mansoureh chegeni

on the one hand, very limited studies were performed on identifying the active regions during swallowing among healthy individuals and those with dementia. On the other hand, to the best of our knowledge, no research has yet compared the injured areas in the brain of patients with dementia with and without dysphagia, such that damage to specific regions in dementia causes dysphagia may be found using this approach. The present study was performed to evaluate the atrophic changes in the internal temporal lobe (hippocampus), frontal (anterior cingulate cortex), and parietal (posterior cingulate cortex), and insula cortex in these patients. the present study is a retrospective cross-sectional study. 54 patients with dementia were investigated. The data were collected using a checklist, including information related to the dysphagia, and the brain MRI findings to determine atrophy. The extent of atrophic changes was recorded in the checklist using the median temporal lobe atrophy (MTA) score, Koedem score scale, and the global cortical atrophy (GCA) scale. To present the results, descriptive statistics, and data comparison, chi-square tests were used. The mean age of the examined patients was 72.01 with a standard deviation of 10.64 years, and range of 50-95 years. Out of them, 32 (59.3%) were male, and 22 (40.7%) were female. The degree atrophy of hippocampus (p=0.12), frontal lobe (P=0.46), parietal lobe (P=0.83), and insular cortex (P=0.91) in the patients with and without dysphagia did not show significant differences. The frequency distribution of the degree of atrophy based on the site of the development of atrophy was significant in the patients with dysphagia (P=0.033). In general, the findings showed that individuals with dementia who had dysphagia had more hippocampal and frontal lobe (and anterior cingulate) atrophy than dementia patients who did not have this impairment.

The purpose of the present study was to evaluate the efficacy of midazolam-ondansetron combination in prevention of postoperative nausea and vomiting (PONV) after middle ear surgery and its comparison with using midazolam or ondansetron alone. 140 patients were divided to four groups to received midazolam 0.75 mg/kg, ondansetron 4 mg, midazolam 0.75 mg/kg and ondansetron 4 mg or normal saline 0.9% (as control) intravenously just before the anesthesia. Assessment of nausea, vomiting, rescue antiemetic and side effects of study drugs such as headache and dizziness were carried out postoperatively for 24 hours. The incidence of postoperative nausea and vomiting was significantly lower in midazolam-ondansetron group compared to midazolam and ondansetron groups (P < 0.001) and there was no significant difference between the two last groups during the first 24 hours postoperatively. Need to the additional antiemetic was significantly more in the control group (71.4%) compared to other three groups; and in midazolam-ondansetron group (11.4%), it was lower than the midazolam (31.4%) and ondansetron (34.3%) groups (P < 0.001). Our study showed that prophylactic administration of midazolam 0.75 mg/kgcombined with ondansetron 4 mg was more effective than using midazolam or ondansetron alone in prevention of PONV after middle ear surgery.