Effect of different dosages of nitroglycerin infusion on arterial blood gas tensions in patients undergoing on- pump coronary artery bypass graft surgery

Background: On-pump coronary artery bypass graft (CABG) surgery impairs gas exchange in the early postoperative period. The main object on this study was evaluation of changes in arterial blood gas values in patients underwent on pump CABG surgery receiving different dose of intravenous nitroglycerin (NTG). Materials and Methods: sixty-seven consecutive patients undergoing elective on-pump CABG randomly enrolled into three groups receiving NTG 50 μg/min (Group N1, n =67), 100 μg/min (Group N2, n = 67), and 150 μg/min (Group N3, n = 67). Arterial blood gas (ABG) tensions were evaluated just before induction of anesthesia, during anesthesia, at the end of warming up period, and 6 h after admission to the intensive care unit. Results: Pao2 and PH had the highest value during surgery in Group N1, Group N2, and Group N3. No significant difference was noted in mean values of Pao2 and PH during surgery between three groups (P > 0.05). There was no significant difference in HCO 3 values in different time intervals among three groups (P > 0.05). Conclusion: our results showed that infusing three different dosage of NTG (50, 100, and 150 μg/min) had no significant effect on ABG tensions in patients underwent on-pump CABG surgery

A review of the etiology, diagnosis and management of halitosis

Halitosis generally refers to the unpleasant odor of breath irrespective of its origin. Oral malodour could result in diverse problems in daily life such as social embarrassment and can adversely affect individuals' social interactions. Though many oral and non-oral sources could give rise to halitosis, it was mainly associated with oral cavity conditions and volatile sulfur compounds -produced by microbial activity- were the main elements of oral malodor. Objective measurement was the first step in assessment to determine presence of malodour. Then, taken a complete history including diet and habit history and performing a comprehensive physical examination contribute to the primary two steps for evaluating a patient complaining. The oral malodor management was mainly achieved by determining and eliminating the etiology of the condition. A major step in this regard was improving the oral health by means of establishing appropriate oral hygiene measures and controlling tongue flora by brushing or scraping and also, use of antiseptics as adjuvant therapy. Current article was systematic reviews the literature on prevalence, classification, diagnosis and treatment of halitosis. © 2015, Iranian Association of Gastroenterology and Hepatology. All rights reserved

A rare presentation of primary hepatic lymphoma: A case report

Primary hepatic lymphoma (PHL) was a rare malignancy usually presenting with abdominal pain, malaise, Hepatomegaly, B-symptoms, fatigue, nausea, vomiting and jaundice. It mostly involves liver without any palpable lymphadenopathy and leukemia in peripheral blood smear. On July 22, 2014, a 64 year old man presented with abdominal pain localizing in Right upper quadrant and fullness from 2 years ago without any wight loss or constitutional symptoms. His physical examination revealed no mass or lymphadenopathy and lab data showed rise in Alkaline phosphatase(ALP) and Gamma-glutamyl transferase(gamma-GT). Abdominal computed tomography(CT) scan with contrast showed a calcified lesion in the left lobe of liver and illdefined hypodense area in medial segment of the left lobe of liver adjacent to gallbladder associated with mild central intra hepatic bile ducts dilation showing more enhancement in delay phase suggested peripheral cholangiocarcinoma. Finally surgical core needle biopsy of the liver confirmed malignant lymphoma of B cell type and patient was referred to oncologist for chemotherapy. His chemotherapy regimen consisted of rituximab 600 milligram (mg), endoxan 1250 mg, adriamycin 80 mg, vincristine 2 mg, prednisolone 100 mg (during five days) for 6 courses. After 5 months chemotherapy, on December 22, 2014 a follow up CT scan with IV and oral contrast was done. There was no evidence of previous mass lesion in the liver. In the follow up on May 9, 2015, he had no specific symptoms and all of his lab data were in normal range