Effect of acupressure on pain intensity and physiological indices in patients undergoing extracorporeal shock wave lithotripsy: a randomized double-blind sham-controlled clinical trial.

BACKGROUND: Despite the widespread use of extracorporeal shock wave lithotripsy (ESWL) as a treatment for kidney stones, it is essential to apply methods to control pain and improve patient comfort during this procedure. Therefore, this study aimed to investigate the effect of acupressure at the Qiu point on pain intensity and physiological indices in patients undergoing ESWL. METHODS: This randomized, sham-controlled clinical trial was conducted at the Shahid Beheshti Educational-medical Center in Hamadan City (western Iran) from May to August 2023. Seventy-four eligible patients were split into intervention (n = 37) and sham (n = 37) groups. Ten minutes before lithotripsy, the intervention group received acupressure at the Qiu point, while the sham group received touch at a neutral point. The primary outcomes were pain intensity measured by the Visual Analog Scale (VAS) and physiological indices such as blood pressure and heart rate at baseline, 1, 10, 20, 30, 40, and 50 min after the intervention. The secondary outcomes included lithotripsy success and satisfaction with acupressure application. RESULTS: The analysis of 70 patients showed no significant differences in the demographic and clinical information of the patients across the two groups before the study (P > 0.05). Generalized estimating equations revealed that the interaction effects of time and group in pain and heart rate were significant at 30 and 40 min (P < 0.05). The results of this analysis for systolic blood pressure revealed a significant interaction at 30 min (P = 0.035). However, no significant interaction effects were found for diastolic blood pressure changes (P > 0.05). CONCLUSIONS: Acupressure at the Qiu point positively impacts pain in patients undergoing ESWL treatment and increases their satisfaction. However, these results for physiological indices require further studies. Thus, acupressure can be considered a simple, easy, and effective option for pain management in patients during this procedure. TRIAL REGISTRATION: [ https://en.irct.ir/trial/69117 ], identifier [IRCT20190524043687N4].

Impact of a spiritual care program on the sleep quality and spiritual health of Muslim stroke patients: A randomized controlled trial.

OBJECTIVES: Stroke patients often experience poor sleep quality and spiritual health due to complications and limitations. In this situation, implementing spiritual care may reduce these problems. Therefore, this study aimed to examine the effect of a spiritual care program on sleep quality and spiritual health of Muslim stroke patients. METHODS: This was a two-group randomized clinical trial conducted in Hamadan, Iran, in 2021, with 117 stroke patients. The samples were selected by convenience sampling and assigned to experimental (N = 59) and control (N = 58) groups based on random permutation blocks. The data were collected using the demographic information form, the Pittsburgh Sleep Quality Index, the Paloutzian and Ellison Spiritual Well-Being Scale, and the Modified Rankin Scale before and one month after the intervention. The experimental group received five daily sessions of spiritual care for 45-60 min based on standard and local methods, including patient orientation and identification of spiritual needs, religious care, supportive spiritual care, and beneficial evaluations. Data were analyzed by chi-square test, Fisher's exact test, independent t-test, and paired t-test at 0.05 significance level in SPSS 21. RESULTS: The socio-demographic characteristics were similar between the groups (p > 0.05). At baseline, there was no significant difference in sleep quality and spiritual health between the experimental and control groups (p > 0.05). However, after the intervention, the sleep quality and spiritual health of patients in the experimental group improved significantly compared with the control group (p < 0.05). CONCLUSION: The spiritual care program improved sleep quality and spiritual health of stroke patients; therefore, nurses should consider these aspects to provide holistic care.

Complementarity of surgical therapy, photobiomodulation, A-PRF and L-PRF for management of medication-related osteonecrosis of the jaw (MRONJ): an animal study.

BACKGROUND: This study aimed to evaluate the complementarity of surgical therapy, photobiomodulation (PBM), advanced platelet-rich fibrin (A-PRF), and Leukocyte and platelet-rich fibrin (L-PRF) for the management of medication-related osteonecrosis of the jaw (MRONJ). METHODS: Sixty rats underwent injection of zoledronate followed by left mandibular first and second molar extractions to induce MRONJ lesions. All rats were examined for the signs of MRONJ 8 weeks post-dental extraction. Forty-nine rats with positive signs of MRONJ were appointed to seven different groups as follows: control (Ctrl); surgery alone (Surg); surgery and PBM (Surg + PBM); surgery and A-PRF insertion (Surg + APRF); surgery and L-PRF insertion (Surg + LPRF); surgery, A-PRF insertion, and PBM (Surg + APRF + PBM); surgery, L-PRF insertion, and PBM (Surg + LPRF + PBM). Euthanasia was carried out 30 days after the last treatment session. The lesions' healing was evaluated clinically, histologically, and radiographically. Data were analyzed using STATA software version 14, and the statistical significance level was set at 5% for all cases. RESULTS: According to the present study, A-PRF and L-PRF treatment resulted in significant improvements in clinical, histological, and radiographical parameters compared to the Ctrl group (P < 0.05). The PBM also decreased wound dimensions and the number of empty lacunae compared to the Ctrl group (P < 0.05). Surg + APRF + PBM and Surg + LPRF + PBM were the only groups that presented a significantly higher mean number of osteocytes (P < 0.05). No significant differences were observed between A-PRF and L-PRF treatment groups (P > 0.05). CONCLUSIONS: Surgical resection followed by applying A-PRF or L-PRF reinforced by PBM showed optimal wound healing and bone regeneration in MRONJ lesions.

Effect of Massage Therapy for the Treatment of Neonatal Jaundice: A Systematic Review and Dose-Response Meta-analysis.

Background: The effectiveness of massage therapy in the treatment of neonatal jaundice has been established in previous literature, but how much the level of massage can reduce the mean of bilirubin in neonates with jaundice is a question that has been addressed in this review. Methods: Four electronic databases, including Cochrane, PubMed, Scopus, and Web of Science, were searched for relevant literature. For the dose-response association between massage therapy and treatment of neonatal icterus, we conducted a meta-analysis using the random-effects model. For any level of intervention, we calculated the overall mean difference (MD) with 95% confidence intervals (CI). Results: Twenty studies were included in our meta-analysis. There was a positive and significant increasing dose-response trend between massage therapy and the mean reduction of bilirubin in neonates with hyperbilirubinemia as follows: <50 minutes massage during the experiment -0.36 (95% CI: -0.67, -0.06; I 2 = 66%), 50-60 minutes massage during the experiment -0.41 (95% CI: -0.95, 0.13; I 2 = 84%), and ≥101 minutes massage during the experiment -1.20 (95% CI: -1.63, -0.78; I 2 = 83%). The heterogeneity across studies was mild to moderate. Conclusions: The presence of a dose-response relationship favors the causal relationship between massage therapy and reduction of neonatal jaundice.

Effects of Inhalation Aromatherapy With Rosa damascena (Damask Rose) on the State Anxiety and Sleep Quality of Operating Room Personnel During the COVID-19 Pandemic: A Randomized Controlled Trial.

PURPOSE: Although aromatherapy with damask rose can reduce anxiety and improve sleep quality in different conditions, no study has yet addressed its effects among operating room (OR) personnel. Considering the high level of workload among Iranian OR personnel during the COVID-19 pandemic which can affect their anxiety and sleep quality, this study evaluated the effects of damask rose aromatherapy on state anxiety and sleep quality among a population of Iranian OR personnel during the COVID-19 pandemic. DESIGN: A randomized, nonblinded, parallel-group controlled trial. METHODS: Eighty OR personnel were divided into the two groups of damask rose and placebo (paraffin oil) using the stratified randomization method. In the first aromatherapy session, the participants inhaled two drops of either damask rose oil or paraffin oil for 10 minutes at the beginning of their morning shift. Then, they attached an absorbent cloth napkin impregnated with 5 drops of products to the side of their pillow for 30 consecutive nights. The Spielberger state anxiety inventory (SAI) and the Pittsburgh sleep quality index (PSQI) were completed before random allocation (T1) and on the 31st day of the study (T3). Also, the SAI was completed 90 minutes after the end of the first aromatherapy session (T2). FINDINGS: The mean changes in the SAI score were significant compared to T1 both at T2 and T3 in favor of the damask rose group (P < .001 in two cases). Similarly, the mean change in PSQI score was significant compared to T1 at T3 in favor of the damask rose group (P < .001). CONCLUSIONS: Damask rose can be effective in reducing state anxiety and improving sleep quality of OR personnel. Further studies are needed to determine the generalizability of the findings.

Concentration of Potentially Toxic Elements in Vegetable Oils and Health Risk Assessment: a Systematic Review and Meta-analysis.

The present study evaluates the concentration of potentially toxic elements (PTEs), including Pb, Cd, As, Fe, Zn, Cu, and Ni, in vegetable oils through a meta-analytic approach. The published studies in relation to the concentrations of PTEs in vegetable oils were retrieved from major international databases such as PubMed, Scopus, Web of Science, and Embase followed by meta-analysis. Moreover, the health risk assessment was evaluated using total target hazard quotient (TTHQ) by a Monte Carlo simulation (MCS) model. According to the results of 51 articles included among 958 retrieved studies, the concentrations of the PTEs were as follows: Cd ≈As (0.110 mg/kg) > Pb (0.086 mg/kg) in cottonseed, canola, and olive oil and Fe (12.964 mg/kg) > Zn (1.044 mg/kg) > Ni (0.893 mg/kg) > Cu (0.264 mg/kg) in cottonseed, olive, and soybean for trace elementals, respectively. Based on the continent type, the higher concentration of Cd, As, and Pb was related to PAHO (American region) and AFRO (African region), and the higher concentrations of Fe, Zn, Cu, and Ni were observed in WPRO (Western Pacific Region), EMRO (Eastern Mediterranean Region), and AFRO. On the other hand, non-carcinogenic health risk assessment of the PTEs indicated that there was a different risk pattern in various countries, and the TTHQ level in adult groups was lower than 1. It can be concluded that the consumption of vegetable oils is safe and does not pose risk to the health of consumers.