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Rahimi M, Makarem J, Maktobi M,
Volume 66, Issue 12 (3-2009)
Abstract

Background: Anal surgeries are prevalent, but they didn't perform as outpatient surgeries because of concerns about postoperative pain. The aim of the present study was to compare the effects of rectal acetaminophen and diclofenac on postoperative analgesia after anal surgeries in adult patients.

Methods: In a randomized, double-blinded, placebo-controlled study 60 ASA class I or II scheduled for haemorrhoidectomy, anal fissure or fistula repair, were randomized (with block randomization method) to receive either a single dose of 650 mg rectal acetaminophen (n=20), 100 mg rectal diclofenac (n=20) or placebo suppositories (n=20) after the operation. The severity of pain, time to first request of analgesic agent after administration of suppositories and complications were compared between three groups. Pain scores were evaluated in patients by Visual Analogue Scale (VAS) in 0 (after complete consciousness in recovery), 2, 4, 12 and 24 hours after surgery. The period between administration of the suppositories and the patients' first request to receive analgesic was compared between groups.

Results: Pain scores were lower significantly in rectal diclofenac than the other groups. The period between administration of the suppositories and the patients' first request to receive analgesic in diclofenac group was 219±73 minutes, was significantly longer compared with placebo (153±47 minutes) and acetaminophen (178±64 minutes) groups. No complications were reported.

Conclusions: Diclofenac suppository is more effective than acetaminophen suppository in post hemorrhoidectomy pain management.


Jafari A, Zahmatkesh M, Sadeghiour Hr, Kajbafzadeh Am, Sarrafnejad Af,
Volume 67, Issue 2 (5-2009)
Abstract

Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Varicocele is a major cause of male infertility, but its pathophysiology is unclear. Recent studies declare that fertile varicocele people with normal semen analysis are also at risk of loss of infertility. The exact mechanism by which varicocele damages spermatogenesis is still unknown. Some studies have reported increased Reactive Oxygen Species (ROS) is a major factor in semen of men with varicocele. The aim of this study was to investigate whether the source of elevated ROS is intracellular or not. In addition, we studied Mitochondrial Membrane Potential (MMP), viability, antioxidant activity, sperm count and motility in these rats.
Methods: The study group consisted of 28 male rats divided in four groups: control, sham, varicocele 1, varicocele 2, Experimental varicocele was established by partial ligation of the left renal vein in last two groups. Animals were sacrificed two and six months after surgery and dilation of the internal spermatic veins was observed. Then, superoxide anion production and Mitochondrial Membrane Potential were evaluated by Flow cytometry sperm characteristics were evaluated by Flow cytometry. Sperm superoxide anion production was assessed by the dihydroethidium and Mitochondrial Membrane Potential with rhodamin 123.
Results: Our results showed intracellular superoxide anion production significantly increased and Mitochondrial Membrane Potential, viability, sperm count and motility significantly decreased in rats with experimental left varicocele. However, there was no significant difference for seminal plasma antioxidant activity between all groups.
Conclusions: Consequently, our findings suggest that one of the main sources of ROS production is intracellular and we must consider it in treatment.


Sabzehkhah S, Vaezi Gh H, Bakhtiarian A, Salarian A, Zare Haghighi M,
Volume 67, Issue 8 (11-2009)
Abstract

Background: Dopaminergic is the most important neurotransmitter is fear. The dopaminergic mesolimbic pathway has essential role in excitable behavior, and it's role in Parkinson disease. The aim of this research in study, the effect of dopaminergic pathway in fear response.
Methods: The elevated plus maze was used in combination with the percentage of time spent in the open arms of the maze (OAT%) and the percentage of entries into the open arms (OAE%) to measure fear. Increases in the OAT% and OAE% indicate an anxiolytic effect (reduction in anxiety), whereas decreases in the OAE% and OAT% indicate an anxiogenic effect. After five days, the rats were injected with saline and different doses of sulpiride and Bromocriptine.
Results: Results showed that intracerebroventricular administration of sulpiride, in the doses of 5, 20μg/rat and bromocriptine, D2 agonist in doses 65, 95μg/rat produced a significant effect comparing to sham groups (p<0.05). While intracerebroventricular administration of sulpiride 15, 10μg/rat, and bromocriptine 70, 80μg/rat, did not show any significant effect comparing with sham group (p<0.05). In the current research intracerebroventricular administration of sulpiride, D2 antagonist at the doses of 5, 10, 15, 20μg/rat and Bromocriptine, D2 agonist in the doses of 65, 70, 80, 95μg/rat were used and theire effect on the fear behavior were studied.
Conclusions: The possible effect of Dopaminergic system in the fear process, especially D2 receptor increase fear.


Samiee H, Tavoli Z, Ghanbari Z, Poormand Gh, Taslimi Sh, Eslami B, Tavoli A,
Volume 67, Issue 9 (12-2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Stress incontinence is the most common type of urinary incontinence which has been treated by different surgical techniques. The objectives of our study were to compare the laparoscopic Burch colposuspension with Trans- obturator Tape (TOT) procedure.
Methods: This randomized clinical trial was conducted on 40 patients with stress incontinence referred to Arash hospital from 2007 to 2009. All patients were randomly divided in two groups (laparoscopic Burch and TOT). Patient information was using obtained demographic, I-QOL (Which contained 22 questions), UDI-6 (urinary symptoms), ISI (Severity of urinary incontinence) questionnaires and urodynamic test.
Results: The data collected from 19 patients in TOT group and 16 patients in laparoscopic Burch groups. The objective cure rate which was determined by no urinary leakage during stress and were analyzed urodynamic evaluation was 75% in laparoscopic and 84.2% in TOT (p=0.53). Result of ISI questionnaire with showing the subjective cure rate following surgery had no significant difference between two groups (p=0.23). UDI-6 questionnaire was used to compare the result of both groups before and after surgery and showed that the improvement in Urgency was significant in TOT in compare to Burch (p=0.04). I-QOL score significantly increased in both groups after six months of operation (p<0.05). But the differences were not statistically significant.
Conclusion: Based on our results subjective and objective cure rate were not significantly different between TOT and laparoscopic Burch colposuspension.


Ghanbari Z, Rostaminia Gh, Kajbafzadeh Ab, Pirzadeh L, Haghollahi F, Naghizadeh Mm, Pirooz E, Jabbari Z,
Volume 67, Issue 9 (12-2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Pelvic Organ Prolapse (POP) and related urinary symptoms are frequent disorders in elderly women and their management improves life expectancy and quality of life. Urodynamic tests applied in pathophysiologic diagnosis and treatment of urinary disorders are not always cost effective. This study aims to evaluate the results of Urodynamic tests in patients with pelvic organ prolaps.
Methods: This case- control study was done using UDI-6 questionnaire during 18 months in vali-e-asr clinic of Imam Khomeini Hospital, Iran with 105 cases of POP the cases were divided into two groups: group one (66 cases with urinary incontinency) and group two (39 without incontinency) and assessed with urodynamic tests.
Results: Based on UDI-6, the patients of group one had more clinical symptoms (frequency, urine leakage, urge incontinence and stress incontinence). (p<0.001). Except for first desire to voide and normal voided volume indices, there were no significant differences in the other urodynamic parameters in two groups. Sensitivity and specificity of urgency leak in group one was 22 and 68/8% and in group two was 30 and 65/5% respectively. Stress leak sensitivity and specificity in group one were 25/4% and 100% and in group two were 57/1% and 71/9% respectively.
Conclusion: In this study, considering sensitivity and specificity of symptoms and urodynamic test for urinary incontinency assessment is advised in patients with POP who need surgery.


Ali Bidmeshkipour, Abaslt Hosseinzadeh Colagar, Maryam Gholinezhad Chari, Pourya Biparva,
Volume 67, Issue 12 (3-2010)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Defective sperm function is now recognized as one of the most important causes of male infertility. Seminal plasma possesses a rich source of different enzymatic and non-enzymatic antioxidants such as vitamin C (ascorbic acid) that protect spermatozoa against oxidative stress as one of the mediators of infertility causing sperm dysfunction and low sperm quality. The aim of this study was investigation of seminal total antioxidant capacity and determination of vitamin C effects on sperm motility.

Methods: We designed a case-control study with a total subject of 62 males. Sperm parameters were analyzed according to World Health Organization guidelines (WHO, 1999). Total antioxidant capacity and vitamin C level of seminal plasma were measured in the 32 normozoospermic as the control group and 32 asthenospermic men as the case group using FRAP (Ferric Reducing of Antioxidants Powers) and RP-HPLC (Reverse Phase High Performance Liquid Chromatography) methods, respectively.

Results: Our results indicated that total antioxidant capacity levels in the seminal plasma of asthenospermic men were significantly lower than healthy men (p=0.002). In addition, we found a positive correlation between reduced total antioxidant capacity levels and low sperm motility. Vitamin C levels of seminal plasma in asthenospermic men were statistically lower than control men (p=0.01).

Conclusions: It is suggested that asthenospermia could be related to an antioxidant deficiency or it&aposs reduction.


Nikseresht S, Etebary S, Sadeghipour Roodsari Hr, Zarrindast Mr, Karimian Sm, Nabavi Zadeh F,
Volume 68, Issue 5 (8-2010)
Abstract

Background: Postpartum depression is a mood disorder that has harmful effects on mothers, infants, family and relationships. Acute decrease of progesterone after delivery has been proposed as a cause for postpartum depression. This hormone can affect neurotransmitters' function. Zinc (Zn) and magnesium (Mg) as trace elements exert their antidepressant effects through neurotransmitter pathways. On the other hand, thiamin (Vit B1) deficiency leads to depression in animal models. The aim of this study was to evaluate effects of combination of zinc, magnesium and thiamine on postpartum depression and role of nitrergic system.

Methods: One hundred ten female mice in five groups were used. Postpartum depression was conducted using progesterone injections. Combinations of Zinc chloride, magnesium chloride and thiamine HCL were administered 30 minutes before open field and forced swimming test (FST). In order to investigate role of nitrergic system, L-arginine and LNAME were administered.

Results: All treatment groups spent less immobility time than the control group (p< 0.05). Combined administration of Zn+ Mg+ Vit B1 caused the most reduction in immobility time. Administration of L-NAME in Zn+ Mg+ Vit B1 group caused reduction in immobility time while administration of L-arginine caused increase in immobility time in the same group.

Conclusion: Zinc, magnesium and thiamine can improve depressive symptoms by nitrergic pathway. These elements as supplement compounds could be alternatives for antidepressants in postpartum period.


Shahbazkhani B, Mehrabi Gh, Nasiritosi M, Forotan H, Asefirad Sh,
Volume 68, Issue 7 (10-2010)
Abstract

Background: In the patients with chronic liver disease chronic increase in serum transaminases may remain of undetermined cause despite thorough investigations. Celiac disease (non tropical sprue) has been reported as one of the causes of elevated levels of serum transaminases. The aim of this cross sectional study was to evaluate the frequency of celiac disease among patients with liver disease with chronic unexplained hypertransaminasemia.

Methods: One hundred patients with unexplained elevated liver enzymes who referred to gastroenterology and hepatology clinic of Imam Khomeini Hospital in Tehran, Iran from March 2009 to March 2010, and no cause were found for this elevation after initial clinical and paraclinical assessments and tests were enrolled in a cross sectional study. After measurement of Anti tTG IgA antibody in the serum of the patients, the biopsy of second part of duodenum were performed in cases with positive results and were assessed regarding evidences of celiac and finally the diagnosis of celiac diseas was confirmed.

Results: The mean age of patients was 39.79±16.77 and 55% of patients were male. The celiac disease was confirmed in 6% of patients (CI: 95%: 2.78- 12.48%). There were no significant differences between frequency of both sexes and means of age, ALT, and AST in the study patients.

Conclusion: In our study, the frequency of celiac disease among patients with chronic liver disease with unknown elevated liver enzymes was 6% which is near the frequency derived from other studies that has been reported.


Saberi H, Miri Sm, Poordel Namdar M,
Volume 68, Issue 9 (12-2010)
Abstract

Background: Topically applied tranexamic acid has been shown to decrease the amount of blood loss associated with major spinal surgical procedures. The aim of this study was to evaluate the effects of locally applied tranexamic acid in epidural space on post-laminectomy blood loss. Methods: One hundred patients who were scheduled to undergo laminectomy in Imam Khomeini Hospital in Tehran, Iran were enrolled in a clinical trial. Patients were divided into two groups of unilateral one level (n=50) and bilateral two level (n=50) laminectomy according to the extent of surgery. Each group was randomly allocated into two groups of tranexamic acid (n=25) and control (n=25). At the end of the operation, 250mg tranexamic acid, with volume of 5ml or 5ml of normal saline were poured on the site of surgery. The blood volume drained during first and second 24hr, and overall hemorrhage, plus the duration of post operative hospitalization were compared between the two groups. Results: The bleeding volume in the 1st 24hr was significantly less in tranexamic acid than control group (p=0.001). The bleeding volume in the 2nd 24hr was significantly less in tranexamic acid than control group (p=0.001). The hospital stay was less in tranexamic acid compared to control group (2.16±0.37 Vs. 2.96±0.89 days, p=0.001) respectively. Conclusion: Locally applied tranexamic acid in epidural space significantly reduces the amount of the 1st day, 2nd day and overall post-laminectomy blood loss, and duration of hospital stay. MicrosoftInternetExplorer4 Vs. 2.96±0.89 days, p=0.001) respectively.
Conclusion: Locally applied tranexamic acid in epidural space significantly reduces the amount of the 1st day, 2nd day and overall post-laminectomy blood loss, and duration of hospital stay.


Keyhani Doost Z, Moayyeri H, Khosroshahi N, Molatefi R,
Volume 68, Issue 10 (1-2011)
Abstract

Background: Epilepsy is a common disease in the pediatric neurology. There are frequent anti-epileptic drugs which are used in management of epilepsy. Anti-epileptic drugs may have some complications on bone and vitamin-D metabolism. In this study we aimed to evaluate vitamin-D metabolism in epileptic children.
Methods: The study was a prospective and cross sectional one. A total 89 epileptic children who were taking anti-epileptic drugs for longer than six months with no underlying disorder in Imam Khomeini and Bahrami Hospitals in Tehran, Iran were enrolled in our study
Results: Forty nine boys and 40 girls were enrolled in this study mean age of the patients was 7.8±2.1 years. Mean duration of anti-epileptic drug therapy was 2.3 years (SD=0.4), 70 of patients were under monotherapy and 19 were under polytherapy. None of the patients had signs of rickets. Serum calcium and phosphor levels were within normal ranges. Serum alkaline phosphates levels were increased more than two times in 43%. 42% had vitamin-D deficiency (25-OH Vit D<10 ng/ml) and another 33% had vitamin-D insufficiency (10<25-oh Vit D<20 ng/ml). 29 patients (32%) were taking prophylactic supplemental Vit D (200-400 IU/day). There was significant difference between patients taking supplemental vitamin-D as prophylaxis and patients who did not (p=0.04). There was no significant difference in vitamin-D levels between patients according to age, gender or different drugs.
Conclusion: Periodic measurement of 25-hydroxy vitamin-D is recommended in epileptic children taking anti-epileptic dugs. Supplemental vitamin-D administration in such patients may be helpful.


Sadeghi Sm, Seyedmehdi Sa, Narimani Zamanabadi M, Sadeghi Sa,
Volume 68, Issue 12 (3-2011)
Abstract

Background: Sinus surgeries are usually associated with bleeding, thus can result in hemodynamic instability. This study investigated the hemodynamic changes induced by remifentanil plus isoflurane administration in comparison with propofol plus remifentanil in patients undergoing sinus surgery.
Methods: In this randomized clinical trial study, 96 patients were divided into two groups of isoflurane (1.2 MAC) plus remifentanil (44 patients, group A) and propofol (100 μg/kg/min) plus remifentanil (52 patients, group B). Twenty-two patients in group A and 23 in group B were male. The remifentanil dosage (0.1 μg/kg/min) was equal in both groups and all received 500 ml isotonic solution during the operation too.  Premedications and anesthetic inductions of both groups were similar. The variables included age, BMI, blood loss during surgery, systolic and diastolic blood pressures, pulse rate and mean arterial blood pressure.
Results: The mean age, BMI, amount of blood loss, mean systolic (30 minutes before and after the intervention) and diastolic blood pressures (60 minutes before and after the intervention), pulse rate (30 and 60 minutes before and after the intervention), mean arterial blood pressure (60 minutes before and after the intervention) were similar in both groups. The average mean arterial blood pressure, 30 minutes after the intervention (p=0.027) and the mean diastolic blood pressure, 30 minutes after the intervention (p=0.011) in the case group had statistically significant differences with the controls.
Conclusion: Based on this study, the combination of isoflurane plus remifentanil could better maintain the hemodynamic stability during sinus surgeries.


Hashemi Sj, Rezaei S, Ansari S, Daie R, Noorbakhsh F,
Volume 69, Issue 4 (7-2011)
Abstract

800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: In the last two decades, cryptococcosis has been gaining a distinct public health importance due to the growing number of AIDS cases. Considering the low sensitivity of direct examination with India ink and culture, use of sensitive techniques is crucial in the diagnosis of cryptococcal meningitis. Polymerase Chain Reaction (PCR) can be used to directly detect Cryptococcus neoformans in CSF samples to increase the diagnostic power in cases where conventional methods are unable to detect the organism.
Methods : In this cross-sectional study, CSF samples were obtained from 25 patients suspected of having neurocryptococcosis. The patients were referred to the Medical Mycology Laboratory of the School of Public Health affiliated to Tehran University of Medical Sciences from March 2009 to February 2010. Three different methods, direct India ink examination, culture and PCR were used to evaluate the CSF samples. Two 102 and 106 of Cryptococcus neoformans dilutions in 1ml of CSF were prepared and examined by the three methods. In PCR method, two primer pairs were selected to amplify the Cryptococcus neoformans URA5 gene. The sequences of primers were for A, B, C and D serotypes.
Results : Only in one case PCR, as well as direct examination and culture were positive. All the other samples were negative in PCR, direct examination or culture. Both CSF dilutions were positive in the three tests in the mentioned patient and the positive control.
Conclusion: PCR method can efficiently identify both control and positive samples of Cryptococcus neoformans.


Keshavarzi F, Nafissi N, Sirati F, Fallah Ms, Salehi R, Harriry Z, Shahab Movahead Z, Vahidi M, Sharifi Z, Sharafi Farzad M, Zeinali S,
Volume 69, Issue 9 (12-2011)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Breast cancer is the most common form of hereditary cancer worldwide and is an important cause of morbidity and mortality. Approximately 5-10% of breast and ovarian cancers are due to the highly penetrating germline mutations in cancer predisposing genes. Two genes, BRCA1 and BRCA2, account for at least half of these cases. The demand for BRCA1 and BRCA2 mutation screening is rapidly increasing as their identification will affect the medical management of people at increased risk for the disease. Therefore, the aim of this study was to investigate BRCA1/2 mutations in 100 high risk Iranian families.
Methods:  One hundred families who met the minimal risk factors for breast/ovarian cancer were screened among the families referred to Kawsar Human Genetics Research Center for the diseases in 2009-2011. The entire coding sequences and each intron/exon boundaries of BRCA1/2 genes were screened for by direct sequencing and MLPA in both patients and the controls.
Results:  In the present study, we could detect the following novel mutations: p.Gly1140Ser, p.Ile26Val, p.Leu1418X, p.Glu23Gln, p.Leu3X, p.Asn1403His, p.Asn1403Asp, p.Lys581X, p.Pro938Arg, p.Thr77Arg, p.Leu6Val, p.Arg7Cys, p.Leu15Ile, p.Ser177Thr, IVS7+83(-TT), IVS8 -70(-CATT), IVS2+9(G>C), IVS1-20(G>A), IVS1-8(A>G), p.Met1Ile, IVS2+24(A>G), IVS5-8 (A>G), IVS2(35-39)TTcctatGAT, IVS13+9 G>C in BRCA1 and p.Glu1391Gly, p. Val1852Ile, IVS6-70(T>G), 1994-1995 (InsA) in BRCA2.
Conclusion: Ten mutations seemed to be pathogenic and the disease-causing mutations were seen in 16% of the families. In addition, from the total number of substitutions and reassortments (42), 80% related to BRCA1 and 20% to mutations in BRCA2 genes.


Khalili Gr, Sajedi P, Danesh H,
Volume 69, Issue 11 (2-2012)
Abstract

Background: Emergence agitation (EA) is a post-anesthetic problem which interferes with a child's recovery and presents a challenge in terms of assessment and management. In this study, we compared the effects of midazolam and ketamine as premedication in the management of EA in children aged 1-6 years.

Methods: In this prospective, randomized clinical trial study, 58 children aged 1-6 years who were undergoing general anesthesia for elective surgery in Alzahra Hospital in Isfahan during 2008 until 2009. The patients were randomly assigned to receive 0.1 mg/kg midozolam (28) or 0.5 mg/kg ketamine (29) by IV route in the premedication room. All patients received a standardized anesthetic regimen and isoflurane was used for the maintenance of anesthesia. The incidence and severity of agitation (agitation score), severity of pain (pain score), anesthesia, recovery and extubation durations were recorded postoperatively.

Results: The prevalence of agitation in midazolam (21.4%) was lower than ketamine group (34.5% P<0.05). In addition, the duration of agitation in ketamine group (21±16.67 min) was significantly higher than midazolam group (6.83±6.55 min), (P<0.05). However, no significant differences were seen in agitation score, pain score, anesthesia, recovery or extubation durations in the two groups (P>0.05).

Conclusion: The study showed that midazolam could reduce the frequency of agitation better than ketamine but both drugs were able to reduce the severity of agitation after short-time surgeries in young children.


Mehrpour Sr, Tavvafi Mr, Sorbi R, Aghamirsalim Mr,
Volume 70, Issue 2 (5-2012)
Abstract

Background: Comminuted subtrochanteric fractures have been a challenge for orthopedic surgeons in terms of appropriate reduction and stable fixation. Numerous methods have been used for the fixation of comminuted subtrochanteric fractures among which some are accompanied with technical difficulties and complications of their own. Regarding the results of previous studies, we decided to evaluate the biological fixation method in comminuted subtrochanteric fractures.

Methods: In this prospective study, we evaluated 20 men with comminuted subtrochanteric femoral fractures. The patients underwent indirect reduction with dynamic hip screw (DHS) or dynamic condylar screw (DCS) fixation within one week of injury. The patients were evaluated clinically for pain, hip and knee range of motion, leg-length discrepancy and angular and rotational deformities, in addition the radiographic assessment of the ::::union::::.

Results: According to Seinsheimer's classification of subtrochanteric fractures, four patients had type III, nine had type IV and seven had type V fractures. Fracture fixation was performed by DCS in eight and by DHS in 12 cases. The average time of the operations was 79.4 (ranging from 60-125) minutes. Mean blood loss was 634 (ranging from 340-1160) milliliters. Uneventfully, ::::union:::: occurred in all patients with no clinical pain or dysfunction.

Conclusion: Submuscular plating with either DCS or DHS is a viable option to treat comminuted subtrochanteric fractures. The results of this study highly suggest use of submuscular plating in the treatment of comminuted subtrochanteric fractures, especially in the third world countries.


Hassani Ebrahim, Mahoori Alireza, Mehdizadeh Hamid, Noroozinia Heydar, Aghdashi Mir Mousa, Saeidi Mohammad,
Volume 70, Issue 3 (6-2012)
Abstract

Background: Perioperative administration of tranexamic acid (TA), decreases bleeding and the need for transfusion after cardiac procedures. Hence, the results may vary in different clinical settings and the most appropriate timing to get the best results is unclear. The primary objectives of the present study were to determine the efficacy of TA in decreasing chest tube drainage, the need for perioperative allogeneic transfusions and the best timing for TA administration following primary, elective, coronary artery bypass grafting (CABG) in patients with a low baseline risk of postoperative bleeding.

Methods: In this double-blind, prospective, placebo-controlled clinical trial in Seiedoshohada Hospital during 2011-2012, we evaluated 150 patients scheduled for elective, primary coronary revascularization. They were randomly divided into three groups. Group B received tranexamic 10 mg/kg prior to, Group A received tranexamic acid 10 mg/kg after cardiopulmonary bypass and group C received an equivalent volume of saline solution. Blood requirement and postoperative chest tube drainage were recorded.

Results: The placebo group (group C) had a greater postoperative blood loss 12 h after surgery (501±288 vs. 395±184 in group B and 353±181 mL in group A, P=0.004). The placebo group also had greater postoperative total blood loss (800±347 vs. 614±276 in group B and 577±228 mL in group A, P=0.001). There was a significant increase in allogeneic blood requirement in the placebo group (P=0.001).

Conclusion: For elective, first time coronary artery bypass surgery, a single dose of tranexamic acid before or after cardiopulmonary bypass is equally effective.


Zahedi H, Maleki A,
Volume 70, Issue 4 (7-2012)
Abstract

Background: Drugs applied topically to the eye may be absorbed systemically to a substantial degree, with the potential to cause serious systemic side-effects. Children may be particularly vulnerable to systemic effects of topically applied agents as topical doses are often not weight-adjusted.

Case presentation: This article describes a case of serious systemic side-effect by the use of topical phenylephrine, tetracaine, tropicamide and atropine in a 17-year old boy candidate for deep viterectomy in Farabi Hospital in 1389. Following application of the aforesaid eye drops, the patient developed hypertension and subsequent loss of conciseness.

Conclusion: Several types of eye drops and their repeated use can lead to their systemic absorption and medical complications due to overdose. Strategies to minimize systemic absorption should be applied, including use of low concentrations of ophthalmic drugs, administration of one type of the drug, use of microdrops and punctal occlusion to minimize absorption via the nasolacrimal duct. While administering ophthalmic drops, one should take these precautions to minimize the systemic effects of the drugs to prevent subsequent complications.


Takzare N, Nikoui V, Ostadhadi S, Nabavi Sma, Bakhtiarian A,
Volume 70, Issue 6 (9-2012)
Abstract

Background: Obsessive-compulsive disorders and depression have a high prevalence during pregnancy therefore, pregnant women may take clomipramine and also take other drugs or consume foods that contain caffeine. As investigations about the teratogenic effects of clomipramine and its concurrent administration with caffeine during organogenesis period are scarce, we aimed to study the teratogenicity of simultaneous administration of clomipramine and caffeine in rat fetus.
Methods: After dividing 42 pregnant rats to several case and control groups, we injected different doses of caffeine and clomipramine to the animals. All the injections were performed on the eighth until the 15th day of pregnancy. We removed the fetuses on the 17th day of pregnancy and studied the morphological features and apparent anomalies of the fetuses macroscopically.
Results: We found a significant rate of mortality, apparent anomalies, abnormal torsion, shrinkage of skin and subcutaneous bleeding in fetuses of rats receiving high doses of caffeine or a combination of caffeine and clomipramine. Statistical analysis of the data revealed a significant increase (P?0.001) in teratogenicity of high doses of caffeine and its combination with clomipramine.
Conclusion: This study implies simultaneous intake of high amounts of caffeine and clomipramine lead to teratogenicity. We recommend pregnant women to avoid uncontrolled consumption of foods that contain caffeine or drugs that contain high amounts of this substance. They should not also take clomipramine with caffeine in the first trimester of pregnancy.


Balali P, Soodi M, Saeidnia S,
Volume 70, Issue 7 (10-2012)
Abstract

Background: Excessive accumulation of beta-amyliod peptide (Aβ), the major component of senile plaques in Alzheimer's disease (AD), causes neuronal cell death through induction of oxidative stress. Therefore, antioxidants may be of use in the treatment of AD. The medicinal plants from the Lamiaceae family have been widely used in Iranian traditional medicine. These plants contain compounds with antioxidant activity and some species in this family have been reported to have neuroprotective properties. In the present study, methanolic extract of seven plants from salvia and satureja species were evaluated for their protective effects against beta-amyloid induced neurotoxicity.
Methods: Aerial parts of the plants were extracted with ethyl acetate and methanol, respectively, by percolation at room temperature and subsequently, methanolic extracts of the plants were prepared. PC12 cells were incubated with different concentrations of the extracts in culture medium 1h prior to incubation with Aβ. Cell toxicity was assessed 24h after addition of Aβ by MTT assay.
Results: Satureja bachtiarica, Salvia officinalis and Salvia macrosiphon methanolic extracts exhibited high protective effects against Aβ induced toxicity (P<0.001). Protective effects of Satureja bachtiarica and Salvia officinalis were dose-dependent.
Conclusion: The main constituents of these extracts are polyphenolic and flavonoid compounds such as rosmarinic acid, naringenin, apigenin and luteolin which have antioxidant properties and may have a role in neuroprotection. Based on neuroprotective effect of these plants against Aβ induced toxicity, we recommend greater attention to their use in the treatment of Alzheimer disease.


Hatam Ahmadi , Parvin Rostami , Mohammad Reza Zarrindast, Mohammad Nasehi , Homa Mohseni Kochesfehani ,
Volume 71, Issue 3 (6-2013)
Abstract

Background: Nucleus accumbens (NAc) and prefrontal cortex (PFC) dopaminergic and glutamatergic systems are involved in regulating of locomotor activity behaviors. This study has investigated the interaction of NAc shell dopaminergic system and prelimbic glutamatergic systems in regulating locomotor activity and related parameters.
Methods: The aim of this study was the effect the drugs injection interaction in the brain of male Wistar rats on locomotor activity and related parameters, in the order of this purpose, open field apparatus that automatically recorded locomotor activity was employed. Unilateral intra-cerebral injection of drugs was done.
Results: Unilateral intra-prelimbic injection of D-AP7 (N-methyl-D-aspartic acid= NMDA receptor antagonist 0.25, 0.5 and 1μg/μl) did not alter locomotor activity behaviors. However, infusion of NMDA (0.9μg/μl) in this region increased locomotor activity (P<0.01), whereas decreased rearing (P<0.01) and grooming (P<0.01) which was blocked by D-AP7 (0.25μg/μl) (P<0.01). Moreover, unilateral infusion of SCH23390 (dopamine D1 receptor antagonist 0.25, 0.5 and 1μg/μl) into the left NAc shell did not alter locomotor activity. However, injection of SKF38393 (dopamine D1 receptor agonist 4μg/μl) into the left NAc shell increased locomotor activity (P<0.05) which was blocked by SCH23390 (0.25μg/μl) (P<0.01). Furthermore, the subthreshold dose infusion of SCH23390 (0.25μg/μl) into the left NAc shell reduced the effect of intra- prelimbic NMDA on locomotor activity (P<0.01). In addition, intra-NAc shell administration of the subthreshold dose of SKF38393 (1μg/μl) potentiated the middle dose (P<0.05), whereas decreased the higher dose of intra-left prelimbic NMDA response (P<0.05) on locomotor activity.
Conclusion: The results suggested a modulatory effect of the NAc shell dopaminergic system on increased locomotor activity by activating glutamate system in prelimbic.

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