Mahboobeh Rasouli

Background and purpose Recurrent aphthous lesions are one of the most common pathological ulcerative conditions in the oral mucosa. Various studies are seeking to find an appropriate treatment with few complications. This study aimed to investigate the effect of the extract of the medicinal plant Scrophularia striata in reducing pain and improving recurrent oral ulcers. Materials and methods In this clinical trial study, 100 patients with oral ulcers complaints referring to the dental clinic of Ilam University of Medical Sciences were investigated. Patients were randomly assigned to two intervention groups with 10% and 15% hydroalcoholic extract and two control groups with simple diphenhydramine syrup and normal saline serum. The rate of wound healing on days 1 and 3 was assessed by direct examination and observation, and the severity of pain and inflammation on days 1, 2, 3, and 5 was assessed by VAS criteria. Data analysis was performed using SPSS 24 software and statistical tests of mean, standard deviation, Kruskal-Wallis, and Wilcoxon were analyzed at a significance level of 0.05. Results The mean standard deviation of the participants' age was 28.15 ± 29 years, 3% smoked cigarettes, and 59% reported stress. 56% had a wound, and 31% had it on the lower lip. On the first day, the wound size did not differ significantly between the groups (p = 0.266), but on the third day, the mean rank difference in wound size between the groups increased significantly (p < 0.001); There was also no significant difference in the severity of inflammation on the first day (p = 0.042), but from the second day onwards, the differences increased significantly (second day p < 0.001, third day p < 0.001, and fifth day p < 0.001). Conclusion A solution prepared from the Scrophularia striata plant is effective in accelerating the healing process of recurrent oral ulcers and the severity of its inflammation. Given the favorable effects and low complication rate of a solution containing the extract of the Scrophularia striata plant, its use can be recommended to people with recurrent minor oral thrush.

Background & objectives: Intravenous (IV) line insertion in neonates has always been a painful and disturbing experience for the neonate as well as the operator. Various methods have been described by the researchers to keep the neonates comfortable during this procedure. This study was conducted to compare the effect of listening to white noise, lullabies, and nature sounds on pain during IV line insertion in the premature infants hospitalized in the Neonatal Intensive Care Unit (NICU). Methodology: In this clinical trial study, 110 premature infants admitted to the NICU were selected by the convenience sampling method and were placed into four groups: e.g., lullaby, nature sound, white noise, and control groups, with 4 blocks. Interventions: the pain of each infant was measured at three steps: before, during the insertion of the intravenous line, and 5 minutes after it. The Neonatal Infant Pain Scale (NIPS) was used to measure pain. The findings were analyzed with SPSS version 23 software. Non-parametric tests such as the Kruskal-Wallis test, Chi-square test, and the Bonferroni post-hoc test were employed. A statistical significance level of P < 0.05 was considered for all tests. Results: The results showed that the pain during IV-line insertion in the white noise group was significantly less than in the other groups, and significantly more in the control group than in the other groups. The pain in the nature sound group was significantly lower than in the lullaby sound group. After 5 minutes of IV-line insertion in premature infants, the pain level was the lowest in all groups. Pain in the control group was 4.34 times (P < 0.001), and in the lullaby group was 0.87 times higher than white noise (P < 0.001); the nature sound was different from white noise. It had no meaning. The results showed that the pain estimation of the four groups during the intervention was lower than before. Also, the pain before the intervention was 0.75 times higher than 10 min after the intervention (P = 0.003). Conclusion: Listening to white noise and the sounds of nature as one of the bio-behavioral solutions has an effect on pain reduction during intravenous line insertion in neonates hospitalized in the NICU, and the application of these simple and effective methods by the nurses working in the NICUs is recommended. Abbreviations: NICU: Neonatal Intensive Care Unit, NIDCAP: Newborn Individualized Developmental Care and Assessment Program, NIPS: Neonatal Infant Pain Scale, IV: Intravenous Keywords: Critical care; Intravenous; Nature sound; Neonate; NIPS; Non-pharmacological; Pain; Premature infants; Sound; White noise Citation: Nickchehre S, Rasuli M, Shoghi M. Comparison of the effect of listening to white noise, lullaby, and nature sounds on pain during intravenous line insertion in premature neonates in the neonatal intensive care unit. Anaesth. pain intensive care 2025;29(6):607-615. DOI: 10.35975/apic.v29i6.2927 Received: May 09, 2024; Revised: October 26, 2024; Accepted: January 01, 2025

Background: Nurses play a crucial role in providing care in Intensive Care Units (ICUs). This study aimed to compare the time spent and types of direct and indirect nursing care provided to patients during COVID-19 pandemic. Materials and Methods: This observational study was conducted in the ICU of Hafthome-Tir Hospital, Tehran, in 2022. The activities of 42 randomly selected nurses were continuously observed and recorded, focusing on direct and indirect care as per the revised International Classification for Nursing Practice checklist. Data were analyzed using dependent t-test (p > 0.05). Results: The data showed that the highest average time for direct care spent on cardiopulmonary resuscitation was 27.30 (6.10) minutes, while the least time for deltoid injections was 4.8 (2.9) minutes. In indirect care, the most time was spent writing reports, 34.90 (10.50) minutes, and the least time spent removing personal protective equipment was 6.11 (3.19) minutes. During data collection, 19 procedures were added to the nursing care checklist due to COVID-19. A dependent t-test showed a significant difference between direct and indirect ICU nursing care (t= -6.62, df = 41, p < 0.001), indicating more time was spent on indirect care. Conclusions: The findings showed indirect care was provided more frequently than direct care, highlighting the need to reassess nursing care delivery methods. The increased demand for indirect care is attributed to time and staffing shortages, along with a rise in patient numbers and hospitalizations compared to pre-COVID conditions.

Background: One of the most appropriate methods for analyzing longitudinal data is multistate model. This study has aimed to evaluate the risk factors of transfer to local recurrence (LR), distant metastasis (DM), and death in rectal cancer patients through multistate survival analysis. Materials and Methods: This is a retrospective cohort of rectal cancer patients in Mashhad, Iran. Multistate models were applied to show the difference between the significant risk factors affecting death and recurrence in different defined transitions. Risk factors include age, sex, primary surgical technique, tumor location, postoperative tumor stage, circumferential or distal resection involvement, surgery time, and surgical complications. Results: A total of 280 eligible patients with a median (interquartile range) survival time of 60 (42-76.2) months were investigated. Based on Cox proportional multistate model, the hazard ratio (HR) of DM increases by 3%/1-year increase in age (P = 0.018). The HR of DM and the HR of LR in patients with postoperative disease Stage II/III were 3.06 and 2.53 times higher than patients with cancer Stage 0/I (P < 0.05). When the resection margins of distal or circumferential were involved, the HR of DM was 3.58 times higher than those patients without involvement. In the extended multistate model, time of DM was a significant predictor of death (P = 0.006). Conclusion: Age and margin involvement in DM path and stage in LR and DM path had a significant effect; however, no effective variable was seen on the death of patients with recurrence. The time of metastasis also had an effect on the path of death.

Background: The mental health of individuals is an effective factor in having harmonious communication with others and changing and improving personal and social environments. This study aimed to investigate the relationship between primary incompatible patterns, cognitiveemotional regulation, and the mental health of operating room technologists in educational therapeutic centers in West Azerbaijan province, Iran. Methods: This cross-sectional descriptive-analytical study consisted of all operating room technologists working in educational centers in West Azerbaijan province. The inclusion criteria were technologists who had no history of mental illness diagnosed by a psychiatrist. The sample consisted of 123 people who were selected by simple random sampling. The data were collected using several demographic data forms, including the Early Maladaptive Schema Questionnaire, the Cognitive-Emotional Regulation Questionnaire (CERQ), and the Mental Health Questionnaire. The obtained data were analyzed by descriptive and inferential statistical tests, including the Kolmogorov-Smirnov test and Spearman correlation in SPSS 20 software. Results: The results showed a direct relationship between early maladaptive schemas and mental health (r=0.37, P<0.05), as well as between emotional cognitive regulation and mental health (r=0.30, P<0.05). A significant difference was found between emotional cognitive adjustment with age (r=0.12, P<0.05) and work experience (r=0.14, P<0.05), as well as between mental health and employment status (r=0.07, P<0.05). There was a direct and significant relationship. Conclusion: Based on the results, a direct and significant relationship was observed between early maladaptive schemas, emotional cognitive regulation, and the mental health of operating room technologists.

Background & Aim: In today's era, when the country is involved with the coronavirus disease and the recent incidents and events have increased the number of people visiting hospitals, and according to the results of the studies, nurses experience more work pressure and stress. Due to the nature of their ...

Background: Comparison of natural orifice specimen extraction (NOSE) and transabdominal specimen extraction (TASE) in colorectal surgery remains controversial. Herein, we aimed to perform a retrospective analysis on surgical outcomes of NOSE and TASE at three hospitals in east of Iran. Method: Consecutive locally advanced rectal adenocarcinoma patients who underwent laparoscopic surgery using either NOSE or TASE from 2011 to 2017 were recruited. These patients were followed-up till 2020. Data, including postoperative complications, long-term overall and recurrence-free survival were analyzed retrospectively. Results: 239 eligible patients were included in this study. 169 (70.71%) patients underwent NOSE, and 70 (29.29%) patients underwent TASE. Although this study has achieved similar outcomes in terms of overall and recurrence-free survival, metastasis, circumferential margin involvement as well as complications of intra-operative bleeding, obstruction, anastomosis-fail, rectovaginal-fistula in women and pelvic collection/abscess in both groups, we observed higher rates of locoregional recurrence, incontinency, stenosis and the close distal margins involvement in NOSE group and also obstructed defecation syndrome in TASE cases. Conclusion: According to our findings, NOSE laparoscopic surgery showed significantly higher incontinency, impotency, stenosis and involvement of the close distal margins rates. Nevertheless, considering the similarity of long-term overall and recurrence-free survival, metastasis, circumferential margin involvement, NOSE procedure is still could be considered as a second choice for lower rectal adenocarcinoma patients.

Background: Since cancer is one of the most common and deadly diseases, its early diagnosis is very important for treatment and prevents the irreparable physical, mental and social consequences of this disease. Oral cancer is also one of the most common cancers, and factors such as gender, age, and smoking influence the incidence of this disease. One of the most important factors affecting cancer is genetic factors. It is not enough to consider clinical factors for the treatment of this disease, and it is also very important to deal with the genes in people's bodies that are effective in their survival against cancer. Also, the survival of people with oral cancer in the early stages of the disease is 80%, so early detection is very important. Therefore, we are looking for a model to better investigate key and effective genes in this disease. Methods: A publicly available dataset of oral cancer (GSE26549) including information of 29096 genes expression profiles of 86 samples was used. A univariate cox regression was used for each gene’s expression to reduce the number of genes. Cox-Boost, Random Survival Forest and Support survival SVM (Recursive Feature Elimination) were used to identify related genes. Shared genes between three methods were discovered for calculating the prognostic score and the Kaplan-Meier curve. To do validation, common genes were selected from the validation dataset (GSE9844) to provide the ROC curve. Results: The univariate Cox regression models selected 945 significant genes. Four shared genes of RPL24, HTR3B, ASAH2B and TEX29 related to time-to-death in oral cancer patients were then identified by using the Cox-Boost, Random Survival Forest and Support survival SVM (Recursive Feature Elimination). The survival distributions of the high-risk and low-risk groups significantly differed. Conclusion: Common genes between three methods were RPL24, HTR3B, ASAH2B and TEX29 which all of them were significant in multiple Cox.

Objectives: Voice is influenced by personality. However, it is still questionable which acoustic features are influenced by personality traits. This study aimed to investigate the relationship between acoustic characteristics and personality dimensions. Methods: Thirty-three participants with dysphonia and 33 participants without dysphonia were recruited to take part in this cross-sectional study. Personality dimensions were evaluated by the revised NEO personality inventory, and acoustic characteristics by using the Praat software. The tasks included prolongation of the vowel /a/, expression of declarative and interrogative sentences, reading, and connected speech. The acoustic features included fundamental frequency range, jitter, shimmer, harmonic-to-noise ratio, intensity, and duration. SPSS V. 23 was used for statistical analysis. For correlation analysis, the Pearson and Spearman correlation coefficients were employed. Results: In individuals with dysphonia, a significant relationship was observed between personality dimensions and the following acoustic features: A. extraversion and intensity in connected speech (P=0.045) and the reading task (P=0.036); B. openness and shimmer in /a/ vowel prolongation (P=0.003); C. openness and the harmonic-to-noise ratio in /a/ the vowel prolongation task (P=0.017); and D. agreeableness and duration in expressing interrogative sentences (P=0.019). Discussion: In Persian-speaking participants with and without dysphonia, some acoustic characteristics were significantly correlated with the mean score of the personality test (revised NEO personality inventory). It seems that each voice feature is influenced by personality dimensions. This finding indicates that changes in acoustic characteristics of voice due to personality can be evaluated in laboratory and hearing examinations.

Background: Anxiety is a common symptom in patients with the Acute Coronary Syndrome (ACS), which can threaten their quality of life. This study was done to compare the effects of aromatherapy using lavender and Benson’s relaxation technique on the anxiety of patients with ACS. Methods: In this randomized clinical trial, 96 patients with ACS were selected using consecutive sampling method from two hospitals in an urban area of Iran. The patients were randomly assigned to three groups of aromatherapy (n=32), Benson’s relaxation (n=32), and control (n=32) using the block size of six. The interventions were performed on two consecutive days, once a day for 20 min. Anxiety was measured before and immediately after the intervention using the Spielberger’s Anxiety Inventory. Data were analyzed using the Chi-square test, Fisher’s exact test, one-way Analysis Of Variance (ANOVA), Bonferroni post hoc test, and mixed-model repeated-measures ANOVA with a 3*2*2 design by the SPSS V. 16. Results: There was no statistically significant difference in state and trait anxiety scores between the groups after the intervention on different time points (P> 0.05). The time (P=0.001), group-day interaction (P=0.005), and time (pretest and posttest) and day (P=0.029) effect on state anxiety was statistically significant. The time (P<0.001) and the group-day interaction (P<0.001) effect on trait anxiety was statistically significant. Conclusion: Benson’s relaxation method and lavender aromatherapy did not significantly reduce anxiety in patients with ACS. Considering the anxiety and its complications in patients with ACS and the importance of its management, further studies are needed to determine appropriate care and treatment for these patients and reduce their anxiety.