مجله دانشکده پزشکی اصفهان
پیاپی 658 (هفته دوم فروردین 1401)

The study aimed to compare the efficacy of Dimenhydrinate-Metoclopramide, Dimenhydrinateondansetron and Dimenhydrinate alone on nausea and vomiting after cataract surgery under local anesthesia and intravenous sedation. 

In this clinical trial study, 160 patients undergoing cataract surgery were divided into four groups of 40. Thirty minutes before induction in the first group (D-M) 0.1mg/ kg metoclopramide + 0.5 mg/ kg Dimenhydrinate, in the second group (D-O) 0.4 mg/ kg ondansetron + 0.5 mg/ kg Dimenhydrinate, in the third group (D), 0.5mg/ kg Dimenhydrinate and in the fourth group (C) 2 cc of distilled water were injected and the incidence and severity of nausea and vomiting at recovery and 2 and 4 hours after surgery and at the time of discharge were evaluated and compared between groups.

The incidence of nausea at recovery in four groups of D-M, D-O, D and C were 13.2, 10.8, 22.2 and 36.1%, respectively, and the difference between the groups was significant (P = 0.015). In the next two hours, the incidence of nausea in the four groups was 10.8, 5.3, 22.2 and 27.9%, respectively (P = 0.035). The incidence of vomiting in recovery was 16.2, 7.9, 16.7 and 33.3% among the four groups, respectively (P = 0.039). Also the intensity of nausea in recovery were statistically different between 4 groups and the Dimenhydrinateondansetron group had the least severity of nausea. Pain intensity was lower in Metoclopramide receiving group.

Dimenhydrinate-ondansetron combination compared with Dimenhydrinate-metoclopramide and Dimenhydrinate alone led to an increased reduction of postoperative nausea and vomiting following cataract surgery.

Volvovaginal candidiasis (VVC) is a common fungal infection in women. The production of extracellular enzymes act as virulence factors in the pathogenesis of Candida species. The aim of this study was to evaluate the activity of phospholipase, proteinase and to investigate the distribution pattern of Sap5 and PLB1 genes in Candida isolates isolated from women with VVC. 

This descriptive cross-sectional study was performed on 135 vaginal swabs of women with suspected VVC. Candida species were identified by PCR-RFLP and the activity of hydrolytic enzymes and frequency analysis of SAP5 and PLB1 genes were evaluated.

The results showed that C. albicans has the highest frequency (67%). In total, 80% of the studied isolates have proteolytic activity and 73% have phospholipase activity. Furthermore, the frequencies of PLB1 and SAP5 genes among Candida species were reported 95.7% and 91.4%, respectively. Simultaneous presence of SAP5 and PLB1 genes was observed in 87% of the isolates.

The results of present study showed the importance of molecular epidemiological studies and understanding the role of virulence factors associated with extracellular enzymes in the pathogenesis of Candida strains.

Intraoperative fluid therapy is to ensure adequate injection of maintenance fluids including electrolytes and glucose to replace fluid deficiency during surgery. Given that there is still no consensus on fluid therapy in neonates, the aim of this study was to evaluate the use of normal saline serum and one fifth-four fifths serum in neonates who are candidates for surgery. 

In a randomized clinical trial study, 72 neonates who were 1- 30-days-old and candidates for surgery, admitted to Imam Hossein Hospital in Isfahan were divided into two groups. Fluid therapy was randomly administered using normal saline or one-fifth-four-fifths fluid in each group. Biochemical and hemodynamic variables such as blood sugar, sodium, pH, bicarbonate BE, heart rate and mean arterial pressure were assessed preoperatively and postoperatively.

Post-operative blood glucose levels after 60-minutes at The Neonatal Intensive Care Unit (NICU) for the normal saline group were 152.56, 148.47 and 155.61 mg/dl, respectively, while in one fifth–four fifths solution group were 242.78, 197.28, 278.19 mg / dl, respectively, which showed a significant difference between the two types of solutions. There was also a significant increase in blood sugar compared to pre-operative states. Mean pre-operative plasma sodium levels showed a significant increase for the normal saline group and a significant decrease for the one fifth-four fifth group.

One fifth- four fifths solution owing to hyperglycemia and hyponatremia is not a suitable choice for intraoperative fluid therapy in neonates. In contrast, normal saline solution performed better in controlling blood sugar and plasma sodium.