The Effect of Performing Preoperative Preparation Program on School Age Children's Anxiety

Objective

The purpose of this study was to examine effects of performing preoperative preparation program on children''s anxiety.

Methods

This study was performed in Amirkola Pediatrics Hospital, Mazandaran. A randomized controlled trail was performed on 122 children (7–12 years of age) admitted for elective surgery during 15 months. The researcher randomly assigned eligible participants in to the experimental and control groups, after pre-test baseline measurement had been taken. Analyzing was performed through independent t-test and χ² test. P<0.005 was considered statistically significant. The experimental group received therapeutic play and the control group received routine preoperative information preparation.

Findings

The mean and standard deviation of the state anxiety scores of children in experimental and control groups before intervention were 35.52±6.99 and 34.98±6.78, after intervention 31.44±5.87 and 38.31±7.44 respectively. The state anxiety score was lower significantly in the experimental group prior to preoperative surgery than in the control group (P=0.000).

Conclusion

Performing preoperative program with using therapeutic play intervention is effective for preparing children before surgery and decreases their anxiety.     

Comparison of artificial neural network and logistic regression models for prediction of outcomes in trauma patients: A systematic review and meta-analysis

Background

Currently, two models of artificial neural network (ANN) and logistic regression (LR) are known as models that extensively used in medical sciences. The aim of this study was to compare the ANN and LR models in prediction of Health-related outcomes in traumatic patients using a systematic review.

Regeneration Defects in Yap and Taz Mutant Mouse Livers Are Caused by Bile Duct Disruption and Cholestasis

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Management of pemphigus disease in pregnancy

Pemphigus can cause complications during pregnancy and may cause serious harm to a fetus. For this study, a comprehensive review of common treatments of pemphigus and their adverse effects associated with pregnancy and male fertility was conducted. We concluded that a period of remission with minimal or no therapy before conception could significantly reduce the risk of the disease flaring up, at least in the first trimester. The period of remission causes a delay in the flare‐up of the disease, which means lower cumulative doses and the prevention of possible congenital abnormalities caused by corticosteroid or immunosuppressant treatments. All common treatments of pemphigus—azathioprine, mycophenolate mofetil, and methotrexate—should be avoided during pregnancy. However, it appears that systemic corticosteroids in a safe dose with a topical form of corticosteroids may be used without serious risk. Due to the lack of data associated with rituximab therapy, it is recommended that this drug be avoided 12 months before conception. It appears that the safest treatment of pemphigus is intravenous immunoglobulin (IVIg), which may be more effective when used with topical corticosteroids. Due to the delayed effect of IVIg, it should be used some months prior to conception.     

Skin fragility in the wild-derived,inbred mouse strain Mus pahari/EiJ

Mus pahari is a wild-derived, inbred mouse strain. M. pahari colony managers observed fragility of this strain's skin resulting in separation of tail skin from the mouse if handled incorrectly. Tail skin tension testing of M. pahari resulted in significantly lowered force threshold for caudal skin rupture and loss in comparison to closely related inbred mouse species and subspecies and even more than a model for junctional epidermolysis bullosa. Histologically, the tail skin separated at the subdermal level with the dermis firmly attached to the epidermis, excluding the epidermolysis bullosa complex of diseases. The dermal collagen bundles were abnormally thickened and branched. Elastin fiber deposition was focally altered in the dermis adjacent to the hair follicle. Collagens present in the skin could not be differentiated between the species in protein gels following digestion with pepsin. Together these data suggest that M. pahari have altered extracellular matrix development resulting in separation of the skin below the level of the dermis with moderate force similar to the African spiny mouse (Acomys spp.).     

Subtrochanteric Fractures: Comparison of Proximal Femur Locking Plate and Intramedullary Locking Nail Fixation Outcome

Fixation of subtrochanteric fracture, even for experienced surgeons, is a challenge. This fracture is most difficult to treat, and the incidence of complications in this type of fracture is higher. This study compared surgical results of two methods, proximal femur locking compression plate and intramedullary locking nail. This is an analytic study, performed on all patients with subtrochanteric fracture who were referred to the hospital during 3 years. They were treated with proximal femur locking plate or intramedullary locking nail. The postoperative complications were evaluated and recorded. Finally, the data were analyzed by SPSS software. Complications were studied in both groups. Neither treatment has statistically significant difference in complications, onset of complications incidence, and time of full-weight bearing. Although the Harris Hip Score among patients improved in both methods of treatment, there is no significant difference between the two groups. The results of subtrochanteric fracture fixation by intramedullary or locking plate were similar and had the same outcome.     

A practical approach to allergic rhinitis and sleep disturbance management.

Sleep quality can be significantly impacted by nasal congestion, a common symptom related to allergic rhinitis (AR). This may lead to decreased learning ability, productivity at work or school, and a reduced quality of life. A number of inflammatory cells and the release of inflammatory mediators lead to increased nasal congestion, causing disrupted sleep and subsequent daytime somnolence. Therefore, it is important to treat AR with medications that improve congestive symptoms without worsening sedation. Second-generation antihistamines and anticholinergic drugs are well tolerated but have little effect on congestion and therefore are limited in their ability to reduce AR-associated daytime somnolence. However, intranasal corticosteroids reduce congestion, improve sleep and sleep problems, and reduce daytime sleepiness, fatigue, and inflammation. Montelukast, a leukotriene receptor antagonist, has joined the approved therapies for AR. Montelukast significantly improves both daytime and nighttime symptoms. AR treatment should endeavor to improve daytime and nighttime symptoms, sleep, and productivity thereby improving quality of life.