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The nasal septum repair surgery is the dangerous operations that any stimulation of this area causes a large change in the rhythm of the heartbeat and blood pressure. This study aimed to determine the effects of tetracaine 0.5% on changes in heartbeat and heart rhythm, hemodynamic changes during surgery, intraoperative bleeding, and pain after septoplasty surgery. The irregular double-blind clinical trial registry of clinical trials Iran with the code number (IRCT: 20150526625N8) in the first half of 2013 on 86 patients in Kashani hospital of Shahrekord. Having selected and matched the patients were divided into two groups. Case group was dropped tetracaine 0.5% in each of the nasal cavity 15 min before the beginning of the operation. The control group was dropped distilled water 15 min preoperation in each of the nasal cavity. The surgery lasted about 30-60 min. Clinical symptoms were evaluated after anesthetic induction as well as pain using the visual analog scale after the operation, in the recovery room. The collected data were analyzed using SPSS version software 17 through independent t-test, Chi-square, and repeated measures variance analysis. Postoperative pain intensity in the experimental group compared to the control group was significantly lower than the control group (P < 0.05); however, blood pressure and heart rate during anesthesia, there was no difference between groups (P > 0.05). Based on the findings, intake of tetracaine drop 0.5% has no impact on some hemodynamic changes during septoplasty operation. However, compared with the control group, pain was significantly reduced.
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INTRODUCTION: Ventilator Associated Pneumonia (VAP) is the second most common infection with high mortality (24-50%). Ondansetron is a reliable and safe drug and it is currently used in the prevention of nausea and vomiting and has no side effects. AIM: The aim of the present study was to examine the effect of ondansetron on prevention of VAP in Intensive Care Unit (ICU) patients. MATERIALS AND METHODS: The present study was a randomized clinical trial study (IRCT201406156480N6), carried out at Kashani Hospital, Iran, in 2013 on 80 patients aged from 15-65 years. The patients were randomly allocated to two groups: Case group (n=40) and Control group (n=40). The patients in first group were injected with 4 mg ondansetron, twice daily for five days. The patients of other group were injected with distilled water as placebo. The presence of VAP was assessed in the two groups. The collected data were analysed by SPSS software through Fisher-exact test. RESULTS: Eleven (13.8%) patients were diagnosed with VAP. Among them, 9 (81.8%) patients were male and 2 (18.2%) patients were female. The incidence of VAP in Case group was 5 (12.5%) patients and in Control group was 6 (15%) patients (p>0.05). Results showed that VAP in Case group was less prevalent than that in the Control group, but this difference was not significant. CONCLUSION: The study did not find an association between ondansetron administration and reduction in VAP incidence; vomiting alone may not be leading to VAP, instead silent micro aspirations may be the cause of it. None of the factor such as age, sex, weight, smoking, drug addiction was found significantly related to VAP. Only variable found related was comorbidity.
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BACKGROUND: Nosocomial infections are one of the main causes of mortality and morbidity in hospitals, especially in intensive care units (ICUs). OBJECTIVE: The aim of this study was to examine the impact of garlic tablets on nosocomial infections in hospitalized patients in intensive care units. METHODS: This clinical trial was carried out on 94 patients, admitted to the intensive care units in Kashani and Al-Zahra hospitals from January 21, 2014 to December 20, 2014. Firstly, the patients were randomly selected by simple sampling, then they were assigned into case and control groups. The case group administered one 400 mg garlic tablet daily for 6 days and the control group received placebo. During the study, inflammatory blood factors and infection occurrence in the two groups were compared. The Data were analyzed by SPSS software version 22 through descriptive tests such as independent t-test, Chi-square test, ANOVA and exact Fisher test for the analyses of primary and secondary outcomes. RESULTS: During the study period, 78 cases of intravenous catheter tip were sent to laboratory for culture, of which, 37 cases were in the intervention group and 41 in the control group. Culture results of Catheter tips was positive in 5 cases and all five cases were in the control group. Frequency distribution of catheter tip culture was significantly higher in the control group than that of the intervention group (p=0.03). CONCLUSION: Based on the results of our study, in people with weakened immune systems and in people with high incidence of opportunistic infections, it is necessary to strengthen their body's immune system stimulants before dealing with these infectious agents, and cause decrease in the diseases insusceptible people. It was suggested that garlic supplementation has shown to be effective in patients admitted to ICU, who are highly susceptible to nosocomial infection, and it can be used for the prevention of septicemia and urinary tract infections. However, further research with larger sample size is needed. TRIAL REGISTRATION: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT207406156480N6. FUNDING: Shahrekord University of Medical Sciences financially supported this research.
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Endotracheal tube (ETT) cuff herniation is a rare, and often difficult to diagnose, cause of bronchial obstruction. We present a case of outside cuff herniation of an endotracheal tube that caused pulmonary right lung atelectasis. A 29-year-old man ,a case of car accident with multiple fractures, was admitted to the emergency ward and transferred to the operating room(OR) for open reduction and internal fixation (ORIF) of all fractures .The procedures were done under general anesthesia (G/A). The past medical history of the patient did not indicate any problem. Anesthesia was induced with thiopental, atracurium and then maintained by propofol and remifentanyl infusions and 100% O2 via orally inserted ETT. The patient was positioned in left lateral decubitus position for operation. Two hours after induction of anesthesia, the oxygen saturation level dropped to 85 % and the breath sounds in the right side of the chest were weakened. The chest x-ray images showed right lung atelectasis especially in the upper lobe. The problem was disappeared after removal of the ETT. In this case, we observed that an ETT cuff herniation can be a cause of airway obstruction. If there is a decreased unilateral breath sounds, we recommend replacement or repositioning of ETT.
