Prognostic study, level III.

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Aim:To determine the effect of severity of depression symptoms on self care behavior in 15th and 30th day after myocardial infarction (MI).Materials and Methods:Gathering data for this cross sectional study was done by Beck depression and self care behavior questionnaires in a heart especial hospital in Rasht in north of Iran. Sample size was 132 after MI patients and data collected from June 2011 to January 2012.Results:Scores of depression symptoms in 15th and 30th day after MI and score of self care behavior in these days had significant difference (P<0.0001). Spearman test showed self care behavior had significant relationship with depression symptoms (P<0.0001). GEE model also showed with control of socio demographic and illness related factors, depression symptoms can decrease self care behavior scores (P<0.001).Conclusion:Severity of depression symptoms increase in 15th to 30th day after MI. This issue can affect on self care behavior. This issue is emphasized on nurses’ notice to plan suitable self care program for these patients.

Introduction Addiction to the Internet and mobile phones in adolescents could be related to loneliness. However, less research has been conducted on this topic in developing countries. This study aimed to examine addiction to the Internet and mobile phones and its relationship with loneliness in adolescents in Iran. Method This was a cross-sectional and analytic study that was conducted between 2015 and 2016 in Rasht, in the north of Iran. Subjects were selected through cluster sampling from female and male teens who were studying in the public and private schools. The Kimberly’s Internet Addiction Test, Cell phone Overuse Scale (COS), and the University of California , Los Angeles (UCLA) Loneliness Scale were used for data collection. Results The mean age of participants was 16.2 ± 1.1 year. The mean of addiction to the Internet was 42.2 ± 18.2. Overall, 46.3% of the subjects reported some degrees of addiction to the Internet. The mean of addiction to mobile phones was 55.10 ± 19.86. The results of this study showed that 77.6% (n = 451) of the subjects were at risk for addiction to mobile phones, and 17.7% (n = 103) of them were addicted to their use. The mean of loneliness was 39.13 ± 11.46 in the adolescents. Overall, 16.9% of the subjects obtained a score higher than mean in loneliness. A statistically significant direct relationship was found between addiction to the Internet and loneliness in the adolescents (r = 0.199, p = 0.0001). The results also showed a statistically significant direct relationship between addiction to mobile phones and loneliness in the adolescents (r = 0.172, p = 0.0001). Conclusion The results of this study revealed that a high percentage of adolescents who have some degrees of addiction to the Internet and mobile phones experience loneliness, and there are relationships between these variables.

BackgroundLack of proper control of acute postoperative pain often leads to lingering or chronic pain. Several studies have emphasized the role of beta-blockers in reducing postoperative pain. Esmolol is a selective short-acting beta-blocker that produces few side effects. The purpose of this study was to examine the effect of intravenous intraoperative esmolol on postoperative pain reduction following orthopedic leg fracture surgery.MethodsIn a clinical trial, 82 patients between 20-65 years of age with tibia fractures and American Society of Anesthesiologists (ASA) physical status I & II who underwent surgery were divided into two groups. Group A received esmolol and group B received normal saline. Postoperative pain was measured at three time points: entering the recovery unit, and at 3 h and 6 h following surgery, using the Visual Analogue Scale (VAS). A P value of < 0.05 was considered significant.ResultsMean VAS scores at all three time points were significantly different between the two test groups (P = 0.02, P = 0.0001, and P = 0.0001, respectively). The consumption of pethidine was lower in group A than in group B (P = 0.004) and the duration of its effect was significantly longer in time (P = 0.026).ConclusionsIntravenous intraoperative esmolol is effective in the reduction of postoperative pain following leg fracture surgery. It reduced opioid consumption following surgery and delayed patient requests for analgesics.

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This study determines the mean concentrations of free amino acids in stimulated and unstimulated whole saliva in healthy young adults. Standardised salivary amino acids as a substitute for their counterpart in blood, searched for the source of free amino acids in saliva, the probable correlation between particular amino acids with caries experience. Stimulated and unstimulated whole saliva were collected by the draining method in 31 dental students. Saliva was purified, and amino acids were separated by high-performance liquid chromatography. DMFT scores were recorded, and the relation of amino acids to caries experience was explored by generalised linear model. Almost all amino acids had higher concentration in unstimulated whole saliva than in stimulated saliva. The normal range of amino acids (95% CI) and their natural logarithm were defined. There was a significant relationship between caries experience and threonine (P < 0·008), citrulline (P < 0·023) and ornithine (P < 0·001) as a detrimental factor, whereas serin (P < 0·026), glutamine (P < 0·015) and phenylalanine (P < 0·014) had an inhibiting effect on caries. However, in comparison, salivary flow rate (P < 0·013) was a more preventive factor than amino acids. Amino acids in saliva contribute as a marker, instead of their counterpart in blood. Unstimulated saliva had higher concentration of amino acids. Amino acids have different impact on caries and may be one of underlying risk factors for caries experience.

Introduction To determine predictors of length of stay (LOS) in the intensive care unit (ICU) after coronary artery bypass grafting (CABG) and to develop a risk scoring system were the objectives of this study. Methods In this retrospective study, 1202 patients' medical records after CABG were evaluated by a research-made checklist. Tarone-Ware test was used to determine the predictors of patients' LOS in the ICU. Cox regression model was used to determine the risk factors and risk ratios associated with ICU LOS. Results The mean ICU LOS after CABG was 55.27±17.33 hours. Cox regression model showed that having more than two chest tubes (95% confidence interval [CI] 1.005-1.287, Relative Risk [RR]=1.138), occurrence of atelectasis (95% CI 1.000-3.007, RR=1.734), and occurrence of atrial fibrillation after CABG (95% CI 1.428-2.424, RR=1.861) were risk factors associated with longer ICU LOS. The discrimination power of this set of predictors was demonstrated with an area under the receiver operating characteristic curve and it was 0.69. A simple risk scoring system was developed based on three identified predictors that can raise ICU LOS. Conclusion The simple risk scoring system developed based on three identified predictors can help to plan more accurately a patient's LOS in hospital for CABG and can be useful in managing human and financial resources.