Comparison of efficacy nebulized fentanyl with intravenous ketorolac for renal colic in patients over 12 years old.

OBJECTIVES: Acute renal colic is one of the common causes of referral to the hospitals. The aim of this study is to compare the efficacy of nebulized fentanyl with that of intravenous ketorolac in renal colic patients. MATERIALS & METHODS: This double-blinded clinical study included 186 patients with acute renal colic who were referred to the emergency department of Besat Hospital, Iran. PATIENT SELECTION: After selecting patients, according to study inclusion and exclusion criteria, they were divided into 2 groups of 93 using random block allocation method. The patients in the groups were treated with either nebulized fentanyl or intravenous ketorolac. The severity of pain was measured using the Numeric Pain Rating Scale (NPRS) of pain. The severity of pain at different times and demographic data were recorded. RESULTS: One hundred and thirty four males and 52 females with a mean age of 42.95 ± 13.13 years were included in the study. The two groups were matched in terms of age, sex, and the severity of the pain before the treatment. Fifteen minutes following the treatment, the severity of pain was decreased in the ketorolac group but did not change in the nebulized fentanyl group. Thirty minutes after the administration of the drug, the severity of pain in the nebulized fentanyl group decreased. At any time, the severity of pain in the ketorolac group was lower than that of the nebulized fentanyl group. CONCLUSION: Intravenous ketorolac had better analgesic effects in renal colic patients compared with nebulized fentanyl. Further studies that include complications and combinational therapy are required.

Social Trends Affecting the Future of Iran's Health System: A Qualitative Study Using Focus Group Discussion.

BACKGROUND: Social issues have short- or long-term as well as positive or negative effects on health systems. Identifying and analyzing events and trends help managers to make the vision and strategic planning. The purpose of this study is to identify the social trends and their impacts on the future of the Iranian health system. METHODS: Focus group discussion (FGD) was used to collect the data in 2017--18. The participants were selected through purposive sampling and the snowball method. The discussions were all written and recorded with the consent of the participants. A qualitative content analysis was used to analyze the data. RESULTS: The participants believed that the most important social trends affecting future of health system in Iran are increase health literacy, demographic transition, nutritional pattern, migration and urbanization, marginal settlement, rising unemployment, and increased usage of personal cars. CONCLUSIONS: The increase in health problems, healthcare costs, and mortality because of social behaviors and trends are considered as threats to the health system. Therefore, policymakers should reduce their negative effects by taking into account and focusing on these trends and making appropriate plans.

Autoclave-assisted synthesis of AgNPs in Z. officinale extract and assessment of their cytotoxicity, antibacterial and antioxidant activities.

In this study, the authors synthesised silver nanoparticles (AgNPs) using autoclave as a simple, unique and eco-friendly approach. The effect of Zingiber officinale extract was evaluated as a reducing and stabiliser agent. According to transmission electron microscopy results, the AgNPs were in the spherical shape with a particle size of ∼17 nm. The biomedical properties of AgNPs as antibacterial agents and free radical scavenging activity were estimated. Synthesised AgNPs showed significant 1,1-diphenyl-2-picryl-hydrazyl free radical scavenging. Strong bactericidal activity was shown by the AgNPs on Gram-positive and Gram-negative bacteria. A maximum inhibition zone of ∼14 mm was obtained for epidermidis at a concentration of 60 µg/ml for sample fabricated at 24 h. The AgNPs also showed a significant cytotoxic effect against MCF-7 breast cancer cell lines with an half maximal inhibitory concentration value of 62 µg/ml in 24 h by the MTT assay. It could be concluded that Z. officinale extract can be used effectively in the production of potential antioxidant and antimicrobial AgNPs for commercial application.