Background: Nutritional therapy in the forms of parenteral or enteral nutrition is an important factor of care and appears to positively impact the clinical outcomes of critically ill patients.

Introduction: Intravenous regional anesthesia is a simple and reliable method for surgeries of the lower extremities. The purpose of this study was to compare the effect of regional intravenous anesthesia with spinal anesthesia on foot surgeries.Materials and Methods: This study was conducted as a randomized clinical trial on 60 patients undergoing foot surgery in two similar groups. In this account, the intervention group received intravenous regional anesthesia with 40 mililitre of lidocaine (0.5%) and the control group underwent spinal anesthesia with marcaine (0.5%). Duration of analgesia, duration of postoperative analgesia after opening the tourniquet, recovery time, postoperative pain intensity based on Visual Analogue Scale (VAS), blood pressure, heart rate during the surgery and recovery period, and other complications such as nausea, vomiting and headache were assessed in both groups.Results: The two groups did not differ in age and sex. The mean duration of analgesia in the spinal group was 121.13±17.30 minutes and in the intravenous anesthesia group was 49.50±5.14 minutes (P<0.001). The mean duration of analgesia after opening the tourniquet was 72.17± 15.29 minutes in the control group and 11.17± 6.22 minutes in the intervention group (P<0.001). The mean recovery time in the control group was 26.83± 4.82 and in the intervention group was 13.10±3.20 min (P<0.001). One hour postoperative pain score was 2.3 ± 0.31 in the control group and 7.1± 0.20 in the intervention group (P<0.001). Hypotension, bradycardia, nausea and vomiting, dizziness, and headache were more incidental in the spinal group than in the intravenous anesthesia group (P<0.001). Conclusion:In short-term foot surgeries, intravenous regional anesthesia is more appropriate than intra-spinal.

Background: During their life, people are constantly moving between health and disease. No doubt, health status is associated with health literacy and attitudes of individuals. Patient education commences early in hospital and continues until full recovery of the patient. Also, it provides appropriate information to patients by which they can acquire a healthier status. Objectives: This study aimed to investigate Iranian nurses' perspective from barriers to patient education in intensive care unit. Materials and Methods: In this qualitative study, 25 nurses were recruited using purposeful sampling. Data were gathered using semi-structural interviews. Moreover, data were transcribed verbatim and analyzed using the content analysis method. Results: Five main barriers were identified as barriers to patient education including nursing personnel shortages, lack of adequate knowledge and motivation, inadequate facilities, ineffective communication, and insufficient supervision and control. Conclusions: The necessity and importance of patient education and the role of nurses in intensive care unit is undeniable. Regarding the importance of the issue, the barriers to effective patient education should be addressed. The barriers, then, should be diminished using appropriate measurements

Background: Conservative oxygen therapy (COT) targets a SpO2 of 90 -92% using the lowest possible FiO2 for mechanically ventilated (MV) adult patients. Conservative oxygen therapy aims to maintain adequate oxygenation while avoiding the harmful effects of hyperoxaemia. However, a lower SpO2 target during MV is recognised as challenging in current clinical norms. Objectives: We sought to describe intensive care clinicians' opinion and self-reported practice of conservative oxygen therapy. Methods: The research tool was a multi-choice questionnaire of intensive care clinicians working at 10 affiliated metropolitan tertiary hospitals from January-April, 2014. Results: Four hundred and twelve (84%) staff members responded to the survey. Of these, 91% (375) were intensive care nurses and 9% (37) were medical doctors. A majority of respondents (86%, 356/412) considered oxygen-related lung injury as "Yes, a major concern". Most respondents, 85% (351/412), felt COT was easy to perform and a few respondents, 6% (23/412), considered performing COT to be stressful. More than 90% of the respondents reported not performing more arterial blood gases to monitor PaO2 during COT and essentially all (98%) indicated a desire to perform COT. Free text comments indicated COT as a challenge to current practice and expressed a strong desire to avoid inadvertent hypoxaemia. Conclusions: Intensive care clinicians varied in their opinion and self-reported practice of conservative oxygen therapy and were genuinely concerned about unintended physiological consequences related to targeting low SpO2 values. We recommend conservative oxygen therapy to be implemented cautiously in conjunction with further evaluation of its impact on outcomes for patients and the perceptions of clinicians.