The effect of chronic caffeine intake on pentylenetetrazole (PTZ)-induced seizure threshold and nitric oxide metabolites in mice

Background: Long-term caffeine intake decreases seizure susceptibility and has protective effect. This protective effect of caffeine may be due to the blockade of A2A adenosine receptors. Considering that activation of adenosine A2A receptors elevates nitric oxide production, the aim of the present study was to investigate the effect of chronic caffeine intake on the pentylenetetrazole (PTZ)-induced seizure threshold and measurement of nitric oxide metabolites levels in mice. Materials and Methods: In this study, NMRI male mice (weighing 25-30 g) were divided into 3 groups including one control and two experimental groups (n=9 in each group). PTZ- induced clonic seizure was measured following oral intake of caffeine in experimental groups (100 and 300 mg/L in the drinking water) or only tap water in the control group for 90 days. Measurement of nitric oxide metabolites in the brain tissues was done at the end of the experiments using the Greiss method. Results: The chronic caffeine intake at concentrations of 100 and 300 mg/L in the drinking water for 90 days did not change the seizure threshold. On the other hand, both concentrations of caffeine significantly decreased nitric oxide metabolites levels compared to the control group (P<0.05). Conclusion: The results of this study confirmed and extended previous studies that chronic caffeine intake has no effect on seizure. Reduced levels of nitric oxide metabolites and resultant decreased neuronal excitability may be the main protective mechanism of the chronic caffeine intake. Blockade of the A2A adenosine receptors following the chronic caffeine intake may be involved in decreased levels of nitric oxide metabolites

Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia: It Is Not Always As It Is Expected

Observation of Coincident arrhythmias is not uncommon but the co-existence of idiopathic verapamil sensitive left ventricular tachycardia (ILVT) with other arrhythmias is very rare. We hereby presented a 30 year old male patient with a history of frequent episodes of palpitations and sustained narrow complex tachycardia. During electrophysiologic study two arrhythmias, one with narrow complexes which was shown to be typical atrioventricular nodal re-entrant tachycardia and the other with wide QRS complexes and right bundle branch block and left axis morphology, compatible with ILVT, were inducible. Radiofrequency catheter ablation of both arrhythmias was done at two consecutive sessions. The patient has remained asymptomatic without antiarrhythmic therapy for the past six months

The acute effects of Water-pipe smoking on Ankle Brachial Index: A cross-sectional Study

Introduction: Numerous studies have shown that waterpipe smokers as well as cigarette smokers are at increased risk of cardiovascular diseases. In this study we sought to evaluate the acute effects of waterpipe smoking (WPS) on ankle brachial index (ABI), an indicator of atherosclerosis and an independent predictor of mortality.Methods: This prospective cross-sectional study was conducted in October 2017. Twenty nine healthy male volunteers who had a history of WPS were enrolled. Demographic data and cigarette and WPS status were recorded via self-reporting questionnaire. Resting heart rate and brachial systolic and diastolic blood pressures of participants were recorded first and ABI measurements were done. Then subjects smoked waterpipe for about 20 minutes and ABI was measured immediately after WPS.Results: A total of 29 male adults with a mean age of 32 ± 9 years were included. The right-sided ABI was 1.05 ± 0.11 before WPS and significantly decreased to 0.98 ± 0.13 after WPS (P value = 0.006). The left-sided ABI before and after WPS were 1.09 ± 0.20 and 0.95 ± 0.18 respectively and the decrease was statistically significant (P value = 0.037). Vital signs before and after one session of WPS showed significant changes in heart rate (P &lt; 0.001) and no significant changes in systolic and diastolic blood pressures (P = 0.09, and P = 0.14, respectively).Conclusion: WPS has an acute effect on ABI as well as heart rate so it should be considered as a potential risk factor for cardiovascular diseases

Evaluation and determining of the Pattern of the Human Albumin Utilization at Shahid Rahimi Hospital, Khorramabad, Iran

Background: The World Health Organization (WHO) has supported many intervention strategies, including executive, educational, and monitoring proceedings to improve the evaluation of drug use and the drug management system. Since the resources are limited, it is essential to utilize existing resources properly. Serum albumin is the most abundant blood protein produced in the liver. Different forms of albumin are available in the market and employed to treat hypovolemia, Cirrhotic ascites, severe burns, septic shock, hyperstimulation syndrome, etc. Due to the high price of albumin and its importance for saving patient’s lives.Methods: precisely according to the determined protocols, and it’s unreasonable and irrational medication should be avoided. Statistical analysis was performed in Shahid Rahimi Hospital of Khorramabad, Iran, from March 2018 to March 2019. Albumin administration for randomly selected patients receiving albumin in different wards was evaluated. The main sources to retrieve information were pharmacy drug folders, patient folders (including laboratory information), and nursing folders. Age, sex, weight, ward, albumin level, symptoms, and final dose were recorded for each patient. Contraindications to the administration of albumin or any caution in its use were also considered. Data were analyzed by using SPSS16 and Excel software. Independent T-test and Chi-square test were employed to compare quantitative and qualitative variables. 271 patients were studied, including 160 men and 111 women.Results: The two male and female surgical wards with 41 patients had the highest percentage of patients admitted with albumin administration. Also, the most common cause of albumin administration in patients was hypoalbuminemia. 55% of albumin prescriptions in Shahid Rahimi Hospital of Khorramabad were irrational, driving a substantial financial burden for the healthcare system and patients. Among all the prescribed cases, only 5.2% were approved by the pharmacist. Finally, 77.1% of patients recovered, and 22.9% died.Conclusion: Considering that the highest percentage of patients receiving albumin administration, both among patients with irrational administration and in general, were in men's and women's surgical wards, it is recommended that the drugs prescribed in these wards be further investigated and get pre- Approved by a pharmacist to prevent higher medical costs for patients and healthcare system.          Keywords: Albumin; Hypovolemia; Cirrhotic Ascites; Septic Shock; Hyperstimulation Syndrome    

The spiritual experiences of students of Iran University of Medical Sciences in 2020

Background: Psychologists consider the acceptance of spirituality as a cultural reality and by acknowledging the positive effects of spirituality on mental health, the World Health Organization also considers the spiritual dimension as the physical, social and emotional dimensions of human existence. Spirituality is a genuine and inner experience that It lies in the nature of every human being. The purpose of this study was to investigate the spiritual experiences of students of Iran University of Medical Sciences in 2020. Methods: The present study was descriptive-analytical. The sample size of 500 students of Iran University of Medical Sciences in 2020 was estimated. For sampling, a list of students was prepared from the faculty education and the sample was selected by regular random sampling method through random number generation software. The data collection tool was a questionnaire with demographic questions and spiritual experiences. The collected data were analyzed after completion with SPSS 20 software. A significance level of 0.05 was considered. Results: The mean score of the meaning-finding component in life was obtained at 57.98. There was a significant relationship between spiritual experiences and gender, age and educational level of students, while no significant relationship was found between spiritual experiences and marital status and residence. Conclusion: In order to ensure the spiritual health of students, it is necessary to plan properly to create a meaningful atmosphere in universities for different age and gender groups

Basic Needs of Mothers with Children Undergoing Hemodialysis: A Meta-synthesis of Qualitative Studies

Background: Mothers of children undergoing hemodialysis encounter severe changes in their daily lives. It is of utmost importance to raise the awareness of treatment teams about the needs of these specific groups of mothers and different problems they may experience. The reason is that it can help health care professionals to support the mothers to fulfill their roles as the primary caregivers of such children. Aim: This study aimed to identify basic needs in mothers of children undergoing hemodialysis. Method: This meta-synthesis review of qualitative studies investigating the needs and experience of mothers whose children had kidney disease and published from January 1997 to October 2017. The articles were searched in four databases, including Web of Science, EMBASE, PubMed, and ProQuest. The search process was accomplished using the keywords “chronic kidney disease,” “hemodialysis,” “children,” “mothers,” “parents,” “caregivers,” “needs,” “experiences,” “perspectives,” and “perceptions”. Finally, 7 articles were chosen out of 567 papers and theses. The MAXQDA software was used to facilitate data management. Results: The systematic review of the qualitative studies revealed three main themes, including the need for child care management skills, the need to maintain family cohesion, and the need for emotional–psychological support. Implications for Practice: Mothers of children under hemodialysis should be considered as nursing clients. Accordingly, a multidisciplinary team can empower mothers to take care of the children under hemodialysis and preserve family coherence, as well as supporting them emotionally and psychologically

Evaluation of the Overall Quality of the Health Technology Assessment Educational Program from the Perspectives of University Professors and Learners in Iran

Abstract Background: Failure to evaluate, examine, assess the requirements, and determine the quality level of the curriculum of educational fields will result in low-quality and obsolete curricula. It will prevent the academic areas from achieving their goals. Therefore, this study evaluates the overall quality of Iran's Health Technology Assessment (HTA) curriculum from the perspectives of instructors and students. Methods: The study was conducted with 127 instructors, students, and Health Technology Assessment (HTA) graduates at Tehran, Iran, Kerman, and Yazd Universities of Medical Sciences. A researcher-made questionnaire did the data collection. Cronbach's alpha coefficient for the entire questionnaire was 91%, and the intra-domain correlation coefficient was 87%, indicating that the instrument is appropriate. The data were analyzed with descriptive and analytical tests based on the normality or non-normality of the test using ANOVA, Kruskal-Wallis, two-way ANOVA, and the Friedman. Results: This research was completed by 114 of 127 participants. According to a review of diverse perspectives, the quality of the educational program in terms of design elements in special courses and executive elements in compensatory courses falls within the range of average (3.66 > mean > 2.33) or average (3.66 > mean > 2.33), to good (mean > 2.33). In addition, the majority of executive elements from special courses and design elements from compensatory classes are in an unfavorable position, with a mean>1.66 to average (3.66> mean >2.33). Conclusions: Problems and inadequacies are observed in a few curriculum implementation elements. Therefore, modifications should be made to remedy the inappropriate details and remove implementation obstacles to enhance the interested groups' capability and practical skills.

The Relationship between Risk Factors of Head Trauma with CT Scan Findings in Children with Minor Head Trauma Admitted to Hospital

BACKGROUND: In emergency medicine for determining the intracranial injury (ICI) in children with head trauma, usually brain CT scan is performed. Since brain CT scan, especially in children, has some disadvantages, it is better to find a procedure which could help to choose only the children with real head trauma injury for brain CT scan.AIMS: The aim of this study is to find such procedure. This study was descriptive, analytic and non-interventional.METHODS: We reviewed the archived files of children with head trauma injuries referred to the emergency department of Imam Hossein Hospital within two years. Patient’s CT scan findings and head trauma risk factors were evaluated in this study.RESULTS: Out of 368 patients, 326 patients had normal brain CT scan. 28 of them showed symptoms of ICI consisting intraventricular haemorrhage (IVH), contusion, subarachnoid haemorrhage (SAH), subdural haemorrhage (SDH), epidural hematoma (EDH), and pneumocephalus. Twenty-seven patients showed skull FX, which 14 of them had an Isolated fracture, and 13 of them also showed symptoms of ICI. Since patients with isolated FX usually discharge quickly from Emergency Department; their data did not include in results of the study. The patients have been divided into two groups: 1- ICI, 2- without ICI. RR (relative risk), CI (Confidence interval) and sensitivity, positive predictive value (PPV), negative predictive value (NPV) and association of these risk factors with ICI were assessed with the Chi-2 test. In the end to determine the indications of CT scan, the presence of one of these five risk factors is important including abnormal mental status, clinical symptoms of skull FX, history of vomiting, craniofacial soft tissue injury (including subgaleal hematomas or laceration) and headache.CONCLUSIONS: For all other patients without these risk factors, observation and Follow Up can be used which has more advantages and less cost