Internal Medicine Today
Year:2018 | Volume:24 | Issue:3 |Papers Count:12

Aims: IV catheter insertion is the most common invasive hospital procedure and its complications are costly for the health care system and patients. Phlebitis, or inflammation of the vein, is an important cause of premature catheter failure. The purpose of this study was to determine the effect of temperature equalization of intravenous administration with body temperature on occurrence of phlebitis. Materials & Methods: This randomized controlled clinical trial was conducted among 106 patients admitted to internal wards of Imam Ali hospital in Sarayan, Iran in 2016 and required intravenous administration. The patients were divided randomly into intervention (53 cases) and control groups (53cases). In intervention group solutions and medications was infused by infusion pump SN-1500SERIAL at range of body normal temperature (37° c) and in control group at a mean temperature of 24° c. Insertion sites were observed every 2 hours for evidence of phlebitis according to Infusion Nursing Society Phlebitis. Data were collected by using information sheet and they were analyzed by using SPSS 22 software and T-test, Chi square test, Spearman test and regression test in Significance level less than 0. 05. Findings: There were no significant differences between the two groups in terms of age, sex, education, marital status, underlying illness, addiction, BMI and mean of received volume. Also results showed no significant difference between the two groups in terms of occurrence of phlebitis (P=0. 28). But it decreased at the first and second 24 hours in the intervention group. Conclusion: Although temperature equalization of intravenous administration with body temperature have low effect on occurrence of phlebitis in first and second days of intervention, but this study showed no significant evidence. Further study with lower and higher than body temperature is recommended.

Aims: Hypiran is a commercial hydro-alcoholic extract of Hypericum perforatum. Its anti-inflammatory and immune modulatory benefits have been reported in several documents. This study was conducted to investigate the beneficial potential of Hypiran in the treatment of ameliorating experimental autoimmune encephalomyelitis (EAE). Materials & Methods: In this experimental study, EAE was induced by guinea pig spinal cord homogenate and complete Freund’ s adjuvant in 30 male Wistar rats (6-8 weeks old, weighing 100± 20 g). Hypiran administration (110 mg/kg-P. O.-daily) was initiated at day 12 post-immunization, when the rats developed a disability score. The brains and blood samples were collected on the day 36 and used for MDA, FRAP, NO and MPO experiments. Findings: Hypiran-therapy led to a better situation in EAE rats. The lipid peroxidation level (MDA assay) was significantly increased in brain tissues of the EAE rat compared to that of the normal control one (P<0. 001). Treatment with hypiran could significantly reduce the MDA levels in brain tissues of the EAE rats compared to that of the EAE rats without treatment. Moreover, Serum analysis showed that hypiran could significantly decline the nitric oxide levels as well as myeloperoxidase activity of the EAE rats compared to that of the EAE rats without treatment. Moreover, docking server analysis indicated that the hypiran could inhibit the MAO enzyme. Conclusion: It seems that hypiran may be as a promising strategy to be treatment of Multiple Sclerosis patients.

Aims: Systemic scleroderma is a multiple chronic autoimmune disease that has important clinical and psychological consequences, including sexual dysfunction. The purpose of this study was to determine the efficacy of integrated treatment group on sexual function and its domains in women with scleroderma. Materials & Methods: This research was a semi-experimental design with pretest, post-test, and follow-up with the experimental and control groups. The statistical population included women with scleroderma referred to Shariati Hospital in Tehran and Iran's Rheumatism Center in the second half of 2017. Of these, 30 patients were selected as available samples and randomly were placed in the control and the experimental groups. The experimental group was subjected to an integrated approach intervention in 9 sessions of 90-minutes, where as the control group did not receive such an intervention. The instrument of this study was the Female Sexual Function Index (FSFI) Questionnaire. Data were analyzed using SPSS24 software and repeated measures ANOVA. Findings: Unilateral psychotherapy intervention significantly increased the mean post-test of sexual function and its six sub-components in both control and experimental groups (p<0. 01, F=19. 59). The satisfaction component with 0. 82 (p<0. 01, F=125. 35) and psychological stimulation with 0. 74 (F=77. 9, p<0. 01) had the most effect on intervention, and the component of orgasm with 0. 33 (F=13. 54, p<0. 01) had the least effect among the components. After three months, there was no statistically significant difference between the post-test and the follow-up of the experimental group, which indicated the stability of intervention effects. Conclusion: Unified psychotherapy is effective in increasing the sexual function of patients with systemic sclerosis and can play a significant role in improving the quality of life of these people.

Aims: Exercise training is one of the methods used in cardiac rehab. The aim of this study was to determine the effect of six weeks of continuous training with Ziziphus Jujube extract consumption on lipocalin-2 and adiponectin levels in plasma and heart tissue in rats with myocardial infraction. Materials & Methods: 30 male Wistar rats weighing 180-320 gr, aged 2-3 months, were randomly divided into 5 groups of 6 each: 1. Healthy control, 2. Infarction control, 3. Infarction + Jujube extract, 4. Infarction +Continuous aerobic exercise, 5. Infarction +Continuous aerobic exercise + Jujube extract. The training program lasted for 5 days per week for 6 weeks and speed of 16 m/min for 40 min per day. The Ziziphus jujube extract was gavaged 400 mg / kg for 6 weeks. In the end, the rats were anesthetized and blood samples were taken from heart tissue. The levels of lipocalin 2 and adiponectin were measured using the appropriate kits and ELISA method and the statistical analysis was conducted using one way ANOVA and Tukey post hoc test at a significant level of p<0. 05. Findings: Adiponectin values in heart tissue of rats increased significantly (p<0. 05) after six weeks of continuous training with Ziziphus Jujube extract consumption. While levels of plasma and heart tissue lipocalin-2 and plasma adiponectin did not change significantly (p>0. 05). Conclusion: Six weeks of continuous training with Ziziphus Jujube extract consumption can improve cardiac damage caused by infarction through increasing adiponectin levels in the heart tissue.

Aims: Among the main responsibilities of an intern and general practitioner is airway management in patients. This study, thus, aims to assess interns’ and general practitioners’ knowledge about endotracheal intubation. Materials & Methods: The studied cases involved physicians and interns responsible for and involved in intubation. Data was collected by a questionnaire developed based on experts’ comments asking about the respondents’ knowledge level. Findings: 78. 65% of interns and 55% of GPs had average knowledge, 17. 98% of interns and 18% of GPs had good knowledge, 3. 37% of interns and 27% of GPs had poor knowledge. Conclusion: This can be helpful in emergency situations by the internes and general practitioners, and can be done by both of them. However, workshops and training courses are suggested to improve their performance and update their information.

Aims: Marital satisfactions vary in different stages of life of couples. Childbirth as special period may cause different challenges regarding to person’ s potential, therefore this study was carried out to compare marital satisfaction between men without child and men with first and second child in transition to parenthood. Materials & Methods: This correlation study was done in 3 groups with 60 men without child, and with first and second child, a multistage sampling was conducted. Instruments include: Enrich marital satisfaction, transition difficulty to parenthood scales and demographics data, that were completed by eligible men refer to Mashhad health care centers in 2014. Data was analyzed with SPSS V16. Findings: The mean age of men was 32. 52± 5. 52 years and 57. 2% had academic education. Men without child had 1. 7% relative dissatisfaction, 20% moderate satisfaction, 61. 7% more satisfaction and 16. 7% most satisfaction. Men with first child had 3. 3% relative dissatisfaction, 31. 7% moderate satisfaction, 51. 7% more satisfaction and 13. 7% most satisfaction and men with second child had 8. 3% relative dissatisfaction, 28. 3% moderate satisfaction, 53. 3% more satisfaction and 10% most satisfaction. There were no significant differences among three groups (p=0. 19). The16. 4% of marital satisfaction in men with child was predicted by transition difficulty to parenthood that implies the strong correlation between these two variables. Conclusion: There was no correlation between men’ s marital satisfaction with childbirth; therefore couples should be consulted not to worry about fatherhood and number of children.

Aims: In this study, the replacement of natural compounds such as green tea by chemical drugs like itraconazole and voriconazole was studied. Materials & Methods: In this study, the effects of the aqueous and methanol extracts of green tea and the synergistic effects of these two extracts were studied along with two drugs of itraconazole and voriconazole against four strains of Aspergillus accordaing to microdilution method to determine the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC). Findings: Two strains of A. flavus ATCC39 and A. terreus ATCC274 are sensitive to itraconazole while two other strains were resistant. All four tested strains were resistant to voriconazole. The aqueous and methanol extracts of green tea did not show antifungal effect but synergistic effects of aqueous extract of green tea and itraconazole were worthwhile against A. niger ATCC9142 and A. fumigatus ATCC278. Also, the combined methanol extracts of green tea and itraconazole against A. niger ATCC9142 and the combined aqueous extracts of green tea and voriconazole against A. flavus ATCC 39 and A. fumigatus ATCC278 were reported valuable. Conclusion: The results of this study showed that there is a valuable synergistic effect between the tested antifungal drugs and the extracts.

Aims: Coronary artery bypass graft surgery is like any other type of surgical procedure for a stressful patient and anxiety and depression are common and important disorders in these patients. The aim of this study is to assess the incidence of anxiety and depression regarding the age and sex differences in patients undergoing open heart surgery. Materials & Methods: In this descriptive cross-sectional study, 205 patients between 30 and 80 years old were selected by available sampling method. Data were collected by a 3section questionnaire, including demographic factor, hospital anxiety and depression scale and State-Trait Anxiety Inventory a day before surgery. The patients were chosen from elective heart surgery in Heshmat hospital of Rasht. The variables were evaluated using chi squre, independent test and one way Anova. Analyses were performed using Spss version 19. Findings: A total of 205 people, 66. 3% patients were men and 33% women. 58. 1% of men and 55. 1% of women were suffering from some degree of depression and this difference was not statistically significant (p=0. 8). Considerable different in trait anxiety and state anxiety of The average score of anxiety and depression of the patients was not significantly different in terms of age as well ( Above and under 50). Conclusion: Considering the high incidence of anxiety and depression in these patients, symptoms should be observed and cured, and if necessary preventive psychological and clinical interviews in these patients are recommended.

Aims: Vasovagal reaction is one of the most common complications of blood donation, this study was conducted to determine the prevalence of vasovagal reactions and its effective factors among blood donors in Mashhad blood transfusion centers. Materials & Methods: This case-control study was performed on 657 blood donors in Mashhad's four blood transfusion centers during 6 months. The donors who had vasovagal reactions were in the case group (218 cases), and 439 donors who did not respond to vasovagal were in the control group. The age, BMI, blood pressure, pulse rate, hematocrit and vasovagal response variables were studied. Data were analyzed by SPSS 11. 5 using Chi-square and Mann-Whitney tests. Findings: The incidence of vasovagal reactions in the six months was 2. 16%. The mean age in the case group was significantly lower than the control group (p<0. 001). Vasovagal reactions were significantly higher in women and in first-time donors, as well as in those with anxiety and in subjects with lower BMI (p<0. 001). The mean reduction in arterial pressure after blood donation was significantly higher in the case group than in the control group (p<0. 001). Conclusion: The incidence of vasovagal reactions is dependent on several factors, including age, sex, BMI, and blood pressure, and with more care from high-risk donors, it can be approximately prevented from vasovagal reaction and increased the possibility of returning to blood donation.

Aims: Given the importance of quality of life among addicts for more effective treatment, this research was designed to assess the effectiveness of acceptance and commitment therapy on quality of life in patients undergoing methadone maintenance therapy. Materials & Methods: The present study was a semi-experimental design with control group. The study population was all addicts under Methadone maintenance treatment (MMT) in addiction treatment clinics in Isfahan in 2017. Through cluster sampling, one center was selected. With target sampling 24 people were chosen, and divided randomly into control and experimental groups. Intervention based on acceptance and commitment was held to the experimental group for 8 sessions. The control group did not receive any intervention. Quality of life Questionnaire (WHOROL-BREF, 1996) was used in both groups in pretest and post– test. Data analyzed by spss software V-23, and One-variable covariance analysis. Findings: ANCOVA analysis results showed the effectiveness of treatment in increasing the quality of life in the experimental group compared with the control group. Conclusion: Acceptance and commitment treatment techniques is effective in quality of life of patients.