Comparison of Sedation With Local Anesthesia and Regional Anesthesia in Transurethral Resection of Prostate (TURP)

ABSTRACT: Introduction & Objective: Transurethral Resection of Prostate (TURP) is usually performed under regional or general anesthesia. An alternative to conventional anesthesia is performing of TURP under local anesthetic infiltration with sedation. The aim of this study was to evaluate the efficacy and complication of sedoanalgesia in TURP. Material & Methods: In a prospective clinical trial from September 2006 to December 2007, 60 patients (30 in each group) with prostate hypertrophy, candidate for TURP, were randomly assigned into two groups. In the first group, standard spinal anesthesia was done. In the second group, five minutes before the operation, 25 mgs of diazepam plus 25-50 mgs of pethedine was intravenously administered followed by injection of 10 ml lidocaine 2% gel in the urethra and the skin in the suprapubic area was anesthetized with 2 ml of 1% lidocaine. Using a 22 gauge nephrostomy needle, the suprapubic skin was punctured and the needle was directed toward prostate apex and 10-20ml of 1% lidocaine was injected at the serosal aspect of the rectal wall. For dorsal nerve block, 5-10ml of 1% lidocaine was injected at penopubic junction, and then a standard TURP was performed. Patients were switched to another anesthetic technique if the selected technique failed. Severity of pain was assessed by visual analogue scale. Results: The average prostate size was 25 grs (range10-50grs) in the local anesthetic group (group 1) and 27.5 grs (range 10-50 grs) in the spinal group (group2). In the local anesthetic group, 82.3% had no or mild pain while moderate to severe pain was reported in 16, 7% of the patients. In the group with spinal anesthesia, these were 93.1% and 6.9% respectively. Intolerable pain was observed in 23.3% and 13.8% of groups 1 and 2 respectively (p>0.05). Two patients in spinal group and 5 in local anesthetic group (3 due to severe pain and 2 for unsatisfaction) required conversion to general anesthesia or receiving additional drugs such as ketamine (p=0.06). Postoperatively, 2 patients experienced headach following spinal anesthesia otherwise there was no significant difference between two groups. Conclusion: local anesthetic TURP with sedation is safe, effective and suitable for patients with prostate glands below 50 gr who require TURP

Determination of Peroxide Value of Edible Oils Used in Restaurants and Sandwich Shops in Yasuj in 2006

ABSTRACT: Introduction & Objective: Nowadays the extensive changes in lifestyle resulted in an increase in consumption of fast food. This type of food, because of using deep–fat frying, may contain some toxic or unfavorable substances which have adverse effects on consumers’ health. The aim of this study was to determine the peroxide value of edible oils which are used in restaurants and sandwich shops in Yasouj city. Materials & Methods: This descriptive study was carried out on all sandwich shops (n=36) and restaurants (n=12) in Yasuj city in 2006. All samples and questionnaire data in restaurants and sandwich shops were collected at 11:30am and 12:30pm respectively based on a national standard protocol, number 493, by a food expert. The peroxide value was determined based on national standard procedure, number 4179, in a food laboratory and the acceptable limit was defined as 7 meq/kg. Results: Findings of this study showed that in terms of health rules and regulations, at least 50% of oils used in restaurants and 70% in sandwich shops were unfavorable. Peroxide value of 58.3% of oils in restaurants and 97.3% in sandwich shops was greater than the acceptable limit. Conclusion: These findings have shown that the health rules and regulations for the oils are not exercised in Yasouj restaurants and sandwich shops and this can have adverse effects on consumers’ health

Hypoglycemic Effects of Achillea Wilhelmsii in Normal and Streptozotocin Induced Diabetic Rats

ABSTRACT Introduction & Objective: Diabetes mellitus is a syndrome, initially characterized by a loss of glucose homeostasis resulting from defects in Insulin secretion, insulin action both is resulting in impaired metabolism of glucose and other energy yielding fuels as lipids and protein. Several medicinal herbs have been described with hypoglycemic effects. These include: Allium Sativum, Trigonella Foenum, Marus nigra, Ocimum Sanctum, and Astragalus Ovinus. The main purpose of the present study was to determine the effect of Achillea Wilhelmsii C. Koch on blood glucose levels of diabetic rats induced by stereptozotocine (STZ). Materials & Methods: In this experimental research, forty-eight male Wistar rats were divided into two groups: non-diabetic (normal) and STZ-induced diabetic mice. Each group was further divided into four groups: control (induced by normal saline) and treatment received 100, 200.and 300 mg/kg aqueous- alcoholic extract of Achillea Wilhelmsii C. Koch daily for one month. The blood glucose level was measured and Data were analyzed by t-test and ANOVA. Results: At the end of first month, significant decrease was observed in blood glucose level in diabetic rats which received 100 mg/kg (p<0/001), 200mg/kg(p<0/01), 300mg/kg (p<0/001) of aqueous alcoholic extract of Achillea Wilhelmsii C. Koch in comparison with control groups. The extract had not have any significant effects on the blood glucose level of normal groups except in those which received 300mg/kg of the extract. Conclusion: The results of this study showed that aqueous- alcoholic extract of Achillea Wilhelmsii C. Koch have a significant effect on reducing the blood glucose level of diabetic rats