مجله دانشکده پزشکی اصفهان
پیاپی 707 (هفته سوم فروردین 1402)

Red blood cell (RBC) storage lesions may dramatically reduce the function of these cells. One of these complications is the gradual increase in oxidative stress, which causes the destruction of RBCs during their storage. This study was designed to investigate the effect of glutathione additive as an antioxidant on the biochemical changes of leukoreduced-RBC (LR-RBC) bags during storage.

The study was experimental. In 2016, it was done in Tehran Blood Transfusion Organization. Ten bags of LR-RBC were collected, processed and stored according to standard procedures. Each unit was divided into two equal parts treated with glutathione or normal saline (control). Sampling of all bags was done during the time points of 3, 14, 21, 35 and 42 days after storage. Used the ELISA method to investigate changes in glutathione and 2,3-diphosphoglycerate (2,3-DPG) and the enzymatic method to measure biochemical parameters such as lactate-dehydrogenase (LDH), lactate concentration and glucose-6-phosphate-dehydrogenase (G6PD) enzyme activity.

The amount of glutathione in the treated group and the control group decreased by 70 % and 60% of the initial value, respectively. With the decrease of glutathione level in the last week of storage, a significant decrease in G6PD activity was observed. The amount of 2,3-DPG decreased to almost zero after 42 days of storage. LDH and lactate increased during storage.

Our results showed that, except for the amount of 2,3-DPG, the rest of the studied parameters were affected by glutathione and glutathione antioxidant was effective in reducing oxidative stress

Inflammatory responses are one the factors influencing the prognosis of multiple trauma patients. Hydrocortisone, with an appropriate dose, diminishes the inflammatory responses without immunosuppression, improving the patients’ immune system. Administering vitamins specifically vitamin B and C to multiple trauma patients, by eliminating free radicals, could decrease the mortality of these patients. This study was done to evaluate the efficacy of treatment with a combination of Hydrocortisone+ Ascorbic acid+ Neurobion (vitB1+B6+B12) on the prognosis of multiple trauma patients hospitalized in Intensive Care Units.

In a three-blind clinical trial study, 60 multiple trauma patients randomly allocated to two groups of intervention and control. In the intervention group, the patients received 1.5g vitamin C every 6 hours for a period of 4 days, Hydrocortisone 50 mg every 6 hours for a period of 7 days, two Neurobion every 12 hours for 4 days. In the control group, the patients received placebo. The patients in both groups were followed for ninety days and eventually, length of ICU stay, the need for mechanical ventilation and duration of mechanical ventilation were determined and compared between the two groups.

The mean duration of mechanical ventilation in the intervention and control group were 8.96 ± 6.03 and 14.8 ± 8.11 respectively which was statistically significant. There were no significant differences between the two groups in other outcome measures.

Our study shows administration of combination of Hydrocortisone+ Ascorbic acid+ Neurobion (vitB1+B6+B12) could decrease the duration of mechanical ventilation in multiple trauma patients.

Background The Patient package inserts are officially published by pharmaceutical companies and authorized by the food and drug administration. The purpose of the package inserts is to provide complete, reliable and safety information about the drug to the consumer. Drug catalogues are another drug information sheet that is made available to physicians due to time constraints and busy schedules to update their knowledge about the existing and novel drugs. Of course, today the digital world has faced tremendous changes in the provision and consumption of pharmaceutical services. Internet of things, artificial intelligence, block chain and cloud computing are new technologies that will revolutionize the future of drug therapy. Digital transformation will lead to accurate drug therapy, cost reduction, saving time and manpower, access to more flexibility and better efficiency in all processes. This review article was about the current situation, challenges and promotion of information provided in the patient package inserts, also the importance of new technologies in the field of medication information.