The comparison between suppository diclofenac and pethidine in post-cesarean section pain relief: a randomized controlled clinical trial

BACKGROUND: Narcotic drugs are usually used for postoperative pain control which could cause several complications such as respiratory depression and apnea. Therefore, replacement of these drugs with safer analgesics is recommended. The aim of this study was to compare the analgesic effects of suppository diclofenac and pethidine in post-cesarean section (C/S) patients.
 METHODS: In this clinical trial, pregnant women who were admitted to Alzahrah Hospital, Isfahan, Iran, between August and February 2004 and met the inclusion criteria were recruited. After obtaining informed consent, the patients were randomly assigned (block randomization) to two groups. In group A, 100 mg rectal suppository diclofenac was used after operation at four time points: at the end of operation and 8, 16 and 24 hours after the operation. Group B received pethidine 1 mg/kg intramuscularly at similar time points. The pain scores were assessed at 2, 10, 18 and 26 hours after C/S using the Visual Analogue Scale (VAS). Age, gestational age, parity, history of previous abortion, C/S and abdominal surgery, level of education, pain score, side effects and satisfaction level were assessed. Analysis was carried out with ANCOVA model and χ2 Mantel Haenszel tests by SPSS.10 software. P<0.05 was considered significant.
 RESULTS: Two hundred forty patients met inclusion criteria. Age, parity, history of previous abortion, history of previous C/S and abdominal surgery, level of education and satisfaction level were similar in the two groups (P>0.05). There was no significant difference between side effects in the two groups except for dizziness in 11 cases in group B. There were significant statistical difference between pain intensity in 10, 18 and 26 hours after C/S in group A and group B (2.05 ± 2.07, 1.4 ± 1.6 and 0.5 ± 1.1 vs. 2.6 ± 2.2, 2.3 ± 2.2 and 1.3 ± 1.9) respectively.
 CONCLUSIONS: The results of the present study showed that the use of suppository diclofenac is an appropriate replacement therapy for pain relief after C/S.
 KEY WORDS: Diclofenac, pethidine, cesarean section, pain relief

Comparing Academic Achievement in Lecture-based Learning Versus Problem-based Learning among Medical Students: A Systematic Review

Introduction: Nowadays researchers widely believe that there are differences in the effectiveness of problem-based training compared to traditional methods such as lecture. This study was done in order to compare academic achievement in lecture-based learning versus problem-based learning among medical students through a systematic review. Methods: This study is a secondary research done using a systematic review method. In this study, all published articles related to comparing academic achievement of medical students through lecture and problem-based methods were analyzed. These studies were conducted from 1998 to 2013. At first, the question of study was defined and search strategy was specified. The related articles were searched through international data bases such as, Pubmed, SCOPUS, Wiley, Springer, Ovid, EMBASE and internal resources such as, Iranmedex, Irandoc, SID, Magiran and related journals using the proper keywords and mixing them. Articles that met the inclusion criteria were assessed using the relevant checklists. Results: Out of the total 95 articles found in the primary search of resources, eight met the inclusion criteria. In most studies comparing these two methods, academic achievement was higher in groups with problem-based learning, and in none of the reviewed studies, academic achievement was found to be less in problem-based group compared with the group receiving traditional or lecture-based methods. Conclusion: The results of this study showed that using a problem-based learning method can increase cognitive abilities of medical students and can be effective in improving their academic achievement

Growth and yield of groundnut (Arachis hypogaea) under varying levels of gypsum and zinc application in Iran

A field study was carried out during spring season of 2021 and 2022 at Astaneh-ye Ashrafiyeh, Guilan, (Islamic Azad University, Lahijan, Iran) northern Iran to study the effect of natural gypsum (NG) and zinc (Zn) foliar application on peanut (Arachis hypogaea L.) yield and quality. NG was applied at 4 levels [0 (NG0); 10 (NG10); 20 (NG20); and 30 (NG30) g/m2] and Zn nano-chelates were applied at 3 levels [0 (Zn0); 1 (Zn1); and 2 (Zn2) g/L)] as foliar application. The results showed that the interaction of NG × Zn was significant for leaf chlorophyll, kernel and pod number per plant, kernel protein, oil content and and kernel yield during both the years. The interaction of NG × Zn was also significant on the P, S and Fe of kernels. Leaf K and Fe contents were significantly influenced only by NG. The comparison between mean revealed that the highest kernel yield (5839 kg/ha), kernel number (93.5 kernels/plant), pod number (66.3 pods/plant) and kernel S (0.384%) were recorded from the plots applied with NG20 + Zn2. The highest leaf chlorophyll (3.83 mg/kg FW) and oil content (46.09%) were related to the treatment NG20 + Zn1. The plots applied with NG10 + Zn2 exhibited the highest kernel protein (17.92%). Based on the results, it can be stated that the NG and Zn as soil application and foliar spray respectively, improved peanut yield and qualitative traits hence can be recommended for similar climatic conditions

The efficacy of topical Royal Jelly on diabetic foot ulcers healing: A case series*

Background: Foot ulcers and infections are the major sources of morbidity in individuals with diabetes mellitus. This study aimed to evaluate the efficacy of topical Royal Jelly (a worker honey bee product) on healing diabetic foot ulcers. Methods: Diabetic patients with foot ulcers that were referred to our clinic at Khorshid Hospital, Isfahan, Iran; were evaluated three times a week and treated according to standard treatments consisted of offloading, infection control, vascular improvement and debridement if required. In addition, all ulcers were measured and then topical sterile 5% Royal Jelly was applied on the total surface area of the wounds. Eventually, they were covered with sterile dressings. Each patient was followed for a period of three months or until the complete healing. Results: A total of eight patients were enrolled in this study. Of these, two had two ulcers and, therefore, ten ulcers were evaluated. Two ulcers were excluded. Seven of the remained eight ulcers healed. Mean duration of complete healing was 41 days. One ulcer did not completely heal but improved to 40% smaller in length, 32% in width and 28% in depth. The mean length, width and depth reduction rates were 0.35 mm/day, 0.28 mm/day and 0.11 mm/day, respectively. Conclusions: Royal Jelly dressing may be an effective method for treating diabetic foot ulcers besides standard treatments