Background & Aim: Patients with end-stage renal disease undergoing hemodialysis are repeatedly exposed to stress and pain from approximately 300 punctures per year to their arteriovenous fistula . Patient comfort with the procedure is therefore of greatest importance for long-term compliance with the treatment and until a successful renal transplant. This study was conducted to determine the effect of rhythmic breathing on pain intensity when the needles are inserted into vascular access for hemodialysis .

  Methods & Materials: This was a quasi -experimental one-group time-series study. Thirty five patients in hemodialysis ward of Hamadan Besat hospital entered into the study via convenient sampling method. In this study, pain intensity during the insertion of hemodialysis vascular needles was measured in six sessions through two methods of routine intervention and rhythmic breathing. The data were collected using visual analog scale. Paired t-test was used to determine pain intensity mean difference between the two conditions . 

  Results: Overall, the results showed that the mean pain intensities were 5.45±1.15 and 2.19±0.92 in two conditions including routine intervention and rhythmic breathing , respectively. Paired t-test showed a significant difference between the routine intervention and rhythmic breathing (P<0.001) .

  Conclusion: These findings showed that rhythmic breathing was effective in reducing pain when the needles were inserted into the vascular access. Therefore, it is recommended to use rhythmic breathing as a simple and non-expensive method to reduce pain in patients before insertion of hemodialysis vascular needles .

Background & Aim: Poor oral care for the ventilated patients in intensive care units (ICU) can result in the accumulation of pathogens and respiratory infections. In this regard, in addition to the chemical methods, a mechanical method has been recommended to be added. However, concerning its effect on pneumonia, different findings have been reported. Therefore, this study was conducted to compare the effects of chlorhexidine solution with or without toothbrushing on the development of ventilator-associated pneumonia among patients in ICUs.

Methods & Materials: This was a single-blind, randomized controlled clinical trial conducted in two selected hospitals of Ahvaz city in 2014. A convenience sample of 68 ventilated patients was randomly allocated to the toothbrush group (34 patients) or the gauze swab group (34 patients) using R software. Both groups received 0.2% Chlorhexidine solution. The intervention was performed in both groups for 3 minutes twice a day for five days. At the end of the fifth day, the development of pneumonia was assessed using the Clinical Pulmonary Infection Score (CPIS). Data were analyzed by Chi-square and t-independent test through SPSS v.16.

Results: The two groups were similar for age, sex, cause of admission, level of consciousness, medication and tobacco use. The majority of patients (58.8%) were diagnosed with pneumonia (Group A: 55.9% and Group B: 61.8%). The Chi-square test showed no significant difference between the two groups for the development of pneumonia (P>0.05).

Conclusion: The use of Chlorhexidine solution with toothbrushing compared to using Chlorhexidine with swab could not reduce the development of pneumonia. However, due to its importance, further research is needed in this regard.