Morphine in Plasma and Cerebrospinal Fluid of Patients Addicted to Opiates Undergoing Surgery: High-performance Liquid Chromatography Method

Background: The prevalence of opium addiction among Iranians is considerable. Since endogenous opioid systems may be altered as a consequence of addiction, it is very important to determine the plasma and cerebrospinal fluid (CSF) levels of morphine in Iranian patients addicted to opiates who will undergo surgery.Methods: We obtained CSF and plasma samples from 50 volunteers with an established opioid addiction pattern. Samples were analyzed using high-performance liquid chromatography (HPLC). Additionally, frequency of nausea and vomiting, baseline heart rate (BHR), and systolic blood pressure (SBP) were recorded within the surgery and postoperatively during a 10-min interval.Findings: 84% of participants were men with a median age of 39.08 years. Mean score of body mass index (BMI) was 23.30 and most of the participants (46%) used opium in its traditional inhaled form. A higher concentration of morphine in blood was found in comparison with CSF (P < 0.001) in relation to the way of use. However, no statistically significant differences were found in relation to the type of addictive substance. No other association was found between the levels of morphine and the clinical characteristics of the patients. Moreover, results revealed no difference between hemodynamic-related data with blood and CSF level in opium-dependent patients.Conclusion: Quantification of plasma and CSF morphine, both immediately before initiation of surgery and subsequently on recovery room, showed that although clinical efficacy of systemic morphine was poor in addicted patients, it had no effect on patients’ hemodynamic variable and following complications after surgery

Novel insights into the treatment of SARS-CoV-2 infection : An overview of current clinical trials

The emergence of the global pandemic caused by the novel SARS-CoV-2 virus has motivated scientists to find a definitive treatment or a vaccine against it in the shortest possible time. Current efforts towards this goal remain fruitless without a full understanding of the behavior of the virus and its adaptor proteins. This review provides an overview of the biological properties, functional mechanisms, and molecular components of SARS-CoV-2, along with investigational therapeutic and preventive approaches for this virus. Since the proteolytic cleavage of the S protein is critical for virus penetration into cells, a set of drugs, such as chloroquine, hydroxychloroquine, camostat mesylate have been tested in clinical trials to suppress this event. In addition to angiotensin-converting enzyme 2, the role of CD147 in the viral entrance has also been proposed. Mepolizumab has shown to be effective in blocking the virus's cellular entrance. Antiviral drugs, such as remdesivir, ritonavir, oseltamivir, darunavir, lopinavir, zanamivir, peramivir, and oseltamivir, have also been tested as treatments for COVID-19. Regarding preventive vaccines, the whole virus, vectors, nucleic acids, and structural subunits have been suggested for vaccine development. Mesenchymal stem cells and natural killer cells could also be used against SARS-CoV-2. All the above-mentioned strategies, as well as the role of nanomedicine for the diagnosis and treatment of SARS-CoV-2 infection, have been discussed in this review. (C) 2020 Elsevier B.V. All rights reserved.Peer reviewe

Admission Dysnatremia in Citically ill Children

Introduction: Many causes of admission to the pediatric intensive care unit (PICU) may potentially induce hyponatremia. This study was aimed at evaluating the incidence of admission dysnatremia in the PICU and its relationship with the underlying disease and demographic factors.Materials and Methods: This observational prospective study was conducted in a 12-bed medical PICU in a tertiary governmental teaching hospital for six months. The study group comprised patients aged 1 month to 18 years. Patients who received intravenous fluid within 24 hours before admission were excluded. Serum sodium was checked on admission and concentrations below 135 and above 145 mEq/L were considered hyponatremia and hypernatremia, respectively.Results: One hundred and ninety-five patients (117 males, 60%) were included in the study. The mean serum sodium level was 137.8 mEq/L ± 5.2. Forty-two patients (20.5%) were hyponatremic and 10 (5.1%) werehypernatremic. The most prevalent diagnosis in hyponatremic patientswas pulmonary diseases followed by renal diseases, central nervoussystem (CNS) diseases, diabetic ketoacidosis (DKA), gastrointestinal (GI)diseases, and cardiovascular and hematologic-oncologic diseases. Fiftypercent of nephrologic patients were hyponatremic. Hyponatremia wasfound in 26.5%, 23.5%, 20%, 16.6%, and 14.2%of the children with lungdiseases, DKA, hematologic-oncologic diseases, cardiovascular diseases,and CNS and GI diseases, respectively. Moreover, 20%, 16.6%, 11.7%,7.1%, and 2.9%of the patients with infectious diseases, cardiovasculardiseases, DKA, CNS diseases, and pulmonary diseases hadhypernatremia, respectively.Conclusions: Hyponatremia is frequent in our PICU. Patients suffering from renal diseases, pulmonary problems, DKA, and hematologic-oncologic diseases have a higher chance of hyponatremia (≥20%).Keywords: Sodium; Hyponatremia; Fluid Therapy; Children; Intensive Care

Cytotoxic activity of the genus Ferula (Apiaceae) and its bioactive constituents

Objective: The genus Ferula L. includes perennial flowering plants belonging to the Apiaceae family. This genus is a rich source of biologically active phytochemicals such as sulfur-containing derivatives, coumarins, sesquiterpenes, sesquiterpene lactones, sesquiterpene coumarins, glucuronic acid, galactose, arabinose, rhamnose, and daucane esters. Over the last decade, considerable attention has been paid to biological activities of these compounds; it is assumed that the most prominent biological features of the genus Ferula are their cytotoxic effects. This article discusses cytotoxic activity of the genus Ferula and their important compounds. Methods: In this mini-review article, papers published from 1990 to April 2016 were included and the following information was discussed; cytotoxic activity of the genus Ferula and their important compounds, the type of cell line used in vitro, concentrations of the extracts/active compound that were used, and the underlying mechanisms of action through which Ferula-related chemicals induced cytotoxicity. In addition, we explained different mechanisms of action through which the active constituents isolated from Ferula, could decrease cellular growth. Conclusion: It is highly recommended that potent and effective compounds that were isolated from Ferula plants and found to be appropriate as adjuvant therapy for certain diseases, should be identified. Also, the versatile biological activities of sesquiterpene coumarins suggest them as promising agents with a broad range of biological applications to be used in the future

Switched Reluctance Motor in Electric or Hybrid Vehicle Applications: A Status Review

Drive systems based on a switched reluctance motor (SRM) are important alternatives in traction applications because of the motor simple and robust structure without using rare-earth permanent magnets. In this paper, different aspects of the SRM-based drive systems for the vehicle traction are presented and reviewed. Motor design and comparison with the permanent magnet motors, power electronics, simulation, control, and thermal design of the drive are explained and discussed

High-frequency modelling of a three-phase pulse width modulation inverter towards the dc bus considering line and controller harmonics

Closed-form analytical formulas are provided to calculate the dc bus harmonics of a three-phase sinusoidal pulse width modulation (SPWM) inverter. The harmonic analysis is performed by using a double Fourier series approach to determine the dc bus current frequency spectrum. For an arbitrary modulation index and load power factor, the full harmonic components of the inverter dc side current are calculated. Based on the developed analytical model, an equivalent circuit is proposed for the inverter harmonic analysis towards the dc bus. Moreover, the impacts of line harmonics and zero sequence injection in controller towards the dc bus are presented. The results show that the 5th and 7th ac line harmonics on the dc side current is appearance of the 6th harmonic in the dc side. The impact of zero sequence injection to the controller on the dc side is negligible. In addition to analytical formulation, different simulations and extensive measurements performed which the results verified the presented analytical framework

Comparison of two anesthetic induction methods:ketamin and thiopental Na for ECT in major depression disorder patients

Background and Aim: Depression is a commomn common psychiatric disordersdisorder.. The Sever severe form of depression, that callled call.ed as . major depression , has many effects on the mental health of patient's patients. It may even lead to health including. suicidal attempt. Electro Convulsive Therapy (ECT) is still the most effective treatment for major depression. The purpose of this studyis comparison ofof the present study was to compare two anesthetic induction methods: ketamin and thiopental Na for ECT in major depression disorder patients. Materials and Methods: The current study was done as a double blind randomized clinical trial on 60 patients with psychiatric disorders 30 of whom were administered ketamin .and 30 .thiopental Na .. Then, the patients' responses to treatment in the form of energy expenditure, duration of seizures , and the Hamilton Depression Rating Scale(HDRS) were evaluated. The obtained data was analyzed by means of Chi-square and mann-whitney tests using SPSS. Software (V:21).. Results: Rate of depression (ketamin:22.50±5.50 and thiopental Na:30.05 ±7.95 ) and energy expenditure (ketamin: 81.33±3.31 and thiopental Na:85.33 ±11.34 ) was higher in thiopental Na. Changes in rate of depression showed significant difference between the two groups but Changes in energy expenditure showed no significant difference. .. Furthermore, duration of seizures (ketamin:35.46±7.93 and thiopental Na:30.09 ±14.38 ) was higher in ketamin group therefore,the difference was significant ... Conclusion: . Severity of depression and seizure duration changes showed that ketamin is better than thiopental Na. Thus, it seems that ketamin administration can be used as an alternative method of anesthesia in depression patients that candidate for ECT.

Field-Oriented Control of a PMSM Drive System Using the dSPACE Controller

Field-oriented control (FOC) of the permanent magnet synchronous motor (PMSM) is one of the widely used scheme in drive system application. Moreover, in some high performance applications, the rotor position information is needed that can be measured by a resolver for example. A drive system is designed and explained based on the FOC of a PMSM using the dSPACE controller. A resolver sensor is used for the position measurement in the system. Simulation and practical implementation results are presented to verify the proper operation of the drive system that is a speed controller in this case

Evaluation of intra ocular pressure and hemodynamic change following intubation with Maccoy, Macintosh and Video laryngoscope

Background & Objective: The induction of anesthesia, laryngoscopy and endotracheal intubation can be associated with adverse hemodynamic response and increased intraocular pressure. The aim of this study was to evaluate intraocular pressure and hemodynamic changes after laryngoscopy and endotracheal intubation with three methods of laryngoscopy (Macintosh, Maccoy and Video laryngoscope).Materials & Methods: One hundred and eighty patients with American Society of Anesthesiology (ASA) classification of I and II, aged 20-70 year, were enrolled in a randomized clinical trial (RCT). Anesthesia was induced by administration of Propofol 2 mg/kg, Fentanyl 1µg/kg and Cisatracurium 0.1mg/kg. the Hemodynamic information of the patients and intraocular pressures were documented and assessed in three stages (after induction of anesthesia and endotracheal intubation, and 5 minutes after endotracheal intubation using Maccoy, Macintosh and Video laryngoscope).Results: Hemodynamic parameters' of patients increased in these three groups compared with those of pre anesthesia measures, but this increase was not significant. Evaluation of intraocular pressure (IOP) in Video laryngoscope group showed that there is a significant drop in intraocular pressure (IOP) compared with other groups. There weren’t any significant differences of IOP after intubation in Maccoy compared to the Macintosh group. Nevertheless there was not any significant difference in IOP, before and five minutes after intubation in these groups.Conclusion: According to a low degree of augment of IOP in Video laryngoscope group and no changes in the Hemodynamic parameters, it seems that the use of Video laryngoscope in eye surgeries might be more suitable for endotracheal intubation

Evaluation of Mexiletine Effect on Bispectral Index Changes and Hemodynamic Responses to Endotracheal Intubation and During General Anesthesia

  Background &Objective: Plaryngoscopy and tracheal intubation increase not only blood pressure and heart rate but also Bispectral Index (BIS) of the patients. In this study, hemodynamic and BIS changes were surveyed after tracheal intubation and during general anesthesia followed by mexiletine prescription . Materials & Methods: In this study, 50 patients aged between 20 and 60 who were candidates for orthopedic surgery of the upper limbs were surveyed. They were divided in two groups randomly. Two hours before induction of anesthesia,  case and control groups received mexiletine 200 mg as capsule and oral placebo, respectively. Systolic  and diastolic blood pressures ,heart rate, and BIS of both groups were compared before induction and intubation; 1,3 and 10 minutes after intubation; and immediately  , 15, 30, 45, and 60 minutes  after  surgical incision. Results:&nbsp;There was not any significant differences in systolic and diastolic pressures of the two groups.  The heart rate was lower in mexiletine group compared to control group, 30 minutes after surgical incision and immediately after extubation (P<0.05).&nbsp;BIS was significantly more in mexiletine groupcompared to control group (p<0/05). Conclusion: It was revealed that  the hemodynamic changes after laryngoscopy and during general anesthesia were significantly lower in mexiletine group compared to the  control group. It`s suggested that the prescription of this drug leads to the increase of BIS after intubation and during general anesthesia