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Due to the critical and important structures in the thorax, transsternal surgery on thoracic vertebrae is very complex and rarely performed. We report a case of successful transsternal surgery on thoracic vertebrae. In this study, a 27-year-old man presented to the hospital with progressive lower extremity complaints. Pathologic lesions and severe destruction of the T3 vertebra were diagnosed. Considering the location of the lesion, an anterior approach was performed. The results of this operation have been very successful and have some noteworthy points. In this study, transsternal surgery is supported in patients with anterior vertebral conditions.

Objectives Many patients experience anxiety and stress before surgery. Anxiety is also different in men and women so that the prevalence of anxiety disorders in women is higher than men. The present study aimed to compare the effect of inhalation aromatherapy on emotional distress of men and women before surgery. Methods This study conducted as a randomized, single blind, placebo-controlled, prospective and clinical trial. It was performed in hospitals affiliated to Shiraz University of Medical Sciences. 90 patients were selected as candidates for surgery and were divided into two intervention groups and one control group. Patients completed the State-Trait Anxiety Inventory questionnaire before the intervention. Patients completed the State-Trait Anxiety Inventory questionnaire (STAI) after 20 min of intervention. Then the data were analyzed using SPSS software, version 16. The significance level in all testes was set at Results Relatively severe anxiety was not observed in men after intervention with lavender and spring orange. In women, relatively severe anxiety was not observed after the intervention with lavender, but in the spring orange group, only in 6.7% of people, relatively severe anxiety and traits were observed, which has decreased compared to before the intervention. In addition, the severity of anxiety in women in the control group increased after placebo intervention (p Conclusions The results showed that inhalation of Citrus aurantium and lavender aroma reduces anxiety in male and female patients.

Background: Menopause is an important physiological phenomenon in women's lives. Women's concern about taking the hormone treatment to ease menopausal symptoms is increasing. Over the past decade, the use of complementary and alternative medicine for the treatment of menopausal problems instead of hormone therapy has increased. Objective: This study aimed to investigate the role of herbal medicine, acupressure, and acupuncture in the menopausal symptoms. Methods: Data source: related articles were searched from internal scientific databases and external databases of “Web of Scopus, Cochrane, PubMed, Science Direct, Ovid, and Google scholar.” Study Eligibility Criteria: The keywords such as menopause, menopausal symptoms, complementary menopausal medicine, acupuncture in menopause, herbal medicine in menopause, and acupuncture in menopause were searched in the studies from 1987 to 2019. Exclusion criteria were inadequate information in the study, lack of access to full-text articles, animal studies, and reports. At the end of the search, 145 articles out of a total of 400 articles were reviewed. Results: In various studies, different herbs such as licorice, valerian, soy, sage, ginseng, etc., were used to improve menopausal symptoms. In addition, acupuncture and acupressure were used to reduce menopausal symptoms. Conclusion: The efficacy and use of complementary and alternative medicine, along with other classical medicine care, can be a new model for improving menopausal symptoms in women. It is recommended that further clinical and review studies be conducted to develop complementary and alternative medicine.

Background: Spirituality is one of the aspects of human existence that manifests itself significantly in times of crisis and stress; it creates meaning in life and inspires one to face problems. The aim of this study is to investigate the importance of spirituality in nursing care. Methods: Data source: related articles were searched from internal scientific databases and external databases of Web of ،Scopus ،Cochrane ،Pubmed, Science Direct ،Ovid, and Google scholar. Study eligibility criteria: Eligibility criteria included keywords of spirituality, religion, spirituality therapy, spiritual health and nursing care searched from 2000 to 2019. The study exclusion criteria were inadequate information in the study, lack of access to full text articles and reports. The study inclusion criteria were case-control studies, review articles, cohort articles, pilot studies, and clinical trials. At the end of the search, 74 articles out of a total of 143 articles were reviewed. Findings: Findings of this study showed that there was a statistically significant relationship between spirituality therapy and reduction of anxiety, depression and pain. It was also found that spirituality therapy improves psychological health and quality of life in cancer, hemodialysis and diabetic patients and improves the quality of life of infertile women. Conclusion: Spiritual nursing therapeutic intervention means taking into account the cultural and religious beliefs and spiritual care of patients in the therapy process and it is taking into account the transcendent dimension of those referred to hospital which leads them to the transcendent source. It is effective in reducing stress, depression, anxiety and pain in patients and enhancing the quality of life of patients with cancer and chronic diseases. The inclusion of spirituality in treatment and the inclusion of spiritual care in the training program of those trained to provide health care services are essential and should be addressed by educational planners and educational authorities.

One of the drawbacks of the mentioned connections after Northridge and kobe earthquakes was the destruction of beam after earthquake, difficulty and non economical displacement of the beam. Several studies are being carried out on a variety of materials and systems that dissipate the seismic loading effects in order to improve the seismic performance of steel frames. By placing dampers in the beam column connections, damage to the beams and columns, which are very difficult to replace after an earthquake, was prevented during an earthquake. During the design process of dampers, in order to concentrate the earthquake loads on the damper, it was manufactured intentionally with a lower strength than the beams and columns. Through this, beams and columns are protected from damage by utilizing the energy absorption capacity of the damper. Slit damper is a plate or a standard section with a number of slits in the web. The damper is attached to the beam by bolting a plate on the damper under the flange of the beam. In this study first compared slit steel damper connection and connection with the reduced beam section (RBS) under cyclic loading. Some suggestions were provided for improvement of the performance of slit steel damper connection and for making its behavior similar to that of reduced beam section connection and transforming it to a connection which can be used in the special bending frame; and these suggestions include increase in the thickness and number of stripe and decrease in the height. the results and simulations showed that increasing in the number of strips, the increase in thickness and decrease in the height of the SSD damper affects significantly the performance of SSD connection.

Every year millions of patients undergo surgery worldwide. Anxiety is a common pre- and postoperative problem. Nonpharmacologic anxiety control has been demonstrated to be more suitable in patients. The objective of this study was to apprise the evidence of the effect of various complementary therapies on pre- and postoperative anxiety among patients. A comprehensive literature search was made on Web of Science, Scopus, Cochrane, PubMed Irandoc, SID Science, ScienceDirect, Ovid, Mag Iran, and Google Scholar for original research studies published between 1980 and 2019. Original articles that reported the effect of complementary therapies in patients undergoing surgery were included. Ninety-six studies were analyzed. All of the studies have documented the effects of complementary therapies on improving pre- and postoperative outcomes of patients. Although methods varied considerably, most of the studies included in this review reported positive results. Therefore, there is some evidence that complementary therapies can lead to positive pre- and postoperative outcomes. Therefore, the efficiency and use of complementary medicine, along with the use of therapeutic techniques in classical medicine, can provide a new model for reducing anxiety before and after surgery. It is recommended that nurses conduct additional reviews or clinical studies so that effective approaches to integrated medical care can be developed and patients' health enhanced.

Background: Nausea and vomiting are of the most common postoperative complications. Postoperative nausea and vomiting (PONV) can increase the patients' length of hospital stay, healthcare costs, and perioperative morbidity. Objective: The current study aimed to evaluate the effects of acupressure in preventing PONV in patients who have undergone general surgery with spinal anesthesia. Methods: This single-blind clinical trial was performed on 70 patients who had undergone general surgery and randomly assigned to an intervention and a control group. In the intervention group, the acupressure wristbands were fastened to one of the patients' wrist so that the pressing buttons were placed on the Pericardium 6 acupoint. In the control group, the wristbands without pressing buttons were loosely fastened on the desired point. The severity and episodes of nausea and vomiting were measured intraoperatively, 1, 3, and 7 h postoperatively. The data were analyzed via repeated measures analysis, t, and Chi-square tests. Results: Over time, the intervention significantly decreased the mean of nausea episodes (P