Dexmedetomidine is as effective as Ketamine in post operative sore throat a randomized double – blind study

Background: sore throat as one of the common postoperative challenges, with a prevalence of 65%, mandates more attention. Many therapeutic approaches have been tested; including ketamine gargle. This study compares the effect dexmedetomidine versus ketamine, both used as preoperative gargle, on the incidence and severity of postoperative sore throat in emergency surgical procedures. Materials and Methods: All patients undergoing emergency surgical procedures who referred to Shohadaye-Tajrish Hospital and needed anesthesia using succinylcholine for rapid sequence induction were considered as the target population and patients with ASA class 1-2, who aged 18-64 years, were enrolled. Inside the operating theatre, patients’ vital signs recorded and they were divided into ketamine and dexmedetomidine groups, each including 20 patients, receiving 0.5 mg/kg ketamine or 0.25µg/kg dexmedetomidine in 100cc water to gargle before induction of anesthesia. Standard similar anesthesia protocols were applied for all patients. In PACU sore throat was assessed using a visual analog scale (VAS) scoring. Results: in the ketamine group, 8 cases and in the dexmedetomidine group, 12 had dry throat (p= 0.150). The mean severity of the postoperative sore throat was 2.10± (minimum score of one and a maximum of 3) without significant difference between the two groups (p=0.344). mean diastolic pressure and SpO2 were significantly lower in the dexmedetomidine group compared with the ketamine group (p=0.047 and 0.001). Conclusion: both dexmedetomidine and ketamine gargle could be equally useful and effective in reducing postoperative sore throat

Molecular detection and antimicrobial resistance of Aeromonas from houseflies (Musca domestica) in Iran

ABSTRACT Objective. This study aimed to report the molecular detection and antimicrobial resistance of Aeromonas among houseflies (Musca domestica) in Shahrekord and Isfahan provinces of Iran. Materials and methods. Flies were caught from household kitchens, cattle farms, animal hospitals, human hospitals, slaughter house and poultry farms and put in collection separate sterile tubes. Isolation was accomplished by culture of flies in alkaline peptone water followed by identification with Aeromonas-specific Polymerase Chain Reaction (PCR). Results. Out of 600 houseflies 73 (12.2%) were infected with Aeromonas spp. Significantly higher frequencies of Aeromonas were isolated in Shahrekord province (13.0%; 39/300) than in Isfahan province (11.3%; 34/300). The recovery frequencies of the organisms were significantly lower in kitchens as compared to those in cattle farms and hospital wards which were similar. Higher proportions of infected flies were obtained during summer whereas low proportions were obtained during winter. Conclusions. It is concluded that houseflies do harbor diarrheagenic pathogens, including Aeromonas especially during summer. The carried organisms are resistant to a number of antimicrobials at different levels. Thus, future plans aimed at stemming infections caused by these organisms should take flies into account. Control efforts of infections caused by this particular bacterium should therefore take into account Musca domestica

Anesthesia considerations in surgical deep brain stimulation for Tourette syndrome management

Tourette’s syndrome (TS) is a neuro-behavioral disease associated by phonic and motor tics with a high frequency of psychiatric co-morbidities. For these cases, deep brain stimulation (DBS) is a developing neuro-modulated treatment option since the first report on a successful surgery in 1999. A male thirty-one years old (77 kg, 178 cm) with diagnosis of Gilles De La Tourette syndrome admitted to neurosurgery ward. His medication included Aripiprazole, pimozide, buspirone, clomipramine, citalopram, phenytoin, Desmopressin and Lithium. The patient underwent implanting DBS (Deep Brain Stimulator) surgery and battery implantation in two steps with two weeks interval. General anesthesia with considerations and according to behavior of disease and drug interactions was performed. The cause and symptoms may be due to central dopaminergic hyperactivity or anomalous dopamine neurotransmission and interventions and anesthesia should be done considering these abnormalities

A Survey on Cortical Bone Trajectory for Spinal Fusions

There have been a number of developments in screw design and implantation techniques over recent years, including proposal of an alternative trajectory entitled as cortical bone trajectory (CBT). Cortical bone trajectory has been investigated in recent medical treatments as an alternative for screw fixation aimed at increasing purchase of pedicle screws in higher density bone. CBT screw insertion follows a lateral path in the transverse plane and caudocephalad path in the sagittal plane. This technique has been advocated because it is reportedly less invasive, improves screw−bone purchase and reduces neurovascular injury. Furthermore CBT pedicle screw fixation provides stabilization to multilevel lumbar segment with low-grade spondylolisthesis comparable to the standard trajectory pedicle screw construct. However, these claims have not been supported by robust clinical evidence. Recent investigations focus on evaluations of CBT as a pioneer method.

The Effect of Percutaneous Laser Disc Decompression on Reducing Pain and Disability in Patients With Lumbar Disc Herniation

Introduction: As low back pain incidence is increasing, noninvasive modalities are gaining attention for their ability to achieve the best possible outcome with the least complications. Percutaneous laser disc decompression (PLDD) is currently popular for this purpose. This study aims to evaluate the effect of PLDD on disability and pain reduction in patients with lumbar disc herniation.Methods: Thirty patients were enrolled in this study. Spinal nerve blocks were conducted by laser discectomy single stage injection of a needle into the disc space. The nucleus pulposus of herniated discs were irradiated with laser in order to vaporize a small part of the nucleus pulposus of the intervertebral discs and reduce the voluminosity of diseased discs. Patients were treated with 1000 J of 980 nm diode laser with 5 W energy. In order to measure the severity of pain, visual analog scale (VAS) and also ODI (Oswestry Disability Index) were used. Data were analyzed using SPSS version 12.Results: Thirty patients participated in this trial including 11 men and 19 women with a mean age (SD) of 40.8 (10.8) years. The mean patients VAS score and ODI level before and after discectomy showed statistically significant differences. The mean VAS and ODI scores showed no statistical difference between males and females (P < 0.05) and percutaneous laser discectomy decreased the VAS and ODI at both groups of patients similarly.Conclusion: We found the use of PLDD reduces pain and disability in patients as a noninvasive procedure

Molecular detection and antimicrobial resistance of Pseudomonas aeruginosa from houseflies (<italic>Musca domestica</italic>) in Iran

AbstractBackgroundPseudomonas aeruginosa is a common bacterium that can cause disease in humans and other animals. This study was conducted to screen for molecular detection and antimicrobial-resistant P. aeruginosa in Musca domestica in different locations in the Iranian provinces of Shahrekord and Isfahan.MethodsMusca domestica were captured by both manual and sticky trap methods, during the daytime, from household kitchens, cattle farms, animal hospitals, human hospitals, slaughterhouses and chicken farms at random locations in Shahrekord and Isfahan provinces of Iran, and subsequently transported to the laboratory for detection of P. aeruginosa. In the laboratory, flies were identified and killed by refrigeration in a cold chamber at −20 °C, then placed in 5 mL peptone water and left at room temperature for five hours before being processed. Pseudomonas isolates were preliminarily identified to genus level based on colony morphology and gram staining, and their identity was further confirmed by polymerase chain reaction.ResultsOverall blaTEM gene was recovered from 8.8 % (53/600) of the P. aeruginosa isolated from houseflies collected from the two provinces. A slightly higher prevalence (10.7 %; 32/300) was recorded in Shahrekord province than Isfahan province (7.0 %; 21/300). The locations did not differ statistically (p ConclusionsHouseflies are important in the epidemiology of P. aeruginosa infections.</sec

The effect of pretreatment with clonidine on propofol consumption in opium abuser and non-abuser patients undergoing elective leg surgery

Objective: Clonidine, an alpha-2 adrenergic agonist, increases the quality of perioperative sedation and analgesia with a few side effects. This study was designed to assess the effect of clonidine premedication on the anesthesics used for elective below knee surgeries in opium abusers and non-abusers. Materials and Methods: In a randomized clinical trial, 160 patients were selected and assigned into four groups. Eighty patients among the opium abusers were divided randomly into clonidine and no clonidine groups, with 40 patients in each, and 80 among the non-abusers were again divided randomly into clonidine and no clonidine groups, with 40 patients in each group. All were anesthetized for elective orthopedic operation using the same predetermined method. The total administered dose of propofol and other variables were compared. Results: The total propofol dose in a decreasing order was as follows: Abuser patients receiving placebo (862 ± 351 mg), non-abuser patients receiving placebo (806 ± 348 mg), abuser patients receiving clonidine (472 ± 175 mg), and non-abuser patients receiving clonidine (448 ± 160 mg). Hence, a statistically significant difference was observed among the four study groups (P value for ANOVA = 0.0001). Conclusion: Adding clonidine as a preoperative medication decreases the patient′s anesthetic needs; this decrease was even more considerable on the anesthetic needs than the effect of opium abuse history on anesthetic dose

Frontal assessment battery in a Persian population with Parkinson's disease

Background: Several studies have indicated that executive dysfunction is the main neuropsychological feature of Parkinson’s disease (PD). The Frontal Assessment Battery (FAB) is a short tool for the assessment of executive functions. Purpose: The aim of this study was to determine the relationship between Persian version of FAB scores and age, education, Mini-Mental State Examination (MMSE), and severity of the disease in Iranian patients with PD. Methods: The study involved 60 healthy participants and 60 patients with idiopathic PD. Age, sex, disease duration, and Unified Parkinson’s Disease Rating Scale (UPDRS) scores were noted. FAB and MMSE were administered to all participants. Both groups were compared according to FAB scores, MMSE, age, and education. Results: FAB scores were significantly lower in patients with PD than in healthy controls (P&lt;0.05). In patients with PD, FAB scores were correlated with MMSE (P&lt;0.05) but not with UPDRS (P=0.93). Conclusion: FAB scores were significantly lower in Iranian patients with PD in comparison to controls and it can indicate that this battery has good discriminate validity and can be a useful tool to identify executive dysfunction in  Iranian patients with Parkinson’s disease. Also it seems that FAB is not useful test to show disease severity in Iranian patients

Numerical modeling of magnetic field impact on the thermal behavior of a microchannel heat sink

The current appraisal evaluates the heat transfer phenomena of the nanofluid stream through the microchannel heat sink, considering the existence of a magnetic field. Moreover, Aluminum oxide (Al2o3)-water nanofluid is elected and implemented as a cooling fluid in this study. Also, the Koo–Kleinstreuer model (KKL correlation) is provided for the computation of the viscosity and effectual thermal conductivity of the nanofluid. Improved Darcy relationship is used for modeling the porous medium, and the two-equation approach's dispersion type is utilized for poking the heat transfer phenomenon among the solid and fluid zones. Due to the nonlinearity of the linked heat transfer relationships in mentioned phases, the well-known analytical Collocation method (CM) model decodes the issue. The influence of the void fraction and the diameter of the nanoparticles, temperature distribution, Hartmann number, fluid velocity, and channel geometry are discussed comprehensively. The obtained outcomes indicate that implementing the magnetic field has a direct connection with the Nusselt number. It was also found that heat transfer increases with the increase in nanofluid concentration. So, for the concentration of 0.04, there is the highest amount of heat transfer