Sha Akhlagh, D Zeighami, E Allahyari, B Maghsoodi, S Azemati, A Alipour, Smr Hadavi,
Volume 6, Issue 2 (9-2010)
Abstract
Background & objectives: Cardiopulmonary bypass often causes a stress hormonal response with subsequent changes in hemodynamic and organ perfusion. Human studies involving cardiopulmonary bypass have shown that very low doses of ketamine can attenuate inflammatory and stress markers, without adverse effects. The aim of this study was to investigate whether low dose infusion of ketamine have hemodynamic stability effect in coronary artery bypass surgery.
Methods: In this double blind-controlled trial, 50 patients undergoing on-pump CABG were randomly assigned to receive either 1.25mcg/kg/min of ketamine infusion (Ketamine group, n=25) or normal saline infusion (Control group, n=25) during 48 hours after induction of anesthesia. hemodynamic measurement including blood pressure, heart rate, central venous pressure, cardiac output, cardiac index, systemic venous resistance, arterial blood gas and lactate were measured previous to induction (T1), 4 h, 24h, and48h after the surgery (T2,T3 and T4). The data were evaluated with using of variance analyzing test and repeated measurement.
Results: There were significant interaction effect between time (pre operation, 4, 24 and 48 hours after operation) and group of study (ketamine and placebo) in assessment of systolic blood pressure (p=0.0001), diastolic blood pressure(p=0.0001), heart rate (p=0.004), central venous pressure (p=0.0001) and lactate (p=0.035). These indicate that ketamine caused decrement in tissue perfusion. Those interactions were not statistically significant for other parameters (p>0.05).
Conclusions: low dose ketamine during and 48 hours after operation not only didn`t show hemodynamic stability effect but also decreased tissue perfusion slightly.
M Baniasadi, Mr Aflatoonian, R Rooholamini, B Aflatoonian, R Abbasi,
Volume 10, Issue 1 (6-2014)
Abstract
Background & Objectives: Breast cancer is the most common cancer among women. Numerous factors are effective in the improvement of patients undergoing surgery in terms of preventing relapse or need for repeated treatment during 6 months after the surgery. This study aimed to determine the factors affecting improvement of patients undergoing surgery for breast cancer using a logistic regression model.
Methods: In this study information of 150 patients were extracted from the surgical records of patients underwent surgery at the Cancer Institute of Tehran Imam Khomeini Hospital. Data were analyzed through SPSS software and using logistic regression models .
Results: Of 150 studied patients, 18 patients (12%) were not fully recovered while 132 (88%) had complete remission. The mean age of the patients was 43 ± 7.5 years, 92.8% were married, and 87.3% had children. According to the results, the odds of non recovery increased by 1.26 times with each one-year increase in age, 5.3 times with each one lymph node involvement, and 8.67 times in the case of metastasis. Other variables, such as marital status, number of children, tumor size, and location of the metastasis showed no significant relationship.
Conclusion : The Results showed that age at diagnosis, due to its relationship with metastases and number of involved lymph nodes can be directly or indirectly affect the outcome. Therefore, increasing the women's awareness about breast cancer seems to be necessary for early diagnosis which requires planning a sufficient screening program by health policy makers of the country.
