مجله دانشکده پزشکی اصفهان
پیاپی 551 (هفته سوم دی 1398)

Knee joint osteoarthritis is the most common articular disease among the elderly of more than 60 years. This study aimed to evaluate the effect of adductor canal block on hemodynamic variables and pain after total knee arthroplasty to find a suitable solution for pain control in these patients.

In this clinical trial study, 68 patients under total knee arthroplasty were randomly divided into two equal groups. In the first group, the patients received Marcaine (12.5-15 mg) for spinal anesthesia; then, anterior hip ultrasound of adductor canal block was done by injecting 15 ml Marcaine 0.5% along with 5 mg/ml epinephrine. This was repeated in the control group with the similar technique and normal saline was used instead of drug. Hemodynamic variables, postoperative pain, and patient and surgeon satisfaction were all studied in both groups.

Intensity of postoperative pain in the intervention group was lower than placebo group after 6 and 12 hours of surgery. The need to narcotics in the intervention group was significantly lower than placebo 24 hours after surgery (P < 0.050 for all).

Using adductor canal block is an effective short-term method to reduce the pain and need to narcotics after total knee arthroplasty.

Colorectal cancer (CRC) is one of the most common cancers of gastrointestinal system. The purpose of this study was to determine the relationship between some of less-studied life style risk factors, sleep quality and the level of physical activity, with colorectal cancer.

This cross-sectional study was conducted in Alzahra hospital, Isfahan, Iran. 50 newly diagnosed patients with colorectal cancer were entered from admitted patients considering as the patient group, 42 firstdegree relatives of them as 1st healthy group, and 58 admitted patients without any cancer diagnosis (randomly selected) as the 2nd healthy group. Demographic characteristics, smoking, alcoholic beverages and carbonated drinks intake, fast food consumption, physical activity level [based on International Physical Activity Questionnaire (IPAQ) short form] and sleep quality (based on Pittsburg Sleep Quality Questionnaire) were collect by the researcher. Variables were analyzed using chi-square and one-way ANOVA tests, then variables with P-value of less than 0.250 were analyzed through multivariate logistic regression model, and the odds ratio (OR) of each factor was calculated.

Age, level of education, and body mass index (BMI), as well as no history of diabetes mellitus and positive history of cholecystectomy were higher in the patient group than in the two healthy groups; but the differences were not statistically significant (P > 0.050). Male gender was significantly associated with OR of colorectal cancer in patient group compared with both healthy groups (OR = 2.86 and OR = 3.57 with 1st and 2nd healthy groups, respectively).

The risk of colorectal cancer is higher in men than in women.

Quality assessment of newborn care is essential to achie desirable and affecting future health outcomes. This study aimed to review the criteria used to evaluate the quality of healthy newborn care in different studies systematically based on the Donabedeian model.

PubMed, Google Scholar, Scopus, Science Direct, Iranmedex, Magiran, and Scientific Information Database (SID) databases were searched oncerning relevant studies with the keyword of "healthy newborn" and "quality of care" and "quality assessment" and their equivalent in Mesh and Persian synonyms. All quantitative, qualitative, English, and Persian-language articles ranging from the beginning of 1998 to the end of September 2019, which examined quality in healthy neonatal care, were included in the study. Of the 2219 articles obtained, 25 were finally included.

After reviewing the studies, the criteria for quality assessment of healthy newborn care were divided into three groups according to the Donabedian model: structure (physical infrastructure, essential drugs and equipment, competent human resources, policies, and clinical guidelines), processes (immediate newborn care and first two hours of birth, delayed newborn care, and neonatal resuscitation), and outcomes (maternal satisfaction, reduction of newborn mortality and complications).

The results of these systematic review showed that currently, there is not a defined comprehensive quality assessment method to take care of a healthy newborn. The development of a comprehensive and reliable tool to assess the quality of these care, which encompasses all the criteria extracted from this study, is essential as a health system requirement to improve the quality of care for healthy newborns.