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The comparison between effects of two general anesthesia techniques Intermittent apenic technique and continuous controlled ventilation in upper airway Laser therapy
Taheri A, Hajimohamadi F, Khagavy Mr ,
Volume 60, Issue 6 (9-2002)
Abstract

Introduction: Laser beam due to finest of incision and reduction of postoperative complication, facilitates airway surgery, but at the same time it increases the danger or firing and the airway management and protection becomes difficult during anesthesia. In this study, two general anesthesia methods (Intermittent Apneic Technique And Continuous Controlled Ventilation With Enveloped Endotracheal Tube) have been compared with each other mater.

Materials and methods: two groups, each consist of 25 patients 10 to 60 years old, and ASA I-II class and below 100kg weight who have been candidate for laser therapy, were given two mentioned methods of anesthesia. All patients were suffering from subglotic stenosis, vocal cord nodules, papillomatosis and oropharyngeal obstruction. Induction and maintenance of anesthesia, and monitoring during surgery (EGG, PETCO2, SaPo2, BP, PR) in both groups were the same.

Results: Homodynamic stability in the both groups were the same and there was no hypoxia and dysrhythmia. In apneic technique group, most of the surgeries needed 2-3 time of apnea, and each apnea duration was 2-4 minutes, without any hypercaphic (Peteco 2>47 mmHg) and hypoxic (Spo2<90 percent) state and duration of laser surgery was about 9-10 minutes. More satisfaction was gained with apneic technique because of having a better surgery filed. All the patients had no recall at the end of anesthesia and patietn's expenses were much lower with no danger of firing.

Conclusion: It has been concluded that intermittent apneic technique in upper airway laser therapy is a better technique of anesthesia.


Petergopalatine Fossa A Key Area In Rhinocerebral Mucormycosis Extension
Sadr-Hoseini S M, Saedi B,
Volume 61, Issue 6 (9-2003)
Abstract
Rhinocerebral mucormycosis is a rapidly progressive fungal infection that spreads from nose and sinuses to brain in short time. Cunent hypothesis about brain involvement explains that infection initiates in nose and progresses into orbit through ethmoidat sinuses via erosion of lamina papyranea. Then infection spreads from orbit apex to cavernous sinus and brain. Therefore, in addition to medical therapy surgical debridement of the sinuses plays a major role in treatment of these patients. The aim of this study is introduction of a new point of view about extension of mucor from the nose to orbit and brain. Also we discuss clinical implication of this perspective on surgery.
Materials and Methods: Since 1997-2002 nine patients with mucormycosis involving nose. Sinuses and orbit were admitted in ENT ward of Imam Khomeini general hospital. 8 patients with positive pathology entered the study. Variable such as age, underlying diseases, symptoms, site of involvement, extent of debridement and its times, and outcome were studied.
Results: After review of the history, surgical reports and pathological results, we found these findings in almost all patients: 1) facial pain, facial anesthesia, paralysis of buccal branch of facial nerve, paralysis of extrocular muscles, chemosis, periorbital edema 2) involvement of cheek subcutaneous tissue, buccal fat pad, IOF, SOF, orbital apex, infraorbital and maxillary nerves 3) involvement of pterygoid fossa with or without infratemporal fossa extension. Three patients have survived. Causes of death in other five patients were pneumonia, hypokalemia, and arrythmis during anesthesia. Mucormycosis was under control in most of these patients.
Conclusion: Pterygopalatine fossa is the main source for replication and extension of mucor. After entrance to the nose, mucor reaches this site and after involvement of IOF and SOF rapidly extends to retrobulbar portion of the orbit. Paranasal sinuses, buccal space, cheek, palate and infratemporal fossa may be secondarily involved. Exploration and debridment of this area has beneficial effect on surviving of these patients.




 


A Study On The Results Of Competing Sentence Test In Patients With Cerebrovascucular Accident
Abolfazli R, Makari N, Bagheri H, Ahmadi M,
Volume 62, Issue 2 (5-2004)
Abstract

Background: Cerebrovasular diseases (CVD) are one of the most common anomalies which may affect on auditory cortex. In this research we have tried to evaluate the function of CANS in a group of 50-70 years old cerebrovascular accident (CVA) patients without hearing problem by using Persian version of C.S.T.

Materials and Methods: This cross-sectional analytic study was established at Loghman-e-Hakim Hospital on a group of 30 normal subject (15 male, 14 female) and a group of 40 patients with CVA including 30 patients (16 male, 14 female) with abnormal CT scan and 10 patients with normal CT scan.

Results: Routine audiologic test including: Pure tone audiometry, Immitance audiometry and speech audiometry were nearly normal in all cases. There were significant differences between mean scores of CST in the patients with CVA and control group (P< 0.05). There were no significant differences between mean scores of CST in male and females (P> 0.05). In spite of nearly normal hearing and high scores in the simple speech tests such as SDS, there were significant differences in mean scores of CST in both ears of CVA patients (P< 0.05). Another important point is that in some of patients with CVA.

Conclusion: Although common radiologic evaluations such as CT scan showed no anatomic or structural anomaly but central auditory assessments such as CST can show dysfunctions of CANS. Therefore, CST might be a valuable test in CANS batteries for the cerebrovascular diseases.


A survey on ergonomic stress factors of musculoskeletal system in Iranian carpet restoration workers
Saraji G.n, Ebrahimy L, Fouladi B,
Volume 65, Issue 13 (3-2008)
Abstract
Background: Musculoskeletal disorders (MSDs) are one of the major problems, encountering work force today. Many researches have revealed the disadvantages and inconveniences that such problems have caused. Some kinds of careers are traditional and complex and are more probable to cause disorders. Carpet restoration is one of these jobs causing musculoskeletal disorders in the work force. The nature of this job puts a lot of pressure on the worker’s body. The postures are most of the time problematic and are in need of some ergonomic actions to be taken in order to prevent from diseases and disorders of musculoskeletal system.
Methods: In a cross- sectional survey, 144 male carpet restoration workers enrolled. NORDIC and PLIBEL checklists were used to assess the musculoskeletal stress factors with injury effects. Another checklist was employed to address demographic characteristics of the population under study.
Results: The results showed that 82% of these workers suffered from some forms of musculoskeletal disorders mostly from knee and lower back discomfort. The more they had job experience, the more they suffered from MSDs. Disorders of neck and upper back had significant relationship with the duration of work experience. Also badly designed tools and awkward posture were of main risk factors. PLIBEL checklist successfully showed the main threatening risk factors of all body parts.
Conclusion: The survey revealed that the incidence of MSDs in these workers is high and there are several risk factors affecting their body during work unsuitable design of tools, incorrect work height and bending position of the body during work were the most risk factors, which observed.
Female carpet weavers’ visual acuity and effective factors: Fordu rural area of Qom
Khajenasiri F, Sotoudeh G,
Volume 65, Issue 14 (3-2008)
Abstract
Background: Healthy vision of workers is one of the important elements in carpet weaving industry which has essential role in improving of the job quality and efficiency. Visual acuity is the primary outcome measure in most studies involving eye diseases. Ihe aim of this study was determination of visual acuity and its effective factors in women carpet weaver in fordu rural area of Qom has been investigated.
Methods: In a cross-sectional (descriptive-analytical) study visual acuity of 177 women carpet weaver has been determined. Job hours per day, job history, age, literacy, trauma history, diabetes history, family history of eye diseases, eye diseases history and family size of subjects were determined .
Results: The results of study indicated that the right eyes visual acuity of 72.4 % of women were desirable (0 – 0.8) and 27.6 % were undesirable (0.9-1.2). These results for the left eyes were 69.5 % and 30.5 % respectively. In addition, the result showed that with increasing the job hours and history and age, percent of women with undesirable both eyes visual acuity were increased. With higher literacy levels, percent of women with undesirable both eyes visual acuity decreased. In subjects with truma history, the undesirable visual acuity was higher. In this study the relation between visual acuity and job history, age, literacy, truma history and eye diseases history were statistically significant (in all cases P<0.05).
Conclusions: High percentage of women carpet weaver were in undesirable visual acuity and in this study the relation between visual acuity and job history, age, literacy, trauma history and eye diseases history were statistically significant (in all cases P<0.05).
Pet ownership and risk of asthma: a case-controlled study
L Sharifi, Z Pourpak, S Bokaie, A Karimi, M Gharegozloo, M Movahhedi, M Moin,
Volume 66, Issue 5 (8-2008)
Abstract

Background: In the treatment of bronchial asthma, the identification, isolation, and elimination of causative allergens is the most effective part of treatment. With the recent diversification within the pet industry, pet owner exposure to many unknown antigens is on the rise. The results of population studies have been contradictory and some epidemiological studies have failed to confirm this, some indicating that keeping pets might actually reduce the risk of sensitization and asthma. The purpose of this study was to determine the association between pet ownership and asthma.

Methods: This case-control study included 300 asthmatic participants referred to the Children's Medical Center over a two-year period. Participants were asked to fill out a questionnaire regarding pet ownership, pet gender and puberty, the place it was kept, how long the pet was kept and the reason for keeping the pet. The same questions were asked from 300 age- and gender-matched nonasthmatic individuals as the control group. Statistical analysis was performed to calculate odds ratios (OR) of asthma morbidity in individuals who kept pets.

Results: The OR for asthma morbidity in patients who kept pets was 2.59 (CI=1.60-4.21 and p>0.001). Financial aim was the most common reason for keeping a pet and most pets were mature and kept outdoors. No significant correlations for pet genders were observed.

Conclusion: This survey provides evidence that pet ownership is an important risk factor for asthma, therefore we suggest that individuals at risk for asthma (atopic individuals) must avoid contact with pets. However, more research in this field in Iran is necessary.


The acute effects of intermittent treadmill running on hunger and plasma acylated ghrelin concentration in individuals with obesity
Gholipour M, Kordi Mr, Taghikhani M, Ravasi Aa, Gaeini Aa, Tabrizi A,
Volume 69, Issue 2 (5-2011)
Abstract
Background: Body weight is regulated by both food intake and energy expenditure. Ghrelin, a hormone produced by the stomach and pancreas, enhances appetite. This study was undertaken to determine the effects of intermittent treadmill running on acylated ghrelin and appetite in individuals with obesity. Methods: Nine inactive male students, with a mean age of 20.56±0.48 yrs, a body mass index of 32.68±0.84 kg/m2 and a maximum oxygen uptake of 34.21±1.48 ml/kg/min, participated in the study in two trials (control and exercise) in a counterbalanced, randomized design. The protocol included intermittent running with a constant intensity at 65% of VO2 max on a treadmill. Blood samples were collected before, during, and 2h after cessation of the exercise. Results: Acylated ghrelin concentrations and hunger ratings decreased significantly in the second phase and remained lower than baseline (P=0.006 and P=0.002, respectively) at the end of the exercise. The total area under the curve values and hunger ratings (all P<0.0005) were significantly lower in the exercise trial compared with the control state. Similarly, growth hormone rose significantly at the second phase and remained higher than baseline (P=0.033) at the end of the exercise trial. Conclusion: These findings indicate that acylated ghrelin and appetite are reduced by running at 65% of VO2 max and remain lower than baseline even two hours afterwards in individuals with obesity. Growth hormone seems to be more responsible for this suppression. Further studies are required to investigate whether this protocol could elicit the same effects in short-term training programs.
Diclofenac suppository versus intramuscular pethidine in post herniorrhaphy pain relief
Noroozinia H, Mahoori A, Hassani E, Akhbari P,
Volume 69, Issue 3 (6-2011)
Abstract
Background: Non-steroidal anti-inflammatory drugs (NSADs) and opioids are frequently administered to relieve postoperative pain. Uncontrolled postoperative pain may produce a range of detrimental acute and chronic health consequences and increase mortality and morbidity. Practically, the analgesic efficacy of opioids is typically limited by the development of tolerance to them or by opioid-related side- effects such as nausea, vomiting, sedation or respiratory depression. This study aims to assess the effects of suppository diclofenac on post-herniorrhaphy pain management. Methods: In this prospective double-blind clinical trial, 60 patients who were candidate for the surgical repair of inguinal hernia were divided into two groups. Patients in group A received 100 mg of suppository diclofenac and patients in group B 50 mg of pethidine after the induction of anesthesia and before surgical incision. Postoperative pain assessment was done by an unbiased observer on the arrival of patients in the recovery room, using a 10-cm visual analogue scale (VAS) at 2-hour intervals for 6 hours. Results: Pain relief was similar in the two groups (P=0.3). Patients in group B required more analgesia two hours post-operatively (P=0.03), while patients in group A had more favorable results regarding pain control (P<0.05). Statistically, there was no difference between the two groups at other intervals. The occurrence of nausea and vomiting was similar in both groups. No respiratory depression was observed in the patients. Conclusion: Preventive analgesia with 100 mg of suppository diclofenac after anesthesia induction for herniorrhaphy produced effective postoperative analgesia with minimum side-effects
Effect of mental imagery on performance elite athletes’ in youth and adult age groups: a randomized trial
Tohid Seif-Barghi , Ramin Kordi , Amir-Hossein Memari ,
Volume 71, Issue 3 (6-2013)
Abstract
Background: Athletes are usually skilled in physical aspects of sports they are widely involved in physical conditioning, technical and tactical training. However they usually ignore the psychological and cognitive skills linked to their performance. Sport imagery is a well known fundamental skill that has a critical role in how a player performs and shows his/her competency during a real world game. On the other hand football as a complex team sport includes several skills linked to physical and psychological properties. We aimed to study the effect of cognitive imagery on elite football players through league competitions in two separate studies.
Methods: Twenty two youth players and Twenty two adult players randomly assigned to imagery and control groups. Players in intervention group received 12 weeks training program for specific cognitive imagery and general cognitive imagery. Imagery training program focused on an important component of football performance as “successful passing”. Players in control group were assigned to a waiting list with no intervention. In order to evaluate outcome variable we assessed successful passing in real compete-tions as player performance in both pre and post test occasions.
Results: Findings of study in youth participants showed that young players in interven-tion group improved the performance of passing compared to control players (OR=1.41, P<0.000, CI 95%: 1.17, 1.69(. In contrary, Imagery performance in adult group remained unchanged in spite of an increasing trend in performance (OR=1.07, P>0.05, CI 95%: 0.82, 1.4(.
Conclusion: These results showed that cognitive imagery intervention can affect elite soccer players’ performance. This effect is more prominent in youth age football players.

Comparison of the effects of growth hormone on acylated ghrelin and following acute intermittent exercise in two levels of obesity
Majid Gholipour , Arezoo Tabrizi ,
Volume 71, Issue 5 (8-2013)
Abstract
Background: The prevalence of obesity has risen enormously over the past few decad-es. Both food intake (Appetite) and energy expenditure can influence body weight. Acylated ghrelin enhances appetite, and its plasma level is suppressed by growth horm-one. The present study, examines the effects of an intermittent exercise with progress-ive intensities on acylated ghrelin, appetite, and growth hormone in inactive male students with two levels of obesity.
Methods: Eleven inactive males were allocated into two groups on the basis of their body mass index (BMI). Six subjects in group one, BMI= 31.18±0.92 kg/m2, and five subjects in group two, BMI= 36.94±2.25 kg/m2, ran on the treadmill with progressive intensities of 50, 60, 70 and 80% of VO2max for 10, 10, 5, and 2 min respectively. Blood samples were collected before the exercise (as the resting values), after each workload (during the exercise), and at 30, 60, and 120 min (during recovery).
Results: Plasma acylated ghrelin concentrations and hunger ratings in two groups were decreased and remained significantly lower than resting values (P=0.008 and P=0.002 respectively) at the end of the trial and there was no significant differences between groups. Growth hormone levels in two groups were increased and remained significant-ly higher than resting values (groups one P=0.012, group two P=0.005) at the end of the trial and there was no significant differences between groups. In addition, there were no significant differences between area under the curves (AUC) values over total periods for acylated ghrelin, hunger ratings, and growth hormone in two groups.
Conclusion: These findings indicate that individuals with two levels of obesity have the same response to the different intensities of treadmill running and two hours thereafter during recovery period, which can be considered for designing a more effective weighting loss training program.

The effect of dexmedetomidine on the hemodynamic responses of endotracheal extubation and sedation level in recovery after cholecystectomy
Alireza Mahoori, Nazli Karami , Seyedeh Zahra Karimi Sarabi ,
Volume 77, Issue 9 (12-2019)
Abstract
Background: Emergence from general anesthesia and removing of tracheal tube can be associated with coughing, agitation, and hemodynamic disturbances. Dexmedetomidine is an alpha two adrenoceptor agonist that has effective sedation with less cardiovascular unstability and respiratory depression and may be useful for extubation and prevention of hemodynamic response during tracheal tube removing. The aim of this study was to evaluate the effect of dexmedetomidine on hemodynamic responses during endotracheal extubation and sedation level in recovery room.
Methods: In an analytical study, fifty women aged 20-50 years old candidate to cholecystectomy under general anesthesia and tracheal intubation were entered randomly to this study in two groups (no. 25) at Imam Khomeini Hospital, Urmia, Iran, and under support of Urmia University of Medical Sciences Urmia, Iran, from May 2017 to May 2018. Ten minutes before end of surgery, 0.8 µg/kg dexmedetomidine in the study group and for the other patients in control group normal saline as placebo were infused over ten minutes. During the emergence phase, blood pressure, heart rate and oxygen saturation were recorded at 0,1,2,3 and 5 minutes after extubation. Also, sedation index was evaluated via the Ramsay sedation score and recorded at recovery room.
Results: Heart rate, systolic blood pressure and diastolic blood pressure in patient with infusion of dexmedetomidine were lower significantly at 1,2,3 and 5 minutes after extubation than control group. Data for heart rate, systolic and diastolic pressure, at min 1 after extubation were 81±6 vs. 88±9, 120.64±13.21 vs. 137.52±11.06, 72.84±8.32 vs. 81.36±9.26 in dexmedetomidine and control groups respectively. Data for heart rate, systolic and diastolic pressure, at min 5 after extubation were 73±6 vs. 80±8, 110.64±10.68 vs. 119.88±10.01, 69.84±8.32 vs. 73.48±5.13 in study and control groups, respectively. As well as 80% of the patients in dexmedetomidine group had satisfactory sedation and cooperation in compare to the 28% in control group (P=0.001).
Conclusion: Intravenous infusion of 0.8 µg/kg dexmedetomidine 10 minutes before extubation of endotracheal tube and during emergence, facilitate extubation and lead to hemodynamic stability and satisfactory sedation.

The outcome of pregnancy following the cerclage
Fahimeh Ghotbizadeh Vahdani , Zahra Panahi , Maryam Tahani , Roya Ghiaghi ,
Volume 77, Issue 11 (2-2020)
Abstract
Background: Cervix insufficiency is diagnosed based on a previous history of pregnancy loss in the second trimester, followed by painless cervical dilatation or premature rupture of the fetal membranes. Abnormal cervical tissue structural appears to be the cause of this complication. There are no diagnostic methods for cervical insufficiency before pregnancy, but magnetic resonance imaging (MRI), hysterosalpingography, and ultrasound can detect uterine anomalies that are risk factors for cervical insufficiency. Cerclage is known as a common procedure for prevention of the preterm labor, caused by cervix insufficiency. This study aimed to evaluate the prevalence of cerclage and it’s complications and prognosis based on the patient’s age, history of cervical insufficiency, history of preterm labor, history of miscarriage, curettage, and cervical and vaginal abnormalities.
Methods: A retrospective cohort study was conducted, including 65 patients, from March 2012 to March 2018, in Valiasr Hospital, Tehran, Iran. Data including the age, history of cervical insufficiency, history of abortion, history of cervix surgery and curettage, gestational age, presence of vaginal and cervical anomaly as well as complications such as bleeding and severe cervical pain and prognosis of cerclage were extracted.
Results: In our study, 65 women who undergone cerclage were evaluated, the mean age of the participants was 28.4 years. Abortion was present in 27.7% of cases, 16.9% once, 7.7% twice and 3.1% three times. In 21.5% of cases, there was a history of curettage and 66.2% had a history of preterm labor. For 4.6% of the subjects, the length of cervix was under 10 mm. Gestational age at the end of cerclage was under 26 weeks in 5.8% of patients. The termination of pregnancy was higher in patients with lower gravida, and the termination of pregnancy was significantly higher in those who were not curetted (P= 0.001). There were no complications, and the prognosis is considered good, in case the termination is above 32 weeks. The birth weight mean was 3041.5 grams. According to our study, the failure of the cerclage is associated with previous history of dilation and curettage (D&C) and higher gravidity.
Conclusion: Putting all the results together, 80% of the cerclage, performed in our institution were successful, without any complications.

Surgical competence in general surgery assistance: a brief report
Leila Sadati, Peigham Heidarpoor, Babak Sabet , Shahram Yazdani ,
Volume 80, Issue 5 (8-2022)
Abstract
Background: The training and education of competent and qualified surgeons have been one of the challenges of the surgical profession. The concept of surgical competence has been affected widely due to a series of developments in the new disease emergence, various surgical techniques and the introduction of advanced tools and equipment into the operating. The development of surgical competence and achieving this goal requires accurate identification and analysis of the dimensions of competence. This study was done to explain the concept of surgical competence using the 8-step Walker and Avant approach.
Methods: This study is a qualitative study that was conducted from May- October 2016 at Shahid Beheshti University of Medical Sciences. The present study is a qualitative and conceptual analysis study, which is done with Walker&Avant's eight-step approach to determine the defining characteristics of the concept of surgical competence. A systematic search was conducted between 1990 and 2020 by keywords search such as surgery, surgical, operation OR laparoscopy AND competence competency development competency proficient, proficiency, expertise, clinical, in the database like Google Scholar, PubMed, SID, Magiran, Scopus, Web of Science. Twenty articles were included in the study based on inclusion and exclusion criteria. Moreover, the defining features of the concept were extracted from it.
Results: Based on the results of this study, the concept of surgical competence was defined and the four dimensions of elements, goals, components and the process of developing surgical competence were identified. Then, by clarifying the characteristics of surgical competence, a model of surgical competence development was drawn. Surgical competence development depends on the acquisition of specialized knowledge and numerous skills that are acquired through experience and deliberated practice under the supervision of others in the surgical community of practice and over time.
Conclusion: Surgical competence is a set of observable and measurable skills that allows a surgeon to manage the surgical process independently pbt while maintaining the patient's safety. It includes specialized knowledge, communication skills, cognitive and technical skills, and basic surgical skills.

Comparison of the analgesic efficacy of pethidine and ketorolac in renal colic patients.
Aref Teymurinejad, Hossein Seidkhani , Zahra Mohebinejad, Amirreza Eidypou , Hamed Azadi ,
Volume 83, Issue 7 (10-2025)
Abstract
Background: Kidney stones are the third most common urinary tract disorder after prostate disease and infection. Painful attacks are the most common clinical manifestation, which is known as renal colic. The aim of the present study is to determine the effect of pethidine, pethidine and ketorolac, and ketorolac in patients with primary renal colic.
Methods: Renal colic patients at Imam Khomeini Hospital in Ilam from April 2023 and March 2023. were divided into three groups of 36 people. The first group received pethidine 25 mg, the second group received ketorolac 30 mg, and the third group received a combination of 2 drugs. A questionnaire included demographic information of the patients, heart rate, systolic and diastolic blood pressure, respiratory rate, oxygen saturation, side effects, pain intensity, length of hospitalization, and type of treatment received.
Results: After receiving the drug, the average heart rate increased in all three groups. But in group A, this increase was less than two groups, B and C, and this difference was not statistically significant (P=0.34). The average systolic blood pressure before receiving the drug was significantly higher in the three studied groups (P=0.006), which decreased after receiving the drug, but this decrease in systolic blood pressure in the three groups was not statistically significant (P=0.98). The average pain intensity before receiving the drug was 8.56 ± 1.2 in group A, 9.17 ± 0.878 in group B, and 8.86 ± 0.961 in group C. There was no significant difference between the three groups in terms of initial pain intensity (P=0.45). While the average pain intensity after receiving the medicine was significantly reduced and there was a significant difference (P<0.000).
Conclusion: Overall, the obtained results showed that ketorolac and pethidine have a faster effect and power compared to pethidine and ketorolac alone in controlling the pain of patients with renal colic, and the need for life-saving treatment is also less in this drug, and according to numerous studies, its side effects are also less.
 
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