[Effect of Ginkgo biloba, risperidone and biperiden regimen in chronic schizophrenia]

Schizophrenia is a disorder characterized by a chronic recurrent course. Despite the availability of an ever-expanding range of typical and atypical antipsychotics, a substantial proportion of patients with schizophrenia show a partial or total lack of response to antipsychotic monotherapy. This study was done to evaluate the clinical effects of Ginkgo biloba as an adjunct to the Risperidone and Biperiden in the treatment of chronic schizophrenic patients. This randomized clinical trial study was carried out on 60 chronic schizophrenic patients in Sina hospital Shahrekord, Iran during 2009-10. Schizophrenia was diagnosed by DSM-IV-TR criteria. Subjects were randomly divided into intervention and control groups. Two groups were matched according to the age, sex, education, duration of illness. Patients in interventional group received Risperidone up to 6mg/day, Biperiden 4mg/day and Ginkgo biloba 240 mg/day for 12 weeks. The control group received Risperidone up to 6mg/day and Biperiden 4mg/day for 12 weeks. The scales for assessment of positive symptoms [SAPS] and assessment of negative symptoms [SANS] were recorded in prior, 6th and 12th weeks. Data analyzed by using SPSS-15 and student t-test. The mean score of positive symptoms were 55.7 +/- 2.1 and 74.4 +/- 2.3 in interventional and control groups, respectively [P<0.05] after 12 weeks. The mean score of negative symptoms were 63 +/- 1.3 and 69.3 +/- 1.8 in interventional and controls, respectivley [P<0.05] after 12 weeks. This study suggested that the use of Ginkgo biloba as an adjunct to Respridone and Biperiden was more effective than Risperidone with Biperiden regimen improving psychological condition of chronic schizophrenic patients

[Effect of initiation time of oral hydration on the return of bowel function and woman's satisfaction after elective caesarean section in primiparous women]

Abdominal operations as gynaecological procedures result in gastrointestinal dysmotility. Early feeding and ambulation are nonpharmacologic interventions which can be useful in re-initiation of bowel function. This study was done to evaluate the effect of early oral hydration on the return of bowel function and woman's satisfaction after elective caesarean section in primiparous women. In this randomized clinical trial, 120 primiparous women undergone elective cesarean section were assigned to control and intervention groups in Hajar hospital, Shahrekord, Iran during 2007. In the interventional group, oral hydration with liquids was started 4 hours after surgery regardless of presence of bowel sounds and solid food was started after bowel sounds appeared. The control group recieved liquid diet 12 hours after the operation if it was tolerated, they were given soft diet and regular food at the next meal. The return of bowel activity, time of ambulating, satisfaction, discharge from the hospital and complications were compared in two groups. The data were analyzed using SPSS-15, Chi-Square, T and one way ANOVA tests. The mean postoperative time interval to first hearing of normal intestinal sounds in interventional versus control groups were [9.5 +/- 1.38 and 12.5 +/- 2.5 hours] the first passage of flatus [15.7 +/- 3.61 vs.22.4 +/- 4.1 hours], time to first sensation of bowel movement [10.8 +/- 1.99 versus 15.7 +/- 3.4 hours] and defecation [18.9 +/- 3.65 versus 23.4 +/- 4.85 hours]. These differences were significant [P<0.05]. Also discharge from the hospital [0.96 +/- 0.18 versus 1.1 +/- 34 days] were significantly shorter in interventional group [P<0.05]. The women in the early feeding group got out of bed [patient mobilisation] earlier than their interventional group [14.1 hours versus 18.8 hours [P<0.05]. Maternal satisfaction was significantly higher among the early fed women [P<0.05]. Early oral hydration after elective cesarean section associated with rapid resumption of intestinal motility and increased woman's satisfaction

[ effect of chewing sugar free gum after elective cesarean-delivery on return of bowel function in primiparous women: a randomize clinical trial]

An important cause of delayed recovery from abdominal surgery is delay in return of bowel Function. The aim of the present study was to assess the effects of chewing sugar free gum after elective Cesarean-delivery on return of bowel function in primiparous women in Hajar hospital of Shahrekord. In a randomized clinical trial, 120 patients, who were scheduled for elective cesarean were randomly allocated to 2 groups of gum-chewing group [n=60] and control group [n=60] postoperatively. The patients in the gum-chewing group chewed postoperatively sugar free gum 4 times daily as soon as they recovered from anesthesia till the time they passed flatus or defecated. Control group recieved routine postoperative dietary management. The mean scores of postoperative time interval to first hearing of normal bowel sounds, passage of flatus, defecation and sensation of bowel movement were compared between the two groups. The data were then analyzed using chi square and t-test [p<0.05]. The mean postoperative time interval to first hearing of normal intestinal sounds [6.5 +/- 1.5 versus 12.5 +/- 2.5 hours], the first passage of flatus [12.2 +/- 2.0 vs.22.4 +/- 4.1 hours], first sensation of bowel movement [7.4 +/- 1.7 versus 15.7 +/- 3.4 hours] and defecation [15.5 +/- 2.5 versus 23.4 +/- 4.8 hours] were significantly lower in the gum-chewing group compared with control group. [p<0.001]. The staying period in the hospital [0.96 +/- 0.18 versus 1.1 +/- 34 days] was significantly shorter in gum-chewing group. [p<0.001]. Chewing gum after elective Cesarean-delivery is safe, inexpensive and helpful which is well tolerated, and associated with rapid resumption of intestinal function and speeds recovery shorter hospital stay

[ effect of massage therapy on the severity of labor in primiparous women]

Labor pain is the most severe pain that most of women experience it. Using novel and supportive methods of relieving labor pains such as massage therapy, labor could be a pleasant and enjoyable experience. This study was conducted to determine the effect of massage therapy on the severity of labor pain in primiparous women. In this clinical trial study a total of 60 primiparous women who were hospitalized in Mahdieh and Hedayat hospitals of Tehran were selected using simple random sampling and randomly divided into two groups of control and case [massage therapy]. The severity of pain before intervention [at the beginning of active phase] in the 4, 8, and 10 cm cervical dilation was measured in both groups by means of a Visual Analogue Scale [VAS]. Duration of the first and the second and type of delivery in both groups were investigated. Data in the two groups were compared using independent t and Chai-square tests. Before intervention, the results indicated that there was no significant difference between the two groups. Mean of severity of pain [at the beginning of the active phase] was 5.88 +/- 1.07 and 6.75 +/- 1.39 in the case the control, respectively [P<0.01]. At the beginning of transitional phase, it was 7.09 +/- 0.89 and 8.54 +/- 1.06 [P<0.05] and at the end of the first stage was 9.16 +/- and 9.73, respectively [P<0.05]. The duration of the first stage of the delivery in the case and control was 246.16 +/- 98.82 and 362.50 +/- 111.84, respectively. Regarding the effect of massage therapy in both decreasing of labor pain and in the acceleration of delivery, education and then using of the method in labor centers would result in decreasing of proposed caesarean sections

[ viewpoints of students and educators, in faculty of nursing and midwifery of Shahrekord university of medical sciences, about the effective factors in academic improvement of students, 2004]

The development of each community is influenced by its educated individuals. Therefore, recognition of influencing factors in academic improvement of students and attention to these factors are essential for persistent development. Therefore, this study was conducted to determine the effective factors and compare the viewpoints of the students and educators, in faculty of nursing and midwifery of Shahrekord University of Medical Sciences, about the effect of these factors. In this descriptive-analytical study which performed in 2004, a total of 232 students, from faculty of nursing and midwifery, educating in third semester or higher and 22 of their educators were examined based on census sampling. The viewpoints about influencing factors on academic improvement were collected by questionnaires including two sections: the first section included demographic questions and the second contained 47 questions in 6 fields. Data were analyzed using descriptive and analytical statistic [general linear model and multivariate analysis of variance]. The findings showed that there was significant relationship between gender, diploma grade-point average, semester or course and academic improvement [P<0.05]. Also from students' viewpoints about influencing factors on academic improvement the upper score belongs to educational content [4.46 +/- 0.63] and the lower score belongs to students' factors [3.85 +/- 0.63] although from educators' viewpoints the upper score belongs to educational content [4.33 +/- 0.68] and the lower score belongs to socioeconomic factors [3.67 +/- 0.71]. The most difference among viewpoints belongs to socioeconomic status [P<0.05] and educational environment domains [P<0.01]. Paying attention to educational quality by medical and science courses designers may have important effects on academic improvement in the students

Analysis of international organizational and management standards in midwifery education and recommendation of appropriate national standards

Today, moving toward high quality and efficient education is essential in educational systems. To achieve it, management, research and educational programs should evolve consistent with the produced knowledge, professional developments and standards. Regarding the important role of midwifery education in improvement of social health, the current study was carried out to identify the international organizational and management standards in midwifery education and to recommend appropriate national standards. This is a triangulation study which was fulfilled in 1381 and 1382, in seven steps. In first three steps, following search and collection of standards of various countries, the survey tool which consists of the fields and recommended standards was designed. In steps four to seven, these fields and standards were surveyed through an opinion poll; using Delphi's method. Sampling population was all the midwifery national board members and heads of midwifery departments in governmental university which at least offer B. Sc of midwifery. The standards should be marked as appropriate, relatively appropriate and inappropriate by participants. Finally, the data was analyzed using descriptive analysis methods. After analyzing the opinions; using Delphi's method, the results were proposed as 37 recommended standards. They were grouped as 13 standards in the field of missions and objectives and 24 standards in the field of organizational and management structure. Extracting organizational and management standards of midwifery and recommending the proper national standards help the planners in defining the missions, visions and goals of the systems. It would also help the authorities in designing proper organizational and management structure and evaluating the midwifery management system