The Development Process of the Ecological Education in Independent Kazakhstan  - Pages 573-579

Primbetova Aigul and Baltabayeva Gaukhar

DOI: https://doi.org/10.6000/2292-2598.2020.08.03.35
Published: 14 October 2020

Abstract: Today, the world community understands that one of the main reasons for the emergence of the global ecological crisis is the low education level, including the ecological one. On the 21st century threshold, the individual's ecological development is becoming a priority and a meaning-forming factor in state education policy. In many ways, it acts not only as a means of preserving nature but also of human civilization as a whole.

This study recommends theorizing and establishing ecological education among learners. The future teacher needs to connect diverse thoughts about ecology and attempt to understand effective practices to cultivate a space of reflection for students and devise effective ways and methodologies to foster ecological education skills thought among student learners.

The purpose of the present study was to collect and analyze environmental education undertaken with various subjects. For systematic analysis, selected databases and journals were analyzed across pre-determined criteria.

The close examination resulted in 11 studies reporting the effects of the interventions (e.g., hands-on practices, field trip activities) and 4 studies reporting participants' views on the effects of the interventions in general. Later, these studies were subjected to content analysis to present the trends and to synthesize the common findings of the selected studies. The techniques and instructions used as the intervention in these selected studies were observed to contribute to the development of participants' gains associated with knowledge of the environment and nature, perception of nature, environmental effect, responsible environment behaviors, and conception and understanding of science.

Keywords: Development, process, ecological, education, Independent Kazakhstan.

The Effect of Intravenous Dexmedetomidine on Postoperative Pain Intensity in Patients undergoing Abdominal Hysterectomy  - Pages 107-111

Sholeh Nesioonpour, Kaveh Behaeen, Ahmad Reza Mohtadi, Ali Ghomeishi and Negin Babadi

DOI: https://doi.org/10.6000/2292-2598.2020.08.02.3
Published: 15 May 2020

Abstract: Objective: The control of perioperative pain and its practice can play an important role in short and long term postoperative convalescence. The aim of this study was to evaluate the effect of dexmedetomidine on postoperative pain in patients undergoing abdominal hysterectomy (TAH).

Methods: This double-blind, randomized controlled clinical trial study was conducted on 70 women aged 35-65 years undergoing general anaesthesia for TAH. In dexmedetomidine group, immediately after induction, a bolus dose of dexmedetomidine 1 μg/kg was injected for 15 minutes and then a dose of infusion 0.5 μg/kg until the end of surgery. In the control group, normal saline was injected. Patients were evaluated for pain intensity according to the visual analogue scale (VAS), the amount of analgesic use during 24 hours after surgery and time of administration of the first dose of pethidine.

Results: Although the mean pain intensity at all times in dexmedetomidine group was lower than the control group, there was a significant difference at 4, 8, 16, and 24 hours after surgery (P <0.05). The time of the first request for administration of the first dose of pethidine was greater than the control group, but there was no significant difference in first-time administration of opioid in the two groups (P >0.05). Although the mean dose of pethidine was lower in the dexmedetomidine group, there was no statistically significant difference between the mean values in the two groups (P >0.05).

Conclusion: This study showed the efficacy of dexmedetomidine in reducing post-operative pain and receiving pethidine after surgery.

Keywords: Dexmedetomidine; Abdominal Hysterectomy, Postoperative Pain.

The Effect of In-Hospital Intervention to Reduce Door to Needle Time in Patients Receiving Tissue Plasminogen Activator  - Pages 112-116

Gholamreza Shamsaei, Shahram Rafie and Fatemeh Pourshams

DOI: https://doi.org/10.6000/2292-2598.2020.08.02.4
Published: 15 May 2020

Abstract: Background and Objective: Attempts have been made to confirm the diagnosis of stroke at the earliest stage and to prevent the development of neurological deficits. Tissue plasminogen activator (tPA) plays a logical role in the treatment of acute stroke by converting plasminogen to plasmin, and recent studies have shown that the drug can be injected up to four and a half hours after the onset of symptoms. The present study aimed to evaluate the effect of an in-hospital intervention to reduce door to needle (DTN) time in acute stroke patients.

Methods: This epidemiological case-control study was performed on patients with acute ischemic stroke from September to March 2016 (n= 25) (group A) who were treated with tPA according to stroke guidelines. Their basic specifications, DTN and Door to Computed Tomography scan (DTC) time were recorded. Then, from April to August 2017, an intra-hospital recipe for tPA injection was provided by investigating the obstacles and causes of intra-hospital delays. Subsequently, stroke patients receiving tPA from September to March 2017 (n= 23) (group B) were examined, and their DTN and DTC were compared with patients in the first group.

Results: The mean DTN and DTC in group A were 67.27±28.83 and 30.40±10.59 minutes, and in group B, were 45±25.98 and 22.17±8.50, minutes, respectively, which made a significant difference between the two groups (P=0.005, P=0.006, respectively). The percentage of patients with DTN less than 60 minutes increased from 52% in group A to 95.6% in group B. The percentage of patients with DTC less than 25 minutes decreased from 32% to 69.56% (P<0.001). The percentage of patients with symptomatic cerebral haemorrhage increased from 12% to 8.7% (P<0.001). The percentage of patients with independent ambulatory (mRS: 0-2) at three months after discharge increased from 48% to 56.5% (P=0.003). The mortality rate also decreased from 24% to 13.4% (P<0.001).

Conclusion: By resolving the causes of intra-hospital delays and using a proper team program, the mean DTN and DTC of patients receiving tPA were reduced. This decrease in DTN time was accompanied by reduced complications in the form of reduced symptomatic cerebral haemorrhage and mortality and improved prognosis.

Keywords: Door to Needle, Door to CT, Thrombolytic plasminogen activator.

The Effect of Midazolam on Prevention of Post-Dural-Puncture Headache  - Pages 94-99

Davood Kashipazha and Mansoureh Babadi

DOI: https://doi.org/10.6000/2292-2598.2020.08.02.1
Published: 15 May 2020

Abstract: Objective: Post-dural-puncture headache (PDPH) is the most common side effect associated with a lumbar puncture (LP). The present study aims to evaluate the effect of midazolam on the prevention of PDPH.

Methods: This single-blind randomized clinical trial study was performed on 120 patients aged 18-60 years who were candidates for diagnostic LP in 2017-2018. In the intervention group (n=30), 3 mg of midazolam was injected intravenously for two minutes 5-10 minutes before LP, and the control group received normal saline as placebo. Patients in both groups were evaluated and compared with each other in terms of incidence, onset, severity, and duration of PDPH.

Results: The incidence of PDPH was lower in the midazolam group, but the difference was not significant (P>0.05). Mean severity, onset time, and duration of PDPH were not significantly different between the two groups (P<0.05). All patients in the intervention group and 75% of patients in the control group with PDPH had a history of headache. There was no significant difference between gender, mean age, BMI, pressure and CSF volume in patients with PDPH (P>0.05). The mean age of patients with PDPH was significantly lower in both groups, and the percentage of women with PDPH was considerably higher than that of men (P<0.05).

Conclusion: Although there was no significant difference between the parameters studied in the two groups, patients with less age, history of headache, lower CSF pressure, and female gender were more likely to develop PDPH.

Keywords: Lumbar puncture, Headache, Midazolam.