Background and Aims:The nonverbal pain scale is one of the instruments which study pain in nonverbal-ventilated patients with regard to the changes of behavioral and physiological indices. The purpose of the study is to survey the psychometric properties of revised-nonverbal pain scale (R-NVPS) and original-nonverbal pain scale (O-NVPS) in ventilated patients hospitalized in critical care units.Materials and Methods:Four nurses studied pain in sixty patients hospitalized in trauma, medical, neurology, and surgical critical care units using R-NVPS and O-NVPS at six times (before, during, and after nociceptive and nonnociceptive procedures). The test was repeated in 37 patients after 8–12 h.Results:Cronbach's alpha coefficient for R-NVPS and O-NVPS was 0.8 and 0.76, respectively. The inter-rater correlation coefficient during different times was r = 0.89–0.96 for R-NVPS and r = 0.80–0.87 for O-NVPS. Test-retest correlation coefficient for R-NVPS and O-NVPS was r = 0.55–0.86 and r = 0.51–0.75, respectively. The meaningful difference in pain score between nociceptive and nonnociceptive procedures (P < 0.001) and a higher pain score in patients who confirmed pain (P < 0.001) showed a discriminant and criterion validity for both scales of NVPS, respectively.Conclusions:R-NVPS and O-NVPS can both be used as valid and reliable scales in studying pain in ventilated patient. However, in comparing the items, “respiration” (R-NVPS) had a higher sensitivity than “physiology II” (O-NVPS) in assessing pain.
The present study has investigated the effectiveness of staged-preconditioning, in both remote and target organs. After IP the myocardial release of the biochemical markers including, creatine phosphokinase (CPK), cardiac creatine kinase (CK-MB), cardiac troponin T (cTnT) and lactate dehydrogenase (LDH) were evaluated in patients who underwent CABG, with and without staged-preconditioning. Sixty-one patients entered the study; there were 32 patients in the staged-preconditioning group and 29 patients in the control group. All patients underwent on-pump CABG using cardiopulmonary bypass (CPB) techniques. In the staged-preconditioning group, patients underwent two stages of IP on remote (upper limb) and target organs. Each stage of preconditioning was carried out by 3 cycles of ischemia and then reperfusion. Serum levels of biochemical markers were immediately measured postoperatively at 24, 48 and 72 h. Serum CK-MB, CPK and LDH levels were significantly lower in the staged-preconditioning group than in the control group. The CK-MB release in the staged-preconditioning patients reduced by 51% in comparison with controls over 72 h after CABG. These results suggest that myocardial injury was attenuated by the effect of three rounds of both remote and target organ IP.
Background: Cesarean section is among the most important gynecological surgeries and is the most common surgery in the present era. Delayed wound healing is among the main post-cesarean complications. It dramatically affects female's quality of life and causes frequent medical visits and even re-hospitalization. Objectives: This study aimed at investigating the effects of grape seed extract on the approximation of cesarean section wound. Methods: This double-blind randomized controlled trial was done during year 2015 on a convenient sample of 129 eligible females, who had undergone a cesarean section at Valiasr hospital, Birjand, Iran. The candidates were randomly allocated to a placebo and two experimental groups. In one experimental group, the participants were treated with 2.5% grape seed extract ointment (group A) while in the other, 5% ointment was used (group B). Wound approximation was measured by using the redness, edema, ecchymosis, discharge, approximation (REEDA) scale at three time points including before ointment application (T1) as well as at the sixth (T2) and the fourteenth (T3) post-intervention days. The data were analyzed via the SPSS (v. 19.0) software and through analysis of variance, Chi-square, Fisher's exact, Friedman's, Wilcoxon, Kruskal-Wallis and Mann-Whitney U tests, at a significance level of 0.05. Results: Before the study intervention, the difference among the groups regarding the mean score of wound approximation was not statistically significant (P = 0.14). However, there were significant differences among the groups regarding the mean score of wound approximation at T2 (P = 0.002) and T3 (P = 0.02).
Conclusions:The findings of this study demonstrate the effectiveness of grape seed extract ointment in accelerating cesarean wound closure. Therefore, the ointment can be used to accelerate wound healing after cesarean section.
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