Infographics or video; which one is more effective in asthmatic patients' health? a randomized clinical trial.

Objective: Asthma disease is a complex medical condition for which the control of symptoms depends on sufficient patient knowledge, self-care, and adherence to medication protocols. Researchers conducted this study to evaluate the impact of infographics and video on asthma patients' adherence to medication. Methods: A randomized clinical trial in which 80 asthmatics were enrolled and allocated to two study groups (infographic and video groups). Researchers used questionnaires to gather demographic data. A nurse assessed Morisky adherence to medication. Researchers performed data analysis using repeated measurements and Least Significant Difference (LSD) in SPSS software version 23. Results: There was no significant difference between the two study tracks (P > 0.05) in the demographic data and adherence to medication in the pretest. The differences between the two intervention groups throughout the one-month follow-up were statistically significant (P < 0.05). There were significant differences between the two intervention groups in pretest and post-test, and pretest and follow-up (P < 0.05). However, there were no significant differences between the two intervention groups in post-test and follow-up (P > 0.05). Conclusions: According to the study findings, both the infographic and video formats may have led to an increase in adherence to medication protocols among asthma patients; but it seems that the infographic format is preferred for long- term use because it does not require usage of a facility. However, education format of asthmatic people is dependent on conditions and patient preferences.

The Effects of Passive Blinking on Exposure Keratopathy among Patients in Intensive Care Units.

Background: Patients in Intensive Care Units (ICUs) are at risk of eye disorders such as Exposure keratopathy (EK) due to impaired blinking and incomplete eye closure. The aim of this study was to assess the effects of passive blinking exercise (PBE) on EK among patients in ICUs. Materials and Methods: This single-blind, randomized, clinical trial was conducted in 2017. The study participants included 51 patients purposively recruited from the three ICUs of Valiasr Teaching Hospital, Arak, Iran. Through coin tossing, one eye of each participant was randomly allocated to the intervention group and the other to the control group. The eye in the control group received routine eye care, whereas the eye in the intervention group received routine eye care and PBE for a week. EK prevalence and severity were assessed daily for 7 consecutive days using fluorescein eye staining papers and an ophthalmoscope with a cobalt blue filter. Results: The study groups did not significantly differ from each other in terms of the baseline prevalence and severity of EK. After the intervention, the prevalence of EK (χ 2 = 13.44, df = 1, p < 0.001) and the prevalence of grade II EK (χ 2 = 8.33, df = 1, p = 0.003) in the intervention group were significantly lower than the control group. Conclusions: PBE is effective in significantly reducing EK prevalence and severity among patients in ICUs. Therefore, critical care nurses are recommended to use PBE for EK prevention and management.

Effect of Nebulized Eucalyptus on Arterial Blood Gases and Physiologic Indexes of Mechanical Ventilated Patients: A Randomized Clinical Trial.

Introduction: Arterial hypoxia is one of the most common findings in critically ill patients. Inhaled medications in ventilated patients can reduce airway resistance, facilitate dilution, and prevent airway infections. This study aimed to examine the effects of nebulized Eucalyptus (NE) on arterial blood gases (ABG) and physiologic indexes of patients receiving mechanical ventilation (MV). Methods: The current randomized clinical trial was performed in three intensive care units (ICUs) of Al-Zahra Hospital in Isfahan, Iran. Using purposive sampling method, 70 intubated patients were selected and randomly divided into NE (n=35) and control (n=35) groups. NE group received 4 ml (5%) Eucalyptus in 6 mL normal saline (NS) every 8 hours since intubation to 3 days by a nebulizer. Control group received 10 mL NS in the same way. Glasgow Coma Scale (GCS) and ABG parameters (pH, BE, HCO3, PCO2, SaO2, and PaO2), and the peak inspiratory pressure (PIP) and tidal volume (TV) were equally assessed in both intervention and control groups. Data were analyzed using SPSS software version 13. Results: There was no significant difference between the patients of both groups in terms of vital signs (blood pressure, temperature, respiratory rate, and pulse rate), GCS, pH, BE, HCO3, PCO2, SaO2, PaO2, PIP, and TV before the study. Amongst the parameters of ABG, there was a significant difference between PaO2 and SaO2 and PIP in the intervention and control groups 3 days after intervention. Conclusion: Inhaled Eucalyptus can improve oxygenation and reduce airway pressure in patients undergoing MV.

Exposure keratopathy and its associated risk factors in patients undergoing general anesthesia in nonocular surgeries.

INTRODUCTION: The most common eye injury during and after general anesthesia is corneal abrasion which can occur at any time after anesthesia and even up to 24 h after it. The aim of this study was to investigate the incidence and factors associated with corneal injury in patients undergoing nonocular surgery. METHODS: This was a descriptive cross-sectional study. A total of 170 patients, who were admitted to the operating room and met the inclusion criteria, were selected through simple nonprobability sampling. Data collection forms were used in order to assess the incidence of corneal injury and its related risk factors. The National Eye Institute scale with fluorescein paper and cobalt blue light by slit lamp were utilized to examine exposure keratopathy. RESULTS: Overall, the results showed that the incidence of keratopathy immediately after eye care removal was found to be 64.7% in the operating room, 65.9% in the recovery room, and 41.2% in 24 h after the surgery. Smokers' patients and drug abusers under general anesthesia underwent endotracheal intubation, received more opioids preoperatively, and had more perioperative bleeding and fluid intake. Moreover, in patients who had received more oxygen flow in the recovery room; the rate of keratopathy was higher. CONCLUSION: Smoking, drug usage, and receiving endotracheal intubation are the risk factors of keratopathy. Therefore, for high-risk patients and procedures, it is indispensable to both obtain preoperative information and take intraoperative precautions in order to prevent eye injuries. Future studies are needed to demonstrate these finding.

Self-care and related factors in patients with type II diabetes in Iran.

PURPOSE: To assess Self-care and related factors in patients with type II diabetes in Iran. METHODS: This descriptive cross-sectional study was performed on 100 patients with type II diabetes who were referred to specialized diabetes centers related to Arak University of Medical Sciences in Iran. Data collection was done using a researcher-made questionnaire. The questionnaire consisted of three parts (the first part was demographic information, the second part was self-care behaviors such as diet, exercise, control, treatment, and prevention of complications over the past seven days, and the third part was factors influencing patients' self-care behaviors). The inclusion criteria were; patients 18-80 years of age with a diagnosis of type 2 diabetes, at least one year passed of diabetes diagnosis, no chronic diseases other than those related to diabetes, had awareness of the diagnosis, had no hearing and speech impairments, and no mental illnesses. The exclusion criteria was the patient's failure to answer all questions of the questionnaire. Data analysis was performed using SPSS software version 16, and using descriptive statistics and Pearson test, independent t-test, one-way analysis of variance and Spearman test. RESULTS: The mean score of self-care in patients was 84.41 ± 11.75 and at the intermediate level. Spearman correlation coefficient test results showed a significant relationship between self-care behavior and gender (p = 0.001), and insurance type (p = 0.035). Also, men had higher average self-care compared to women (p = 0.001). The highest average score of self-care was in Adherence to medication and the lowest score was in exercise and physical activity. CONCLUSION: Due to the low self-care score in exercise and physical activity and the lack of periodic renal examinations, planning and educational interventions in all aspects of self-care, especially in terms of sports and physical activity, and periodic renal examinations are essential.

The Impact of Normal Saline on the Incidence of Exposure Keratopathy in Patients Hospitalized in Intensive Care Units.

BACKGROUND: Patients in the intensive care unit (ICU) have impaired ocular protective mechanisms that lead to an increased risk of ocular surface diseases including exposure keratopathy (EK). This study was designed to evaluate the effect of normal saline (NS) on the incidence and severity of EK in critically ill patients. MATERIALS AND METHODS: This single-blind randomized controlled trial was conducted on 50 patients admitted to ICUs. The participants were selected through purposive sampling. One eye of each patient, randomly was allocated to intervention group (standard care with NS) and the other eye to control group (standard care). In each patient, one eye (control group) randomly received standard care and the other eye (intervention group) received NS every 6 h in addition to standard care. The presence and severity of keratopathy was assessed daily until day 7 of hospitalization using fluorescein and an ophthalmoscope with cobalt blue filter. Chi-square test was used for statistical analysis in SPSS software. RESULTS: Before the study ( first day) there were no statistically significant differences in the incidence and severity of EK between groups. Although, the incidence and severity of EK after the study (7th day) was higher in the intervention group compared to the control group, their differences were not statistically significant. Although, the incidence and severity of EK, from the 1st day until the 7th, increased within both groups, this increase was statistically significant only in the intervention (NS) group. CONCLUSIONS: The use of NS as eye care in patients hospitalized in ICUs can increase the incidence and severity of EK and is not recommended.

Effect of nebulized eucalyptus on contamination of microbial plaque of endotracheal tube in ventilated patients.

BACKGROUND: Formation of biofilm and bacterial colonization within the endotracheal tube (ETT) are significant sources of airway contamination and play a role in the development of ventilator-associated pneumonia (VAP). This study was conducted to examine the effect of nebulized eucalyptus (NE) on bacterial colonization of ETT biofilm. MATERIALS AND METHODS: We performed a randomized clinical trial in three intensive care units (ICUs) of an educational hospital. Seventy intubated patients were selected and randomly divided into intervention (n = 35) and control (n = 35) groups. The intervention group received 4 ml (5%) of eucalyptus in 6 ml normal saline every 8 h. The placebo group received only 10 ml of normal saline in the same way. On extubation, the interior of the tube was immediately sampled using a sterile swab for standard microbiological analysis. Chi-square and Fisher's exact tests were used for statistical analysis in SPSS. P values less than 0.05 were considered statistically significant. RESULTS: In both samples, Klebsiella pneumoniae and Acinetobacter baumannii were the most frequently isolated bacteria. In the control group, heavy colonization was greater than in the intervention group (P = 0.002). The frequency of isolation of K. pneumoniae in the intervention group was lower than in the control group (P < 0.001). However, there was no difference between the two groups in other isolated bacteria. CONCLUSIONS: NE can reduce microbial contamination of the endotracheal tube biofilm in ventilated patients. Moreover, K. pneumoniae was the most sensitive to NE.

Comparison the efficacy of herbal mouthwash with chlorhexidine on gingival index of intubated patients in Intensive Care Unit.

BACKGROUND: Intubated patients in Intensive Care Unit (ICU) are not able to take care of their mouth health, so they are at risk of bacterial colonization and dental plaques formation that can lead to systemic diseases such as pneumonia and gingivitis. AIMS: In randomized, double-blind clinical study, the efficacy of natural herbal mouthwash containing Salvadora persica ethanol extract and Aloe vera gel was compared with chlorhexidine on gingival index (GI) of intubated patients in ICU. MATERIALS AND METHODS: Seventy-six intubated patients (18-64 years old with mean age 40.35 ± 13.2) in ICU were admitted to this study. The patients were randomly divided into two groups: (1) Herbal mouthwash and (2) chlorhexidine solution. Before the intervention, the GIs was measured by modified GI device into two groups. The mouth was rinsed by mouthwashes every 2-3 h for 4 days. 2 h after the last intervention, GIs were determined. RESULTS: Along with mechanical methods, herbal mouthwash in reducing GI was statistically significant than that of chlorhexidine (P < 0.05). CONCLUSION: The results of this study introduce a new botanical extract mouthwash with dominant healing effects on GI (1.5 ± 0.6) higher than that of synthetic mouthwash, chlorhexidine (2.31 ± 0.73).