مجله پزشکی بالینی ابن سینا
سال بیست و هشتم شماره 3 (پیاپی 101، پاییز 1400)

Considering the importance of pain management using effective medicines, the present study aimed to compare the analgesic effect of magnesium sulfate and gabapentin on postoperative pain in patients undergoing laparoscopic cholecystectomy.

The present randomized clinical trial study was conducted on patients undergoing laparoscopic cholecystectomy in the operating room of Ayatollah Mousavi Hospital in Zanjan in 2019. The patients were assigned to three groups of 30 using the block randomization method. One group received 50 mg/kg of magnesium sulfate in 100 ml of normal saline within 1 h during the operation, the second group received 600 mg of gabapentin capsule 1 h before the operation, and the third group did not receive any additional medicines. The overall opioid dose, the time of the first analgesic request, and the Visual Analogue Scale (VAS ), 6, 12, 18, and 24 h postoperatively were compared in the three groups using repeated measures of ANOVA.

Based on the results, there was not a significant difference among the three groups in terms of gender and age (P>0.05). Moreover, the three groups t significantly differ in pain and drug dose received (P<0.001). The results of the Tukey post hoc test demonstrated that the pain and drug dose received in the control group was significantly higher than those in both intervention groups (P<0.001). Nonetheless, this difference between the two groups of magnesium sulfate and gabapentin was not statistically significant (P>0.05).

As evidenced by the obtained results, in patients undergoing laparoscopic cholecystectomy, gabapentin and magnesium sulfate significantly reduced pain intensity and the need to use drugs; however, there was no significant difference between the two drugs.

One of the most common extracutaneous complications in psoriasis patients is ocular complications, which is controversial concerning its effect on choroidal thickness. This study aimed to compare the psoriasis patients with healthy individuals in terms of the thickness of the choroidal layer using the optical coherence tomography technique.

In this case-control study, 30 psoriasis patients were compared with 32 healthy individuals who were matched for gender and age. Choroidal thickness was measured in both groups using the optical coherence tomography technique. Furthermore, the relationship of the choroidal thickness with the severity and duration of the disease was assessed in patients.

The mean choroidal thickness of the left eye (312.1±12.0 mµ vs. 296.3±20.8 mµ), right eye (310.6±12.5mµ vs. 297.5±17.5mµ), and regardless of the left or right eye (311.3±12.2 mµ vs. 296.9±19.1mµ) was significantly higher in patients, compared to the control group (P=0.001 for all three mean values). No significant relationship was found between disease duration and severity with choroid thickness. Moreover, the patients with multiple limb involvement had a higher mean choroid thickness; however, it was not statistically significant.

According to the results of the present study, patients with psoriasis have a greater choroidal thickness, compared to healthy individuals, which is not related to the severity, type of involvement, and duration of the disease.

Cardiovascular Disease (CVD) is the leading cause of death in developing countries. Inflammation significantly contributes to the process of atherosclerosis. Therefore, evaluating White Blood Cells (WBC) and platelet counts as markers of inflammatory as well as hematocrit as a marker of blood viscosity may predict coronary events. The present study aimed to evaluate the relationship between hematological indices and the incidence of cardiovascular events.

This study was based on the results of the Isfahan Cohort Study (ICS) which was a long-term, population-based study of 6504 adults over the age of 35 years with no history of CVD who were followed up for any incidence of CVD from 2001 to 2015. Basic levels of hematological indices were measured by entering the study.

About 49.5% of the population were male. The mean age of the population and individuals with CVD were about 51 and 57.6 years, respectively. Significant relationships were observed between systolic and diastolic blood pressures, fasting blood glucose, triglyceride, cholesterol, Low-Density Lipoprotein (LDL) levels, and waist circumference with the incidence of cardiovascular events (P<0.001 for all). Hematocrit, hemoglobin, RBC, and WBC measures were significantly associated with the incidence of cardiovascular events (P=0.002 for all). There was no significant relationship between platelet levels and the incidence of cardiovascular events.

Hematological indices including WBC and RBC counts as well as hemoglobin and hematocrit levels can predict the incidence of cardiovascular events.

Diabetes is the most common chronic metabolic disease in the world and one of its control principles is the patient's adherence to the physician's treatment recommendations. This study aimed to determine the adherence to medication treatment and related factors in type 2 diabetic patients referring to the Diabetes Clinic of Shahid Beheshti Hospital, Hamadan, Iran, in 2020.

The present cross-sectional study was conducted on 284 patients with type 2 diabetes referring to the Diabetes Clinic of Shahid Beheshti Hospital. The data collection tool was a researcher-made questionnaire whose validity and reliability were confirmed in a pilot study. Data were analyzed in Stata software (version 11) at the significance level of 0.05.

Most of the patients were women (64.08%) and urban dwellers (79.08%). The mean age of the patients was obtained at 54.78 years, and 47.89% of the patients had poor medication adherence. Patients' medication adherence showed a statistically significant relationship with gender, marital status, education, physician's respectful behavior, respect for patient privacy, physician skill, the satisfaction of the physician, a history of other diseases, and a history of hypertension (P<0.05).

It was revealed the medication adherence rate was not satisfactory in patients with type2 diabetes. In this study, the identified causes associated with poor medication adherence included factors related to the patient, care team and health system, treatment, and disease status.

Low back pain is one of the most common musculoskeletal disorders. Exercise therapy is one of the most common treatments for low back pain. The aim of the present study was to investigate the effects of 6-week core stability exercises on disability and dynamic balance in women with non-specific chronic low back pain.

This controlled clinical trial with pre-test, post-test, and follow-up design was performed on 24 women with non-specific chronic low back pain within the age range of 30-50 years. They were randomly divided into experimental and control groups. Oswestry Disability Index and Biodex stability system were used to assess disability and dynamic balance indices (overall, anterior-posterior, medial-lateral indices, and limit of stability), respectively. Core stability exercise sessions were held for the experimental group three times per week for 6 weeks and the control group received no intervention. Data were analyzed by using mixed analysis of variance repeated measure at a significance level of P ≤ 0.05.

The results showed that core stability exercises led to a significant increase in the limit of stability and a significant decrease in disability and overall, anterior-posterior, and medial-lateral dynamic postural stability indexes (P≤0.05). Moreover, significant differences were observed between the two groups regarding all outcome measures after the intervention. Besides, there was a significant difference between pre-test and follow-up stages in terms of outcome measures (P≤0.05).

According to findings, the core stability exercises resulted in considerable improvements in disability and balance in women with non-specific chronic low back pain.

Elevated blood pressure may develop in hypertensive patients after performing resistance training. The present study aimed to investigate the effect of beetroot juice on cardiovascular and functional changes during and after a session of acute resistance training in men with hypertension.

In the present single-blind quasi-experimental study, 20 men with hypertension were randomly divided into two groups of Beetroot Juice (BJ) and Placebo (PLA). Upper and lower body muscular strength, Perceived Exertion (RPE), Systolic and Diastolic blood pressure (SBP, DBP), and resting and continuous Heart Rate (HR) were measured after resistance training in the pre-test. In the post-test, BJ and PLA groups consumed beetroot juice and non-caloric cherry flavor Beverage (4.5 mg/Kg Bodyweight), respectively, 150 minutes before repeating the measurements. Data were analyzed using three-way ANOVA, student’s t-test, and Mann–Whitney U test at a significance level of 0.05.

Beetroot juice significantly reduced SBP, DBP, and HR at rest and after resistance training compared to PLA. Furthermore, BJ significantly increased lower body muscular strength and decreased RPE during resistance training.

Beetroot juice is a useful beverage that easily and harmlessly controls blood pressure in hypertensive patients. This drink prevents the risk of high blood pressure in addition to improving performance during resistance training.

Trichomoniasis is the most common sexually transmitted parasitic disease in the world. Due to its importance and the need for recognizing its prevalence and epidemiology, this study was conducted to determine the rate of T. vaginalis infection in women referred to Health Centers in Arak, Iran, in 2020.

In this cross-sectional study, from 630 women undergoing genital examinations, a sample of the vaginal swab was prepared, kept in a special container, and transferred to the laboratory within 2 hours. Furthermore, a questionnaire containing demographic characteristics and clinical signs of patients was completed. The samples were examined using two methods of wet smear and culture in a Diamond medium. The obtained data were recorded and analyzed.

According to the results, 41.5% of the participants were in the age group of 25 to 34 years. The prevalence of trichomoniasis in the study population was 0.9%. The rate of infection was not related to age and education level; however, it was related to the marital status of patients (P<0.003). The most common symptom in patients was vaginal discharge, which was present in 67.1% of the women. Infection of patients showed statistically significant differences with different intensities of vaginal discharge, consistency of vaginal discharge, as well as itching and burning. The minimum lethal dose of metronidazole was determined to be 6.2 μg/ml in 24 hours and 1.6 μg/ml in 48 hours.

The prevalence of trichomoniasis in this population was relatively low and was associated with marital status, clinical symptoms, discharge and consistency of vaginal discharge, as well as burning and itching. Moreover, the investigated samples were sensitive to metronidazole.

Balance disorder is one of the most common problems in the elderly, leading to falls and serious injuries. One of the most important issues in the health of the elderly is balance and its related components. Therefore, the present study aimed to assess balance function tests, the relationship between age and anthropometric index, and perform equilibrium tests using structural equation modeling.

A total of 136 elderly men and women living in a retirement home in Hamadan were included in this cross-sectional study. Balance function tests included finger-to-nose test, maintaining balance on one foot, standing up and walking tests, and heel-toe walking tests. Data were analyzed using an independent t-test, Pearson correlation coefficient, and structural equation model with 95% confidence using SPSS (version 23) and EQS (version 6.1) software.

The mean (standard deviation) age of the participants in this study was 66.05±2.83 and out of 136 patients, 77 (56.62%) cases were female. There was a significant difference between the mean scores of men and women in balance performance tests. In the Finger-to-nose test, women with the dominant and non-dominant hand performed the test in less time, and in other tests, the men performed faster. The intra-class correlation (ICC) coefficient obtained in all tests showed high repeatability of these tests. The coefficients obtained from the structural equation model showed that for every one year increase in age, the motor index and the anthropometric index increased and decreased significantly by 0.68 and 0.60 units, respectively. There was a decrease of 0.06 units in the mean of equilibrium performance tests. The model of fitted structural equations was confirmed based on the fitted goodness index (χ2 was not significant total, (0.095-0.077) 0.089: RMSEA, 0.918CFI: and GFI: 0.908).

Age and gender were effective on balance function tests and anthropometric indices. The mean motor index and anthropometric index increased and decreased significantly for every one year increase in age. Furthermore, among the balance performance tests, the most difficult test was related to standing on one leg.