[Pharmaceutical effects of ephedrine, atropine and mucosal phenilephrin on hemodynamic alterations of women during spinal anesthesia in cesarean section]

Hemodynamic alteration and hypotension due to spinal anesthesia can reduce tissue perfusion and increase ischemic risk, myocardial infraction, renal failures spinal damages and even deep veins thrombosis. This study was designed to compare pharmaceutical effects of ephedrine, atropine and mucosal phenilephrin on hemodynamic alteration of women during spinal anesthesia in cesarean section. This randomized clinical and double blind study was done on 90 singleton pregnant women with ASA I and II class .the subjects gone elective cesarean section and allocated into three groups. subjects were received 500 ml ringer lactate before spinal anesthesia. Subjects in group I, II and III first received 0.1 mg/kg atropine [IV] 0.01mg/kg ephedrine and 100 micro gr phenilephrin [mucosal] prior spinal anesthesia, respectively. Hemodaynamic indexes including blood pressure, heart Rate, oxygen saturation and drug side effects were determined every 5 minutes interval through the surgery. Data was analyzed by using SPSS-11.5, Chi-Square and ANOVA tests. Hemodaynamic indexes were changed during study, but three medicine showed similar effect on heart Rate, blood pressure and changes of oxygen saturation [P<0.05]. There was a significant differences among three groups for dosage of extra ephedrine to control of blood pressure [P<0.05]. This increase dosage of extra ephedrine was 56.7%, 20% and in ephedrine, phenilephrin and atropine groups,respectively. Nosia rate was 6.7%, 50% and 46.7% in phenilephrin, atropine and ephedrine groups, respectively [P<0.05]. This study showed that to prevent of blood pressure drop following spinal anestasia atropine, phenilephrin and ephedrine can be prescribed, but ephedrine is recommended for lowering the rate of nosia

Problem-based learning: a new experience in education of pediatric nursing course to nursing students

Based on the available evidence and experiment problem-based learning [PBL] is one of the most successful methods in achievement of higher education objective. In this method, learning is basically depended on the group discussion which is helpful in learning of medical subjects on the clinical cases. Despite its advantages, the standard form of problem-based learning method is not applicable in the university courses because of the large number of students and time consuming. In this study, an alteration of the standard PBL was used and the results were compared to those of the lecture-based learning in terms of education and learning. This quasi experimental and two-step study was performed on 60 nursing students, who were attending the course. They were random divided into two equal groups of experiment and control. The topics o pediatric nursing were taught to the experimental group and control group by problem-based learning and lecture-based learning, respectively. The students were evaluated for educational achievement using a multiple choice question test. Data was analyzed using descriptive statistics. Our findings showed that the mean of the final score of the students who learned by PBL method was significantly higher [15.5 +/- 1.6] than that of the students who learned by lecture-based method [12.6 +/- 1.7] [p<0.05]. Our results showed that learning by the modified standard PBL method was more effective and successful than that of the lecture-based method. Therefore, this method is recommended for teaching of special nursing courses

application level of the infection control methods in the operation wards of Shahrekord university hospitals compared to the standards in 2005

Nosocomial infection is an important health problem. The operation rooms of the hospitals are potentially favorite places for distribution of these diseases. It is now known that using standard control methods could prevent the infections. The aim of this study was to find the application level of these methods in Shahrekord university hospitals and to compare them with the present standards methods. This descriptive analytical study was performed in three operation wards including 7 operation rooms. Data was collected using a questionnaire consisted of 54 questions about facilities and equipments, 8 questions about personnel practice related to infection control, 12 questions about individual hygiene and scrub methods, 8 questions about disinfection and sterilization and 7 questions about using preventive measures. The data was analyzed using t-test. The findings showed that application of disinfecting and sterilizing methods [93.75%], individual health, scrub methods [79.2%], and the patient admission process [84%] were poor. In conclusion, the operation wards have to be reviewed and supervised regularly for personnel, equipments, buildings, and training of the personnel to use disinfection control methods