[ effect of Entonox on severity of pain and mother hemodynamic and fetus apgar in natural vaginal delivery]

Labor pain, is one of the severe pains which is experienced by humans. Fear of this pain is caused elective cesarean for delivery in women. One of the safe and inexpensive drug methods for pain relief in delivery is entonox. In this study, the effect of entonox on the severity of pain, mothers hemodynamic and fetus apgar in natural vaginal delivery was investigated. In this clinical trial study, 60 women with an equal qualification who refferd to hajar hospital in Shahrekord were randomly chosen for vaginal delivery. They were randomly divided into two groups, one group [case] received entonox gas and other group [control] did not. Entonox was given to mothers by a mask after start of active phase of labor. The case group received entonox up to the end of the second phase of delivery, and the effect of entonox was recorded on the severity of pain and mother hemodynamic condition. Fetus apgar in natural vaginal delivery was compared between two groups. Data were analyzed using descriptive and analytic tests. The mean of pain scores in case group was 3.98 +/- 2.7 and 5.60 +/- 3.8 for control group [P=0.03] and it was 7.20 +/- 0.6 and 10 for each group in the second phose of delivery respectively. There were no significant differences between two groups in the maternal blood pressure, fetal heart rate and apgar scores. The mean of maternal heart rate and respiratory rate in case group were more than control group, but nausea and vomiting in the first and second stages of labor in case group were more than control group. In vaginal delivery, entonox can create adequate and effective analgesia without major complications for mothers and fetuses, and this can reduces the complications of cesarean section

[ 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 intravenous low dose ketamine on postoperative pain]

Postoperative pain causes various problems such as medical complications, excess cost and administration of opioid drugs. Although previous studies have shown the preventive effect of ketamine on postoperative pain, the administered dose was high [over 1mg/kg], which may cause adverse effects. The aim of this study was to assess the effect of low dose [0.5 mg/kg] of ketamine on postoperative pain. Sixty women that were candidate for elective cesarean section were recruited for our study and were divided randomly into two groups of case and control. Sixty seconds before operation, case and control groups received 0.5 mg/kg ketamine or placebo, respectively. Techniques of anesthesia and surgery were the same. Pain severity was assessed by McGill pain questionnaire, at 4 visits [the first at recovery then every 6 hours]. Case patients showed a lower mean pain score [P<0.05, t-test]. study suggests that low dose of ketamine is an effective drug for postoperative pain, which could be considered as an alternative of its high dose

[Evaluation of scoliosis screening results in 10-14 years old students of Shahrekord]

Scoliosis is referred to abnormal curvature of spinal column beyond 10 degrees. The most common type of it, is adolescent idiopathic scoliosis. Scoliosis screening test is the most economic and simplest method for diagnosis of the disease. Preferred age of scoliosis screening is 10-14 years old when growth spurt is occurring. This study was performed on 936 students between 10-14 years old in Shahrekord. Diagnosis was based on observation of asymmetric anatomical landmarks [such as spinout process, pelvic and shoulders], Adam's forward bending test and radiographic measurement of Cobb's angle. Eighty-six persons out of 936 were referred to orthopedic clinic. Seven cases had idiopathic scoliosis, 5 females and 2 males. Two persons had thoracic, 4 had thoracolumbar and 1 had lumbar congenital curvature. Two patients had family history of scoliosis and overall prevalence of idiopathic scoliosis was 0.7%. During exercise all 7 patients got tired sooner than their classmates and had higher incidence of back pain. Two girls and one boy needed surgery. Also 3 girls and 1 boy needed Brace treatment. Using this method, the patients can be recognized easier and more rapidly. Therefore, both the curve progression and dysfunction of limb are inhibited leads to decrease need for surgery