Preoperative Oral Valiflore Reduces Anxiety in Laparoscopic Cholecystectomy: A Double Blind, Placebo Controlled Study

AbstractMany patients undergoing surgical procedures experience preoperative anxiety. Therefore; develop a drug as a premedication with strong anxiolytic effect and minimal psychomotor impairment is desirable. Under ethics committee approval, eighty patients, who met the inclusion criteria, were randomly assigned to two groups to receive either oral Valiflore (600 mg, Niak) or placebo as a premedication, 90 minutes before surgery. A numerical rating scale (NRS) for anxiety and the Ramsay sedation scale were measured at baseline, and 15, 30, 60, 90 minutes after premedication. Psychomotor function recovery was assessed using the Digit Symbol Substitution Test and the Trieger Dot Test on arrival in the operating room, 30 and 90 minutes after tracheal extubation. The duration of anesthesia, surgery and recovery time were recorded for each patient. There were no statistically significant differences in the patients’ demographic characteristics, ASA physical status, basal NRS score, the sedation level at different time intervals, duration of anesthesia, surgery and recovery time in the two groups (P > 0.05).The NRS anxiety scores were significantly lower in the Valiflore group in comparison with the control group (P < 0.001). There was no significant difference in psychomotor function test in both groups. Oral Administration of Valiflore as a premedication reduces anxiety before surgery without inducing sedation. Keywords:Anxiety; Herbal Medicine; Premedication; Preoperative anxiety; Valiflore Trial registry number:IRCT201404115175N13 Short title: Valiflore reduces pre-operative anxiety

The Concentration of Mercury, Cadmium and Lead in Muscular Tissue of Fishes in Khersan River

Background: Aquatic ecosystems including fish in rivers may be widely contaminated by heavy metals released into waters from industrial, agricultural and other human activities.This study aimed to investigate the level of contamination of theses heavy metals (mercury, cadmium and lead) in fish caught in Khersan river, the largest tributary of Karun river. Methods: The heavy metals level of mercury, cadmium and lead was investigated by atomic absorption spectrometry using Perkin Elmer 4100ZL in rainbow trout, pike and common carp species caught in Khersan river. Results: The average concentration of mercury, cadmium and lead in muscular tissue of trout, pike and common carp in all three breeding areas were (0.023,0.110, 1.12), (0.026, 0.162, 1.34) and (0.027, 0.155, 1.45) mg/kg, respectively and only lead metal was more than the level determined by the World Health Organization and European Commission regulations. The concentration of cadmium and lead in muscular tissue of caught fishes indicated an inverse and significant relationship with increasing weight and reducing fish metabolism (r=-0.568 and r=-0.517). The concentration of heavy metals of fishes in the river reduced by an increase in fish age, length and weight. Conclusion: The level of mercury and cadmium in fishes of Khersan river was shown not to be threatening for their consumers, but the increase for lead concentration reflects the fact that the entry of urban, rural and agricultural wastewater affects the concentration of heavy metals in fishes of the river that may be threatening for their consumers

The effects of synbiotics supplementation on reducing chemotherapy-induced side effects in women with breast cancer: a randomized placebo-controlled double-blind clinical trial

Abstract Background The prevalence of breast cancer and its mortality rate are increasing rapidly among women worldwide. On other hand, the courses of chemotherapy as the main treatment for these patients are too much exhaustive and annoying. This study was designed to evaluate the use of synbiotics (probiotics + prebiotics) supplementation as a safe and inexpensive adjuvant treatment in reducing common chemotherapy side effects in women with breast cancer. Methods The current study was conducted on 67 women with definitive diagnosis of breast cancer who were hospitalized to receive one-day chemotherapy sessions, and met the inclusion criteria. The patients were randomly allocated to the intervention or control group to receive synbiotics or placebo, respectively. They received oral consumption of synbiotics supplements twice a day for 8 weeks. The primary outcome was the changes in severity or experience of chemotherapy complication, analyzed by intention to treat (ITT). The instruments included 7 validated questionnaires which were used to assess chemotherapy complications in the initiation, 4 weeks and 8 weeks after intervention. Dietary intake was measured by 24-h dietary recall at the beginning, week 4 and week 8. Data were analyzed by SPSS software version 24. P-value < 0.05 was considered as statistically significant. Results 67 breast cancer patients participated in the study. 8 weeks after intervention and adjusting the confounders, the severity of chemotherapy complications including unnormal defecation (P = 0.005) and fatigue (P < 0/001) decreased significantly in the synbiotics group compared to the placebo group. Furthermore, nausea/vomiting (P = 0.015), and anorexia (P < 0.001) were decreased at the end of the study compared to the first visit, but it was not statistically significant compared to the placebo group. Conclusions Synbiotics supplementation during chemotherapy can potentially reduce the severity of fatigue and abnormal defecation. It can help reduce anorexia and nausea/vomiting. Trial Registration This study was registered in the Iranian Registry of Clinical Trials (IRCT) (registered code: IRCT20091114002709N56) (date of registration: 5/5/2021). Direct link to the trial page: https://www.irct.ir/trial/54559

The impact Atopic dermatitis on the life quality of childrens 1-6 year

Background: Eczema or atopic dermatitis (AD) is one of the most prevalent skin diseases in the world. Although, the disorder is not fatal, it can cause life quality reduction. The aim of the current study was to investigate the impact of atopic dermatitis on life quality of 1-6-year-old children. Materials and Methods: The current study is a descriptive and analytical one designed to assess quality of life (QOL) in 1-6-year-old children with atopic dermatitis in Kurdistan province (West of Iran). All the children who attended skin clinic of Besat Hospital, Sanandaj- Iran, during 2014 and 2016, participated in the study. Quality of life questionnaires were used to obtain data. Parents of the participating children were asked to complete the questionnaire. Index of Scoring Atopic Dermatitis (SCORAD) was used to determine the severity of the disease. The study data were analysis using Stata-12 software. Results: During the study, 53 children with atopic dermatitis were identified and 66.04% were male. According to the classification of SCORAD index, 54.36% of the children (19 subjects) were included in the moderate group (SCORAD 14-40) and 63.46% (33 persons) in the severe group (SCORAD> 40). Mean of life quality score was 9.24 ± 10.48 (range 0-30) and there was no statistically significant difference between the genders (P >0.05). Conclusion: There was a positive correlation between the quality of life and pain severity in AD children; and children with atopic dermatitis had low quality of life and itching, wound, discomfort and sleep disorder, were the factors that mainly impact on their life quality

Safety and outcomes of intravenous thrombolytic therapy in ischemic stroke patients with COVID-19: CASCADE initiative

BACKGROUND: There is little information regarding the safety of intravenous tissue plasminogen activator (IV-tPA) in patients with stroke and COVID-19. METHODS: This multicenter study included consecutive stroke patients with and without COVID-19 treated with IV-tPA between February 18, 2019, to December 31, 2020, at 9 centers participating in the CASCADE initiative. Clinical outcomes included modified Rankin Scale (mRS) at hospital discharge, in-hospital mortality, the rate of hemorrhagic transformation. Using Bayesian multiple regression and after adjusting for variables with significant value in univariable analysis, we reported the posterior adjusted odds ratio (OR, with 95% Credible Intervals [CrI]) of the main outcomes. RESULTS: A total of 545 stroke patients, including 101 patients with COVID-19 were evaluated. Patients with COVID-19 had a more severe stroke at admission. In the study cohort, 85 (15.9%) patients had a hemorrhagic transformation, and 72 (13.1%) died in the hospital. After adjustment for confounding variables, discharge mRS score ≥2 (OR: 0.73, 95% CrI: 0.16, 3.05), in-hospital mortality (OR: 2.06, 95% CrI: 0.76, 5.53), and hemorrhagic transformation (OR: 1.514, 95% CrI: 0.66, 3.31) were similar in COVID-19 and non COVID-19 patients. High-sensitivity C reactive protein level was a predictor of hemorrhagic transformation in all cases (OR:1.01, 95%CI: 1.0026, 1.018), including those with COVID-19 (OR:1.024, 95%CI:1.002, 1.054). CONCLUSION: IV-tPA treatment in patients with acute ischemic stroke and COVID-19 was not associated with an increased risk of disability, mortality, and hemorrhagic transformation compared to those without COVID-19. IV-tPA should continue to be considered as the standard of care in patients with hyper acute stroke and COVID-19