Internal Medicine Today
Year:2013 | Volume:19 | Issue:2 (60)|Papers Count:12

Aims: The main type of anxiety in burned patients is the one caused by pain.Emotional support can tranquilize patients during the process of care and treatment.This research has been conducted to study how Therapeutic Communication can help reduce the pain anxiety and how it affects recovery from burn wounds.Methods: This quasi-experimental research was conducted in a period of ten months in 2005 in the women’s burn ward of Imam Reza hospital in Mashhad. The sample included 60 patients, who were selected non-randomly and were divided into two groups of 30 women, half in intervention and half in control group. The data collection tools were self-report checklist to determine pain anxiety and the observation checklist to observe the extent of burn wound healing. The Therapeutic Communication plan was implemented for the intervention group. Data were analyzed by SPSS 12 software using Chi-square, independent T and Variance Analysis tests.Results: No significant statistical difference regarding the rate of anxiety (P=0.63) and wound healing (p=0.73) was observed between control and intervention groups in the pre-intervention stage. During and after the intervention, the rate of anxiety in the subjects of the intervention group was significantly decreased (p=0.0001). Also the rate of wound healing in the intervention group was significantly increased during (p=0.018) and after (p=0.001) the intervention, comparing to the control group. The average rate of wound healing after the intervention in the subjects of control and intervention groups showed a significant difference (p=0.009).Conclusion: The therapeutic communication between the nurse and patients positively influences the reduction of anxiety and the process of wound healing.

Aims: Diabetes mellitus is a metabolic disorder which caused by hyperglycemia.Since the serum magnesium level plays an important role in obvious diabetes side effects, the aim of this survey was to evaluate the effect of oral magnesium sulfate administration on blood glucose and serum lipids in streptozotocin-induced diabetic male rats.Methods: This experimental study was performed on 32 Wistar-Albino male rats, which were weighed between 200-250gr. One half of animals were given intra peritoneal injection of 50mg/kg streptozotocin solution which was prepared in sodium citrate buffer. Rats were divided into two healthy A and B groups and two diabetic C and D groups. A and C groups’ samples were feed by rodent's diet and tap water but B and D groups’ samples received normal diet and water containing 10mg/ml magnesium sulfate during the experiment. At the end of the experiment, serum glucose and lipoprotein profile of rats were measured. Obtained data were analyzed by SPSS 17 using ANOVA and Tukey tests.Results: Blood glucose, serum Triglyceride and LDL level in group D were significantly decreased compared to those of group C, but there was no significant difference in the HDL and total cholesterol level between groups C and D.Conclusion: Oral magnesium sulfate consumption cause in blood glucose decreasing and serum lipoprotein profile improvement in streptozotocin-induced diabetic male rats.

Aims: Regarding to importance of Ivermectin as a clinical anti-parasite drug, identification of its interaction with other drugs is necessary. At present study, the interaction of Verapamil as an inhibitor P-glycoprotein was evaluated on Ivermectin concentration in serum and cerebrospinal fluid in dog.Methods: In this experimental study with animal model which was done in faculty of veterinary medicine of Ahvaz in 2011; 10 mixed breed dogs was randomly divided into 2 groups (5 dogs at each group). First group received 0.2mg/kg of Ivermectin for each kilo of body weight and second group received of 3mg/kg of Ivermectin for each kilo of body weight along with verapamil. The level of Ivermectin was detected by HPLC in blood samples 1, 2 and 3 hours and in cerebrospinal fluid 1.5 hours after injection. Statistical analysis was carried out by SPSS 16. Repeated measurement and T-independent test were used for comparison of sample means.Results: In both groups, the serum concentration of Ivermectin was decreased at second hour and then increased in comparing with first hour. The Ivermectin was not detected cerebrospinal fluid of first group while it was 45.44±10.91ng/ml in second group.Conclusion: Serum concentration of Ivermectin increases by intramuscular injection after one hour and Verapamil increases cerebraospinal fluid concentration of Ivermectin.

Aims: Obesity is one of the most common problems in societies which can induce many diseases. Some methods have been suggested and are used for the treatment of obesity which herbal therapy is one of them. The aim of this study was to determine the effect of Fitana herbal compound as an anti-obesity product on weight and blood lipid profile in male Wistar rats.Methods: In this study 40 male Wistar rats with the average weight of 280-300g were used. The rats were divided into 5 groups as experimental I (200mg/kg of aqueous extract of Fitana), and experimental II (400mg/kg of aqueous extract of Fitana), experimental III (200mg/kg of alcoholic extract of Fitana), control I (negative control) and control II (5mg/kg of Orlistat). Data were analyzed by SPSS 11.5 using Tukey and ANOVA tests.Results: There was no significant difference in the mean of weight and BMI among experimental groups. Triglyceride level was only decreased significantly in experimental group II (62.62±9.94; p=0.0014) and III (62.12±12.02; p=0.011) in comparison with negative control group (84.37±13.51mg/dl).Conclusion: Oral consumption of Fitana herbal compound can reduce triglyceride level in blood.

Aims: Wound complication after cesarean is a severe problem that may happen in spite of correct application of section technics. Inappropriate nutrition delays wound healing because of the decreasing of body’s saved energy that make wound vulnerable to infection. The aim of this paper was to detect the effect of early post cesarean feeding on wound healing.Methods: This random clinical trial was performed in mothers, candidate for cesarean section in Ommolbanin hospital of Mashhad in 2009.82 samples were selected by purposed sampling method and divided randomly into 2 equal groups of early- and normal feed. Data were collected by interview and observation forms, visual analog scale of pain and flatulence and REEDA scale. The level of flatulence and pain were measured in both groups 4, 12, 24, 36 and 48 hours after surgery by visual scale. Data was analyzed using Chi-square, Fisher’s exact, Kruskal Wallis, independent T and Mann-Whitney U tests by SPSS 11 software.Results: The mean of REEDA score for cesarean wound healing was 0.39±1.1 in the early feed group and 0.63±1.1 in normal feed group that hadn’t a significant difference (p=0.257). The severity of flatulence, 24, 36 and 48 hours after surgery, and the pain intensity, 36 and 48 hours after cesarean section, had significant differences between 2 groups.Conclusion: Although the early feeding is not effective on post cesarean wound healing, it decreases post cesarean pain and flatulence.

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Aims: After training motor learning with one organ transfers to the other organ.Considering Carpus Callosum deficit in children with ASD, this study was aimed to investigate intermanual transfer of motor learning from right hand to left hand and vice-versa in children with ASD compared to their typical matched peers.Method: In this randomized clinical trial study, 31 boys with ASD and typical peers were selected by purposed sampling method from Najafabad elementary schools from February to May 2011. Participants were screened using Autism Spectrum Screening Questionnaire (ASSQ). Serial reaction time task was used for group comparison. Data were entered to SPSS 19 statistical software after collection and were analyzed using repeated measure ANOVA, paired T-test, and two-way ANOVA.Results: There were no significant difference between two groups in transfer accuracy from right hand to the left (p=0.191), transfer speed from right hand to the left (p=0.095), transfer accuracy from left hand to the right (p=0.052), and also transfer speed from left hand to the right (p=0.459).Conclusion: Intermanual transfer of learning from right to the left hand and vice versa is intact in children with ASD.

Aims: Endotracheal intubation is a process that typically done in intensive care unit and emergency rooms by physicians, nurses and health care personnel. Because several factors such as positive pressure ventilation, duration of intubation, temperature and body movements can cause the cuff pressure changes, this study was done to evaluate the relationship between temperature and cuff pressure of endotracheal tube.Methods: This single-group correlation study was performed in the middle 6 months of 2011 in intensive care units and emergency departments’ patients of local hospitals of Mashhad University of Medical Sciences and 70 patients with an endotracheal tube or tracheostomy (with cuff) connected to mechanical ventilation were enrolled. Inventory data collected from the endotracheal tube cuff pressure and temperature were recorded. The collected data were analyzed by SPSS 11.5 software using Pearson and Spearman correlation, general linear model coefficients, Kruskal Wallis and Mann-Whitney U tests.Results: Endotracheal cuff pressure was abnormal in 80% of cases. There was a positive significant difference between endotracheal tube cuff pressure which was measured at 10 different times and the temperature change (p=0.001). No interactive effects were observed in every 10 measurements, between temperature and inspiratory oxygen percentage and endotracheal cuff pressure (p>0.05).Conclusion: Endotracheal tube cuff pressure of most patients is outside the standard range. The temperature affects the endotracheal tube cuff pressure.

Aims: Spinal anesthesia is the procedure of choice for caesarean section. There is no risk of airway hazards, such as difficult airway intubation and aspiration in this method. Some cases avoid to choose this method, because of fear of complications specially headache. This Study has been done to assess the true extent of headache after surgery with spinal anesthesia and its related factors.Methods: This cross-sectional analytic study was done in 2011 for one year in 22th of Bahman hospital of Gonabad.200 pregnant women that was candidate for caesarean section under spinal anesthesia were selected by achievable and purposeful sampling method. All procedure was performed in a sitting position and with a disposable 25-gauge needle with 75mg Lidocaine 5% and 25 micrograms Fentanyl. Data were gathered and analyzed using the SPSS 11.5 software and independent T and Chi-square tests.Results: 12 patients (6%) in 24 hours after spinal anesthesia and 44 cases (22%) in first week after spinal anesthesia experienced headache. Headache happening had a significant relationship with body mass index (p=0.028) and occupational factors (p=0.011) in the first week. Hypotension was the most complication (52.5%) during spinal anesthesia.Conclusion: Hypotension is the most complications during spinal anesthesia. Those with higher body mass index and those who were employed are at higher risk for headache in first week after spinal anesthesia.

Aims: Use of anti-pain drugs, especially narcotics, has serious side effects and the combination of non-pharmacological methods with drugs can be the most effective way of pain relief. One of the non-pharmacological methods is the guided imagery.This study was done to evaluate the effect of guided imagery on pain of orthopedic operations in traumatic patients.Methods: This clinical trial with 2 groups was conducted in traumatic patients’ referred to Shahid Hasheminejad hospital of Mashhad in 2010.74 patients were selected by simple nonrandomized sampling method. Data collection instruments were McGill Pain Questionnaire, numerical analogue scale and imagery potential Questionnaire. Data was analyzed by SPSS 18 software using independent T, Chisquare, Fisher’s exact, Mann-Whitney U, variance analysis with repeated measures, Friedman correlation and two way variance analysis tests.Results: total pain and pain quality scores had significant difference between 2 groups in the third day (p=0.0001). Imagery score had no significant relationship with pain intensity and pain duration but had a significant correlation with pain quality (r=-0.423; p=0.009). Intragroup differences of the total pain score 3 days before to 3 days after and different days before and after the surgery and the pain intensity score of different days before and after the surgery were significant.Conclusion: Guided imagery leads to decreasing of total pain and pain duration scores and improvement of pain quality in the third day after surgery of patients with fracture but do not affect the pain intensity.