Single-blind Clinical Trial Study Research Articles

Adjunctive silymarin supplementation and its effects on disease severity, oxidative stress, and inflammation in patients with Alzheimer’s disease

ABSTRACT Background Brain tissue in Alzheimer's patients is exposed to oxidative stress. Silymarin is an adjunct drug that has anti-inflammatory and antioxidant properties. Objective This study aimed to evaluate the effect of silymarin on biomarkers of oxidative stress, inflammation, and disease severity in Alzheimer's patients. Methods This randomized, single-blind clinical trial study was performed on 33 patients with Alzheimer's disease (AD) whose disease was confirmed by DSM-5 criteria and by brain imaging. Patients in the case group received three 250 mg silymarin capsules daily (each containing 150 mg silymarin), as an adjunctive medication in addition to the routine medication regimen. In the placebo group (control), patients received the same amount of placebo. All patients underwent Mini Mental State Exam (MMSE) and a panel of blood tests including malondialdehyde, neopterin, catalase, paraoxonase-1, total oxidative status, and total antioxidant capacity to reevaluate the changes pre/postintervention at the end of the trimester. Results The catalase and MDA serum levels after the adjunctive silymarin treatment decreased significantly (Catalasebefore silymarin = 9.29 ± 7.02 vs Catalaseafter silymarin = 5.32 ± 2.97, p = 0.007 and MDAbefore silymarin = 4.29 ± 1.90 vs MDAafter silymarin = 1.66 ± 0.84, p < 0.001) while MMSE increased notably (MMSEbefore silymarin = 10.39 ± 6.42 vs MMSEafter silymarin = 13.37 ± 6.81, p < 0.001). Conclusion Silymarin can be effective as an adjunct drug and a powerful antioxidant in reducing oxidative stress and improving the course of AD.

Comparison of Standard and Lateral Methods of Laryngeal Mask Airway Insertion in the Management of Pediatrics Airway

Background: The Laryngeal Mask Airway (LMA) has traditionally become an alternative device for airway management. This clinical trial compared two standard and lateral techniques in inserting laryngeal masks in pediatric airway management.&#x0D; Methods: This single-blind clinical trial study was conducted on pediatrics aged 2-6 years who were candidates for elective inguinal herniorrhaphy with ASA I and II under general anesthesia. The pediatrics were randomly assigned to either the standard or lateral methods according to the random number table. The time required to insert LMA and airway pressure as well as the number of attempts to insert in both groups were measured. Data analysis was performed using SPSS version 25; the significance level was less than 0.05.&#x0D; Results: Chest movement and mean airway pressure had no significant difference in both groups (p&gt;0.05). The mean LMA insertion time in the lateral and standard methods was 22.94±7.89 and 65±15.27 seconds, respectively (p=0.001). There was no case of mucosal damage in the lateral method, but ten children had mucosal damage in the standard technique (p=0.001). In the lateral method, LMA was inserted for the first time in 32 pediatrics (94.1%) and two pediatrics (5.9%) in the second time but in the standard group, LMA was inserted in the second time in 11 pediatrics (32.4%) (p=0.006).&#x0D; Conclusion: The lateral method for inserting LMA is practically easy, requires less effort, and has the least complications. Another advantage of the lateral method compared to the standard technique is that inserting a finger into the pharyngeal cavity is unnecessary.

The effectiveness of home modifications on the risk of falling in older adults with dementia: A randomized clinical trial

Introduction: This study aimed to investigate the effectiveness of modifying the home environment on falls in older adults with dementia. Methods: In this single-blind clinical trial study, 44 older adult patients with dementia who met the inclusion criteria, were included in the study and then randomly assigned to intervention ( n = 22) and control ( n = 22) groups using a balanced block randomization method. The intervention group received home modifications, while the control group did not receive any modifications. After intervention, The HOME Fall and Accident Screening Tool was used to assess falls. The ethics committee of Tehran University of Medical Sciences approved the study procedure (IR.TUMS.FNM.REC.1399.163) and this study was registered in the Iranian Registry of Clinical Trials with the code: IRCT20210106049950N1. Results: Comparing the mean fall risk scores between the two groups at the beginning of the study showed no significant difference in the risk of falling ( p = 0.6). By contrast, at the end of the study, this difference became significant between groups ( p &lt; 0.001). This comparison in the control group at the beginning and end of the study indicated no significant difference ( p = 0.32). However, it was significant in the intervention group at the beginning of the study and after modifications ( p &lt; 0.001). Conclusion: Modifications by applying changes and reforms to the home environment reduced the risk of falling in older adults with dementia.

Comparison of the Effect of Aloe vera and Warm Compresses on Pain Due to Phlebitis in Hospitalized Children

Background: Phlebitis and pain are among intravenous injection's most common side effects. Different pharmacological and non-pharmacological techniques have been used to treat phlebitis. Aloe vera gel and warm compress are non-pharmacological nursing methods for phlebitis. Objectives: The present study compares the effect of Aloe vera and warm compress on pain due to phlebitis in children admitted to pediatric wards. Methods: This single-blind clinical trial study was conducted on 90 children with phlebitis. The participants were selected using convenience sampling and randomly assigned to three control, Aloe vera compress intervention, and warm compress intervention groups. The data in this study were collected using the patient demographic information questionnaire and Wong-Baker Faces Pain Rating Scale. The pain scores were evaluated in all three groups before the intervention. The intervention for the children in the warm compress group was a warm compress for 20 minutes twice daily (once every 12 hours). The intervention for the Aloe vera compress group was 5 cc of Aloe vera gel applied twice daily (once every 12 hours) for three days. Pain intensity was recorded and assessed in the pre-intervention stage for the children in all three groups. It was also measured for the warm compress group half an hour after the intervention and for the Aloe vera group at the beginning of the intervention. Pain intensity was also measured and evaluated for the children in the control group. Data analysis was performed with SPSS-22 software at a significance level of less than 0.05 (P &lt; 0.05) using the chi-square test, independent samples t-test, one-way analysis of variance (ANOVA), and Fisher’s exact test. Results: The ANOVA results showed that there was no statistically significant difference between the three groups (P &gt; 0.05) in the average pain intensity scores before the intervention and the first day after the intervention, but the average pain intensity scores in the three groups on the second day (P = 0.04) and the third day (P = 0.002) showed a statistically significant difference after the intervention. On the third day, the difference in the pain intensity scores was significant between the two intervention groups (P = 0.03) and the control group. Moreover, the pain intensity score for the children in the Aloe vera group decreased more significantly compared to the warm compress group (P = 0.001). Conclusions: The results showed that applying both Aloe vera and warm compresses effectively reduced the pain induced by phlebitis, but Aloe vera reduced the pain caused by phlebitis more than warm compress. Thus, the Aloe vera compress can be used as an easy and simple method to reduce the pain caused by phlebitis.

Effects of physical activity by the teach-back educational method on the physical ability and quality of life in hemodialysis patients: a clinical trial†

Abstract Objective To determine the effect of physical activity by using the teach-back educational method on hemodialysis patients’ quality of life (QOL) and physical ability. Methods This is a single-blind clinical trial study involving a control group. A total of 90 patients who admitted to the dialysis centers of Beheshti and Besat hospitals in Hamadan were selected using a convenience sampling method and were randomly assigned to intervention (n = 45) and control (n = 45) groups. Data were collected using a demographic information checklist, a kidney disease QOL questionnaire, and a 6-minute-walk distance (6MWD) checklist. The patients’ QOL questionnaire was completed, and the 6MWD was recorded before and at the end of the 2nd, 4th, 6th, 8th, and 12th weeks of the intervention. In the intervention group, the patients were taught to perform physical activities with Pilates stretches in different resistances using the teach-back educational method during dialysis sessions for 12 weeks. Data were analyzed by using the independent t-test and chi-square test using SPSS-22 software. Results Before the intervention, no differences were observed between the experimental and control groups in terms of demographic characteristics, QOL, and physical ability (P &gt; 0.05). The physical ability and QOL levels of patients exercising in the test group were higher than those in the control group after the intervention (P &lt; 0.05). Based on the results, the 2 groups significantly differed with regard to the scores of various dimensions of QOL and physical ability after the intervention (P &lt; 0.05). Conclusions Physical activity by using the teach-back method can effectively increase physical ability and improve QOL of hemodialysis patients. Therefore, the recommendations and inclusion of exercise in the dialysis care plan can effectively promote patients’ health.

Evaluating the Effectiveness of Ibuprofen from 2 Different Brands in Patent Ductus Arteriosus Closure in Preterm Neonates

Background: Patent ductus arteriosus (PDA) is a common condition in premature babies, with a prevalence rate of 30 - 60%, and often requires medical or surgical intervention. Objectives: This study aimed to assess the effectiveness of 2 different brands of ibuprofen in PDA closure in preterm infants weighing less than 1500 g. Methods: This single-blind clinical trial study was performed on 75 premature neonates with PDA in the pediatric ward of Vali-Asr Hospital in Birjand from March 2014 to March 2019. Patients were treated with two brands of ibuprofen at doses of 10 mg/kg for the first day and 5 mg/kg for the second and third days (24 and 48 hours afterward). Before and three days after the last dose, the children were examined by pediatric cardiologist echocardiography. The data were input into SPSS version 23 and analyzed using descriptive statistics, such as mean and SD. Inferential statistics, such as the chi-square test, were also employed with a significance level of P-value &lt; 0.05. Results: There was a significant difference between the rate of PDA closure, 78.8% in the Pedea group vs. 54.8% in the Ibuprofen group (P = 0.03). In the Ibuprofen group, there was no difference in drug efficacy in PDA closure between male and female neonates (P = 0.663). Also, in the Pedea group, there was a significant difference in terms of efficacy between male and female neonates (P = 0.049). No significant difference was observed in PDA closure between the two medications based on their sizes (P = 0.616 in small size, P = 0.266 in medium size, and P = 0.175 in large size). Conclusions: Pedea is more effective than Ibuprofen. It reduces complications and the need for surgery. However, there was no significant relationship between the two drugs based on the PDA sizes. Therefore, it seems logical to use the Iranian brand of ibuprofen, considering the benefits equal to the foreign one.

Clinical Effectiveness of Ultrasound-Guided Biolaser Versus Ozone Therapy in Reducing Chronic Pain in Knee Osteoarthritis: A Three-Month Follow-Up Study

Background: Biolaser is an emerging technology, which has attracted the attention of many surgeons and specialists in different medical fields. Objectives: This study aimed to evaluate the clinical effectiveness of ultrasound-guided biolaser radiation versus ozone therapy in reducing chronic pain in patients with knee osteoarthritis during a three-month follow-up. Patients and Methods: Sixty patients referring to pain clinic of Shohadaye-Tajrish and Akhtar hospitals in 2017, were included in this randomized single-blind clinical trial study. According to a randomized table of numbers, in Biolaser group (n = 30): 10 mL of normal saline + 5 mL of lidocaine 1% + BioLaser + Physical Therapy and in the Ozone group (n = 30), received 10 mL Ozone (30 mic/mL) plus 5 mL lidocaine 1% + BioLaser placebo + Physical Therapy received. The patients were evaluated for pain using visual analog scale (VAS) and knee function with Knee injury and Osteoarthritis Outcome Score (KOOS) questioner. The patients were followed up 4 &amp; 12 weeks and reviewed at weeks 12 after the injection by an observer who was unaware of the groups (IRCT20111121008146N15). Results: Comparison of the mean age (56.8 ± 8.5 years in the biolaser group vs. 51.5 ± 5.4 years in the ozone therapy group; P = 0.721) and body mass index (31.1 ± 3.4 kg/m2 in the biolaser group vs. 30.5 ± 2.6 kg/m2 in the ozone therapy group; P = 0.214) did not indicate any significant differences between the two groups. The pain severity decreased significantly at different times in the biolaser and ozone therapy groups (P = 0.018). The knee pressure sensitivity score was 1.3 ± 0.5 in the biolaser group and 1.6 ± 0.4 in the ozone therapy group at 12 weeks post-treatment (P = 0.037). The knee circumference was also 35.6 ± 3.0 cm in the biolaser group and 39.7 ± 3.9 cm in the ozone therapy group at 12 weeks post-treatment (P = 0.032). The KOOS performance score was 46.9 ± 9.4 in the biolaser group and 49.3 ± 7.9 in the ozone therapy group (P = 0.187). Besides, the KOOS quality of life score was 10 ± 1.3 in the biolaser group and 10.4 ± 1.5 in the ozone therapy group (P = 0.586). Conclusion: Biolaser therapy under ultrasound guidance was found to be a safe, non-invasive, and effective method, which could improve chronic pain in knee osteoarthritis during a three-month follow-up.

Educational Facial Emotion Recognition in Children With Autism Spectrum Disorder: A Clinical Trial Study

Objectives: The disability to recognize facial emotions is one of the behavioral problems in autistic children. This study was designed to evaluate the effect of education on the promotion of face recognition. Methods: This single-blind clinical trial study was conducted on children with autism. The participants were allocated with random sampling to the two groups. Autistic children in the intervention group were educated in 10 sessions with 40 facial emotions images, each session lasted 20 min. Autistic children in the control group underwent routine teaching. The assistant researcher completed the Benton questionnaire for each child before and after the study. The obtained data were analyzed with SPSS software, version 22. Results: This study showed that education on facial emotions has good effects on the recognition of facial expressions by children with autism. In addition, a significant difference is identified between the two study groups in identifying facial emotions (P&lt;0.001). Discussion: Education to children with autism improved facial emotion identification. Therefore, according to the increase in children with autism all over the world such as in Iran, it seems that caregivers and health managers should review and use our study results for providing a supportive environment to promote recognition emotional states of the face and ultimately to improve the child’s treatment.

Evaluation of Episiotomy Characteristics of EPISCISSORS-60 Scissors Compared with Mayo Scissors: A Single-Blind Randomized Clinical Trial.

It seems that angled scissors may be able to minimize the occurrence of obstetric anal sphincter injuries (OASIS) during vaginal delivery by correcting the angle of the episiotomy incision.For this purpose, this study aimed to evaluate the episiotomy characteristics of EPISCISSORS-60 scissors compared with Mayo scissors. In this single-blind clinical trial study, 64 pregnant women candidates for natural childbirth were included; 32 women underwent episiotomy with Mayo scissors and 32 underwent episiotomy with the EPISCISSORS-60 instrument. Then, post-suturing angle, incision length, episiotomy, postpartum pain, bleeding volume, and the incidence of OASIS and dyspareunia were assessed. The collected data were analyzed by independent sample t test, chi-square test, and the Fisher exact test. Episiotomy incision length in the EPISCISSORS-60 group with a mean of 4.75 ± 0.72 cm was significantly longer than the Mayo group with a mean of 3.91 ± 0.52cm (P < 0.001). In addition, the incidence of dyspareunia was not significantly different between the 2 groups (6.3% vs 15.6%; P = 0.426). Sphincter damage did not occur at all in the EPISCISSORS-60 group and only 2 cases of grade 3 sphincter rupture occurred in the Mayo group (P = 0.238). The mean of post suturing angle in the EPISCISSORS-60 group (59.09° ± 3.47°) was significantly higher than the Mayo group, with a mean of 31.06° ± 7.21° (P < 0.001). According to the results of the present study, the use of EPISCISSORS-60 can be associated with a higher post-suture episiotomy angle compared with Mayo scissors. As a result, both the incidence of OASIS and its long-term side effects, like dyspareunia, were decreased. However, in our study, the incidence of these complications was very rare and not different between the 2 groups.

Evaluation of the Effect of Carvedilol in Preventing Right Ventricular Dysfunction in Breast Cancer Patients Receiving Anthracycline.

Today, it has been shown that it is possible for right ventricular (RV) wall motion abnormalities or RV functional disorders to occur during cancer treatment. Now, considering the effect of carvedilol on beta 1, 2, and alpha receptors and its antioxidant properties, it seems that it can prevent RV abnormalities. Therefore, the aim of this study was to investigate the possible protective effects of carvedilol in preventing RV dysfunction in patients with breast cancer treated with anthracyclines. The present single-blind clinical trial study was performed on 23 patients with breast cancer that 12 of them received only the anthracycline antineoplastic doxorubicin (Adriamycin®) chemotherapy (control group) and 11 patients received carvedilol in addition to anthracycline. To evaluate the effect of carvedilol, patients underwent transthoracic echocardiography before intervention and 2 weeks after the end of treatment with anthracyclines. The two parameters of RV ejection fraction and RV fractional area change in the carvedilol group with a mean of 66.41% ± 8.10% and 51.85% ± 6.89% were slightly higher than the control group with a mean of 64.58% ± 6.83% and 50.48 ± 5.79%, respectively, which was not statistically significant (P > 0.05). In contrast, RV S wave tissue Doppler imaging (S-TDI) in the control group with a mean of 0.13 ± 0.02 m/s was significantly lower than the carvedilol group with a mean of 0.14 ± 0.02 m/s (P = 0.022). According to the results of the present study, the effect of using carvedilol as a preservative on improving RV function was seen compared to the control group, although this difference was not statistically significant.

The effect of Nutrition Bio-shield superfood (NBS) on disease severity and laboratory biomarkers in patients with COVID-19: A randomized clinical trial

BackgroundNutrition Bio-shield Superfood (NBS) is an organic and viable herbal supplement that could improve the function of the immune system. The present study aims to determine the effect of NBS on disease severity and laboratory biomarkers in patients with COVID-19. MethodsThis current study was a randomized, comparative, parallel two-arm and single-blind clinical trial study performed in Tehran, Iran. In total, 70 patients with COVID-19 were included in the present study and assigned to two groups including 1) intervention group (n = 35) and 2) control group (n = 35). All patients included in the intervention group received 4.5 gr daily rate of NBS superfood, three times the daily rate of 1.5 gr for 14 days. In contrast, patients included in the control group received a placebo three times a day for 14 days. The measurement of laboratory parameters including CRP, ESR, D-Dimer, LDH, CPK, SGOT, SGPT, ALP, FBG, WBC count, PLT, and lymphocyte count was performed using standard kits and methods. Moreover, all serum samples were tested to determine the levels of IL-6 and TNF-ɑ using specific commercially available ELISA kits according to the instructions of the manufacturer. ResultsA significant decrease in the mean serum level of several variables including CRP (p < 0.001), ESR (p < 0.001), D- Dimer (p = 0.001), LDH (p < 0.001), SGOT (p = 0.002), SGPT (p = 0.019), ALP (p < 0.001), WBC count (p < 0.001), body temperature (p = 0.013), IL-6 (p < 0.001), and TNF-α (p < 0.001) was seen 14 days after intervention from baseline in the intervention group than control group. In contrast, in the intervention group, the significant increase from baseline of lymphocyte percentage (p < 0.001) and oxygen saturation (p < 0.001) was seen 14 days after receiving NBS superfood than the control group. ConclusionResults showed that the use of NBS superfood had various beneficial effects on COVID-19 disease severity. These results suggest that NBS superfood can be used as an effective natural supplement in the treatment process of COVID-19 disease.

Comparison of the effects of Date Syrup with Saffron-Honey Syrup on the Progress of Labor in Nulliparous Women: A Single Blind Randomized Clinical Trial.

Background:Assessing the progress of labor is a primary step in intrapartum care. This study was performed to assess comparison of the effects of date syrup with saffron–honey syrup on the progress of labor in nulliparous women.Materials and Methods:A randomized single-blind clinical trial study was conducted on 189 women who were referred to Bea'sat Hospital of Sanandaj from October 2019 to March 2020. Patients were randomly divided into three groups saffron–honey syrup, date syrup, and placebo syrup each including 63 cases. Each participant in the intervention and control groups received a maximum volume of 150 ml of saffron–honey syrup, date syrup, or placebo syrup. The syrups were given at the 4 cm dilation, and every 30–60 min until the end of the active phase of the first stage of labor. Data collection tools included a two-part questionnaire and a partograph form. The results were analyzed by Statistical Package for the Social Sciences (SPSS) 24 using Chi-squared test, analysis of variance, and last significant difference as a post hoc test, the significance level was set at 0.05.Results:The duration of the active phases of the first (F2 = 92.70, p < 0.01), second (F2 = 66.76, p < 0.01), and third (F2 = 12.34, p < 0.01) stages of labor was shorter in the date syrup and saffron–honey syrup groups than in the control group (p < 0.01). Additionally, both experimental groups exhibited no significant difference in terms of duration between the first (p = 0.312), second (p = 0.724), and third (p = 0.911) stages of labor.Conclusions:Date syrup and saffron–honey syrup can be used as one of the safe and available herbal methods to facilitate labor.

The Effect of Rectal Suppository of Anethum graveolens on the Postpartum Hemorrhage Rate: Evidence from a Single-Blind Clinical Trial Study

Background: Postpartum hemorrhage (PPH) is a leading cause of mortality and morbidity worldwide. Anethum graveolens (dill) is one of the recommended herbs to reduce bleeding. Objectives: This study aimed to evaluate the efficacy of rectal suppository of Anethum graveolens on the postpartum hemorrhage (PPH). Methods: Following a randomized clinical design, 70 eligible pregnant women admitted for vaginal delivery to Umm-al-Banin Hospital in Mashhad (Iran) in 2018 were recruited in this trial. Subjects were selected by available method and randomly assigned into two groups of intervention and control. Both groups, immediately after the delivery, received routine hospital interventions. Instantly after the expulsion of the placenta, the intervention group received the first dose of rectal suppository and the subsequent doses up to five doses at intervals of 30 min. PPH was measured by weighing the blood bags and pads for 4h after labor. Data were collected using a sample selection checklist, demographic and pregnancy information forms, birth, infant, and placenta information forms, and partograph sheets. Data were analyzed by SPSS version 22 using an independent t-test or the Mann-Whitney test. Results: The two groups were homogeneous in terms of mediating variables. The mean bleeding rate at the end of the first fourth after delivery was 306.2 ± 11.2 cc in the control group and 282.4 ± 9.6 cc in the intervention group. Therefore, there was a statistically significant difference concerning post-delivery bleeding between the two groups (P = 0.001). Conclusions: Based on the findings, the rectal suppository of Anethum graveolens could effectively reduce the PPH without any adverse effects. Therefore, this efficient herbal approach is suggested to overcome the PPH.

The Effect Of Silver-Coated Endotracheal Tube On The Incidence Of Ventilator-Induced Pneumonia In Intubated Patients Admitted To The Intensive Care Unit (ICU)

Background and Aim: Ventilator-associated pneumonia (VAP) is one of the main problems of intubated patients in the intensive care unit. the antibacterial endotracheal tube ara capable of reducing VAP via stopping bacterial colonization and biofilm formation. Therefore, in this study, the effects of silver-coated endotracheal tube on the incidence of VAP were investigated. Materials and Methods: In a single-blind clinical trial study, 108 patients in need of intubation were selected and divided into two intervention groups (antibacterial endotracheal tube) and control (standard non-coated endotracheal tube). Demographic information, secretion volume and shape, leukocytosis, decreased oxygen saturation, fever were recorded for all patients and compared in the two intervention groups. Results: The mean age (±SEM) in the intervention and control groups was 42.93 (±1.42) and 47.86 (±2.08) years, respectively. Furthermore, the incidence of VAP in the intervention and control groups was 5 (±1.8) and 8.5 (±2.1) days, respectively. Patients receiving a antibacterial endotracheal tube had a significantly reduction in the volume of secretions (P = 0.0027), incidence of purulent secretions (P = 0.04), fever (P = 0.019), leukocytosis (P = 0.0006), culture positive (P = 0.0001), and the onset of VAP symptoms (P = 0.001). The incidence of VAP in the intervention and control groups was 18% and 26%, respectively, and the antibacterial endotracheal tube significantly reduced the incidence of VAP (P = 0.0003). Conclusion: Silver-coated endotracheal tube?? has a more effective role in improving the prognosis of intubated patients admitted to the ICU when comparing with standard non-coated endotracheal tube.

Cold Therapy and Respiratory Relaxation Exercise on Pain and Anxiety Related to Chest Tube Removal: A Clinical Trial.

Background:Current strategies to control pain and anxiety of chest tube removal are not efficacious. The aim of this study is to determine the effects of cold therapy and respiratory relaxation exercise on pain and anxiety of chest tube removal.Materials and Methods:A parallel single-blind clinical trial study was conducted in Imam Khomeini Hospital, Iran, on 120 patients. Participants were randomized into 4 groups of 30. Numeric Rating Scale was used to assess pain and anxiety. One-way ANOVA test and Fisher's exact test were used to analyze demographic data. The Kruskal–Wallis test was used to compare the severity of pain and anxiety between groups; the Friedman and Mann–Whitney test were used to compare the severity of pain and anxiety within groups with a significance level of 0.05.Results:Pain intensity was weak before chest tube removal and there was no significant difference in basal pain. Pain immediately after chest tube removal was significantly higher than other times in each group (χ2 = 57.16, χ2 = 63.70, χ2 = 46.49, χ2 = 59.04, df = 3, p < 0.001). There was no significant difference in pain score immediately (p = 0.052) and 15 min (p = 0.329) after Echest tube removal in experimental groups compared to the control group. No significant difference was found between control and experimental groups in anxiety score immediately (p = 0.995) and 15 min (p = 0.976) before chest tube removal.Conclusions:Mentioned methods were not effective in reducing pain and anxiety. It is suggested to investigate effects of different methods of removing chest tubes and applying cold with a larger sample size.

Comparison of The Effect of Breads Containing Milled Sesame or Flaxseed on Blood Pressure of Patient in Stage I Hypertension

Introduction: Flaxseed and sesame both are capable of reducing blood pressure, but no studies have been done to compare their effects on hypertension. The purpose of this study was to compare the effect of breads containing either milled sesame or flaxseed on blood pressure of patients with type I hypertension.&#x0D; Methods: This was a randomized, single blind clinical trial study. Demographic information was obtained from 100 eligible patients and they were randomly allocated to flaxseed or sesame groups. They received breads containing 30 g of either flaxseed or sesame for 14 weeks. Blood pressure, abdominal circumference, and BMI (body mass index) were measured at the beginning, seventh week, and at the end of study. Questionnaires regarding their eating habits and physical activities were also completed at these times. Data was analyzes by SPSS version 16 and independent sample t test and repeated measurement test.&#x0D; Results: Both sesame and flaxseed significantly reduced systolic and diastolic blood pressure (p=0.001) and there was no significant difference. On average, systolic pressure decreased by 9.5 mmHg with sesame and 10 mmHg with flaxseed. Likewise, diastolic blood pressure decreased by 5.05 mmHg with sesame and 5.8 mmHg with flaxseed. BMI and abdominal circumference reduced in both flaxseed (p= 0.001 and 0.001, respectively) and sesame (p=0.01 and 0.02, in order). No difference was observed between these groups.&#x0D; Conclusion: Both sesame and flaxseed could similarly decrease systolic and diastolic blood pressure, abdominal circumference, and BMI. Therefore, they could be used as supplements in reducing blood pressure.

The Effect of Fluid Therapy Before Spinal Anesthesia on Prevention of Headache After Cesarean Section: A Clinical Trial.

Background: Despite numerous studies on postdural puncture headache (PDPH) and the factors affecting it, issues such as prevention methods and techniques that are associated with a lower prevalence of this complication are still under discussion and research.The aim of this study was to evaluate the effect of increasing fluid therapy of patients before surgery on the incidence of postoperative headache.Methods: This single-blind clinical trial study was performed on 60 patients undergoing elective surgery with spinal anesthesia based on the inclusion criteria in 2017 in Neyshabur. After obtaining the consent of the patients, the participants were randomly divided into two groups of intervention (A) and test (B) (30 people in each group). Data were created by self-checklist and visual analog scale (VAS) pain measurement criteria were recorded by phone during 4, 7, 24, 48, 72 hours, and 7 days after surgery.Results: In the study, the average headache increased up to 72 hours after surgery in the experimental group and in the intervention group up to 48 hours after surgery and then decreased.Conclusion: The results of our study generally showed that fluid therapy did not reduce headache, but showed decreasing trend of headache. According to the research results, more research is needed on the causes of headache after spinal anesthesia.

Comparison of Ultrasound-Guided Femoral and Infrapatellar Nerve Block Effects after Anterior Cruciate Ligament Repair Surgery

Background: There are various protocols for pain management after anterior cruciate ligament (ACL) reconstruction surgery. Objective: This study aimed to compare two blocking protocols, including femoral nerve block (FNB) and infrapatellar nerve block (IPNB) in terms of pain severity, patient satisfaction, and muscle force preservation. Materials and Methods: This single-blind clinical trial study investigated the patients who underwent elective knee arthroscopic ACL surgery randomly either by ultrasound-guided FNB or IPNB. Subsequently, the patients were evaluated 1, 3, 6, 12, and 24 h following NB for pain severity, patient satisfaction level, and muscle force. Results: The pain score (both at rest and in flexion) was significantly lower in the first three h after the intervention in the FNB group. Moreover, the mean score of the patients’ satisfaction in the first hours was significantly higher in the FNB group after the procedure. Additionally, the IPNB group obtained a significantly faster mean time required for the first dose of opioid request. The mean dose of used opioids over 24 h was significantly lower in the FNB group. There was a significant difference between the groups in terms of the muscle strength score within 24 h; moreover, the FNB group obtained a significantly greater delay in muscle recovery. Conclusion: The FNB is associated with greater pain relief and satisfaction in patients who underwent arthroscopic ACL reconstruction surgery, compared to the IFNB technique. However, a further delay in the recovery of quadriceps muscle force is evident in the FNB group.

Comparison of Ultrasound-Guided Femoral and Infrapatellar Nerve Block Effects after Anterior Cruciate Ligament Repair Surgery

Background: There are various protocols for pain management after anterior cruciate ligament (ACL) reconstruction surgery. Objective: This study aimed to compare two blocking protocols, including femoral nerve block (FNB) and infrapatellar nerve block (IPNB) in terms of pain severity, patient satisfaction, and muscle force preservation. Materials and Methods: This single-blind clinical trial study investigated the patients who underwent elective knee arthroscopic ACL surgery randomly either by ultrasound-guided FNB or IPNB. Subsequently, the patients were evaluated 1, 3, 6, 12, and 24 h following NB for pain severity, patient satisfaction level, and muscle force. Results: The pain score (both at rest and in flexion) was significantly lower in the first three h after the intervention in the FNB group. Moreover, the mean score of the patients’ satisfaction in the first hours was significantly higher in the FNB group after the procedure. Additionally, the IPNB group obtained a significantly faster mean time required for the first dose of opioid request. The mean dose of used opioids over 24 h was significantly lower in the FNB group. There was a significant difference between the groups in terms of the muscle strength score within 24 h; moreover, the FNB group obtained a significantly greater delay in muscle recovery. Conclusion: The FNB is associated with greater pain relief and satisfaction in patients who underwent arthroscopic ACL reconstruction surgery, compared to the IFNB technique. However, a further delay in the recovery of quadriceps muscle force is evident in the FNB group.

Effects of Vestibular Rehabilitation on Fatigue and Activities of Daily Living in People with Parkinson's Disease: A Pilot Randomized Controlled Trial Study.

One of the most disabling nonmotor symptoms in persons with Parkinson's disease is fatigue, which can decrease the quality of life by restricting the function and activities of daily living (ADL). Nonetheless, sufficient evidence for treating fatigue, including drug or nondrug treatment, is not available. In this study, we evaluated the probable effects of vestibular rehabilitation on fatigue and ADL in patients with Parkinson's disease. Methods. This was a single-blind clinical trial study in which patients with Parkinson's disease voluntarily participated based on the inclusion and exclusion criteria. The patients were randomly assigned to the case and control groups. The case group received 24 sessions of vestibular rehabilitation protocol, and conventional rehabilitation was performed in the control group (i.e., 3 sessions each week, each lasted about 60 minutes). Both groups were also given fatigue management advice. Fatigue was measured by the Parkinson Fatigue Scale (PFS) and the Modified Fatigue Impact Scale (MFIS). ADL was measured by the Functional Independence Measure (FIM). All changes were measured from the baseline at the completion of the intervention. Results. Both fatigue (P ≤ 0.001) and ADL (P ≤ 0.001) improved significantly more in the vestibular intervention group than in the control one. Conclusion. Vestibular rehabilitation may improve fatigue and ADL and therefore can be used as an effective intervention for patients with Parkinson's disease, which was also found to be well tolerated.