ABSTRACT
Background: Increased intracranial pressure (ICP) is a modifiable secondary injury that is associated with poor outcomes in patients with traumatic brain injuries (TBIs). Therefore, the present study was conducted with the aim of determining the ICP of TBI patients by measuring the thickness of the optic nerve sheath diameter (ONSD). Materials and Methods: The present cross-sectional study was conducted on 220 patients with severe TBI that referred to Khatam-al-Anbya Hospital in Zahedan in 2021. The measurement of ONSD was performed by ultrasonography. Results: The results of this study revealed that 22.7% of TBI patients had high ICP. The mean of right and left ONSD in patients with normal ICP was 3.85 ± 0.83 and 3.85 ± 0.82 mm, respectively, and was significantly lower than that of patients with abnormal ICP (high ICP) with the mean of 3.85 ± 0.82 and 6.12 ± 0.84 mm, respectively (P value <.001). In addition, the right ONSD with the cutoff point of 5.13 mm, the sensitivity of 84%, and the specificity of 95.29% and the left ONSD with the cutoff point of 5.24 mm, the sensitivity of 90%, and the specificity of 95.88% had a significant diagnostic value in the diagnosis of high ICP (P value <.05). Conclusion: The findings of the present study indicated that the measurement of ONSD is a cost-effective and minimally invasive procedure with a higher accuracy in diagnosing high ICP in TBI patients.
ABSTRACT
Background: The present study aimed at comparing the effect of ketorolac and morphine on the pain control in patients with renal colic. Materials and Methods: The present clinical trial was performed on 272 patients with renal colic that were divided into two groups. Patients in the first and second groups intravenously received morphine at a dose of 1.0 mg/kg and ketorolac at a dose of 30 mg, respectively. Then, systolic blood pressure, diastolic blood pressure, heart rate, respiration rate (RR), and oxygen saturation percentage (SpO2) as well as patients' pain scores before and 5, 15, 30, 60, and 90 min after the intervention were recorded and evaluated. Results: The results of this study revealed that the mean pain scores of patients before and after the intervention were not significantly different between the two groups (P > 0.05). However, patients' pain significantly relieved over time in both groups (reduce: Morphine group = 9.4 and ketorolac group = 9.09; P < 0.001). In addition, nausea, dizziness, and a decreased SpO2 in the morphine group were 5.1%, 2.9%, and 1.5%, respectively, and in the ketorolac group only dizziness was 2.2% (P > 0.05). Conclusion: According to the results of this study, the efficacy of ketorolac in reducing patients' pain was not significantly different from that of morphine. Therefore, considering that the occurrence of complications in the ketorolac group was lower than that of the morphine group, it can be stated that ketorolac is a safer and more reliable drug than morphine in relieving pain in patients with renal colic.
ABSTRACT
BACKGROUND: Improving the quality of clinical education requires continuous review of the current situation, identifying strengths, and correcting weaknesses. This study aimed to investigate the association between academic motivation with quality of clinical education, academic achievement, and burnout. MATERIALS AND METHODS: This cross-sectional study was done in 2020 on all of the 140 internship students of Shahrekord University of Medical Sciences, using the consensus method. The data collection tools included standard questionnaires such as Herman's Academic Motivation, Clinical Education Quality, Maslach Modified Academic Burnout, Pham and Taylor Academic Achievement, Satisfaction of Educational Welfare Facilities. Data were analyzed using SPSS (ver. 22) software and descriptive statistics (mean, standard deviation, frequency and percentage of frequency), Spearman rank, correlation coefficient and Mann-Whitney and Kruskal-Wallis statistical tests. P < 0.05 is considered statistically significant. FINDINGS: The mean ± SD of age was 25.68±2.03. 86 (61.4%) of the internship were female and 87 (62.1%) were single. Mean± SD of academic motivation and quality of clinical education were 81.51± 8.73 and 28/99± 11/52 respectively. Also, the Mean± SD of academic achievement and academic burnouts were 147/61± 14/94 and 42/37± 10/42 respectively. RESULTS: Academic motivation had a meaningful and positive relationship with academic achievement and satisfaction of welfare facilities but a negative correlation with academic burnout. Also, academic achievement and academic burnout had a negative correlation but a positive correlation was seen between the quality of clinical education and satisfaction of welfare facilities. CONCLUSION: Considered the results, recommended improving welfare education facilities by using up-to-date training aids, upgrading educational infrastructure, and employ young staff in the education office. For improving the quality of clinical education, appropriate educational methods, conducting developmental assessments continuously, using simulated environments, and improving students' motivation.
ABSTRACT
BACKGROUND: Kidney stone is normally treated by opioids with a variety of side-effects including hypotension, respiratory depression and apnea, nausea and vomiting. Regarding less complications of intravenous acetaminophen, we aimed to compare it with intravenous morphine in management of renal colic pain. MATERIALS AND METHODS: A randomized controlled clinical trial was applied with a convenience sampling method, as 124 patients suffering from renal colic pain were randomly assigned into two groups of 62 patients. Pain was assessed using visual analog scale ruler. Results were analyzed by SPSS.18 using the descriptive statistic, Chi-square, ANOVA, independent t-test and logistic regression. RESULTS: According to the findings, 84 subjects (67.7%) were male. The mean age of participants were 39.06 (11.58). The mean of pain scores were not significantly different between two groups before administration of drugs (P = 0.415), while the more pain relief was achieved in morphine group after the intervention. Sex and age as influencing factors did not develop a significant difference in both groups. About the adverse effects, morphine had more complications and both groups showed a significant difference in occurrence of dizziness (P = 0.000) and hypotension (P = 0.014). CONCLUSION: Comparing intravenous morphine and acetaminophen in renal colic pain reviled that morphine can develop greater pain relief, but more complications such as dizziness and hypotension. Acetaminophen can be also be effective in renal colic pain, so it is concluded that acetaminophen can be administered as a less harmful drug for patients with renal colic pain.
