Effectiveness of aromatherapy with lavender compared to progressive muscle relaxation on anxiety and vital signs in patients under spinal anesthesia:A randomized clinical trial

Objective:This study aimed to determine the effectiveness of aromatherapy with lavender essential oil compared to progressive muscle relaxation(PMR)on anxiety and vital signs of patients under spinal anesthesia.Materials and Methods:This clinical trial was conducted on 120 spinal anesthesia candidates who were randomly assigned into three groups of 40 including control,PMR(Jacobsen group),and aromatherapy.The state-trait anxiety inventory was completed on surgery day and 15 min after the end of the intervention by the samples of all three groups,and at the same time as completing the questionnaire,vital signs were also measured and recorded.Results:The mean score of anxiety after intervention was lower than that before the intervention in the aromatherapy group(P<0.001).The mean score of anxiety in the aromatherapy group was significantly lower than that in the Jacobsen group(P<0.001).Moreover,data analysis showed a significant decrease in the mean arterial blood pressure scores of the PMR(P=008)and aromatherapy(P<0.001)groups and a statistically significant increase in the mean heart rate scores in the control group(P=0.002).Conclusion:The use of aromatherapy with lavender is more effective than PMR therapy in reducing the anxiety level of patients undergoing spinal anesthesia.Due to the high level of anxiety and its serious effects on the patient’s hemodynamics,aromatherapy with lavender can be used as an easy and cheap method to reduce anxiety in operation rooms.

Effects of Olive Oil and Grape Seed Oil on Lipid Profile and Blood Pressure in Patients with Hyperlipidemia: A Randomized Clinical Trial

Background and Aims: Hyperlipidemia is one of clear risk factors of diabetes. Regarding its importance, this study was designed to compare the effects of olive oil and grape seed oil on serum lipids and blood pressure in patients with hyperlipidemia in 2015. Methods and Results: In this clinical trial, 60 patients with hyperlipidemia who met inclusion criteria were recruited. Subjects were randomly assigned 3 groups: 1) consume 20 ml/day refined olive oil;2) consume 20 ml/day grape seed oil;3) the control group received no oil. The study period was six weeks. All participants were under Step I diet. Height and weight measurements were taken by Seca scale. Blood pressure, total cholesterol, high-density lipoprotein, triglyceride and fasting blood sugar were measured at baseline and after 6 weeks by standard methods. Low-density lipoprotein levels were calculated by the Friedewald’s formula. Data were analyzed with ANOVA test in SPSS software version 16.0. Sixty participants (36 female and 24 male) with the average age of 47.5 ± 9 y and the mean body mass index of 31.78 ± 5.41 kg/m2 had completed the study. Olive oil intervention decreased systolic blood pressure significantly compared to grape seed oil group (P = 0.01). Triglyceride was significantly decreased in olive oil and also triglyceride groups (P = 0.02 and 0.004, respectively). Conclusion: Overall, the effects of olive oil and grape seed oil were better than control group. However, we suggest the substitution of dietary lipids with olive oil because of its more beneficial effects. Registration number for clinical trial: IRCT2014070218329N1 registration code in Iran Clinical Trial site.

Age as a predictor of clinical outcomes and determinant of therapeutic measures for emergency medical services treated cardiogenic shock

BACKGROUND The impact of age on outcomes in cardiogenic shock(CS)is poorly described in the pre-hospital setting.We assessed the impact of age on outcomes of patients treated by emergency medical services(EMS).METHODS This population-based cohort study included consecutive adult patients with CS transported to hospital by EMS.Successfully linked patients were stratified into tertiles by age(18-63,64-77,and>77 years).Predictors of 30-day mortality were assessed through regression analyses.The primary outcome was 30-day all-cause mortality.RESULTS A total of 3523 patients with CS were successfully linked to state health records.The average age was 68±16 years and 1398(40%)were female.Older patients were more likely to have comorbidities including pre-existing coronary artery disease,hypertension,dyslipidemia,diabetes mellitus,and cerebrovascular disease.The incidence of CS was significantly greater with increasing age(incidence rate per 100,000 person years 6.47[95%CI:6.1-6.8]in age 18-63 years,34.34[32.4-36.4]in age 64-77 years,74.87[70.6-79.3]in age>77 years,P<0.001).There was a step-wise increase in the rate of 30-day mortality with increasing age tertile.After adjustment,compared to the lowest age tertile,patients aged>77 years had increased risk of 30-day mortality(adjusted hazard ratio=2.26[95%CI:1.96-2.60]).Older patients were less likely to receive inpatient coronary angiography.CONCLUSION Older patients with EMS-treated CS have significantly higher rates of short-term mortality.The reduced rates of invasive interventions in older patients underscore the need for further development of systems of care to improve outcomes for this patient group.