[ effect of ginkgo on stress level of nurses]

Mental Health of Nurses in recent decades, attracted more attention. Therefore strategies to reduce stress level is essential. Ginkgo biloba is one of thes herbs that has widely usage in complimentary medicine.With regard to the these points and consider of positive effects of Ginkgo biloba, this study aimed to assess the effect of Ginkgo biloba on nurses stress levels. This clinical trial was a double blined cross sectional study that nurses eligible to participate in the study using sampling methods were selected and Then randomly given drug or placebo to nurses. The medication and placebo was 40 mg, twice a day. After the two -week, the experimental and control group were switched. In this study 62 nurses for two weeks consume ginkgo. Sum score of occupational stress questionnaire in case group after intervention was 40.15 with standard deviation 10.26. sum score of occupational stress questionnaire in control group after intervention was 34.55 with standard deviation 12. With regard that stress in nurses has problems such as decrease quality of care and unsatisfaction and unefficacy and fatigue and these factors lead to emotional disorder then intervention for control them is necessary. Therefore with regard that this research identify positive effect of ginkgo on stress levels and ginkgo is a part of complimentary therapy has a wildly application then we can use that for increase quality of life in nurses

Isolated renal mucormycosis after liver transplantation: an unusual case report

Mucormycosis is a rare complication of immunosuppression. Most of the reported cases have been rhinocerebral or disseminated. Isolated renal involvement is extremely rare and until now less than 30 patients have been reported in the English literature. Isolated renal mucormycosis with renal artery rupture in a liver transplant patient has not been reported so far. Herein we report an extremely rare case of isolated renal mucormycosis in a liver transplant patient who was successfully treated with nephrectomy

Liver transplantation for caroli disease

Caroli disease is a rare congenital disorder characterized by multifocal, segmental dilatation of intrahepatic bile ducts. Patients with Caroli disease who have recurrent bouts of biliary infection, particularly those who also have complications related to portal hypertension may require liver transplantation. In liver transplant ward of Shiraz University of Medical Science we had 4 patients with Caroli disease who were transplanted. Herein, we describe the demographic characteristics and post-transplant course of the patients. These patients presented with liver failure, recurrent cholangitis and portal hypertension sequelae unresponsive to medical treatment. The mean age of patients was 24.5 [range: 18-36] years, the mean MELD score was 17.5 [range: 11-23], three patients were female; one was male. All of the patients had good post-transplantation course except for one patient who developed post-operative biliary stricture for whom biliary reconstruction was done

Post-reperfusion syndrome and outcome variables after orthotopic liver transplantation

Post-reperfusion syndrome [PRS] is an important during liver transplantation. We studied the occurrence and severity of PRS in patients who underwent orthotopic liver transplantation [OLT] to investigate how PRS was correlated to clinical variables and outcomes. We retrospectively recorded intra- and peri-operative data for 184 adult patients who received cadaveric OLT during a 3-year period from 2005 to 2008. Patients were divided into two groups according to the severity of PRS: Group 1 [mild or no PRS] comprised 152 patients; and group 2 [significant PRS] consisted of 32 patients. There were no significant differences in demographic and pre-operative data between groups. Group 2 had more total blood loss than group 1 [p=0.036], especially after reperfusion [p=0.023]. Group 2 required more packed red cell transfusions [p=0.005], more fresh frozen plasma [p=0.003] and more platelets [p=0.043] than group 1. Fibrinolysis was more frequent in group 2 [p=0.004]. hospital stay in group 2 was significantly longer than in group 1 [p=0.034], but the frequencies of other outcomes including infection, re-transplantation, dialysis, rejection and extended donor criteria did not differ significantly between groups. Bleeding, blood transfusion and fibrinolysis occurred more often in the group of severe PRS after reperfusion. Although postoperative complications like rejection, infection and the dialysis rate were not significantly different in the two groups, hospital stay was more prolonged in the group with severe PRS

Outcome and characteristics of patients on the liver transplant waiting list: Shiraz experience

The only curative therapy for end-stage liver disease is transplantation but due to a shortage of available donor livers the waiting list mortality is high. This study aimed to evaluate the outcome and characteristics of patients on the waiting list for liver transplantation in Shiraz, southern Iran during the period from April 2004 to March 2007. Medical records of all chronic liver disease patients >/= 14 years that were on the waiting list for liver transplantation at the Nemazee Hospital Organ Transplant Center during April 2004 to March 2007 were reviewed. Hospital records were used to retrieve demographic, clinical and laboratory data. Records of the referring gastroenterologists provided information about the etiology and complications of liver disease. The patients were followed at the end of the study period by clinic visits or telephone contact. There were 646 patients on the waiting list for liver transplant during April 2004 to March 2007. Hepatitis B was the most common etiology of liver disease [31.2%]. Of those on the waiting list, 144 patients 22.3%] underwent liver transplant and 166 [25.7%] died while waiting for a transplant. The mean waiting period for transplant was 6.6 months. Receiving a transplant was correlated with the etiology of liver disease and Rh blood group [p<0.05] but had no significant association with gender or ABO blood type. Among non-transplanted patients, survival was lower in those who had a history of encephalopathy, SBP or uncontrolled ascites and in patients with a Child-Turcotte-Puph [CTP] class C and/or a Model of End-stage Liver Disease [MELD] score >/= 15. Hepatitis B virus is the most common cause of end-stage chronic liver disease amongst patients on the waiting list for liver transplant in Shiraz, southern Iran. Patients with a MELD score >/= 15 particularly those with a history of SBP, hepatic encephalopathy or uncontrolled ascites are recommended for waiting list enrollment