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Background: N-acetylcysteine (NAC) is an antioxidant derived from the amino acid cysteine and is one of the drugs used in the treatment of respiratory diseases. The aim of this study was to investigate the effect of NAC on the treatment of acute respiratory distress syndrome in mechanically ventilated patients admitted to the intensive care unit. Methods: This study was a randomized clinical trial. Patients under mechanical ventilation admitted to the intensive care unit were examined. Patients in the intervention group received daily 150 mg/kg of NAC on the first day of admission and then 50 mg/kg up to the fourth day of admission. Patients in the control group received routine care. The vital signs, level of consciousness, and other important variables were recorded. Data were analyzed using statistical tests and SPSS software version 24. Results: There was no significant difference between MAP, heart rate, respiratory rate, O2Sat, APACHE II score, and pulmonary capacity of the patients in the two groups on the first, second, third and fourth days after the intervention (p>0.05 ). There was no significant difference between the level of consciousness (according to GCS criteria), respiratory index (PAO2/FIO2) and PEEP of patients in the two study groups within 1 to 2 days after the intervention (p>0.05). There was a significant difference between the level of consciousness (based on GCS criteria), respiratory index (PAO2/FIO2) and PEEP of patients in the two study groups within 3 to 4 days after the intervention (p0.05). Conclusion: It seems that N-acetylcysteine has a positive effect on the treatment of acute respiratory distress syndrome in mechanically ventilated patients admitted to the intensive care unit.

Background: Epidural block approach and drugs are common options for improving the sensory and motor block duration and postoperative pain management. Objectives: The study aimed to compare the analgesic effects of dexmedetomidine and morphine as adjuvants to bupivacaine for epidural anesthesia in leg fracture surgery. Methods: This prospective clinical trial was conducted on patients (n = 80, age range: 18 - 60 years) categorized as ASA class I or II. After a clinical examination, the patients were allocated to receive either lumbar epidural bupivacaine + morphine (BM) (12 mL bupivacaine 0.5% + morphine 2 mg) or bupivacaine + dexmedetomidine (BD) (12 mL bupivacaine 0.5% + dexmedetomidine 1 µg/kg). After drug administration, the sensory block level was assessed at 2-min intervals using the Cold Swab method until it reached the T12 level. At the T12 level of sensory block, the surgery began when motor block reached grade 3 of the modified Bromage scale. Results: The BD group had a significantly shorter time to reach the sensory and motor block than the BM group (P < 0.001). The duration of sensory and motor block was significantly longer in the group BD than in the BM group (P < 0.001). Moreover, the BD group showed lower VAS scores (P < 0.0001) and longer time to first analgesia demand than the BM group. Conclusions: Combined bupivacaine + dexmedetomidine prolongs the sensory and motor block duration and controls postoperative pain more effectively, indicating that it is an appropriate combination for epidural anesthesia.

Background: Spinal anesthesia is the most common technique used for cesarean delivery due to some advantages compared to regional anesthesia. It is easily performed and provides a rapid onset of block. Though bupivacaine is a generally used long-acting amide type local anesthetic drug for spinal anesthesia, ropivacaine may sometimes be selected. Objectives: This prospective, randomized, double-blinded study was aimed at comparing clinical efficacy and safety between ropivacaine and bupivacaine during cesarean section. Methods: After getting ethical committee approval and written informed consent, 65 women who referred to Imam Khomeini Hospital of Ahvaz, Iran in 2018 were chosen for elective cesarean delivery under spinal anesthesia. They were randomly allocated to receive either ropivacaine 1% (n = 33) or bupivacaine 0.5% (n = 32). Afterwards, the differences in the anesthetic efficacy, vital signs, and hemodynamics of participants between the two groups were recorded. Results: Duration of sensory block was shorter in the ropivacaine group than bupivacaine group (132.5 ± 21.6 min vs. 175.8 ± 26.2 min; P < 0.001). Ropivacaine also produced a shorter duration of motor blockade than bupivacaine (124.8 ± 20.2 min vs. 168.2 ± 21.7 min; P < 0.001). There is no difference between the two groups in terms of systolic and diastolic blood pressure, but the heart rate of patients in the bupivacaine group is significantly higher than the ropivacaine group. Conclusions: The results suggest that ropivacaine and bupivacaine are two efficient drugs in anesthesia in the cesarean section, ropivacaine is a better choice due to little influence on the hemodynamics and shorter duration of sensory block and motor block which are useful for the recovery and also safe to the patients.

Background This study compared the effects of fish oil and paraffin oil on critically ill adult patients with hypoalbuminemia admitted to the intensive care unit (ICU). Methods The present single-center, double blind, randomized controlled trial was conducted on 104 patients hospitalized at ICU. The study group (n = 53) was administered with 5 gr fish oil via nasogastric tube (900 mg EPA and 600 mg DHA) for 14 consecutive days, while the control group was administered with the paraffin oil (n = 51). Serum levels of lipid profile, liver enzymes, creatinine, blood urea nitrogen, and albumin were measured. Results It was found that in the study group, the TG level statistically decreased, while the levels of HDL-C and albumin increased. In addition, receiving omega 3 oil had no significant effect on serum levels of total cholesterol, LDL-C, VLDL, liver enzymes, creatinine and BUN. Conclusion In general, receiving EN fortified with fish oil may increase the serum levels of albumin and HDL-C while decreasing the TG levels in in the patients with hypoalbuminemia. Thus, omega-3 PUFA may play a therapeutic role in increasing the albumin level in patients with hypoalbuminemia. The relationship of alterations in albumin levels with the use of fish oil requires further investigation.

For data collection, Technological Capability Questionnaire (Lall, 2001) and Organizational Innovation Questionnaire (Choopani et al., 2012) have been administered after determining the reliability and validity. The statistical population of the study is comprised of all employees of the Water and Sewage Organization, the Regional Water Company, and the Regional Power Company of Sistan and Baluchestan Province. Also, stratified sampling method is used to select employees with an associate or higher degree. A total of 149 questionnaires were completed and returned by responders from the three communities after distributing the questionnaire. After data analysis using the Lisrel and Spss v19 softwares through the statistical methods of regression and Spearman correlation coefficients, it was clear that there was a significant positive relationship between technological capability and organizational innovation. There was also a significant positive correlation between the three dimensions of technological capability (investment capability, manufacturing capability, and communication capability) and organizational innovation.

Current research is aimed to study the extent of social capital of employees and its relation with development of social entrepreneurship in 3 organizations: Emdad Committee, Welfare organization and Social Security organization in Jiroft city. Statistical population of this study is all of employees of aforementioned organizations in 2013 which have been evaluated 182 persons. Studied sample in current research is 150 persons. To collect required data, questionnaire has been used. To determine reliability of questionnaire, viewpoints of experts and university professors have been used. According to consensus of experts, questionnaire has the content reliability. Obtained Cronbach's alpha coefficient for questionnaire of social capital is 0.92 and for questionnaire of social entrepreneurship is 0.86 which have required durability. Ultimately, to analyze data, SPSS 19 software for correlation between variables and multivariable regression has been used. Also, to evaluate the model, Structural equation models helping Lisrel8.50 software has been used.