مجله دانشکده پزشکی اصفهان
پیاپی 656 (هفته چهارم اسفند 1400)

Due to the need to prevention of postoperative pain after mastoidectomy-tympanoplasty, the present study was performed to evaluate the preemptive effect of adding morphine to topical lidocaine on postoperative pain intensity.

In this double-blind clinical trial study, 80 patients who were candidates for elective mastoidectomy- tympanoplasty surgery were randomly divided into two groups of 40; the first group underwent local anesthesia with lidocaine, and the second group underwent local anesthesia with lidocaine with morphine. Patients were evaluated for hemodynamic parameters, postoperative pain intensity during surgery and recovery and 24 hours after surgery, and the findings were compared between the two groups.

Evaluation of patients' pain intensity in recovery and ward showed that at the time of patients' recovery and two hours after surgery, the intervention group had a lower intensity; but in 12 and 24 hours after surgery, no significant difference was seen between the two groups. In the intragroup study, pain intensity significantly reduced in both groups, but the rate of pain reduction in the intervention group was significantly higher. The trend of changes in hemodynamic parameters during surgery and length stay in recovery was not significantly different between the two groups.

Addition of morphine to topical lidocaine reduces the postoperative mastoidectomy-tympanoplasty surgery, while topical use of this drug has no effect on patients' hemodynamics, longer recovery, and extubating time.

Finding non-invasive methods in predicting pathological stage is important for more accurate prognosis and treatment-related decision-making. In this study, using immunohistochemical CD34 staining, the association between the rate of angiogenesis and tumor pathological stage was examined in colon adenocarcinoma.

In this comparative cross-sectional study, 60 cases with colon adenocarcinoma admitted to Afzalipour hospital in Kerman, Iran, between 2014 and 2016, were enrolled. Appropriates Paraffin blocks of tumoral tissue were selected, and the mean number of vessels was determined through CD34 staining. The groups were then compared in terms of the pathological stage of individual cases.

The mean number of vessels was 25.2 ± 8.9, and the minimum and maximum were 11 and 44, respectively. The mean number of young vessels in 12 patients (20%) was mild, in 29 patients (48.3%) was moderate, and in 19 patients (31.7%) was severe category. ANOVA test demonstrated that the number of new vessels was significantly lower in cases at lower stages.

Significant reverse association was observed between the rate of angiogenesis and pathological stage. Therefore, the number of young vessels created in the tumor can probably be one of the predictors of pathologic stage.

Accidental and intentionally poisoning caused by rice tablets (aluminum phosphide) are relatively common in Iran, and lead to insignificant complications and deaths every year. In this case report, we introduce a case of rice tablets poisoning with nervous system symptoms and different findings in brain magnetic resonance imaging (MRI).

The case was a 28-years-old man who intentionally consumed rice tablets, and was referred to emergency department with dyspnea, dizziness, dull abdominal pain, nausea, and loss of consciousness. Examinations demonstrated a sharp drop in blood pressure, cold hands and feet, and increased heart rate. Emergency support measures were performed for the patient. During the hospitalization, the patient experienced an exacerbation of systemic symptoms and loss of consciousness, as well as right side hemiparesis. MRI images showed parenchymal hemorrhages of the cerebral hemispheres with diffuse and severe cerebral edema, numerous small and diffuse areas of bleeding, and symptoms of acute diffuse leukoencephalopathy.

Imaging techniques such as MRI can be deployed for the diagnosis of neurological toxic effects (e.g., stroke, bleeding, white matter changes, and brain edema) caused by rice tablets poisoning.