مجله دانشکده پزشکی اصفهان
پیاپی 535 (هفته سوم شهریورماه 1398)

A significant number of patients undergoing maxillofacial surgery needs nasotracheal intubation. In nasotracheal intubation, selecting the most appropriate nostril regarding normal anatomical conditions can be effective in reducing the time needed to pass the tube through the nose and epistaxis. The purpose of this study was to evaluate the effect of choosing right or left nostril on the post nasotracheal intubation complications.

In this study, 111 patients underwent maxillofacial surgery with nasotracheal intubation of the left (n = 55) and the right nostril (n = 56), were enrolled. Intubation time and complications such as bleeding, epistaxis, bronchospasm, vomiting, and submucosal intubation were recorded and compared between the two groups.

The time of intubation through the right nostril with 55.72 ± 51.47 seconds was not significantly different from the left nostril with 57.86±48.88 seconds (P = 0.826). In contrast, the incidence of epistaxis in intubation through the right nostril with 25.0% was significantly lower than the left one with 43.6% (P = 0.039).

 According to the results of this study, although the time of intubation through the both nostrils was not different between the two groups, the incidence of epistaxis and its severity in the intubation through the right nostril were far less than the left one. Therefore, it seems that the right nostril be an appropriate pathway of intubation in the patients with a natural-looking nose.

This study aimed to evaluate the effect of captopril added to standard chemotherapy regimen containing capecitabine in the prevention of hand and foot syndrome in patients with colorectal cancer.

n a clinical trial study, 66 patients with colorectal cancer under chemotherapy with capecitabine-containing regimens were distributed in two groups of 33. The first group received 50 mg of captopril daily and the control group, placebo with a similar dose from one week before commencement of chemotherapy to the end of third course of treatment. Patients in two groups were evaluated for the onset of hand and foot syndrome three and six weeks after starting chemotherapy, and four weeks after the end of third course of chemotherapy.

At the end of our study, 2 patients (6.1%) in the intervention group and 8 patients (24.2%) in the control group suffered from hand and foot syndrome (P = 0.039). Six weeks after the start of treatment, the prevalence of hand and foot syndrome in intervention and control groups was 3 (9.1%) and 5 (15.2%) (P = 0.45), and 2 (6.1%) and 8 (24.2%) cases four weeks after the completion of the three courses of chemotherapy, respectively (P = 0.039).

 Administration of captopril in patients undergoing chemotherapy with capecitabine-containing regimen reduced symptoms of hand and foot syndrome four weeks after the completion of the three courses of chemotherapy. According to the similarity of the pathogenesis of hand and foot syndrome with other vascular disorders, administration of captopril seems to reduce the symptoms of hand and foot syndrome.

Nowadays, electroconvulsive therapy (ECT) is considered as an effective treatment for psychological disorders. The ECT, and induced seizure, stimulates cardiovascular system through parasympathetic system and then sympathetic stimulation. Therefore, heart rate and blood pressure increase significantly to the extent that may cause ischemia and coronary diseases in high-risk patients. In the current study, the effects of two different doses of labetalol treatment on hemodynamic changes during ETC were compared.

The current cross-sectional randomized clinical trial study was conducted on 36 patients underwent two sessions of ECT. Each time, they were randomly treated with one of the labetalol doses of 0.2 or 0.4 mg/kg. Furthermore, all the patients were treated with 0.5 mg/kg succinylcholine and 2 mg/kg sodium thiopental. Blood pressure, heart rate, oxygen saturation, recovery duration, time of spontaneous respiration return following ECT, and dose-related complications were recorded in two groups and compared.

Comparison of two groups presented no statistical differences regarding mean arterial, systolic, and diastolic blood pressure; while nausea and vomiting occurred less in low-dose-treated group (P = 0.020).

 Both doses of 0.2 and 0.4 mg/kg labetalol could make a stable hemodynamic without affecting the quality and duration of the seizure in negative manner; but low dose of labetalol was accompanied with fewer adverse effects.

Today, high-energy photon beams are widely used in the treatment of all types of cancers. However, the production of electrons as contaminants in the photon pathway provides the necessity for research in this field.

Using BEAMnrc code, a Varian2100C/D accelerator head was simulated with 6 MV energy. Applying the advanced techniques of the variance reduction, Depth Dose curves at the Isocenter were obtained and compared to the measurements.</em> We used DOSXYZ code to calculate the Percentage depth dose (PDD) and profile curves. The effect of eliminating electron contamination by helium bag between the accelerator head and treatment bed, Vacuum, Al, Pb, Poly(methyl methacrylate) (PMMA) filters and their composition were also investigated.

By increasing the source to surface distance (SSD) and the air column, we expected an increase in the contribution of electron contamination, but our results showed that increasing the height of air column acted like a filter and scattered low-energy electrons. The presence of helium instead of the air column reduced the surface dose by about 10% compared to the air column. Electron contamination increased for light elements such as Al and PMMA, and decreased by 3.5% for the lead filter.

The use of materials with lower atomic numbers and high densities for filtration of electron contamination of the head of the device and secondary collimators and helium bag is simultaneously proposed.

Despite the expensive and time-consuming pre-clinical assessments, more than 50% of medicines fail to reach manufacturing cycle due to the low therapeutic index or possible side effects. Moreover, the challenge of drug resistance and person-to-person variation in complex diseases, such as cancer, and the growing concept of personalized medicine has also made a strong demand for more reliable pre-clinical drug assessment models. Cell culture is an essential and widely-used model in pre-clinical trials, but today we know that traditional culture methods fail to mimic the real in-vivo microenvironment, and hence they are proven to be responsible for the trails’ failure. It seems that the problem is going to be solved by the advent of three-dimentional (3D)-cell culture systems in which cell-cell and cell-matrix interaction, as well as the gradients of drugs, oxygen, metabolites, and nutrients, are well designed to efficiently mimic natural conditions, and provide more reliable results for drug assessments. A variety of researchers have purposed that this new paradigm, either directly or indirectly (by affecting gene expression and inducing natural phenotypes), affect cell behavior to meet the challenge of pre-clinical and clinical inconsistency. Recently, 3D-cultures on microfluidic platforms are used to provide a higher level of adaptation to living bodies. Due to the comparable similarity between microchips and living cells scales as well as the body vessels, besides the possibility to run a dynamic culture situation with real physical tension, etc. they are more potent to mimic actual in vivo microenvironment. Therefore, here, we are going to review various models of 3D-cell culture systems, and discuss their impact on pharmaceutical researches.