مجله دانشکده پزشکی اصفهان
پیاپی 739 (هفته سوم آذر 1402)

The aims of this study were to compare the effects of two doses of 0.4 and 0.6 mg/kg mannitol on the rate of diuresis, residual renal function, hemodynamic changes and creatine phosphokinase changes in brain death patients.

In a single-blind randomized clinical trial study on brain death patients hospitalized in the intensive care units of Al-Zahra Hospital in Isfahan, 30 brain death patients were divided into two groups of 15, the first group was given 0.4 g/kg mannitol and the second group was given 0.6 g/kg mannitol with 1 mEq of sodium bicarbonate per kg for 20 minutes. And these values were repeated up to three times every 8 hours. Creatine phosphokinase levels were measured 8 hours after each dose of mannitol and urinary output 2 and 8 hours after each dose of mannitol and renal function, 8 hours after the last dose, and the mean changes were compared between the two groups.

Mean changes in serum creatine phosphokinase level were significantly decreased in the two groups, but the rate of reduction was not significantly different between the two groups. Glomerular filtration rate was significantly increased in both groups, but the rate of change was not different between the two groups. Also, changes in urinary output were significantly different between the two groups.

The use of 0.6 g / kg of mannitol is not superior to the dose of 0.4 g / kg of this drug in improving renal function and reducing creatinine phosphokinase levels.

Environmental toxic factors, with their destructive effects on nerve cells and myelin tissue, can induce nervous system dysfunction. The neuroprotective role of valproic acid as an inhibitor of Glycogen synthase kinase 3β (GSK3-β) has been proven in some neurodegenerative diseases. In the present study, the effects of this combination were investigated in preventing myelin tissue destruction and maintaining its density in the corpus callosum of mouse brain.

40 female C57BL/6 mice weighing 20-25 grams were divided into four groups including control, sham, cuprizone and, valproic acid/cuprizone groups. The valproic acid combination was used intraperitoneally, daily, and at a dose of 300 mg/kg. At the end of the research, to check myelin density, Teloidin blue staining, immunohistochemistry and, real-time methods were used.

The results showed that the density of myelin and the percentage of cells expressing the Myelin Basic Protein (MBP) marker increased significantly in the group that received valproic acid compared to the cuprizone group. In addition, the results of myelin-specific gene expression analysis showed that the use of valproic acid can increase the expression of this gene.

The results of the present study showed that valproic acid has the ability to prevent myelin tissue destruction and maintain its density, and therefore, the use of this combination can be a suitable combination to prevent and reduce the progression of diseases that destroy nerve tissue.

Having children is influenced by social, economic, cultural, and personal factors. Mothers' satisfaction from receiving appropriate pregnancy and childbirth care promotes physical and mental health and creates a positive experience of childbirth. It may provide the basis for increasing the intention to childbearing. The purpose of this study is to investigate the relationship between satisfaction from pregnancy and childbirth care to have more children.

In this cross-sectional study, 423 eligible women were referred to comprehensive health centers in Bandar Abbas, Iran in 2022 and participated by the available sampling method. The tools of data collection were demographic, satisfaction with pregnancy, and childbirth care questionnaires. The data were analyzed using statistical tests of t-test, chi-square, ANOVA, and Spearman's correlation coefficient.

The intention to childbearing had a positive correlation with the age of the person and her spouse, the age of marriage, the gender of the children, and the place of delivery. Most participants' satisfaction with pregnancy and childbirth care was average. The majority of women who had received good and complete pregnancy and delivery care had the intention to become pregnant again. There was a positive correlation between satisfaction with pregnancy care (r = 0.25) and satisfaction with childbirth care (r = 0.15) intending to have children again.

The results of the present study showed a correlation between the desire to have children again and satisfaction from pregnancy and childbirth care. This finding confirms that if population policies can design and implement programs that increase women's satisfaction with pregnancy and childbirth care, they can be very effective in creating the intention to have children again.