The Effect of Oral Triiodothyronine in Outcome of Pediatric Congenital Cardiac Surgery

Background: Cardiac surgery especially in small children is associated with a marked decrease in thyroid hormone levels consistent with the phenomenon referred to as Sick Euthyroid Syndrome (SES). The purpose of the present study was to determine if oral triiodothyronine could reduce the length of ICU stay, vasoactive inotropic score (VIS), and promote ejection fraction in infants and children undergoing cardiac surgery with CPB. Materials and Methods: In a double-blind clinical trial, one hundred and twenty children aged 6 to 60 months and scheduled for different types of cardiac surgery with CPB, were randomized into two groups to receive either 2 mcg/Kg triiodothyronine (trial group) or 5% dextrose water (placebo group), immediately after anesthesia and 24 hours after surgery. The perioperative serum thyroid hormone levels and hemodynamic variables were determined. The intubation time, ICU stay length, ICU inotropic use, and cardiac ejection fraction was recorded. Results: The basic demographic data were comparable in two groups. No significant side effects or adverse reactions were seen due to hormone therapy. Intubation time, ICU stay, and VIS values were significantly shorter between the two groups. Conclusion: In children undergoing cardiac surgery with CPB, perioperative oral small-dose triiodothyronine therapy could improve clinical indices of perioperative care

Red Cell Distribution Width as a Predictor of Outcome in Cyanotic Congenital Cardiac Surgery

Background: Red blood cell distribution width (RDW) is a vital marker associated with various clinical states. In the present study, we aimed to determine the associations between RDW changes and adverse effects caused by pediatric cardiac surgery. Materials and Methods: In the present research, we retrospectively analyzed 100 pediatric patients enrolled in this study who were candidates for cardiac surgery. RDW was determined pre-and postoperatively and at the time of discharge from the hospital. Intubation time, duration of intensive care unit (ICU) stay and hospital stay, cardiopulmonary bypass (CPB) time, aortic cross-clamp (ACC) time, vasoactive inotropic score (VIS), and mortality rate were determined as well. Results: Intubation time, duration of hospital stay, CPB time, ACC time, VIS, and mortality rate were significantly higher in the patients with higher RDW rates. Conclusion: This study demonstrated that RDW could be used as an essential indicator in predicting both morbidity and mortality caused by pediatric congenital heart surgery

شیوه‌های درمان در میان‌رودان (بر اساس الواح میان‌رودانی)

Background and Aim: Disease and how to deal with it has always occupied the human mind. The medical contents of the "Nippur" clay tablets indicate that the subject of medicine and medicine had a special place among the inhabitants of the Mesopotamia region (Babylon, Assyria, Sumer and Elam) in 3000 BC. The oldest surviving medical records are from the late third millennium BC in Sumerian, containing 12 medicinal versions. In addition to the Sumerian tablets, several tablets in the Akkadian language have been obtained which are about medical diagnoses and explain the method of treatment, and also show that they were familiar with the anatomy of the body and used terms for various organs of the body. The purpose of this article is to study the subject of medical science in Mesopotamia and to show what methods of treating Mesopotamian physicians in ancient times in the treatment and treatment of diseases and were they familiar with the anatomy of the body at that time? Methods: The research is based on historical-descriptive method and the authors of this article have compiled the library method. Ethical Considerations: In reference to texts and sources, honesty and trustworthiness have been observed. Results: The findings show that they had names for kidney, spleen, intestine, lung, blood and brain and this indicates that they were familiar with these organs of the body. By studying the tablets, we also find that they used a variety of plants, minerals, and animal components to make medicine. Conclusion: Mesopotamian tablets show that they were aware of the anatomy of the human body and had letters for each part. They wrote their observations of the patient's symptoms on their tablets and guessed the disease, and performed various treatments for various ailments, such as bandaging, oil massage, using pills, syrups, drops, sprays, and surgery. Please cite this article as: Sharifian F, Fekripour K, Heidarpour A. Anatomy, Medications and Treatment in Mesopotamia (Based on Mesopotamian Tablets). Tārīkh-i pizishkī, i.e., Medical History. 2022; 14(47): e14.زمینه و هدف: بیماری و چگونگی مقابله با آن همواره ذهن بشر را مشغول کرده است. مطالب پزشکی الواح گلی «نیپور» حاکی از آن است که موضوع پزشک و پزشکی در 3000 سال قبل از میلاد مسیح در میان ساکنین منطقه میان‌رودان (بابل، آشور، سومر و عیلام) از جایگاه ویژه‌ای برخوردار بوده است. کهن‌ترین نسخه پزشکی به دست‌آمده لوحه‌ای گلی به زبان سومری مربوط به اواخر هزاره سوم پیش از میلاد، شامل 12 نسخه دارویی است. علاوه بر الواح سومری چندین لوحه به زبان اکدی نیز درباره تشخیص‌های پزشکی به دست آمده است که حاوی اطلاعات ارزشمندی درباره نحوه درمان بیماری‌ها است. این الواح باستانی نشان از دانش این اقوام باستانی از آناتومی بدن دارد. آن‌ها برای هر یک از اندام‌های مختلف بدن، اصطلاحی در نظر گرفته‌ بودند. نویسندگان سعی دارند در این مقاله، ضمن بررسی موضوع علم پزشکی در میان‌رودان، نشان دهند که پزشکان میان‌رودانیِ عهد باستان، چه شیوه‌هایی را در معالجه بیماران و درمان بیماری‌ها به کار می‌بردند و آیا در آن زمان با آناتومی بدن آشنایی داشتند؟ روش: پژوهش حاضر بر اساس شیوه تاریخی ـ توصیفی نگاشته و مطالب آن به روش کتابخانه‌ای تدوین شده است. ملاحظات اخلاقی: در تدوین این پژوهش، اصل امانتداری و صداقت استناد به متون مورد استفاده، اصالت منابع و پرهیز از جانبداری در مراجعه به متون یا تحلیل‌ها، رعایت شده است. یافته‌ها: یافته‌ها حاکی از آن است که پزشکان میان‌رودانی برای کلیه، طحال، روده، ریه، خون و مغز اسم‌هایی را در نظر گرفته بودند و این نشان‌دهنده دانش آن‌ها از ارگان‌های بدن بود. همچنین با مطالعه این الواح پی می‌بریم که آن‌ها از انواع گیاهان، مواد معدنی و اجزای جانوران برای تهیه دارو استفاده می‌کردند. نتیجه‌گیری: الواح میان‌رودانی نشان می‌دهند پزشکان آن دوره از آناتومی بدن انسان آگاهی داشتند و نام‌هایی را برای هر بخش در نظر گرفته بودند. آن‌ها در الواح، مشاهدات خود از علائم بیمار را می‌نوشتند و بیماری را حدس می‌زدند. برای بیماری‌های مختلف روش‌های درمانی مختلف مانند انجام بانداژ، ماساژ با روغن، استفاده از قرص، شربت، قطره و اسپری و جراحی به کار می‌بردند

Comparing the effects of pethidine and diclofenac suppository on patients with renal colic in the emergency department

Objective: Renal colic is a common cause of emergency room visits. Due to the spontaneous passage of more than 90% of kidney stones, treatment in the emergency department (ED) is limited to pain control. Analgesics currently used are selected based on physician experiences and various theories from different sources. The aim of this study was to compare the common drugs (pethidine and diclofenac) used for renal colic in Iran. Methods: In this single-blinded randomized clinical trial, 90 patients with renal colic who referred to the ED of Imam Reza hospital in Kermanshah were randomly assigned to each of 3 treatments including pethidine suppository (50 mg, iv), diclofenac suppository (50 mg), and a combination of pethidine and diclofenac suppository. In this regard, the response to treatment and duration of hospitalization were compared. Results: The best medicine to relieve pain intensity in patients under 25 years was diclofenac suppository. In patients in the age range of 25-45 years, pethidine and diclofenac were the best choice. Conversely, in patients older than 45 years, pethidine was the best treatment. We could also observe a decrease in the length of hospitalization in patients who received pethidine. Conclusion: It can be concluded that morphine is more appropriate to control pain and reduce the length of hospitalization in patients with renal colic. Clinical Trial Registration: irct.ir, Identifier: IRCT2010121453

Evaluation of sleep problems in preeclamptic, healthy pregnant and non-pregnant women.

Sleep problems are common complaints among pregnant women. This study was designed to compare subjective sleep problems in non-pregnancy condition, healthy and preeclamptic pregnancy as a major complication of pregnancy. We hypothesized that some sleep problems are more prevalent in females with preeclampsia.In this cross-sectional study, 102 women with preeclampsia, 106 healthy pregnant women in the third trimester and 103 healthy non-pregnant women were selected through random sampling. Age and parity were matched in the three groups. We used Global sleep assessment questionnaire (GSAQ) to check the subjective sleep problems, and then we performed statistical analysis using Analysis of variance (ANOVA) and Pearson Chi-square tests.Our findings revealed significant differences in initial insomnia (p = 0.034), fragmented sleep (p = 0.022), snoring (