Gabapentin and Fluoxetine for treatment of psychological symptoms: a cross over study

       The somatic and metabolic changes due to menopause can result in numerous symptoms including psychological symptoms. This study compares the effectiveness of Gabapentin vs. Fluoxetine in treatment of psychological symptoms of menopause. Methods:Eighty menopausal women with history of hot flashes and predefined psychological symptoms participated in a cross-over study conducted at the Amir-Al-Momenin hospital, Semnan, Iran.  Participants were randomly divided into two groups: A and B. The study included two rounds of treatment, each 4 weeks long, separated by a two-week washout period. In the first round of treatment, group A was treated with Fluoxetine 20mg/d and group B with Gabapentin 300 mg/d. In the second round of treatment, group A received Gabapentin while group B received Fluoxetine (cross-over).All participants were asked to fill out the "Green Climacteric Scale" questionnaire at the beginning of the study and also following each round of treatment. They were also asked to monitor and keep track of the side effects of the medications by filling out another form. There was no significant difference between the two groups in age, body mass index, and age at menopause (p>0.05). The severity of irritability, fatigue, difficulty in concentrating, difficulty in sleeping, nervousness, and palpitation reduced to a significantly greater extent when the participants were treated with Gabapentin than when they were treated with Fluoxetine. Side effects (tremor) developed in only 2 Fluoxetine users and 2 Gabapentin users during the first 4 weeks of treatment. Our findings suggest that Gabapentin is more effective in alleviating the psychological symptoms of menopause than Fluoxetine. Thus, we recommend Gabapentin 300 mg/d for menopausal women who primarily complain about psychological symptoms, or those with contraindication to hormonal therapy.

The effect of hearing loss on acoustic parameters of voice in children

Introduction: By means of normal hearing system and appropriate auditory feedback, we can control acoustic parameters of voice such as phonation, quality of voice, pitch and intensity. Materials and Methods: The aim of this cross-sectional study was investigation and comparison of some acoustic parameters of voice including: mean of intensity range, frequency range, shimmer, and harmonic to noise ratio between 2 groups of children (17 hearing impaired and 17 normal children). These groups were matched with respect to age and sex. The mean of each parameters were calculated using collection of speech studio software and electrolaryngograph apparatus and were compared between two groups of children. Results: The mean of intensity range between two groups was not statistically different (P=0.462). The mean of frequency range between two groups was not statistically different either (P=0.277). The mean of Shimmer in children with hearing loss was higher than normal children (P=0.010). The mean of Harmonic to noise ratio (HNR) in children with hearing loss was lower than normal children (P=0.001). Conclusion: It can be concluded that most susceptible acoustic parameters of voice for improving by hearing aids and speech therapy services are frequency and intensity range. The higher mean of shimmer and lower mean of harmonic to noise ratio (HNR) in hearing impaired children in comparison with normal group is caused by excessive pressure that these children are bearing on the larynx and related structures

Effects of smoking cigarette on some acoustic voice parameters and elements of speech pattern of male subjects

Introduction: The harmful effects of smoking cigarette on body organs are well documented. There are more than 40 acoustic voice parameters and the effects of smoking cigarette on them are still studied. The aim of this study was to examine and compare some acoustic voice parameters between smoker and non smoker men. Material and Methods: In this cross–sectional study, some acoustic voice parameters including; fundamental frequency, jitter, shimmer, irregularity, contact quotient and elements of speech pattern were compared between 2 groups of men consisting of 20 smokers and 20 non-smokers. Each parameter was calculated using speech studio software and an electrolaryngograph. Results: The men’s voices differed on several parameters. The mean fundamental frequency in smokers was significantly lower (P<0.001) than this one in non-smokers. The mean jitter, shimmer and irregularity of men who smoke were significantly higher (P<0.001) than those mean in the men who did not. The mean silence among smokers was significantly higher (P<0.001) than that mean among nonsmokers. In contrast, the mean of voicing in the men who smoke was significantly lower (P<0.001). No significant difference was observed between the two groups with respect to contact quotient, nasality, and friction. Conclusion: Fundamental frequency is the most vulnerable acoustic parameter of voice in smokers. The higher means for jitter shimmer and irregularity of voice in men who smoke is most likely related to epithelial changes in the vocal folds, inflammation caused by cigarette smoking, and the neurologic effects of nicotine and other chemical materials of cigarettes. It seems that the increased time of silence during connected speech of smokers is related to the defective quality of the closed phase of vocal cords movement

Is it Necessary to initiate antibiotic therapy in children with pharyngitis?

Streptococcuscus Beta Hemolytic Group A is the most important pathogen causing which may lead to purulent and non purulent angina. Rheumatic fever is the most important complication that is the cause of 30% to 40% of cardiac disease and disablement. This study was performed to evaluate prevalence of Streptococcuscus Beta Hemolytic Group A and estimate role of clinical findings in children with Streptococcuscus angina diagnosis. antibiotic resistance was also assessed evaluated in the patients with bacterial pharyngitis. Throat culture was performed on 104 patients referred to Amiralmomenin hospital of Semnan at the age range of 5 to 15 years having angina without begin on antibiotic treatment after the completion of the questionnaire. A frequency of 1% have been assessed for Streptococcuscus Beta Hemolytic Group A, coagulase -positive Staphylococci and non-group A Streptococcuscus frequencies were 10.6% and 17.3% respectively. 100% of patients had pharyngeal erythema, 72% had fever, 55% had exudates and 52% had cervical adenopathy. The diagnosed Streptococcuscus was sensitive against penicillin, erythromycin and amoxicillin and resistant against cotrimoxazole. In examining Staphylococcus aureus antibiotic-resistance, only 40% of cases were sensitive to clindamycin and 40% were also sensitive to vancomycin. Very low frequency of group A Streptococcuscus has undermined the routine use of antibiotic and show that the clinical based diagnosis alone is not reliable and rational use of antibiotics requires the use of other diagnostic methods such as throat culture and rapid antigen test (RATs). Also in analyzing coagulase -positive Staphylococci antibiotic resistance, we can see increased cases of resistance against neomycin and clindamycin which indicates the necessity of rational treatment of patients afflicted by strep to coccal infections

Effects of healthy lingual local sense on formant frequencies of Persian vowels

Introduction: In order to evaluate the effects of healthy lingual local sense on the phonetic quality of Persian vowels, changes in their main acoustic features were analyzed following local anesthesia the surface and sides of the tongue to partly block the normal neural feedback mechanisms in speech. Materials and Methods: Six Persian vowels (/a/, /o/, /u/, /e/, /i/, /æ/) were prolonged 3 times using habitual loudness with and without lingual local anesthesia (Lidocaine Hydrochloride Oral Topical Solution, USP (Viscous) 2) by 5 male speakers. The formant frequencies of vowels (F1and F2) were analyzed and compared using the Speech Studio Package (Laryngograph Ltd). Results: The difference between mean values of F1 and F2 before and after lingual local anesthesia were not statistically different for the /a/, /æ/ and /u/ vowels (p0. 05). The mean value of F2 for this vowel was decreased to 262 Hz. The difference between the mean values of F1 and F2 before and after local anesthesia were also significantly different for the /e/ and /i/ vowels (p>0. 05). Conclusion: According to our results, lingual local sense has effects on the production of some Persian vowels. Perhaps the healthy local sense of the tongue and normal articulatory models has an important role in the production of vowels

Localised application of vibration improves passive knee extension in women with apparent reduced hamstring extensibility: a randomised trial

QuestionDoes the localised application of vibration over the hamstrings improve hamstring extensibility?DesignRandomised controlled trial with concealed allocation, intention-to-treat analysis, and assessor blinding.Participants30 non-athletic females (aged 18–22 yrs) with limited hamstring extensibility bilaterally.InterventionThe experimental group received 3 sessions of localised application of vibration per week for 8 weeks. At each session, 3 sets of vibration were applied over the left and right hamstring muscles. The control group continued their usual daily activities. Both groups were asked to perform no specific exercises during the 8-week intervention period.Outcome measuresHamstring muscle extensibility was measured bilaterally at baseline and at the end of the 8-week intervention period by measuring passive knee extension in supine with 90 deg of hip flexion.ResultsAt baseline, the mean lack of knee extension was 27 deg (SD 9) in the experimental group and 24 deg (SD 8) in the control group. At 8 weeks, this had changed to 13 deg (SD 5) in the experimental group and 23 deg (SD 9) in the control group. This was a significant treatment effect: mean between-group difference of 13 deg (95% CI 11 to 16).ConclusionAn 8-week regimen of localised application of vibration over the hamstring muscles significantly reduces knee extension lack in women with reduced range on the passive knee extension test.Trial registrationIRCT201011031254N6

Detection of helicobacter pylori in pediatric patients with adenotonsillar hypertrophy

Background: Adenotonsillar hypertrophy is one of the most prevalent causes of upper airway obstruction in pediatric patients. Recent studies have shown contradictory findings about helicobacter pylori colonization in adenotonsilar tissue and its role on adenotonsilar hypertrophy. According to this, we decided to investigate relationship between helicobacter pylori colonization and adenotonsillar hypertrophy.Methods: This is a comparative study in otorhinolaryngology department of Amir Almoemenin hospital in Semnan. In this study, pediatric patients with adenotosillar hypertrophy (n=50) were compared with control group (n=50) in terms of H. pylori colonization in adenotonsillar tissue. All of them were examined by urease breath test (UBT). Adenoid and tonsil biopsy specimens (in 30 patients with adenotonsilectomy) were collected and underwent the RUT for investigating colonization of Helicobacter pylori.Results: Fourteen percent of patients with adenotonsillar hypertrophy and 20% of control were found helicobacter pylori infection. There was no significant association between helicobacter pylori and adenotonsillar hypertrophy (odds ratio: 0.65 with confidence interval: 0.2-2.09).Conclusion: This study showed lack of relationship between adenotonsillar hypertrophy and Helicobacter pylori. However, more studies and samples are needed to provide a definitive judgment

Improving Cognitive Regulation in Patients with Bipolar Disorder Using Cyberspace-Based and Family-Centered Intervention

Introduction:Bipolar Affective Disorder is cyclic swinging of mood between mania or hypomania and depression. The present study aimed to examine cognitive regulation in patients with bipolar disorder using the cyberspace-based family-centered intervention.Method:This study was a quasi-experimental research with a pretest-posttest design and a follow-up period. The statistical population of the study included patients with bipolar disorder and a family member. 30 patients with a family member were selected by convenient sampling method and randomly assigned to experimental and control groups. Garnefski Cognitive Emotion Regulation Questionnaire (CERQ) was the research tool. After administration of the questionnaires, the Miklowitz family-focused therapy was performed for the experimental group using cyberspace. At the end of the course, participants in both groups were evaluated using the research tools. Data were analyzed using SPSS22 software and mixed analysis of variance with the repeated measures.Result:The results of analysis of variance with repeated measures showed that the Miklowitz model led to a significant difference in the score of emotion regulation with an effect size of 45% in the experimental and control groups (P&lt;0.05). In other words, the cognitive emotion regulation and its subscales have been evident in the experimental group. Conclusion:As a result, it can be said that the use of the Miklowitz model through cyberspace affects cognitive emotion regulation and subscales of self-blame, acceptance, rumination, positive refocusing, refocusing on planning, positive reappraisal, putting into perspective, catastrophizing, and other-blame.Declaration of Interest: Non

Survey of Factors that Affect the Arteriovenous Fistulas Survival in Semnan and Mahdishahr, Iran

Background: First step in chronic dialysis is establishing a suitable dialysis access. Arteriovenous fistula (AVF) has been known as the gold standard for hemodialysis; and due to complex interaction of factors that affect thesurvival time of fistula, we decided to evaluate survival time and affective factors among the dialysis patients.Methods: In a historical cohort study, we analyzed 52 patients of the Semnan and Mahdishahr Dialysis Centers. The data recorded by history taking and physical examination.Results: The survival of fistula was 83%, 80%, 67%, and 40% after 1, 3, 5, and 10 years respectively. Our results showed that the survival time of fistula was higher among patients with left-side AVFs. Factors such asage, gender, underlying disease, dialysis session per week, the time that patients started dialysis after installing fistula and fistula infection did not statistical significant affect the survival time.Conclusions: The survival time of AVF among dialysis patients of Semnan and Mahdishahr is satisfying, and installing the fistula in left hand lead to higher survival