مجله دانشکده پزشکی اصفهان
پیاپی 564 (هفته چهارم فروردین 1399)

This study aimed to compare the anti-shivering effects of 100 mg and 200 mg oral celecoxib with control group undergoing orthopedic lower extremity surgeries under spinal anesthesia.

In a randomized double-blinded clinical trial study that was conducted at Ayatollah Kashani hospital in Isfahan, Iran, the patients undergoing elective orthopedic surgery of the lower extremity under spinal anesthesia with class 1 stage based on the American Society of Anesthesiologists (ASA) scale, were evaluated. The first group received placebo tablets, the second group received 100 mg oral celecoxib, and the third group received 200 mg oral celecoxib 3 hours prior to spinal anesthesia. Incidence and intensity of shivering was compared 10 minutes after the anesthesia, and every 15 minutes until the end of surgery in all three groups.

A significant difference was observed between the three groups at all periods of time (P < 0.05). The group receiving 200 mg celecoxib experienced the less shivering.

A dose of 200 mg oral celecoxib was reported to be more effective on shivering during and after the orthopedic lower extremity surgery in patients under spinal anesthesia as compared to 100 mg oral celecoxib and the control group.

No studies thus far have addressed the efficacy of probiotics, especially synbiotics, on management and improving the symptoms of hypothyroidism. The aim of this study was to investigate the effects of synbiotic supplementation in fatigue management and mental health status in patients with hypothyroidism on levothyroxine treatment.

This study was conducted as a randomized, double-blind, placebo-controlled clinical trial. Sixty patients with levothyroxine-treated hypothyroidism were randomly divided into two groups to receive either 500 mg/day of synbiotic (n = 30) or a placebo (n = 30) for 8 weeks.

Synbiotic supplementation led to a significant decrease in general fatigue (P = 0.002) in synbiotic group. In the synbiotic group, other aspects of fatigue showed a decreasing trend, whereas the changes were not statistically significant. In addition, synbiotic supplementation significantly reduced the anxiety score in the synbiotic group at the end of the study (P = 0.028), while no significant effect was found from probiotics on depression, anxiety, and stress score in the intervention group compared to the placebo group.

Synbiotic supplementation for 8 weeks may have beneficial effects on general fatigue and anxiety among the patients with hypothyroidism, whereas these effects were not statistically significant between the two groups. Synbiotic supplements can be considered as a therapeutic strategy to improve the symptoms of patients with hypothyroidism. Further studies with larger sample size and longer duration are needed to confirm the current findings.

Obesity is always associated with chronic (low-grade) inflammation, which causes insulin-resistance in type-II diabetes mellitus. Dramatically, cholesterol level rises with starting diabetes and lower insulin level. With this increment, the statistical observations indicate a high risk of vascular diseases such as atherosclerosis. Therefore, the direct relationship between these complications, which is known to be the most important cause of mortality in these patients, has led scientists to take a serious and effective look at developing strategies and methods for controlling the inflammation of the immune system. Recent findings in the field of medicinal herbals and ingredients has shown that their macromolecules, due to specific structures and viability, have a potential impact on immune function of various aspects such as controlling inflammation, and modification or suppression of specific performance; using of those medicinal plants is emphasized by the World Health Organization, too. The global extensive studies about immunological effects of plant extracts such as Saponin molecules in cedar leaf extract have led to the discovery of compounds with amazing anti-inflammatory effects. Research conducted in Iran and elsewhere on plants containing active ingredient Saponins Christine A has shown that this group of plant molecules, as significant inhibitor of phosphorylation complex, with inhibition of inhibitor IĸBα nuclear factor kappa B (IĸBα-NF-ĸb), cause to modulate the induction of inducible nitric oxide synthase (iNOS) gene expression in the cytoplasm. Moreover, by disrupting the nitric oxide equilibrium in inflammatory environments, it can relieve mild tissue inflammation, which can improve obesity related to type-II diabetes mellitus and its complications. As an overall assessment of the reviewed studies, it can be concluded that the Saponins, especially molecules Saponins Christine A, can be considered seriously as a natural proimmuno-drug in treatment of inflammation of mild chronic obesity in type-II diabetes, and related complications such as insulin resistance, type-II diabetes, hypercholesterolemia, and arteriosclerosis.