[ effect of aromatherapy with orange essential oils on anxiety in patients undergoing hemodialysis]

All hemodialysis patients experience some degree of anxiety during hemodialysis. Anxiety increases morbidity and mortality. The aim of this research is to compare the effect of orange essential oil aromatherapy on anxiety of hemodialysis patients. In this clinical trial, sixty-two hemodialysis patients were randomly assigned to two groups: an orange oil group [n=31], and a usual care group [n=31]. In orange oil group, subjects inhaled orange oil using handkerchiefs smeared with orange oil for 15-20 minutes. This method was used three times a week for four weeks. In the usual care group, subjects received the routine care of the hemodialysis ward. The level of anxiety in the two groups was measured and compared before intervention, as well as after the first, second, third, and fourth weeks of intervention, using Spielberg State-Trait Anxiety Inventory questionnaire. Before intervention, the mean state anxiety scores were 46.9 +/- 9.7 and 48.3 +/- 11.6 and the mean trait anxiety scores were 46.5 +/- 9.2 and 47.9 +/- 11.6 in orange oil and usual care groups, respectively. After intervention, the mean state anxiety scores were 35.9 +/- 8.7 and 45.1 +/- 1.7 and the mean trait anxiety scores were 36.0 +/- 10.0 and 45.6 +/- 11.8 in orange oil and usual care groups, respectively. In orange oil group, the level of state and trait anxiety decreased significantly compared with usual care group [p < 0.001]. Also, in orange oil group, the level of state and trait anxiety decreased significantly between the first, second, third, and fourth weeks of intervention [p < 0.05]. Orange oil aromatherapy can reduce state and trait anxiety in hemodialysis patients without important complications

[Diagnostic validity of BCL-2 in ganglion cell staining and its application in Hirschprung's disease diagnosis]

Hirschsprung's disease is a congenital disorder, characterized by the absence of ganglion cells in the intramural and submucosal plexus in distal parts of large bowel. Diagnosis is based on the histopathologic examination of hematoxilin and eosin stained sections. Due to diagnosis limitation by Hematoxylin and Eosin staining [H and E], this study was done to identify the ganglion cells by BCL-2 immunoreactivity and compared it with H and E staining. In this laboratory study, paraffin blocks of 36 specimens demonstrating ganglion cells on original H and E stained sections and 35 specimens lacking ganglion cells on H and E staining, were selected. Recuts were stained by H and E and BCL-2 methods. Ganglion cells were observed in 36 cases by H and E staining but in BCL-2 staining ganglion cells were detected in 29 cases. In 35 cases reported negative for ganglion cells on H and E staining, ganglion cells were detected in 5 cases by BCL-2 method. Sensitivity, spesificity, positive and negative predictive values for BCL-2 method for diagnosis of hirshsprung's disease were 81%, 86%, 85% and 86% respectively.discordancy [positive BCL-2, negative H and E] was 14%. Immunohistochemistry method using BCL-2 improve the accuracy of diagnosis in hirschsprung's disease, when accompanied with H and E staining, particulary for negative slides

[ degree of agreement of quantiferon TB gold test and tuberculin skin test in nurses]

Tuberculin skin test [TST] is the standard method for diagnosis of latent tuberculous infection. Positive results of TST [significant induration] may be seen in persons with latent M.tuberculosis infection and negative results of this test may be seen in patients with active tuberculosis. After performing TST false positive reactions may be seen with nontuberculous mycobacterial infections or false negative results may be encountered in anergic patients with tuberculosis disease. Quantiferon TB Gold test [QFT] is a new diagnostic test which assays the amount of released interferon gamma from peripheral blood lymphocytes in response to M.tuberculosis antigens. The purpose of this study was to determine the degree TST and QFT correlation. This descriptive study carried out on 72 nurses of two internal medicine and infectious diseases wards of Imam Reza and Imam Khomeini hospitals in Kermanshah located in West of Iran, during 2009. 58 of nurses were vaccinated with BCG vaccine and none of them had any immune compromising condition. TST was performed by intradermal injection of 0.1 ml of standard tuberculin test [5 TU] and QFT was performed 48 hours then after using peripheral whole blood. The amount of released interferon gamma from lymphocytes in response to antigens were measured by ELISA method. Three of nurses excluded and this study was done on 69 nurses. Overall the degree of agreement of TST and QFT was 63.7% [P=0.69 and Kappa=0.139]. The degree of discordance between these tests in PPD negative but QFT positive persons was 15.94% and in PPD positive but QFT negative persons was 20.3%. The sensitivity and specificity of QFT was 41.67% and 75.56% respectively. The degree of agreement of TST and QFT in vaccinated and unvaccinated nurses was 63.8% [Kappa=0.143] and 66.67% [Kappa=0.54] respectively. There was no significant difference between QFT and TST in diagnosing latent tuberculous infection

Effects of vitamin E administration on APACHE II score in ARDS patients

The acute respiratory distress syndrome [ARDS] is a common clinical disorder caused by injury to the alveolar epithelial and endothelial barriers of lung. In ARDS patients, oxidative stress is increased and plasma antioxidant levels are reduced. Vitamin E has an important role in antioxidant defense mechanisms. In this study the effect of vitamin E on decrease of APACHE II score in ARDS patients was investigated. Twenty patients [mean [SE]: age = 51.2 +/- 6.41 years] with ARDS were enrolled. After diagnosis based on inclusion and exclusion criteria, ten patients as treatment group received 600 IU vitamin E daily intramuscularly. Control group received normal saline as placebo. Plasma samples and Acute Physiology and Chronic Health Evaluation [APACHE] II score were obtained before administration, 4hrs and 12hrs after each intervention and repeated three days for each patient. Results were analyzed by use of an SPSS software package with a repeated-measures analysis of variance [ANOVA]. Significant changes were observed in APACHE II score from first to seventh measurement [p=0.0001] in treatment group, but vitamin E concentration altered significantly in only first to seventh measurement [p = 0.019]. From the results of this study, it seems that the use of vitamin E as a lipid-soluble antioxidant along with other supportive measures is beneficial in decreasing APACHE II score in ARDS patients