BackgroundKetamine, as an opium alternative, has been proposed for pain relief in the emergency department (ED).ObjectivesThis study was carried out to compare low dose ketamine (LDK) with morphine for pain relief in trauma patients.MethodsIn this randomized double-blinded clinical trial, 300 trauma patients from the ED of 2 teaching hospitals in Tehran, Iran were enrolled and randomly divided into 2 equal groups. The 1st group received 0.2 mg/kg of ketamine while the 2nd group received 0.1 mg/kg of intravenous morphine. The pain intensity and complications were measured and compared every 15 minutes to 1 hour.ResultsFifteen minutes after drug injection in both groups, a significant reduction was found in average pain intensity compared to the initial pain (P = 0.01). At 15 minutes, no significant difference was found in both groups in regards to average pain intensity (P = 0.23). The average pain intensity at 30, 45, and 60 minutes in the group receiving morphine was lower than the ketamine group (P = 0.01, P < 0.001, P < 0.001 respectively). Two complications (drop in O2 saturation below 90% and flushing) were significantly greater in the morphine group.ConclusionsThe results of this study suggest that LDK, at a dose of 0.2 mg/kg, in the earlier minutes leads to significant reduction of pain when compared to that of intravenous morphine. It also created fewer complications than morphine.

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Introduction: Cancer as a formidable diagnosis causes the loss of life expectancy in patients. This study was conducted to determine the effectiveness of logotherapy on the life expectancy of cancer patients in the 5 th Azar Hospital of Gorgan, Iran. Material and methods: This quasi-experimental study with two groups (intervention group and control group) was conducted on 40 cancer patients referred to Gorgan's 5 Azar hospital in Golestan province in the north of Iran from 1 March 2019 to 1 December 2019. The samples were selected by simple random sampling method. The Snyder's Hope Scale (AHS) was used for data collection. In the logotherapy group, eight 60-90 minute-long sessions were performed in 4 groups included 5 participants. The data were analyzed by SPSS-16 statistical software using descriptive statistics (mean table and standard deviation) and inferential statistics (paired t-test and ANOVA test). Results: The result of the paired t-test showed no significant difference before and after the intervention in the control group (p = 0.67), but this test showed a significant difference in the intervention group before and after the intervention (p = 0.01). The ANOVA test also showed a significant difference between the two groups (p < 0.01). Conclusion:Considering the effectiveness of logotherapy on increasing the life expectancy of cancer people, it is recommended that relevant authorities should try to use this low-cost method to address the problems related to the meaning of life and life expectancy in cancer patients, and change the attitude of patients towards life expectancy.

A 26-year-old male patient referred to our center with a history of extremely itchy crusted skin lesions in his groins for one year. Moreover, his friend, a 25-year-old male, also developed similar lesions in the groin after using the shared pool, whose condition also did not improve with similar treatment. A regular mycology test (direct and culture test) was performed, as well as molecular examination. The antifungal susceptibility assay to terbinafine, itraconazole, posaconazole, fluconazole, and voriconazole was conducted according to the Clinical and Laboratory Standards Institute M38 third ed. The sequencing study identified T. tonsurans as the causative organism in both patients. The abovementioned organism isolated from both patients displayed resistance against terbinafine and fluconazole (MIC ≥ 4 µg/ml and MIC ≥ 8 µg/ml, respectively). Moreover, the susceptibility of both subjects to posaconazole (0.313 µg/ml), voriconazole (0.25–0.0625 µg/ml), and (1 µg/ml) itraconazole increased. The present report aimed to emphasize the increase in antifungal resistance and a demand for antifungal stewardship, to control this public health threat.