Comparative Study of the Effects of Clonidine and Tranexamic Acid on Intraoperative Bleeding in Rhinoplasty: A Clinical Trial.

Introduction: The present study was conducted to compare the effects of clonidine and tranexamic acid on the volume of bleeding and quality of the surgical field in terms of bleeding in candidates who underwent rhinoplasty. Methods: In this two-sided clinical trial, candidates eligible for rhinoplasty were randomly assigned to two treatment groups: tranexamic acid and clonidine. The first group received tranexamic acid at a dose of 700 µg/kg of body weight 2 hours before the surgical procedure, whereas the second group received clonidine orally at a dose of 2 mg/kg of body weight, 90 minutes before surgery. Subsequently, the volume of bleeding was calculated based on the amount of blood collected via suction and in blood-soaked gauze, which was previously weighed. Results: Among the 92 patients who underwent rhinoplasty, 82% were women. The mean age and standard deviation (SD) of individuals who underwent rhinoplasty were 29.22 ± 8.50 years. There were no significant differences between the two treatment groups in terms of age, gender, and body mass index. The volume of blood collected via suction during rhinoplasty, categorized into surgery duration <63 minutes and ≤63 minutes, showed a significant difference between the 2 treatment groups. Conclusion: The use of tranexamic acid, compared with clonidine, resulted in lesser intraoperative bleeding and better surgical field quality. Considering the superior effectiveness of tranexamic acid in reducing intraoperative bleeding, it is recommended to use tranexamic acid instead of clonidine in rhinoplasty.

The comparison of capnography and epigastric auscultation to assess the accuracy of nasogastric tube placement in intensive care unit patients.

BACKGROUND: Placement of nasogastric (NG) tubes is a common procedure for patients especially in intensive care units (ICUs). Thus, it is important to determine the correct placement of the tube to prevent misplacement in the airways. Accordingly, the aim of this study was to compare the epigastric auscultation and capnography in assessing the accuracy of NG tube insertion in ICU patients. METHODS: In this descriptive comparative study, 60 patients were selected trough convenience sampling. After insertion of the NG tube in a standard method, the accuracy of placement of the tube with both epigastric auscultation and capnography was investigated. The NG tube insertion accuracy was then confirmed via radiography. Data analysis was performed using statistical software SPSS version 23. RESULTS: The result showed that capnography had a sensitivity, specificity, and accuracy of 100, 92.5, and 95% respectively, but epigastric auscultation had 90, 80, and 83.4% respectively. The Kappa agreement coefficient between two methods was - 0.759. CONCLUSION: The results revealed that the use of the capnography is preferable over the epigastric auscultation to confirm the correct insertion of the NG tube. It is recommended that more than one method be applied to detect and confirm the correct insertion of the NG tube.

The Effect of Life Skills Training on the Self-Management of Patients with Multiple Sclerosis.

Background: Training sessions are the most common framework used to provide self-management for patients with multiple sclerosis Objective: This study was conducted to determine the effect of life skills training on the self-management of patients with multiple sclerosis. Findings showed that life skills training had a significant effect on the overall self-management score; thus, self-management of patients increased after training life skills (F = 25.1821, P <0.01). Materials and Methods: This semi-experimental study was conducted on 80 subjects with MS in the MS Society in Tehran (Iran) in 2016. The experimental group received four one-hour sessions of life skills training. The control group received routine care. Patients of both groups filled MS self-management (MSSM) scales at baseline and a month after the last training session. Independent t-test was used to compare findings between the two groups; pairwise t-test was used to compare results before and after the test. Covariance test was used to present the research results and data was analyzed by using SPSS21. Findings: Mean and standard deviation of age were 32.22±8.88 and 33.02±10.34 in the control and experimental groups, respectively. Results: Comparison of total self-management showed a significant difference between the control and experimental groups after receiving life skill training (P<0.01). Moreover, there was a significant difference in the mean of total self-management in the experimental group before and after the intervention; self-management increased after intervention (p-value<0.001). Conclusion: This study showed the positive effect of life skills training because its main goal is to prepare and help patients solve problems and deal with difficulties resulting from the disease. Therefore, life skill training is suggested for patients suffering from MS.

The Effect of Pharyngeal Packing during Nasal Surgery on the Incidence of Post Operative Nausea, Vomiting, and Sore Throat.

INTRODUCTION: Nausea and vomiting after ear, nose and throat (ENT) surgery is one of the most common and notable problems facing anesthesiologists in this area. This study was conducted to determine the effect of a pharyngeal pack on the severity of nausea, vomiting, and sore throat among patients after ear, pharynx, and throat surgeries. MATERIALS AND METHODS: This randomized clinical study was performed in 140 patients (61 men and 79 women; age range, 20-40 years) who had undergone nasal surgery in 2010. Patients were divided into two groups: the first group were treated using a pharyngeal pack (case group) and the second group were managed without a pharyngeal pack (control group). Statistical analysis was performed using the Chi-square test and the Mann-Whitney U test. SPSS software was used for data analysis. RESULTS: The mean severity of nausea and vomiting in the two groups was 2.057, 1.371 and 1.100, respectively, with no significant differences between groups. However, the mean severity of sore throat was 1.714 in the group with the pharyngeal pack and 1.385 in the group without pharyngeal pack (P=0.010). CONCLUSION: Not only does a pharyngeal pack in ENT surgery not reduce the extent and severity of nausea and vomiting, but it also increases the severity of sore throat in patients when leaving the recovery room and discharging hospital.