A Comparison Between the Hemodynamic Effects of Cisatracurium and Atracurium in Patient with Low Function of Left Ventricle who are Candidate for Open Heart Surgery

BACKGROUND: The need for muscle relaxants in general anesthesia in different surgeries including cardiac surgeries, and the type of relaxant to be used considering its different hemodynamic effects on patients with heart disease can be of considerable importance. In this study, the hemodynamic effects of two muscle relaxants, Cisatracurium and Atracurium in patients whit low function of left ventricle who are candidate for open heart surgery have been considered. METHOD: This study has been designed as a randomized prospective double-blind clinical trial. The target population included all adult patients with heart disease whose ejection fraction reported by echocardiography or cardiac catheterization was 35 or less before the surgery, and were candidate for open heart surgery in Shahid Rajaei Heart Center. Taking into account the inclusion and exclusion criteria, the patients were randomly placed in two groups of 30 people each. In the induction stage, all the patients received midazolam, etomidate, and one of the considered muscle relaxant, either 0.2 mg/kg of cisatracurium or 0.5mg/kg of Atracurium within one minute. In the maintenance stage of anesthesia, the patients were administered by infusion of midazolam, sufentanil and the same muscle relaxant used in the induction stage. The hemodynamic indexes were recorded and evaluated in different stages of anesthesia and surgery as well as prior to transfer to ICU. RESULTS: In regard with descriptive indexes (age and sex distributions, premedication with cardiac drugs, ejection fraction before surgery, basic disease) there was no statistically significant difference between the groups. CONCLUSIONS: The significant difference of hemodynamic indexes between the two groups of this study, and the need for hemodynamic stability in all stages of surgery for patients with low function of left ventricle who are candidate for open heart surgery, proves that administering Cisatracurium as the muscle relaxant is advantageous and better

HIF-1α gene/protein and oxidative stress in patients with colorectal cancer: A pilot study

Background: Several risk factors such as may enhance the development of colorectal cancer (CRC). These include hypoxia and oxidative stress. We investigated serum pro-oxidant antioxidant balance (PAB) and HIF-1α Gene/protein levels in CRC patients over 3 months. Method: Fifty newly diagnosed cases of CRC and 50 healthy individuals were recruited. Tumor sections and marginal healthy tissue, for use as control tissue, were obtained on the day of surgery and HIF-1α mRNA gene expression was determined using Real-Time PCR. Blood from each patient was collected to measure serum PAB using a colorimetric assay, and serum HIF-1α protein concentrations were measured using ELISA method in the patient group before, 24 h after surgery, at the time of discharge, one month, and three months after surgery. The control group samples were obtained on the day of a routine check-up. Results: The expression of the HIF-1α gene in the tumor tissue was 7.31 times greater than in healthy tissue margins (p 0.05). Conclusion: HIF-1α gene expression was significantly higher in tumor tissue than normal marginal tissue and serum HIF-1α protein and PAB levels in patients with CRC were higher preoperatively than the control subjects, and decreased over the 3 months of follow-up. © 202

Studies on Mefenamic Acid Microparticles: Formulation, In Vitro Release, and In Situ Studies in Rats

In this study, we investigated the in vitro characteristics of mefenamic acid (MA) microparticles as well as their effects on DNA damage. MA-loaded chitosan and alginate beads were prepared by the ionotropic gelation process. Microsponges containing MA and Eudragit RS 100 were prepared by quasi-emulsion solvent diffusion method. The microparticles were characterized in terms of particle size, surface morphology, encapsulation efficiency, and in vitro release profiles. Most of the formulation variables manifested an influence on the physical characteristics of the microparticles at varying degrees. We also studied the effects of MA, MA-loaded microparticles, and three different polymers on rat brain cortex DNA damage. Our results showed that DNA damage was higher in MA-loaded Eudragit microsponges than MA-loaded biodegradable chitosan or alginate microparticles