Eurasian Journal of Chemical, Medicinal and Petroleum Research

Abstract Background: Postoperative pain remains a significant clinical challenge, affecting up to 80% of surgical patients and impeding recovery. Standardized pain management protocols, including Enhanced Recovery after Surgery (ERAS) pathways and opioid-sparing analgesia strategies, have developed to address this issue through systematic, multimodal approaches.

Objective: This study aims to assess the effectiveness of standardized pain management protocols in improving postoperative recovery outcomes among surgical patients.

Methods: A systematic review and meta-analysis conducted following PRISMA guidelines. PubMed, Embase, Web of Science, and Cochrane Library searched for randomized controlled trials and comparative studies evaluating standardized pain protocols versus conventional care. Primary outcomes included postoperative pain scores, opioid consumption, and length of hospital stay, opioid-related adverse effects, and patient satisfaction. 58 studies (5,614 patients) were included in the final analysis.

Results: Standardized pain protocols were associated with significantly reduced 24-hour morphine consumption (MD: -9.47 mg, 95% CI: -13.00 to -5.95), lower pain scores at 24 hours (MD: -0.72, 95% CI: -0.97 to -0.47), reduced PONV incidence (OR: 0.73, 95% CI: 0.59-0.90), and improved patient satisfaction (MD: 0.88, 95% CI: 0.36-1.40). Length of stay showed a reduction from 3.0 to 2.1 days (p

Abstract Objectives: Globalization has led to increasingly diverse patient populations in healthcare settings. Emergency departments (EDs), as high-pressure, fast-paced environments, require staff to possess strong communication and social interaction skills to ensure quality care. This study aimed to investigate the relationship between cultural intelligence (CQ) and the communication skills and social interactions of ED staff members.

Methods: This cross-sectional study conducted on 197 ED staff members from three hospitals in Zanjan, Iran, in 2019. Data collected using the Cultural Intelligence Scale (CQS), a Communication Skills Scale, and a Social Interactions Questionnaire. Data analysis performed using descriptive statistics and correlation tests.

Results: Participants' mean scores for cultural intelligence and communication skills were 85.78 ± 6.24 (out of 140) and 55.41 ± 3.9 (out of 90), respectively. For social interactions, the mean score for positive thoughts (47.86 ± 4.14) was higher than for negative thoughts (33.01 ± 3.92). The total CQ score showed a significant positive correlation with communication skills (P < 0.001). Furthermore, higher CQ scores were significantly associated with increased positive thoughts and decreased negative thoughts (P < 0.001).

Conclusions: The findings demonstrate that higher cultural intelligence among ED staff is associated with better communication skills and positive social interactions. Healthcare leaders recommended to educational programs and workshops to enhance the cultural intelligence of ED personnel, which can improve both staff communication and the quality of patient care.

Abstract Context: Cardiac arrest remains one of the leading causes of death worldwide, with survival rates remaining low despite advances in treatment protocols. Nurses play a critical role as first responders in cardiopulmonary-cerebral resuscitation (CPCR). Therefore, ensuring adequate CPCR training for nursing staff is essential to improve patient outcomes.

Objective: This systematic review aimed to provide an overview of CPCR training methods for nurses in Iran and to evaluate their effectiveness in improving nurses'' knowledge, skills, and performance.

Methods: A systematic search conducted in international databases including PubMed, Scopus, CINAHL, Google Scholar, and Persian databases including SID, IranMedex, and Magiran for articles published between 2010 and 2020. English and Persian keywords including "education," "training," "cardiopulmonary-cerebral resuscitation," "nurses," "knowledge," "skill," and "performance" were used. 21 articles were identified; after removing duplicates and screening for relevance, 10 studies were included in the final review. Quality assessment performed using appropriate critical appraisal tools.

Results: The review identified three main categories of CPCR training methods: conventional (lectures, pamphlets, and mannequin practice), modern (simulation, workshops, video-based, and flipped classroom), and integrated approaches. Conventional methods primarily improved knowledge but showed limited effects on skills retention. Modern and integrated methods demonstrated superior outcomes in enhancing both knowledge and practical skills. Simulation-based and workshop approaches yielded the highest skill acquisition and satisfaction levels among nurses.

Conclusions: Integrated training methods combining conventional and modern approaches are the most effective for improving nurses'' CPCR competence. Healthcare policymakers and educational managers should implement standardized, multifaceted training programs with regular refresher courses to maintain CPCR skills.

Abstract Introduction: Chronic post-mastectomy pain is a common and disabling survivorship problem, and growing evidence suggests that early postoperative inflammation may contribute to its development. C-reactive protein is an accessible biomarker of surgical inflammatory response. This study aimed to evaluate whether first-postoperative-day C-reactive protein levels are associated with subsequent chronic post-mastectomy pain.

Material and methods: This descriptive cross-sectional study was conducted at Tabriz University of Medical Sciences in 2022 on 50 women undergoing mastectomy, selected by convenience sampling. Sample size was estimated using the Cochran single-group formula. The main variables included first-postoperative-day serum C-reactive protein level and chronic post-mastectomy pain at follow-up, alongside demographic, clinical, surgical, oncologic, and postoperative variables potentially related to pain development.

Results: Among 50 women undergoing mastectomy, 19 (38.0%) developed chronic post-mastectomy pain. Mean first-postoperative-day CRP was significantly higher in patients with chronic pain than in those without pain (36.2 ± 11.6 vs 23.9 ± 8.7 mg/L, P < 0.001). Axillary lymph node dissection (84.2% vs 54.8%, P = 0.034), longer operative time (127.9 ± 25.1 vs 109.8 ± 21.6 minutes, P = 0.011), and early postoperative complications (36.8% vs 12.9%, P = 0.046) were also associated with pain development.

Conclusion: Elevated first-postoperative-day CRP was independently associated with chronic post-mastectomy pain, suggesting that an intensified early postoperative inflammatory response may play an important role in pain chronification after breast cancer surgery.

Abstract Introduction: Early postoperative inflammation after lumpectomy may be influenced by tumor biology, particularly estrogen receptor expression, which modulates immune signaling and cytokine activity. However, its relationship with surgical inflammation remains unclear. This study aimed to evaluate the association between estrogen receptor expression and inflammatory responses during the first 24-hour postoperative period.

Material and methods: This descriptive cross-sectional study was conducted at Tabriz University of Medical Sciences in 2026 on 45 women undergoing lumpectomy, selected by convenience sampling. Estrogen receptor expression was assessed immunohistochemically in surgical specimens, while early postoperative inflammation was evaluated by 24-hour serum C-reactive protein measurement. Additional variables included age, body mass index, menopausal status, tumor characteristics, operative duration, white blood cell count, temperature, drainage volume, and pain score.

Results: Our study demonstrated that ER-negative patients exhibited a more pronounced inflammatory response post-lumpectomy. The ER-negative group showed significantly higher 24-hour CRP (16.83 vs. 12.46 mg/L; p=0.001) and WBC counts (10.08 vs. 8.71 × 10³/µL; p=0.017) than ER-positive patients. Regression analysis confirmed an independent inverse association between ER expression and postoperative CRP levels (adjusted β=3.92; p=0.003), underscoring a distinct link between molecular phenotype and acute systemic inflammatory intensity.

Conclusion: ER-negative status in breast cancer patients significantly exacerbates the systemic inflammatory response during the first 24 hours after lumpectomy. This association suggests that ER expression serves as a critical molecular biomarker for early postoperative recovery. Consequently, patients with ER-negative tumors may require heightened clinical surveillance and targeted anti-inflammatory interventions to manage the observed surge in acute inflammatory markers following surgical resection.

Abstract Introduction: Laryngeal squamous cell carcinoma remains a major clinical challenge, and conventional margin assessment may overlook molecular alterations associated with residual disease and field cancerization. DUSP1, a regulator of MAPK signaling, may contribute to tumor behavior. This study aimed to assess DUSP1 expression levels in tumor and surgical margin samples of LSCC.

Material and methods: This descriptive cross-sectional study was conducted in 2024 at Tabriz University of Medical Sciences on 50 patients with laryngeal squamous cell carcinoma, selected through convenience sampling based on the Cochran formula for single-group studies. DUSP1 expression was measured in paired tumor and surgical margin samples, alongside demographic, clinical, and pathological variables, including age, sex, smoking status, tumor site, grade, TNM stage, lymph node involvement, and margin status.

Results: In this study of 50 patients with laryngeal squamous cell carcinoma, mean DUSP1 expression was significantly higher in tumor tissue than in paired surgical margins (2.73 ± 0.68 vs. 1.41 ± 0.37; P=0.001). Tumoral DUSP1 expression was also greater in smokers, poorly differentiated tumors, advanced-stage disease, node-positive cases, and positive surgical margins, indicating a consistent association between elevated DUSP1 levels and more aggressive clinicopathological characteristics.

Conclusion: DUSP1 was significantly overexpressed in LSCC tumor tissue compared with surgical margins and was associated with adverse clinicopathological features. These findings suggest that DUSP1 may serve as a promising molecular indicator of tumor aggressiveness and local disease extension.

Abstract Introduction: Tibial fractures present substantial healing challenges because limited soft-tissue coverage, vulnerable blood supply, fracture complexity, and host-related factors increase the risk of impaired union. Although plate fixation restores alignment and stability, it may contribute to infection, nonunion, malunion, and implant-related complications. This study aimed to evaluate healing time and complications following tibial fracture plating from a pathologic perspective.

Material and methods: This descriptive cross-sectional study included 52 patients who underwent plate fixation for tibial fractures at Shahid Madani Hospital, Tabriz, selected through convenience sampling. Demographic, clinical, fracture-related, laboratory, operative, and postoperative data were collected from medical records and follow-up assessments. Healing time was determined using clinical and radiographic evidence of union, while postoperative complications, including infection, impaired union, malalignment, and implant-related failure, were documented.

Results: Patients with postoperative complications were older and had more severe injuries, including higher rates of open and comminuted fractures, longer time to surgery, and worse preoperative inflammatory and nutritional profiles (all significant variables, P<0.05). Healing time was markedly prolonged in complicated cases (23.2 ± 4.6 vs 15.9 ± 3.2 weeks, P<0.001). Independent predictors included age (OR=1.04), open fracture (OR=2.86), CRP (OR=1.17), surgical delay (OR=1.38), and operative duration (OR=1.21).

Conclusion: These findings indicate that postoperative complications after tibial plate fixation are driven by both fracture severity and adverse preoperative biological status. Early surgical management, control of inflammation, and optimization of hemoglobin and albumin levels may improve healing and reduce complication risk. Preoperative CRP and operative burden appear particularly valuable for risk stratification and perioperative decision-making.

Abstract Introduction: This study compares intensive care unit outcomes between obese and non-obese postmenopausal women undergoing gastric surgery, a population vulnerable to distinct metabolic and respiratory risks. Ultimately, we aim to evaluate how obesity status influences postoperative ICU length of stay, complication rates, and resource utilization in these patients.

Material and methods: This descriptive cross-sectional study was conducted at Tabriz University of Medical Sciences during 2023 and included 215 postmenopausal women selected through convenience sampling. Sample size was estimated using the Cochran formula for a single-population proportion. The study assessed demographic, clinical, surgical, and ICU-related variables, including obesity status, comorbidities, operative characteristics, inflammatory markers, postoperative complications, and key intensive care outcomes.

Results: Obese postmenopausal women experienced significantly longer ICU stays (54.82 ± 14.63 vs. 38.15 ± 9.47 hours; p < 0.001) and prolonged mechanical ventilation (8.42 vs. 4.15 hours). Higher rates of respiratory distress (29.81% vs. 9.91%; p < 0.001) and wound infections (12.50% vs. 3.60%; p = 0.014) were observed. Consequently, obesity extended total hospitalization to 8.74 days compared to 6.82 days (p < 0.001), reflecting a more complex and resource-intensive postoperative recovery trajectory.

Conclusion: Obesity in postmenopausal women significantly impairs recovery after gastric surgery, leading to extended ICU stays and increased respiratory and infectious complications. These findings suggest that obese patients require more intensive perioperative management and specialized monitoring. Clinicians should prioritize early mobilization and targeted pulmonary interventions to mitigate the heightened resource utilization and clinical risks associated with elevated body mass in this population.