فصلنامه ابن سینا
سال چهاردهم شماره 1 (پیاپی 40، بهار و تابستان 1390)

Cancer is defined as one of the most leading causes of death in Iran, as well as the whole world. Chemotherapy as a common modality might have several consequences such as nausea and vomiting.Metoclopramide, anti 5HI3, antagonist and benzodiazepines are used to decrease vomiting symptoms. However, the effectiveness of benzodiazepine is unknown so far. This study aimed to evaluate the role of Lorazepam in decreasing of metoclopramide dosage. Seventy consecutive patients were sampled to assess the outcome. lorazepam was randomly added to premedication drugs in one of two chemotherapy courses for all patients. The lorazepam proscribed one night before chemotherapy and continued for three days after chemotherapy every 12 hours. The frequency and severity of nausea showed a significant decrease with lorazepam vs. grade II+ acute decrease from 85% to 53% (p<0.0001), grade II+ delayed nausea decreas from 86.24% to 55%. (p<0.0001), grade II+ delayed vomiting decrease from 69.14% to 13% (p<0.0001) Despite previous studies the results of this study show a clear impact of lorazepam benefits on the decrease severity & frequency of nausea and vomiting.

Phlebitis is an inflammatory response to intravenously injected chemotherapy drugs and thereported incidenceis about 70% among colorectal cancer patients. The purpose of this study wasto determine the effect of external use of Sesame Oil (SO) in prevention of chemotherapy-induced phlebitis. This randomized controlled clinical trial was performed on 60 patients with colon or rectum cancer, whorandomly divided in two equal, control & intervention groups.This protocol was used 10 drops of SO every 12 hours, two times a day, from the first day of chemotherapy up to the four teenth day, whereas control group received nothing. Data tools included a bipartite questionnaire (demographic Q, clinical Q & Infusion Therapy scale) for measurement of phlebitis. The incidence of phlebitis in intervention group were significantly lower than that in control group (p<0.05). Kaplan–Meier survival analysis showed that the median survival was Less than4 days in the intervention and 8 days more in the control. In addition, there was statistically significant difference between grade and incidence ofchemotherapy-induced phlebitis with SO and control group (p<0.05). This study shows that external use of SO is effectiveand well tolerated for prophylaxis from chemotherapy- induced phlebitis. Therefore, it can be suggest as a selected Prevention methodforreducingthecomplication.

The fear of labor pain caused to increased of cesarean rate in women, therefore most of women preferd to use of the non pharmacological approachs. From the non pharmacological analgesia approachs can point to the ice massage. Thus, regarding to the importance of the labor pain this study was adminestered to investigate the impact of ice massage and placebo on intensity of labor pain. This Study is a randomized controlled trial that performed on to parturient women that refferd for labour? ?ocated hospitals of Tehran city. Parturient women were randomly assigned to two groups and intervention performed on hegu point Data collected from the VAS on four times then data interedin SPSS program and analyzed. The findings of this study indicated that the average of pain in the before of intervention was non-significance difference between two groups. The comparison of average of pain in immediate, half and one hour after intervention, independent T test showed that there was significanct difference between two groups only in half hour after intervention. In base of findings this research, although ice massage caused to decreased intensity of labor pain, but attention to high intensity of labor pain and increased of this pain during the first stage of labor seem to this method can´t only decreased the pain intensity of labor and need to accompaining with the other non pharmacololitical analgesic methods or repeated this method until during the first stage of labor.

dialysis inadequacy is one of the determinant factors of disability and mortality rate in dialysis patients. Enhancing the quality of dialysis is really effective to improve prognosis. There are lots of factors determine dialysis adequacy. The aim of this study was to assess the dialysis adequacy in hemodialysis patients in selected hospital in Tehran. this cross-sectional study was performed on 100 patients admitted in hemodialysis ward of Besat hospital and baqiyatollah hospital in 1389.a researched-made questionnaire used gathering demographic data and Adequacy of dialysis were calculated by Daugirdas II Formula too. URR common characteristic were also measured. Data was analyzed by parametric and nonparametric tests. The mean of KT/V and URR were 1.23±0.38 and 14±11.04 respectively. the mean age of samples was 62.21±13.7 years Paired t-test showed significant differences between means of weight and BUN, before and after dialysis. the result show that dialysis adequacy just in half of the hemodialysis patients (50/5%) is optimum and KT/V is more than 1/2 and URR common characteristic in (46%) of patients is more than (65%).

Tuberculosis is one of the major health problems, especially in developing countries. This study aimed to further understanding of the medical community with this problem in domestic and international air travel, and ICAO has been predicted that by 2015 that is reached number of travel- air to more than 5 / 2 million per year. Ease and duration of air travel, with large numbers of international travelers- international, has increased the likelihood of contact with infectious TB. To access the resources of articles were used PubMed. nejm. civil aviation, WHO and the papers published in reputable scientific journals of Iranian and foreign research data from 2000 to 2011 and the Ministry of Health and Medical Education. pulmonary tuberculosis is the most common type of tuberculosis in Iron and world and sputum smear-positive pulmonary TB, so that makes up 53 percent of all TB cases. nonpulmonary tuberculosis is 28% of all cases of tuberculosis. Considering that more tuberculosis in pulmonary tuberculosis is spread through the air, air travel time outlast 8 h is danger for travelers. Over 80 percent of the total number of people with TB annually are in developing country, Regarding the transmission of tuberculosis, information is necessary required for reduced risk of transmission of TB on flights travelers.

Generally it seems that “stress” might be considered as “absence of internal tranquility” which contains positive and/or negative aspects. Occupational stress is defined as “any harmful physical or mental response, occurs due to individual incompatibility with his/her ability” which might lead to aggressive behaviors, occupational injuries, physical diseases and even death. Some factors such as work environment and economical problems have been suggested in the literature as the related risk factors for occupational stress. Occupational stress has not been evaluated properly among Iranian military personnel. However, attention to some factors such as work environment and stress-coping strategies might be useful to reduce occupational stress among this population.

The high speed and low altitude at which modern military aircrafts operate necessitated designing and manufacturing new systems to escape aircrews. The most important and common escape system is ejection seat. Although the ejection seats saved many aircrews, but is associated with many injuries including spinal fractures due to the severe loading exerted during ejection. There are many studies investigated the spinal fractures following ejection but our knowledge about the incidence, patterns and causes of these injuries are insufficient. Furthermore, the incidence of spinal fractures reported in current studies using modern ejection systems is high enough to remind that the design and structure of the current seats must be modified to reduce the number of ejectees suffering from spinal fractures which may be followed bi spinal cord injuries. The purpose of current study was to briefly review the available reports about the incidence and causes of spinal fractures in ejectees.

Wartime injuries are frequently high-energy wounds. In modern warfare wounds involve in many cases the musculoskeletal system and therefore military orthopaedic surgeons have assumed a pivotal role in the frontline treatment of these injuries. The majority of injuries were caused by exploding (approximately 55 percent) and approximately 20 percent were from gunshot wounds. The increased numbers of extremity injuries have led to the necessity for new technologies in managing complex war wounds. In warfare situations and particulary from long-distance evacuations, it became necessary to develop alternate forms of wound management. Sometimes, due to massive secretion, dressing changes were necessary twice daily. Therefore, starting 2003 negative pressure wound therapy (NPWT) dressings were instituted to treat the complex war injury. However, the use of NPWT for the care of complex war wounds at battlefield trauma hospitals and/or in the aeromedical evacuation transport system aboard aircraft is still a new application of this wound treatment not yet accepted as doctrine.

Salutary water supply is one of the most important challenges in emergency conditions. Salutary water is main agent in human healthy, especially in emergency conditions and water may polluted in main source, after infiltration, during reservation in consumption site or between these processes. While water is easily contaminated, clean and safe drinking making it very difficult. Adequate water supply and emergency water and monitor water quality.

Management is a very important concept in nursing. Improvement of nursing manager's skills must performance through education. The promotion of Nursing manager's skills cause improving of nursing job satisfaction and their efficacy and increase the quality of nursing care. This is a review systematic article. The information is based on searching in library, associated researchers and experience of researcher in one of the army hospital. Skill manager's education is necessary and it is a main subject in nursing that cause enhancement of nursing care. The groups of nursing managers who aren’t enough experts in management cause irregularity in organization, decreasing job satisfaction and efficiency which will effect in reduction of quality in nursing care. According to researches there is a meaningful relationship between nursing job satisfaction and quality of nursing care. Also, According to studies, group discussion is a method that cause improve critical thinking, So it seems this method can be an effective one for improving quality of nursing care.

A major cause of chronic wound is deep ulcer resulted from burn Scar. Burn wounds that do not heal within 3 weeks can change to burn scars. These scars often remain in the inflammatory phase for a long and do not have function of normal skin. So, mild trauma to this scar can cause tissue damage that leads to chronic wound. In modern surgery, after 7 days total burned tissue excision can help to lead primary healing. In this paper we present a successful surgical treatment of a rare case with a history of multiple chronic wounds on his left leg from 30 years ago in underlying burn ulcers from 60 years ago.