[ effect of intra abdominal wall infiltration with bupivacaine in reducing postoperative diclofenac need in elective cesarean sections]

Considering the side-effects of opiums and NSIADS drugs such as respiratory depression, apnea and GI effects, today it has been paid more attention to intra abdominal wall infiltration of local anesthetics for this purpose. The aim of this study is to determine the effect of intra abdominal wall infiltration with bupivacaine to reduce post operative diclofenac need in elective cesarean sections. In this double- blind, placebo-controlled trial, 60 healthy women with single term pregnancy underwent spinal anesthesia were randomized into two groups. Patients, then received a combination of 30cc of bupivacaine with 1.5cc of epinephrine as intra abdominal wall infiltration or equal volume of saline in cesarean section at the time of abdominal closure. Pain was assessed using a visual analogue scale 1, 2, 3, 4,8 and 12 h after the operation. Also mean diclofenac consumption was assessed during 12 h after the operation. The final analysis was done with statistical tests by SPSS [P<0.05 was considered significant]. Mean pain scores at 1 and 2 h after the operation was significantly lower in bupivacaine group than placebo [p<0.05]. Mean diclofenac consumption was lesser in bupivacaine group than placebo [p<0.05]. Also the time we prescribed diclofenac in bupivacaine group was later [p<0.05]. Intra abdominal wall infiltration with 30cc of 0.25% bupivacaine leads to less paid and less diclofenac consumption at the first hours after cesarean section

[Survey the knowledge attitude and practice on papsmear in nurses and midwives]

Despite the easy of detection of cervical cancers in the pre-cancer stage, it is still one of the most common cancers in Iran and the world. The responsibility of womens education about this safe and unexpositive screening test is for nurses and midwives. Survey the knowledge, attitude and practice on Popsmear in nurses and midwifes in Alzahra Maternity Hospital. In this cross-sectional study, 80 Nurses and midwives of Alzahra maternity Hospital were studied. Data collection tool was a questionnaire designed in 5 section to determine their knowledge, attitude and practice. Chi- square, Mann- Whitney - U, Fishers exact test, Kruskal-Wallis and T - student test SPSS ver14 were used for statical analysis. Knowledge of 91.3% of participations was scored as "Good" and it was significantly different between nurses and midwives. 83.8% of them has "positive" attitude toward the test. There was no significant relationship between attitude, age, duration of occupation and marital status of two groups. Nurses and midwives were matched in terms of age; marital status and duration of occupation.42/9% were remarked to have [good] practice. With regard to Knowledge role of nurses and midwives in performing papsmear screening test it is necessary to improvement their education and compare their attitude and practice