Pars Journal of Medical Sciences
Year:2023 | Volume:21 | Issue:4|Papers Count:8

Introduction: Rhinoplasty is one of the most challenging cosmetic surgeries. The nature of surgery itself and hemodynamic instability in patients causes bleeding during surgery, which affects the quality of the surgical field of view, complications during and after surgery, and the outcome of surgery. Therefore, the purpose of this study is the effect of tranexamic acid drug on hemodynamic changes in patients undergoing septorhinoplasty surgery.Materials & Methods: This double-blind randomized clinical trial study was conducted on 51 patients aged 18 to 44 years with anesthesia class І, II who were candidates for septorhinoplasty surgery. The patients were randomly divided into two groups of tranexamic acid and control. Hemodynamic parameters at times; before induction, after induction, 1 minute after induction, 5 minutes after induction, 30, 60, 90 and 120 minutes during the operation, entry into recovery and exit from recovery were measured. Data analysis was done using spss software version 21 and descriptive statistics (mean and standard deviation) and inferential statistical tests.Results: The average trend of systolic and diastolic blood pressure from the time before induction to outside of recovery in the control and tranramic acid groups showed a significant difference (P<0.001). In the times before and after induction, 5 minutes, 15 minutes, 30 minutes, 60 minutes, 90 minutes, 120 minutes, a significant difference in the average heart rate between the two groups was observed (P<0.05). In the control group and the tranamic acid group, the mean trend of O2SAT from the time before induction to the time outside of recovery showed a significant difference (P<0.001).Conclusion: The results of the present study showed that the use of a dose of 250 mg of tranexamic acid had adecreasing trend in the average hemodynamic changes over time, and during these times, the decreasing changes in heart rate were significant. Therefore, it seems that tranexamic acid can be used in septorhinoplasty surgery to maintain hemodynamic stability.

Introduction: Inadequate health literacy will lead to an increase in mortality and disease burden, as well as an increasein healthcare costs in adults. The aim of the present study was to investigate health literacy and related factors among the clients of comprehensive health service centers in Jahrom city in 2023.Materials & Methods: The present study was an analytical cross-sectional study that was conducted on 648 people aged 30 to 65 in Jahrom city. Multi-stage sampling was used in this study. A standardized health literacy questionnaire and demographic characteristics were used to collect information. The collected data were analyzed using SPSS22 software using Chi-Square test. A significance level of p<0.05 was considered.Results: The average age of the participants was 10.48±44.68. Of the total participants, 19.3% had inadequate health literacy, 26.4% had limited health literacy, 36.6% had adequate health literacy, and 19.8% had excellent health literacy. Health literacy showed a statistically significant relationship with gender, age, marital status, education level and financial status (p<0.01).Conclusion: Health literacy was reported to be unfavorable in more than 45% of the population aged 30 to 65 in Jahrom city. Therefore, designing interventions to increase health literacy in adults based on demographic variables can help improve the health of this group of people.

Introduction: Cataract is one of the most common diseases in the world and the most common cause of vision lossand blindness in the world. Stability of hemodynamic symptoms is one of the most important factors during cataract surgery. Therefore, the aim of this study is to investigate the effect of melatonin and tizanidine on hemodynamic parameters and anxiety in patients undergoing cataract surgery.Materials & Methods: This prospective clinical trial study was conducted on 90 patient's candidates for cataract surgery.Patients into three equal groups; Melatonin, tizanidine and placebo were divided. Hemodynamic parameters were recorded at baseline and every 5 minutes during surgery. After the operation was completed and the patients were transferred to the recovery room, postoperative anxiety in the recovery room and 24 hours after the operation (calling the patient) was checked by means of RASS tools.Results: There was no difference in the variables of age, sex, weight between the studied groups. Heart rate, diastolic and systolic blood pressure decreased over time in all three groups. Diastolic blood pressure in the 10th minute of surgery (late surgery) in the tizanidine group was significantly lower than the control group (P<0.05). Tukey's post hoc test showed that in the recovery room, the level of anxiety in people who received melatonin or tizanidine was significantly lower than the control group (P<0.05). There was no difference between the anxiety levels of the melatonin group and the tizanidine group (P=0.904).Conclusion: The results of this study showed that melatonin and tizanidine can reduce the anxiety of patients in theacute phase after surgery. Since tizanidine may lower blood pressure, melatonin prodrug seems to be a better option for reducing pain and anxiety in patients undergoing cataract surgery.

Introduction: Empathy is one of the most effective indicators of nursing performance, therefore understanding theconcept of empathy in the ICU seems necessary to provide better care in this challenging environment. However, empathy faces barriers in this area. This study was conducted using the content analysis approach with the aim of explaining the factors that inhibit among in intensive care nurses.Materials & Methods: In this qualitative study, 12 semi-structured interviews were conducted with an average duration of 30-45 minutes with ICU nurses selected by purposive sampling during the period 2021-2022. The interviewees' statements were analysed after being recorded and converted into text using MAXQDATA 11 software and conventional content analysis methods.Results: The coding process was carried out after removing duplicate codes and merging similar codes as a continuous comparative analysis. Eleven subcategories and three main themes were identified, including "organisational barriers", "individual barriers" and "barriers related to environmental and cultural factors". Finally, the general theme (the main theme) was obtained under the title 'Barriers to empathy in nurses'.Conclusion: The results of this study showed that intensive care nurses face significant barriers to empathy. Giventhat knowledge of the barriers to empathy and their removal will contribute greatly to improving patient care, it is necessary to identify and remove the existing barriers known to managers and policy makers.

Introduction: Blastocystis is an extracellular and noninvasive unicellular enteric parasite with zoonotic potential.Intestinal epithelial cells produce nitric oxide (NO), primarily on the apical side, in order to target luminal pathogens. L-arginine acts as a substrate for inducible nitric oxide synthesis (iNOS), which leads to the synthesis of nitric oxide. The current study was designed to assess the effect of L-arginine on Blastocystis ST3 in vitro conditions.Materials and Methods: The parasite was cultivated in DMEM F-12`s medium and was then identified by polymerase chain reaction (PCR) and the subtype of the parasite was determined which was subtype 3. Then, the methyl thiazolyl tetrazolium (MTT) and flow cytometry methods were used to evaluate the cytotoxicity and probable apoptosis of the prepared drugs /substances on CaCO2 cells. This study investigated the concentrations of L-arginine ( 0.1, 0.2, 0.4, 0.8 and 1.6 mM ) and Metronidazole (1, 2, 4, 8 and 16 μg/ml), and their effect on 24 and 48 hour time points after exposure to the parasite. Then, the final number of parasites was counted after staining with trypan blue by a Neubauer slide and the values of IC50 were calculated for each substance.Results: It was found that after 48 hours the number of live Blastocystis trophozoites decreases with the increase in L-arginine concentration and At the concentration of 1.6 mM the number of live trophozoites was 33.83 (P< 0.05).Conclusion: L-arginine, in high concentrations‚ is capable of inhibiting Blastocystis trophozoites In vitro.

Introduction: Female-headed households, due to continuous and chronic exposure to various pressures, often facepsychological challenges. Resilience is a crucial variable influencing the mental health of women in such circumstances. This study aims to assess the impact of implementing the Peplau Interpersonal Theory on the resilience of female-headed household members.Materials and Methods: This is a quasi-experimental study. The target population consisted of female-headed households covered by the Welfare Office of Khorramabad. Using convenience sampling, 60 female householdheads were selected from those covered by the Welfare Office, and they were randomly assigned into two groups: control and intervention. The intervention for the experimental group included face-to-face and individual training sessions based on the Peplau theory. Data were collected using demographic information questionnaires and the Connor-Davidson Resilience Scale before and one month after the intervention. The gathered data were analyzed using descriptive and inferential statistical tests with SPSS software version 22.Results: Both intervention and control groups did not have statistically significant differences in terms of demographic variables and the level of resilience before the intervention (P>0.05). Comparison of the average resilience score showed a significant increase in the participants of the intervention group compared to the control group (p<0.001).Conclusion: Based on the findings of this research, it can be concluded that education based on Peplau interpersonaltheory increases the level of resilience in female-headed households. Therefore, counselors and welfare professionals, as well as other executive bodies, should pay special attention to improving the resilience of female-headed household members.

Introduction: Breast cancer is one of the most common cancers among women. Since microarray is a new method incancer diagnosis, in the current study, the microarray library of MCF-7 breast cancer cells after irradiation was examined to predict the gene expression pattern and metabolic pathways related to it.Materials and Methods: Microarray data extracted from National Center for Biotechnology Information (NCBI) related to MCF- 7 cells were analyzed by GEO2R and R software. Then the genes that had increased and decreased expression were extracted and gene ontology analysis was performed using DAVID and Enrichr databases.Results: In this study, after 48 hours of irradiation, 234 genes with Log2FC>1 increased expression and 146 genes with Log2FC<-1 decreased expression (Adjusted p value <0.05). KEGG analysis on genes with increased expression showed that these genes are related to type 1 diabetes (P=2.43E-04). The genes extracted in this pathway included HLA-DRB5, HLA-DRB4, CPE, TNF, HLA- DRB1 and HLA-DM (Adjusted p value <0.05). Also, the findings show that the genes involved in type 1 diabetes in the islets of Langerhans include CPE, MHC-II, and TNF-α.Conclusion: The findings of this study showed that the increase in irradiation time in breast cancer cells probablyleads to the activation of pathways related to type 1 diabetes through CPE, MHC-II and TNF-α genes in the islets of Langerhans.

Introduction: Nowadays occurrence of resistant to clarithromycin which is a key component of eradication therapyfor Helicobacter pylori strains is a worldwide health concern. Point mutations in 23srRNA gene is one of the main causes of clarithromycin resistance. This study aimed to examine rate of clarithromycin resistance and its link with 23srRNA gene point mutation.Materials and Methods: This study was conducted on 100 patients suffering from gastric complications had referred to Tehran valiasr clinic during january of 2022. Two separate biopsy samples were collected from each patient and used for pathological and microbiological examinations. Antimicrobial susceptibility tests were performed by agar dilution and PCR.Results: 53% (53/100) of the study patients were diagnosed as H. pylori+. Pathological findings indicated that 54.7% (29/53) of the H.pylori+ patients suffered from Chronic Gastritis, 37.7% (20/53) from Sever Active Gastritis and 7.5% (4/53) with Intestinal Metaplasia. Clarithromycin resistant were found among 13.2% (7/53) of patients. The MIC values of 0.125 mg/L and 2 mg/L were determined as the MIC50 and MIC90 values, respectively. Based on PCR results, all clarithromycin resistant strains had point mutations A2142G in 23SrRNA gene.Conclusions: The findings revealed the existence of point mutations in 23srRNA gene which may be related withresistance to clarithromycin in H. pylori strains.