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Reviews in Clinical Medicine - Volume:2 Issue: 1, Winter 2015

Reviews in Clinical Medicine
Volume:2 Issue: 1, Winter 2015

  • تاریخ انتشار: 1393/10/05
  • تعداد عناوین: 12
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  • Behnaz Boroumand Rezazadeh*, Hamid Zamani Moghadam, Mohammad Gharavifard Pages 1-4
    Ketamine, among wide variety of sedative drugs, has shown beneficial effects when using during the procedural sedation, specifically in pediatrics. Various parameters should be considered in order to perform a safe and effective procedural sedation including optimum dosage of the sedative, administration methods of sedation, and need for applying any adjuvant drug. In this study, we aimed to review the studies, which have compared the efficacy of the different ways of the injection of ketamine such as intravenous or intramuscular ketamine application. Based on data obtained from the related articles, efficacy and safety of these two methods of ketamine usage in the pediatric procedural sedation were widely similar, but the intravenously administration of the ketamine can be proposed as the preferable mode.
    Keywords: Ketamine, Intravenous, Intramuscular, Pediatric sedation, Procedural sedation
  • Reza Ghasemi, Mostafa Dastani*, Alireza Abdolahi, Hamid Reza Rahimi Pages 5-8
    Atherosclerosis is a chronic slow-developing condition affecting medium-size and large blood vessels. It is the principal underlying pathology of coronary heart disease and stroke. In some countries, coronary artery disease (CAD) is the cause of nearly half (48%) of the deaths and, loss of productivity life. Peripheral arterial disease (PAD) is defined as atherosclerosis in peripheral arteries instead of coronary arteries. CAD and PAD have same risk factors and underlying pathophysiological processes. Therefore, patient with CAD should be considered for PAD. Ankle brachial index (ABI), duplex sonography, and some other non-invasive techniques are recommended for PAD diagnosis in patients with the history of CAD. Pharmacotherapy, endovascular interventions, and surgical management could be chosen according to the patient’s situation. Cardiologists and general practitioners should consider PAD in a patient with CAD or DM as a strong correlated disease.
    Keywords: Atherosclerosis, Coronary artery disease, Peripheral arterial disease
  • Amir Rezaei Ardani, Azam Motamedi Nasab Pages 9-14
    Worldwide growing methamphetamine abuse is one of the most serious health problems with several different consequences for victims, especially in developing countries. Chronic methamphetamine abuse is associated with several psychiatric problems in all countries which are faced to epidemic methamphetamine abuse. Methamphetamine-induced psychosis is a major medical challenge for clinical practitioner from both diagnostic and therapeutic viewpoints. Stimulant psychosis commonly occurs in people who abuse stimulants, but it also occurs in some patients taking therapeutic doses of stimulant drugs under medical supervision. The main characteristic of meth psychosis is the presence of prominent hallucinations and delusions. Other drugs, such as cocaine and marijuana, can trigger the onset of psychosis in someone who is already at increased risk because they have “vulnerability”.The current literature review attends to explain several aspects of MIP epidemiologically and clinically. Investigators proposed pharmacologically treatment based on recently published data.
    Keywords: Methamphetamine, Psychosis, Treatment
  • Ameneh Movahedian*, Nayereh Ghomian, Samaneh Soltani, Nushin Chalakinia Pages 15-18
    Complications related to pregnancy and childbirth are the leading causes of disability and death among women of reproductive age in developing countries, constituting at least 18% of the global burden of disease in this age-group. Preeclampsia is a serious, pregnancy-specific disorder that affects up to 8% of pregnant women. Preeclampsia may lead to maternal and offspring mortality and it increases the risk of premature birth and fetal growth restriction. Vitamin D is a potent immunomodulatory agent. There is an evidence pointing toward an association between the vitamin D status and preeclampsia risk. The purpose of the present study is to review the available literature investigating the role of serum levels of vitamin D in preeclampsia.The study findings further highlight the possibility that vitamin D deficiency is a strong, independent risk factor for preeclampsia and vitamin D supplementation may be a simple step to reduce the risk of adverse pregnancy outcomes providing lifelong benefits both to the mother and her developing child.
    Keywords: Deficiency, Pregnancy outcomes, Preeclampsia, vitamin D
  • Majid Safarpanah*, Mehran Hiradfar Pages 19-23
    In recent years, laparoscopy has become a popular surgical method. Laparoscopy is a minimally invasive surgery, which results in minor traumas in comparison with conventional open surgeries. There are several risk factors associated with laparoscopy based on the involved organ and the patient’s general situations. Due to the improvements of clinical approaches, laparoscopic splenectomy has been known as a gold standard method for spleen removal as a result of various diseases, such as ITP. The human spleen plays a key immunologic role in defense against a number of organisms, particularly encapsulated bacteria. The spleen can cause significant morbidity and/or hematologic disturbance if it becomes hyperfunction (hypersplenism) or hypertrophied (splenomegaly). Laparoscopic surgery for cancer is also an appropriate procedure if good tissue handling techniques are maintained. In this study, we attempted to review the results obtained from recent articles about the beneficial features of the laparoscopic splenotectomy in comparison with conventional open surgery.
    Keywords: Laparoscopy, Splenectomy, Spleen, surgery
  • Mohammad Saleh Soltankhah, Mohammad Reza Majidi, Shahaboddin Shabani Pages 24-27
    Nasal polyp is macroscopic edematous mass and it is a most common nasal complaint of the patients. The exact etiology is still unknown and controversial, but the main causes are assumed to be the inflammatory conditions and allergy. Their clinical presentations are obstruction, rhinorrhea, postnasal drip. Nasal polyp is more common in allergic patients with asthma. Treatment of this complication is associated with both medical treatment and surgery. Corticosteroids (systemic and topical) are shown to be beneficial in reducing the size of nasal polyp. Corticosteroids are also used as a primary treatment and postoperative management for avoiding recurrence. The rate of leukotrienes is increased in polyps. It is reported that leukotriene receptor antagonists (antileukotriene) have a beneficial effect on nasal polyp treatment. Montelukast is an antileukotriene. It can be used to modify the symptoms of nasal polyp. There is no significant difference between corticosteroids and montelukast clinical efficacy.
    Keywords: Antileukotriene, Corticosteroids, Montelukast, Nasal polyp
  • Azadeh Tafakori, Mohammad Gharavifard, Hamid Zamani Pages 28-31
    There are various criteria that affect the efficacy of the procedural sedation strategies required for performing different processes in emergency departments. Selecting the most effective and the safest sedative with or without analgesic effect for every individual patients and intervention is one of the main parts of the each emergency department practices. Based on previous studies, various sedative agents have been proposed, which have different benefits and adverse effects including propofol, ketamine, etomidate etc. Different side effects of administrating each drug, alone or in combination with each other, have been proposed such as vomiting, respiratory depression, hypoxia, hypotension and cardiac arrest. In this study we aimed to briefly review the properties of applied sedatives in different studies and also mention few related clinical trials with proper blinding, which were conducted to evaluate the efficacy of the sedative in procedural sedation.
    Keywords: Analgesia, Emergency, Etomidate, Ketamine, Procedural sedation, Propofol
  • Mahmoud Ebrahimi, Azamat Sabouri Arteh*, Hamid Reza Rahimi Pages 32-36
    Coronary artery disease (CAD) is a major global problem. In addition, it is higher risk of mortality for women more than men are when develop in female gender Atherosclerotic plaques consist of deposits of fatty material in the tunica intima. The role of inflammatory process in CAD has been known from 1980’s. Several studies investigated the innate immunity and adaptive immunity roles in atherosclerosis and they concluded that it plays a key role in atherosclerosis. Coronary artery bypass grafting (CABG) is a widely used method for the treatment of CAD. Based on the literature, CABG is the most common surgical operation done worldwide. In During the first 10 years after CABG, up to 50% of saphenous grafts will occlude. Graft restenosis is beginning with acute thrombosis, intima hyperplasia, and plaque formation. In this review, some molecular pathways of graft failure and restenosis such as apoptosis and nuclear factor kappa B (NF-ĸB) are described.
    Keywords: Apoptosis, Atherosclerosis, Coronary artery bypass grafting, Coronary artery disease
  • Samaneh Solltani*, Masoumeh Mirteimouri, Ameneh Movahedian, Nushin Chalakinia Pages 37-41
    Postpartum hemorrhage is among the leading causes of maternal mortality throughout the world. Severe blood loss contributes to the increased blood transfusion risk with its concerned inherent adverse events and therefore increased rate of emergency re-operative interventions such as arterial ligation or hysterectomy. It also can lead to protracted anemia, particularly in low or median income countries. Extended application of antifibrinolytic agents such as tranexamic acid has been customary for long years to stop or reduce blood loss in postpartum period. However, there are not enough reliable evidence to approve the real efficacy of these drugs. In this brief and summary review, we pointed to a few conducted studies. The PubMed was searched for keyword including postpartum hemorrhage, tranexamic acid, cesarean section, vaginal delivery, and blood loss prevention. The articles with language other than English were excluded from our review. We concluded that more convincing information is needed to determine the precise effects of tranexamic acid, and its benefits against adverse effects.
    Keywords: Blood loss, Cesarean section, Postpartum hemorrhage, Tranexamic acid, Vaginal delivery
  • Neda Partovi, Homa Falsoleiman* Pages 42-44
    Percutaneous coronary intervention is an option for the treatment of coronary artery disease such as acute coronary syndrome and stable angina.Acute coronary syndrome has two groups including acute myocardial infarction and unstable angina.Periprocedural myocardial infarction is a frequent and prognostically important complication of percutaneous coronary intervention and can be easily monitored by measuring myocardial enzymes. Coronary microvascular dysfunction in patients undergoing primary percutaneous coronary intervention for the treatment of ST-segment elevation myocardial infarction is associated with poor prognosis. Even after recanalization, reperfusion injury often occurs including no-reflow or slow-flow in which sufficient myocardial blood flow cannot be obtained and results in a poor outcome of cardiac function in the long term.Nicorandil is the opener of the adenosine triphosphate-sensitive potassium channel and is known to have an antiarrhythmic effect and myocardial protective functions such as reduction of the coronary microvascular resistance by relaxing the smooth muscles of blood vessesl and preconditioning.In this literature review, we evaluate articles about acute coronary syndrome and stable angina undergoing PCI.
    Keywords: Nicorandil, Myocardial infarction (MI), Percutaneous coronary intervention (PCI), Stable angina Unstable angina
  • Seyed Esmael Nezhadhoseini*, Kazem Fotohi, Mohammad Vejdani Pages 45-48
    Breast surgical site infection is not only one of the main causes of the morbidity and mortality of cases under different types of surgeries, but also it results in longer hospitalization and additional expenses. Identifying various potential parameters related to the occurrence of surgical site infection after the surgery and getting accurate knowledge about them can be beneficial in preventing the surgical site infection. Various types of studies have been conducted to evaluate the possible risk parameters of surgical site infection in every surgery. In this study, we tried to provide a brief review of the available literature regarding the risk factors associated with breast surgical site infection. To this end, we searched the Pubmed database for the relevant articles. We selected eight articles, which have studied the parameters with statistically significant association with the breast surgical site infection. According to our review, further studies with larger sample size can be effective in better evaluating the associated risk factors and presenting the exact effect of some uncertain risk factors of the surgical site infection after breast surgeries.
    Keywords: Breast reduction, Breast surgery, mastectomy, Risk factors, Surgical site infection
  • Sareh Mousavi, Fereshteh Ghaderi, Ali Eshraghi Pages 49-51
    Adipose tissue surrounding the heart may contribute in the progression of coronary atherosclerosis due to its proximity to the coronary arteries. In addition, epicardial adipose tissue has paracrine and endocrine functions. It can secrete numerous bioactive molecules. Most previous studies examined the relation between coronary artery disease and epicardial adipose tissue have used echocardiography and have reported controversial results, probably due to differences in measurement techniques and study populations. This study aimed to give a brief review on the value of echocardiographic assessment of epicardial adipose tissue in the prediction of coronary artery disease severity.Epicardial adipose tissue, easily and non-invasively evaluated by transthoracic echocardiography, can be considered as an adjunctive marker to classical risk factors despite all the limitations. Moreover, it might be recommended as a useful quantitative screening examination for the prediction of the presence and the severity of coronary artery disease and the extent of atherosclerosis.
    Keywords: Angiography, Coronary artery disease (CAD), Echocardiography, Epicardial adipose tissue (EAT)