Preemptive Effect of Two Different (Intracuff and Intravenous) Routes of Dexamethasone Administration on Postoperative Sore Throat and Cough

Introduction: The most common complications following anesthesia intubation include postoperative sore throat, post-extubation cough, and hoarse voice. Currently, the use of preoperative Dexamethasone has been effective in controlling these complications. Therefore, the present study aimed to compare the preemptive effect of intracuff and intravenous routes of Dexamethasone administration for postoperative sore throat and cough. Materials and Methods: In the present clinical trial, 96 patients who underwent general anesthesia intubation were randomly assigned to three groups. The first group received 4 mg intracuff Dexamethasone, the second group received 4 mg intravenous Dexamethasone, and the third group was administered a placebo. Cough frequency and severity of a sore throat after extubation were investigated in the three groups. Results: Any significant difference was not observed among the three groups regarding hemodynamic variables (P>0.01); however, the incidence of cough was significantly lower in all the three groups (P<0.01). Also, the average severity of a sore throat in PAR and 1 h after surgery in the three groups was significantly lower (P<0.05). Moreover, no difference was detected in the groups regarding the severity of a sore throat within 24 h post-surgery (P>0.01). Conclusion: The use of two methods of intravenous and intracuff Dexamethasone administration before surgery reduced the incidence of postoperative cough and the severity of sore throat in patients.

A Comparative Study of the Detection of cAMP response element binding protein (CREB) in the Peripheral Blood of Alzheimer's Patients and the Healthy subjects as a Biomarker for the diagnosis of Alzheimer

Introduction: Alzheimer's disease is a neurodegenerative disease, which usually helps some biomarkers, such as amyloid proteins, to diagnose the disease. Therefore, the purpose of this study was to compare the expression of a protein binding protein to the adjuvant responder to circular adenosine monophosphate (CREB) in peripheral blood of patients to Alzheimer's and healthy elderly people as a biomarker for diagnosing Alzheimer. Materials and Methods: In this case-control study, 32 patients with Alzheimer's disease and 32 normal blood samples were taken. Using real time PCR, CREB expression was evaluated. Results: The mean CREB level in the case group was 0.89 ± 0.30 and in the control group was 1.01 ± 0.03. The mean of BDNF level in the case group was significantly higher than the control group (P <0.001). There was no significant relationship between the level of CREB with age, sex, MMSE score and Cornell scale for depression in dementia (P> 0.05). Conclusion: Reducing CREB levels in people with Alzheimer's disease can be a factor in diagnosis in comparison to healthy people.

The Impact of Educational Package on Nursing Students' Knowledge towards Fertility Preservation, a Quasi-Experimental Study

Background: Recent advances in diagnosis and treatment of cancers have resulted in survival improvement in young patients with cancer. Given the side effects of cancer treatments on the function of the reproductive system, health care providers need to be educated about the side effects of cancer treatment and fertility preservation. The aim of this study was to explore the effect of education on nursing students' knowledge towards fertility preservation methods in patients with cancer. Methodology: This was a quasi-experimental one-group pre-test post-test research study that was carried out by the nursing faculty at Islamic Azad University of Tonekabon in 2018. Data was collected through a two-part questionnaire, including demographic characteristics and 32 questions about the knowledge of fertility preservation in patients with cancer. The study intervention was an educational package which includes 8 sessions of small group education, planning questions, and a booklet. Students were asked to complete the questionnaire before starting an educational session and again two weeks after the last session. Results: The difference in the mean score of the nursing students’ knowledge before and after the educational package intervention was significant (P= 0.0001). Also, the knowledge rank of nursing students after the intervention was significantly better than before (P = 0.0001). There was a significant difference between the mean score of knowledge based on gender (0.0001), marital status (0.0001) and residency (0.0001). Conclusion: In conclusion, educational intervention towards fertility preservation had a positive effect on nursing students’ knowledge. Therefore, the importance of considering this new approach to fertility preservation in patients with cancer should be considered in the nursing curriculum as they consider as the main resource of the medical information to the patients

Conservative Treatment of Huge Retroperitoneal Hematoma Postpartum: Case Report

Introduction: Retroperitoneal hematoma are an important factor for hospitalization in patients with trauma and proper treatment is still under discussion and Controversial. We describe a successful case of conservative treatment of huge hematoma after cesarean section. Case presentation: An Iranian 34-year-old multigravida(G4L3) woman with three previous cesarean sections from Urmia province presented to our hospital with amniotic fluid leak. She had full-term pregnancy. Caesarean section was done. One day after caesarean section, she became dyspnea and had chest pain in left side. Embolism is suspected and enoxaparin was administered. According, hemoglobin decreased (HB:6.2) after administered the second dose of enoxaparin and a clear dullness percussion led tosuspected to hemorrhage and retroperitoneal hematoma was discontinued enoxaparin. After the patient is stable, the patient was discharged and retroperitoneal hematoma was followed up by ultrasonography and conservative treatment. Conclusion: Conservative treatment of retroperitoneal hematoma postpartum with good clinical evolution, depends on status of the patient, cause of injury and its evolution.

Antibacterial Activities of 5-Nitro-2-uryl and 5-Nitro-2-Imidazolyl Derivatives of 1,3,4-Thiadiazole

Introduction: Nitrofurans and nitroimidazoles are broad-spectrum antimicrobial agents, which affect the microbial DNA. The aim of the present study was to evaluate the new derivatives of these two groups of antimicrobials against certain Gram-positive and Gram-negative bacterial strains. Materials and Methods: Seven new derivatives of nitrofurans and nitroimidazoles were synthesized, and 6.4 mg of each derivative was dissolved in dimethyl sulfoxide. Then, 8 serial dilutions (0.5, 1, 2, 4, 8, 16, 32, and 64 μg/ml) of each derivative was prepared using Muller-Hinton broth, and the minimum inhibitory concentration for each derivative was measured and compared to ciprofloxacin (standard). Results: All the derivatives had no antibacterial effects against Gram-negative bacteria (minimum inhibitory concentration > 64 μg/ml); only 2-(5-nitro-2-furyl)-5-(n-pentylsulfunyl)-1,3,4-thiadiazole exhibited mild antibacterial effects against Klebsiella pneumonia (minimum inhibitory concentration of 16-32 μg/ml). The antibacterial effects of the derivatives against Gram-positive bacteria also showed variations from complete inhibition of the growth of Staphylococcus epidermidis and Bacillus subtilis (minimum inhibitory concentration < 0.5 μg/ml) by 2-(5-nitro-2-furyl)-5-(n-buthylthio)-1,3,4-thiadiazole to no inhibition of S. epidermidis and streptococcus pyogenes. Conclusion: These compounds have weak antibacterial effects; only two derivatives showed antibacterial effects similar to that of the positive control.

Post-treatment Guillain-Barre Syndrome in a Patient with Brucellosis; A Case Report

Introduction: Guillain-Barre Syndrome is an uncommon complication during acute brucellosis. Case presentation: In this study, we present a case of Guillain-Barre Syndrome in a 22-year old male patient with complaints of weakness in his lower limbs. He had a history of acute Brucella infection for four months and received antimicrobial medication. Conclusion: the patients can be affected by GBS after antimicrobial treatment.

Evaluating the Causes and Frequency of Frequent Referral to the Emergency Department of Imam Khomeini Educational Hospital in Sari

Introduction: Emergency department is one of the most important units of a hospital. In general, the most serious cases are referred to emergency department, and the highest numbers of hospital admissions occur in the emergency department. This study aimed to obtain a comprehensive estimate of the number of frequent visitors to the emergency department of Imam Khomeini educational hospital, Sari. Materials and Methods: This cross-sectional descriptive study was performed retrospectively by referring to the patient medical records at the Sari Imam Khomeini education hospital. The records were screened to identify frequent emergency department visitors in 2017. Data analysis was performed using SPSS 21. Results: The number of emergency department visitors in the Sari Imam Khomeini Hospital in 2017 was 29,765; of them, 594 (6.2%) were repeat visitors and were included in this study. The mean age of the frequent emergency department visitors was 56.17 years. The most common complaint was weakness and lethargy in 39.9% patients, abdominal pain in 30%, shortness of breath in 14%, and other causes in 14%. The most common underlying disorders were anemia, followed by obstruction pulmonary disease. Conclusion: We obtained detailed data of frequent emergency department visitors to aid the development of suitable evidence-based policies. New policies are necessary for the management of various sections of the emergency department and inpatient admissions. Such policies will allow better decision-making for non-emergency patients and outpatient admissions.

Risk Evaluation of Loss in Professional Efficiency, Health, and Work Safety Using Psychophysiological Factors

Introduction: A transformation in modern production and an increase in workload requires an improvement in the occupational psychophysiological selection, the search for new approaches for its implementation, and the creation of special ways for the evaluation of the psychophysiological state of workers. The aim of this investigation is to develop an approach for the quantitative evaluation of the efficient reduction in risk in worker’s occupational activity, and the probability of health and safety depletion during the entire life period of work. Materials and Methods: The investigation is based on the data of 110 psychophysiological indicators, received from a survey that encompassed the workers of operative service in electric power engineering industry of Ukraine. The data was examined using statistical tools, factor analysis, and multivariate regression models. Results: The developed technique made it possible to determine the statistical significance and to estimate the impact of the important phychophysiological factors on the level of success in the occupational activity of workers under dangerous circumstances. The model includes the variable that describes the age of the worker and provides analysis for 4 categories of ages. Conclusion: The important factors that influence the risk of reduction in occupational efficiency of the workers are variability, the total error, and the number of positive values according to the pendulum methodology; the average reaction time according to the square-circle technique; variability according to the square technique; and adaptability and time of the task performance according to the adaptability methodology. The workers belonging to the same age group do not significantly change the risk of depletion in their occupational efficiency.

Ruptured Aneurysm of Sinus of the Valsalva: Case Series

Introduction: We present three cases of ruptured sinus of Valsalva aneurysm concomitant with a cardiac lesion in 2 cases of ventricular septal defect and 1 case of bicuspid aortic valve with mild aortic insufficiency. Case presentation: In 2/3 cases, the site of ruptured sinus of Valsalva aneurysm originated from right coronary cusps and one from non-coronary cusps. Both ruptured sinus of Valsalva aneurysm from right coronary cusps communicated to right ventricle, and one that originated from non-coronary cusps ruptured to right atrium. All cases were diagnosed by transthoracic echocardiography and confirmed by transesophageal echocardiography. Two underwent the surgery, while one did not want to continue treatment. Conclusion: ruptured sinus of Valsalva aneurysm is a rare cardiac anomaly. In the Eastern countries, the most common associated anomalies with ruptured sinus of Valsalva aneurysm are ventricular septal defect and aortic regurgitation. Ruptured sinus of Valsalva aneurysm mainly originates from right coronary cusps and is ruptured into right ventricle. Transthoracic echocardiography and transesophageal echocardiography are employed to confirm the diagnosis. In this cohort, the coexistences of ruptured sinus of Valsalva aneurysm with ventricular septal defect and aortic regurgitation (case 1), ventricular septal defect (case 2), aortic regurgitation and bicuspid aortic valve (case 3) are observed.

Linkage Between Serum Vitamin D and Precancerous Colon Polyps: Letter to Editor

Colon cancer is the third most common type of cancer in the USA and accounts yearly for 11% of all cancer deaths (Center for Disease Control and American Cancer Society). Thus, identifying strategies that reduce its incidence is critically important. Calcitriol, the most active form of vitamin D, is a pleotropic hormone with a wide range of biological activities. Due to its ability to regulate calcium and phosphate metabolism, 1,25D3 plays a major role in bone health. In addition, 1,25D3 binds to the vitamin D receptor and thereby regulates the expression of a number of genes which control growth, differentiation and survival of cancer cells. Although a well-recognized physiological role of vitamin D is the regulation of calcium and phosphate metabolism, recent studies suggest a much broader range of biological functions of vitamin D, including potential anti-neoplastic effects. Garland et al. discovered in 1980 that colon cancer mortality rates in the U.S. were highest in places where populations were exposed to the least amount of sunlight, and proposed that vitamin D might be a protective factor against colon cancer. Since then, extensive studies have reported anti-neoplastic actions of vitamin D, particularly in colorectal cancer.