Background: The prevention of ventilator-associated pneumonia (VAP) can decrease the duration of mechanical ventilation, length of hospital stay, mortality, and healthcare costs. Objectives: The aim of this study was to compare the effect of the elevation of head of bed (HOB) to 30 and 45 degreess on the incidence of VAP. Methods: This study was a 3 group controlled randomized clinical trial. It consisted of 120 patients who were under mechanical ventilation and hospitalized in the intensive care unit (ICU) from February to July 2016 in the selected governmental hospitals of Iran University of Medical Sciences. The patients were allocated into 3 groups. The patients of intervention groups received interventions consisting of HOB elevation to 30 and 45 degreess for 3 consecutive days. The patients in the control group were in the routine position in the bed for 3 consecutive days. The HOB elevation was measured using the goniometer and recorded by nurses in perticular forms. At the end of the third day, VAP and pressure ulcers were evaluated using the clinical pulmonary infection score (CPIS) as well as Braden scales. The data were analyzed using descriptive and inferential statistics. Results: Statistically significant differences were reported in terms of VAP between the groups of the HOB evelation to 30 degrees (32.50%) and 45 degrees (20.00%) and control groups (52.50%) (P = 0.01). However, the mean scores of pressure ulcer showed no statistically significant differences between the groups (P = 0.625). The greatest change in position was performed by the staff nurses

BACKGROUND AND PURPOSE: The clinical differentiation of Parkinson's disease (PD) from other extrapyramidal syndromes has made a challenge in neurology. This study aimed to compare the specificity and sensitivity of brain MRI volumetry and dopamine transporter scans in differentiating PD from other extrapyramidal syndromes in the early stages of the disease. METHODS: This study included 34 patients younger than 70 years old with less than 3 years of extrapyramidal symptoms. Demographic and clinical history of the patients, including age, sex, and disease duration, was gathered. Disease severity was assessed using Unified Parkinson's Disease Rating Scale III (UPDRS III). For all patients, 99m Tc-TRODAT single-photon emission computed tomography (SPECT) and MRI volumetry were performed. Patients were followed up for 1 year and examined for final diagnosis. RESULTS: According to the quantitative 99m Tc-TRODAT analysis, all of the specific binding ratio (SBR) parameters, including right, left, and bilateral SBRs, were significantly higher in the non-Parkinsonian patients. Also, the results indicated a high diagnostic accuracy for both quantitative 99m Tc-TRODAT analysis (about 88% for SBR parameters) and MRI volumetry (71% for bilateral olfactory bulbs volume) in diagnosing PD. Regarding the diagnosis of PD, there were no significant differences between quantitative scan results and olfactory bulb volumetry according to the area under the receiver operating characteristic curves. CONCLUSION: 99m Tc-TRODAT has a higher accuracy in differentiation of early PD from non-Parkinsonian conditions, particularly essential tremor. Olfactory bulbs volumetry by using MRI can also serve as a potential alternative method in this regard.

Background & Aim: The prevention of ventilator-associated pneumonia (VAP) can decrease the duration of mechanical ventilation, length of hospital stay, and healthcare costs. One of the interventions is raising the head of bed (HOB) to 45 degrees. This study was perfomed with the aim of determining the effect of the HOB elevation to 45 degree on the incidence of VAP on hospitalized in Intensive Care Unit (ICU). Materials & Methods: This study was a randomized clinical trial. It consisted of 80 patients who were under mechanical ventilation and hospitalized in Intensive Care Unit (ICU) from February to July 2016 in the selected governmental hospitals affiliated to Iran University of Medical Sciences. The samples were assigned to two groups, i.e. control and intervention, using a randomised block method. The patients in intervention and control groups had HOB elevation to 45 degree and routine position for three consecutive days. In both groups, HOB elevation in every shift was measured using the goniometer and was recorded by nurses in the angel of bed form. At the end of the third day, ventilator-associated pneumonia was evaluated, using the Clinical Pulmonary Infection Score (CPIS). Data analysis was performed with chi-square, Fisher's exact test, and T-Test via SPSS v.20. Results: There was a statistically significant difference between two groups with regard to VAP (P-value=0.002). The incidence of VAP were 52.5% in the control group and 20% in the intervention group. Conclusion: According to the results of this study, HOB elevation of 45 degree were effective in preventing VAP. Hence, it is recommended that the patients hospitalized in ICU,and under mechanical ventilation, should be positioned 45 degree according to their conditions.

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