Top PDF Effect of ear plugs & eye mask on sleep among ICU patients: A randomized control trial

Effect of ear plugs & eye mask on sleep among ICU patients: A randomized control trial

Effect of ear plugs & eye mask on sleep among ICU patients: A randomized control trial

Sleep is one of the basic human needs required for health and energy conservation, appearance and physical well-being. During sleep, certain hormones such as serotonin and the growth hormone are released and chemical changes and increased cellular nutrition take place so as to make the body the activities of the next day. It promotes repair, re- organization, memory enhancement, learning functions and causes reduction in stress, anxiety and neurological pressures and helps the individual in recovering energy for better focus, ustment and enjoying daily activities Sleep may not reach significance for an individual until it is lacking or disturbed. At that point, an tempered, irritable, over reactive ely with situations or people. Sleep is a complex, active process that is programmed by man’s hour biological clock is based on a night cycle, which programs human to sleep at night and
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Impact of oral melatonin on critically ill adult patients with ICU sleep deprivation: study protocol for a randomized controlled trial

Impact of oral melatonin on critically ill adult patients with ICU sleep deprivation: study protocol for a randomized controlled trial

Sleep goals for ICU patients are to get enough sleep, reset the disordered circadian rhythms, adjust the abnor- mal sleep structure, reduce sleep interruption, overcome fatigue and anxiety, facilitate nursing care and treat dis- ease. An ideal therapy for improving sleep in the ICU should be economical, feasible, rapid in onset and offset and without local and systemic adverse effects. At pre- sent, there is no effective treatment in use to improve ICU sleep that covers all of these ideal properties. Current studies are mainly focused on non-drug treat- ments such as earplugs and/or eye masks [10,15] and imagery and relaxation [16]. These treatments are rela- tively safe but do not guarantee efficacy. Among the studies, the clinical research on earplugs and/or eye masks has some maturity [15]. Some domestic and inter- national experts and scholars have recommended that ICUs incorporate earplugs and/or eye masks into routine nursing care [17]. However, Bourne et al. [18] and Gabor et al. [7] showed that environmental factors were re- sponsible for a fraction of arousals and awakenings, and Perras et al. [19] indicated that the physiological regula- tion of melatonin secretion by darkness and light was abolished in severely ill patients in the ICU. Therefore, treatments based on environmental factors might have limited effects. Recently melatonin, a physiological sleep aid, has gained interest among ICU scholars.
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Effects of earplugs and eye masks combined with relaxing music on sleep, melatonin and cortisol levels in ICU patients: a randomized controlled trial

Effects of earplugs and eye masks combined with relaxing music on sleep, melatonin and cortisol levels in ICU patients: a randomized controlled trial

Results: Data from 45 patients (20 in intervention group, 25 in control group) were analyzed. Significant differences were found between groups in depth of sleep, falling asleep, awakenings, falling asleep again after awakening and overall sleep quality ( P < 0.05). Perceived sleep quality was better in the intervention group. No group differences were found in urinary melatonin levels and cortisol levels for the night before surgery, and the first and second nights post-surgery ( P > 0.05). The urinary melatonin levels of the first and second postoperative nights were significantly lower than those of the night before surgery ( P = 0.01). The opposite pattern was seen with urinary cortisol levels ( P = 0.00). Conclusion: This combination of non-pharmacological interventions is useful for promoting sleep in ICU adult patients; however, any influence on nocturnal melatonin levels and cortisol level may have been masked by several factors such as the timing of surgery, medication use and individual differences. Larger scale studies would be needed to examine the potential influences of these factors on biological markers and intervention efficacy on sleep.
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Effect of Using Eye Mask on Sleep Quality in Cardiac Patients: A Randomized Controlled Trial

Effect of Using Eye Mask on Sleep Quality in Cardiac Patients: A Randomized Controlled Trial

The study instrument comprised two parts including a demographic questionnaire and the Pittsburgh sleep quality index (PSQI). The demographic questionnaire consisted of questions about participants’ demographic and clinical data including age, gender, marriage, em- ployment, education level, history of hospitalizations, and medical diagnosis. The PSQI is a self-report question- naire developed for evaluating sleep quality (14, 15). The PSQI consists of 7 components subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and day- time dysfunction. The score for each component ranges from 0 to 3, resulting in a total PSQI score of 0-21. Higher scores represent lower sleep quality (16, 17). In this study we used Farsi version of PSQI, which has yielded satisfac- tory validity and reliability. Cronbach’s alpha coefficient was 0.77 and corrected item-total correlations ranged from 0.30 to 0.7 for the seven components of the PSQI (14).
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Impact of earplugs and eye mask on sleep in critically ill patients: a prospective randomized study

Impact of earplugs and eye mask on sleep in critically ill patients: a prospective randomized study

A major limitation of our study was that many patients did not wear earplugs and an eye mask all night long. Subsequently, the study was likely to be underpowered to detect a significant difference, as suggested by the in- crease in N3 stage sleep in the per-protocol analysis. Some patients removed their devices, whereas in others earplugs and the eye mask shifted during the night. The general tolerability of the intervention is a key to its suc- cess. Previous studies have shown that many patients found earplugs and even an eye mask uncomfortable or very uncomfortable [40], with compliance averaging 13% [38]. Patients complained about earplugs not staying in place and sore ears or reported feeling anxious when they did not hear any background noise [11, 40, 41]. Pa- tients also complained that eye masks made them feel hot and sweaty and were too tight, causing a feeling of claustrophobia [40]. Consequently, patients may be un- willing to use earplugs or an eye mask [42]. This is all the more true in that patients of the intervention group who wore earplugs only part of night had even poorer sleep quality than patients in the control group. It raises the hypothesis that the poor tolerance of the device al- tered sleep architecture, possibly because of anxiety and claustrophobia. ICU staff should therefore improve the acceptability of these devices by clearly explaining the potential benefits to the patients, by helping patients to choose the best device in terms of shape and size, and Table 3 Main outcomes at intensive care unit discharge,
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Effect of nursing supportive care on state anxiety of patients receiving ECT: A controlled Randomized clinical trial

Effect of nursing supportive care on state anxiety of patients receiving ECT: A controlled Randomized clinical trial

An overall finding of this study reveals that nursing Supportive Care is effective on reducing state anxiety of patients receiving ECT. Aside from vast application of this procedure, it is stressful and anxiety in psychiatric patients can lead to negative consequences. Thus providing interventions to decrease this anxiety is needed. These interventions can be delivered by nurses. Based on the results of current investigation, nurses should spend more time with patients to meet their needs and reduce their anxiety.

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Sleep apnoea and metabolic dysfunction

Sleep apnoea and metabolic dysfunction

One of the problems impacting on delivery of the best healthcare to OSA patients is fragmentation of services and treatments. Mechanical therapies are implemented by sleep or dental specialists, while lifestyle modification is usually managed by other teams. The way forward is to integrate both clinical training and management, to ensure interdisciplinary skills in the full range of OSA therapeutics in one setting. It will be important to underpin this disruption of therapeutic silos by more randomised controlled trials built from the current knowledge base, to further unveil the role of lifestyle modification and exercise in the management of OSA [92, 93]. While there is a clear benefit in employing intensive lifestyle interventions with or without CPAP therapy for the management of the obese OSA patient, further exploration into the most effective lifestyle prescription (encompassed by a specific diet and exercise programme) is warranted. The relative effectiveness of weight loss versus CPAP or mandibular advancement devices from a metabolic perspective is yet to be confirmed, as does a comparison of weight loss in males versus females and in comorbid type 2 diabetes. Furthermore, the feasibility and sustainability of delivering these programmes in a clinical environment must be explored. Chronic care models managing obesity, such a lifestyle modification targeting ‘‘waist loss’’ [64], demand further validation as does a parallel change in health promotion and the social constructs around managing obesity and OSA. It is essential for OSA and obesity chronic care to be combined, whereby there is an up skilling of both the sleep medicine and obese/metabolic medical workforce. This also necessitates the investigation of adherence issues common with CPAP use and long-term weight loss therapeutic commitment and sustainability.
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Evaluation of the impact of a psycho educational intervention on knowledge levels and psychological outcomes for people diagnosed with Schizophrenia and their caregivers in Jordan: a randomized controlled trial

Evaluation of the impact of a psycho educational intervention on knowledge levels and psychological outcomes for people diagnosed with Schizophrenia and their caregivers in Jordan: a randomized controlled trial

In reviewed literature, there were disparities in the oper- ational definition of relapse. However, the majority of these studies adopted numbers of readmission, or exacer- bations in psychotic symptoms of more than 5–10 points measured on the Brief Psychiatric Rating Scale (BPRS) or PANSS, the number of increases in anti-psychotic medica- tion dosage, or medication compliance. For this study, re- lapse is defined as the number of readmissions measured at baseline three months prior to the study commencing, at end of intervention immediately and three months fol- low up. Furthermore, relapse with medication means the numbers of increasing current antipsychotic medications prescribed to patients during the same intervals. These data will be obtained from participants’ medical records.
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Effect of low level laser therapy on pain, quality of life and sleep in patients with fibromyalgia: study protocol for a double blinded randomized controlled trial

Effect of low level laser therapy on pain, quality of life and sleep in patients with fibromyalgia: study protocol for a double blinded randomized controlled trial

The sleep studies will be carried out at the Sleep Labora- tory of the Post Graduate Program in Rehabilitation Sciences (UNINOVE) through complete nocturnal standard level I polysomnography using the Somnolo- gica Studio (Embla A10 version 3.1.2, Medcare Flaga, Hs. Medical Devices, Reykjavik, Iceland), composed of 16 channels for the monitoring of electroencephalogram, electrooculogram, electromyography of the submentum and tibialis anterior muscles and electrocardiogram, in- cluding channels for digital oximetry, nasal pressure (canulla), pressure transducer, respiratory movements (Xtrace thoracic and abdominal straps) and body pos- ition. The assessments will be performed manually by a specialized reader following the guidelines of the Ameri- can Academy of Sleep Medicine [24], and the criteria of the Brazilian Sleep Society and the report of the results will be drafted by a specialist in sleep medicine. The Ber- lin Questionnaire will be administered also. This 10-item patient history questionnaire has recognized efficacy in differentiating individuals with a greater risk of sleep apnea. Moreover, the Epworth Sleepiness Scale (Johns, 1991) [25] will be employed for the assessment of exces- sive daytime sleepiness.
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A randomized control trial to evaluate the effect of adjuvant selective laser trabeculoplasty versus medication alone in primary open-angle glaucoma: preliminary results

A randomized control trial to evaluate the effect of adjuvant selective laser trabeculoplasty versus medication alone in primary open-angle glaucoma: preliminary results

Methods: This prospective, randomized control study recruited 41 consecutive primary open- angle glaucoma subjects with medically-controlled IOP 21 mmHg. The SLT group (n = 22) received a single 360-degree SLT treatment. The medication-only group (n=19) continued with their usual treatment regimen. In both groups, medication was titrated to maintain a target IOP defined as a 25% reduction from baseline IOP without medication, or 18 mmHg, whichever was lower. Outcomes, which were measured at baseline and at 6 months, included the Glaucoma Quality of Life-15 (GQL-15) and Comparison of Ophthalmic Medications for Tolerability (COMTOL) survey scores, IOP, and the number of antiglaucoma medicines.
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EFFECT OF PHARMACIST DIRECTED COUNSELLING SERVICES ON KNOWLEDGE, ATTITUDE, AND PRACTICE (KAP) AND BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS: A RANDOMIZED CONTROL TRIAL

EFFECT OF PHARMACIST DIRECTED COUNSELLING SERVICES ON KNOWLEDGE, ATTITUDE, AND PRACTICE (KAP) AND BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS: A RANDOMIZED CONTROL TRIAL

DISCUSSION: Pharmacist plays a significant role in providing patient counseling services to patients suffering from chronic disorders 9 . This study will generate evidence on role pharmacist mediated counseling in hypertension management. It is very difficult to control blood pressure with medication alone. So, a combination of non-pharmacological and pharmacological therapy will have a significant effect on blood pressure control in hypertension. The study findings reveal that there was a significant improvement in KAP and BP control in the intervention compared to the control group. Most of the patients in the study were belongs to the male gender, which was similar to the study conducted in Guntur 10 . The mean age of the study was 43.7 ± 9.11 years in the intervention and 43.8 ± 8.26 in control groups. These findings slightly contrast with a study conducted by Ramanth KV et al., where the majority of the persons belong to 50- 70 years 11 . All the socio-demographic and clinical characteristics of the study participants were equally distributed between intervention and control groups.
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Dexmedetomidine improved renal function in patients with severe sepsis: an exploratory analysis of a randomized controlled trial

Dexmedetomidine improved renal function in patients with severe sepsis: an exploratory analysis of a randomized controlled trial

Previous randomized controlled trials reported that dexmedetomidine might attenuate renal injury during the perioperative period in patients who underwent car- diac surgery [20–22]. Zhai et al. showed that dexmedeto- midine reduced the levels of serum urea nitrogen, creatinine, and neutrophil gelatinase-associated lipocalin after cardiac valve replacement surgery under cardiopul- monary bypass [20]. However, no randomized controlled trials have reported that dexmedetomidine improves renal function among patients with sepsis. Future studies are needed to confirm our results regarding the im- provement of renal function in patients with sepsis.
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Effect of Treatment of Obstructive Sleep Apnea by Uvulopalatoplasty on Seizure Outcomes: A Case Report

Effect of Treatment of Obstructive Sleep Apnea by Uvulopalatoplasty on Seizure Outcomes: A Case Report

CPAP is the most common method for the treatment of OSA, in which the patient wears a nasal mask that blows the air into the nostrils via a fan and keeps the airways open during sleep [8]. Research has shown that significant improvements in insomnia and snoring are feasible by using this device [7]. Most of the patients presenting with OSA begin their treatment with the CPAP device. The bi-level positive airway pressure (BiPAP) device is very similar to the CPAP machine. This device is often used for the treatment of central sleep apnea, a condition in which apnea occurs without obstruction of the respiratory tract. The BiPAP device may also be used if the patient is unable to endure CPAP therapy [10]. For the young patients who cannot tolerate a CPAP device, surgery is the best choice [10]. The patients should be hospitalized for a couple of days after the surgery and may have complications after soft palatal tissue reduction, such as nasal regurgitation of liquids [10]. Recently, laser-assisted uvulopalatoplasty (LAUP) has become more popular than UPPP [9]. OSA increases the risk of driving accidents and related mortality [11]. Patients with cerebral palsy are at increased risk of OSA. This condition is primarily managed by medication; however, tracheostomy is required to secure the airways in most cases [12]. In addition to the problems mentioned above, OSA is associated with pulmonary hypertension, right-sided heart failure, nocturnal hypoxemia, cerebrovascular accidents (CVA), cardiac arrhythmia and systemic hypertension [13].
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Cortisol total/CRP ratio for the prediction of hospital acquired pneumonia and initiation of corticosteroid therapy in traumatic brain injured patients

Cortisol total/CRP ratio for the prediction of hospital acquired pneumonia and initiation of corticosteroid therapy in traumatic brain injured patients

acquired pneumonia by day 28 in patients with CIRCI (de- fined by a change in baseline cortisol at 60 min of < 9 μg/ dl after ACTH (250 μg) administration) [12]. However, in head trauma patients, we found no interaction between response to corticosteroid therapy and CIRCI status (using the same definition as previously described) [3]. The actualized recommendations for the diagnosis of CIRCI provide that ACTH stimulation test was not superior to random cortisol for the routine diagnosis of CIRCI [30]. Moreover, measuring plasma-free cortisol level over plasma total cortisol level was not recommended in pa- tients with suspected CIRCI [30]. Here, the total and free cortisol blood levels were strongly correlated independ- ently of the inflammatory status of the patient, explaining why we choose to focus on total cortisolemia.
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20th European Students' Conference. Promising medical scientists willing to look beyond

20th European Students' Conference. Promising medical scientists willing to look beyond

The Ets related gene, ERG, encodes a transcription factor with a crucial role in hematopoiesis. Furthermore, ERG rearrangements correlate with subgroups of myeloid leukemia, Ewing sarcoma and prostate carcinoma. Also, high ERG expression predicts adverse outcome in patients with acute T-lymphoblastic and acute myeloid leukemia. Recently, ERG knock-out in mice caused failure in embry- onic hematopoiesis and adult stem cell maintenance. The significance of ERG contributing to this disadvantageous phenotype in mice as well as in patients with acute T-lym- phoblastic and acute myeloid leukemia still needs to be determined because downstream targets of ERG in leukemia remain unknown. Therefore, we performed a genome-wide analysis of ERG target genes in T-lym- phoblastic leukemia. Chromatin Immunoprecipitation on chip (ChIP-on-chip) experiments were performed using two independent ERG specific antibodies for the enrich- ment of ERG-bound DNA templates in T-lymphoblastic leukemia cells (Jurkat) with input or IgG as controls. Enriched DNA templates and control DNA were differen- tially labelled and co-hybridized to high resolution promoter chip arrays with 50-75mer probes (770,000) representing 29,000 annotated human transcripts (NimbleGen). Based on two independent ChIP-on-chip assays, bioinformatic analysis (ACME) yielded statisti- cally significant enriched peaks (using a sliding window of 1000 bp, and a p-value < 0.0001) identifying promot- er regions of 365 potential ERG target genes. Bioinformatic analysis (DAVID server) categorized the 365 potential ERG target genes and genes belonging to leukemia and oncogenic transformation were selected for further validation by real-time PCR. The design of pro- moter primers included the highly conserved ETS GGAA DNA binding site. Genes with at least two-fold enrich- ment (ERG ChIP versus control) included WNT2 (17-fold), OLIG2 (14-fold), WNT11 (7-fold), UBAC2 (8-fold), CCND1 (5-fold), WNT9A (4-fold), DUSP4 (4-fold), CD7 (3-fold), EPO (3-fold), ERBB4 (3-fold), RPBJL (3-fold), TRADD (3-fold), PIWIL1 (2-fold), TNFRSF25 (2-fold), TWIST1 (2-fold), HDAC4 (2-fold). Genes correlated with the WNT-pathways (WNT2, WNT11, FZD7) and genes that have shown oncogenic potential (e.g. STAT5A) were
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Efficacy of a brief multifactorial adherence-based intervention in reducing blood pressure: a randomized clinical trial

Efficacy of a brief multifactorial adherence-based intervention in reducing blood pressure: a randomized clinical trial

Clinical inertia is one of the most important modifiable factors related to lack of BP control. Moreover, changes in AHT regimens have been associated with improvements in systolic and diastolic BP. Our study hypothesized that clinical inertia could be an important confounder, espe- cially if general practitioners (GPs) overseeing patients in the intervention group were more prone to change AHT treatment than GPs of control patients. Thus, to minimize the possibility of differential effects between groups, GPs

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Sleep disturbance in older ICU patients

Sleep disturbance in older ICU patients

The aim of the present review was to provide a brief, yet comprehensive, overview of current data examining sleep characteristics (ie, quantity, quality, and circadian changes) in samples that included patients 80 years or older, who were admitted to the intensive care unit (ICU). The PubMed data- base was searched using the following key terms: “sleep”, “intensive care unit”, “ICU”, “80 years”, “older”, “elderly”, and “senior”. Excluding reviews, only those studies from the past 10 years that explicitly stated that individuals 80 years and older were included in their sample were considered. The search resulted in 19 studies that met our criteria (Table 1). Relevant studies referenced within these publications that met our criteria but that were older than 10 years were also included in our summary of findings.
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The effects of a 2 h trial of high flow oxygen by nasal cannula versus Venturi mask in immunocompromised patients with hypoxemic acute respiratory failure: a multicenter randomized trial

The effects of a 2 h trial of high flow oxygen by nasal cannula versus Venturi mask in immunocompromised patients with hypoxemic acute respiratory failure: a multicenter randomized trial

A randomized trial with a final crossover period com- pared HFNO with standard nonhumidified oxygen therapy in 37 consecutive ICU patients with ARF who did not require immediate NIV or MIV [32]. Dryness and discomfort were significantly lower in the HFNO group. The patients were not immunocompromised, and they had less severe hypoxemia compared with those in our study. In a trial conducted in a cardiothoracic and vascular ICU, researchers randomized 60 patients to HFNO or heated and humidified oxygen therapy via a standard facemask [31]. The need for IMV or NIV within 24 h was lower in the HFNO group (10.3 % vs. 30 %, P = 0.006). Neither comfort nor dyspnea was assessed. More- over, most of the patients had undergone heart surgery and were therefore likely to benefit from the positive ex- piratory pressure delivered by HFNO [31]. Our patients had severe hypoxemia and immune deficiencies. In a
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Effectiveness and pulmonary complications of perioperative laryngeal mask airway used in elderly patients (POLMA EP trial): study protocol for a randomized controlled trial

Effectiveness and pulmonary complications of perioperative laryngeal mask airway used in elderly patients (POLMA EP trial): study protocol for a randomized controlled trial

Among numerous risk factors for the development of PPCs, aging is a well-accepted and independent one [7, 8]. Even when the patient is free from respiratory co-morbidity and does not show any evident physical decline before sur- gery, PPCs can still be triggered by an episode of severe in- cidence such as surgery and anesthesia [7]. Multiple studies have suggested that patients aged > 60 or 65 years are at higher risk of developing PPCs, and the risk increases with increased age [9, 10]. Other risk factors for developing PPCs include smoking, obesity, pulmonary co-morbidities, positive cough test, prolonged surgery time, limited laryn- geal height, and extended forced expiratory time [11, 12].
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A randomized control trial to assess the effect of distraction technique on pain during immunization among infants

A randomized control trial to assess the effect of distraction technique on pain during immunization among infants

Table 4 depicts the comparison of mean pain score during immunization among infants in Control, Experimental group I & Experimental group II. It reveals that the mean pain score of Control group was higher (6.87) as compared to that of Experimental group I (3.27) and Experimental group II ( 2.50). Based on one way analysis of variance, the difference between mean pain score of infants in Control, Experimental group I and Experimental group II was found to be statistically significant at p<0.01 level . According to Tukey’s HSD, the difference in mean pain score between Control and Experimental group I and also between Control and Experimental Group II was statistically significant at p< 0.01 level and the difference in mean pain score between Experimental group I and Experimental group II was statistically significant at p< 0.05 level. Hence it can be concluded that infants in Experimental group I who were given light producing toy and infants in Experimental group II who were given sound producing toy as distraction technique experienced less pain as compared to those who did not receive any distraction technique. There is significant difference in effectiveness of sound and light producing toy when used as distraction technique and it was found that sound as a distraction technique was more effective as compared to light as distraction from pain during immunization among infants. Hence the Research hypothesis was accepted and Null hypothesis was rejected. Thus the distraction is an effective technique in reducing level of pain among infants during immunization.
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