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Background: Hypothermia is a common complication in trauma patients. Studies show that the management of hypothermia in trauma patients in the pre-hospital phase may be underestimated. Objectives: The purpose of this study was to evaluate the effect of thermal care workshop on the staff readiness to manage hypothermia in trauma patients. This quasi-experimental study utilized convenience sampling after obtaining the approval of the Research Ethics Committee and involved 60 qualified EMS staff who were divided into two groups including: intervention group (30 technicians) and control group (30 technicians). The intervention group received the treatment in the form of a workshop. Nonetheless, the control group did not receive any educational intervention. The data were collected before, immediately after and 45 days after the workshop to determine EMS staff readiness using a validated researcher-made questionnaire. In this study, the significance level was 0.5.Results: There was a significant difference between the posttest results of the control group and the intervention group (p less-than 0.001). Moreover, in the intervention group, there were significant differences between the pretest results and the two posttest results (p less-than 0.001). Finally, the readiness gained after the workshop lasted for 45 days. Conclusion: The thermal care workshop enhanced the readiness of emergency medical personnel. The generalization of the results of this study is restricted due to the fact that random selection and random assignment of participants were not possible in the present study. It is recommended that more robust studies be designed to evaluate, prevent and manage hypothermia in trauma patients in the pre-hospital phase

Background: Renal colic is one of the most prevalent diagnoses made in emergency departments. Main medications used to relieve renal colic is opioids and non-steroidal anti-inflammatory drugs (NSAID). As far as these medications may have some side effects, researchers have always focused on proposing analgesics with more efficacy and less side effects. In the present study, it was tried to compare paracetamol and intravenous morphine plus diclofenac in renal colic. Methods: In this single-center double-blinded randomized clinical trial, a total of 180 18 - 65 years old patients with definite diagnosis of renal colic with documented renal system calculus attending emergency department of Emam Reza educational-clinical center, Tabriz-Iran were included. These patients were randomly divided into two control and intervention groups, where the control group received intravenous morphine plus diclofenac and intervention group received intravenous paracetamol. Then, patients’ pain was measured using visual analog scale 0, 10, 20, 30, minutes and 24 hours after administration of medications and compared with each other. In this study, SPSSTM Version 15 was used for statistical analysis. Results: There was no statistically significant difference between the two groups. Difference between patient’s pain severity in intervention and control groups was not statistically significant, however, both groups experienced statistically significant reduction in pain severity from a time stage to another (P< 0.05). Considering side effects, nausea was the only side effect that occurred, which affected 14 patients (15.55%) in the control group, while no side effects were recorded for the intervention group. Conclusions: Based on the present study, paracetamol may be proposed as an effective alternative for routine medications in treatment of renal colic, due to the fact that it has comparable efficacy in pain reduction with opioids and NSAIDs as well as has less side effects.

Introduction: Presence of family and patients’ relatives throughout resuscitation procedure is one of the most challenging concerns. Methods: In an interventional (quasi-experimental) study that was conducted during a 6 months period, the patients’ relatives were randomly divided into two groups of intervention (the relatives who were eager to be present throughout the resuscitation procedure- under the family protection protocol, all of the procedure steps were explained to the relatives by an expert nurse who was not involved in the resuscitation procedure and control group (those who were not invited routinely to be present throughout the resuscitation procedure. However, if the control group were eager to be present, they were allowed to observe the procedure (these people were not supported by the protocol). After 90 days, subjects were contacted through telephone and filled standard questionnaires (Hospital Anxiety and Depression Scale [HADS]) and Impact of Event Scale (IES) were completed for all subjects. These questionnaires focus on anxiety, depression and post-traumatic stress disorder (PTSD). The obtained data were analyzed. Results: One hundred thirty three relatives were divided into two groups of control (59 subjects) and intervention (74 people). No significant difference was observed between two groups regarding demographic features. The evaluation after 90 days revealed depression, anxiety disorders and PTSD to be significantly more prevalent in control group than the intervention group (P < 0.0001 ). Conclusion: Emotional and psychological support and intervention on the patients’ relatives are efficient and can prevent the emergence of psychological disorders.

Context: The liver as an important organ in the body has many essential functions in physiological processes. One of the major activities of liver is drug metabolism. Hepatic dysfunction affecting hepatic physiological activities, especially drug metabolism can cause many problems during anesthesia and administration of different drugs to patients. Evidence Acquisition: Studies on hepatic disorders and hypnotic anesthetics prescribed in hepatic disorders were included in this review. For this purpose, reliable databases were used. Results: Anesthesia should be performed with caution in patients with hepatic dysfunction and drugs with long half-life should be avoided in these patients. Conclusions: A review of the literature on the use of hypnotic drugs in patients with liver dysfunction showed that some hypnotic drugs used during anesthesia could be safely used in patients with impaired liver function. In these patients, certain drugs should be used with caution.

The specificity of relationship of endoscopic evidence of nodular gastritis with Helicobacter pylori infection is unclear.To assess the relationship of endoscopic nodular gastritis and H. pylori infection among children.124 children (median age 8.2 years, range 1-15) undergoing upper GI endoscopy for abdominal pain underwent urease test and histological examination of gastric mucosa to determine the presence and density of H. pylori infection, and presence and severity of gastritis.H. pylori infection was detected in 57 (46%) children. Endoscopic nodular gastritis was present in 46 of these 57 patients (81%) and in 24 of 67 (36%) H. pylori-negative patients (36%). The frequency of endoscopic nodular gastritis was related to increasing age (p0.0001), presence of H. pylori, grade of histologic gastritis, and H. pylori density (p0.0001).Endoscopic finding of nodular gastritis is associated with presence of H. pylori infection and active chronic gastritis in children.