthesia, immediately after spinal anesthesia and 5 minutes after spinal anesthesia, there was a significant difference in mean heart rate between Medin and Paramedin groups (P <0. 05). On the first and fourth days, the incidence of PDPH was higher in the paramedin group than in the medin group. But the results of statistical analysis showed that there was no significant difference between the two groups in the incidence of PDPH at different times (p <0. 05). Conclusion: Although different benefits have been mentioned for each of Madin and Paramedin methods, but in relation to the incidence of headache, in this study, no significant difference was reported between Madin and Paramedin groups. Therefore, with more studies and more studies related to patient satisfaction, the best method can be used in choosing intrathecal anesthesia technique.

Introduction: The purpose of this study is to compare the accuracy of the real-time ultrasound method in determining the correct location of intubation, compared to conventional methods, in the patients of the emergency department of Imam Rezai Hospital in Mashhad. Methods & Materials: This is a descriptive-analytic prospective study to determine the diagnostic value of real-time ultrasound for the accuracy of intubation. The standard test to determine the correct intubation is lung auscultation findings, checking ventilator curves and, if observed, passing the tracheal tube through the vocal cords. Data analysis was done to calculate sensitivity, specificity, positive and negative news value. A positive test was considered as passing the endotracheal tube into the esophagus (wrong tube placement). Results: In this study, 52 patients were examined. Endotracheal intubation was confirmed by chest auscultation in 30 cases. By observing ventilator curves, confirmation of endotracheal intubation was confirmed in 26 cases. Observation of vocal cords was confirmed in 37 cases. Based on this, 26 patients had all three approval scales for endotracheal intubation. Ultrasound confirmed the correctness of intubation in 36 cases. Considering the gold standard as the positiveness of all three tests, and considering the fact that the tube does not pass through the trachea as the factor we are looking for, the sensitivity of endotracheal ultrasound is 96. 15% and its specificity is 57. 69%. Came. The values of PLR, NLR, PPV, NPV were 2. 27, 0. 07, 69. 44% and 93. 75%, respectively. Conclusion: In short, tracheal ultrasound test has a higher specificity than sensitivity for detecting tracheal intubation errors, which means that it is more effective in correctly identifying patients whose intubation errors did not occur than those who did. It is more reliable. However, the high rate of intubation errors in our study affects these results.

Introduction: Lycopene is a lipophilic carotenoid found in high quantities in tomatoes. The aim of this study was to investigate the effects of lycopene on serum concentrations of leptin, cholecystokinin, neuropeptide Y, and body weight changes in adult female rats. Methods & Materials: In this experimental study, 32 adult female Wistar rats were divided into four groups of eight including control, Sham, and two experimental groups receiving lycopene (at concentrations of five and 10 mg/kg). Lycopene was administered to the animals by gavage. Twenty-nine days after the start of the experiment and after weighing the animals, blood samples were taken from heart and serum concentrations of cholecystokinin, leptin, and neuropeptide Y were measured. Results were analyzed using ANOVA statistical test and Duncan's test at significance level of p≤, 0. 05. Results: Lycopene at concentration of 10 mg/kg significantly increased leptin (4. 01±, 0. 62) and cholecystokinin (1158. 62±, 65. 68) while significantly reduced neuropeptide Y (138. 05±, 26. 09) and body weight (21. 12±, 2. 10) compared to the control group (leptin: 3. 07±, 0. 47/ cholecystokinin: 925±, 158. 55/ neuropeptide Y: 200. 45±, 26. 55/ body weight: 24. 50±, 2. 82) (P<0. 05). Conclusion: Lycopene reduces body weight by increasing serum levels of appetite-reducing hormones (leptin and cholecystokinin) and inhibition of orexigenic neuropeptide Y hormone.