Evaluation of depression and anxiety in patients with thalassemia: a comparative study

Background: More studies in the field of thalassemia patients focus on medical treatment and less attention to the psychosocial problems aspect. Objective: The aim of this study was evaluation of depression and anxiety in these patients in Qazvin province. Methods: This case-control study has been conducted in Qods Hospital of Qazvin (2016). The study population included thalassemia major patients and control group were participating in this study (n=147 in each group). All subjects completed the hospital anxiety and depression scale (HADS). In addition to clinical history, socioeconomic and demographic characteristics of patients collected and analyzed using proper statistical methods independent t-test, chi-square test. Findings: Borderline abnormal (borderline case) and abnormal states of anxiety were reported 27.2% and 42.2% in case group compared with 22.4% and 6.8% in the control group (P<0.001). In addition, borderline and abnormal states of depression were significantly different in the case group than the control group (respectively 20.4% and 59.2% vs 24.5% and 12.9%, P<0.001). Among patients with thalassemia, depression and anxiety scores significantly were associated with noncompliance and iron chelation, marital status (single) and socioeconomic state (P<0.001). In addition, Moreover, in terms of depression individuals with diabetes, headaches and skin disorders significantly were higher scores of depression and in terms of anxiety individuals with low back pain, headaches and skin disorders were higher scores. Conclusion: The prevalence of depression and anxiety in patients with thalassemia is considerable and related to socioeconomic and demographic characteristics, so it is essential that psychiatric consultation systems created in thalassemia clinics of Qazvin province

Effect of addition of Ondansetron or Magnesium to Lidocaine on duration of analgesia of intravenous regional anesthesia in elective upper extremities surgery: comparative study.

BackgroundThis study aimed at evaluating and comparing the effect of ondansetron and magnesium added to lidocaine on intravenous regional anesthesia (IVRA) in the surgery of upper extremity.Settings and design The current randomized, clinical trial was conducted on 45 patients considered as candidates for upper extremities surgery in Qazvin, Iran. The patients were randomly assigned into three groups. Group C only received 3 mg/kg lidocaine, group O lidocaine + 4 mg/kg ondansetron, and group M lidocaine + 7.5 mL magnesium sulfate 20%. Then, the sensory and motor blocks, tourniquet pain, the amount of administered extra fentanyl, pain intensity, and other parameters involved in analgesia were analyzed in the groups using the statistical tests.ResultsThe time for onset of sensory and motor blocks in group M was significantly shorter than the groups C and O (P &lt;0.05). In terms of the recovery time of sensory block, the time of group O was significantly longer than those of groups M and C (P &lt;0.05). The amount of administered extra fentanyl and tourniquet pain after block in groups O and M were significantly lower than those of group C (P&lt; 0.05). No significant difference was observed in postoperative pain and other features among the groups (P &gt;0.05).ConclusionMagnesium had more rapid effectiveness and ondansetron had prolonged postoperative analgesia. Although the induced analgesia relatively improved the intensity of pain, it failed to maintain its supremacy in postoperative pain. To obtain more conclusive results, further studies are required.BackgroundThis study aimed at evaluating and comparing the effect of ondansetron and magnesium added to lidocaine on intravenous regional anesthesia (IVRA) in the surgery of upper extremity.Settings and design The current randomized, clinical trial was conducted on 45 patients considered as candidates for upper extremities surgery in Qazvin, Iran. The patients were randomly assigned into three groups. Group C only received 3 mg/kg lidocaine, group O lidocaine + 4 mg/kg ondansetron, and group M lidocaine + 7.5 mL magnesium sulfate 20%. Then, the sensory and motor blocks, tourniquet pain, the amount of administered extra fentanyl, pain intensity, and other parameters involved in analgesia were analyzed in the groups using the statistical tests.ResultsThe time for onset of sensory and motor blocks in group M was significantly shorter than the groups C and O (P &lt;0.05). In terms of the recovery time of sensory block, the time of group O was significantly longer than those of groups M and C (P &lt;0.05). The amount of administered extra fentanyl and tourniquet pain after block in groups O and M were significantly lower than those of group C (P&lt; 0.05). No significant difference was observed in postoperative pain and other features among the groups (P &gt;0.05).ConclusionMagnesium had more rapid effectiveness and ondansetron had prolonged postoperative analgesia. Although the induced analgesia relatively improved the intensity of pain, it failed to maintain its supremacy in postoperative pain. To obtain more conclusive results, further studies are required

Relationship Between Upper Airway Ultrasound Parameters and Degree of Difficult Laryngoscopy for Endotracheal Intubation

Background Limited research has been conducted on the role of ultrasound in predicting difficult laryngoscopy (DL). This study aimed to evaluate the predictive values of upper airway ultrasound parameters for the degree of DL during intubation. Methods and Materials This observational-prospective study was performed on 120 patients requiring intubation during elective surgery. Initially, the degree of DL was assessed by the Mallampati Scale. The patients' neck circumference was then measured and recorded.&nbsp; Ultrasound was used to determine the Hyomental distance in the neutral position (HMDN) and in the head extension (HMDE), as well as tongue width (TW), tongue thickness (TT), oral cavity height ratio (OCH), the amount of soft tissue (ST), and the Tongue thickness-to-oral cavity height ratio (TT/OCH) was used. Afterward, the patients underwent general anesthesia and were intubated. The degree of difficult intubation was measured based on the Cormack-Lehane classification system, according to which the patients were divided into easy and difficult laryngoscopy groups. Finally, the effectiveness of the two methods of ultrasound and intubation was compared. Results The Cormack score and Mallampati class recorded intubation difficulty as 28.3% and 30.8%, respectively. According to the Cormack score, only the neck circumference was significantly associated with intubation difficulty (P = 0.002). In terms of Mallampati class, the neck circumference and HMDN, HMDE, TT, OCH, and ST were significantly associated with the degree of DL (P &lt;0.05). The predictive value of ultrasound parameters for the degree of DL was low based on both of the criteria (AUC &lt;0.7). Conclusion The results showed that although Mallampati class lacked the desirable accuracy, it provided a better predictive measure for the degree of DL during intubation compared to the Cormack score

Comparison of blood lead levels between oral and inhalation opium addicts and its relationship with hematological parameters

Background and objectives: The current study aimed at comparing the level of blood Pb in oral and inhalation opium addicts and its relationship with hematological parameters. Materials and method: For this purpose, a total of 166 patients (83 addicts as the case and 83 non-addicts as the control groups) were enrolled in the study. A venous blood sample was taken from all the subjects in order to determine the serum level of Pb, iron (Fe), and other hematological parameters. In addition, the clinical and demographic status of the subjects were recorded and analyzed using appropriate statistical methods. Results: Among the enrolled patients, 48 were oral and 35 were the inhalation opium consumers. Oral and inhalation opium addict groups had higher levels of blood Pb compared with the control group (F = 131.13, P <0.001). There was no significant difference between oral and inhalation addict groups (P >0.05). More investigations showed a negative relationship between the blood levels of Pb, and those of Fe, hemoglobin(HB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and positive relationship with red cell distribution width (RDW) (P >0.05). Conclusion: The results showed that the serum level of Pb was associated with those of Fe and Hb in opium addicts in comparison with the controls. These changes had a significant effect on other hematological parameters in the case group in comparison with the control group. However, there was no significant relationship between different forms of opium us

Prevalence of Anxiety and Depression in Diabetic Patients: A Comparative Study

Background: Living with diabetes and managing it can have substantial emotional burden on individuals. These changes might affect individuals’ lives in terms of stress and depression. The purpose of this study was to determine the prevalence of stress and depression among diabetic women who referred to endocrine clinic of Qazvin in 2014. Methods: For this purpose, 250 patients (125 individuals suffering from diabetes and 125 individuals as a control group) participated in this study. All individuals completed the beck depression inventory and the cattell anxiety inventory. In addition to these, demographic and clinical records were collected from their medical records and were analyzed by appropriate statistical methods. Results: In terms of the Maximum of mild anxiety there were 52 diabetic individuals (41.6%) versus 69 individuals of the control group (55.2%); in terms of Moderate-severe anxiety there were 73 cases (58.4%) versus 56 patients (44.8%) (P value = 0.031). In studying the Maximum of mild depression, there were 43 patients (34.4%) versus 92 (73.6%); in terms of Moderate-severe depression, there were 82 patients (65.6%) versus 33 (26.4%) (P value=0.001). Ona closer examination among age, type of diabetes, duration of diabetes, and insulin injections; only the duration of having diabetes was significantly associated with depression as one of the mental health variables. Conclusions: This study showed that anxiety and depression are significantly more common among diabetic patients in comparison to the control group in the city of Qazvin; therefore, it is necessary to develop primary care by a system based on the reaction, so that an effective treatment for mental health would take place and, ultimately, the impact of these interventions should be studied. Keywords: Mental Health, Anxiety, Depression, Diabete

Effect of addition of ondansetron or magnesium to lidocaine on duration of analgesia of intravenous regional anesthesia in elective upper extremities surgery: Comparative study

Background: This study aimed at evaluating and comparing the effect of ondansetron and magnesium added to lidocaine on intravenous regional anesthesia (IVRA) in the surgery of upper extremity. Methods and Materials: The current randomized, clinical trial was conducted on 45 patients considered as candidates for upper extremities surgery in Qazvin, Iran. The patients were randomly assigned into three groups. Group C only received 3 mg/kg lidocaine, group O lidocaine +4 mg/kg ondansetron, and group M lidocaine +7.5 mL magnesium sulfate 20%. Then, the sensory and motor blocks, tourniquet pain, the amount of administered extra fentanyl, pain intensity, and other parameters involved in analgesia were analyzed in the groups using the statistical tests. Results: The time for onset of sensory and motor blocks in the M group was significantly shorter than the groups C and O (p<0.05). In terms of the recovery time of the sensory block, the time of group O was significantly longer than those of groups M and C (p<0.05). The amount of administered extra fentanyl and tourniquet pain after block in groups O and M were significantly lower than of group C (p<0.05). No significant difference was observed in postoperative pain and other features among the groups (p>0.05). Conclusion: Magnesium had more rapid effectiveness and ondansetron had prolonged postoperative analgesia. Although the induced analgesia relatively improved the intensity of pain, it failed to maintain its supremacy in postoperative pain. To obtain more conclusive results, further studies are required. Keywords: Bier Block, Ondansetron, Magnesium, Lidocain

Investigating effect of Helicobacter pylori treatment on improvement of non-alcoholic fatty liver parameters: a randomized trial

Background and objective: The correlation between the eradication of Helicobacter pylori (HP) and non-alcoholic fatty liver disease (NAFLD) is a controversial one. The aim of this study is to investigate the effect of Helicobacter pylori treatment on liver function tests and lipid profiles and to compare its effects with exercise therapy and diet alone. Method: This was a double-blind randomized clinical trial conducted at Qazvin University of Medical Sciences. One hundred patients with NAFLD having a positive test for urea breath testing were randomly assigned into one of the intervention and comparison groups. The diet and physical activity program were given to two groups of patients for 8 weeks, three sessions per week. In addition to the above therapy, the patients in the intervention group also received HP treatment for 2weeks. The data corresponding to anthropometric and clinical features before and after the intervention were collected in both groups and compared using appropriate statistical methods. Results: After the treatment interventions, the variables of weight, BMI, blood glucose, triglyceride, AST, ALT, total cholesterol, and LDL-C were significantly decreased in both groups (p < .05). In the between-group comparisons, only ALT was significantly lower in the intervention group (HP) (p < .05). Conclusion: Findings of this study showed that the eradication of Helicobacter pylori could significantly improve the ALT index, but it had no additional effect on changes in metabolic indicators. Trial registration: Registration number: IRCT2015042020951N2 Name of trial registry: The study of treatment of Helicobacter pylori in improvement of non-alcoholic fatty liver disease The date of registration: 2015-05-12 Where the full trial protocol can be accessed: https://fa.irct.ir/trial/18489 Keywords: Non-alcoholic fatty liver disease, Helicobacter pylori, Alanine transaminase, Aspartate aminotransferase

Comparing the Postoperative Sore Throat Incidence and Hemodynamic Changes after Using Macintosh and GlideScope Laryngoscopes and Laryngeal Mask Airway

Background Studies have shown that postoperative sore throat (POST) is the most common complication of tracheal intubation; however, its actual incidence and extent are not well documented. Objective The aim of this study was to evaluate and compare the incidence of POST and hemodynamic changes after using macintosh laryngoscope (MCL), glidescope laryngoscope (GSL), and laryngeal mask airway (LMA) for elective surgery. Methods This randomized double-blind clinical trial was conducted on 90 patients undergoing elective surgery in Shahid Rajaee Hospital in Qazvin, Iran. Patients were randomly divided into three groups based on the used intubation techniques including MCL, GSL, and LMA. The incidence of POST, hemodynamic changes, laryngoscopy duration, intubation duration, and number of attempts were compared in three groups and analyzed by ANOVA, independent t-test and chi-square. Findings POST incidence was significantly higher in the MCL group compared to other two groups (P<0.05). Duration of laryngoscopy was significantly longer in the MCL group compared to the GSL group (8.2±2.4 vs. 6.8±1.7; P=0.02). Regarding hemodynamic variables, only heart rate in the LMA group 3 minutes after intervention was significantly lower compared to other two groups (P=0.02). Conclusion POST incidence was higher after using GSL and hemodynamic changes were less by using LMA. The preferred method for older people or cardiovascular patients is LMA. Further studies are needed to confirm these results

Prevalence of depression and anxiety and their association with body mass index among high school students in Qazvin, Iran, 2013-2014

Background: Evidence shows that mental disorders among adolescents are associated with suicide, drug abuse, acute infectious diseases and low educational performances. Objective: To determine the prevalence of depression and anxiety and their associations with body mass index (BMI) among high school students in Qazvin, Iran in 2013-2014. Methods: A descriptive and analytical cross-sectional study using cluster-sampling method recruited 1,040 students among high schools in Qazvin, Iran from March 2013 to April 2014. Data were collected using questionnaires including demographic, Beck depression inventory and Beck anxiety inventory, and were analyzed with SPSS-19 by descriptive analyses, t-test, Chi-square and Pearson correlation. Results: The prevalence of depression and anxiety was 31.8% and 14.9%, respectively and these amounts were significantly higher in girls than in boys (p<0.05). Respondents showed 23.75% and 11.07% mild to moderate symptoms of depression and anxiety, respectively as well as 8.08 and 3.75% severe symptoms of depression and anxiety, respectively. There was a positive and significant association between depression and anxiety (r=0.256, p<0.001) and between depression and body mass index (BMI) (r=0.333, p<0.001), however there was an inverse association between anxiety and BMI (r=0.086, p<0.006). Conclusion: The current study made a significant step forward in assessment of mental disorders and BMI to show the significance of depression and anxiety among adolescents in Qazvin. Therefore, effective interventions are necessary to improve this situation as well as the evaluation of the effectiveness of the interventions