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Background and Aims: General anesthesia induces endocrine, immunologic, and metabolic responses. Anesthetic drugs affect endocrine system by changing the level of stress hormones and hemodynamic of the patient. The purpose of this study was to compare the effects of propofol and isoflurane on hemodynamic parameters and stress-induced hormones in laparoscopic cholecystectomy (LC) surgery. Material and Methods: Seventy patients of elective LC were included in this study. Patients were randomly divided into two equal groups of 35 patients; group P received propofol (70–120 μg/kg/min) and group I received isoflurane (mac: 1.28%) as anesthesia maintenance. The following parameters were monitored, checked, and recorded from preanesthesia period to 10 min after PACU entry according to a planned method: hemodynamic parameters (heart rate and mean atrial pressure), level of blood sugar, and serum epinephrine level. Results: Heart rate and mean atrial pressure changes did not show significant differences between the two groups in all stage (P > 0.05), but isoflurane group tolerated lower fluctuating changes. Blood glucose and serum epinephrine level rise in the isoflurane group were significantly higher than the propofol group (P < 0.05). Conclusion: Maintenance anesthesia by inhalation gas base on isoflurane has not shown a significant difference with total intravenous anesthesia base on propofol on hemodynamic parameter. However, propofol has a consistent effect on decreasing stress hormone and suggested for LC surgery. [ABSTRACT FROM AUTHOR]

One of the important wards in educational hospital due to special conditions of patients is operating rooms (ORs). Anesthetic gases sevoflurane among air anesthetic pollutant is very dangerous for health care worker (HCW) and patients. The aim of this study was to associate the concentration of anesthetic toxic sevoflurane gases (ppm) indoor air in Emam, Razi and Golestan teaching hospitals OR during 2016. In the current study, portable pump SKC equipped with sorbent Tube Tenax TA 250 mg was used to sampling and measurements of sevoflurane gases concentration in the ORs. Three detection places were selected for sampling volatile anesthetic gases sevoflurane. In this study, health risks produced by non-cancer causing agents are quantified by calculating the hazard index (HI). Based on result this study, the Emam and Golestan had the lowest and the highest sevoflurane concentrations. According to the results from the current study, level of sevoflurane on indoor air quality in the operation room in Emam, Razi and Golestan hospitals were 2.058, 2.201 and 2.289 ppm, respectively. According result this study HI was under 1.0 and it amount showed that no significant risk of adverse health effects related to exposure to concentration of sevoflurane in Emam, Razi and Golestan teaching hospitals OR during 2016. Result showed that the average concentration of sevoflurane in studied hospitals were more than the standard level (2 ppm) and exposure to this concentration of sevoflurane could be threaten for HCW. Based on result our study, the average level of sevoflurane was significantly higher than that of ORs without standard ventilation in comparison with ORs with standard ventilation system. Performed active for decreasing anesthetic gases can cause decrease health endpoint in OR HCWs and costs. While OR management in ambient air can cause disorders in staffs and causing more spiritual and material costs. [ABSTRACT FROM AUTHOR]

Various contaminants in the water which are used for dialysis may be harmful to patients, therefore, the standard compliance is vital for dialysis water. The aim of this study was the analysis of the effect of hemodialysis system in pollutants removal from Razi hospital hemodialysis instruments. This cross-sectional descriptive research studied the microbial water quality of hemodialysis instruments in Razi hospital of Ahwaz, Iran. Experiments were done according to the book of standard methods from hemodialysis instruments during 2016. Finally, the relationship between results at different months and stations was done, using SPSS and descriptive statistics. Results shown that the average of microbial parameters and chemical quality in water influent hemodialysis instruments were pH =7.595, SO4=3.5 mg/l, Na=70 mg/l, C=22.95 mg/l, Mg=51.05 mg/l and HPC=1 Cfu/ml. Also, total coliform and fecal coliform in water influent-indicated that the reverse osmosis process was good. Razi hospital hemodialysis system effluent was mitted Iran environmental standards. [ABSTRACT FROM AUTHOR]

During the last century, most of people around the world moved from communicable to non-communicable diseases, mainly due to air pollution. Air pollutants and dust storm increase risk of morbidity, for cardiovascular and respiratory diseases, and increase the number of deaths. The city of Ahvaz is considered as the focal point of air pollution and dust storm in Iran. The aim of this study was to determine the number of Hospital Admission Respiratory Disease (HARD) including asthma attacks, acute bronchitis and chronic obstructive pulmonary disease attributed to PM by a descriptive study during normal and dust event days in Ahvaz during the time period 2010-2012. The hourly PM data was collected from the Iranian Environmental Protection Agency and Razi hospital. The annual PM mean concentrations reached 282, 288 and 278 μg/m in 2010, 2011 and 2012, respectively. The number of HARD attributed to PM was 1438, 1945 and 1393 people, respectively, and the highest number of daily admissions was attributed to the highest daily PM concentration in Ahvaz. The average number of daily HARD during dusty days was higher than normal days, and a significant positive correlation, between the number of hospital admissions and dusty days, was found. Dust had significant impact on HARD in Ahvaz. [ABSTRACT FROM AUTHOR]

Background and Objective: Postoperative nausea and vomiting (PONV) is the main concern for 40-70% of patients undergoing laparoscopic cholecystectomy. Our objective was to compare carbon dioxide gas at low pressure and standard pressure for the occurrence of PONV on patients undergoing laparoscopic cholecystectomy. Methods: This double- blind trial was conducted on 50 women patients aged between 18 to 60 years with acute cholecystectomy. The patients were divided into two groups: low pressure (LP) (received LP gas, 7-9 mmHg) and standard pressure (SP) (received SP gas, 14-15 mmHg). Nausea and vomiting in patients at hours 0-4, 4-8, 8-12, 12-24 after the surgery were recorded. Results: The frequency of PONV in the LP and SP groups did not demonstrate statistically significant different (P > 0.05). Nevertheless the frequency of shoulder pain after 4 hours at the LP group compared with SP group was significantly different (P < 0.023). Conclusions: The use of low pressure gas compared to standard pressure gas to create pneumoperitoneum could not reduce the PONV whereas the frequency of shoulder pain in LP group was reduced. Low pressure gas was associated with reduction of surgeon visibility and subsequently more prolonged surgery duration. [ABSTRACT FROM AUTHOR]

Background: This study aimed to prevent and control the pain after arthroscopy that leads to patient satisfaction, rehabilitation, and return to normal life as soon as possible. It is hypothesized that there is no difference between intra-articular injection of dexmedetomidine and placebo after knee arthroscopy regarding pain level., Methods: This double-blind randomized clinical trial was conducted on 70 patients aged 18-60 years who were candidates for elective knee arthroscopic surgery with the American Society of Anesthesiologists Classification I-II. All patients underwent spinal anesthesia equally and were randomly divided into two groups of 35 cases per group. The drug group (D) received 2 μg/kg dexmedetomidine with 0.9% normal saline reached to a volume of 20 ml, and 20 ml of 0.9% normal saline was injected into the knee joint through the cannular sheath in the control group (C). Postoperative pain intensity was recorded 1, 2, 4, 8, 16, 24 h after injection using the Visual Analogue Scale. The time of requesting the first analgesic and the amount of analgesics consumed were recorded after 24 h., Results: There was no significant difference between the two groups in terms of age, height, weight, duration of spinal anesthesia, and duration of surgery ( P>0.05 ). In group D, there was a decrease in postoperative pain, a decrease in the amount of analgesic consumed, and an increase in the time of the first analgesic request, compared to group C ( P<0.05 )., Conclusion: This study showed that intra-articular injection of dexmedetomidine relieved postoperative pain, reduced analgesic consumption, and increased the time of first analgesic request after knee arthroscopy., Competing Interests: The authers declare there was no conflict of interest.

Background: Postoperative nausea and vomiting (PONV), as one of the complications after laparoscopic cholecystectomy, occurs in over 40% - 77% of cases. Considering the numerous complications of synthetic drugs, there is a growing tendency towards the use of herbal medicines due to their unique features. Ginger root is one of the herbal compounds effective on nausea and vomiting., Objectives: The aim of this study was to evaluate the effect of preoperative Zintoma capsules on PONV after laparoscopic cholecystectomy., Methods: In this quasi-experimental study, 130 eligible patients were randomly assigned to intervention (n = 65) and control (n = 65) groups using the four-block method. The intervention group received two capsules of 500 mg and one of 250 mg Zintoma. The control group received three placebo capsules. The severity of patients' PONV was recorded at 0, 2, 6, 12, and 24 hours after surgery using a checklist and a standard VAS instrument. Data were analyzed using t -test, Chi-square test, and LSD Post Hoc test (ANOVA) in SPSS 19., Results: The severity of PONV and vomiting was significantly different between the two groups (P = 0.001) at the above time points. The mean severity of nausea (by VAS) changed in the intervention group from 7.92 ± 1.28 to 0.33 ± 0.67 and in the control group from 8.00 ± 1.20 to 2.11 ± 1.55. The postoperative vomiting was less frequent in the group receiving the Zintoma capsules. The postoperative use of chemical anti-vomiting and nausea drugs was significantly lower in the intervention group than in the placebo group (P = 0.001)., Conclusions: Zintoma capsules can be used as a supportive treatment in the prevention of nausea and vomiting by reducing the incidence rate of PONV.

Nurses have the most important role among health care workers (HCWs) in each hospital (Aiken et al., 2008) [1]. Nurses education can lead to the improvement of nursing care If is implemented and designed based on nurses' needs and proper principles (Aiken et al., 2008) [1]. Nowadays, increased quality of the treatment and increase the chances of survival of patients with acute respiratory failure are very important (Teixeira et al., 2013) [2]. Nursing care plan in ICU patients is one of the important elements in nursing care, and one of the main strategies is promotion of education level. Nurses due to longtime relationship with nursing staff in 24 hours and use of multiple roles of education have excellent position in evaluating educational needs and performing clinical educator roles. The effect of education on the nursing care quality of patients who were under mechanical ventilation (UMV) in intensive care unit (ICU) ward of Razi hospital is evaluated during 2015. The present study is descriptive-analytical and semi experimental research. Research statistical population included 30 nurses. In this paper, the effects of communication with the patient, correct suctioning, compliance of aseptic techniques, the correct discharge of tube cuff, chest physiotherapy, the correct change positions, health food gavage, prevent of foot drop, oral hygiene, the eyes hygiene and protect the cornea have been studied. After completion of the questionnaires by patients, the obtained coded data were fed into EXCEL. Reliability was confirmed with coefficient Alfa 0.86 and the result of software and techniques were entered to SPSS for statistics and analysis.