Double-blind Randomized Clinical Trial Study Research Articles

Effect of Low-Level Laser Therapy on Trismus, Facial Swelling, and Pain Following Surgical Extraction of Impacted Lower Third Molars

Background: Light amplification by the stimulated emission of radiation (laser) is currently used as a therapy method for decreasing inflammation followed by oral surgeries. Therefore, the present study aimed at evaluating the effect of using diode low-power laser irradiation (photobiomodulation) on the amount of pain, swelling, and trismus due to latent mandibular third molar surgery (surgical removal of latent mandibular third molars). Methods: In this double-blind randomized clinical trial study, 16 individuals with latent mandibular third molars with an identical condition were selected. The teeth were randomly assigned to two groups of laser irradiated intervention group and a non-irradiated control group. A 940 nm diode laser with an output power of 200 mW and an energy density of 12 J/cm2 was applied for 60 seconds at a distance of 1 cm three intraoral points and an extraoral point. The distance between incisal edges of upper and lower central teeth, the horizontal distance between corners of lips and auricle (LE), the vertical distance between the outer canthus of the eye and the mandibular angle (EA), and pain visual analogue scale were measured before surgery and two and seven days after surgery. Results: There was no statistically significant difference between the two groups regarding EA and LE before intervention and on days 2 and 7 after intervention (P>0.05). However, the pain score was significantly higher before intervention (3.31±0.7 vs. 2.38±0.8, P=0.001) and on day 2 after intervention (6.5±1.32 vs. 4.5±0.97, P<0.001) in the control group. On day 7, a higher maximum jaw opening (MJO) was observed in the intervention group (40.68±5.76 vs. 36.81±4.35, P=0.04). Conclusions: Adjunctive diode laser photobiomodulation after third molar surgery was associated with a significant reduction in pain and trismus.

A Comparative Study of Montelukast and Azelastine add on Therapy in Moderate to Severe Allergic Rhinitis Treatment: A Double-Blind Randomized Clinical Trial.

Allergic Rhinitis (AR) is a prevalent chronic inflammatory nasal condition with significant negative effects on the patients' quality of life. This study aimed to investigate the efficacy of Montelukast and intranasal antihistamine in combination with intranasal corticosteroid (INCS) in moderate to severe allergic rhinitis on the patients' quality of life and AR control. This double-blind randomized clinical trial study was carried out on 66 moderate to severe AR patients referred to Namazi Hospital, Shiraz, Iran from 2020 to 2021, who were randomly divided into 3 groups. Group one received Montelukast add-on therapy and Budesonide nasal spray. The second group received intranasal antihistamine (Azelastine) add-on therapy and Budesonide nasal spray and the third group as the control group received intranasal Budesonide spray with a placebo tablet.To measure the impact of each medication on the patient's quality of life and AR control, we employed the Sino-Nasal Outcome Test-22 questionnaire (SNOT 22). We evaluated the symptoms and compared them at baseline, one and three months after the start of treatments. Spirometry was performed to investigate the possibility of co-morbid asthma at baseline and end of the study. The patients' mean age was 30.13 ± 12.7 years. Most patients experienced perennial AR (65.2%). Reduction of mean scores SNOT22 was statistically different between groups (P-value < 0.001). Three months after treatment, the mean decrease of SNOT-22 in the Azelastine group was statistically significant compared to both Montelukast (P-value < 0.001) and control groups (P-value < 0.001). No significant difference was observed between the Montelukast and control groups (P-value = 0.142). 23 of 66 patients were diagnosed with asthma and asthma treatment was initiated. The amount of FEV1 change after AR treatment was not statistically significant between the groups in asthmatic patients (P-value = 0.351). Based on our findings, we recommend Azelastine in conjunction with an intranasal corticosteroid for the treatment of moderate to severe allergic rhinitis. In moderate to severe AR or even asthma management, Montelukast has no greater impact than INCS.

The effect of heparin concentration on results of venous blood gas of patients admitted to cardiac intensive care unit: A double-blind clinical trial.

BackgroundThe aim of the present study was to investigate the effect of heparin (1000 IU/mL) in the blood sample on the results of venous blood gases of patients admitted to the cardiac intensive care unit.Materials and methodsThe present double-blind randomized clinical trial study was performed on 282 samples from 141 patients admitted to the cardiac intensive care unit. Insulin syringes with heparin (1000 IU/mL) and heparin (5000 IU/mL) and 1 cc of blood sample were taken from the peripheral vein, then distributed in two syringes and given to the analyzer.ResultsIn the present study, the mean age of the samples was 49.96 ± 9.58. There was a statistically significant difference between the two groups in terms of values of partial pressure of carbon dioxide (PCO2) (P < 0.001), partial pressure of oxygen (PaO2) (P < 0.001), blood oxygen saturation (P < 0.001), bicarbonate ion (P < 0.001), excess base (P < 0.001), hemoglobin (P < 0.001), calcium (P < 0.001), potassium (P < 0.001), and sodium (P < 0.001) in the two groups.ConclusionOverall, heparin (1000 IU/mL) led to a less disruption in the results of venous blood gases, and since it has not significantly increased the risk of clots, it is recommended to be used for venous blood gas sampling.

Anti-proteinuria effect of active vitamin D in patients with type 2 diabetic nephropathy.

Proteinuria is a common complication in patients with type 2 diabetic nephropathy (DN). The aim of this study was to evaluate the anti-proteinuria effect of active vitamin D in patients with type 2 DN. A double-blind randomized clinical trial study was conducted on 42 DN patients selected by convenience sampling method. After selecting patients based on inclusion criteria, they were randomly divided into control and intervention groups. Patients in the intervention group received 0.25 mg of active vitamin D per day for 12 weeks. The variables evaluated in the patients on the first day of the intervention included fasting blood sugar (FBS), calcium, phosphorus, creatinine, glomerular filtration rate (GFR), systolic and diastolic blood pressure, and proteinuria. These variables were also evaluated at the end of the first, second, and third month of intervention. Data were collected and analyzed in Statistical Package for Social Sciences software version 22. Around 52.5% of the patients participating in this study were male and 47.5% were female. The mean age of the patients was 55.52 ± 6.58 years. The results of repeated measures analysis showed that active vitamin D significantly reduced proteinuria (P = 0.000) in patients in the intervention group. The changes in FBS (P = 0.235), calcium (P = 0.393), phosphorus (P = 0.694), creatinine (P = 0.232), GFR (P = 0.347), systolic blood pressure (P = 0.615), and diastolic blood pressure (P = 0.115) were not significant in patients in the intervention group. Prescription of active vitamin D can significantly reduce the incidence of proteinuria in patients with DN.

Comparison of Effect of Metformin Versus Combination of Folic Acid/Myo-inositol in Infertile Women with Poly Cystic Ovary Syndrome Undergoing In Vitro Fertilization: A Randomized Clinical Trial

Background: Previous studies have reported contradictory results regarding the effectiveness of metformin and myo-inositol on improving reproductive outcomes in patients with polycystic ovary syndrome (PCOS). Therefore, this study aimed to compare the effectiveness of these two drugs on improving reproductive outcomes of PCOS patients undergoing in vitro fertilization (IVF) treatment. Methods: This double-blind randomized clinical trial study was con­ducted on 140 infertile women with PCOS who were scheduled to undergo IVF in Yas Hospital, Tehran, Iran in 2020. The patients were randomly divided into two groups, including metformin and combination of myo-inositol and folic acid treatment groups. Reproductive outcomes were compared between the two groups. Results: The mean age of the patients was 30.66 ± 5.7 years (30.51 ± 5.88 in metformin treatment group and 30.9 ± 5.53 in myo-inositol group, P = 0.68). There was no significant difference between the two groups regarding the reproductive outcomes, including pregnancy rate, change in BMI, number and quality of oocytes, number and quality of embryos, follicle number, follicle size, ectopic pregnancy rate, and abortion rate (P &gt; 0.05). Conclusion: There is no significant difference in the effect of metformin and myo-inositol on improving reproductive outcomes. Therefore, due to the lack of significant differences in the effectiveness of these two drugs and considering their availability and cost, one of them can be prescribed for the patients.

Effects of sodium selenite and selenium-enriched yeast on cardiometabolic indices of patients with atherosclerosis: A double-blind randomized clinical trial study.

Introduction: Atherosclerosis and related cardiovascular diseases (CVDs) are the major causes of mortality worldwide. The available reports regarding the effects of selenium (Se) supplementation in the realm of atherosclerosis have been equivocal. The present investigation is aimed to assess the effects of sodium selenite and Se-enriched yeast supplementation on metabolic parameters among atherosclerotic patients. Methods: In this double-blind placebo-controlled randomized clinical trial, 60 patients diagnosed with atherosclerosis were randomly allocated into either 200 μg/day selenite, yeast, or placebo groups for eight consecutive weeks. Serum levels of lipid profile and glycemic indices were measured at the baseline and end of the intervention. Results: There were no significant within-or between-group changes in levels of total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-c), fasting blood sugar, insulin, and homeostatic model assessment for IR throughout the study (P ≥0.05). Only the low density lipoprotein cholesterol (LDL-c) levels were significantly lower in the yeast group in comparison with the placebo group (P = 0.015). Conclusion: The administration of Se-enriched yeast is significantly effective in decreasing LDL-c levels in patients with atherosclerosis. Additional clinical trial studies investigating the effect of Se administration on glucose homeostasis parameters and lipid profiles in atherosclerotic patients are suggested for a more definitive conclusion.

Comparison of the effectiveness of ondansetron versus metoclopramide in hyperemesis gravidarum: a randomized clinical trial

Objective: Nausea and vomiting are the most common complications and the first cause of hospitalization of pregnant women in the first trimester of pregnancy. Given the maternal and fetal complications as well as the negative psychosocial and economic effects of nausea and vomiting, the present study aimed to compare the antiemetic effects of ondansetron and metoclopramide.&#x0D; Methods: The present double-blind randomized clinical trial study was conducted on 153 pregnant women with a complaint of nausea and vomiting during pregnancy referred to the obstetrics and gynecology ward. Patients were randomly divided into two metoclopramide and ondansetron groups. The outcomes of interest were nausea and vomiting, the number of used doses of the drug, and the length of hospital stay. The Pregnancy-Unique Quantification of Emesis (PUQE) questionnaire was used to assess the severity of nausea and vomiting.&#x0D; Results: The mean age was significantly higher in the metoclopramide group (28.44±6.45 vs. 25.43±5.42 years, P=0.004). On day 3, the PUQE score was significantly higher in the ondansetron group (6.60±1.10 vs. 6.56±0.88, P&lt;0.001). The decrease in the severity of nausea and vomiting was significantly higher in the ondansetron group (5.29±1.35 vs. 4.90±1.17, P=0.05) in the second day compared to the first day. In the repeated measure analysis, significant differences were found between the two treatment groups (F=7.01, P=0.009). There was no significant difference between the two groups in terms of the length of hospital stay (P&gt;0.05).&#x0D; Conclusion: In this study, ondansetron revealed more efficacy than metoclopramide on the nausea and vomiting of pregnancy (NVP) management. Ondansetron may, therefore, be considered as a safe and effective alternative for metoclopramide in the treatment of NVP.

Enigmatic Neural Pathways: Potentiating Viral Neuroinvasion Into the CNS.

Enigmatic Neural Pathways: Potentiating Viral Neuroinvasion Into the CNS.

Evaluating a new verbal working memory-balance program: a double-blind, randomized controlled trial study on Iranian children with dyslexia

BackgroundIt is important to improve verbal Working Memory (WM) in reading disability, as it is a key factor in learning. There are commercial verbal WM training programs, which have some short-term effects only on the verbal WM capacity, not reading. However, because of some weaknesses in current verbal WM training programs, researchers suggested designing and developing newly structured programs that particularly target educational functions such as reading skills. In the current double-blind randomized clinical trial study, we designed a new Verbal Working Memory-Balance (VWM-B) program which was carried out using a portable robotic device. The short-term effects of the VWM-B program, on verbal WM capacity, reading skills, and postural control were investigated in Iranian children with developmental dyslexia.ResultsThe effectiveness of the VWM-B program was compared with the VWM-program as a traditional verbal WM training. In comparison with VWM-program, the participants who received training by the VWM-B program showed superior performance on verbal WM capacity, reading skills, and postural control after a short-term intervention.ConclusionsWe proposed that the automatized postural control resulting from VWM-B training had a positive impact on improving verbal WM capacity and reading ability. Based on the critical role of the cerebellum in automatizing skills, our findings support the cerebellar deficit theory in dyslexia.Trial registration: This trial was (retrospectively) registered on 8 February 2018 with the Iranian Registry of Clinical Trials (IRCT20171219037953N1).

Effect of the addition of Chitosan and TiO2 nanoparticles on antibacterial properties of an orthodontic composite in fixed orthodontic treatment: a randomized clinical trial study

Due to the existing demands for methods independent of patient co-operation in preventing and overcoming the incidence of white spot lesions (WSLs) and caries in fixed orthodontic treatments, several studies have considered the modification of orthodontic composites using antimicrobial nanomaterials. In this regard, the aim of this study is to investigate the effect of the addition of chitosan nanoparticles (NPs) and TiO2 NPs on Streptococcus mutans (S. mutans) counts and the enamel mineral content in fixed orthodontic patients. A double-blind randomized clinical trial study was carried out in 24 patients (i.e., 48 upper second premolars and 48 maxillary lateral incisors) who were candidates for fixed orthodontic treatment. In the case of the control group, the bracket was bonded to the tooth with an orthodontic adhesive (Transbond XT, 3M Unitek, USA) while, in the experimental group, the bracket was bonded to the tooth with Transbond XT containing 1% chitosan NPs and 1% TiO2 NPs. For the maxillary lateral incisor and upper second premolar teeth, the S. mutans counts around the brackets were measured, through the usage of real-time PCR, at the time points of 1 day, 2 months, and 6 months after bonding the brackets to the tooth. Furthermore, the enamel mineral content measurement was also performed around the brackets at 1 day, 2 months, and 6 months after bonding the brackets to the tooth. The S. mutans counts were analyzed using Friedman and Mann–Whitney U tests. The Repeated measures ANOVA test and Independent samples T-test were also applied, in order to evaluate the mineral content. According to the results, there was a significant reduction in the S. mutans counts of experimental group at the time points of 1 day, 2 months, and 6 months in both maxillary lateral incisor and upper second premolar teeth. However, we did not observe any significant differences in the control group between the reports at 1 day, 2 months, and 6 months in both maxillary lateral incisor and upper second premolar teeth. The outcomes of this study indicate that, with regard to maxillary lateral incisor teeth, there were no significant differences between the results of the experimental group and control group at the time points of 1 day, 2 months, and 6 months. Furthermore, with respect to the upper second premolar teeth, no significant differences were observed between the two groups at 1 day and 2 months; however, S. mutans counts were significantly lower in the experimental group than in the control group at the time point of 6 months. Moreover, our gathered data confirmed the absence of any significant differences between the experimental group and control group, in terms of enamel mineral content, at the time intervals of 1 day, 2 months, and 6 months. In conclusion, the incorporation of chitosan NPs and TiO2 NPs in orthodontic composites induces an antibacterial property in the resultant adhesive to be used for fixed orthodontic treatment.

Ketamine Sub-Dissociative Dose Vs. Morphine Sulfate for Acute Pain Control in Patients with Isolated Limb Injuries in the Emergency Department: A Randomized, Double-blind, Clinical Trial.

Objective:To compare the ketamine efficacy at a sub-dissociative morphine dose to reduce pain in isolated limb traumatic injuries.Methods:A double-blind randomized clinical trial study was carried out on patients referred to emergency departments (EDs) due to isolated limb traumatic injuries. Eligible patients were divided into two groups which one group received 0.1 mg/kg ketamine and the other group received 0.05 mg/kg morphine, intravenously. An observed side effect includes pain scores and vital signs were recorded at baseline of every 5 minutes for 30 minutes.Results:Totally, 73 patients with the mean age of 32.9±10.4 were enrolled of whom 59 (80.8%) individuals were men. The baseline characteristics difference of the two study groups was not statistically significant. The results showed that the change of mean pain score was -6.2 (95% CI: -5.72 to -6.69) points in the group receiving ketamine compared to -5.8 (95%CI: -5.15 to – 6.48) in the group who were administered morphine. At all assessed checkpoints, the pain mean score was lower in the ketamine group than in the morphine group (p<0.05); the mean of total pain reduction was greater in the ketamine group during the observation period compared with patients who received morphine (p=0.002).Conclusion: The study findings suggest that the sub-dissociative ketamine efficacy in controlling of the acute pain is not lower than morphine sulfate in patients with isolated limb trauma in ED’s. Thus, it can be considered as a safe and effective alternative approach.

Early maternal complications of cesarean section in two technique of Closure and non-closure of parietal peritoneum: a double blind randomized clinical trial

Introduction: Cesarean section is performed with two technique of closure or non-closure of the peritoneum, but there is disagreement about the advantages and disadvantages of these techniques. Accordingly, this study was performed with aim to compare the early maternal complications of cesarean section in two technique of closure or non-closure of the parietal peritoneum. Methods: This double-blind randomized clinical trial study was performed on 120 patients undergoing cesarean section at Hamadan Fatimah Hospital in 2019. Samples were randomly divided into two groups: closure of the peritoneum (n=60) and non-closure of the peritoneum (n=60). The maternal complications during and after surgery were recorded. Data were analyzed by SPSS software (version 21) and Chi-square, independent t-test and repeated measures. Results: The results showed that operative time and bleeding during surgery were significantly fewer in patients receiving non-closure technique (p 0.05). Conclusion: The complications such as bleeding during surgery, the duration of surgery, ileus after surgery, pain, and consumption of analgesic will occurs with less intensity in patients receiving non-closure technique than patients with closure technique; however, these two methods were not different in terms of surgical wound infection.

Comparison of horse and cow milk on sleep disorders in children with attention deficit hyperactivity disorder: a double-blind randomized clinical trial study

Comparison of horse and cow milk on sleep disorders in children with attention deficit hyperactivity disorder: a double-blind randomized clinical trial study

Effects of administration of dexmedetomidine with intrathecal bupivacaine on analgesia after femoral and tibia orthopedic surgery: A double-blind randomized clinical trial study

Effects of administration of dexmedetomidine with intrathecal bupivacaine on analgesia after femoral and tibia orthopedic surgery: A double-blind randomized clinical trial study

The effect of melatonin on reduction in the need for sedative agents and duration of mechanical ventilation in traumatic intracranial hemorrhage patients: a randomized controlled trial.

PurposeThis study aimed to determine the effect of exogenous melatonin on the number of sedative drugs and the duration of mechanical ventilation in traumatic intracranial hemorrhage patients in ICU.MethodsThis double-blind randomized clinical trial study was conducted in the ICU wards of Golestan Hospital, Ahvaz, Iran, from September 2017 to March 2018. In this study, 52 patients with intracerebral hemorrhage were selected by convenient sampling (26 patients in each group) and were randomly assigned to two groups of melatonin and control. Sedation and pain management package was applied to both groups. Outcomes: Amount of the sedative and opioid drug; mechanical ventilation time; ICU staying time; Glasgow Coma Score; hemodynamic parameters.ResultsThere was no significant difference between them in terms of demographic characteristics. Cumulative doses of morphine and mechanical ventilation time were significant in two groups. (P < 0.05) The mean length of ICU staying was not significant. Glasgow Coma Score on the 6th day was significant in two groups (P < 0.05). Diastolic blood pressure was significant between groups (P < 0.001).ConclusionThis study presented that morphine consumption and mechanical ventilation time were significantly lower in the melatonin group than in the control. Also, rise in GCS in the melatonin group was faster in the melatonin group than in the control. The use of melatonin can be recommended for patients with ICH in the ICU for better outcomes.

Effects of Topical Sesame Oil Extracted from Tahini (Ardeh) on Pain Severity in Trauma Patients: A Randomized Double-Blinded Placebo-Controlled Clinical Trial.

Objective:To investigate the effects of sesame oil extracted from tahini (Ardeh) on pain severity in patients with upper or lower limbs trauma. Methods:This double-blinded randomized clinical trial study was conducted on 120 patients with upper or lower trauma in Shahid Rajaee Hospital, Shiraz, Iran, from May the 1st through November 30th, 2016. The patients were randomly assigned to two groups using block randomization. The intervention group received topical sesame oil extracted from tahini (Ardeh) and the placebo group received cooking oil. Pain severity, pain sensitivity and heaviness of painful site were assessed. Results:Overall, we included 90 patients with traumatic limb injuries in this study who were randomized to two study groups. The mean age of the patients was 28.3 ± 6.8 (ranging from 25 to 35) years and there were 63 (70%) men and 27 (30%) women among the patients. In the sesame oil group, the mean changes in the pain severity (-1.53 ± 0.57, P<0.001), pain sensitivity (-1.45 ± 0.64, P<0.001) and heaviness of painful site (-1.56 ± 0.68, P<0.001) were significantly lower when compared to the placebo group in the second day of the intervention. None of the patients experience adverse drug effects. Conclusion:Our findings suggest that the topical use of sesame oil extracted from Tahini has a pain reliever effect on the skin after bruising and it helps prevent skin discoloration in patients with traumatic injuries of limbs.

The effect of Achillea Millefolium L. on vulvovaginal candidiasis compared with clotrimazole: A randomized controlled trial

IntroductionVulvovaginal candidiasis is the second most common cause of vulvovaginal infections. The aim of this study is to evaluate the effectiveness of vaginal cream of Achillea millefolium extract in women with vulvovaginal candidiasis in comparison with vaginal clotrimazole. Materials and methodsThis double-blind randomized clinical trial study was conducted on 80 women diagnosed with vulvovaginal candidiasis clinically and by laboratory test; 40 women received vaginal cream clotrimazole 1 % and 40 received vaginal cream containing the aqueous extract of A. millefolium for 7 days. Clinical and laboratory assessments were performed before and after the intervention. Minimum inhibitory concentration of the extract was evaluated with Broth micro-dilution procedure. ResultsThe Dermatology life quality index score showed significant reduction in both groups after treatment, but it was significantly more reduced in control group (p < 0.05). Improvement in vulvar erythema was observed in both groups with no statistically difference (p = 0.1). Vaginal culture was negative in term of Candida in 28(77 %) patients of control group and in 18(53 %) patient of experimental group (p < 0.05). The Minimum inhibitory concentration of the extract was 37.5 mg/mL for the standard strain. Discussion and conclusionStudy results showed that vaginal cream containing A. millefolium could reduce the complaints of vulvovaginal candidiasis. But, future studies with a larger sample size and different dosages are recommended to assess the outcomes of this new treatment.

Effect of Nigella sativa oil supplement on risk factors for cardiovascular diseases in patients with type 2 diabetes mellitus.

This study aimed to evaluate the effects of Nigella sativa oil on serum level of systemic inflammation, oxidative stress, fasting blood glucose (FBG), and lipid profile in patients with type 2 diabetes mellitus (T2DM). This double-blind randomized clinical trial study was based on 50 patients with T2DM. Patients were allocated randomly to either N. sativa oil or placebo groups. The intervention group received 1,000 mg N. sativa oil as two capsules, daily for 8 weeks, whereas the placebo group received a corresponding placebo. At baseline and the end of the study, 5 ml blood was collected from each patient after 14-hour fasting for measuring serum C-reactive protein (hs-CRP), malondialdehyde (MDA), FBS, and lipid profile. Analyses covariance was performed to compare investigated parameters between two groups, controlled for relevant covariates. Using N. sativa supplement was significantly associated with decrease in FBS (p < .001), triglyceride (p < .001), total cholesterol (p < .001), low-density lipoprotein cholesterol (p < .001), serum hs-CRP, MDA (p < .001) and increase in serum level of high-density lipoprotein cholesterol (p < .001) in intervention group compared with placebo group. Nigella sativa oil supplement has cardiovascular protective effects in patients with T2DM, by improving the lipid profile and glycemia, by reducing the C-reactive protein level and the lipid peroxidation.

تأثیر رایحه‌درمانی با مریم‌گلی بر کیفیت خواب زنان یائسه

Introduction: One of the most common problems in menopausal women is sleep disturbance that can lead to reduced quality of life. Therefore this study was performed with aim to investigate the effect of Salvia officinalisaroma on sleep quality of postmenopausal women. Methods: This double-blind randomized clinical trial study was performed on 60 postmenopausal women referred to Kermanshah health centers in 2019. The subjects were randomly assigned into two groups of intervention and control (n=30 in each group). The subjects in the intervention group, for 3 consecutive nights in a week, for one month, 2 drops of essential oil of salvia that existed in a dropper poured on a cotton ball in the form of a neck pendant, and inhaled before sleep and removed from the neck after awakening. The control group also used placebo in the same way. Before and after the intervention, Pittsburgh Sleep Quality Index (PSQI) was completed by both groups. Data were analyzed by SPSS software (version 20) and Chi-square, Kolmogorov Smirnov, independent t, Wilcoxon and Mann-Whitney tests. PResults: The mean score of sleep quality before the intervention was similar in both groups (p = 0.191). But after the intervention, the mean score of sleep quality in aromatherapy group (3 ± 1.57) was significantly decreased compared with control group (7.13± 1.33) (p <0.001) and aromatherapy led to the improvement of sleep quality in the intervention group. Conclusion: Aromatherapy using salvia officinalishas a significant effect on improving sleep quality in postmenopausal women. Therefore, given that postmenopausal women have sleep disorder, it is suggested that this method be used as a useful method for improving sleep quality and health promotion.

Comparing the effects of ketorolac and Paracetamol on postoperative pain relief after coronary artery bypass graft surgery. A randomized clinical trial

IntroductionPain management after coronary artery bypass graft (CABG) surgery remains challenging.ObjectiveThis study aimed to compare the effects of Ketorolac and Paracetamol on postoperative CABG pain relief.MethodThis double-blind randomized clinical trial study was conducted in Ahvaz, Iran, from September 2018–December 2019. Two consecutive groups of 60 patients undergoing elective on-pump coronary artery bypass graft surgery.InterventionThe patients were divided into 0.5 mg/kg of ketorolac mg/dl and 10 mg/kg of Paracetamol after surgery for pain management. Primary outcomes were: visual analog pain scale (VAS) at the time point immediately after extubation (baseline) and at 6, 12, 24 and 48 h and the total dose of morphine consumption. Secondary outcomes included the hemodynamic variables, weaning time, chest tube derange, in-hospital mortality and myocardial infarction.Statistical analysis: The data were analyzed using SPSS version 22(SPSS, Chicago, IL). The Mann-Whitney U-test was used to compare demographic data, VAS scores, vital signs, and side effects. Repeated measurements were tested within groups using Friedman’s ANOVA and the Wilcoxon rank-sum test. Values were expressed as means ± standard deviations. Statistical significance was defined as a p-value < 0.05.ResultsCompared with baseline scores, there were significant declines in VAS scores in both groups throughout the time sequence (P< 0.05). The statistical VAS score was slightly higher in the Paracetamol group at most time points, except for the time of 6 h. However, at 24 and 48 h, the VAS score in group Paracetamol was significantly higher than in group Ketorolac. There were no significant differences between groups about hemodynamic variables.ConclusionThe efficacy of ketorolac is comparable to that of Paracetamol in postoperative CABG pain relief.Trial registryIRCT20150216021098N5. Registered at 2019-09-12.