فهرست مطالب

Iranian Red Crescent Medical Journal
Volume:20 Issue: 5, May 2018

  • تاریخ انتشار: 1397/02/10
  • تعداد عناوین: 8
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  • Serdar Kalemci, Aydln Sarihan *, Yelda Dere Page 1
  • Saeed Kashani, Hashem Jarineshin, Fereydoon Fekrat, Maryam Moradi Shahdadi *, Neda Soltani Shahabadi Page 2
    Background
    The prevalence of ventricular fibrillation after removal of the aortic cross - clamp in patients undergoing coronary artery bypass surgery is about 74% - 96% cross - clamp. Defibrillation shock and different types of agents are used to treat ventricular fibrillation (VF).
    Objectives
    This study was aimed to compare the effects of combining lidocaine lidocaine magnesium sulfate sulfate with amiodarone magnesium sulfate sulfate in the prevention of reperfusion - induced ventricular fibrillation.
    Methods
    This randomized, double- blinded clinical study included 74 ASA class II and III patients undergoing coronary artery bypass grafting (CABG) in a university - affiliated hospital, Bandar Abbas, Iran, in the years 2015 - 2016. Patients were divided into two groups based on a random sample table of block. Both groups received magnesium sulfate through the cardiopulmonary cardiopulmonary bypass pump. lidocaine 2% (100 mg) and amiodarone (300 mg) were injected respectively to group lidocaine magnesium sulfate (LM) and group amiodarone magnesium sulfate (AM) patients before aortic cross - clamp release. The incidences of arrhythmias were recorded within 30 minutes after release of the aortic sross - clamp (ACC). Additionally, the defibrillation shocks (frequency and level of joules delivered), amount of inotrope agent, and the hemodynamic and arterial blood gas parameters were recorded up to 24 hours post - operatively.
    Results
    There was no significant difference between the two groups in terms of demographic characteristics, ejection fraction, and ASA class. The prevalence of ventricular fibrillation (VF) and atrial fibrillation (Af) 30 minutes after ACC release were 46.7% and 53.3% (P = 0.240) vs. 33.3% and 66.7% (P > 0.999); while, up to 24 hours post - operatively were 60% and 20.0% vs. 0.0% and 0.0% in groups LM and AM respectively. The number of defibrillations in the lidocaine magnesium sulfate group was significantly higher 57.9% vs. 25% in groups LM and AM respectively (P = 0.004).
    Conclusions
    The use of amiodarone magnesium sulfate reduces the number of defibrillation following the release of the Aortic cross - clamp compared with lidocaine magnesium sulfate.
    Keywords: Amiodarone, Atrial fibrillation, Lidocaine, Bypass, Coronary Artery, Clamp, Magnesium Sulfate, Ventricular fibrillation
  • Farnaz Faroughi, Sakineh Mohammad Alizadeh Charandabi, Yousef Javadzadeh, Mojgan Mirghafourvand * Page 3
    Background

    Women with borderline gestational diabetes mellitus (BGDM) have a greater risk of complications in comparison with normal women.

    Objectives

    The aim of this randomized clinical trial was to determine the effects of garlic pill on fasting blood sugar (FBS) and relapse of prediabetes symptoms (primary outcomes), as well as blood pressure, neonatal anthropometric indices, and mode of delivery (secondary outcomes) in pregnant women with prediabetes.

    Methods

    This triple-blind, randomized clinical trial was conducted on 49 women with prediabetes at 24 to 28 weeks of gestation in Tabriz, Iran, 2015 - 16. The participants were assigned to the intervention (n, 26) and control (n, 23) groups using block randomization. The intervention group received a 400-mg garlic pill per day, while the control group received a placebo pill per day for 8 weeks. Four and eight weeks following the intervention, FBS and blood pressure were measured. The newborns’ anthropometric indices and mode of delivery were also recorded after delivery.

    Results

    The mean FBS level in the garlic group decreased from 106.6 (11.1) mg/dL before the intervention to 83.6 (6.3) mg/dL at 4 weeks after the intervention and 79.4 (6.1) mg/dL at 8 weeks after the intervention (adjusted mean difference, -3.7). The garlic pill also led to a significant decrease in prediabetes symptoms at 4 weeks after the intervention (P

    Conclusions

    The results revealed that garlic pill could reduce FBS level, prediabetes symptoms, and diastolic blood pressure. However, further research with a larger sample size is required for more accurate results.

    Keywords: Garlic, Pregnancy, Prediabetes, Fasting Blood Sugar
  • Soghra Nikoomazhab, Parvin Abedi, Azam Honarmandpour *, Mohammad Reza Haghdoust Page 4
    Background
    The most vulnerable time to develop mood disorders such as sadness, depression, and psychosis is the postpartum period. Postpartum blues is the most common mood disorder and can endanger the relationships between mother, child and family, and in case of lack of appropriate treatment can cause irreparable damages.
    Objectives
    The current study aimed at investigating the effect of evening primrose oil on the intensity of postpartum blues among primiparous females.
    Methods
    The current double-blind randomized, controlled, clinical trial was conducted from December 2012 to November 2013 on 132 primigravida females referred to health centers of Ahvaz, Iran. They were randomly divided into 2 groups of 66 to receive a daily dose of 1 g of evening primrose oil capsules (intervention group) or similar placebo capsules (control group) from the beginning of the week 37 week of pregnancy up to 2 weeks postpartum. Females in both groups were asked to complete the Edinburg questionnaire on the days 4, 10, and 14 postpartum. Data were analyzed using t test, chi-square test, and repeated measures, and P
    Results
    There was a statistically significant difference (P = 0.0001) between the 2 groups regarding the severity of the postpartum blues (the severity in the intervention group was less than that of the placebo group, P = 0.0001). The score of Edinburgh questionnaire was significantly less in the intervention group compared with that of the control group on the days 4, 10 (P = 0.0001), and 14of postpartum (P = 0.01) (P = 0.014). The averages of Edinburgh score in the intervention group was significantly less compared with those of the control group on the days 4 (10.5 ± 0.57 vs. 13.3 ± 3.28; P = 0.0001), 10 (11.2 ± 1.22 vs. 14.9 ± 3.6; P = 0.001), and 14 postpartum (11.7 ± 1.3 vs. 13.05 ± 2.6; P = 0.08).
    Conclusions
    The use of evening primrose oil effectively reduced the severity of postpartum blues.
    Keywords: Postpartum, Evening Primrose Oil, Primiparity, Females
  • Fatemeh Assarian, Fatemeh Sadat Ghoreishi *, Mahbubeh Borna, Mohammadreza Razzaghof Page 5
    Background
    Obsessive-compulsive disorder (OCD) is the fourth common psychiatric disorder. Among the anxiety disorders, OCD has the least therapeutic response and 40-60% of OCD patients do not satisfactorily respond to the first-line standard treatment known as treatment-resistant OCD. One of the best therapeutic strategies is the augmentation therapy, which is adding antipsychotics to the standard treatment (SSRIs).
    Objectives
    In this study, the efficacy of risperidone and aripiprazole was compared as an augmentation therapy.
    Methods
    In this double blind randomized clinical trial, 100 patients with treatment-resistant OCD were diagnosed based on the DSM-IV-TR and were followed for twelve weeks. The patients were randomly divided into two groups of aripiprazole and risperidone and received an average daily dose of 5 mg and 1.5 mg for twelve weeks, respectively. The efficacy of treatment was measured and compared by the Yale-brown obsessive compulsive scale (Y-BOCS) at 4, 8 and 12 weeks.
    Results
    The mean Y-BOCS score of patients in risperidone and aripiprazole groups were 25.26 ± 4.17 and 25.02 ± 4.46; respectively and had no significant difference (P = 0.79) at the beginning of the trial. At the end of the study (12th week) it was changed for the risperidone and aripiprazole groups to 20.00 ± 4.45 and 16.24 ± 4.41, respectively (P
    Conclusions
    It was found that both aripiprazole and risperidone could be effective in treatment of treatment-resistant OCD patients. However, aripiprazole showed a higher efficacy compared to risperidone.
    Keywords: Treatment-Resistant, Obsessive-Compulsive Disorder, Risperidone, Aripiprazole
  • Jun-Li Tsai, Shang-Feng Tsai * Page 6
    Introduction
    Necrotizing fasciitis is not rare in clinical practice but a Klebsiella pneumoniae-related is rare, especially in patients undergoing hemodialysis. Many patients with necrotizing fasciitis have a miserable outcome even though they receive amputation.
    Case Presentation
    A 76-year-old male was initially admitted to the center due to suspected cellulitis in Taichung, Taiwan. However, the treatment response was beyond expectation and a plain film X-ray was performed on his leg. To our surprise, it showed apparent gas and calciphylaxis. Easy examination detected the severe disease. Immediate surgical debridement was performed and his legs and life were successfully saved, although the outcomes of the disease were miserable. The tissue culture yielded Klebsiella pneumoniae. This pathogen, related to necrotizing fasciitis, is rare in the current published articles. The possible risk factors were endemic region, diabetes mellitus, calciphylaxis, old age, frequent iron supplements, and repeated tissue hypoperfusion during hemodialysis.
    Conclusion
    In conclusion, meticulously and timely diagnosed necrotizing fasciitis in high risk groups is the most important factor to ensure a positive patient outcome.
    Keywords: Klebsiella pneumoniae, Necrotizing Fasciitis, Hemodialysis
  • Mehrdad Karimi, Firoozeh Akbari Asbagh, Roja Rahimi, Majid Safavi, Gholamreza Pourmand, Fatemeh Sadat Hoseini, Mohammadreza Mirzaei * Page 7
    Introduction
    Almost 50% of infertilities are associated with males and among them 30to 50% are idiopathic. Empirical treatments are used in idiopathic male infertility, yet not enough scientific evidence is available for the application of such remedies. date palm pollen (DPP) is one of the drugs suggested for such patients in Iranian traditional medicine (ITM).
    Case Presentation
    This study was performed on a 35-year-old male patient with idiopathic infertility. He previously had severe oligoasthenoteratozoospermia and was under medical supervision at Yas hospital of the Tehran University of Medical Sciences from August 2016 to February 2017, where he was treated with DPP at a dose of 3 g twice daily, for three months. The second semen analysis was carried out after a quarter of the treatment period, followed by re-analyses after one and three months of finalizing the treatment period. The results obtained showed impressive improvement in the quality of semen parameters. Within six months, the initial values of normal morphology (1%), total motility (3%), progressive motility (0.0), and sperm concentration (0.1 million) increased to 20%, 60%, 10%, and 10 million, respectively.
    Conclusions
    The results of this study indicate that the drug may be operative in improving semen parameters in such patients, and more clinical studies are required in this regard.
    Keywords: Date Palm, Infertility, Oligospermia, Pullen, Semen, Spermatozoa, Traditional