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Showing 19 results for Ameli

P Jabalameli , B Ghazi Moghaddam ,
Volume 52, Issue 1 (30 1994)
Abstract

The treatment of choice for bladder tumors is TUR, but because of high incidence of recurrence in these tumors, various treatments are suggested. In one study, 32 patients involved with superficial T.C.C. of bladder selected and divided in two equal groups. In the first group, after T.U.R, 10 million IU of a alpha-interferon was injected into the bladder through a catheter and in the other group, after TUR, they treated with injection of BCG into bladders. The results of these two drugs in prevention of recurrence and their side effects were studied and compaired
P Jabal Ameli , H Hal Ataei,
Volume 53, Issue 2 (5-1995)
Abstract

We report our experience with 124 patients were referred 70 our urology clinic in Sina hospital for urinary retention. Serum PSA analyzed by using a monoclonal assay. All patients underwent digital rectal examination. The patients devided in 3 groups: Group 1 (87 men) with a serum PSA level less than 4 ng/ml, group 2 (26 men) with a serum PSA level 4-10 ng/ml and group 3 (11 men) with a serum PSA level greater than 10 ng/ml. After prostate biopsy and trans urethral resection or open prostatectomy, of the 87 men in group 1, one man had cancer of the prostate, of the 26 men in group 2, 2 men had cancer of the prostate and of the 11 men in group 3, 9 men had prostate cancer.
P Jebelameli , M Ayatiafin , A Akhavantafti ,
Volume 55, Issue 6 (1 1997)
Abstract

Only orchiectomy is still commonly used today either as a single therapy or in combination regimens. Hypophysectomy & adrenalectomy showed such devastating effects on the endocrine equilibrium as to be inconsistent with an acceptable quality of life or even with survival. Chemical adrenalectomy was also tried with drugs (eg. aminoglutethmide, spironolactone) leading to consequences superimposable to those of surgical adrenalectomy. Along with orchiectomy, three groups of substances are commonly used today for the hormonal therapy of prostate cancer: estrogens, LHRH agonists & anti androgens. Bilateral orchiectomy removes 90-95% of circulating testosterone. Clinical studies document 60-80% of positive responders to castration, on continued evaluation, relapse occurs usually within 6-24 months in responders, with a death rate of 50% within 6 months. The androgenic activity still remaining after castration may explain the partial & progressively decreasing effectiveness of this & other testosterone reducing therapies. Antiandrogens define substances that act directly at the target site, where interacting with steroid hormone receptors, they impede the binding of androgens. A trend towards the combination of testosterone-reducing & androgen-blocking treatment is developing in modern therapy of prostate cancer. This is due to the complementary characteristics of the two different pharmacological mechanisms that are involved. In this study castration+antiandrogen is compared to castration alone. The results demonstrate a significantly greater percentage of positive objective & subjective responses with antiandrogen than with placebo. In addition survival time was increased in patients treated with castration+antiandrogen than castration+placebo.
M Jabalameli , E Ameri ,
Volume 56, Issue 4 (1 1998)
Abstract

This paper represents a retrospective study of 142 patients with skeletal tuberculosis during the years 1350 to 1357 at Shafa Yahiaian Hospital. Confirmation of diagnosis is made by positive culture or pathology. The mean age of the patients was 27.5 years (range from 1.5 to 72 years). Most of the patients were in the second, first and third decade respectively. 45.3% of the patients were female. The spine was the most common site and was affected in 40.88% of the patients. The next sites were knee, hip and elbow, in order of frequency. The commonest site in spine was thoracic. The mean of sedimentation rate in the first visit was 48. Tuberculin skin test was negative in 23% of the patients. Evidence of pulmonary tuberculosis in chest radiography was present in 48.61% of the patients. Five patients had tuberculosis osteomylitis without involvement of the joint.
Mirsalehian A, Jabalameli F, Kazemi B, Alizadeh S A,
Volume 61, Issue 6 (15 2003)
Abstract

Background: Staphylococci as a micro-organism, has the most importance to cause nosocomial infections, particularly in patients with indwelling catheters or other medical devices. Unfortunately 90% of Staphylococci isolated from the nosocomial infections are resistant to methicillin, and methicillin resistance strains are also resistant to a wide range of antimicrobial drugs, therefore detecting of these strains are valuable to eradicate the infection elements. Despite guidelines published by the national committee for clinical laboratory standards (NCCLS) for testing of susceptibility to methicillin for Staphylococci, the phenotypic method for detecting methicillin resistance remains controversial. Therefore, the genetic assays have been used to detect antimicrobial susceptibility of Staphylococci to methicillin.
Materials and Methods: Resistance to methicillin is coded by mec A gene in staphylococcus, and this gen must be detected in genetic assays. In this study 155 clinical staphylococcal isolates (70 coagulase- negative staphylococcus and 85 coagulase- Positive staphylococci) were evaluated for susceptibility to methicillin by using disk diffusion method.
ResuIts&Conclusion: Methicillin resistance was shown in 62 coagulase- negative staphylococcus (72.9%) and 27 coagulas positive staphylococcus (38.6%) but 63 coagulase negative Staphylococci (74%) and 28 coagulase positive isolates with mec a gene associated resistance were detected by PCR method. The results of this test were compared to the results for mec A gene detection by PCR test as a gold standard. The sensitivity, specifity and accuracy of the disk diffusion test for coagulase-negative staphylococcus were 96.8%, 95.45% and 96.47% and for coagulase positive staphylococci were 98.43%, 95.45% and 98.32% respectively.

 


Aligholi M, Emaneini M, Hashemi F. B , Shasavan Sh, Jebelameli F, Kazemi B,
Volume 64, Issue 9 (1 2006)
Abstract

Background: Staphylococcus aureus (SA (is an important cause of nosocomial and community-acquired infections. The emergence of antibiotic resistance, especially in methicillin-resistant SA (MRSA) strains, has caused difficulties in treatment of such infections. The determination of antibiotic resistance patterns, particularly domestic patterns of Iran, is essential for appropriate treatment of MRSA infections and proper infection control measures in our country.
Methods: The antibiotic resistance of 338 SA isolates from various clinical specimens was determined by disk agar diffusion (DAD), minimum inhibitory concentration (MIC) and polymerase chain reaction (PCR) methods.
Results: Using the DAD method, 47% (160/338) of the SA isolates were resistant to oxacillin, and only 6% (20/338) were resistant to vancomycin. By PCR, 48% (162/338) of the isolates had the mecA gene. The MIC of oxacillin in 93% of isolates was higher than 256µg/mL. The MRSA isolates, showed a high resistant to gentamicin (40.5%), erythromycin (40%), and ciprofloxacin (38%). However, only a few of the SA isolates showed a high resistance to vancomycin (5%) or erythromycin (3.5%).
Conclusion: The results of this study can provide guidance for physicians toward a more appropriate treatment of SA infections in Iran, thereby preventing the emergence of further antibiotic resistance among SA. Our results also revealed the need for further investigations using a higher number of specimens representing a wider variety of locations to determine the antibiotic resistance patterns in our state more precisely.
Mirsalehian.a, Nakhjavani.f, Peymani.a, Jabalameli.f, Mirafshar.s M, Hamidian.m,
Volume 65, Issue 1 (5 2008)
Abstract

Background: The incidence of ESBL producing species have been steadily increased in recent years, resulting in limitation of infection control issues and therapeutic options.The purpose of this study was to evaluate prevalence of Enterobacteriaceae and also assess epidemiology ESBL producing strains isolated from patients admitted in ICUs.
Methods: A total of one hundred fifty isolates were collected from urine, sputum, blood, wound and other clinical samples from patient admitted in ICU and then were identified by biochemical tests .All of the samples were screened by DAD method according to The NCCLS Guideline. The species that met NCCLS screening criteria was further tested for Clavulanic Acid effect by confirmatory method.
Results: A total of one hundred fifty isolates,133(89.3%) were found to be resistant at least on of the indicators cephalosporin tested according to NCCLS Guideline. 121(80.6%) of the isolates were resistant to all the indicators tested .89(59.3) isolateds were confirmed as ESBL producers. The number of isolates ESBL producing was as follow: Klebsiella pneumoniae 33 (76.74%), E.coli 20 (60.60%), Enterobacter cloacae 8 (47.05%), Citrobacter diversus 6 (54.54%), Enterobacter aerogenes 7 (53.84%), Citrobacter freundii 4 (40%), Klebsiella oxytoca 6 (62.5%), Proteus mirabilis 4 (50%), Serratia marcescens 2 (40%), Proteus Volgaris 0%.All of the isolates sensitive to imipenem.
Conclusion: The present study shows high prevalence of ESBL producing Enterobacteriaceae from patients admitted in ICU .The increased rate of these species in most cases due to the administration of inadequate and irrational antimicrobial therapy .To overcome this problem, it needs to develop new antimicrobial agents, limiting the Unnecessary Use of antimicrobial and increasing compliance with infection control issues.
Mirsalehian, Feizabadi, Akbari Nakhjavani, Jabal Ameli, ,
Volume 66, Issue 5 (5 2008)
Abstract

Background: The resistance of Pseudomonas aeruginosa strains to broad spectrum cephalosporins may be mediated by extended spectrum b-lactamases (ESBLs). These enzymes are encoded by different genes located either on chromosome or plasmids. In this study, we determined the antimicrobial resistance patterns of P. aeruginosa isolates and screened for ESBL production.

Methods: After isolation from burn patients in Tehran Hospital, identification of P. aeruginosa isolates were assessed using biochemical tests. We then performed disk agar diffusion (DAD) according to CLSI guidelines to determine the pattern of antimicrobial resistance. The frequency of ESBLs and prevalence of the OXA-10 and PER-1 genes were determined with combined disk and polymerase chain reaction (PCR) methods, respectively.

Results: One hundred strains of P. aeruginosa were isolated. The resistance of these strains to cephpodoxime, aztreonam, ciprofloxacin, ofloxacin, ceftazidime, cefepime, imipenem, meropenem, cefotaxime, levofloxacin, piperacilin- tazobactam and ceftriaxon was 100%, 90%, 83%, 92%, 85%, 88%, 63%, 66%, 98%, 89%, 70% and 91%, respectively. Of these, 40 strains (40%) were ESBL positive, 29 strains (29%) were OXA-10 positive and 18 strains (18%) were PER-1 positive.

Conclusion: Our results confirm the need for proper antimicrobial therapy in burn hospitals, considering the resistance pattern and frequency of strains producing ESBLs and the presence of the OXA-10 and PER-1 genes. Since an increase in the prevalence of ESBL in P. aeruginosa strains might lead to the transfer of these ESBL genes to other gram-negative bacteria, we recommend the use of appropriate drugs, especially cephalosporins, in burn hospitals.


Mirsalehian A, Jabalameli F, Mirafshar Sm, Bazarjani F, Gorjipor A, Goli H.r,
Volume 66, Issue 6 (5 2008)
Abstract

 Comparing Intensity Elicited Maximum Reflex Amplitude Between Noise Induced Hearing Loss & Acoustic Trauma at 1kHZ, Contralaterally, and Investigate Relationship Between Amplitude and Hearing Impairment


Mirsalehian A, Akbari Nakhjavani F, Bahador A, Jabal Ameli F, Bigverdi R, Goli H,
Volume 68, Issue 10 (5 2011)
Abstract

Background: Pseudomonas aeruginosa is an important opportunistic pathogen causes clinical infections among burn patients. Metallo-β-lactamases (MBLs) are important mechanisms of Carbapenem (drug of choice) resistance among Pseudomonas aeruginosa isolates. The aims of this study were to determine the antibiotic susceptibility pattern and to detect the prevalence of MBLs among Pseudomonas aeruginosa
Methods: Initially, the antibiotic resistance patterns of 170 clinical strains isolated from burn patients in Motahari Hospital in Tehran, Iran were determined by Kirby-Bauer disc diffusion method. All of the clinical isolates using two phenotypic and genotypic methods.  Pseudomonas aeruginosa isolates resistant to Imipenem were screened for production of MBL by E test with Imipenem / Imipenem plus EDTA (E test MBL). PCR assay was performed for detection of blaVIM genes.
Results: Based on the study results, the percentage of resistance was as below: Imipenem (10 μg) 52.9%, Amikacin (30 μg) 81.7%, Carbenicilin (100 μg) 74.7%, Polymixine B (300 unit) 10%, Ticarcilin (75 μg) 84.7%, Tobramycin (10 μg) 88.2%, Colisitin (10 μg) 34.1, Colisitin (25 μg) 28.3%. Of 90 Carbapenem resistant isolates, 10(11/1%) isolates were positive by E test, all were sensitive to Colisitin and Polymixine B. All of the Imipenem resistant Pseudomonas aeruginosa isolates were examined by PCR for the presence of the blaVIM genes. All MBL-producing isolates carried blaVIM-1 genes.
Conclusion: Considering the high prevalence and clinical importance of MBL-producing isolates, rapid identification of them and use of the appropriate infection control measures are necessary to prevent further spread of infections by these organisms.


Rahbar M, Jabalameli M, Aqajani N, Shafipour R,
Volume 70, Issue 5 (5 2012)
Abstract

Background: There are not many reports regarding the treatment approaches of congenital dislocation of the knee in the literature. Therefore, the preferred method of treatment of this rare congenital disease is still controversial. Hereby, we report the treatment outcome of 29 patients admitted in Shafa Yahyaian Hospital during 40 years.

Methods: In this retrospective study done in Shafa Yahyaian Hospital in Tehran, Iran during 2010, we retrospectively reviewed the medical records of 29 patients treated conservatively or surgically for congenital dislocation of the knee. Patients had been evaluated for an average follow-up of 8.5 years.

Results: Overall, 54 knee dislocations had been treated surgically (58%) or conservatively (42%). Range of knee motion, persistent recurvatum, instability, valgus deformity after treatment and limping were the more important factors reported in the two surgically or conservatively treated groups. Knee function was satisfactory in patients with conservative treatment. Despite 80% of instability in the operated knees, patients could ambulate with or without braces and had a range of motion equal to 80 degrees. Knee function was also good after quadricepsplasty with transarticular pins in selected cases.

Conclusion: We recommend a conservative approach to the disease, regardless of the patient's age at the time of treatment and subsequent surgery in patients with dissatisfactory recovery. Quadricepsplasty with transarticular fixation is recommended as a good option in treating these patients. Posterior capsulorrhaphy for patients with CDK and ligamentous laxity is also recommended.


Mahmood Jabalameli , Mohammad Rahbar, Mehran Radi , Hosseinali Hadi ,
Volume 71, Issue 4 (July 2013)
Abstract

Background: High tibial open wedg osteotomy is one of the most important modality for treatment of varus deformity in order to correct deformity and improving signs and symptoms of patients with primary degenerative osteoarthritis. The aim of this study was to investigate the results of high tibial open wedge osteotomy in patients with varus deformities.
Methods: This retrospective study conducted on twenty nine patients (36 knees) undergone proximal tibial osteotomy operation in Shafa Yahyaian University Hospital from 2004 to 2010. Inclusion criteria were: age less than 60 years, high physical activity, varus deformity and involvement of medical compartment of knee. Patients with obesity, smoking, patelofemoral pain, lateral compartment lesion, deformity degree more than 20 degree, extension limitation and range of motion less than 90 degree were excluded. The clinical and radiologic characteristics were measured before and after operation.
Results: Fourteen patients were females. All of them were younger than 50 years, with mean (±SD) 27.64 (±10.88). The mean (±SD) of follow up time was 4.33 (±1.7). All the patients were satisfied with the results of operation. Tenderness and pain decreased in all of them. In all patients autologus bone graft were used, in 15 cases (42.5%) casting and in the rest T.Buttress plate were used for fixation of fractures. In both groups of primary and double varus the International knee documentation committee (IKDC) and modified Larson indices were improved after operation, but there was no significant difference between two groups.
Conclusion: High tibial open wedge osteotomy can have satisfying results in clinical signs and symptoms of patients with primary medial joint degenerative osteoarthritis. This procedure also may correct the deformity and improves the radiologic parameters of the patients.


Kamyar Tavakkoli Tabassi , Mojtaba Ameli , Leila Gholami Mahtaj,
Volume 71, Issue 9 (December 2013)
Abstract

Background: Various surgical procedures were described for the correction of the external genitalia in male-to-female transsexualism. In all these methods complications such as vaginal stenosis, unpleasant appearance of external genitalia and lack of consent are seen. This paper describes a method of surgery for repair of these complications and success rate of this surgery.
Methods: Reconstructive surgery was performed by one surgeon in 16 patients from 2009 to 2011 in Imam Reza Hospital of Mashhad. Mean age 25.75 years of age from 21 to 31 years. Due to the condition of each patient appropriate reconstructive surgery was performed. These surgeries include: clitoroplasty, inverted U flap, labioplasty, urethroplasty, removal of excess skin and increasing depth of vagina. After the surgery, the patients admitted for complete bed rest up to 5 days. They received postoperative prophylaxis medication for anti-thromboembolic events.
Results: Only 3 complications were seen in all 16 patients. One hematoma of surgery site, one infection of surgery site and a blood transfusion. Eleven patients had history of vaginoplasty using small intestine and 10 patients with penile and perineal skin. From 3 to 24 months follow up after discharge were done, no patient had a major complication in long-term follow up and were generally satisfied with their sexual intercourse.
Conclusion: This study has some limitations. Follow-up of the patients was performed for about one year that longer follow-up for these patients is favorable. Also, evaluation of patients' satisfaction from their intercourse was not performed as systematically with using an standard questionnaire and by a person who is blind to the study. Using this method of restoring external genitalia in the hands of expert surgeon, aesthetic and functional result would be expected very well.

Mahmoud Jabalameli , Abolfazl Bagheri Fard , Ali Jahansouz , Tahmineh Mokhtari ,
Volume 71, Issue 11 (February 2014)
Abstract

Background: Genu valgum deformity is exaggerated valgus alignment of lower extremity mechanical axis in knee with a joint line that slopes superolaterally and is corrected by distal femoral osteotomy. In this study the results of treatment and satisfaction in patients with genu valgum were evaluated according to knee society score (KSS) and changes in pre-operation and post-operation lower extremity mechanical axis were compared to each other. Methods: The present study is a cross-sectional study that was performed on 27 patients (30 knees) who have had distal femoral varus osteotomies between 2005 to 2011. Patient’s data were collected from hospital documents, pre-operation and post-operation alignment views and physical exams of operated patients. Radiographs were from the lower extremities and including three joints of hip, knee and ankle (alignment view). Mechanical axis of femur and tibia were drown and they were compared to each other. For measuring patient satisfaction, KSS score was used. All data was collected and evaluated by SPSS 16 software. Results: In this study, 30 knees (in 27 patients) by mean of 30.7±3.36 months follow- up, (range, 5-76 months) were evaluated. The mean of ages in patients was 19.66±4.35, (range 10-34 years). Ten cases (37%) of valgus were on the right side and 14 cases (52%) on the left side and three (11%) cases were reported on both sides. Based on Student’s t-test, there was a significant difference in post- operation lower extremity mechanical axis. The mean of KSS score was 82.52 and the score was defined as 60.7% excellent, 25.1% good, 7.1% fair, and 7.1% poor in patients. According to the results of study, in five patients were non-::::union:::: and re-operated. Conclusion: Distal femoral varus osteotomy is a reliable procedure in knees with valgus correction. This procedure with precise selection of patients, have acceptable end results.
Zahra Qaempanah , Hossein Arab-Alibeik , Marjan I Ghazi Saeed, Mohammad Ali Sadr-Ameli,
Volume 73, Issue 4 (July 2015)
Abstract

Background: Warfarin is the most common oral anticoagulant. This drug is used for the prevention and treatment of thromboembolic patients. It is difficult for physician to predict the results of warfarin prescriptions because there is narrow boundary between therapeutic range and complications of warfarin. Therefore drug dose adjustment is normally performed by an expert physician. Decision support systems that use extracted knowledge from experts in the field of drug dose adjustment would be useful in reducing medical errors, especially in the clinics with limited access to experts. The aim of this study was to propose a method for boosting the maintenance dose of warfarin for a maximum period of three days to eliminate disruptions in International Normalized Ratio (INR). Methods: In a retrospective study, from December 2013 to February 2014 in Shahid Rajaee Heart Center, Tehran, Iran, 84 patients with International Normalized Ratio below (INR) the therapeutic range was selected who was undergone a boosting dose during three days. Patients with unstable maintenance dose were excluded from the study. In this study, data from 75 patients receiving warfarin therapy were used for developing and evaluation of the proposed model. The INR target range for 37 patients out of remaining 75 cases was between 2.5 and 3.5, while for 38 patients the intended INR range was between 2 and 3. A separate fuzzy model was designed for each of the above-mentioned therapeutic ranges. Results: The recommended dose for 37 patients having INR therapeutic range of 2.5 to 3.5 has mean absolute error and root mean squared error of 1.89 and 2.78 respectively for three days. These error rates are 1.97 and 2.88 respectively for 38 patients who are in therapeutic range 2 to 3. Conclusion: The results are promising and encourage one to consider this system for more study with the aim of possible use as a decision support system in the future.
Mitra Jabalameli , Seyyed Taghi Hashemi , Somayeh Asadpoor ,
Volume 77, Issue 5 (August 2019)
Abstract

Background: Post-dural puncture headache (PDPH) is commonly seen after neuraxial block and it usually lasts for up to two days or in some cases for up to two weeks. Several types of regimens have been suggested for treatment, such as theophylline and caffeine. This study aimed to evaluate the effects of aminophylline, paracetamol, and administration of aminophylline and paracetamol concurrently on prevention of PDPH.
Methods: In a double-blind randomized clinical trial, we evaluated 120 patients in four groups (n=30) undergoing spinal anesthesia for extremity surgery in educational hospitals of Isfahan University of Medical Sciences (Alzahra and Ayatollah Kashani Hospitals), Iran, from 2016 to 2017. In group A aminophylline was injected slowly intravenously (1.5 mg/kg), in group B paracetamol (1000 mg) was injected intravenously, in group C aminophylline and paracetamol was injected with the same dose and in control group (n=30) normal saline was injected intravenously. After patients entered the operating room, mean arterial blood pressure and heart rate were measured and oxygen saturation was monitored. Before spinal anesthesia, 15 minutes before leaving the recovery room, every 6 hours in first day and daily in first week after the surgery, incidence of PDPH in each group were evaluated. The frequency of nausea between the four groups was also studied.
Results: 42 patients (35%) out of the 120 ones suffered from headache. 40% of patients who had received aminophylline, 33.3% of patients who had received paracetamol, 20% of patients who had received aminophylline and paracetamol and 46.6% of patients who had not received any drug suffered from headache (P=0.05). The frequency of nausea was not significantly different between the four groups at any time. The average of heart rate, mean arterial pressure and oxygen saturation in recovery and 24 hours after operation were not significantly different between the four groups.
Conclusion: This study shows that intravenous administration of aminophylline and paracetamol significantly reduces the incidence of post-dural puncture headache (PDHP) in lower extremity surgery and we can use this regimen for prevention.

Ramin Haghighi, Hossein Bavandi , Ahmad Kameli, Abdullah Razi, Hossein Zeraati ,
Volume 80, Issue 6 (September 2022)
Abstract

Background: The prevalence of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) in men increases with age. Alpha-adrenergic receptor antagonists are first-line drugs for the treatment of LUTS, and tamsulosin is the drug of choice. The aim of this study was to compare the efficacy of tamsulosin 0.4 mg and 0.8 mg on lower urinary tract symptoms in patients with benign prostatic hyperplasia.
Methods: This double-blind clinical trial was conducted in the Urology unit of Emam Hassan Hospital in Bojnurd from May 2019 to Feb 2020. In this study, 92 patients with LUTS due to BPH were selected according to available method and randomly assigned into two groups of intervention. In the first group, patients received tamsulosin 0.4 mg and in the second group, tamsulosin 0.8 mg once daily for 8 weeks. The effectiveness of treatment was evaluated using IPSS criteria before and 8 weeks after treatment. According to a checklist, side effects were evaluated during treatment. Data was analyzed based on independent t-tests and repeated measures ANOVA by SPSS software version 22. A significance level of 0.05 was considered.
Results: The results showed that the two groups were not significantly different in age and duration of symptoms. According to the statistics test, there is a significant difference between the two groups in the post-treatment phase. Also, based on analysis of variance with repeated measures statistical test, there was a significant difference between and within two groups in IPSS criteria at different stages of evaluation. The prevalence of complications was (8.6%) in the first group and (11.9%) in the second group. The prevalence of complications was not significant between the two groups.
Conclusion: Tamsulosin is effective in reducing lower urinary tract symptoms and Tamsulosin 0.8 mg is an effective treatment regimen for the treatment of LUTS secondary to benign prostatic hyperplasia in those who have not responded to 0.4 mg treatment. Drug side effects were well tolerated in patients.

Atefeh Ghosouri, Mitra Jabalameli , Behzad Nazemroaya, Roxana Najafian ,
Volume 81, Issue 7 (October 2023)
Abstract

Background: More than one-third of women develop headaches in the first week after childbirth. Approximately 75% are benign primary headaches such as migraines or tension headaches. Others are secondary and include headaches of vascular origin or from hypertensive disease, infection, space-occupying lesions and dural puncture. Postdural Puncture Headache (PDPH) is a common and annoying complication of spinal anesthesia, especially in cesarean section. This study compares the impress of an Atropine-Neostigmine mixture and Ondansetron on Post Spinal Puncture Headaches in Cesarean sec.
Methods: This triple-blinded controlled randomized clinical trial was conducted on 60 pregnant women candidates for cesarean section under spinal anesthesia, that was carried out from May 2021 to August 2021 at Behshti Medical and Education Center affiliated with Isfahan University of Medical Sciences. The study was approved by the Ethics Committee of the University (IR.MUI.REC.1400.009) and informed consent was obtained from the patients/legal guardians. This clinical trial was registered at www.irct.ir with identification code IRCT 20160307026950N39.
 People were randomly assigned into three groups. A mixture of neostigmine (20 micrograms per kilogram) and atropine (10 micrograms per kilogram) in the first group and 4 mg of Ondansetron in the second group and a similar volume of normal saline in the control group were administered before surgery. Patients were followed up for headaches up to seven days after surgery. The severity of the headache was measured using the VAS scale. One-way analysis of variance (ANOVA) and non-parametric equivalent, Kruskal-Wallis, chi-square test, and repeated measure test were used to measure the relationship between the variables.
Results:  Analysis of the data did not show a significant difference between the three groups in terms of headache severity (P=0.788), headache duration, (P=0.723), the time elapsed from lumbar puncturing to the occurrence of the first headache (P=0.653), and the frequency of attempts for correct spinal tap (P=0.685).
Conclusion: none of our considered interventions had a noticeable impress on preventing or reducing PDPH in Cesarean section.

Fatemeh Najafi, Masoumeh Amiri Delui, Maryam Moradi , Parastoo Sarkhosh, Zahra Rezaian, Farnoosh Sharifymood, Fateme Kameli ,
Volume 82, Issue 1 (April 2024)
Abstract

Background: one of the most common and important complications of COVID-19 is cough. The present study was designed with the aim of comparing the effect of althaea officinalis and eucalyptus nebulizer on the severity of cough in COVID-19 patients.
Methods: in this randomized clinical trial, from January 2022 to June 2022, 36 patients with COVID-19 were selected and randomly divided into three groups. Next, the severity of cough was recorded two hours before the intervention based on the visual analogue (VAS) in both groups until the patient was admitted to the hospital, then, one cc aqueous extract of althaea officinalis with five cc Normal Saline for the althaea officinalis group and four cc aqueous extract eucalyptus whit five cc Normal Saline for the eucalyptus group, were nebulized once a day for 15 minutes. Two hours after the intervention, the intensity of cough was again recorded in two groups. This intervention continued until the hospitalization of the patients. No intervention was done for the control group. The data was analyzed with Spss software at a significance level of less than 0.05.
Results: In this study before the intervention, there was no statistically significant difference between the three groups in terms of cough intensity (p>0.05), but after the intervention on the second and third days, there was a statistically significant difference between the three groups in terms of cough intensity. The rate of reduction in cough severity in althaea officinalis group was higher than the other two groups (p<0.05).  Also, the results of Friedman's test indicated that althaea officinalis and eucalyptus nebulizers incense improved the severity of cough in patients over time.
Conclusion: the use of althaea officinalis and eucalyptus nebulizer improved the severity of cough in patients with COVID-19, but althaea officinalis nebulizer had a greater effect on cough severity compared to eucalyptus. It is suggested to use althaea officinalis nebulizer as well as eucalyptus as a treatment method along with other treatment methods.


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