Shiraz Emedical Journal
Volume:12 Issue: 2, Apr 2011

Perianesthesia aspiration is a threatening side effect, whose severity depends on pH and volume of aspirated gastric juice. Because of the loss of consciousness while anesthesia, the protective reflexes disappear and expose the person in the risk of aspiration. Pharmacological attempts have been made to eliminate the risk of pulmonary aspiration. The aim of this study was to compare oral pantoprazole and famotidine on gastric volume and pH in elective surgeries. In a double-blind randomized clinical trial, 120 candidates of elective surgery were randomized into 3 groups (control or C, pantoprazole or P and famotidine or F groups). The patients in group C، P and F were given placebo، pantoprazole 40mg and famotidine 40mg orally at 11 pm a night before surgery respectively. After induction of anesthesia, gastric contents were aspirated and analyzed for the pH and volume. PH values were 2. 87±0. 92 in group C, 4. 53±1. 29 in group P and 3. 79±1. 97 in group F. There was statistical difference between groups C, P and F (p<0. 05). The results showed a considerable decrease in the gastric volume in groups P and F comparing to group C. (p<0. 05). We concluded that oral pantoprazole is effective in reducing gastric pH comparing to famotidine and placebo،and famotidine is effective in reducing gastric volume comparing to pantoprazole.

Earthquakes may provoke crush injuries complicated by acute kidney injury (AKI). Management of rhabdomyolysis and acute renal failure (ARF) following crush injury is through improve the setting of primary triage and intensive care unit (ICU). This article summarizes scientific reports on management strategies of the ARF following crush injury available until 2010. Measures that should take into account for disasters and traumatic rhabdomyolysis include establishment of epidemiologic data about specific disaster conditions that predispose traumatic rhabdomyolysis and AKI, assessment and rescue team, local and public interventions, and programmed medical and social trained team. Early rehydration, urine alkalinization and, forced diuresis improve the outcome of kidney injury, risk of permanent renal failure and mortality.

Iodinated contrast media in patients with chronic kidney disease induce to loss of residual renal function. So Magnetic resonance imaging with gadolinium has replaced iodinated contrast agents in these patients. Nephrogenic systemic fibrosis is a recently identified disorder seen only in patients with kidney failure, particularly in patients on dialysis. The evidence has implicated gadolinium as the 2 main cause of this disorder Skin involvement occurs in all patients and some have systemic manifestations. It is under-diagnosed by clinicians who are unfamiliar with the condition. Although no Therapy has shown consistent benefit, but prevention in high risk patients should be considered.

The interference of acute episiotomy pain with daily activity needs more attention and the application of cold is one method to reduce these complications. In this randomized controlled trial, 121 healthy women have been chosen and divided in three groups of control and cold therapy (using pad containing cooling gel and ice pack). Subjects took the sedatives during the first four hours and then based upon the severity of perineal pain. The sedation of pain has been evaluated using numerical rating scale (0-100%) and the interference of pain with ten daily activities has been evaluated using numerical rating scale (0-10) in the first, second, fifth, and tenths days. There is a significant statistic difference in sedation of pain between the three groups in the first, second, fifth, and tenth days and the interference of pain with mood, sitting, babysitting, social activities, urination in the tenth day, defecation in the second, fifth, and tenth day (p<0/05). Pad containing cooling gel acts better than ice pack in reducing the complications of episiotomy.

Understanding the molecular and cellular mechanisms underlying liver inflammation and fibrosis would facilitate to design appropriate therapeutic interventions to halt or reverse the process of liver fibrosis. A review of literature was performed in 2010 to summarize scientific reports on inflammation pathways of hepatitis. Articles indexed in the Pub Med database during recent ten years searched for hepatitis, inflammation pathways, treatment modalities, and stem cell transplantation to investigate cellular and molecular pathways and biologic role of growth factors, cytokines, and mediators engaged in liver inflammation facilitate the development of pharmacological intervention. This manuscript reviews some recent scientific advances, and therapeutic interventions in liver inflammation, and fibrosis.

Chlamydia trachomatis is the most common cause of sexually transmitted venereal infection in the world. There is little information about the prevalence of C trachomatis in Jos, Nigeria. The study was carried out to determine the prevalence of C trachomatis infection in women attending the gynaecology clinic of the Plateau State Specialist Hospital and to assess the variables associated with the infection. A questionnaire was administered, followed by collection of endocervical swabs from patients who gave their consents using sterile plastic-shaft Dacron swabs. Collected samples were analyzed using Chlamydia Rapid Test Device- Swab/Urine (INTERCHEMICAL LTD. CHINA). Samples were collected from a total of 164 women, aged between 14 and 45 years. Ninety two (56.1% of total sample) tested positive for C trachomatis. The prevalence was slightly higher in patients within the age group 25-29 (17.68%) than in the age group 20-24 (15.24%). Both age groups 15-19 and 30-34 had a prevalence of 7.93% each. The age groups 35-39, 40-44, 45-49 and <15 had prevalence of 3.66%, 3.05%, 0.16%, and 0.00% respectively. Married women were related to a higher percentage of infection than single women: 38.41% versus 17.07%. Age of onset of sexual activity played a role in infection with C trachomatis. Women who started having sex earlier in life had a higher prevalence. History of other sexually transmitted diseases was found to be significantly associated with genital C trachomatis infection (41.46%) (P<0.05). Fourteen percent of the women had history of infertility, 26.22% spontaneous abortion, 22.12% pelvic inflammatory disease (PID) and 42.68% had more than one sexual partner (past/present). A 56.1% prevalence of C trachomatis genital infection was found. Awareness campaigns and Chlamydia screening and monitoring activities should be initiated and supported by the government.

Hemophagocytic syndrome (HPS) is a disorder characterized by benign proliferation of hystiocytes and marked hemophagocytosis in bone marrow. Hemaphagocytic syndrome (HPS) is a rare manifestation of brucellosis. Genitiurinary complications of brucellosis are very diverse and include hydrocele, urinary tract infection, pyonephrosis, epididymo-orchitis, infertility and prostatitis. Acute prostatitis is rarely reported as the first manifestation of. This article is introducing a case of brucellosis presented with acute prostatitis and concurrent hemophagocytic syndrome.

In patients with infective endocarditis affecting the aortic valve, a major complication may occur in a mechanism of direct extension of an infected jet of aortic regurgitation striking the ventricular surface of the anterior mitral leaflet. We present a 36-year-old Male with infective endocarditis of the bicuspid aortic valve, who developed a secondary infection complicated by a Mitral valve leaflet kissing abscess.