Propofol-alfentanil vs propofol-remifentanil for posterior spinal fusion including wake-up test

Background. Wake-up test can be used during posterior spinal fusion (PSF) to ensure that spinal function remains intact. This study aims at assessing the characteristics of the wake-up test during propofol-alfentanil (PA) vs propofol-remifentanil (PR) infusions for PSF surgery. Methods. Sixty patients with scoliosis and candidates for PSF surgery were randomly allocated in either alfentanil (PA) or remifentanil (PR) group. After an i.v. bolus of alfentanil 30 μg kg-1 in the PA group or remifentanil 1 μg kg-1 in the PR group, anaesthesia was induced with thiopental and atracurium. During maintenance, opioid infusion consisted of alfentanil 1 μg kg-1 min-1 or remifentanil 0.2 μg kg-1 min-1, in the PA group and the PR group, respectively. All patients received propofol 50 μg kg-1 min-1. Atracurium was given to maintain the required surgical relaxation. At the surgeon's request, all infusions were discontinued. Patients were asked to move their hands and feet. Time from anaesthetic discontinuation to spontaneous ventilation (T1), and from then until movement of the hands and feet (T2), and its quality were recorded. Results. The average T1 and T2 were significantly shorter in the PR group 3.6 (2.5) and 4.1 (2) min than the PA group 6.1 (4) and 7.5 (4.5) min. Quality of wake-up test, however, did not show significant difference between the two groups studied. Conclusion. Wake-up test can be conducted faster with remifentanil compared with alfentanil infusion during PSF surgery. © 2006 Oxford University Press

Efficacy of a modified bier�s block in patients undergoing upper limb bone surgery

Background: Intravenous regional block, called the Bier's block, refers to an analgesic technique applied for soft tissue surgeries and closed bone manipulations of the limbs. There are a number of complications in traditional method of block, including pain in tourniquet site, immediate return of pain after tourniquet deflation, wound hemostasis and some others. Objectives: The aim of this study was to assess the outcomes and complications of our new method of blockage. Patients and Methods: In this experimental study, twenty-five patients undergoing hand surgery were prospectively studied. Induced anesthesia was a modifcation of the Bier's block with two concurrent changes including insertion of the intravenous cannula at the antecubital region rather than distal and the proximal anesthetic direction by an elastic band wrapped tightly around the proximal forearm distal to the cannulation site. The pain relief was measured by the verbal descriptive scale at intervals after block, during the operation, after deflation of the tourniquet and one hour after the operation. Results: This study showed the presence of analgesia at surgical and tourniquet sites during the operation in 96 of patients, as well as considerable pain relief at surgical site during one hour after deflation of the tourniquet. Conclusions: The study indicated advantages of this modified Bier's block compared to the traditional one including ability to perform surgery on upper limb bones and considerable pain relief at surgical and tourniquet sites during the operation until one hour thereafter. © 2015, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM)

The effect of intra-articular meperidine and bupivacaine 0.5 on postoperative pain of arthroscopic knee surgery; a randomized double blind clinical trial

Background: Arthroscopic knee surgeries have a painful postoperative course, which often necessitates acute pain management. Among different analgesia techniques, Intra-articular injection is the technique of choice for many pain specialists, based on its confined effect to the surgical site (knee), lack of systemic effects and promotion of safe early ambulation. Objectives: The aim of this study was to compare analgesic effects of intra-articular meperidine, bupivacaine 0.5 or their combination after knee arthroscopic surgery. Patients and Methods: Sixty ASA class I-II patients� candidates for arthroscopy knee surgery enrolled in a randomized double blind study to receive either 20 mL of bupivacaine 0.5; 100 mg meperidine (diluted in normal saline) or bupivacaine 0.5 along with 100 mg meperidine. A written informed consent was obtained from all patients. Postoperative analgesia duration, VAS at 2, 6, 12 and 24 hours, the Results: The bupivacaine-meperidine group had better duration of postoperative analgesia (P = 0.001), latter first analgesic request (P � first analgesic request time, total fentanyl consumption in first 24 hours, patients� satisfaction and adverse effects were recorded. 0.001), lower total fentanyl consumption in first 24 hours after the operation (P = 0.001), less mean VAS at 2 hours (P = 0.001) and more patients� overall satisfaction (P = 0.01) compared with each medication alone. VAS at 6, 12 and 24 postoperative hours were not different between the groups of study. No adverse effects were observed. Conclusions: Although postoperative intra-articular meperidine is a better alternative for bupivacaine, their combination could improve their analgesic effects compared with each other alone. © 2015, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM)

Review paper: Experimental models of absence epilepsy

Introduction: Absence epilepsy is a brief non-convulsive seizure associated with sudden abruptness in consciousness. Because of the unpredictable occurrence of absence seizures and the ethical issues of human investigation on the pathogenesis and drug assessment, researchers tend to study animal models. This paper aims to review the advantages and disadvantages of several animal models of nonconvulsive induced seizure. Methods: The articles that were published since 1990 were assessed. The publications that used genetic animals were analyzed, too. Besides, we reviewed possible application methods of each model, clinical types of seizures induced, purposed mechanism of epileptogenesis, their validity, and relevance to the absence epileptic patients. Results: The number of studies that used genetic models of absence epilepsy from years of 2000 was noticeably more than pharmacological models. Genetic animal models have a close correlation of electroencephalogram features and epileptic behaviors to the human condition. Conclusion: The validity of genetic models of absence epilepsy would motivate the researchers to focus on genetic modes in their studies. As there are some differences in the pathophysiology of absence epilepsy between animal models and humans, the development of new animal models is necessary to understand better the epileptogenic process and, or discover novel therapies for this disorder. © 2020 Iran University of Medical Sciences. All rights reserved

Diagnostic Accuracy of Sixty Four Multi-Slice CT Angiography in Assessment of Arterial Cut-Off and Run-Off in Comparison with Surgical Findings

Background/Objective: The accurate anatomic mapping and determination of the severity of arterial disease, an important health problem of the elderly, is of great significance. We aimed to determine the diagnostic value of 64-multislice CT angiography (MSCTA) in run-off and cut-off sites of arterial disease. Patients and Methods: Throughout the study, MSCTA followed by an operative intervention was carried out on a total of 38 patients with clinical signs and symptoms suggestive of arterial disease (AD) all of whom had the indication for vascular surgery. The mean age of patients was 34±15.86 (range, 23 to 93) years. MSCTA was executed using a 64-slice CT scanner, during the arterial phase of injecting the nonionic, contrast medium with a power injector at the rate of 5 ml/sec into the antecubital vein and exploration and revascularization of peripheral arterial disease was performed intraoperatively. Results: Atherosclerosis and arterial disease, the most common causes of vascular occlusion, were more common in the lower extremities. According to MSCTA findings, the most frequent site of stenosis was the superficial femoral artery. Spearman’s correlation coefficient showed a high degree of agreement amongst the raters. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the accuracy of MSCTA compared to surgery were 83.8%, 96%, 96.8%, 81.3% and 89%, respectively. MSCTA findings were compared with surgery as a standard of reference, which showed concordance in the majority of cases (81.6%). Cut-off sites were correctly identified by MSCTA in 97.3% of the patients and the most common sites of discordance were the run-off sites (18.2%). Conclusion: MSCTA angiography as a novel diagnostic modality may be a suitable alternative and a viable choice for routine clinical diagnosis

Impact of Silicon Foliar Application on the Growth and Physiological Traits of Carthamus tinctorius L. Exposed to Salt Stress

Althought safflower is a tolerant crop against many environmental stresses, but its yield and performance reduce under stress. The aim of this experiment was to investigate the effect of silicon (Si) application on the possibility of increasing salinity resistance and related mechanisms in safflower. A greenhouse experiment was conducted to investigate the effects of Si spraying (0, 1.5 and 2.5 mM) on safflower plants grown under salt stress condition (non-saline and 10 dS m−1). Salinity reduced seedling emergence percent and rate, growth parameters and disrupted ion uptake but increased emergence time and specifc leaf weight. Spraying of Si increased plant height, fresh and dry weight, leaf area, relative water content (RWC), potassium, calcium and silicon content, while sodium absorption was decreased. As a result, the K+/Na+ and Ca2+/Na+ ratios were increased. Elevated ion contents and ratios indicate an enhanced selectivity of ion uptake following silicon application and may increase ion discrimination against Na+. Treatment with 2.5 mM Si showed the most positive effect on the measured growth traits. Decrement in leaf area ratio under salinity indicates a more severe effect of salinity on leaf area compared to biomass production. On the other hand, silicon reduced the specific leaf weight under stress and non-stress conditions, which revalues the positive effects of silicon on leaf area expansion. Improvement of RWC may a reason for the icrease in leaf area and biomass production. Data shows that spraying with Si especialy with 2.5 mM can reduce salinity stress damage to safflower and increase biomass production

Striae gravidarum: Associated factors

Background: Striae gravidarum (SG) is the most common change in connective tissue of pregnant women and may cause cosmetic concerns. Objectives: To determine the frequency of SG in Iranian pregnant women and its possible associations with the characteristics of themselves and their newborns. Methods: One hundred and eighteen primigravid pregnant women were included in this prospective observational study at their first prenatal visit, among them 114 completed the study and gave birth. Results: One hundred (87.7) of 114 women developed SG with a mean Davey's score of 4.04±2.47. The mean gestational age at which SG first appeared was 27.57±5.38 weeks. Family history of SG in mother, baseline and delivery body mass index, greatest abdominal and hip girths, newborn weight, height and head circumference were significantly associated with the presence of SG. All of these factors were also correlated with Davey's score. Conclusion: Genetic and physical risk factors may be involved in the development of SG in primigravid women. © 2007 The Authors Journal compilation © 2007 European Academy of Dermatology and Venereology

Anticonvulsant and neuroprotective effects of Pimpinella anisum in rat brain

Background: Essential oil of Pimpinella anisum L. Apiaceae (anise oil) has been widely used in traditional Persian medicine to treat a variety of diseases, including some neurological disorders. This study was aimed to test the possible anti-seizure and anti-hypoxia effects of anise oil. Methods: The effects of different concentrations of anise oil were tested on seizure attacks induced by pentylenetetrazol (PTZ) injection and neuronal hypoxia induced by oxygen withdrawal as well as on production of dark neurons and induction of long-term potentiation (LTP) in in vivo and in vitro experimental models of rat brain. Results: Anise oil significantly prolonged the latency of seizure attacks and reduced the amplitude and duration of epileptiform burst discharges induced by injection of intraperitoneal PTZ. In addition, anise oil significantly inhibited production of dark neurons in different regions of the brain in epileptic rats. Anise oil also significantly enhanced the duration of the appearance of anoxic terminal negativity induced by oxygen withdrawal and inhibited induction of LTP in hippocampal slices. Conclusions: Our data indicate the anticonvulsant and neuroprotective effects of anise oil, likely via inhibition of synaptic plasticity. Further evaluation of anise oil to use in the treatment of neurological disorders is suggested

Effects of black seed (Nigella sativa), ginger (Zingiber officinale) and cone flower (Echinacea angustifolia) on the immune system of rainbow trout, Oncorhynchus mykiss

This study was carried out to evaluate the effects of dietary essential oils of ginger (Zingiber officinale), black seed (Nigella sativa) and cone flower (Echinacea angustifolia) on the immune system of cultured rainbow trout, Oncorhynchus mykiss. A total of 360 fish were divided into 4 groups and 3 replicates each containing 30 fish. The fish were fed for 21 days with 1% of the herbal essential oils and with unsupplemented diet as the control group. Haematological and immune parameters including serum lysozyme, number of phagocytic bacteria, Hb, PCV, MCV, MCH, MCHC, number of RBC and WBC were studied. Treatments recorded enhancement in immune parameters compared to the control group. Significantly higher serum lysozyme level and phagocytic germs were detected in the groups fed black seed, ginger and cone flower (P0.05). The results of this study demonstrated that essential oils might strengthen the non-specific immunity of rainbow trout

IHTC14-22229 First and Second Law Analysis of Fluid Flow in the Regenerator of Pulse Tube Refrigerators

ABSTRACT The objective of the present work is to analyze the performance of the regenerator of pulse tube refrigerators. Hydrodynamic and thermal behavior of the regenerator is investigated in this respect. To consider the system performance, a system of conservation equations including two energy equations for the regenerator as a porous media is employed. The present model considers one dimensional periodic unsteady compressible flow in the regenerator. The conservation equations are transformed by implementing the volumetric average scheme. Method of harmonic approximation is employed to derive an analytical solution. To explore the system performance, net energy flow and entropy generation minimization technique is applied in order to calculate the regenerator first and second law efficiencies. The effect of geometry and operating key parameters on the regenerator performance are considered as well