مجله دانشکده پزشکی اصفهان
پیاپی 510 (هفته دوم اسفند ماه 1397)

Coughing and sore throat are among the most common complications of intubation. Variety of drugs have been experimented to reduce these complications, but the information in this regard is limited and controversial. The current study compared intracuff alkalinized lidocaine, intravenous lidocaine, and a control group. This was a randomized controlled double-blinded clinical trial study on 99 patients undergoing intubation. Patients were randomly divided into three equal groups, intracuff alkalinized lidocaine, intravenous lidocaine, and control group, in them, the cuff was filled with air till pressure reached under 30 cmH2O. Cough frequency and sore throat severity were assessed and compared based on visual analog scale (VAS) immediately after extubation, and within 15 minutes, 1, 2, 3, 12, and 24 hours after extubation. Comparison of sore throat among 3 groups in different times showed no difference (P > 0.050); but within 24 hours decreased in all three groups of intracuff alkalinized lidocaine (P < 0.001), intravenous lidocaine (P < 0.001), and control (P = 0.001). Sore throat severity decreased significantly in all three groups during a period of 24 hours (P < 0.050). Comparison of cough frequency immediately after extubation (P = 0.005) and within 24 hours (P = 0.007) was significantly less in intracuff alkalinized lidocaine group. Within 24 hours, the frequency of coughing decreased significantly in all three groups of intracuff alkalinized lidocaine (P = 0.040), intravenous lidocaine (P = 0.001), and control (P = 0.002). Based on the current study, there was no difference among alkalinized intracuff lidocaine, intravenous lidocaine, and control group in the reduction of sore throat, but to reduce cough, alkalinized lidocaine was significantly influential.

This study aimed to investigate the effect of low-dose lactulose as a prebiotic on the prevention of sepsis in infants with very low birth weight. In a clinical trial study, 50 infants with very low birth weight were selected, and randomly divided into two groups of 25. The first group received low-dose lactulose feeding, and the second group received distilled water feeding as placebo. The frequency of late-onset neonatal sepsis was determined and compared between the two groups. Late onset neonatal sepsis was seen in 14.8% and 40.0% of infants in lactulose and placebo group, respectively (P = 0.040). Moreover, the time to reach full dose enteral nutrition was significantly shorter in the lactulose group (12.85 ± 3.33 days) compared to placebo group (15.20 ± 5.24 days) (P = 0.030). As a prebiotic in infants with very low birth weight, lactulose feeding is beneficial and without side effects in late-onset neonatal sepsis. These findings show the possible beneficial effects of prebiotics, and requires further studies with larger sample sizes. Keywords: Sepsis, Neonate, Lactulose, Prebiotics

Oral squamous cell carcinoma (OSCC) accounts for about 90% of all malignant oral tumors, and is often diagnosed in advanced stages. In this study, changes in the expression of microRNA-155 (miR-155) and carcinoembryonic antigen messenger RNA (CEA mRNA) in peripheral blood of patients with oral cancer were investigated. In this study, 30 patients and 30 healthy people were selected. The miR-155 and CEA mRNA levels in their peripheral blood were measured and evaluated using real-time polymerase chain reaction (real-time PCR) technique. Positive miR-155 marker was observed in 21 people from 30 with oral cancer, and 7 of 30 healthy subjects. The CEA mRNA marker was positive in 23 of the 30 patients, and 5 out of 30 healthy subjects. In sum, the outcome of this study can be seen as a screening diagnostic test for early detection of the disease in the early stages.

The use of nanocomposites is increasing nowadays. The present study aimed to evaluate the effects of intraperitoneal injection of zinc oxide (ZnO)-chitosan nanocomposites on serum liver enzymes and liver injury in male rats. 32 male Wistar rats were equally divided into four groups of one control and three treatment groups. The treatment groups received intraperitoneal injections of ZnO-chitosan nanocomposites (80, 160, and 320 mmol/ml) for four weeks. Control rats were treated with normal saline. At the end of the experiment, the serum samples were taken from the heart, and serum liver enzymes of alanine transaminase (ALT) and aspartate transaminase (AST) were determined. After euthanasia, liver and brain samples were taken to determine brain malondialdehyde (MDA) level, and liver histological investigation. There was a significant increase in serum ALT levels following intraperitoneal injection of ZnO-chitosan nanocomposite at 160 and 320 mmol/ml compared with the control group (P < 0.05). Serum AST levels did not change compared with the control group (P > 0.05). In histological analysis, the group received 320 mmol/ml nanocomposites showed sinusoidal distention and necrosis. There were no significant changes in brain MDA between the experimental groups. The administration of ZnO-chitosan nanocomposite can increase liver enzyme levels. These compounds could be toxic, and their use should be limited in industry and medicine.

Stress in jobs such as medicine can cause physiological and psychological damage. Therefore, the aim of this study was to investigate and compare the stress among emergency physicians, identify strategies for managing stress, and ranking these strategies.

This cross-sectional study was conducted on 91 emergency physicians of Shahid Sadoughi, Shohadaye Kargar, Afshar, and Shahid Rahnemoon hospitals in Yazd City, Iran, in year 2017. The participants were selected using convenience sampling method. In this survey, we studied general physicians, emergency medicine specialists, and the residents of internal medicine, general surgery, cardiology, and emergency medicine. The questionnaire used in this article was obtained from Miguel research, and according to the opinion of the professors, its questions reduced from 192 to 125 questions, and after verification of validity and reliability, it was used.

Afshar hospital had the highest mean of stress (325.20 ± 57.30), and hospitals of Shahid Sadoughi (304.9 ± 52.8), Shahid Rahnemoon (288.02 ± 39.01), and Shohadaye Kargar (174.70 ± 21.60) were ranked next. Moreover, the dimensions of communication with the supervisor (17.40 ± 2.29) and communication with the staff had the lowest (20.24 ± 2.60) and medical care in general (18.20 ± 2.73) and family conditions (27.12 ± 2.98) had the highest mean of dimensional stress. The results of ranking stress management strategies also showed that emergency doctors showed negative reactions in stressful situations to reduce stress.

Emergency practitioners work in a high-profile environment, which reduces their work efficiency and burnout. Therefore, recognizing the dimensions of stress and its management solutions can improve working conditions.