مجله دانشگاه علوم پزشکی گیلان
پیاپی 125 (بهار 1402)

I read the study conducted by Alizade et al. [1] which was interesting. I need to indicate some points about the use of Optical Coherence Tomography (OCT) in ophthalmology and optic nerve diseases. As Alizadeh et al. [1] stated, OCT has become popular for the diagnosis and follow-up of retinal and optic nerve diseases due to its high reproducibility. In this letter, I discuss the role of OCT in optic nerve ischemia and share my experiences in this field. Then, I review the role of OCT angiography (OCT-A) and recent developments in this field, as well as the role of artificial intelligence in ophthalmology.

The coronavirus disease 2019 (COVID-19) pandemic led to depression, stress and mental health problems in medical students working in hospitals.

 The present study aims to evaluate the professional quality of life (QoL) of medical interns in Rasht, Iran during the COVID-19 pandemic.

 This cross-sectional study was conducted on 152 medical interns working in hospitals affiliated to Guilan University of Medical Sciences in 2020. The professional QoL was assessed using the professional quality of life scale (ProQOL).

 The mean scores of compassion satisfaction, burnout, and secondary traumatic stress were 38.4±8.3, 30.9±5.4, and 25.3±7.5, respectively. Compassion satisfaction had a significant relationship with marital status, history of underlying diseases, being resident of the city, and work shift duration.

 The professional QoL of medical interns in Rasht is low. Considering the differences in the spread of COVID-19 in Iran, it is necessary to conduct more study in other cities and on other medical trainees.

 Epilepcy is a chronic neurological disease, and due to its complex mechanism, the current therapeutic drugs for it are not effective enough. It may have a non-neurological origin such as astrocytes and microglia.

This study aims to investigate the effect of cabergoline and levetiracetam (alone or combined) on the histological and stereological structure of the cerebral cortex, hippocampus, and cerebellum in rats with pentylenetetrazol (PTZ)-induced seizure. 

 In this experimental study, samples were 30 female rats in five groups of control, seizure (PTZ-induced kindling), seizure+levetiracetam, seizure+cabergoline, seizure+levetiracetam+cabergoline. Levetiracetam and cabergoline were used at 50 and 0.05 mg/kg doses, respectively, and half of these doses were used in the seizure+levetiracetam+cabergoline group. After anesthesia, animals’ brain tissue was removed and after preparing tissue slices, the number of neurons and neuroglia was examined using stereology technique.

 In the cerebral cortex and in the molecular and granular layers of the cerebellum, the numbers of neurons and neuroglia in the treatment groups were not significantly different from those in the control group, but a significant decrease was observed in the CA1, CA2, and CA3 regions of the hippocampus in the seizure group compared to the control group. In dentate gyrus, the number of neurons in all treatment groups and the number of neuroglia in the seizure group showed a significant decrease compared to the control group. In the Purkinje layer of the cerebellum, there was no significant change in the number of neurons compared to that in the control group.

 The hippocampus is more involved in the occurrence of seizure activity than other parts of the brain. Neurons and neuroglia play an essential role in seizures, but more studies are needed for determining the relationship between the number of these cells and the use of cabergoline because their number decreases in different parts of the hippocampus following chronic seizures, where the relationship is different between dendrite gyrus and CA regions.

 Oral lesions can affect people’s quality of life by interfering with chewing, swallowing, and speech. These lesions may originate from epithelial or mesenchymal tissues. Malignant oral lesions can be life-threatening. Epidemiological data of oral lesions in Iran is limited.

 This study aims to investigate the frequency of oral lesions in Rasht, Iran.

 In this cross-sectional study, histopathologic data of oral lesions reported by Razi laboratory in Rasht from 2015 to 2019 were evaluated. The data collected: Patients’ age and sex, histopathologic findings, and location, type and origin of lesions. Non-specific diagnoses and dental and bone lesions were excluded.

 A total of 259 pathologic reports were included. The mean age patients was 52.09±19 years, and 40.2% were male. Oral lesions in patients aged <40 years were mainly benign (64.2%), whereas half of lesions in patients ≥70 years were mostly malignant. Tongue was the most common location of the lesions (34.7%) and the main location for malignant lesions (46.7%). Benign lesions were significantly higher in females whereas malignant lesions were significantly higher in males (P=0.011). Epithelial tissues were the most common site of origin (49%) and salivary glands were the least common site of origin (11.6%) for oral lesions.

 Malignant oral lesions are more common in Iranian men aged >70 years, where the tongue is the most common site of involvement and epithelial tissue is the main site of origin.

 People who take statins respond differently to them due to genetic differences. One of the most significant enzymes involved in drug metabolism is cytochrome P450 2D6 (CYP2D6) enzyme, coded by the CYP2D6 gene. Individuals who carry two non-functional alleles in this gene are considered as poor metabolizers. Recognizing poor metabolizers may help prevent adverse effects of drugs. 

 This study aims to assess the association of CYP2D6*4, as the most frequent non-functional allele of CYP2D6 gene, and response to atorvastatin in patients with high low-density lipoprotein (LDL) level in northern Iran.

 A total of 180 patients with high LDL level underwent treatment with atorvastatin for 8 weeks to assess their response. They were assessed in terms of CYP2D6*4 polymorphism using the amplification-refractory mutation system/polymerase chain reaction method and the results were validated by the sanger sequencing method. At the end, the association between CYP2D6*4 allele and response to atorvastatin was assessed. 

 In patients, the percentage of the CYP2D6*4 variant was 7%. This allele was not observed in homozygous patients. There was no significant association between CYP2D6*4 polymorphism and response to atorvastatin, which might be due to low frequency of CYP2D6*4 in patients. The observed allelic frequency was close to the frequency reported in previous studies for healthy Iranian people.

 It seems that CYP2D6*4 polymorphism is not the cause of poor metabolism in poor metabolizers in northern Iran. Therefore, to diagnose poor metabolizers in this region, further studies on other genes are recommended.

 Patients who undergo major orthopedic surgery are at risk of acute kidney injury (AKI) due to blood loss, electrolyte disorders, infection, and other co-morbidities. In this study, we aim to investigate the frequency of AKI and its risk factors in patients undergoing major orthopedic surgery in Rasht, Iran.

 This is an analytical cross-sectional study on 180 patients undergoing major orthopedic surgery. Those with a history of chronic kidney disease and dialysis were excluded. 

 The data including patients’ age, gender, drug history, history of underlying diseases, duration of surgery, mean arterial pressure during and after surgery, and use of inotrope during and after surgery, and creatinine level before and after the surgery. 

 The mean age of patients was 47.3±22.8 years. The incidence of AKI was 11.11%. The use of some drugs, duration of surgery, MAP, and inotrope use had no significant relationship. The occurrence of AKI had a significant relationship with the history of heart disease, diabetes, and kidney disease. Multiple linear regression analysis results showed that with the increase of one unit in preoperative creatinine level, the postoperative creatinine level increased by 0.3.

 The incidence of AKI after major orthopedic surgery in Rasht city is relatively high. Careful monitoring of kidney function before, during, and after major orthopedic surgery is important; it can prevent the occurrence of postoperative AKI.

 Various drugs are used as adjuvants to improve the quality of supraclavicular block method. 

 This study aims to investigate the effect of adding dexmedetomidine to lidocaine in the supraclavicular block method in patients candidate for upper extremity surgery.

 This double-blind randomized controlled clinical trial was conducted on 61 patients candidate for upper extremity fracture surgery receiving the supraclavicular block method from 2017 to 2018. They were randomly divided into two groups of lidocaine-normal saline (30 mL of 1.5% lidocaine plus normal saline) and lidocaine-dexmedetomidine (30 mL of 1.5% lidocaine plus 1 μg/kg of dexmedetomidine). The supraclavicular block characteristics and intraoperative hemodynamic changes were measured.

 There was no statistically significant difference between the two groups regarding the demographic factors. The mean age of patients was 43.09±10.92 years, and most of them were male. The mean onset time of sensory-motor blockade was faster and the duration of sensory-motor blockade and analgesia were longer in the lidocaine-dexmedetomidine group than in the other group. These differences were statistically significant. There was significant differences in hemodynamic parameters among nine assessment times in each group and between the two groups.

 Adding dexmedetomidine to lidocaine in the supraclavicular block method accelerates the blockade onset and increases the duration of blockade and analgesia after surgery without causing any considerable side effects.