[Needs of caregivers of patients with head trauma after discharge and level of its fulfillment]

Introduction: Traumatic Brain Injury [TBI] is one of the most important matters of public health in which people affected often lose their functional abilities and have dependent life and in result these patients a caregiver for care and support. Thus families are at front line of challenges and great stresses

Objective: The aim of this study was to determine needs of caregivers of patients with head trauma after discharge and level of its fulfillment in patients referring to one of educational- therapeutic center in Rasht city

Methods: This is a cross-sectional descriptive-analytical study conducted on 51 family members of patients with head injury who were selected by census method from available samples in 2013. In this study two questionnaires of demographics and Standard Family Need Questionnaire [FNQ] were used for data collection and analyzed by descriptive statistics and Chi square, independent T Test, ANOVA and Exact Fischer tests

Results: The most important need was related to subscale of health information and the least related to getting involved with caring. There was a significant relationship between level of caregivers' needs and their occupational status [P<0.046], patients' age range [P<0.023] and patients' clinical condition [P<042]. The maximum rate [3.49 +/- 0.56] of need fulfillment was related to subscales of community support and health information and the minimum [2.965 +/- 0.78] was related to instrumental support. There was a significant relationship between meeting the needs in all domains and health insurance [P<0.044]

Conclusion: The most important family need was related to subscales of health information that were often met. Apprehension of needs and difficulties of caregivers lead to increase of awareness of nurses and other custodians of healthcare about the necessity of helping caregivers of patients with Traumatic Brain Injury

[Single dose versus triple dose of antibiotic in prophylaxis of wound infection in acute appendicitis: prospective randomized study]

Wound infection is one of the most common problems in surgery and antibiotic usage is one of the ways to prevent it. This Study was performed for six months. All patients who were admitted for acute appendicitis in even days were given single dose of 500mg of metronidazole via IV route and all the patients who were admitted in the odd days were given single dose of 500mg metronidazole via IV route, plus two Separate doses of metronidazole in post operation period. There were 145 patient who were evaluated for this study with 115 male [%79.3] and 30 female [%20.7]. The first group [n=69] were received single dose of metronidazole where the second group [n=76] were received three doses of metronidazole. All patients had not any signs of wound infection. There weren't any meaningful statistical differences for prophylaxis of wound infection between single dose and multiple dose of antibiotic

Rare peripheral nerve schwannoma

Schwannoma, a benign tumor of nerve sheath origin, is commonly found in the head and neck, as well as flexor surfaces of the extremities. It can rarely occur in the breast and stomach with only a few cases being reported. The cases are: 1- a 57-year- old man with breast mass, 2- a 58 -year -old man with gastrointestinal complaints who were finally diagnosed as peripheral nerve schwannomas. Clinical suspicion and histopathological confirmation are the keys to schwannomas diagnosis. Surgical excision is the treatment of choice for such patients

[Situation of supplementary feeding in 6-12 month old children in ilam]

Exclusive breast feeding is highly recommended for children under six months and the best time for starting supplementary food is the end of sixth months. Inadequate feeding can lead to malnutrition. Since infants' supplementary feeding pattern is influenced highly by the socio-cultural status; it is necessary to study the subject in diverse conditions. This study aimed to investigate supplementary feeding pattern in 6-12 months children referred to Ilam clinics in 2002. In this study, 364 mothers with 6-12 months children were selected using convenient sampling method from 10 health care centers. Data were collected using a four-sectioned questionnaire including mothers and their babies demographic characteristics, feeding pattern [frequency, the type of milk], supplementary food [the age of onset and the type of the first supplementary food, the time of starting mixed foods, and the source of information about supplementary food] and mothers' performance about feeding with supplementary food. The questionnaire was filled via interview. Findings showed that the growth curve in 84.8% of babies was in the health road. About 38% of babies were the first child. In 50.9% of samples, supplementary food was started before 6 months of age and in 49.9% of the cases, it was started after 6 month old. Supplementary feeding accompanied with breast feeding in 83.5% of the infants. The most used supplementary food was rice mucilage [40.8% of the babies]. The interval between starting one supplementary food and the other one was 3-4 days in 50.2% of the cases. Also 80.8% of samples started feeding in the amount of one spoon and increased it gradually. The majority of mothers [64%] did not add sugar, salt and spices in order to attract their babies. As well, 75.6% of samples used spoon and cup for feeding and 92.9% knew the safe time for keeping cooked food in the refrigerator. The source of information about supplementary feeding in 65.4% of mothers was health care providers and in 5% were books and booklets. Findings indicated that more than half of mothers began supplementary feeding for their children before 6 months old without pursuing any accepted pattern. It seems that usual educational programs in Ilam were unable to answer all the problems aroused in this issue. Hence, educating mothers using other methods such as visual teaching material is recommended