ObjectiveTo assess the effectiveness and advantages of ultra-mini-percutaneous nephrolithotomy (UM-PCNL) versus standard PCNL (S-PCNL), as one of the most important differences between the various PCNL techniques is the size of the renal access, which contributes to the broad spectrum of complications and outcomes.Patients and methodsThis clinical randomised trial was conducted in 2016. In all, 70 patients with renal or upper ureteric stones of 10–20 mm in diameter, who were candidates for PCNL, were divided equally into two groups. Group A, underwent UM-PCNL using a 9.8-F ureteroscope through a 16-F sheath; and Group B, underwent S-PCNL using a 24-F nephroscope through a 30-F sheath. The stones were fragmented by pneumatic lithotripsy. Any perioperative complications and need for analgesia were recorded, and postoperative pain was assessed in both groups using a visual analogue scale (VAS).ResultsThere were statistically significant differences in postoperative haemoglobin values, haemoglobin drop, transfusion rate, duration of hospitalisation and postoperative VAS pain score between the groups (P < 0.05). There were no significant differences in operation time, need for auxiliary procedures or stone-free rate.ConclusionA minimally invasive UM-PCNL using a 9.8-F ureteroscope can play an important role in the treatment of symptomatic renal and upper ureteric stones of <20 mm in diameter with lesser blood loss, duration of hospitalisation, need of transfusion, and postoperative pain compared with S-PCNL.
BackgroundNausea and vomiting are one of the most common complications of cesarean sections under spinal anesthesia. Recently, the use of drugs to treat nausea and vomiting has decreased, and nonpharmaceutical and alternative traditional medicine are often preferred.ObjectivesThis study aimed to determine the effect of ginger extract on the incidence and severity of nausea and vomiting after cesarean section under spinal anesthesia.MethodsIn this double-blind randomized clinical trial, 92 pregnant women, each of whom underwent a cesarean section under spinal anesthesia, were divided in two groups: a control group and an intervention group. The intervention group received 25 drops of ginger extract in 30 cc of water, and the control group received 30 cc of water one hour before surgery. The incidence and severity of nausea and vomiting were assessed during the surgery and two and four hours after the surgery using a self-report scale. Data analysis was performed using SPSS software and statistical tests.ResultsThere was no statistically significant difference between the two groups in terms of maternal age, duration of fasting, duration of surgery, and confounding factors (P > 0.05). According to an independent t-test, there was a significant relationship between the two groups in terms of the incidence and mean severity score of nausea and vomiting during the cesarean section (P < 0.05). However, no statistically significant relationship was found between the two groups in terms of the incidence and mean severity score of nausea and vomiting two and four hours after surgery (P > 0.05).ConclusionsThe findings of this study showed that ginger extract can be used for the prevention of nausea and vomiting during cesarean section under spinal anesthesia.
BackgroundEye examination as one of the painful procedures for retinopathy of prematurity screening can cause some pain-related physiological and behavioral changes in preterm infants. Multisensory stimulation is an analgesic non-pharmacological method that has analgesic effects on infants during painful procedures.ObjectivesThis study aimed to determine the effect of multisensory stimulation on induced pain during eye examination for retinopathy of prematurity screening in preterm infants.MethodsIn this double-blind clinical trial, 80 preterm infants were randomly divided into two groups. In the intervention group, multisensory stimulation program was performed for 15 minutes before the beginning of examination while the control group received the routine care. Pain score for each infant was recorded by premature infant pain profile. Data were analyzed using independent t-test, Mann-Whitney, and ANOVA with repeated measures by SPSS software (version 16).ResultsThe mean gestational age was 30.4 ± 1.7 weeks in the multisensory stimulation group and 30.6 ± 1.8 weeks in the control group. Based on ANOVA with repeated measures, the pain score was significantly different between two groups during the assessment process (P < 0.001). The changes in pain severity during the examination were also significant between the two groups (P < 0.001); so that the pain was more intensive in the control group than the intervention group.ConclusionsMultisensory stimulation program as a safe and easy method can reduce pain in neonates and may be used as a way to reduce pain during eye examination in infants.
Background: There are extremely stressful stimuli in the NICU environment. Although attempts have already saved neonates in this unit, this can disturb the adaptability of the infants with environmental stimuli. Methods: In this study, 120 preterm infants were randomly divided into experimental and control groups. The quiet time protocol was implemented at 16:00-18:00 while the control group received a routine program at 11:00-13:00. SpO2 and respiratory rate were measured in 15-min intervals and one hour before and after both times. The sound level and light intensity were also measured. Data analysis was done by independent t-test, Mann Whitney, and ANOVA using SPSS version 11.5. Results: Of all infants, 40% were girls and 60% were boys. Regarding intra-group comparison, the Friedman's nonparametric test showed that the percentage of oxygen saturation in the quiet-time group was not significantly different at the first, second, and third hours during the intervention (P = 0.32); in the control group, it was not also significant. The respiratory rate at the second hour of the intervention was lower in the quiet time group than in the control group (P < 0.07). Conclusions: The implementation of the quiet time protocol can decrease heart rate and respiratory rate through a decrease in environmental stimuli (noise, light, and infant handling), and thus, is recommended for reducing stress in preterm infants.
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