ABSTRACT
Cryotherapy is the simplest and oldest therapeutic method in treatment of damaged soft tissue. The aim of this study was to assess the efficiency of two methods of cryotherapy, the ice pack and cooling gel pad on perineal pain due to episiotomy. This randomized controlled trial study was conducted on 81 healthy primiparous women with normal vaginal delivery and episiotomy in Ommul- Banin hospital of Mashhad in 2006. They were allocated to two groups of cryotherapy [41 in cooling gel pad group and 40 in ice pack group]. The level of perineal pain, the coldness of cooling devices were evaluated during the first 10 minutes and also, duration of analgesia effect at 1, 2, 5, 10 days after intervention. The questionnaire was used in the first measurement. The correlation between each question measured twice, and the least agreement was r=0.60. The data were analyzed with SPSS 16, Chi square and fisher's exact test. There was a statistically significant difference between the two groups [cooling gel pad, ice pack] considering to the pain level on second day [P=0.001], fifth day [P=0.02], tenth day [P=0.005], during the use of cooling device. But there was no significant difference between the two groups regard to coldness in the first 10 minutes and duration of analgesia effect of cooling device in first, second, fifth and tenth day. In terms of the properties of cooling device such as reduction the need of taking of oral analgesia drug and satisfaction of patients, so cooling gel pad is better than ice pack for reducing episiotomy pain.
ABSTRACT
Nowadays, nosocomial infection is one of the greatest problems in hospitals. Normal flora of staffs hands and the bacterial agents on the surface of medical equipment can become progressively colonized with potential pathogens during patient care. This study was carried out to determine the bacterial agents existed on staffs hands and in the wards of hospital to step in to control nosocomial infection. In this descriptive study, during 17 months [22.mar.2010- 30.aug.2011], 403 samples, using sterile swab, were randomly obtained from the staffs hands and medical equipment of emergency departments, ICU, male operation room and female surgical unit. The samples were cultured on Blood agar [BA] and Eosin methylene blue [EMB]. Then, identification of isolated bacteria was done with diagnostic tests. Of 430 samples, 530 bacteria were isolated from staffs hands [N= 291] and medical equipment [N= 234]. The most common bacterium from personnel's hands [144; 49,5%] and medical equipment [24; 10%] is Staphylococcus aureus. Also, three isolates of pseudomonas aeruginosa from staffs hands of male surgical ward and medical equipment of ICU, and two isolates of Acinetobacter.spp from ICU's medical equipment were identified. With regard to the findings, it seems that applying the appropriate disinfectant agents by using standard procedures is necessary
ABSTRACT
Episiotomy occuring during delivery can be a source of serious short and long term morbidity. So a delay in healing can also increase the duration of perineal pain. Nowadays attention has recently focused on maternal morbidity and improving diagnosis and treatment of perineal injury following childbirth. So, this study was done to evaluate the effectiveness of cold therapy in two patient groups [gel pad and ice pack] and compare them with control group in term of wound healing and intensity perineal pain after episiotomy in primparous women who gave birth at Hazrat Ommolbanin University Maternity Hospital in Mashhad-Iran from October 2005 to February 2006. In this randomized controlled trial, 121 healthy primparous women with include and exclude criteria which underwent normal delivery with episiotomy were chosen in the two cold therapy groups [gel pad and ice pack] and one control group. Evaluation of wound healing with REEDA scale and evaluation of intensity pain with numeric scale [NRS] [0-10] during the first 4 hours and on 1[st], 2[nd], 5[th], 10[th] days after episiotomy and evaluation of satisfaction of women from analgesia at 10th day were conducted. Data were analysed by statistic methods with chi-square, Kruskal Wallis, Mann-Withney u, Jonckheere trepstra, analysis variance and exact tests with software spss. The results showed a statistically significant difference in the wound healing in 2[nd] day [P<0.001], 5[th] day [P<0.001] and 10th day [P<0.001] and intensity perineal pain in 3 the groups at first 4 hours [P=0.003] and 10[th] day [P=0.044] after episiotomy. Also satisfactory was in favor of the maternity gel pad group. Using to maternity gelpad is effective in reducing perineal morbidity. So it suggested as a complementary treatment in clinical services and is a comfirmation to the correct and invasive treatment and can be an acheivement in promoting health level and also, women's satisfaction
Subject(s)
Humans , Female , Wound Healing , Pelvic Pain , Pain, Postoperative/therapy , Parity , Cold Temperature , IceABSTRACT
Active pushing in second stage labor is acceptable, despite its complications for fetus and it has been noticed by midwifes and obstetricians. Recent studies have shown that spontaneous pushing decreases fetal acidosis. So, the objective of this study was to assess the effect of spontaneous and active pushing in second stage labor on fetal outcome in primiparous women. This clinical trial study was done on 108 primiparous women with uncomplicated labor that based on fliess table randomly assigned to spontaneous and active groups. In spontaneous group used her own urge to push and in active groups encouraged to take a deep breath, hold it and push for ten numbers. After delivery, cord arterial blood PH value and Apgar score [1 min and 5min] were measured. The results of this study showed that arterial cord PH was higher in the spontaneous pushing versus active pushing [p<0.001]. Apgar score [1min and 5min] had no significant difference between two groups. There was significant correlation between Apgar score [1min and 5min] and arterial umbilical pH [p=0.028, p=0.019]. Spontaneous pushing decreases fetal acidosis so it can be effective, healthy, and cheap method for improving neonatal outcome