مجله دانشکده پزشکی اصفهان
پیاپی 512 (هفته چهارم اسفند 1397)

Of the most common complications occur after anesthesia with intubation is postoperative sore throat, coughing after extubation, and hoarseness. Today, the use of dexamethasone before surgery is effective in controlling these complications. Therefore, the purpose of this study was to compare the prophylactic effect of two different methods of administration of dexamethasone (intracuff and intrsvenous) on sore throat and cough after surgery. In this clinical trial study, 96 patients undergoing general anesthesia and intubation were randomly assigned into three groups. The first group received 4 mg intravenous dexamethasone, the second group received 4 mg intracuff dexamethasone, and the third group received placebo. The frequency of cough and the severity of a sore throat were evaluated in three groups. There was no significant difference between the three groups based on hemodynamic variables (P > 0.05), but the cough rate in the first and second groups was significantly lower than the control group (P < 0.01). Moreover, the mean of the severity of sore throat in recovery and 1 hour after surgery in the first and second groups were significantly lower than the control group (P < 0.01). However, there was no difference between the groups based on the severity of sore throat within 24 hours after surgery (P > 0.05). Using intravenous and intracuff dexamethasone before surgery can reduce the amount of cough and the severity of sore throat in patients.

Surgery of inguinal hernia has complications such as postoperative nausea and vomiting. Regarding the unpleasant side effects of anti-nausea and anti-vomiting drugs, as well as prolonged hospital stay, this study aimed to evaluate the effect of acupressure PC6 and REN 12 points on nausea intensity of patients undergoing inguinal hernia surgery. This was a double-blind randomized clinical trial study performed on 60 patients undergoing inguinal hernia repair in two groups of intervention. After the surgery and full patient consciousness, acupressure was applied on PC6 and REN 12 points separately in each group for 5 minutes; 2, 4, and 6 hours later, acupressure was repeated on those points. Two hours after each acupressure, severity of nausea were determined using a visual analog scale (VAS). Data were analyzed using t, chi-square, and Fisher’s tests via SPSS software. In PC6 intervention group, recorded scores were as 16.17 ± 0.63, 8.83 ± 0.49, 2.97 ± 0.23, 0.50 ± 0.11, and 0.00 ± 0.00in without, mild, moderate, sever, and very sever nausea, respectively, whereas in REN12 intervention group, these scores were as 18.70 ± 0.80, 14.53 ± 0.64, 6.67 ± 0.42, 2.47 ± 0.37, and 0.50 ± 0.47, respectively. Generally, acupressure particularly on the PC6 point reduces severity of nausea in patients after inguinal hernia surgery; these results are better compared to the REN12 point.

Size estimation of hidden populations are complicate with direct methods. This study aimed to size estimate groups at high risk of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in men, using Network Scale Up in South of Iran. 500 men between 18 and 45 years old were recruited. 8 populations at high risk of HIV were defined: opium users, unknown drug users, ecstasy users, alcohol users, injection drug users (IDUs), men who have extramarital sex with females (MSF), men who have sex with female sex workers (MFSW), and men who have sex with other men (MSMs). We asked respondents whether they know anybody in their social networks of the above subpopulation (probability method), If yes, how many people do they know (frequency method). Estimates derived in the frequency method were higher than the probability method. Based on the frequency method, 4.38% [95% confidence interval (CI): 2.58%-6.17%] of men used alcohol at least once in last year. 2.16% (95% CI: 0.88%-3.43%) had extramarital sex, 1.94% (95% CI: 0.73%-3.14%) were opium users, 1.88% (95% CI: 0.68%-3.07%) had experience of unknown drug consumption, 1.64% (95% CI: 0.52%-2.75%) had sex with a female sex worker, 0.48% (95% CI: 0.12%-1.08%) were ecstasy drugs user, 0.34% (95% CI: 0.17%-0.85%) had sex with other men, and 0.26% (95%CI:0.18%-0.70%) were injection drug users. The size of the population of alcohol users and men who have extramarital sex is higher than other high-risk groups. Developing a special preventive program is needed to control HIV transmission based on the frequency of high-risk groups in each region.

The purpose of this study was to introduce a new and noninvasive technique for antidromic electrophysiological evaluation of the feet digital nerves to find normal values of amplitudes and nerve conduction velocity (NCV). Ring electrodes were used to record sensory nerve action potentials from the digits one, two, and three of the foot. The E1 electrode was placed on the proximal phalanx, and the E2 electrode was located 1 cm distal to E1. The nerves were stimulated 10 cm proximal to the E1 electrode on the plantar surface. The 95% confidence intervals (CI) were used to report the normal values of the amplitudes, distal sensory latencies, and nerve conduction velocities. Twenty three healthy volunteers with a mean age of 47.3 ± 8.2 years were recruited in this study. The 95% CI of the sensory amplitudes were 5.2-7.5 μV, 6.0-8.9 μV, and 6.9-10.1 μV for the first, second, and third digits, respectively. There was an inverse relationship between the age and the amplitude (r = -0.48; P = 0.03). The relationship between body mass index (BMI) and amplitude was not significant (r = 0.23; P = 0.41). This new and noninvasive electrodiagnostic technique can be useful in early detection of distal neuropathy of the lower limbs; particularly when the routine electrodiagnostic studies may not be capable of diagnosing the subclinical neuropathy.

Heavy menstrual bleeding during menstruation or hypermenorrhea or menorrhagia, which is called "Efrate Tams" in Traditional Iranian Medicine, is one of the most common causes of visiting health centers by women. The present study aimed to provide nutritional guidelines recommended in the Traditional Iranian Medicine for this complaint which their effects on bleeding regulatory pathways are also proven in conventional medicine. In first phase of this study, we conducted a review with a focus on the sources of Traditional Iranian Medicine; in second phase, electronic databases of PubMed, Scopus, and Magiran were studied with the key words of "Menorrhagia", "Hypermenorrhea", "Efrate Tams", "Heavy Menstrual Bleeding", "Nutrition", and “Food supplements”. Similarities and differences of our search results were extracted and classified, and the resulting data were analyzed. From the perspective of Traditional Iranian Medicine, foods such as egg yolk, lentils, meat extracts, pomegranate, quinceand, and Sumac are prescribed to reduce bleeding in patients with menorrhagia, and new studies have demonstrated anti-inflammatory, anti-oxidant, hematopoietic, and anti-fibrinolytic effects of some of these foods. Designing an appropriate diet for women with menorrhagia, along with common treatments, may help promoting health states of these patients.