Acta medica Iranica
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Acta medica Iranica · Nov 2010
Randomized Controlled TrialAnalgesic effects of intrathecal sufentanil added to lidocaine 5% in elective cesarean section.
The quality of subarachnoid block can be improved by adding opioids to the local anesthetics. We compared the analgesic effects of different doses of intrathecal sufentanil added to lidocaine %5 for elective cesarean section. This study was a prospective, randomized, double-blind, controlled trial. 90 pregnant women with ASA class I-II, scheduled for elective cesarean section under spinal anesthesia were enrolled in this study. ⋯ No differences were detected in other side effects such as hypotension, nausea & vomiting. The addition of sufentanil 10 versus 5 micrograms to lidocaine 5% provided more duration of analgesia for cesarean delivery. So, the adding of 10 micrograms sufentanil to lidocaine 5% for cesarean section has more effective analgesia with minimum side effects.
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Acta medica Iranica · Sep 2010
Randomized Controlled TrialTeaching evidence-based medicine more effectively.
Evidence-based Medicine (EBM) is becoming an integral component of graduate medical education competency and a requirement for grad medical education practice-based learning core competency. This study tries to compare the efficacy of conferences utilizing small-group discussions with the traditional conference method in enhancing EBM competency. The participants in this randomized controlled trial (RCT) were 170 members of the medical faculty who were divided into two groups of 86 (intervention) and 84 (control). Following the intervention, EBM competency was assessed by a written examination. statistical analysis made use of chi-square test, independent sample t-test and relative risks for univariate analysis. Mantel-Hanszel was used for bivariate analysis. Cox proportional hazard models were used to evaluate multivariate-adjusted associations between EBM educational intervention and EBM knowledge, attitude and skills. A new indicator of number needed to intervention (NNI) was defined and computed. ⋯ Conferences followed by small-group discussions significantly enhance EBM knowledge, attitude, critical appraisal skills and literature review skills.
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Acta medica Iranica · Sep 2010
Comparison of the frequency of old septal deviation in patients with and without traumatic nasal bone fracture.
Investigating the frequency of traumatic nasal bone fracture in patients with and without old septal deviation and possible deviation. Prospective study of 105 patients with nose trauma conducted and cases were divided into two groups: a study group 35 patients with nasal fracture and a control group of 70 patients without nasal fracture. ⋯ In comparison, only 39 (54%) of patients in the control group were diagnosed with old septal deviation. Existing old septal deviation significantly increases the risk of traumatic nasal bone fracture.
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Traumatic abdominal wall hernias are a type of acquired hernia secondary to blunt trauma Caused, by direct trauma from handlebar like objects. This rare hernia is named 'Handlebar hernia'. We report a case of such hernia without any significant intra-abdominal injury. ⋯ Postoperative course was uneventful. The authors recommend clinical suspicion for traumatic hernia in all patients with traumatic abdominal wall injury. Definitive treatment includes surgical exploration with primary repair of all tissue layers of the abdominal wall.
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Acta medica Iranica · Jul 2010
Spirometric indices after bronchodilator test in obstructive lung disease.
Bronchial responsiveness to bronchodilator medications is usually tested to establish reversibility of airflow obstruction. Among the various tests to establish bronchodilator response, FEV1, FEF(25-75%) or FEF50%, and FVC are the most widely used. In a cross-sectional study, we assessed spirometric responses after administration of bronchodilator in 187 workers with obstructive pattern in spirometry. ⋯ The increase in FEV1% predicted was inversely correlated with baseline FEV1. In conclusion, we consider that FEV1 is the most reliable spirometric index for assessing bronchodilator response. And Bronchial reversibility has an inverse relationship with baseline measures.