مجله دانشکده پزشکی اصفهان
پیاپی 484 (هفته چهارم امرداد 1397)

Postoperative cognitive disorder is one of the most common complications after surgery especially in the elderly population, of which delirium is the most important. This complication may cause changes in personality and memory of patients, and increase postoperative complications. In this study, we decided to compare the preventative effects of intravenous administration of dexamethasone and lidocaine on postoperative cognitive disorder after cataract surgery in the elderly.
In this double-blind clinical trial study with control group, 333 patients above 65 years of age were divided randomly into three groups receiving lidocaine, dexamethasone, and placebo. The cognitive scores before and after the surgery were compared between the groups.
Findings: In the three groups receiving lidocaine, dexamethasone, and placebo, 6.4%, 3.6%, and 5.3% had cognitive disorder prior to surgery, respectively, which had no significant difference (P = 0.62). The prevalence of the postoperative cognitive disorders in the three groups of lidocaine, dexamethasone, and placebo was 12.0%, 9.9%, and 6.9%, respectively, which was not significantly different either (P = 0.98). The prevalence of cognitive disorders after one week in the three groups of lidocaine, dexamethasone, and placebo was 3.8%, 1.8%, and 8.8%, respectively, which was not significantly different (P = 0.98).
The administration of lidocaine or dexamethasone had no significant effect in reducing postoperative cognitive disorder, but since the use of dexamethasone is limited in patients with cataract undergoing surgery due to various underlying medical conditions, using lidocaine is preferable in such patients.

Obstetrics hemorrhage is a common reason of mortality among all of countries and also the country of Iran. Therefore, assessment of its incidence could be one of the most important strategies for the policy makers to improve mothers’ health. This study aimed to determine the prevalence of obstetric hemorrhage and its related factors in the second- and third-level hospitals affiliated to Isfahan University of Medical Sciences, Iran, during the third quarter of year 2016.
This descriptive-analytic study was conducted on 2477 pregnant mothers. Data were collected by daily visiting of the labor, and gynecology and high-risk pregnant mothers’ wards. Data were analyzed using descriptive and inferential statistics via SPSS software.
Findings: The prevalence of obstetric hemorrhage was 7.8%, and significant relation was between performing and the number of prenatal care (P 0.05). Logistic regression showed that prenatal care and underlying disease were more predictable for hemorrhage than other variables (P The prevalence of obstetric hemorrhages was close to the reference textbooks in the referral hospitals affiliated to Isfahan University of Medical Sciences, which indicated the possibility of managing this incidence in all of the hospitals of Isfahan Province. Since obstetric hemorrhages are mostly preventable, it has been emphasized to benefit from all of the opportunities, especially in promotion of prenatal care and controlling of underlying disease.

Substance abuse is one of the most common social problems in societies. In order to perform preventing actions, it is essential to consider the condition of substance abusers along with standard drug therapy. Therefore, this study aimed to investigate the status of life skills and family health among substance abusers, and compare it with healthy cases.
This study was performed on 240 cases (120 individuals in each group). After obtaining consent from individuals and recording demographic data, life skills were measured based on the ten dimensions of life skills according to World Health Organization, and family health based on Family-of-Origin Scale. Chi-square, Student t, and ANCOVA tests were used to compare the data.
Findings: Subjects with a history of substance abuse were significantly less educated (P Family function determines and affects its member's physical, social, mental, and moral health, and an unhealthy family has long-term and widespread outcomes on its members. Considering the low score of life skills in people with a history of substance abuse, and the role of these skills in increasing individual and social abilities, it is necessary to codify interventions to educate these patients.

Dopamine plays an important role in regulating gastric acid secretion in the central nervous system. Dopamine D2 receptors of hypothalamic ventromedial nucleus (VMH) are involved in modulation of food intake, suggesting a potential role of the VMH D2 receptor in modulating gastric acid secretion. Hence in this study, we investigated the effect of the VMH D2 receptor blockade on basal gastric acid secretion.
A guide cannula was stereotaxically implanted in VMH of male Wistar rats weighing 220-250 g. The D2 receptors antagonist sulpiride (0.005, 0.050, 0.500, and 1.000 μg/0.5 μl) or saline (0.5 μl) were injected into VMH after a 5-day recovery period. Gastric acid secretion was measured using the pylorus-ligation method and titration with NaOH 0.01 N.
Findings: Sulpiride at the doses of 0.050 (P Sulpiride at the dose of 0.500 μg/0.5 μl had maximum effect on the secretion activity of stomach. Blocking VMH D2 receptors decreases the secretion activity of stomach in rats.

Myocardial perfusion imaging (MPI) is an important imaging technique in the monitoring of cardiovascular complications. This modality plays an important role in diagnosis and treatment assessment of patients with cardiovascular diseases. Although myocardial perfusion imaging is a valuable diagnostic tool, complexity of this modality can result in a variety of artifacts and pitfalls which may limit its clinical applications. These issues may originate from the patients, the nuclear medicine equipment or the technologist.
Case Report: This report provides three illustrative examples of artifacts in myocardial perfusion single-photon emission computed tomography (SPECT) due to both technologists and patient's mistakes.
It is crucial to be aware of factors resulting in artifacts, to limit and recognize them in order to prevent misinterpretation of the results of myocardial perfusion imaging.