Long-term pulmonary functional status following coronary artery bypass grafting surgery

BACKGROUND: The present study aimed to describe the long-term alterations of pulmonary function and also to describe its association with post-operative pain after coronary artery bypass grafting (CABG) surgery. METHODS: In this prospective study, thirty non-smoker male patients undergoing isolated on-pump CABG were consecutively included in this study. Pulmonary function measurements were performed, in a sitting position, preoperatively, a week postoperatively, and 6 months after the surgery using a Medical Graphics PF/Dx pulmonary function system. Pain was determined by using visual analog scale (VAS) pain scores with a standardized questionnaire's. RESULTS: Regarding functional class, all patients had New York Heart Association (NYHA) Class II to III. A week after operation, a severe restrictive pulmonary impairment was revealed with a mean decrease in VC to 60.9 +/- 9.2% and in forced expiratory volume in one second (FEV1) to 64.6 +/- 12.2% of pre-operative values (P < 0.001). Regarding sternotomy related pain, the mean pain VAS score was preoperatively 3.3 +/- 1.5 that reached to 6.2 +/- 2.5 and 4.8 +/- 2.2 1 week and 6 months after the operation (P < 0.001). The trend of the changes in pain score within 6 months of operation was significantly similar to the trend of the changes in some pulmonary function indices such as FEV% and residual volume (RV). CONCLUSION: A significant reduction is expected in most pulmonary functional parameters following CABG despite normal pulmonary function state preoperatively. Severe pain originated from sternotomy may be an important factor related to pulmonary dysfunction following CABG

Is herbal therapy safe in obesity? A case of apium graveolens (Celery) induced hyperthyroidism

BACKGROUND: Apium graveolens is one of the well-known herbs used for the treatment of different; however, allergic reactions have been reported after its use. This report aimed to demonstrate the A. graveolens induced hyperthyroidism after its oral consumption for weight loss. CASE REPORT: Mr. A, 48-year-old, with no history of any thyroid diseases, was diagnosed with hyperthyroidism due to daily consumption of 4 g of dried celery leaves for 45 days. After cessation of consumption and treatment with methimazole, the symptoms remitted. Then, the medication was discontinued when the lab tests and ultrasound were normal and indicated the patient’s definite recovery. In 2 months follow up of, he was normal and thyroid-stimulating hormone (TSH), T4, T3, anti-TSH receptor, anti thyroperoxidase and antithyroglobulin were in normal ranges. CONCLUSION: Hyperthyroidism may be induced by consumption celery. Although many studies have reported side effects such as allergic reactions for this herb, this is the first report of hyperthyroidism induced by celery in which the patient recovered after discontinuing the medication. Therefore, it can be assumed that celery induces hyperthyroidism as a side effect of this herb if it is used for a long term. © 2016,.Isfahan University of Medical Sciences(IUMS). All rights reserved

Use of lipid-lowering medicinal herbs during pregnancy: A systematic review on safety and dosage

BACKGROUND: Hyperlipidemia is one of the important diseases in pregnancy that causes fetal abnormalities during pregnancy and after the birth. Unfortunately, the usual anti-fat drugs are associated with high morbidity in fetus and due to people's inclination towards taking herbs, it is required to identify side effects of medicinal herbs in pregnancy. The aim of this study was to present hypolipidemic herbs that would not any complications for mother and fetus. METHODS: In this review article, the major electronic databases such as EBSCO, Central Register of Controlled Trials (CENTRAL), China Network Knowledge Infrastructure (CNKI), Cochrane, Google scholar, MEDLINE, SciVerse, Scopus, and Web of Science were searched using the key words “herbal” and “hyperlipidemia”, “herbal” and “pregnancy” matched by MeSH from their respective inceptions till September, 2016. Total of 1723 publications (145 review articles, 855 original research articles, and 723 abstracts) about the effect of herbals on hyperlipidemia and 682 publications (200 abstracts, 423 original research articles, and 59 review articles) about the effect of herbals in pregnancy were retrieved. At the end, a list of medicinal plants effective on hyperlipidemia alongside their effects on pregnancy was developed. Finally, the plants effective on hyperlipidemia and safe during pregnancy were determined and their dosage, complications, mechanism of action, and side effects were reported. RESULTS: A total of 110 effective herbs on hyperlipidemia were identified and complications of 95 plants in pregnancy were studied. At last, among the 55 selected plants effective on hyperlipidemia and examined for pregnancy, we reported 12 herbs with their dosage and special considerations that can be used to treat hyperlipidemia during pregnancy. CONCLUSION: Some medicinal plants can be used to treat hyperlipidemia during pregnancy without any significant side effects both on mother or fetus

Systematic review on safety and drug interaction of herbal therapy in hyperlipidemia: a guide for internist.

Because of reporting high side effects related to biosynthetic drugs, recent attention has been paid to the use of herbs instead of chemical drugs to balance serum lipids. The present systematic review aimed to evaluate the safety of herbal medicines and also to assess drug interaction in herbal therapy in treating hyperlipidemia. The international research databases including MEDLINE; Google scholar, Web of Science SciVerse Scopus (SCOPUS); EBSCO Academic Search; Cochrane Central Register of Controlled Trials (CENTRAL); and a Chinese database (China Network Knowledge Infrastructure [CNKI]) were searched from their respective inceptions up to September 2014 with the search terms of "hyperlipidemia", "herbal medicine", "medicine traditional", "extract plant", "Traditional Medicine" and "Chinese Herbal Medicine" without narrowing or limiting search elements. A total of 85 randomized clinical trials (RCTs) studies were finally assessed on human subjects. A notable number of herbal drugs that are commonly used as an anti-hyperlipidemia agent may be interacted with a variety of biosynthetic drugs. In this regard, the most common reported herb-drug reactions were related to anticoagulants, antidepressants, anti-epileptic, anti-inflammatory, and/or even antihypertension and anti-lipidemic drugs. Also, a considerable number of anti-lipidemic drugs of plants origin may be accompanied with metabolic disturbances and serious complications within pregnancy and breast feeding. The main fundamental principles for administration of these drugs include physicians' complete awareness of the effects and interactions of these drugs, educating people not taking these drugs arbitrarily, and closely monitoring the verification and distribution of the drugs in the society

Comparison of the effect of Citrus aurantium and diazepam on preoperative anxiety

چکیده: زمینه و هدف: اضطراب قبل از عمل بعنوان یک شکایت عمده در اکثر بیماران مراجعه کننده برای انجام اعمال جراحی شناخته شده است. با توجه به تاثیر برخی گیاهان دارویی بعنوان ضد اضطراب و آرام بخش این مطالعه با هدف مقایسه تاثیر عرق بهار نارنج و دیازپام بر اضطراب بیماران قبل از عمل جراحی انجام گرفت. روش بررسی: در این مطالعه کارآزمایی بالینی دوسوکور تعداد 60 بیمــار 48-14 ساله مراجعه کننده به بیمارستان آیت اله کاشانی شهرکرد جهت عمل جراحی انتخابی نوع متوسط به صورت در دسترس، انتخاب و بطور تصادفی در دو گروه 30 نفره تقسیم شدند. 2 ساعت قبل از عمل به گروه 1، cc 100 عرق بهار نارنج و به گروه 2 محلول یک قرص mg 5 دیازپام در cc 100 آب بصورت خوراکی داده شد. میزان اضطراب بیماران توسط پرسشنامه اضطراب اسپیل برگر و علایم حیاتی بیماران قبل و دو ساعت پس از دریافت دارو ثبت گردید. داده ها با استفاده از آزمون های آماری کای دو، t زوج و t مستقل مورد ارزیابی قرار گرفت. یافتــه ها: گروه ها از نظر ویژگی های دموگرافیک، نبض و اضطراب قبل از عمل همسان بودند. میزان اضطراب موقعیتی پس از مصرف دارو در هر دو گروه مصرف کننده بهار نارنج (از 18/10±23/24 به 45/11±53/21) و دیازپام (از 11/8±68/27 به 94/7±68/24) کاهش یافت (05/0

Effect of scientific principles of gavage feeding in oral medicine administration on knowledge and function of nurses in intensive care unit (ICU)

Medication through an enteral feeding tube is one of the main cares in patients hospitalized in the intensive care unit continuously being a challenge. Correct delivery of medication through an enteral feeding tube requires specific knowledge and skills in this field. The nurse as the main responsible for administering a drug, has a very important role in this regard. This study was carried out as a quasi-experimental study on 90 cases of ICU nurses. First, using a questionnaire (pretest), the level of knowledge and practice in intensive care unit was measured. The training course for speech, along with a pamphlet and face to face, was held and again after a month their awareness and performance was measured by questionnaire (post-test).For analysis of data, SPSS software (version 21) and paired tests and chi-square was used. Results showed the mean score of nurses' knowledge prior to applying scientific principles (12/9889 ±2/04167) and their knowledge after that (19/3333±0/71893); mean performance score prior to applying scientific principles was significantly difference with the average score of their next performance (P=0/0001). Also results indicated that the average of all subscales of knowledge and practice (preparation, dosage forms, thumbs up and tubal obstruction, drug interactions and side effects) significantly increased after the application of scientific principles (P=0/0001). This study showed that the application of scientific principles in accordance with the instructions provided, significantly increases knowledge and practice of nurses

A new method to measure anatomic knee alignment for large studies of OA: data from the Osteoarthritis Initiative

SummaryObjectiveTo develop and validate a new and improved software method to rapidly determine femur–tibia angle (FTA).MethodsThree readers, two skilled and one unskilled, without any formal medical training, measured FTA in 142 subjects from the Osteoarthritis Initiative (OAI). The reader reliability was assessed using the intra-class correlation coefficient (ICC), root mean square standard deviation (RMSSD), and Bland–Altman plots, comparing the existing and new FTA methods. Gender-specific linear regression assessed the relationship of FTA with the hip–knee–ankle angle (HKA).ResultsThe ICC (RMSSD) for intra- and inter-reader reproducibility of the existing FTA method was 0.96 (0.77°) and 0.92 (1.38°), respectively, and for the new technique was 0.98 (0.25°) and 0.98 (0.37°), with similar results for all three readers. Bland–Altman 95% limits of agreement were greater than ±2° for the existing, and ±1° for the new method. The r-value for the relation of FTA to HKA was 0.68 and 0.72 for the existing and new methods, respectively. Varus (HKA ≤ −2°)/neutral (−2° < HKA < 2°)/valgus (HKA ≥ 2°) alignment based on predicted HKA agreed moderately with measured HKA (weighted kappa = 0.53), and had moderate sensitivity (73%) and specificity (84%) for varus malalignment. The new FTA was related to HKA using a linear equation with a slope of 0.98 and an offset of 4.0°.ConclusionsSince it is largely automated and uses unambiguous anatomical landmarks, the new method is highly reproducible and can be made on a standard posteroanterior (PA) knee radiograph by a relatively unskilled reader

Sequence analysis of ORF94 in different white spot syndrome virus (WSSV) isolates of Iran

White spot syndrome virus (WSSV) is a pathogen that causes high mortality in shrimp culture in the whole world. Sequence analysis of WSSV has shown similarity of WSSV isolates in different countries with exception of a few variable genomic loci. This study investigated the sequence variation of some Iranian WSSV isolates and previously identified isolates. Samples were collected during target surveillance and were feed, broodstock, post-larvae, artemia, crabs, and wild and cultured shrimp of northern Persian Gulf (Boushehr and Khuzestan provinces). The open reading frame (ORF) 94 sequence of different Iranian WSSV isolates were amplified using specific primers from positive samples. The ORFs 94 sequence of positive samples were sequenced and registered in the Gene Bank and then compared to other WSSV isolates. The number of repeat units in ORF94 showed that WSSV isolates were varied in number. There are SNPs (G and T) in position 48 of RUs that varies in different Boushehr and Khuzestan isolates. Also these sequences were compared to Gene Bank WSSV isolates and showed a high similarity (>90%) to Southeast Asian countries. To our knowledge this is the first report of sequence analysis in Iranian WSSV isolates applications

Effect of 2% Chlorhexidine on Shear Bond Strength of Composite Resins to Dentin

Abstract Background and Aim: Intracanal medicaments can affect the bond strength of composite to dentin. The aim of this study was to evaluate the effect of 2% chlorhexidine (CHX) gel as an intracanal medicament on shear bond strength of three different composite resins to dentin. Materials and Methods: In this in-vitro study, 60 intact extracted human premolars were utilized. Each tooth was sectioned vertically and dentin of the buccal surface was exposed. Then, specimens were divided into six groups of 10 teeth. In groups 1-3, dentin was exposed to CHX and in groups 4-6, dentin was exposed to saline. All prepared surfaces were rinsed with distilled water and dentin bonding agent specific for each composite was applied on the dentin surfaces. Z100, Z350 and P90 composites were applied to the treated surfaces and cured. The shear bond strength was recorded in Newtons and converted to MPa. Data were analyzed using the Kruskal-Wallis and Dunn tests. Results: The lowest mean shear bond strength was reported for normal saline and Z100 composite group (18.47 MPa) and the highest for CHX and Z350 group (42.26 MPa). No statistically significant difference in bond strength values was found between normal saline and CHX groups (P>0.05). There was a significant difference in bond strength values of different composite resins in normal saline (P<0.05) and also in CHX groups (P<0.05). Conclusion: Application of 2% chlorhexidine gel slightly but not significantly increases the mean shear bond strength of composite to dentin. The type of composite influences the shear bond strength to denti

What we know about 2019-nCoV in Iran in the early stage?

On 10 January 2020, a new coronavirus causing a pneumonia outbreak spread rapidly in all of the World. On 19 February 2020, the first official announcement of death from 2019-Nov was made in Iran. As of 7 March 2020, there were 101,927 confirmed cases of Covid-19 infection, including 3486 deaths, reported in the World. In the eastern and Mediterranean region Iran with 4747 confirmed cases of Covid-19 infection and 124 deaths, is in the critical stage. Therefore, there is a matter of urgency combating this new virus and stopping the epidemic. Here, we focus on symptoms and the development of fast diagnosis methods, as well as potential management to prevent or treat the Covid-19 infection. © 2020, Indian Virological Society