The Effect of Morphine on the Incidence of Postoperative Nausea and Vomiting after Strabismus Surgery with Propofol

Background: Corrective strabismus surgery is associated with moderate pain and a very high incidence of postoperative nausea and vomiting (PONV). In our treatment centers Morphine is used a lot and it’s associated with high incidence of PONV and we have few alternative analgesics. The aim of this study was to compare the incidence of postoperative emesis with intravenous morphine in patients undergoing corrective strabismus surgery with propofol anesthesia with the control group. Methods: In a prospective, double-blind, randomized study, 126 patients who were candidates for strabismus surgery (either sex or any age) were randomly assigned to receive morphine or placebo. None of the patients received any premedication and a standardized anesthesia technique was used for all the patients. The incidence of PONV in patients within 24 hours after the surgery was compared. Results: During 24 hours after strabismus surgery, 29 (46%) patients in the morphine group and 27 (42.9%) in the control group had nausea. The frequency of vomiting was 11 (17.5%) patients in morphine group and 9 (14.3%) in the control group. There was no significant difference between the two groups regarding nausea episodes (P=0.85) and vomiting episodes (P= 0.8). Conclusion: According to the results of this study, morphine does not increase PONV after strabismus surgery

Phytochemical properties and antiviral effect of green tea (Camellia sinensis) extract on adenovirus in vitro

Background and aims: The lack of effective antiviral drugs for adenoviruses is one of the most important problems in this area. The aim of this study was to investigate the phytochemical properties and antiviral effect of the green tea extract (GTE) on adenovirus in HEp2 cells in vitro. Methods: In this experimental study, dried leaves of green tea were extracted by maceration. Total phenolic content (TPC), total flavonoid content (TFC), and antioxidant capacity of the extract were measured by Folin-Ciocalteu, aluminum chloride, and 2,2-diphenyl-1- picrylhydrazyl (DPPH) colorimetric methods, respectively. The amounts of some phenolic compounds in the extract were also determined using high-performance liquid chromatography. The toxicity of the extract on Hep2 cells and antiviral activity of the extract on adenovirus were assessed by the MTT colorimetric method. The half-maximum cytotoxicity concentration (CC50) and the 50 inhibitory concentration (IC50) of the extract were calculated as well. Results: Phytochemical investigations showed that the IC50 of DPPH radical was 42.1 ± 3.2 μg/mL compared with butylated hydroxytoluene (IC50 of 33.5 ± 3.67 μg/mL). The TPC and TFC of the extract were 74.2 mg GAE/g and 16.3 mg RE/g of the dry extract, respectively. The extract demonstrated the highest amounts of syringic acid, gallic acid, 3,4-dihydroxybenzoic acid, and rutin levels (67.27, 20.12, 7.39, and 2.97 mg/g DW, respectively). Based on the results of cell culture, the CC50 and IC50 of GTE were 103.3 μg/mL and 25.16 μg/mL, respectively. Conclusion: GTE with phenolic and flavonoid compounds can exert dose-dependent inhibitory effects on adenoviruses

Comparison of Ondansetrone, Metoclopramide and Midazolam for Preventing PONV Prophylaxis after Strabismus Surgery

Abstract Background: The aim of this study was to compare the effect of ondansetron, midazolam and metoclopramide with placebo in preventing PONV following strabismus surgery. Materials and Methods: 160 patients were divided into 4 groups of 40 by simple random method: group ON received Ondansetrone 0.05mg/kg, MT group received Metoclopramide 0.15mg/kg, MD group received Midazolam 0.03mg/kg intravenously and group CT received the solution of NaCl 0.9% as placebo infused with the same volume and the same manner 30 minutes before the end of surgery. The patients were evaluated for nausea, vomiting, need and dosage of anti-emetic drugs, time of liquid and solid diet tolerance, drug complications and satisfaction score for the initial 24 hours after anesthesia. Results: The frequency of nausea (p=0.001) and vomiting (p=0.084) was lower in ON group and both of these complications were lower in MD group compared with MT and CT group. Use of rescue antiemetic was higher in MT and CT groups (p=0.001). Patient satisfaction was higher in ON group compared with other 3 groups (p=0.001). Conclusion: Prophylactic use of Ondansetron is more effective with fewer side effects than Metoclopramide and Midazolam in the prevention of PONV following strabismus surgery. Furthermore, metoclopramide was less effective and was associated with more adverse effects compared with other 2 drugs

Estimating the Survival Rate in Glioblastoma Multiforme Patients who Received a Peptide Vaccine: A Systematic Review and Meta-analysis

Introduction: Glioblastoma Multiforme (GBM) has a poor prognosis, with current treatments providing no advantage in terms of survival. Certain new immunotherapy methods, such as peptide vaccines, have been used in clinical trials. In this meta-analysis, the effectiveness of peptide vaccinations on the survival rate of GBM patients was studied. Methods: A comprehensive search was carried out using three electronic databases: PubMed, Scopus, and ISI. The purpose of this research was to assess Overall Survival (OS). The pooled overall one-year and two-year survival rates in GBM with peptide vaccination were calculated using the general inverse variance technique as random effects hazard ratios (HRs). In the study, subgroups of countries were compared with each other. Japan had the highest one-year survival rate, and the US had the highest two-year survival rate. Results: With 95% Confidence Intervals (CIs), the one-year OS rate in GBM patients treated with peptide vaccination increased significantly, but the two-year survival rate did not increase. As a result, while additional research is needed, it cannot be concluded that it is an effective therapy for GBM. Conclusion: Our study found that while peptide vaccination treatment did not increase second-year survival, it improved first-year survival. More research needs to be done to find effective vaccinebased treatments for GBM that can help patients survive longer. Author keywords cancerous gene; glioblastoma multiforme; meta-analysis; MHC-II-restricted peptides; Peptide vaccines; surviva

Studying the Effect of Intravenous Acetaminophen and Dexamethasone on Postoperative Headache after Cataract Surgery under Sedation and Topical anesthesia

Abstract Background: Up to now, there is no single opinion on how to control pain after surgery and clinical research in this area has been continuing. This study aimed to compare the effect of intravenous Acetaminophen, Dexamethasone and placebo on postoperative pain after cataract surgery under sedation and topical anesthesia. Materials and Methods: In a clinical trial study, 120 patients undergoing cataract surgery under sedation and topical anesthesia were distributed into three equal groups. 10 minutes before the end of surgery, the first group received 0.01 mg/kg Dexamethasone, the second group received 15 mg/kg Acetaminophen and third group received the same volume on normal saline as placebo. Pain intensity and additional analgesic consumption were assessed during operation and recovery and compared between the three groups. Results: In the three groups of Acetaminophen, Dexamethasone and control groups, 6, 10 and 18 patients had postoperative headache (16.7%, 27% and 47.4% respectively) and there was a significant difference between the three groups(p=0.014). Also, pain intensity was significantly higher in control group compared with other two groups from 30 minutes after arrival to the recovery room until 24 h postoperatively (p0.05). Conclusion: Intravenous Acetaminophen administration is more effective than Dexamethasone and placebo to reduce pain and analgesic requirements after cataract surgery

Comparing the Effect of Intravenous and Inhalational Anesthtics on Hemodynamic Changes in Deep Vitrectomy Surgery

Abstract Background: Due to high prevalence of vitrectomy surgery, and the importance of anesthetic technique in conducting an uncomplicated surgery, we decided to do this study. Materials and Methods: This prospective randomized study was conducted on 80 patients 40-80 years old candidating deep vitrectomy sugery under general anesthesia that were categorized into II and III Class by American Society of Anesthesiologist (ASA). Patients were randomly allocated to two groups of 40 members. Anesthesia was induced in both groups in the same manner. For maintaining anesthesia, patients from I group receiVed 1.2% isofluran with 50% O2 in air at 4L/min and infusion of remifentanil (0.1 mg.kg-1.min-1). But in the P group, we used propofol up to 10mg/kg /hr with infusion of remifentanyl. Propofol and isoflurane in fusion was discontinued with the last surgical stitches, but remifentanil infusion continued in both groups until the eye was covered with shield. Hemodynamic variables were recorded just before the induction of anesthesia and in different time intervals till discharging of the patients from the recovery room. Then, data were compared. Results: Results showed that there is a significant change in propofol group compared to isofluran in deep vitrectomy surgery operations. Conclusion: Hemodynamic changes are more significant in maintaining propofol anesthesia when compared with isoflurane

Effect of Normothermic and Cold Eye Irrigation Solution (BSS) and Viscoelastic Gel on the Consumption of Sedative Drugs in Phacoemulsification Cataract Surgery

Abstract Background: This study aimed to compare the effect of cold eye irrigation solution (BSS) and viscoelastic gel with their combination in room temperature on the dosage of sedative drugs which we use in Phacoemulsification cataract surgery. Material and Methods: 190 patients scheduled for cataract surgery under sedation were randomly divided into two equal groups. During surgery, we used cold (4ºc) and warm (room temperature) BSS and viscoelastic gel in the first and second group respectively. For all patients, we started sedation with Midazolam and Fentanyl and in case that we needed additional drug, we used Sodium Thiopental till we reached desired sedation level. Ramsay sedation scores (before, during and after surgery) and total sedative drug consumption were evaluated and compared between two groups and at the end of the surgery, we checked and recorded the satisfaction score of patients and surgeon about the quality of sedation. Results: The average dosage of Midazolam wasn’t significantly different between two groups, while the average dosage of Sodium Thiopental was significantly lower in cold group. Also, the average time on which we reached desired Ramsay sedation score and the level of Ramsay score were significantly different between two groups. Conclusion: Using cold BSS and viscoelastic gel in cataract surgery in comparison of their combination in room temperature will reduce the dosage of sedative drugs which we use during surgery and help us getting a more effective sedation and higher patient and surgeon satisfaction

Comparing the Effect of Supplemental 80% and 40% Oxygen on Postoperative Nausea and Vomiting in the Pediatrics Undergoing Strabismus Surgery

Abstract Background: Postoperative nausea and vomiting (PONV) is one of the most common complications in the patients undergoing strabismus surgery. The aim of current study was comparing supplemental 80% and 40% oxygen on reducing postoperative nausea and vomiting in the pediatrics undergoing strabismus surgery. Materials and Methods: In this clinical trial study, 100 pediatric patients scheduled for strabismus surgery under general anesthesia were allocated randomly into two parallel supplemental 80% and 40% oxygen groups during surgery. PONV in patients was compared until 24hrs after operation. Results: In the first 6hrs postoperatively, PONV in the supplemental 40% and 80% oxygen groups were 48.8% and 30.6% respectively, also were 20.8% and 12.2% in the 6 to 24hrs postoperatively. Therefore, there were no significant differences between both groups in regarding of PONV in 6hrs and 6 to 24hrs postoperatively (p values were 0.18 and 0.25, respectively). Conclusion: According to our results, there is no any difference between 40% and 80% oxygen postoperatively in the pediatrics undergoing strabismus surgery

Neuroprotective effect of wild lowbush blueberry (Vaccinium angustifolium) on global cerebral ischemia/reperfusion injury in rats: Downregulation of iNOS/TNF-alpha and upregulation of miR-146a/miR-21 expression

This study aims to investigate the neuroprotective effect of wild lowbush blueberry on CIRI in rats. Accordingly, CIRI and reperfusion were induced in rats for 60 min and 24 h, respectively. Then, the mechanisms of the neuroprotective effects of BBE were investigated in the injury through evaluating miR-146a, miR-21, and their targets in a CIRI rat model. After that, the BBE (30, 60, and 120 mg/kg b.wt) was intraperitoneally injected for 14 days, then CIRI was induced by BCCAO for 60 min for ischemic stroke and reperfusion for 24 h. Several parameters including the oxidative stress levels in the hippocampus and serum were measured 24 h after the CIRI. The findings showed that the BBE significantly decreased the levels of malondialdehyde (MDA) and nitric oxide (NO) and increased ferric ion reducing antioxidant power (FRAP) levels in the hippocampus and serum following the stroke. The BBE also maximized the miR-146a and miR-21 expressions and moderated iNOS and TNF-alpha expressions in the hippocampus. Likewise, the BBE enlarged the CA1 and CA3 domains of the post-stroke pyramidal cell layers of the hippocampus. Overall, the results revealed that BBE had potent neuroprotective efficacy against CIRI via the effective modulation of neuroinflammatory cascades and protected neurons against ischemic death