The effect of epidural morphine sponge in postoperative pain control after Microdiscectomy

Opiates such as morphine are one of the most effective classes of medication prescribed to treat both acute and chronic pain.They act to suppress pain through mu-receptor activation on primary afferent nerve fibers, dorsal horn neurons and supraspinal pain center neorons. When morphine is administered epidurally, it diffuses to the cord substance, producing analgesia [1],The aim of this study was to check the efficacy of this method for controling postoperative lumbar pain after microdiscectomy. In a randomized clinical trial, numbers of 100 patients were included into two equal groups due to low back radicular pain and underwent microdiscectomy. In study group, an absorbable gelatin sponge (Gelfoam) is contoured to the epidural space, placed in methylprednisolone acetate (40-80 mg), and then injected with 2 mg/ml morphine and control group received an absorbable gelatin, placed in methylprednisolone acetate (40-80 mg) and were injected with normal saline (5mL) as a placebo. The main outcome to be compared between trial and placebo groups were: Patient comfort rate in recovery room and ward, amount of analgesics used, postoperative ambulation time, post operative hospitalization days. The restlessness and agitation during recovery in study group was lower than control group. Mean systolic blood pressure increment was lower in morphine group. Only 6% of patients in study group compared to 98% in placebo group had either moderate or severe pain six hours after operation. Mean morphine dose used for study group was 10.75 mg compared to 21.4 mg among control group patients (P < 0.0001). Mean ambulation time was 2 days among study group patients compared to 2.6 days in control group. Mean hospitalization length was 4.7 and 7 days in study and control group respectively. By means of the technique assigned to the patient (an epidural morphine sponge) during Lumbar microdiscectomy the results were: Better controlled postoperative pain, early ambulation of patients and decreased hospitalization length.

PapG Gene cloning, Escherichia coli uropathogen and examination of its subsequence diversity

infections are one of the most prevalent human infections. Despite different antigens and toxins of interfering bacteria in infection, one of the important agents in the infections arising from Escherichia coli and the other gram negative bacteria is bacterial binding to host cell surface, so inhibiting the bacterial binding is an appropriate strategy to inhibit the infection. Whereas PapG protein acts as adhesion, it can be an appropriate candidate for developingvaccine. Material and Methods: A Genomic DNA of Escherichia coli bacterium extracted from clinical strain containing PapGII gene. Upon designing primer for PapGII gene, the PCR reaction was applied. The product of PCR was cloned in pBluescript (SK-) plasmid. Using Clustal W and MEGA4 software, the gained subsequence was alignmented with the gene subsequence existing in gene bank and its gene diversity was studied. Results: Based on was down alignment, N terminal on the protein surface and DNA are protected. Conclusion: N terminal domain of PapG gene is a conserved sequence among clinical straines? And it could be used for designing a vaccine against urinary tract infection

fimH gene cloning, of Escherichia coli uropathogen and examination of its subsequence diversity

Background: Escherichia coli uropathogen is the most prevalent pathogen separated from urinary tract that often is originated from intestinal flora of the own person. Urinary tract infection is one of the most prevalent infectious diseases in Human. Whereas binding stage has an important role in bacteria colonization and then the infection is created, one of the most important strategies for inhibiting the infection is inhibiting the bacterial binding. As fimH protein is acting as adhesion it could be an appropriate candidate for producingvaccine. Material and Methods: First, genomic DNA of Escherichia coli bacteria extracted from strain 35218 ATCC. Upon designing primer for fimH gene, the PCR reaction has been applied with Taq DNA Polymerase and then pfu DNA polymerase enzymes. pBluescript (SK-) plasmid has been applied for cloning the product of PCR. Using ClustalW and MEGA4 software, the subsequence was alignmented with the gene subsequence existing in gene bank and its gene diversity was examined. Results: After sequencing the cloned fimH gene using ClustalW and MEGA4 software, the result of this subsequence were alignmented with the subsequence of Escherichia coli containing fimH gene existing in gene bank and based on this alignment, N terminal on the protein surface and DNA are protected. Conclusion: N terminal domain of fimH gene is a conserved sequence among clinical isolates and it could be used for designing a vaccine against urinary tract infection