International journal of physiology, pathophysiology and pharmacology最新文献

Background: Pain management after surgery is a challenging medical issue, and clinical research in this area has continued. This study aimed to compare the effect of Aminophylline, ketamine, and paracetamol on the pain intensity after deep vitrectomy and compare it with the control group.

Methods: In this clinical trial, 240 patients undergoing deep vitrectomy were included in the study. The protocol of the current study was approved in the Ethics committee of Isfahan University of Medical Sciences (IR.MUI.REC.1396.3.876) and this study was registered in Iranian Registry of Clinical Trials (IRCT20210919052523N1) (https://www.irct.ir/trial/58884). The patients were randomly divided into four equal groups. Twenty minutes before surgery, in the first group, 0.15 mg/kg ketamine, in the second group 1 g acetaminophen, in the third group 3 mg/kg of aminophylline, and in the fourth group, normal saline was infused in the same manner. All drugs were diluted with 100 ccs of normal saline and infused intravenously within 15 minutes. The four groups of hemodynamic variables, pain intensity, and rescue analgesic drugs were compared.

Results: There was no significant difference between the groups based on hemodynamic variables (P>0.05). The severity of pain up to 2 hours after surgery and the rescue to analgesia in the ketamine and paracetamol groups were significantly lower than that of aminophylline and placebo.

Conclusion: Using ketamine or paracetamol effectively decreases pain intensity after deep vitrectomy surgery without producing significant adverse hemodynamic changes.

Background: Type 2 diabetes is a significant problem in today's society. Considering the possible effect of self-efficacy training on diabetes control, we aimed to investigate its impact on type 2 diabetes control.

Methods: This randomized controlled clinical trial was performed in 2018 in Isfahan city. Iranian Registry of Clinical Trials (IRCT) code for this study is IRCT20190219042762N1 (https://en.irct.ir/trial/37677). In so doing, 161 patients with diabetes were divided into two groups: intervention and control. The intervention group received six self-efficacy and healthy lifestyle training sessions, and self-efficacy strategies were taught in all sessions. Metabolic indices and the data collected by Diabetes Management Self-Efficacy Scale (DMSES) were analyzed before and three months after training by descriptive and inferential statistics.

Results: The self-efficacy score of the intervention group was significantly higher after training (175.7±18 vs. 163.7±26, P = 0.001). Also, the cholesterol level, LDL, and systolic blood pressure reduced significantly in this group after the intervention (167±39 vs. 179±43.7 mg/dl, 94.2±31 vs. 102.6±39 mg/dl, 115.6±1.4 vs. 120.1±1.8 mmHg, respectively. P<0.05).

Conclusion: Generally, self-efficacy training effectively improved metabolic control in patients with type 2 diabetes.

Several anti-HIV medications are currently available and used in medical care for HIV-positive people all over the world. Drug resistance is a global problem that necessitates the development of a new treatment regimen to address it. In several countries, ritonavir (RTV)-boosted atazanavir (ATV) is now used. There is evidence that patients taking RTV-boosted ATV on a regular basis have a higher ATV exposure, increasing the risk of toxicity. A recent theory suggests that a smaller dose of ATV/r may be sufficient. In this article, the authors reevaluate the dose of ATV/r for HIV patients based on existing data on the genetic epidemiology of CYP3A5 6986 A > G. According to the research, the likelihood of an individual achieving the therapeutic range of ATV through concentrations in various ATV/r regimens differs depending on baseline sex and CYP3A5 6986 A > G type. With the exception of a normal dosing regimen for male subjects, all have a chance of reaching the therapeutic range of ATV through concentrations (overall probability greater than 1). As a result, the lowering of the ATV/r dose should be considered primarily for male HIV infected patients.

Background: Induced stimulation while endotracheal intubating affects hemodynamic status. The present study compares the hemodynamic changes caused by endotracheal intubating after administering two doses of intranasal Dexmedetomidine.

Methods: In an experimental (before-after) trial, 88 patients undergoing general anesthesia enrolled in the study. The Iranian Register of Clinical Trial (IRCT) code of the study was IRCT20160307026950N15 (https://en.irct.ir/trial/39269). Patients were allocated to two intervention groups and one control group by random. Intranasal Dexmedetomidine and Normal saline 0.9% were administrated 30 minutes before induction of anesthesia. (1 μg/kg Dexmedetomidine in group 1, 2 μg/kg Dexmedetomidine in group 2 and 1 mg Normal saline 0.9% in group 3). Vital signs and hemodynamic parameters were measured and recorded in minutes 1, 3, 5, and 10th after induction. Data analysis was done by ANOVA and Chi-square tests.

Results: Heart rate, systolic and diastolic blood pressure, and mean arterial pressure were reduced in patients receiving dexmedetomidine (P<0.05), but there were no significant changes in the control group. In arterial oxygenation (P>0.05), there was no significant difference between the three groups in the arterial blood oxygen amount.

Conclusion: Premedication of intranasal dexmedetomidine influences the hemodynamic changes due to anesthesia induction. The dose of 2 µg/kg is better than one µg/kg in improving the hemodynamic state following intubation.

Background: COVID-19 infection is a severe condition in pregnant women. Previous studies have suggested that anti-COVID-19 antibodies may be able to be transmitted from mother to fetus, which in itself is a protective factor in infants against the disease. However, few studies have been done in this area. In the present study, we aimed to investigate the presence of anti-COVID-19 antibodies in infants born to symptomatic and asymptomatic mothers with positive COVID-19 test.

Methods: This is a cross-sectional study performed in 2021 in Abadan on neonates, born to symptomatic and asymptomatic mothers with positive COVID-19 test. All pregnant women over the age of 38 weeks with positive PCR tests for COVID-19 were included. We collected five cc of blood from the umbilical cord of neonates immediately after birth. The samples were sent to the laboratory in laboratory tubes to measure the anti-COVID-19 IgM and IgG levels.

Results: We evaluated data of 20 neonates born to mothers with symptomatic COVID-19 and 10 neonates born to asymptomatic mothers with positive COVID-19 tests. In symptomatic groups, sixteen neonates (80%) had positive IgG antibodies and the mothers of all these neonates had positive antibodies. The mean IgG levels in infants was 73.26 ± 12.54 RU/ml and the mean IgM levels were 14.29 ± 3.71 RU/ml. Among neonates born to mothers with no symptoms, 7 neonates (70%) had positive IgG antibody. All mothers had positive antibodies. The mean IgG levels in infants were 74.50 ± 11.37 RU/ml and the mean IgM levels was 12.49 ± 2.88 RU/ml. There were no significant differences between two groups of neonates regarding positivity of IgG and antibody levels (P>0.05 for all).

Conclusion: 80% of infants born to mothers with COVID-19 pneumonia had positive IgG levels that were in line with the previous reports.

Objectives: COVID-19 immunization has been shown to be effective in the prevention of COVID-19. Traditionally, two doses of COVID-19 vaccines are required. Booster immunization is generally required when immunity has deteriorated.

Methods: The effectiveness of the alternate boost immunization protocol is still unknown. The authors of this study used a cost-effectiveness analysis, which is a retrospective analysis on datasets on cost and effectiveness, to examine the projected cost-effectiveness of boosting COVID-19 vaccination by a fourth dose.

Results: The cost-effectiveness of the fourth-dose COVID booster vaccine was found to be higher in this study.

Conclusion: It could imply that vaccinating against the current pandemic of the novel form, omicron, with the additional COVID-19 vaccine is a smarter idea.

Background: Adenotonsillectomy is a safe and common operation to remove adenoids and tonsils. Here we decided to compare the two dosages of tranexamic acid and their effects on hemodynamic changes and anesthesia-related indexes during surgical interventions.

Methods: This is a double-blinded clinical trial performed in 2019-2020 on 64 children who were candidates for adenotonsillectomy. The patients were randomly divided into two groups of 32 based on the table of random numbers. Group A received 5 mg/kg slowly tranexamic acid for 10 minutes and group B received 10 mg/kg tranexamic acid slowly for 10 minutes. The study protocol was approved by the Research committee of Isfahan University of Medical Sciences and the Ethics Committee has confirmed it (Ethics code: IR.MUI.MED.REC.1398.639) (Iranian Registry of Clinical Trials (IRCT) code: IRCT20171030037093N33, https://en.irct.ir/trial/46553).

Results: The mean volume of intraoperative bleeding in children in group A is significantly higher than in children in group B (P < 0.05). However, no significant difference was observed between the length of stay in recovery and the duration of extubation and the mean dose of propofol in the two groups (P > 0.05). The mean arterial oxygen saturation of children in both groups increased significantly over time (P < 0.05). However, no significant difference was observed between the two groups (P > 0.05). According to the results, the mean HR in both groups decreased significantly over time (P < 0.05). In addition, the mean HR in children in the group B was significantly lower than children in the group A (P < 0.05).

Conclusion: Administration of 10 mg/kg of tranexamic acid during tonsillectomy is associated with lower amounts of bleeding and lower heart rate than 5 mg/kg dosage. These results were in line with most previous studies.

Background: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosa diseases. This study aimed to investigate the association of RAS with general health and oral health-related quality of life among dental students of Shahrekord University of Medical Sciences in 2020.

Methods: In this cross-sectional study, a researcher-made checklist about the type, size, location, number, and recurrence rate of ulcers, oral health-related quality of life questionnaire (OHIP-14), and a 28-item general health questionnaire (GHQ-28) were completed by 100 dental students.

Results: The proportion of RAS was significantly higher among females than males (61.1 versus 38.9, P=0.03) and was associated with family involvement history (P<0.001) and a Tendency to eat spicy foods (P=0.02). Moreover, the oral health-related quality of life was significantly lower among students with a history of RAS (8.17 ± 8.33 versus 4.22 ± 4.10, P=0.003). The results showed that GHQ-positive status was significantly associated with ulcer size (P=0.01). The general health status was positively correlated with RAS prevalence (p=0.04). Also, an investigation of the OHIP questionnaire showed that there was a significant correlation between physical status (r=0.31, P<0.001), insomnia, and mental status (r=0.33, P<0.001) with OHIP total score.

Conclusion: The results of this study confirmed a significant association between aphthous stomatitis and general health and oral health-related quality of life. So possibly improving general health and oral health-related quality of life may be effective in preventing aphthous stomatitis.

Background: Different treatment strategies for chronic rhinosinusitis (CRS) have been evaluated. Here we aimed to investigate the effects of fluticasone spray alone and in combination with itraconazole or doxycycline.

Methods: This is an open-label clinical trial performed in 2020-2021 in Isfahan on patients with CRS. This survey's Iranian Registry of Clinical Trials (IRCT) code was IRCT20200825048515N50 (https://en.irct.ir/trial/60826). Demographic data of all patients including age and gender and duration of CRS, were obtained. The SNOT-22 and Lund-Kennedy questionnaires were evaluated and recorded for the symptomatology of CRS. Patients were randomly assigned to the treatment groups to receive 100 mg of doxycycline with intranasal fluticasone spray, intranasal fluticasone spray alone, or itraconazole 100 mg capsules with intranasal fluticasone spray. After one month of treatment, the scores and patient satisfaction were evaluated and compared.

Results: Data of 104 patients was analyzed. Patients had improvements in their symptoms and SNOTT-22 scores. The mean SNOTT-22 score was 55.36±8.36 in all patients. During the study, patients had improvements in their symptoms and SNOTT-22 scores. The mean final SNOTT-22 score was 47.77±7.36 at the end of the survey (P=0.02). Our data also demonstrated significant improvements in the Lund-Kennedy score in all patients during the study (P<0.05).

Conclusion: There were no significant differences between the clinical condition of patients receiving intranasal fluticasone, intranasal fluticasone in combination with doxycycline or itraconazole.