مجله دانشکده پزشکی اصفهان
پیاپی 516 (هفته چهارم فروردین 1398)

One of the main adverse effects of fentanyl, as the most commonly used anesthetic drug in children, is coughing. Several medications have been used to reduce this complication. In this study, the effect of ketamine and lidocaine on cough reduction after fentanyl injection was investigated. This was a randomized clinical trial study on 120 children under general anesthesia aged 6 months to 2 years, with class I and II based on the American Society of Anesthesiologists (ASA) scoring. Patients were divided into 3 equal groups treated with lidocaine (1 mg/kg), ketamine (0.15 mg/kg), and normal saline (control group). The incidence and severity of cough, heart rate, mean arterial pressure, and oxygen saturation were compared between the 3 groups. The incidence (P = 0.03) and severity (P = 0.03) of cough in control group was significantly higher than two other groups of ketamine and lidocaine. Based on our findings, use of ketamine and/or lidocaine significantly reduces the incidence and severity of coughing following intravenous fentanyl administration under general anesthesia.

Hydatidosis is a protozoal disease caused by Echinococcus granulosus, and presents as an endemic disease in Iran. Hepatic hydatid cyst is the most common involved body organ that requires surgical cyst resection in case of being symptomatic. Among most serious complications of hydatid cyst surgery is biliary fistula. The current study aimed to assess the etiologic factors of biliary fistula incidence. This was a census retrospective cross-sectional study conducted on 69 patients underwent open hydatid cyst resection in Alzahra hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, during the years 2015-18. Patients' information including age, gender, previous history of hepatic surgery, cyst diameter, cyst location, and serum level of alkaline phosphatase (ALP) prior to surgery were recorded. Then, patients were followed considering the incidence of biliary fistula. Association of mentioned factors with biliary fistula occurrence was assessed. 15 patients (21.7%) presented biliary fistula. No statistical association was found between the incidence of biliary fistula and gender (P = 0.08), age (P = 0.75), position of hydatid cyst (P = 0.89), hydatid cyst size (P = 0.37), previous history of surgery (P = 0.50), and serum level of ALP prior to the surgery (P = 0.26). Based on findings of the current study, no significant association was detected between the incidence of biliary fistula following open resection of hydatid cyst and factors such as age, gender, previous history of hepatic surgery, cyst size, cyst location, and serum levels of ALP. Further studies with greater study populations are recommended.

Domestic violence against the women is a common problem in the world. Providing health services in Iran contain anger management training intervention as a major step for reducing domestic violence and consequences. In this study, we evaluated the effect of stress and anger management training program, which belonged to the Iranian Ministry of Health, Treatment, and Medical Education. This randomized quasi-experimental study, with pre/posttests, was performed in 2018, in one of the health centers in Isfahan City, Iran. The score of anger management skills, as well as the prevalence exposure to violence were compared between two equal groups of 44 married woman with exposure to violence, without any interventions (control group), and with 4 sessions of training anger management skills (interventional group). Before and 3 month after training, anger management skills questionnaire and Iranian violence screening checklist were completed for both groups. Data were analyzed using analytical tests such as chi-square, t, and paired t, via SPSS software. Both groups were similar in age and exposure to violence (P = 0.530). The score of anger management skills before the training was 24.75 ± 9.92 and 23.25 ± 9.47 in interventional and control groups, respectively (P = 0.470). After training, the score became 31.30 ± 6.48 and 23.34 ± 8.72 in interventional and control groups, respectively (P < 0.001). The exposure to violence did not change in both groups after the intervention. The training program belonged to the Iranian Ministry of Health, Treatment, and Medical Education increased anger management skills in women. Many studies showed that other training methods are effective on anger management skills. Moreover, long-term studies even showed that exposure to domestic violence had been decreased.

Frankincense is a gum resin of Boswellia trees genus that has been favored in the Iranian traditional medicine for its anti-inflammatory and anti-tumor properties. Glioblastoma is one of the most malignant adult cancers that is resistant to radiation therapy and chemotherapy. The aim of this study was to investigate the effect of an active ingredient of frankincense, 3-O-acetyl-beta-boswellic acid, on interleukin-6 expression in human glioblastoma cell line. Human glioblastoma cell line was obtained from cell bank of Pasteur Institute of Iran, and treated with different concentrations of 3-O-acetyl-beta-boswellic acid for 24 hours. The effect on cell survival was evaluated using MTT assay, and half maximal inhibitory concentration (IC50) was calculated as well. Cultured cells were treated with concentrations of 5, 15, and 25 μM of 3-O-acetyl-beta-boswellic acid. RNA was extracted and converted to complementary DNA (cDNA), and used for interleukin-6 expression studies via real-time polymerase chain reaction (PCR). IC50 was calculated as 39.88 μM. 3-O-acetyl-beta-boswellic acid at concentrations of 5, 15, and 25 μM significantly reduced the expression of interleukin-6 in a dose-dependent manner (P < 0.05). The results of this study indicate anti-inflammatory and anti-tumor effects of 3-O-acetyl-beta-boswellic acid by decreasing the expression of interleukin-6 in the inflammatory environment of glioblastoma tumor cells. Therefore, it can be considered as a beneficial ingredient in the treatment of glioblastoma.

Necrotizing enterocolitis (NEC) is a common and serious disease among premature infants. That is why a lot of studies have been done to know the etiology and prevent, and a lot of researches to assess the preventive effect of prebiotics on it. The aim of this study was to provide clear picture of the relationship between the consumption of antibiotics and NEC in premature infants. This was a type of secondary study that done according to a systematic review. This review included clinical trial studies considered the preventive effect of prebiotic supplements on NEC in premature infants. After searching the keywords, 1358 articles were found in databases in which 9 articles were related to the current research. Finally, by omitting systematic reviews and analytical descriptions, only 5 articles were included in this systematic review. After the final analysis, it was found that the consumption of prebiotics did not have any significant effect on the prevention of NEC. More researches are suggested due to insufficient related articles, and few number of premature infants included in these studies.