Research articles
Farnaz Moslemi; Sousan Rasooli; Marjan Dehdilani; Homayoun Sadeghi-Bazargani; Mahnaz Dehdilani
Volume 20, Issue 7 , July 2018, Pages 1-9
Abstract
Background: Pain after laparoscopy may still be moderate to severe due to stretching of the intraabdominal cavity and peritoneal inflammation. Systemic Lidocaine with anti-inflammatory properties may reduce this pain.Objectives: The aim of this study was to evaluate the effect of perioperative intravenous ...
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Background: Pain after laparoscopy may still be moderate to severe due to stretching of the intraabdominal cavity and peritoneal inflammation. Systemic Lidocaine with anti-inflammatory properties may reduce this pain.Objectives: The aim of this study was to evaluate the effect of perioperative intravenous infusion of Lidocaine on postoperative pain relief after the gynecologic laparoscopic procedure. Methods: A double-blind, randomized clinical trial study was conducted in Iran, during the years 2014 and 2015. A sample of 60 females with American anesthesiology association (ASA) physical class I or II, who were scheduled for gynecologic laparoscopy wereselected through consecutive sampling and were randomly assigned to receive either intravenous Lidocaine or Normal saline, as placebo, prior to induction of anesthesia and until the end of surgery. The severity of postoperative pain was evaluated starting at the recovery unit until 24-hours postoperatively for a total of 8 times using the visual analogue scale (VAS) scoring system. Time to first analgesic request, total analgesic dose used in the first 24-hours, and any probable postoperative complications were recorded. Risk ratio (RR) and number needed to treat (NNT) were used to analyze the data along with the generalized linear model for multivariate analysis of repeated measurements over time.Results: The VAS at recovery was lower at recovery with a mean score of 2.8 in the Lidocaine group versus 3.9 in the control group (P = 0.02). Results of generalized linear modeling revealed that pain intensity decreased over time in both groups (P = 0.02), and the groups had different trend slopes in pain intensity over repeated measurements at various time points up to 24 hours after laparoscopy, while controlling for the baseline VAS at recovery and ASA PS (P = 0.016). However, when controlling for use of the pain- killers, the trends were not found to be different. Patients in the Lidocaine group were 3.8 times more likely not to need postoperative analgesic (95% CI: 1.4 to 9.9). Mean total analgesic dose was 1.3 mg in the Lidocaine group versus 38.2 mg in the control group differing significantly between the 2 groups (P < 0.01). Use of Lidocaine was associated with lower postoperative nausea and agitation. Conclusions: Systemic perioperative Lidocaine could improve the pain pattern and severity as well as nausea and agitation aftergynecologic laparoscopy. Although no significant side effects were detected in this study, the benefits of the intervention should be weighed against its safety.
Research articles
Fatemeh Assarian; Fatemeh Sadat Ghoreishi; Mahbubeh Borna; Mohammadreza Razzaghof
Volume 20, Issue 7 , July 2018, Pages 1-7
Abstract
Background: Obsessive-compulsive disorder (OCD) is the fourth common psychiatric disorder. Among the anxiety disorders, OCD has the least therapeutic response and 40-60% of OCD patients do not satisfactorily respond to the first-line standard treatment known as treatment-resistant OCD. One of the best ...
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Background: Obsessive-compulsive disorder (OCD) is the fourth common psychiatric disorder. Among the anxiety disorders, OCD has the least therapeutic response and 40-60% of OCD patients do not satisfactorily respond to the first-line standard treatment known as treatment-resistant OCD. One of the best therapeutic strategies is the augmentation therapy, which is adding antipsy- chotics to the standard treatment (SSRIs). Objectives: This study was aimed at comparing the efficacy of Risperidone and Aripiprazole as augmentation therapy in the resis-tant cases of obsessive-compulsive disorder. Methods: In this double-blind randomized clinical trial, 100 patients with treatment-resistant OCD were diagnosed based on the DSM-IV-TR and were followed for 12-weeks. The patients were randomly divided into two groups of Aripiprazole and Risperidone and received an average daily dose of 5 mg and 1.5 mg for twelve weeks, respectively. The efficacy of treatment was measured and compared by the Yale-brown obsessive-compulsive scale (Y-BOCS) at 4, 8 and 12 weeks. Results: The mean Y-BOCS score of patients in Risperidone and Aripiprazole groups were 25.26 ± 4.17 and 25.02 ± 4.46; respectively and had no significant difference (P = 0.79) at the beginning of the trial. At the end of the study (12th week), it was changed for the Risperidone and Aripiprazole groups to 20.00 ± 4.45 and 16.24 ± 4.41, respectively (P < 0.001). Furthermore, there was a significant decreasing trend of Y-BOCS scores in both groups, which was demonstrated by the repeated measurement analysis (P < 00.1). Conclusions: It was found that both Aripiprazole and Risperidone could be effective in the treatment of treatment-resistant OCD patients. However, Aripiprazole showed a higher efficacy compared to Risperidone.
Research articles
Mohammad Azizkhani; Fereshteh Ghorat; Sayed Mohammad Ali Soroushzadeh; Mehrdad Karimi; Saeed Yekaninejad
Volume 20, Issue 7 , July 2018, Pages 1-10
Abstract
Context: Neck pain is a prevalent complaint. Several clinical trial studies were conducted to evaluate the effects of cupping therapy on neck pain. The objective of this study was to assess the evidence for the effectiveness of cupping therapy as an intervention to conservative management of neck pain. ...
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Context: Neck pain is a prevalent complaint. Several clinical trial studies were conducted to evaluate the effects of cupping therapy on neck pain. The objective of this study was to assess the evidence for the effectiveness of cupping therapy as an intervention to conservative management of neck pain. Evidence Acquisition: We performed a systematic search in PubMed, Ovid, MEDLINE, CINAHL, EMBASE, Cochrane Library, a web of science, and Iranian medical databases through March 2017 without time restrictions. All clinical trials were done on non- specificneck pain, where at least one of the therapies assessed pertains to cupping therapy, were included in the study. Outcomes were pain intensity (e.g., Visual Analogue Scale, VAS), disability (e.g., Neck Disability Index, NDI), quality of life on the SP36 questionnaire, and other outcomes due to neck pain. A meta-analysis was performed to assess the effectiveness of cupping in managing neck pain. Results: Meta-analysis of five trials revealed significant differences in pain relief in favor of cupping therapy compared with the control group (VAS 100 cm, MD, -0.84 (-1.22, -0.46), I2 = 54.7%). Furthermore, a meta-analysis of six studies revealed that cuppingtherapy was clinically superior to the control group in patients with neck pain (SMD = -0.60 (-0.86, -0.35), I2 = 16.4%). Assessment of quality of life using the SP36 questionnaire showed that cupping therapy increased the quality of life in patients with neck pain compared with the control group (SMD = -0.56 (-0.20, -0.92), I2 = 51.4%).Conclusions: This study provides some evidence that cupping therapy may improve treatment of patients with neck pain.
Research articles
Soghra Nikoomazhab; Parvin Abedi; Azam Honarmandpour; Mohammad Reza Haghdoust
Volume 20, Issue 7 , July 2018, Pages 1-8
Abstract
Background: The most vulnerable time to develop mood disorders such as sadness, depression, and psychosis is the postpartum period. Postpartum blues is the most common mood disorder and can endanger the relationships between mother, child, and family, and in case of lack of appropriate treatment can ...
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Background: The most vulnerable time to develop mood disorders such as sadness, depression, and psychosis is the postpartum period. Postpartum blues is the most common mood disorder and can endanger the relationships between mother, child, and family, and in case of lack of appropriate treatment can cause irreparable damages.Objectives: The current study aimed at investigating the effect of evening primrose oil on the intensity of postpartum blues among primiparous females. Methods: The current double-blind, randomized, controlled clinical trial was conducted from December 2012 to November 2013 on 132 primigravida females referred to health centers of Ahvaz, Iran. They were randomly divided into two groups of 66 to receive a daily dose of 1 g of evening primrose oil capsules (intervention group) or similar placebo capsules (control group) from the be- ginning of the 37 weeks of pregnancy up to 2-weeks postpartum. Females in both groups were asked to complete the Edinburg questionnaire on the days 4, 10, and 14 postpartum. Data were analyzed using the t-test, Chi-square test, and repeated measures, and P < 0.05 was considered significant. Results: There was a statistically significant difference (P = 0.0001) between the two groups regarding the severity of the postpartum blues (the severity in the intervention group was less than that of the placebo group, P = 0.0001). The score of Edinburgh question- naire was significantly less in the intervention group compared with that of the control group on the days 4, 10 (P = 0.0001), and 14of postpartum (P = 0.01) (P = 0.014). The averages of Edinburgh score in the intervention group was significantly less compared with those of the control group on the days 4 (10.5 ± 0.57 vs. 13.3 ± 3.28; P = 0.0001), 10 (11.2 ± 1.22 vs. 14.9 ± 3.6; P = 0.001), and 14 postpartum (11.7 ± 1.3 vs. 13.05 ± 2.6; P = 0.08). Conclusions: The use of evening primrose oil effectively reduced the severity of postpartum blues.
Research articles
Farnaz Faroughi; Sakineh Mohammad-Alizadeh Charandabi; Yousef Javadzadeh; Mojgan Mirghafourvand
Volume 20, Issue 7 , July 2018, Pages 1-9
Abstract
Background: Women with borderline gestational diabetes mellitus (BGDM) have a higher risk of complications in comparison with normal women. Objectives: The aim of this study was to determine the effects of garlic pill on fasting blood sugar (FBS) and relapse of prediabetes symptoms (primary outcomes), ...
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Background: Women with borderline gestational diabetes mellitus (BGDM) have a higher risk of complications in comparison with normal women. Objectives: The aim of this study was to determine the effects of garlic pill on fasting blood sugar (FBS) and relapse of prediabetes symptoms (primary outcomes), as well as blood pressure, neonatal anthropometric indices, and mode of delivery (secondary out- comes) in prediabetic pregnant women.Methods: This triple-blind, randomized clinical trial was conducted on 49 women with prediabetes at 24 to 28 weeks of gestation in Tabriz, Iran, during 2015 - 16. The participants were assigned to the intervention (n, 26) and control (n, 23) groups using block randomization. The intervention group received a 400-mg garlic pill per day, while the control group received a placebo pill per day for eight weeks. Four and eight weeks following the intervention, FBS and blood pressure were measured. The newborns’ an- thropometric indices and mode of delivery were also recorded after delivery.Results: The mean FBS level in the garlic group decreased from 106.6 (11.1) mg/dL before the intervention to 83.6 (6.3) mg/dL at four weeks after the intervention and 79.4 (6.1) mg/dL at eight weeks after the intervention (adjusted mean difference, -3.7). The garlic pill also led to a significant decrease in prediabetes symptoms at four weeks after the intervention (P < 0.001) and diastolic blood pressure at four and eight weeks after the intervention (P = 0.041), compared to the control group. No significant difference was observed between the groups in terms of systolic blood pressure at four and eight weeks after the intervention, anthropometric indices, or mode of delivery.Conclusions: The results revealed that garlic pill could reduce FBS level, prediabetes symptoms, and diastolic blood pressure. How- ever, further research with a larger sample size is required for more accurate results.
Case reports
Jun-Li Tsai; Shang-Feng Tsai
Volume 20, Issue 7 , July 2018, Pages 1-4
Abstract
Introduction: Necrotizing fasciitis is not rare in clinical practice, but a Klebsiella pneumoniae-related is rare, especially in patients undergoing hemodialysis. Many patients with necrotizing fasciitis have a miserable outcome even though they receive amputation. Case Presentation: A 76-year-old male ...
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Introduction: Necrotizing fasciitis is not rare in clinical practice, but a Klebsiella pneumoniae-related is rare, especially in patients undergoing hemodialysis. Many patients with necrotizing fasciitis have a miserable outcome even though they receive amputation. Case Presentation: A 76-year-old male was initially admitted to the center due to suspected cellulitis in Taichung, Taiwan. However, the treatment response was beyond expectation, and a plain film X-ray was performed on his leg. To our surprise, it showed ap- parent gas and calciphylaxis. Easy examination detected the severe disease. Immediate surgical debridement was performed, and his legs and life were successfully saved, although the outcomes of the disease were miserable. The tissue culture yielded Klebsiella pneumoniae. This pathogen, related to necrotizing fasciitis, is rare in the currently published articles. The possible risk factors were the endemic region, diabetes mellitus, calciphylaxis, old age, frequent iron supplements, and repeated tissue hypoperfusion during hemodialysis.Conclusion: In conclusion, meticulously and timely diagnosed necrotizing fasciitis in high-risk groups is the most important factor to ensure a positive patient outcome.
Research articles
Mahdiyehsadat Eftekharafzali; Mitra Mehrabani; Haleh Tajadini; Bijan Ahmadi; Mohammad Javad Zahedi
Volume 20, Issue 7 , July 2018, Pages 1-7
Abstract
Background: Functional dyspepsia (FD) is one of the most common problems around the world. Pistacia atlantica has beneficial effects in gastrointestinal disorders and is used for treating functional dyspepsia in Persian Medicine.Objectives: The aim of this study was to assess the effect of “Pistacia ...
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Background: Functional dyspepsia (FD) is one of the most common problems around the world. Pistacia atlantica has beneficial effects in gastrointestinal disorders and is used for treating functional dyspepsia in Persian Medicine.Objectives: The aim of this study was to assess the effect of “Pistacia atlantica” (Baneh) on functional dyspepsia.Methods: This randomized, double-blind, placebo-controlled trial was carried out on 119 patients (18 to 60 years old) with func- tional dyspepsia based on Rome III criteria. Subjects were randomly divided to intervention (n = 61) and placebo (n = 58) groups. Participants received capsules twice daily (500 mg capsules containing 350 mg Pistacia atlantica resin plus 150 mg sugar in the inter- vention group, and 500 mg capsules containing 350 mg starch powder plus 150 mg sugar in the placebo group) for four weeks and they were followed up for one month. The intensity and frequency of gastrointestinal symptoms, such as fullness, bloating, nausea, pain, and burning were assessed using the questionnaire on arrival, two and four weeks, and one month after the intervention. Results: Fifty-three patients in the Pistacia atlantica group and 48 patients in the placebo group completed the study. The severityand frequency of gastrointestinal symptoms, such as early satiation nausea, pain, and burning were significantly decreased in the Pistacia atlantica group. For example, severity of early satiation was 1.67 ± 0.13 in pistacia and 2.54 ± 0.17 in placebo groups in eight weeks (P > 0.001) and frequency of this symptom was 2.39 ± 0.27 and 4.41 ± 0.34 in Pistacia and placebo groups, respectively, in eight weeks (P > 0.001), which was significantly decreased in the Pistacia group. No serious adverse effects were reported. Conclusions: This study revealed that Pistacia atlantica is significantly effective in functional dyspepsia symptoms.
Research articles
Nurgul Gungor Tavsanli; Sevgi Nehir
Volume 20, Issue 7 , July 2018, Pages 1-10
Abstract
Background: End-stage renal failure (ESRD) deteriorates the quality of life of patients, as it increases their dependence on others and reduces their self-esteem. Objectives: This study was conducted to investigate whether body image perception and social functioning of dialysis patients with End-stage ...
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Background: End-stage renal failure (ESRD) deteriorates the quality of life of patients, as it increases their dependence on others and reduces their self-esteem. Objectives: This study was conducted to investigate whether body image perception and social functioning of dialysis patients with End-stage renal failure (ESRD) differed in dialysis patients with chronic renal failure (CRF). Methods: This case-control study included 120 patients, who underwent dialysis treatment in a state hospital from November 2014 to January 2016. The patient information form, body image scale, and social functioning scale were used for data collection. Data were analyzed using descriptive statistics (e.g., frequency, percentage, and mean), Chi-square test, independent t-test, and correla- tion tests.Results: Among ESRD patients, 88.6% were ≥ 56 years old, 65.7% were male, 97.1% underwent dialysis three times a week, and 97.1% were shunted. On the other hand, among patients with CRF, 71.8% were ≤ 55 years old, 51.8% were male, 52.7% underwent dialysis three times a week, and 50.8% were shunted. Regarding body image, 51.3% of ESRD patients, whose children noticed the change in their body image, felt most uncomfortable with the change in their body image, while 48.2% and 22.0% of CRF patients, whose children or others noticed the change in their body image, felt most uncomfortable, respectively; the difference between the groups was significant (P < 0.05).Conclusions: In the present study, there was no significant difference among CRF and ESRD patients in terms of body image percep- tion. However, there were differences in terms of social functioning. In fact, social functioning of CRF patients was superior to the ESRD group. It was concluded that better perception of body image is associated with the better social functioning of these patients.
Research articles
Ailin Talimkhani; Iraj Abdollahi; Maryam Zoghi; Elaheh Talebi Ghane; Shapour Jaberzadeh
Volume 20, Issue 7 , July 2018, Pages 1-7
Abstract
Background: Unihemispheric concurrent dual-site anodal transcranial direct current stimulation (a-tDCSUHCDS) of the primary mo- tor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) are introduced as effective techniques on M1 corticospinal excitability enhancement and its after-effects. Objectives: ...
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Background: Unihemispheric concurrent dual-site anodal transcranial direct current stimulation (a-tDCSUHCDS) of the primary mo- tor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) are introduced as effective techniques on M1 corticospinal excitability enhancement and its after-effects. Objectives: The current study aimed at investigating the potential effects of multiple sessions of a-tDCSUHCDS of M1-DLPFC on motor skills learning in healthy individuals.Methods: The randomized, clinical trial was conducted on a total of 37 volunteers completed all sessions of the study and were randomly divided into two groups of a-tDCSUHCDS and sham stimulation by the block randomization method. The current study was performed from January to May 2017 in Iran. Participants attended daily 20-minute motor training sessions for three consecu- tive days, while they concurrently received a-tDCS. Motor skills were assessed before the intervention (day 1), immediately after the intervention (day 3), and one week after the completion of the intervention.Results: A total of 37 participants were included in the data analysis. Immediately after the completion of the intervention on day 3, mean skills in the experimental and control groups were 0.33 and 0.30, respectively. One week after the completion of the interven- tion, mean skills in the experimental and control groups were 0.36 and 0.29, respectively. The trend of motor learning considerably increased in the experimental (0.17; P < 0.001) and control (0.11; P < 0.001) groups. No significant difference was observed in mo- tor learning immediately after the intervention between the groups (P = 0.23), while there was a significant difference in long-term offline learning between the groups (P = 0.04).Conclusions: Greater motor skills in the a-tDCSUHCDS group compared with the sham tDCS group at one-week retention indicated the robustness of the a-tDCSUHCDS effect.
