Effects of N-acetyl cysteine and melatonin on early reperfusion injury in patients undergoing coronary artery bypass grafting: A randomized, open-labeled, placebo-controlled trial.

OBJECTIVES: This study assessed the efficacy of oral consumption of N-acetyl cysteine (NAC) and melatonin (ML) in reducing early reperfusion injury and acute oxidative stress in patients undergoing coronary artery bypass grafting (CABG) with respect to the measurements of cardiac troponin I, lactate, malondealdehyde (MDA), and tumor necrosis factor-α (TNF-α) levels in the blood. METHODS: This study was a randomized, open-label, placebo-controlled trial. Eighty eight patients, aged between 39 to 76 years and eligible for CABG, were recruited and randomly assigned into 3 intervention groups through a simple randomization method and underwent CABG surgery. Blood samples were withdrawn from arterial line, before the induction of anesthesia (before the start of surgery), after incision (before aortic cross-clamping), during global ischemia (during aortic cross-clamping), after aortic cross-clamping (on set of reperfusion), 15 minutes after reperfusion, and after recovery at the intense care unit. The blood samples were analyzed for troponin I, lactate, MDA and TNF-α levels. RESULTS: There was no significant difference in influencing variables among the groups at the baseline. Overall mean troponin I, lactate, and TNF- α levels were significantly different between the intervention groups (all P < .001) at the recovery phase. Post-hoc pairwise comparisons showed that the differences of mean serum levels between ML and control groups were statistically significant for MDA, TNF- α, lactate, and troponin I (P < .001, P = .001, and P = .001, respectively). The differences between NAC and control groups and between ML and NAC groups were only significant for mean lactate level (P < .001). CONCLUSION: The current study revealed that ML and NAC are potent antioxidants with similar efficacy in terms of reducing CABG related cardiac injury and oxidative stress with the dosage employed for the intervention.

Relapse Coping Strategies in Young Adults Addicts: A Quantitative Study in Iran.

BACKGROUND: Cognitive-behavioral coping approach is known as an effective strategy to preventing relapse. Its goal is to forget incompatible behaviors and replaces them with the compatible answers. OBJECTIVES: This study examines relapse coping strategies in young adults in selected substance abuse treatment centers in Iran. PATIENTS AND METHODS: The present is a descriptive cross-sectional study. The sample consisted of 70 self-referred young addicts (18-24 years). Adolescence Relapse Coping Questionnaire was used to assess relapse coping strategies. Descriptive statistics was used to analyze the data. RESULTS: The findings revealed that 71.2% have experienced a relapse totally. It was hard to control the hypothetical high risk situation and they greatly wanted to use the substance (mean 7.39 of 10). Addicts have used of all three coping skills in "definitely would do" level. CONCLUSION: Enhancing self-efficacy through training coping skills, especially abstinence - focused coping skills to react properly in high risk situation can be useful.

High risk situations predicting relapse in self-referred addicts to bushehr province substance abuse treatment centers.

BACKGROUND: Relapse prevention is a medical intervention designed for educating cognitive and behavioral skills to avoid continued drug abuse and relapse. OBJECTIVES: This study examined high risk situations for relapse for self-referred addicts are related in Bushehr province substance abuse treatment centers. PATIENTS AND METHODS: The present study is descriptive cross-sectional. The sample size consisted of 609 self-referred addicts to Bushehr province substance abuse centers. IDTS Marlatt questionnaire was used. Analytical and descriptive statistics were used to analyze the data. RESULTS: The findings showed that 73.1% of addicts have used substance during the past 12 months, and 72% have experienced a full relapse. Unpleasant emotions and physical discomfort was the most important reason for relapse and testing personal control and pleasure emotions the least important reason. Interpersonal factors have also a great role in this regard. CONCLUSIONS: Considering the high rates of relapse, more attention should be paid to reasons for relapse. It seems necessary that both clinical and psychological approaches would be undertaken simultaneously.

Nurses' perceptions of evidence-based practice: a quantitative study at a teaching hospital in Iran.

BACKGROUND: Evidence-based practice (EBP) provides nurses a method to use critically appraised and scientifically proven evidence for delivering quality health care and the best decision that leads to quality outcomes. The purpose of this study was to measure the practice, attitude and knowledge/skill of evidence-based practice of nurses in a teaching hospital in Iran. METHODS: This cross-sectional study was conducted in 2011.The study sample was composed of 195 nurses who were working at the Fatemeh Zahra Hospital affiliated to Bushehr University of Medical Sciences (BPUMS). The survey instrument was a questionnaire based on Upton and Upton study. This tool measures Nurses' perceptions in the three sub-scales of practice, attitude and knowledge/skill of evidence-based practice. Descriptive statistical analysis was used to analyze the data. Pearson correlation coefficients were used to examine the relationship between subscales. RESULTS: The overall mean score of the evidence-based practice in this study was 4.48±1.26 from 7, and the three subscales of practice, attitude and knowledge/skill in evidence-based practice were, 4.58±1.24, 4.57±1.35 and 4.39±1.20, respectively. There was a strong relationship between knowledge and performance subscale (r=0.73,p<0.01). CONCLUSION: Findings of the study indicate that more training and education are required for evidence-based nursing. Successful implementation of evidence-based nursing depends on organizational plans and empowerment programs in hospitals. Hence, hospital managers should formulate a comprehensive strategy for improving EBP.