Comparing efficacy and safety of high-dose and standard-dose rifampicin in the treatment of brucellosis: a randomized clinical trial.

BACKGROUND: In a few studies, higher doses of rifampicin improved the outcome of patients with TB. There is no information regarding efficacy and safety of higher doses of rifampicin in patients with brucellosis. OBJECTIVES: To compare efficacy and safety of higher and standard doses of rifampicin, each with doxycycline, in the treatment of patients with brucellosis. METHODS: Within a randomized clinical trial, clinical response and adverse events of high-dose rifampicin (900-1200 mg/day) plus doxycycline 100 mg twice daily were compared with standard-dose rifampicin (600 mg/day) plus doxycycline 100 mg twice daily in 120 patients with brucellosis. RESULTS: Clinical response occurred in 57 (95%) of patients in the high-dose group and 49 (81.66%) of patients in the standard-dose group (P = 0.04). The most common adverse events of the treatment were nausea (37.5%), skin rash (13.33%), vomiting (10%) and transaminitis (7.22%). Incidence of these events was comparable between the groups. CONCLUSIONS: The rate of clinical response in patients with brucellosis who were treated with high-dose rifampicin plus standard-dose doxycycline was significantly higher than in the patients who received the standard doses of rifampicin and doxycycline, without further adverse events. The high-dose rifampicin therefore improved clinical response in patients with brucellosis with a similar safety profile to the standard dose. If these findings are confirmed in future studies, higher doses of rifampicin may be recommended for treatment of patients with brucellosis.

Efficacy of simulated video on test anxiety in objective structured clinical examination among nursing and midwifery students: A quasi-experimental study.

AIM: This research investigated the effectiveness of simulated video on test anxiety in the Objective Structured Clinical Examination (OSCE) among nursing and midwifery students. DESIGN: A quasi-experimental study with a two-group pre-test and post-test design. METHODS: This study was conducted on 118 nursing and midwifery students in Shahroud northeast of Iran in 2019 using the census sampling method. The intervention group received a 15-minute OSCE simulation video half an hour before the test. Data were collected using the Sarason test anxiety questionnaire in two stages: one week before the test and after the simulation film was screened. Data were analysed using descriptive and inferential statistics (Independent t-test, Chi-square, Exact fisher and Paired t-test). RESULTS: At baseline, no significant difference was observed between groups in the total mean score of test anxiety. The mean score of test anxiety significantly decreased in the OSCE simulation video group after the intervention.

Effect of aromatherapy massage by orange essential oil on post-cesarean anxiety: a randomized clinical trial.

OBJECTIVES: Many women in recent years have been willing to undergo puncture surgery for childbirth, which, like other surgeries, has physical and psychological side effects such as incision, infertility, chronic pain, and anxiety. Therefore, it is important to reduce and improve these side effects. The aim of this study was to determine the effect of foot massage with orange essential oil on anxiety in women undergoing cesarean section. METHODS: This randomized clinical trial study was conducted in 2019 on 80 women referred to Bahar Shahroud Hospital after cesarean section surgery. The samples were divided into two groups by intervention (foot massage with orange essential oil) and control (foot massage without orange essential oil). The Spielberger scale was used to determine anxiety scores after cesarean section. In the intervention group, the feet were massaged with orange essential oil, and in the control group, the orange essential oil massage was performed without oil. Anxiety before, immediately after, and 60 min after the intervention was measured and evaluated in both groups. Data analysis was performed using descriptive and inferential statistics. Significant levels were considered for all statistical tests (p<0.05). RESULTS: The anxiety score before the intervention in the two groups of intervention and control was 57.12 ± 3.12 and 57.07 ± 3.54, respectively, which were not significantly different, but immediately after the intervention, the anxiety scores in both groups decreased significantly so that there was a further decrease in the intervention group (52.10 ± 4.75 and 56.02 ± 3.77), 1 h after the intervention, the anxiety score in the intervention group decreased compared to the previous stage and increased in the control group (50.40 ± 3.74 and 56.85 ± 4.27). CONCLUSIONS: Foot massage with orange essential oil can probably be effective as a proper nursing intervention in reducing anxiety after cesarean section surgery.

A randomized trial of the effect of peer education on the sexual quality of life in patients with myocardial infarction.

Background One of the factors associated with readmission is inappropriate sexual activity after myocardial infarction (MI). This study aimed to assess the effect of peer education on the sexual quality of life (SQOL) in patients with MI. Methods In this randomized controlled clinical trial, 70 patients with MI meeting the inclusion criteria were assigned to experimental or control groups using block randomization. Peer education for the intervention group was provided on the third day after MI. Education sessions lasted from 90 to 120 minutes. Data were collected using demographic, sexual quality of life-female (SQOL-F), and sexual quality of life-male (SQOL-M) questionnaires during the fourth week after MI. Results There was no significant difference between the two groups before the intervention in terms of demographic and SQOL. The mean of SQOL in the peer education group was significantly higher than the control group at the 4-week follow-up. Conclusions According to the results, using peer education is recommended for the sexual health care professionals.

The Effects of Inhalation Aromatherapy Using Lavender Essential Oil on Postoperative Pain of Inguinal Hernia: A Randomized Controlled Trial.

PURPOSE: One of the main problems after inguinal hernia surgery is postoperative pain. The purpose of this study was to examine the effects of aromatherapy with lavender oil inhalation on postoperative pain after inguinal hernia surgery. DESIGN: A randomized controlled design was used. METHODS: Ninety participants were selected and assigned to two groups: the intervention group (n = 45) and the control group (n = 45). The patients in the intervention group inhaled four drops of 2% lavender essential oil with oxygen for 20 minutes. The patients in the control group inhaled only oxygen. Postoperative pain was measured 0 minutes after being transferred to the surgery ward, and then 2 hours, 6 hours, and 24 hours after surgery using the visual analog scale. FINDINGS: In comparison to the control group, levels of pain severity in the intervention group were significantly lower in four stages of measurements (P < .001). Also, in all stages, measurements showed significant statistical differences within the groups (P < .001). CONCLUSIONS: Aromatherapy with lavender essential oil helped decrease postoperative pain after inguinal hernia surgery.

The effects of omega-3 on the sleep quality of patients with uremic pruritus undergoing hemodialysis: a randomized crossover study.

OBJECTIVES: Information on sleep quality and its effective factors in the patients undergoing hemodialysis are important factors in future planning for improving sleep quality and ultimately the quality of life in these patients. The present study investigated the effect of omega-3 on the sleep quality of hemodialysis patients. METHODS: The 52 hemodialysis patients were randomized into two groups and underwent two different treatment modes (A and B). The first group was given omega-3 and cetirizine and the second group only received cetirizine for six weeks. After one week wash out, the study was followed by crossover treatment in both groups for six weeks. Sleep quality and pruritus severity were evaluated in patients before the intervention and at the end of each treatment period using the Pittsburgh Sleep Quality Index and the Yosipovitch Itch Questionnaire. The collected data was analyzed using repeated measures ANOVA and the Pearson correlation coefficient. RESULTS: The results of the study showed that majority of the patients (94.2%) had poor sleep quality (sleep score > 5 based on the questionnaire) and 5.8% of the patients had favorable sleep quality (sleep score < 5). Repeated measures ANOVA showed that sleep quality scores were different in two groups in phases 0, I and II (p <0.001). CONCLUSIONS: Sleep quality improved in both modes but more improvement was observed in mode A. Therefore, omega-3 fatty acids can be used as a suitable method for improving sleep quality in hemodialysis patients.

Perioperative effects of oral midazolam premedication in children undergoing skin laser treatment. A double-blinded randomized placebo-controlled trial.

PURPOSE: To investigate and compare the efficacy of oral midazolam with two different dosages in orange juice on perioperative hemodynamics and behavioral changes in children who underwent skin laser treatment in an academic educational Hospital. METHODS: Ninety children, candidates for skin laser treatment were randomly assigned to 1 of 3 groups of 30 each: the placebo group received 0.1 ml/kg orange flavored juice, group 2 and 3 receiving 0.5 and 1 mg/kg of injectable midazolam mixed with an equal volume of orange juice, respectively. The main outcome measures included the mask acceptance, patients' behavioral scales and postoperative events. RESULTS: There were no significant differences in heart rate, respiratory rate, and systolic blood pressure among the three groups. However, arterial oxygen saturation was significantly reduced in those given 1 mg.kg(-1) midazolam. The median scores of anxiety, separation from parent, preparing an intravenous line, acceptance of the oxygen mask, good sedation, crying reduction and consciousness level were better in midazolam group. Postoperative agitation and re-crying were also more frequent in placebo receivers. Those given 1 mg.kg(-1) midazolam were significantly more optimal for sedation, crying, consciousness, preparing an intravenous line, and postoperative re-crying compared with 0.5 mg.kg(-1) midazolam receivers. CONCLUSION: As a preanaesthetic medication, the 1 mg.kg(-1) dose of orally given midazolam especially in a volume of orange juice and can optimize the children's behavior during skin laser treatment with no serious adverse effects, enhancing their parents' satisfactions about the sedative protocol.

Perioperative effects of oral midazolam premedication in children undergoing skin laser treatment: a double-blinded randomized placebo-controlled trial / Efeitos peroperatórios da premedicação oral de midazolam em crianças submetidas a tratamento de pele por laser: estudo duplo-cego randomizado e controlado

PURPOSE: To investigate and compare the efficacy of oral midazolam with two different dosages in orange juice on perioperative hemodynamics and behavioral changes in children who underwent skin laser treatment in an academic educational Hospital. METHODS: Ninety children, candidates for skin laser treatment were randomly assigned to 1 of 3 groups of 30 each: the placebo group received 0.1 ml/kg orange flavored juice, group 2 and 3 receiving 0.5 and 1 mg/kg of injectable midazolam mixed with an equal volume of orange juice, respectively. The main outcome measures included the mask acceptance, patients' behavioral scales and postoperative events. RESULTS: There were no significant differences in heart rate, respiratory rate, and systolic blood pressure among the three groups. However, arterial oxygen saturation was significantly reduced in those given 1 mg.kg-1 midazolam. The median scores of anxiety, separation from parent, preparing an intravenous line, acceptance of the oxygen mask, good sedation, crying reduction and consciousness level were better in midazolam group. Postoperative agitation and re-crying were also more frequent in placebo receivers. Those given 1 mg.kg-1 midazolam were significantly more optimal for sedation, crying, consciousness, preparing an intravenous line, and postoperative re-crying compared with 0.5 mg.kg-1 midazolam receivers. CONCLUSION: As a preanaesthetic medication, the 1 mg.kg-1 dose of orally given midazolam especially in a volume of orange juice and can optimize the children's behavior during skin laser treatment with no serious adverse effects, enhancing their parents' satisfactions about the sedative protocol.

OBJETIVO:Investigar e comparar a eficácia do uso oral de midazolam com duas diferentes doses de suco de laranja na hemodinâmica peropeatória e mudanças de desempenho em crianças submetidas tratamento de pele por laser em Hospital educacional e acadêmico. MÉTODOS:Noventa crianças candidatas a tratamento de pele por laser foram distribuídas aleatóriamente em três grupos de 30 cada: o grupo placebo recebeu 0.1mg/kg de suco de laranja, grupos dois e três receberam 0.5 e 1mg/kg de midazolam injetável misturado em igual volume de suco de laranja respectivamente. Os principais registros incluíam a aceitação da máscara, escalas de comportamento e eventos pós-operatórios. RESULTADOS:Não houve diferenças significantes cardíacas, respiratórias e pressão sanguinea sistólica nos três grupos. Contudo, o nível de saturação de oxigênio foi reduzido significantemente nos que receberam 1mg.kg-1 de midazolam. Os níveis médios de ansiedade, separação dos pais, preparo intravenoso, aceitação da máscara de oxigênio, boa sedação, redução do choro e nível de consciência, foram melhores no grupo midazolam. Agitação pós-operatória e retorno do chora foi mais freqüente nos que receberam placebo. Observou-se que o grupo que recebeu 1mg.kg-1 foi melhor comparado ao que recebeu 0.5mg.kg-1. CONCLUSÃO:Como medicação pré-anestésica na dose de 1mg.kg-1 de midazolam, fornecida em igual volume de suco de laranja, é satisfatória no comportamento de crianças durante tratamento de pele por laser, proporcionando satisfação dos pais.

Iron status in diffuse telogen hair loss among women.

The relationship between iron body status and different types of hair loss has been investigated in a number of studies, however, with relatively discrepant findings. Therefore we conducted an analytical case-control study to assess whether diffuse telogen hair loss in women of childbearing age (15 to 45 years old) is associated with iron deficiency. Using the analytical case-control methodology, we studied 30 consecutive women with documented diffuse telogen hair loss in comparison with 30 women without hair loss. Study subjects had no history of nutritional supplement intake or chronic underlying diseases, and had normal thyroid function and inflammatory profiles. Biochemical investigations were performed in all study women. The mean ferritin level and trasferrin saturation was statistically significantly lower in patients with diffuse telogen hair loss than in subjects without hair loss (16.3+/-12.6 vs. 60.3+/-50.1, ng/mL; P<0.0001 and 20.3+/-9.7 vs. 28.3+/-11.8 percent; P=0.006, respectively). Also, total iron binding capacity was significantly higher in patients than in control group (367.8+/-58.2 vs. 319.2+/-60.1 microg/dL; P=0.004). Of nine patients with iron deficiency anemia (Hb <12 g/dL), eight patients had telogen hair loss (odds ratio: 10.5, 95%CI: 1.2-90.7; P=0.013). Odds ratio (95% confidence interval) for diffuse telogen hair loss was 21.0 (4.2-105.0) at serum ferritin levels < or =30 ng/mL. Women with iron deficiency status are at a risk of telogen hair loss. The important role of serum ferritin in hair loss is becoming more evident. In women without systemic inflammation or other underlying disorders, serum ferritin levels below or equal to 30 ng/mL are strongly associated with telogen hair loss.

Effect of opium on glucose metabolism and lipid profiles in rats with streptozotocin-induced diabetes.

BACKGROUND: This experimental study was performed to determine the impact of opium use on serum lipid profile and glucose metabolism in rats with streptozotocin-induced diabetes. MATERIAL AND METHODS: To determine the effect of opium, 20 male rats were divided into control (n = 10) and opium-treated (n = 10) groups. After diabetes induction, the animals were investigated for daily glucose measurements for 35 days. Serum lipid profile and haemoglobin A1c (HbA(1c)) were assayed at the baseline (before induction of diabetes) and at 35-day follow-up. RESULTS: The glycaemia levels in the rats treated with opium were similar to the levels measured in the control rats (544.8 +/- 62.2 mg/dl v. 524.6 +/- 50.0 mg/dl, P = 0.434). In addition, there was no difference between the opium-treated rats and control rats in HbA(1c) (6.5 +/- 0.5% v. 6.6 +/- 0.2%, P = 0.714). Compared to the control rats, the serum total cholesterol, high density lipoprotein (HDL), triglyceride and lipoprotein (a) in the test animals were similar. CONCLUSION: Opium use has no significant effect on glucose metabolism and serum lipid profile in rats with induced diabetes.

Abnormalities of vitamin D and calcium metabolism after surgical treatment of morbid obesity: a study of 136 patients.

OBJECTIVE: To assess the effect of bariatric surgical treatment of morbid obesity on bone mineral metabolism. METHODS: We analyzed pertinent vitamin D and calcium metabolic variables in 136 patients who had undergone a malabsorptive bariatric operation. Measurements of bone mineral density (BMD), serum 25-hydroxyvitamin D (25-OHD), 1,25-dihydroxyvitamin D [1,25-(OH)2D], parathyroid hormone (PTH), calcium, phosphorus, and alkaline phosphatase were performed. Statistical analyses assessed correlations among various factors. RESULTS: The mean age (+/-SD) of the study group was 48.34 +/- 10.28 years. Their mean weight loss was 114.55 +/- 45.66 lb, and the mean duration since the bariatric surgical procedure was 54.02 +/- 51.88 months. Seventeen patients (12.5%) had a T-score of -2.5 or less, and 54 patients (39.7%) had a T-score between -1.0 and -2.5. Of 119 patients in whom serum 25-OHD was measured, 40 (34%) had severe hypovitaminosis D (25-OHD <8ng/mL), and 50 patients (42%) had low hypovitaminosis D (serum 25-OHD 8 to 20 ng/mL). The magnitude of weight loss correlated negatively with serum 25-OHD, calcium, phosphorus, and calcium x phosphorus product values and positively with serum alkaline phosphatase level. Serum 25-OHD and calcium concentrations correlated positively with the BMD. PTH, serum 1,25-(OH)2D, and alkaline phosphatase concentrations correlated negatively with the BMD, a reflection of the presence of secondary hyperparathyroidism, an accelerated conversion of 25-OHD to 1,25-(OH)2D by the elevated PTH levels, and increased osteoblastic activity. The mean daily vitamin D supplementation was 6,472 +/- 9,736 IU. CONCLUSION: Hypovitaminosis D and subsequent bone loss are common in patients who have undergone a bariatric surgical procedure for morbid obesity. These patients require rigorous vitamin D supplementation.