مجله دانشکده پزشکی اصفهان
پیاپی 400 (هفته چهارم آبان 1395)

Addiction is a brain disorder associated with neurobiologic changes. Medial prefrontal cortex (mPFC) plays an important role in learning, memory, reward system and addiction processes. Present study investigated the effect of 2-amino-5-phosphopentanoic acid (AP5), glutamate receptor antagonist, on morphine tendency.
We used 27 groups (n = 6) of male Wistar rats; 7 groups were used for determining the effective and ineffective doses of morphine and 20 experimental groups also were used for studying the effect of various doses of AP5 on morphine tendency in acquisition and expression phases of conditioned place preference (CPP) paradigm; then, CPP index was calculated.
Findings: Doses of 2.5, 5, 7.5 and 10 mg/kg of morphine significantly increased CPP index in morphine groups compared to saline group (P It seems that microinjection of AP5 into the prefrontal cortex reduces CPP index and consequently morphine tendency; these may be due to the impairment of learning and dysfunction of reward-related memory in response to morphine.

Nausea and vomiting are common and troublesome complication after the surgery. Although several medications as prophylactic or therapeutic are used in relation to this problem, but neither of them could not completely suppress and have numerous side effects. This study was performed to compare the prophylactic efficacy of ginger and metoclopramide in reducing nausea and vomiting after cholecystectomy.
90 patients undergoing cholecystectomy that met the inclusion criteria were divided randomly into two groups (n = 45). Before starting the operation, first group received ginger and the second group received metoclopramide. Thereafter, the severity and duration of nausea and vomiting after first and second hour of surgery was measured via visiting and self-designed questionnaire. Data were analyzed using chi-square test via SPSS20 software at the significant level of P Findings: The two groups were not significantly different in terms of age (P = 0.18), weight (P = 0.07) and gender (P = 0.82). The two groups were divided into two subgroups of less or equal to 60 years of age [33 (55%) and 27 members (45%) in ginger and metoclopramide groups, respectively) and more than 60 years of age [12 members (40%) in ginger and 18 members (60%) in metoclopramide group). In terms of body weight, the two groups were divided into three subgroups of less than 70 kg [6 (85.7%) and 1 patient (14.3%) in ginger and metoclopramide groups, respectively], 70 to 90 kg [36 (45.6%) and 43 patients (54.4%) in ginger and metoclopramide groups, respectively] and more than 90 kg [3 (75%) and 1 patient (25%) in ginger and metoclopramide groups, respectively]. In terms of gender, patients were divided into two subgroups of men [28 (49.1%) and 29 patients (50.9%) in ginger and metoclopramide groups, respectively] and women [17 (51.5%) and 16 patients (48.5%) in ginger and metoclopramide groups, respectively]. The severity of nausea and vomiting at the first hours after the surgery in the group receiving ginger decreased more than the group who received metoclopramide.
Ginger reduced incidence of nausea and vomiting more than metoclopramide during the postoperative period. It can be used as a supportive treatment in the prevention of nausea and vomiting.

Nowadays, the health challenges related to life length is increasing. This research aimed to compare the levels of social health among two groups of older people living at home and at old people’s homes.
The statistical population of this analytic-descriptive research includes all over-60-year-old people living at houses and old people’s homes in Tehran city, Iran, during the year 2014. The sample size was 400 (200 elderly living at home and 200 living at old people’s home). The sampling procedure was done based on cluster random method. The levels of social health of both groups were compared using Keyes social health questionnaire. Data analyzed using descriptive statistical methods and chi-square and t tests via SPSS software.
Findings: The mean of social health status was 60.60 and 62.83 among elderly living at old people’s home and home, respectively (P = 0.027 which showed the social health status was statistically different.
The results showed that there was a significant difference between the two studied groups of elderly people regarding the level of social health. Therefore, the authorities must pay more attention to this group and perform the required planning and preparations in order to increase the elderlie’s social health.

Dietary intakes, especially dairy products, can be the cause of change or onset of the symptoms in functional gastrointestinal disorders (FGIDs) like irritable bowel syndrome (IBS). This study aimed to investigate the relationship between dairy consumption and prevalence of IBS in Iranian adults.
This cross-sectional study was based on SEPAHAN project that was done among 4763 of staffs of Isfahan University of Medical Sciences, Iran, during 2 phases. IBS and nutrient intake were assessed using ROME III criteria and validated food frequency questionnaire (FFQ), respectively. Completed questionnaires of the 2 phases which were of the subjects with lactose intolerance were excluded which resulted in 2849 questionnaires. Cases were devided to 3 consecutive groups of dairy consumption named dairy intake tertiles. The odds ratios (OR) were evaluated for IBS in dairy intake tertiles.
Findings: Prevalence of IBS was estimated 20.7%. There was no significant difference between odds ratio of IBS in crude models of low- and high-fat dairy consumption. Controlling for potential confounders did not change the results. However, there was a positive and negative association between consumption of average amount of high fat (OR: 1.11, Confidence interval of 95%: 0.87-1.41) and higher intake of low-fat dairy products (OR: 0.87, Confidence interval of 95%: 0.69-1.10) with higher prevalence of IBS. In addition, abdominal pain was related adversely to average amount of dairy consumption (OR: 0.79, Confidence interval of 95%: 0.64-0.98).
There was no significant association between IBS prevalence and dairy consumption; although, average intake of dairy products can be protective against abdominal pain.

Post-dural-puncture headache (PDPH) is commonly seen after neuroaxial block and several types of regimens have been suggested for treatment. This study aimed to evaluate the effects of aminophylline, paracetamol and administration of aminophylline and paracetamol concurrently on prevention of post-dural-puncture headache.
In a double-blind randomized clinical trial, we evaluated 136 patients in four groups (n = 34) undergoing spinal anesthesia for elective cesarean section in Shahid Beheshti and Alzahra hospitals of Isfahan province, Iran, during March to December 2015. After umbilical cord clamping, in four group aminophylline (1.5 mg/kg), paracetamol (12.5 mg/kg), aminophylline and paracetamol with the same dose and normal saline was injected slowly intravenously. Before spinal anesthesia, each 15 minutes during execute time of surgery and in recovery room, every 6 hours in first day and daily in first weak after the surgery, incidence of post-dural-puncture headache in each group was evaluated.
Findings: 42 patients (33.88%) out of the 136 ones suffered from headache. 26.5% of patients who had received aminophylline, 32.4% of patients who had received paracetamol, 14.7% of patients who had received aminophylline and paracetamol and 50% of patients who had not received any drug suffered from headache (P = 0.007).
This study shows that intravenous administration of aminophylline and paracetamol significantly reduces the incidence of post-dural-puncture headache in cesarean section and we can use this regimen for prevention.