MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES
Year:2018 | Volume:61 | Issue:1 |Papers Count:9

Introduction: Return of spontaneous circulation is the primary goal in cardiac arrest patient and CPR Quality is important determinant of Return of spontaneous circulation. CPR feedback tools have improved the quality of CPR performance, but its effects on patient outcome are unclear. This study was to investigated the” Effect of Capnography Feedback During CPR on Return of Spontaneous Circulation ". Subjects & Methods: This clinical trial study was performed on 130 cardiac arrest patients in two group by conventional CPR and with the use of Capnography feedback by a Separate CPR team at Ghaem Hospital in Mashhad. Rate of return of spontaneous circulation of the patients were evaluated. portable sidestream capnography was used. Results: In this study, the majority (60%) of 130 patients were male. The mean age of patients was 57. 2 ± 15. 7 year and the most common initial cardiac rhythm was asystole (52. 3 %). In more than 50% of cases the arrival time of cpr team was less than a minute, return of spontaneous circulation rate in the control group was 44. 6 % and in the Capnography group 63. 1%, which was significantly different (P =0/035). Conclusion: Based on our findings, Capnography feedback during resuscitation improves quality of cpr and rate of return of spontaneous circulation, therefore, its use is recommended in all cases of hospital resuscitation.

Background: Usage of indicators to predict the outcome of weaning from the ventilator is a controversial issue. An index with high diagnostic accuracy can properly identify the Patients ready for weaning from mechanical ventilation and prevents premature weaning and its complications. Two of the introduced weaning indicators are RSBI and CROP but their predictive value in predicting the outcome of weaning from mechanical ventilation is different or contradictory. Objectives: This study was to Compare RSBI and CROP in predicting the outcome of weaning from mechanical ventilation in patients admitted to ICU. Materials and methods: This prospective, single-blind study was performed on 80 adult patients who were on mechanical ventilation for more than 24 hours in 3 ICUs (Internal-General-stroke) of Mashhad Ghaem hospital from October 2015 to May 2016. All the patients ready for weaning were identified and studied in one group. All of them were ventilated with PSV mode with minimum support for 30 mins. If the patient’ s vital signs were stable during those 30 mins, we measured the required respiratory variables and arterial blood gas values to calculate CROP and RSBI. Then the SBT was performed, with a T-piece for 120 mins. finally the diagnostic accuracy of each index was evaluated according to the weaning outcome and prediction of indexes. Results: There were 57 successful and 23 unsuccessful weaning cases. The specificities were CROP 0. 85 and RSBI 98. 2. The sensitivities were CROP 0. 75 and RSBI 0. 26. The diagnostic accuracy were CROP 85. 2 and RSBI 77. 5. The new threshold value obtained in this study was very different for RSBI. CONCLUSIONS: According to the analysis performed by the cut-off points obtained in previous studies, CROP index has the highest diagnostic accuracy, sensitivity and specificity were both high. The cut-off point of RSBI previously reported for non-homogeneous patients population is not extensible to all with different etiologies.

Introduction: Huge similarities between clinical characteristics of borderline personality disorder and bipolarII disorder has caused many conversations in terms of the relationships between two disorders. Many studies have investigated the similarities and differences of these two disorders in the field of symptomology, pathology and etiology. On this base, the goal of the current research was to investigate and compare the executive function of borderline and bipolar II disorders patients to know more about the relationship between these two disorders. Subjects & Methods: A total of 25 patients with borderline personality disorder and 27 patients with bipolar-II disorder, who were referred to the Kamkar-Arabnia hospital in Qom, were selected through convenience sampling method. These two groups were compared together and to a healthy control group, by Wisconsin Card Sorting Test, that is used to measure the executive functions. Collected data were analyzed by using independent t-test, X2 and ANOVA. Results: Results showed that two clinical groups had poorer performance in all of the executive functions in comparison with healthy controls. Patients with borderline personality disorder showed poorest performance on cognitive flexibility domain. Patients with bipolar II had lowest performance on inability to receive feedback. There was no significant difference between the two clinical groups in none of the executive functions domains. Conclusion: These results provides empirical support for previous findings, which have reported executive dysfunctions, in both groups of patients. Although, there is no significant difference between the two clinical groups in executive functions in this study, more extensive studies are needed for clarification of relationship between the disorders.

Introduction: Caffeine is one of the most commonly used stimulants among athletes, which can be accompanied by increased vigilance and performance. The purpose of this research was to answer the question whether caffeine consum ption affect the blood pressure in swimmers? Subjects & Methods: In this study, 16 young swimmers selected randomly in two groups based on age and body mass index, caffeine and placebo. Young swimmers swam an hour before the 5 mg caffeine per kg of body weight or placebo was ingested in the form of gelatin capsules. Blood pressure of subjects in three stages, before taking caffeine or placebo, one hour after use and immediately after swimming the 100m front crawl was measured. Data, using independent t-test and paired t-test, were analyzed. Results: The results showed that systolic and diastolic blood pressure and mean arterial blood pressure increased with caffeine intake at rest (p<0/05), but in the end of the activity difference between caffeine and placebo was not significant ) p>0/05). Conclusion: According to the findings, caffeine increases blood pressure at rest and do not seem to be taking this matter before swim, considered to be a risk factor.

Introduction: Given the high prevalence of chronic diseases, complementary treatments can be one of the ways to decrease the prevalence of these diseases. It has been shown that honey consumption can have beneficial effects on cardiovascular disease risk factors. The current study aimed to investigate the effect of honey intake compared with sucrose on blood pressure and fasting blood glucose among young healthy subjects. Subjects & Methods: There were 60 healthy subjects, aged 18 to 30 years that were enrolled in this double blind randomized trial for one month. Participants were assigned randomly into two groups: honey (received 70 gram honey per day) and sucrose (received 70 gram sucrose per day). We measured Systolic and diastolic blood pressure and collected fasting blood glucose from all subjects in the beginning and end of study. Results: In the present study, there was no difference on the baseline FBS, SBP and DBP between the two groups (P > 0. 3). Results showed that honey intake can decrease the FBS in healthy young individuals, but sucrose consumption increased it. In addition, The effect of sucrose on FBS was move significant than honey (P < 0. 001). Intake of sucrose and honey cannot significantly decrease the SBP and DBP. Confounding variables including age, physical activity and some nutrient intakes were adjusted in all analyses. Conclusion: It is our conclusion that honey consumption decreases the FBS, but has no significant effect on SBP and DBP. Further studies are required to confirm these findings.

Introduction: Due to the importance of negative depression syndrome and negative affects in psychological well-being, the aim of the present study was to determine the effectiveness of mindfulness-based stress reduction model on Positive and Negative Affects and reducing the Depression syndrome in a non-clinical population. Methodology: The present research was a quasi-experimental study. The statistical population included all female undergraduate students studying in all faculties of Shahed University of Tehran. Having selecting eligible participants, they were categorized into two groups randomly: mindfulnessbased stress reduction group (11 people) and control group (9 people). Experimental group participated in the course which was hold at the faculty of Humanities of Shahed University for two months from November to January (eight sessions), while the control group did not receive training at all. The two groups received two questionnaires before and after their training, i. e., Beck Depression Inventory (II) and Positive and Negative Affect scale (PANAS). The acquired data were analyzed using U Mann Whitney and Wilcoxon signed-rank tests via SPSS software. Resuls: Using therapy pattern of mindfulness-based stress reduction results in reducing Depression syndrome and negative affects levels in experimental group compared to control group but do not make change in Positive affect level participants. Therefore, This therapeutic pattern can be applicable in students and non-clinical populations, while using clinical precautions. Conclusion: According to our findings, mindfulness-based stress reduction model proved to be effective in reducing Depression syndrome and Negative Affects in non-clinical populations.

Introduction: OSCE is a combination of simulation tasks to assess medical students' skills in diagnosis and treatment of diseases. it is vital to measure the quality of an OSCE. One of the important steps in assessing the quality of a test is to determine it's reliability. This study aimed to determine the reliability coefficient of the second clinical skills test in Mashhad by using generalizability theory. Subjects & Methods: The OSCE was conducted in two days and consists of 15 parallel stations. 75 students and 30 examiners participated in this test. Check lists collected and recorded in Excel. Variances and mean squares (MS) calculated by using SPSS. Variance for stations, students and examiners and generalizability and reliability coefficients calculated by using EDUG. Mann-Whitney U and Chi square tests were used for assessing relation between students’ gender and score, raters’ gender and score and relation between students gender and raters gender. Results: There was no significant relationship between gender of students and their scores, gender of examiners and students’ scores, and between gender of students and gender of examiners. Reliability coefficient was calculated 0/98 and interaction between students, examiners and station component had the largest effect on creating measurement error. Conclusion: this exam had a good reliability coefficient and according to results we can say, using Generalizability Theory for estimating the reliability coefficient, measurement error, and to identify impact of any facets on measurement error is a logical way. However, more research needs to be done.

Introduction: It is important to keep a sufficient amount of circulating blood and tissue perfusion during surgery. Different compounds including crystalloid and colloidal solutions are proposed for this purpose. There is a lot of evidence that there is a clinically difference in the use of various crystalloids. In this study, the effect of two methods of fluid therapy with Ringer’ s Lactate and Ringer’ s solution on acid-base balance and postoperative complications in patients candidate for elective operation was studied. Subjects & Methods: This clinical trial study was performed on 86 patients undergoing major anesthetic surgery in ASA class I and II and had no heart and kidney problems. The fluid therapy was performed with a ringer's lactate solution in one group (n = 43) and in the other group with ringer solution (n = 43). Before starting surgery, blood samples were taken for hemoglobin, hematocrit, albumin and electrolytes, and arterial blood samples for analysis of arterial blood gas. At the end of the anesthesia, the patient was transferred to the recovery and was evaluated for recovery in the wake delay and other complications such as nausea and vomiting. Results: In this study, hemoglobin and hematocrit were significantly reduced in ringer's lactate groups after fluid therapy, and the amount of albumin after fluid therapy was reduced in the ringer's lactate group. There was no significant difference in sodium levels in both groups before and after fluid therapy. However, the amount of potassium and calcium significantly increased after the liquid therapy in the ringer's lactate group and the amount of chlorine in the ringer group significantly increased. Bicarbonate and PH were increased after fluid therapy in ringer's lactate group and decreased significantly in ringer group. Also, the amount of bleeding during operation and duration of postoperative hospitalization was higher in ringer group, but this difference was not statistically significant. Nausea and vomiting were reported more in the ringer group than in the ringer's lactate group, but this difference was not statistically significant. Also, the delay in waking in the ringer group was significantly higher than ringer's lactate group. Conclusion: According to the findings of this study, it seems that in elective surgery, the replacement of crystalloids ringer and ringer's lactate, there is a significant difference in PH and postoperative complications following the use of these serums. The blood acidity following fluid therapy with ringer was higher in comparison to fluid therapy with ringer's lactate, and the delay in awakening in this group was reported high.