farshad hashemian

Bleeding during endoscopic sinus surgery has an unfavorable effect on the surgical field and prolongs the time of surgery. In this study, we assessed the efficacy of topical furosemide on bleeding and the quality of the surgical field during endoscopic sinus surgery.In this clinical trial, 76 patients with chronic rhinosinusitis were selected for endoscopic sinus surgery and randomly assigned to two groups, topical furosemide (intervention) and normal saline (control). The intervention group received 20 micrograms of intranasal spray twice daily, and the control group received regular intranasal saline spray, similar to the intervention group. In addition, the quality of the surgical field (scoring by the BOEZAART grading system) and the amount of bleeding during surgeries were measured. All data were analyzed.In the intervention and control groups, the mean surgical bleeding volume was 187.70± 24.79 and 229.21± 28.18 ml (P <0.001), the mean of Boezaart scale 2 and 3 (P <0.001) and the mean of surgical time were 106.53±14.67 and 126.63 ± 15.42 minutes (P <0.001), respectively. In patients of the intervention group with and without polyps, the mean surgery time was 99.56± 12.15 and 118.84 ±10.03 minutes (P <0.001), and the mean bleeding volume during endoscopic sinus surgery was 176.46 ± 22.58, 208.46 ±12.14 ml (P <0.001) respectively.Our findings showed that nasal, topical furosemide spray significantly reduced the amount of bleeding during endoscopic sinus surgery and time of the surgery and improved the quality of the surgical field.

It has often been observed that continuing medical education (CME) programs offered to medical specialists did  not meet the expected  results. The purpose of this study was to evaluate current CME programs and provide solutions, suggestions and novel models to improve CME programs for professionals in the fields of medicine and pharmacy.

The format and models of CME programs held for professionals working in the fields of medicine and pharmacy were assessedat the Continuing Education Center of the Ministry of Health and Medical Education inIran and in several prominent which claimed to have more successful results. Moreover, comparative studies of the patterns and strategies used in various countries were assessed.

A high proportion of both physicians and pharmacists agreed that use of media such as films, videos and slides will lead to enhanced learning. A low proportion of both physicians and pharmacists believed that virtual classes are more productive.Conclusions were drawn after analyzing the obtained results and reviewing the strategies and models used by various countries in the region and  abroad.

Consequently, the use of virtual reality and personalization of CME programs based on Artificial Intelligence and Data Mining were proposed.

Pain is an unpleasant sensation in the body or mind. Uncontrolled pain can increase mortality and morbidity with its negative physiological effects. Effective pain management especially in emergency conditions is essential to keep the patient in optimal conditions and to achieve good clinical results. As most of the injured and traumatic conscious patients with acute pain in emergency situations, need control and perfect pain management during transfer to hospital essential to feel satisfied and improve the quality of service and to decrease mortality and morbidity. Due to some limitation to use opioid drugs in pre-hospital systems, the goal of this study was to evaluate the efficacy of non-opioids drugs in different doses on pre-hospital emergency traumatic conscious patients.

Infusion of 1 gr IV acetaminophen and 30 mg IV ketorolac were studied separately and in combination 500 mg acetaminophen and 15 mg ketorolac on 95 patients in three separate groups in the pre-hospital pain control system. Patient pain score was collected at 5 intervals.

The results showed that there was no significant difference between the three groups in pain scores reduction finally (p> 0.05). The rate of pain reduction in emergency department is very important and these criteria was significant (p< 0.05).

The results of this study suggest that the combination of ketorolac and acetaminophen reduces pain more rapidly than either alone.According to our findings we suggest a combination of apotel and ketorolac is injected in advance in moderate to severe conscious traumatic patient before any change in the position of patients if there are not any contraindications.

 Preparation of a new product with the goal of reducing chlorhexidine’s side effects without decreasing (and even increasing) its effectiveness is a desirable goal for researchers in the field of oral hygiene. The aim of this study was to evaluate the efficacy of Chlorhexidine 0.2% and Cetylpyridinium 0.05% combination in reducing oral bacteria in comparison with Chlorhexidine 0.2%, Cetylpyridinium 0.05% and Persica mouthwashes.

100 healthy volunteers aged between 18 and 30 years were randomly assigned to 5 groups. The first group received Chlorhexidine 0.2%, the second group received Cetylpyridinium 0.05%, the third received Persica, the fourth received Chlorhexidine 0.2% plus Cetylpyridinium 0.05%, and the fifth group received Chlorhexidine 0.05% plus Cetylpyridinium 0.05%. Samples were obtained at baseline and thirty minutes after oral rinsing with the mouthwashes. The number of colony-forming units (CFU/mL) before and after mouthwash administration was compared for each sample.  

The preparation with the most bacterial count reduction was found to be Chlorhexidine 0.2% and Cetylpyridinium 0.05% combination. However, the difference between efficacy of Chlorhexidine 0.2% plus Cetylpyridinium 0.05% and Chlorhexidine 0.05% plus Cetylpyridinium 0.05% was found not to be statistically significant.                                                       

A new mouthwash preparation including chlorhexidine 0.05% and cetylpyridinium 0.05 % combination is the most desirable due to the increased efficacy and fewer side effects.

 It is suggested that surgery results in changes in kinetic profile of some medication. The aim of this study was to investigate possible alterations in pethidine’s half-life in postoperative pain management following orthopedic surgery of the inferior limb.

Twelve patients who were classified as class I patients according to the American society of anesthesiologists physical status classification were enrolled. Following the surgery of the lower limb, 25 mg of pethidine was injected intravenously. After that, 5, 30, 60 and 180 minutes following the injection, blood samples were taken and concentration of pethidine in blood samples were measured by High Performance Liquid Chromatography method. Moreover, patients’ pain levels were assessed on visual analogue scales.

The average half-life of pethidine was measured to be 29.68 minutes. Thirty minutes after the injection, significant relationship between plasma levels of pethidine and pain scale was reported (p= 0.041, r= 0.595). Moreover, men were found to perceive more pain than women. Pain scale was considerably different between smokers and non-smokers (p= 0.006), although blood concentration of pethidine was not significantly different between these two groups (p=0.09).

Orthopedic surgery most probably results in alterations in pharmacokinetic profile of pethidine. Moreover, gender and smoking status of the patients influence pain perception. Thus, pharmacokinetic alterations due to inferior limb orthopedic surgery, gender-related factors and smoking status of the patients should be considered in pain management in clinical settings.

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a relatively common disease with serious impacts on patient quality of life. Recurrence of polyps after functional endoscopic sinus surgery (FESS) is a dilemma. Vitamin D3 (VD3) is known to inhibit the proliferation of nasal polyp-derived fibroblasts. The present study aimed to investigate the effects of oral VD3 on the recurrence of polyposis after FESS. This triple-blind placebo-controlled clinical trial was conducted on 40 patients with CRSwNP who did not respond to medical treatment and were candidates for FESS. In addition, the patients had VD3 insufficiency. Following the surgery, all the patients received routine treatment (i.e., fluticasone spray, irrigation, cefixime 400 mg daily for 10 days, and montelukast for a month). Moreover, the case group received oral VD3 tablets 4000 IU (single daily dose) for a month, and the control group received placebo in the same manner. The Sino-Nasal Outcome Test (SNOT-22) and Meltzer endoscopic grading scores were recorded at months 1, 3, and 6 after the study. In this study, 6 months following the intervention, the severity of polyposis was reported to be significantly lower in the VD3 group compared to the placebo group based on SNOT-22 (16.25±10.16 in the VD3 group vs. 47.45±13.55 in the placebo group; P<0.001) and Meltzer scores (0.50±0.60 in the VD3 group vs. 2.65±0.93 in the placebo group; P<0.001). No adverse effects were observed in the case group.                      This study showed the efficacy and safety of vitamin D supplementation in the reduction of polyposis recurrence after FESS in patients with CRSwNP.

Cytotoxic waste management is one of the significant issues in healthcare system. The aim of the present study was to review studies conducted on investigation of possible levels of cytotoxic drug residues in hospital effluents.

All peer-reviewed journal articles on investigation of possible levels of cytotoxic drugs residues in hospital effluents which were published before May 2019 were investigated. 51 publications which were mostly published between 2011 and 2016 were included.

Anticancer medication continue to enter hospital effluents and urbane wastewaters. Hospital effluents seem to be one of the main sources of water contamination in this regard. Cytotoxic drugs and their metabolites are detected in hospital effluents in different countries across the globe. Platinum-based antineoplastic drugs, methotrexate, cyclophosphamide, ifosfamide and tamoxifen were found with higher concentrations across different studies.

Hospital waste management is one of the most important issues in health care system. According to the results of the present study, cytotoxic drugs residues are detected in the effluents of oncology wards of the investigated hospitals. Therefore, establishment of strict rules and regulations, provision of cytotoxic waste disposal and removal for the purpose of inactivating cytotoxic drugs in hospital effluents prior to entrance of the effluents to the sewage treatment systems is mandatory.

Malachite green exhibiting anti-fungal properties has been used illegally in aquaculture. Due to its teratogenicity, it is necessary to monitor that malachite green is not used in fish farming. The aim of the present study was to measure probable levels of the remaining malachite green in rainbow trout fish in Tehran by high performance liquid chromatography (HPLC). The present study was conducted on 42 rainbow trout species with an average weight of 850-1000 g purchased from different parts of Tehran during summer 2017. Fish fillet samples were kept at -20°C until analysis. After extraction, the resulting mixture contained leucomalachite green was then oxidized to malachite green and analyzed by HPLC method. Out of 42 samples, 3 (7.1%) contaminated cases were reported in the concentration range of 78-89 ppb. According to our results and other studies, malachite green is used not only in Iran but also in many countries illegally. However, by comparing the results from previous studies, it seems that its consumption in Iran’s fishing industry has been declining. Therefore, it is recommended to use alternative materials as fungicides and promote monitoring of its use in the aquaculture industry by inspection authorities.

Objective and The aim of this study was so assess the knowledge and attitude of the people in Iran regarding the antibacterial resistance caused by antibiotics. increasing concern toward antibiotic resistance led to many researches on the causes of this issue. The public awareness plays a critical role, according to the studies. Another important factor is the attitude of the people regarding the antibiotic use and the effect of their behavior on its resistance. The practice of each individual patient may contribute to the antibiotic resistance and major health problems and increased rate of death. A questionnaire based survey was carried out among the female population of 1000 in Tehran, Iran. An intervention course was carried out, training the volunteers. After the completion of the training course, the volunteers had to take another test to asses the effect of the training on the knowledge, attitude and practice of people regarding the antibiotic use. Before the course, people considered antibiotic as safe drugs, therefore taking them without prescription and the malpractice was evident from the incomplete course of treatment. There was a significant difference indicating the effect of the course on the public awareness and their attitude which may lead to better practice regarding antibiotic use. There may be other contributing factors to the malpractice such as financial status and experience of no significant toxicity of the drugs, making them an optimum prevention or treatment option, according to the public. This intervention was successful regrading the attitude of the people, but long term studies are required to assess them in practice

Psoriasis vulgaris is a chronic skin disease which is treated by many systemic or topical drugs. There is no cure for this disease and patients have to take medicaments for a long time, so having knowledge on adverse effects of current medicaments may prevent them and improve treatment process. The aim of this study was to evaluate the incidence of side effects of non biologic systemic drugs in psoriasis.
In this observational study, we evaluated 200 hospital charts of patients with moderate to-severe psoriasis referred to dermatology clinics of Shohada and Loghman Hospitals in Tehran in 2016. SPSS statistical tools were used to determine the percentage of adverse events. Chi square was used to show the association of gender-related complications and student T-test to evaluate age-related complications.
%56 of patients were male, %26.5 were 25-34 year-old, with mean age of 42±14.2 years and %83.5 of patients had no family history of psoriasis. 11% of patients were hypertensive. Methotrexate was the most commonly used drug and the most common reported adverse event for it was increasing liver function tests (%6.2 in oral and %21.2 in IM injections). The most common reported adverse event for cyclosporine was increased blood pressure which was seen in 17 patients (15.3%). The most common side effect of acitertin was scaling, observed in 11 (%9.6) of patients. There was no relationship between age and sex of patients and development of side effects.
This study showed systemic treatments for psoriasis can change laboratory biomarkers and cause skin eruptions.

Considering that the cosmetics today are not have used only for luxury purposes and have effective medicinal components, pharmacists require knowing about the components and ingredients of such products with a scientific level on different usages. As mentioned above, the main objective of this study is investigating the knowledge of pharmacists employed in the pharmacies of Tehran about cosmetics.
This study has been conducted by descriptive method using surveys. For completing the surveys, referring to the pharmacies, in personal, and delivering the forms to pharmacists, they were asked to complete it in the same time and they returned it to the surveyor.
According to results, it can be seen that 57% of pharmacists generally answered correctly, i.e., the information of almost 43% of pharmacists for sunscreen cares seems not to be enough. Furthermore, the awareness of pharmacists about depilatories and their physicochemical properties and ingredients was weak (21.5%).
It was considered as the only significant relation between age of pharmacists and their knowledge such that by increase in their age, their knowledge to two products, sunscreen care, and depilatory was decreased. On the other side, in Iran, the role of pharmacists has not been defined in this field-necessity of providing cosmetics information.

This study was designed to examine the antidepressant effect of celecoxib (200 mg/day) augmentation of sertraline in the treatment of female patients with first episode of major depression over 8 weeks of therapy.Thirty female outpatients diagnosed with first episode of major depression, were recruited for this study. Participants were randomly assigned into two equal groups receiving either sertraline plus celecoxib 100 mg twice daily or sertraline plus placebo twice daily. Patients were assessed by Hamilton Depression and Anxiety Rating Scale at baseline, week 4 and week 8 of treatment. Both treatment groups showed notable improvement in their symptoms from baseline; however, celecoxib group showed greater decrease in Hamilton Depression Scores compared to the placebo group after four weeks of treatment. Response rates were also found to be significantly higher in the celecoxib group compared to the placebo group over 4 weeks. Nevertheless, the mentioned differences between two groups were not significant at the end of week 8. Also, remission rate was remarkably higher in celecoxib group in comparison with placebo at the end point. The results suggested that celecoxib may hasten the onset of therapeutic action of sertraline and increase response and remission rate in depressive disorders.

Fresh frozen plasma (FFP) and prothrombin complex concentrate (PCC) reverse oral anticoagulants such as Warfarin. We compared the standard dosage FFP and PCC in terms of efficacy and safety for patients with mechanical heart valves undergoing interventional procedures while receiving Warfarin. Fifty patients were randomized (25 for each group) with mechanical heart valves [international normalized ratio (INR) >2.5]. FFP dosage was administered based on body weight (10-15 ml/kg), while PCC dosage was administered based on both body weight and target INR. INR measurements were obtained in different time after PCC and FFP infusion. The mean ± SD of INR pre treatment was not significantly different between the PCC and FFP groups. However, over a 48-hour period following the administration of PCC and FFP, 76% of the patients in the PCC group and only 20% of the patients in the FFP group reached the INR target. Five (20%) patients in the PCC group received an additional dose of PCC, whereas 17 (68%) patients in the FFP group received a further dose of FFP (P=0.001). There was no significant difference between the two groups in Hb and Hct before and during a 48-hour period after PCC and FFP infusion. As regards safety monitoring and adverse drug reaction screening in the FFP group, the INR was high (INR > 2.5) in 86% of the patients. There was no report of hemorrhage in both groups. PCC reverses anticoagulation both effectively and safely while having the advantage of obviating the need to extra doses.

The prevalence of response variability to clopidogrel in Iranian patients undergoing elective percutaneous coronary intervention (PCI) with stenting, impleta has not been fully investigated. We evaluated clopidogrel antiplatelet effects of 300 mg versus a 450 mg in open blind randomized clinical trial in a referral teaching hospital in Iran. Methods Fifty patients scheduled for elective PCI were enrolled. One group received 300 mg and the other one received 450 mg before PCI procedure. Platelet aggregation analyzed by optical aggregometery at baseline and after loading dose prior to PCI.Results The ratios of responders (IPA ≥30%), hypo-responders (10%≤IPA<30%), and nonresponders(IPA <10%) were 36%, 42%, and 22%, respectively. Significantly more patients achieved 95% IPA with the high-dose tirofiban regimen.Conclusions It can be concluded that 450mg of clopidogrel had approximately 35% and 300 mg ofclopidogrel had 20% reduction in ADP-induced platelet aggregation, although therewas still a broad inter-individual variation by increasing dose.

Diaper rash is a common but non life threatening condition during infancy. Different modalities of treatment are suggested. Sucralfate acts as a physical barrier to irritants and has antibacterial activities. Promising reports of the effect of topical sucralfate on wound epithelialization along with its bacteriostatic properties led us to carry out a trial to evaluateits role as a topical agent in the treatment of diaper dermatitis and compare its efficacy with topical zinc oxide. This double blind randomized clinical trial was conducted in Shariati hospital from April 2008 to September 2009. Sucralfate and zinc oxide were formulated as 20% ointments with the same excipients. All patients were randomly treated topically with either sucralfate (N=25) or zinc oxide (N=21) for 7 days. Diaper severity scores were obtained before treatment and at days 3, 5, 7 by the authors. A total of 46 infants (54.3% female and 45.7% male) with mean age of 4.4±6.5 months entered the study. The mean age,sex, frequency of diaper change (per day) and everity of diaper rash showed no statistically significant difference between two groups. Sucralfate 20% ointment was significantly superior in healing diaper dermatitis at days 5 and 7 (p < 0.05 and 0.01respectively) and showed a significantly shorter healing time (3.24+/-2.02 days) in comparison with zinc oxide 20% ointment (5.42+/-2.39 days) (P = 0.002). Since sucralfate in topical formulations acts as a physical barrier with proved safety and no noticeable absorption,it may be used as a potential treatment for diaper dermatitis.

As there is no evidence of previous studies on evaluating the level of job satisfaction and the major causes of dissatisfaction among the pharmacists in Iran, this study was designed. This study is a cross-sectional descriptive analysis of pharmacists practicing in Tehran private-sector pharmacies. We selected a stratified random sampling using number of prescriptions as a variable for stratification. The questionnaire was divided into three sections containing the demographic characteristics, general health perception and job satisfaction. Of all the participants, 62% were the owners of pharmacies and 38% were pharmacists in charge (non-owner). Seventy-eight percent of respondents reported satisfaction about their psychological and physical state. Just 11% of pharmacists were financially satisfied and 49% felt relaxed at the workplace. There was no correlation between the satisfaction and owning the pharmacy or sex of respondents. Spearman›s correlation showed that the income satisfaction correlated negatively with age (p ≤ 0.001) and years of experience (p < 0.05). Moreover, the average working hours was significantly higher among men compared to women (p < 0.01) and among owners relative to non-owners (p < 0.05). Overall, general health perception and quality of life among the respondents were at satisfactory level. However, work-related satisfaction was not high enough and most interviewed pharmacists were financially dissatisfied.

There are suspended fungal spores in the air and in the nasal mucosa of adults, especially in areas with a humid climate. Several studies have revealed the role of fungi in the pathogenesis of chronic rhinosinusitis (CRS) in recent years but it is a topic of controversy, especially in regions with low humidity. The aim of this study was to evaluate the prevalence of fungal species in intraoperative specimens from patients who underwent functional endoscopic sinus surgery (FESS) for CRS in Hamadan, a high altitude region of Iran. In this prospective cross-sectional study specimens were obtained from 62 patients with a diagnosis of CRS according to clinical and computed tomography criteria who underwent endoscopic sinus surgery. During the functional endoscopic sinus surgery, specimens were collected from the nose and sinuses of patients and preserved in conical centrifuge tubes containing Sputolysin and chloramphenicol. The specimens were then plated on Sabouraud dextrose agar, Mycosel agar, Niger seed agar, and Chrom Agar/Candida plates and incubated at 30°C for up to 1 month. At the end of the incubation period the samples were evaluated microscopically to detect fungi and identify their genera and species. The fungal cultures were positive in 16 out of 62 patients with CRS (25.8%). In order of frequency the fungal genera and species were: Aspergillus fumigatus (9), Aspergillus niger (3), Candida albicans (2), Penicillium sp. (1) and Cladosporium sp. (1). The percentage of positive cultures collected was higher in winter but the difference was not statistically significant compared to the rest of the year. Our data show that 25.8% of patients tested positive for the presence of fungi. The results strengthen the theory regarding the role of fungi in the pathogenesis of CRS even in areas with low humidity. Aspergillus was the most commonly isolated fungus.

Pseudo aneurysm has been an increasingly common complication of catheterization procedures during the past two decades, with the greatest incidence being in the femoral artery. Treatment of the iatrogenic femoral artery pseudo aneurysm with the injection of thrombin is reported to be an efficacious and safe procedure. In this study, we evaluated the efficacy and success rate of per coetaneous ultrasonographically-guided thrombin injection and compression method for the treatment of pseudo aneurysm and to determine the effect of thrombin injection on systemic coagulation parameters. This Cohort clinical trial was conducted on patients with femoral pseudo aneurysm after percutaneous intervention (PCI) in Shaheed Rajaie Cardiovascular Medical and Research Center. The patients were divided into two randomized groups and treated with either the compression method or the percutaneous ultrasonographic-guided thrombin injection method. Pseudo aneurysm size, pseudo aneurysms neck size, thrombin dose, thrombosis time, outcome of therapy, and complications were documented prospectively. Duplex sonographic follow-up examinations were performed at 0 and 24 hours afterwards. Partial thrombin time as well as the Quick test (pro thrombin time) was monitored before and after the intervention. Thirty patients with femoral pseudoaneurysm following catheterization between 15 and 85 years of age were enrolled in this study. The mean size of the pseudo aneurysms length was 2.45 ± 1.15cm (SD) and pseudo aneurysms width was 2.06 ± 1.07cm. In total, 13 thrombin injections were administered. The mean thrombin dose was 500-2000 IU. The success rate of thrombin injection was %92.30 (12 of 13 patients), which was significantly higher than 82.35% (13 of 17 patients) in the compression method (p value<0.05). No thrombo embolic, infectious, or allergic complications occurred. In this study, the percutaneous ultrasonographically-guided thrombin injection method was successful and safe in the management of femoral pseudoaneurysms. Changes in coagulating factors indicated the possibility of thrombin passage into the arterial circulation.

To study the effects of a high dose alpha-tocopherol on serum total cholesterol (TC), triglyceride (TG), and the high density lipoprotein (HDL) levels of patients with schizophrenia receiving olanzapine. Thirty six adults diagnosed with schizophrenia based on DSM-IV who were taking olanzapine for a minimum of thirty days entered this eight-week, double blind, placebo-controlled study. Patients were randomized to receive alpha-tocopherol 400IU or placebo capsules twice a day for 2 weeks, then three times a day for 6 more weeks. Fasting total cholesterol (TC), triglyceride(TG),and HDL levels were measured at the baseline and weeks 4 and 8. TC, TG and HDL levels did not change significantly during this study. There were no significant differences in TC, TG and HDL levels between the two groups at the baseline and weeks 4 and 8.High-dose vitamin may not improve triglyceride and cholesterol levels in patients who are already on olanzapine. Further studies with greater number of patients and for a longer duration are needed.

This study was conducted to compare the effects of clomipramine and fluoxetine on fasting blood glucose (FBS) in children with obsessive-compulsive disorder (OCD). Thirty nondiabetic children with OCD entered this randomized trial. Subjects were between 7 to 17 years of age and had not received any medication that could affect blood glucose level for at least 2 weeks prior to the initiation of the study. Patients were assigned to receive 20 to 60 mg/d of fluoxetine or 75 to 200 mg/d of clomipramine for 8 weeks. The exclusion criteria were pregnancy and lactation, history of diabetes mellitus, any liver and thyroid disorder, epilepsy and major heart disease. Additionally, none of the patients should have received electroconvulsive therapy within 6 months prior to the initiation of the study. FBS levels were measured at baseline, 4 and 8 weeks after the initiation of the trial. In the fluoxetine group, FBS level was decreased from 82.93 mg/dL (baseline) to 79.73 mg/dL at week 4 (P<0.001) and to 72.53 mg/dL at week 8 (P<0.001). On the other hand, in the clomipramine group, FBS level was increased from 84.93 mg/dL (baseline) to 87.00 mg/dL at week 4 (P<0.05) and to 95.33 mg/dL at week 8 (P<0.001). This 8-week study demonstrated that FBS levels may decrease in children with OCD who received flouxetine, and may increase in those treated with clomipramine. Therefore, it is suggested that FBS levels should be monitored and taken into consideration when choosing between fluoxetine and clomipramine in the treatment of OCD.

Abstract: The optimization of pain management following surgery with minimal side effects, is one the major goals of surgical and medical teams. In this randomized double blind study, sixty ASA (American Society of Anesthesiologist) class I or II patients, undergoing urological surgery, were assessed to receive either pethidine or tramadol using a standard method for general anesthesia. Pain intensity was assessed by verbal rating, through a 4-step scaling system. Results of this investigation have revealed that the mean total drug administered in tramadol group were 244.53 + 56.95 mg and in pethidine group 176.78+42.99 mg respectively. There were no significant differences in analgesic effect, observed in either group during early hours following surgery, but after 8,12 and 16 hours significant differences were observed. Analgesic properties of tramadol were almost comparable with pethidine nevertheless; pethidine was superior in some extent. No significant differences in patient’s PaO2 were found, but PaCO2 at 1 and 4 hours after surgery had a greater retention in pethidine group. (P<0.001). There was a significant reduction in respiratory rate in pethidine group at 4,8,12 and 16 hours following surgery, compared with tramadol group (P<0.001). Incidence of dizziness was greater in patients who received pethidine (P<0.001), and sweating was higher in tramadol group (P<0.01). Also there was a greater need for metoclopramide to overcome nausea in tramadol group (P<0.05). Results of this study may suggest that tramadol could be considered as a safe and effective analgesic, following urological surgery as compared with pethidine