Journal of Sabzevar University of Medical Sciences
Year:2009 | Volume:15 | Issue:4 (50)|Papers Count:9

Background and purpose: There are many studies about nursing clinical settings and their problems, but the teaching style of teachers on the bedside has not been studied as a whole. Therefore, this study was conducted to assess, describe and interpret nursing trainers’ perceptions of the teaching style in clinical settings.Methods and Materials: The grounded theory approach was used to conduct this study. Fifteen nursing teachers were interviewed individually in 2006-2007. The interview protocols were tape-recorded and later transcribed verbatim. The transcriptions were analyzed using Strauss and Corbin's method. Results: Three major themes and 12 sub-themes emerged from the study data which portray the clinical teaching styles of the nursing teachers. The main themes are multiple styles in teaching, nature of clinical teaching, control and adaptation in the educational atmosphere and multiplicity in teaching style. Individualized styles were observable across teachers, but they varied across situations, type of skills (content), educational environment and facilities, levels of the learners, and the control and accommodation of teachers with the teaching atmosphere. Conclusion: Although teaching style is a complex phenomenon, but this study has helped emerge some of the rules and principles of clinical training of nurses.

Background and Purpose: Pretreatment with crystalloid has not been able to maintain blood pressure during elective cesarean section under spinal anesthesia, and it seems that prophylactic ephedrine+crystalloid can reduce hypotension and administration of high doses of ephedrine. The aim of the present study is to compare the effects of ephedrine+crystalloid pretreatment with crystalloid alone on blood pressure during elective caesarean section under spinal anesthesia.Methods and Materials: In this double blind clinical trial, we enrolled 72 women admitted to Ali-ebne-Abitaleb hospital in Zahedan, Iran, who were candidates for elective caesarean section under spinal anesthesia in 2006,and divided them into group A (ephedrine+cistalloid) and group B (placebo+cristalloid) by convenience sampling. Infusion with 10ml/Kg of ringer solution was made within 10-15min before the initiation of spinal block in both groups. Also, 10mg ephedrine in group A and placebo in group B were added to the solution. After newborn delivery, 20 IU oxitocin and 2mg midazolam were administered to all patients. Systolic BP, HR, nausea, vomiting, level of spinal block and neonatal Apgar were recorded and analyzed by Chi-square and student's t-tests (P<0.05 was considered as statistically significant).Results: Episode of hypotension occurred in 25% of group A and 55.6% of group B patients, suggesting a statistically significant difference between the two groups (P=0.008). However, there were no significant differences between the two groups in their mean systolic BP after intervention (105.61±7.13 in group B versus 107.89±9.84 in group A, in 1-10min; also, 106.20±8.52 in group B versus 109.39±6.72 in group A, in 11-60min). Conclusion: Prophylactic infusion of ephedrine±crystalloid is more effective than crystalloid pre-hydration in the prevention of hypotension during spinal anesthesia for elective caesarean section.

Background and Purpose: Magnesium deficiency has recently been proposed as a novel factor implicated in the pathogenesis of diabetes complications such as vascular disorders but the mechanism has not been completely clarified. The present study was designed to determine the effect of oral magnesium sulfate administration on skin microvascular blood flow in diabetic rats.Methods and Materials: In this experimental study, 50 male Wister rats (200–250 g) were divided into two diabetic and one control groups. One diabetic group received magnesium sulfate (10 g/L) in drinking water for a 10-week period. The other two groups received only tap water. After 10 weeks, animals were deeply anaesthetized and placed on a heating pad to maintain their body temperature at 37±0.5°C. Laser Doppler flow meter was used to measure the relative changes in skin blood flow. After stabilization, we used ACh, SNP, L-NNA+ magnesium sulfate (0.1M) in control and experimental animal by microsyringe pump microinjection. In order to analyze the obtained data, Student t-test and One-way ANOVA were used in SPSS with p<0.05.Results: Sodium nitroprusside and acetyl choline-induced cutaneous perfusion were increased significantly in the Mgtreated diabetic group compared to control diabetic group (p< 0.01) , non-diabetic group (p< 0.05) and diabetic group(p< 0.05) respectively. Also, local microinjection of magnesium sulfate (0.1M) increased cutaneous blood flow in all groups (p< 0.01).However, the administration of Nw-Nitro-L-Arginine (LNNA; NO synthase inhibitor) prior to magnesium sulfate attenuated (p < 0.05) but did not abolish the increase in cutaneous blood flow in trained diabetic and normal rats. Conclusion: From the results of this study, it may be concluded that the chronic use of magnesium sulfate with the potentiation of nitric oxide pathway can improve skin microvascular blood flow of diabetic rats.

Background and Purpose: One variable that potentially affects labor is the adequacy of maternal hydration throughout labor. Maternal fasting and muscular performance during labor may lead to dehydration. The present study was designed to determine the effect of intravenous hydration on the process of labor.Methods and Materials: This study is a randomized clinical trial conducted on 200 pregnant women admitted to Sabzevar Maternity Hospital in Sabzevar, Iran. The control group received 40 cc intravenous fluids per hour according to hospital protocol, however, Center in Sabzevar, Iran. of Sabzevar University of Medical Sciences, Iran the case group received 120 cc per hour. Labor outcome was evaluated and compared in two groups. The data were collected through interview and observation, and analyzed in SPSS using Mann Whitney U and chi-square. Results: Mean duration of the third stage of labor in the cases was 6.65 and in controls 10.33 minutes, with the difference being statistically significant (p<0.1). First-minute Apgar scores were better in 97% of neonates born to the case group (p=0.08). Conclusion: Hydration on labor causes the third stager of the labor to shorten, and first-minute Apgar scores to increase.

Background and Purpose: Hyperlipidemia, particularly hypercholesterolemia, is commonly accepted as a major risk factor for atherosclerosis and coronary heart diseases. Egg yolk is one of the richest sources of dietary cholesterol in human nutrition. As egg yolk has relatively lower cholesterol level in eggs enriched with Omega-3, the present study was conducted to determine the effect of consuming eggs enriched with omega-3 fatty acids on serum lipid profile and blood pressure.Methods and Materials: In this quasi-experimental research, twenty-six (8 male and 18 female) university students were randomly selected from healthy volunteers for this study. Two well-cooked moderately sized eggs were added to the subjects' breakfast in addition to their regular diet for 4 weeks. Anthropometric and metabolic measurements, their intake of energy, and other nutrients were compared using paired t-test in SPSS before and after the new diet was given. Results: The consumption of enriched eggs for 4 weeks (2 eggs per day) significantly decreased the average level of triglyceride (p=0.0001), systolic (p=0.0001) and diastolic (p=0.001) blood pressures from 93.8 mg/dl, 117.3 mmHg, and 78.84 mmHg before the new diet to 67.5 mg/dl, 95.38 mmHg, and 69.46 mmHg, respectively, after consuming eggs. However, HDL-C (p=0.0001), PUFA (p=0.03), and cholesterol intake (p=0.0001) significantly increased from 46.26 mg/dl, 20.3 gr/day and 231.1 gr/day to 65.6 mg/dl, 25.7 gr/day and 510.1 gr/day, respectively, at the end of the study. No significant changes were found in other parameters.Conclusion: The enrichment of eggs with omega-3 fatty acids raises HDL-C levels and decreased the triglyceride and blood pressure.

Background and Purpose: Opioids are frequently added to local anesthetics in order to improve analgesia in neuraxial blocks, which may lead to – sometimes intolerable - pruritus in the patients. In this study, the effect of meperidine on pruritus following the prescription of opioids (in the scale and dose of mg) in regional anesthesia was investigated.Methods and Materials: This clinical trial was conducted on 54 patients in two groups of 27. The patients included those hospitalized fro cesarean section in the midwifery ward, as well as those in the surgical-orthopedic ward. Both groups received anesthetic and opioids (meperidine in mg doses). The first group, i.e. the control group, received a certain volume of physiologic serum, and the second group, i.e. the experimental group, received the same volume of physiologic serum plus IV meperidine (nanogram dose). Pruritus was measured in the conventional scale at hours 0, 6, 12, and 24 after surgery. In the statistical analysis, Mann Whitney U, Fisher's exact test, and chisquare were used.Results: in the experimental group, incidence and intensity of pruritus (in case of occurring) were significantly lower than the control group (intensity score being one).Conclusion: Using nano-doses of opioids (meperidine) is effective in preventing pruritus.

Background and Purpose: Technology has caused great progress in the novel molecular diagnosis and research methods in medical laboratory. Novel methods have also led to the higher accuracy rates in laboratory procedures, which are of considerable importance in clinical follow-up of genetic diseases. Therefore, this study is intended to investigate factors affecting gene amplification in polymerase chain reaction in order to enhance diagnostic accuracy.Materials and Methods: This descriptive analytical research was conducted on 61 adenocarcinoma specimens in the cellular and molecular departments of Sabzevar and Isfahan Universities of Medical Sciences in Iran. DNA was extracted by the standard kit; then, the segment AURKA gene and P53 Gene were amplified using two pairs of specific primers and different concentration Mgcl2 in a PCR assay. PCR product was electrophoresized in agarose gel.Results: Electrophoresis of PCR product with Mgcl2 concentrations of 3 and 5 mm was better than 1.5 mm. The primer with concentration of 1 mm was better than 5 and 10 mm. From the two pairs of primers used in amplifying AURKA gene axon 4, one pair of primers was better than the other pair. From the two pairs of primers used for amplifying the axon 5 of P53 gene in PCR assay, one pair was better than the other.Conclusions: Primer type and concentration of Mgcl2 are important in amplifying genes in the polymerase chain reaction assay.

Background and Purpose: Most congenital anomalies are preventable and their identification and prevention are much more cost-effective than their treatment and rehabilitation. The present study was conducted to determine the incidence of apparent congenital anomalies in neonates born in Mobini Maternity Hospital in Sabzevar, Iran.Methods and Materials: This cross-sectional descriptive research was conducted on all neonates born with apparent anomalies from February 2005 to February 2006. The data collection instrument was a questionnaire including the information on parents, neonate, and the anomaly which was confirmed by a pediatrician. The collected data were analyzed in SPSS 11.5 using chi-square.Results: Out of 7786 live neonates, 191 cases (2.4%) had distinct congenital anomalies. Incidence of anomalies was 56.5% in males (108 cases), which was significantly higher than females (p<0.001). The most common anomalies were musculoskeletal (43.97%) and genitourinary (17.8%).Conclusion: The findings indicate that the incidence of anomalies in neonates born in Sabzevar is similar to other studies.