مجله دانشکده پزشکی اصفهان
پیاپی 533 (هفته اول شهریور ماه 1398)

This study aimed to compare the effect of two different levels of end-tidal carbon dioxide on cognitive impairment in elderly patients undergoing surgery.

In this clinical trial study, 240 patients over 65 years of age were randomly distributed into two groups. In the first group, the end-tidal carbon dioxide (ETCO2</sub>) pressure was maintained in the range of 35-40 mmHg, and in the second group in the range of 40 to 45 mmHg. Patients' cognitive scores before surgery, and 24 hours, one week, and six weeks later were compared between the two groups.

In the first 24 hours, the incidence of cognitive impairment was 12.5 and 11.7 percent in first and second groups, respectively; while at the first week after surgery, this rate was 6.7 and 11.7 percent, and at the sixth week, 5.0 and 9.2 percent, respectively, based on the short test of mental status. In all cases, the difference between the two groups was not statistically significant.

 in the range of 35 to 45 mmHg has no effect on the cognitive impairment of elderly patients under cataract surgery with general anesthesia. Therefore, further studies on the effects of different extents of ETCO2</sub> on cognitive impairments are necessary.

Non-compliance to gluten-free diet (GFD), due to less of knowledge and inappropriate nutritional behaviors, is associated with an increase in disease progression and long-term complications in patients with celiac. The aim of this study was to determine the effect of nursing consultation on knowledge and practice of patients with celiac for adherence to GFD.

100 patients with celiac disease participated in this clinical trial study. They were divided into two groups (control and experimental) randomly. The patient in experimental group received a nursing counseling intervention and the control group received the celiac association routine care. Data collection tool was a reasearcher-made questionnaire including demographic variables and questions for assessing knowledge and practice for adherence to GFD. Data were collected before and after 7 weeks of intervention. Data were analyzed (descriptive and analytic) using SPSS software.

Before the intervention, the level of knowledge and practice of the subjects in adherence to GFD was 91.12 ± 8.63 and 54.12 ± 5.30 in control group and 91.18 ± 9.43 and 52.94 ± 6.06 in experimental group, respectively. After counseling, there was an increase in the knowledge and practice scores in GFD adherence in the experimental group (127.58 ± 1.80 and 73.78. ± 3.24, respectively) compared to the control (92.62 ± 7.43 and 54.82 ± 6.13, respectively) (P < 0.050).

 Nursing counseling results in greater adherence to GFD by raising knowledge of patients about celiac disease and related risk factors as well as the benefits of changing behavior and performance. The importance of the role of nursing counseling in following up the GFD was emphasized in this study.

In recent years, due to their small size and increased surface-to-volume ratio, the use of nanoparticles in diagnosis, drug delivery, and treatment has received much attention. The most important problem in chemotherapy is the limited access to the central part of the tumor due to its low blood flow. The aim of this study was to investigate the toxicity of polydopamine-coated and uncoated  nanoparticles on melanoma B16-F10 cells.

 nanoparticles were co-precipitated and coated with dopamine. Then, the effect of cytotoxicity of the coated and uncoated nanoparticles on the B16-F10 cells was studied using MTT assay.

 nanoparticles were toxic to B16-F10 at the concentration of 450 μg/ml and duration of 72 hours. Coated nanoparticles had no toxicity at any concentration at the duration of 48 and 72 hours.

The cytotoxic properties of uncoated nanoparticles were significantly higher than the coated nanoparticles. Polydopamine coating shell can reduce the toxicity of the nanoparticles, and it can be used for bonding the drugs, as well as a contrast agent in magnetic resonance imaging (MRI).

Recurrent miscarriage is a reproduction problem that affects 1-5 percent of couple. Sexual function of women suffering from recurrent miscarriage is not considered as it should be. The purpose of this study was to compare sexual function and intimacy in women with and without recurrent miscarriage.

This cross-sectional study was performed on 208 women referring to selected health centers in Tehran City, Iran, in 2018. Data collection tools included a demographic and midwifery questionnaires, Female Sexual Function Index, and Bagarozzi Sexual Intimacy Questionnaire (sexual dimension). Data analysis was performed using SPSS software.

The mean of total female sexual function score was 27.25 ± 4.99 and 31.22 ± 2.57 in groups with and without recurrent miscarriage, respectively. 53 women (51%) with and 13 cases (12.5%) without recurrent miscarriage had sexual dysfunction (P < 0.001). Moreover, the mean score of female sexual intimacy was 43.88 ± 6.41 and 47.08 ± 3.07 in women with and without recurrent miscarriage, respectively (P < 0.001).

 The high prevalence of sexual dysfunction in women with recurrent miscarriage reveals the need for attention to sexual issues in these women.</div>

Kienbock's disease is an enigmatic entity that causes wrist pain and disability in young adults. This study aimed to assess clinical and radiological outcomes radial shortening as its most common treatment.

In a retrospective research, the data of medical records of 100 patients with Kienbock's disease were studied. They included 66 men and 34 women with mean age of 28.9 ± 7.6 years, who treated using radial shortening surgery. The wrist indexes and Disabilities of the Arm, Shoulder, and Hand Score (Quick DASH) were calculated and analyzed.

60% of the patients were ulnar minus, 26% neutral, and 14% ulnar plus. Mean Quick DASH score was 11.34 ± 6.30 in patients in the Lichtman stages I and II, and 23.05 ± 10.40 in the Lichtman stage III. Delayed union after 5 months occurred in 3%, screw back out in 1%, and superficial infection in 1%. Mean duration of union was 16 weeks. Ulnar variance was the same amongst different Lichtman stages. At follow up, 29% had none, 39% mild, 23% moderate, 8% severe, and 1% extreme pain. Ulnar variance changed from -0.9 to +0.1. Bilateral involvement was noted in 4% and dominant arm involvement in 45%. In 26% of patients, radius was shortened less than 1 millimeter. No radiological progression or improvement occurred during follow up.

 After radial shortening surgery in Kienbock's disease, clinical improvement was commonly expected, even if the radius was not shortened to reach to neutral ulnar variance. This improvement was more obvious in patients in in the Lichtman stages I and II.</div>