Masoomeh Tabari; Alireza Sharifian; Elham Bakhtiari; Negin Yadollahi
Abstract
Introduction: Airway safety for difficult intubation or failure to intubate is important during anesthesia. This study assessed the airway before anesthesia, and the diagnostic value of neck circumference (NC) and sternomental distance (SMD) tests was investigated in predicting difficult tracheal intubation ...
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Introduction: Airway safety for difficult intubation or failure to intubate is important during anesthesia. This study assessed the airway before anesthesia, and the diagnostic value of neck circumference (NC) and sternomental distance (SMD) tests was investigated in predicting difficult tracheal intubation during cesarean section.Methods: In a cross-sectional study, 101 women who were candidates for cesarean section were selected through the convenience and non-random sampling method. The modified Mallampati test (MMT), upper lip bite (ULBT), thyromental distance (TMD), neck circumference (NC), and sternomental distance (SMD) tests were performed to estimate the laryngoscopy problem. The success rate of airway assessment by SMD and NC was evaluated using the Cormack-Lehane score. Data analysis was performed using the software SPSS version 16.0.Results: TMD (p=0.034) and NC (p<0.001) indicated substantial association with laryngoscopy grades. The sensitivity was 35.29% and 58.82%, and the specificity was 93.93% and 59.09% for NC and SMD. The accuracy, NPV, and PPV of NC was higher than the SMD test (74% vs. 59%, 73.80% vs. 73.58, and 75% vs. 42.55%). The PPV and NPV were 43.63% and 77.77% for TMD. MMT, with high sensitivity (73.52%) and specificity (90.90%), increased the risk of difficult laryngoscopy up to 24-fold when adjusted for TMD, SMD, and NC [p<0.001; OR=24.38 (6.31-94.25)]. Although NC indicated low sensitivity, it had maximum specificity (93.93%) in predicting difficult intubation.Conclusion: High Mallampati grades increase the risk of difficult laryngoscopy. NC presented low predictive values, and SMD and TMD lack predictive values for difficult intubation.
Farhad Heydarian; Maryam Bagherian; Elham Bakhtiari; Elahe Heidari; Forough Rakhshanizadeh
Abstract
AbstractObjective: The present study aimed to determine the effect of training parents by film, poster or graphics, and verbal explanation, on the enhancement of their satisfaction with the performance of this procedure.Materials and Methods: This cross-sectional quasi-experimental study was conducted ...
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AbstractObjective: The present study aimed to determine the effect of training parents by film, poster or graphics, and verbal explanation, on the enhancement of their satisfaction with the performance of this procedure.Materials and Methods: This cross-sectional quasi-experimental study was conducted on the children with febrile seizures referred to the Emergency and Pediatric Wards of hospitals affiliated with Mashhad University of Medical Sciences. They were LP candidates; nonetheless, their parents did not consent to the performance of this procedure. The children were randomly assigned to three groups. In the first group, videos of the location and method of LP were presented to the parents. The second group received this information via posters, and the parents in the third group were given a verbal explanation. Results: The children included 49 (4.54%) females with a mean age of 15 months. There was a significant relationship between the reason for parental refusal of LP and their final satisfaction (P=0.022). There was a significant relationship between parents' satisfaction with the performance of LP and their education (P=0.029). The film method had the lowest chance of success, and the verbal explanation method enjoyed the most remarkable success in enhancing parental satisfaction (P= 0.013).Conclusion: Although the use of posters and videos was less effective than verbal explanation, it increased the satisfaction of LP in some parents. In fact, it is more beneficial to try to alter parental misperceptions of LP in non-emergency situations.
Mohammad Alipour; Vida Jahanian; Zahra Momtaz Kaffash; Elham Bakhtiari; Abolfazl Akbari
Abstract
Introduction: The use of a laryngeal mask airway is associated with complications, such as a sore throat. This study aimed to evaluate the effect of taking the licophar pill on reducing sore throat due to laryngeal mask implantation in cataract surgery candidates.
Methods: In this study, 241 patients ...
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Introduction: The use of a laryngeal mask airway is associated with complications, such as a sore throat. This study aimed to evaluate the effect of taking the licophar pill on reducing sore throat due to laryngeal mask implantation in cataract surgery candidates.
Methods: In this study, 241 patients over 18 years of age with cataract surgery and ASA Ι or ΙΙ were randomly divided into the intervention and control groups. The intervention group received one licophar pill half an hour before surgery; however, the control group received nothing. The sore throat severity was measured 1, 3, 6, 12, and 24 h after surgery using the Visual-Analogue Scale (VAS). The data were analyzed in SPSS software (version 16).
Results: Out of 241 patients, 120 cases received licophar pills. There was no significant difference between the two groups in terms of gender; however, the mean age was lower in the control group. On the other hand, the rate of sore throat was significantly higher in the control group, compared to the intervention group. In addition, postoperative pain scores in the intervention vs. control group 1, 3, 6, 12, and 24 h were 0.466 (1.454) vs. 3.842 (3.359), 0.383 (1.298) vs. 3.280 (3.056), 0.275 (1.102) vs. 2.694 (2.580), 0.200 (0.890) vs. 2.074 (2.271), and 0.108 (0.574) vs. 1.429 (1.714), respectively. Moreover, 103 and 40 patients in the intervention and control groups reported no pain (VAS=0), respectively, 1 h after surgery.
Cocclusion: The present study showed that the use of licophar lozenge half an hour before surgery has a significant effect on reducing postoperative sore throat.
Elhan Bakhtiari; Farhad Heydarian; Mohammad Ali kiani; Zahra Askari; Mohammad Heidarian
Abstract
Objective: The aim of present study was evaluation and comparison of the white blood cell, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) in febrile children with or without convulsion. Methods: Three hundred sixty eight febrile children aged 6-60 months with or without convulsion ...
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Objective: The aim of present study was evaluation and comparison of the white blood cell, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) in febrile children with or without convulsion. Methods: Three hundred sixty eight febrile children aged 6-60 months with or without convulsion were studied. Demographic, white blood cell (WBC), ESR and CRP were compared and analyzed. Results: There was 368 children (184 patients with febrile convulsion as case group and 184 febrile patients without convulsion as control group), with the average age of 26.6±14.4 months and 17.71±15.4 months respectively (p=0.001). In case group 59.78% and in control group 43.48% were male (p=0.002). There was no significant difference between groups regarding WBC, ESR and CRP. There was significant relationship between leukocytosis and convulsion in patients with longer than 15 minutes convulsion (p=0.03). There was not any significant relationship between febrile convulsion patients according to type, duration and frequency of convulsion in ESR and CRP. Conclusion: Leukocytosis and elevated ESR and CRP in patients with febrile convulsion can represent underlying etiology of the fever and it may not be due to convulsion itself. But in longer than 15 minutes convulsion, it can lead to leukocytosis itself.
Farhad Heydarian; Neda Fakhr Ghasemi; Elham Bakhtiari; Hasan Golmakani; Mohammad Heidarian
Abstract
Introduction: Febrile seizure (FS) is a highly frequent presenting complaint in children. It is defined as a seizure that occurs in children between 6 to 60 months related to a fever of 38°C or more without any other explanatory causes of seizure such as evidence of central nervous system (CNS) infection ...
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Introduction: Febrile seizure (FS) is a highly frequent presenting complaint in children. It is defined as a seizure that occurs in children between 6 to 60 months related to a fever of 38°C or more without any other explanatory causes of seizure such as evidence of central nervous system (CNS) infection or a previous seizure without fever. The aim od study is to evaluate mean folic acid serum levels in febrile children with or without seizures.Methods: The mean folic acid serum levels and demographic data of 100 children aged 6 to 60 months, admitted to the Ghaem Hospital of Mashhad, Iran in 2018-2019, were collected, where the patients with febrile seizure were considered as the case group and the febrile ones without seizure as the control group. The inclusion criteria were children aged 6 to 60 months with febrile seizures who were admitted to the pediatric ward. The exclusion criteria were having a past medical history of seizure, meningitis, or encephalitis.Results: There were 49 febrile convulsive children (cases) and 51 febrile children without a seizure (controls). The mean serum folic acid level was 7.07 and 9.89 ng/ml for cases and controls respectively (P-value < 0.001).Conclusion: Children with febrile seizures had significantly lower serum folic acid levels than febrile children without a seizure.
Mohsen Sabermoghaddam; Elham Bakhtiari; Mohammad Alipour
Abstract
Intoduction: Sore throat is a common postoperative complication in patients undergoing general anesthesia. Several factors contribute to this complication, and the airway management method plays a pivotal role in this regard. The present study aimed to assess the effect of diphenhydramine gargling on ...
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Intoduction: Sore throat is a common postoperative complication in patients undergoing general anesthesia. Several factors contribute to this complication, and the airway management method plays a pivotal role in this regard. The present study aimed to assess the effect of diphenhydramine gargling on sore throat in patients undergoing cataract surgery with laryngeal mask insertion. Methods: This placebo-controlled, double-blind, clinical trial was conducted on two groups of intervention and control. The patients in the intervention group gargled 8 cc (20 mg) of diphenhydramine diluted to 20 cc with normal saline 20 minutes before anesthesia induction. The control group patients gargled 20 cc of normal saline 20 minutes before anesthesia induction. The score of sore throat severity was determined based on the visual analogue scale during recovery three, six, 12, and 24 hours postoperatively. Results: Initially, 176 candidates of eye surgery using laryngeal mask airway (LMA) were enrolled in the study, and three patients were excluded from the intervention group due to withdrawal. In the intervention group, 36 patients (42.9%) were female, and 48 patients (57.1%) were male. In the control group, 46 patients (52.3%) were female, and 42 patients (47.7%) were male. The mean age of the subjects was 59.5±16.74 and 57.94±15.74 years in the intervention and controls groups, respectively. No significant differences were observed between the groups in terms of age and gender (P=0.53 and P=0.29, respectively). The mean score of pain severity was 0.3±0.14 and 1.7±0.14 in the intervention and control groups, respectively, which indicated a significant difference between the groups at each measurement point (P<0.001). However, the reported pain severity scores were not correlated with age, gender, mask size, and duration of surgery. Conclusion: Gargling 20 milligrams of diphenhydramine suspension 20 minutes prior to LMA insertion in the patients undergoing eye surgery significantly reduced the post-anesthesia sore throat compared to the control group. Moreover, sore throat had no associations with the age, gender, duration of surgery, and mask size of the patients.