Effects of gabapentin on early postoperative pain, nausea and vomiting in laparoscopic surgery for assisted reproductive technologies

Prevention and treatment of postoperative pain, nausea and vomiting continues to be a major challenge in postoperative care. This study was designed to compare the effects of small dose of oral gabapentin with placebo as premedication on early postoperative pain, nausea and vomiting in patients undergoing ambulatory laparoscopic surgery for Assisted Reproductive Technologies (ART). Seventy women undergoing ambulatory laparoscopic surgery were randomly assigned to receive oral gabapentin 300 mg or placebo as premedication 1 h before surgery. Patients were anesthetized with the same anesthetic techniques. Duration of anesthesia, severity of postoperative pain and presence of Post Operative Nausea and Vomiting (PONV) were compared between the study groups. Demographic data and the duration of anesthesia were not statistically different between the study groups. There were significant differences in median VAS scores (25th-75th) measurements at all time points in the study groups (p < 0.05). Ten patients (28%) in control and one patient (0.02%) in gabapentin group required additional IV analgesic that was statistically significant (p = 0.012). Two patients in gabapentin and nine patients in placebo group had nausea (p = 0.022). None of patients in gabapentin but four patients in placebo group had vomiting (p = 0.114). Administration of oral gabapentin 300 mg before ambulatory laparoscopic surgeries, decreased postoperative pain, analgesic requirement and nausea.     

Comparison the effects of metoclopramide and dropridol associated with dexamethasone on post operative nausea and vomiting

The aim of study was, comparison of effects of Metoclopramide and Dropridol associated with Dexamethasone on prevalence of nausea and vomiting after operation was considered. In this study 160 patients ASA physical status I were divided into two groups. In both groups, premedication and induction of anesthesia were given equally according to weight. To the first group, Metoclopramide associated with Dexamethasone and to the second group, Dropridol associated with Dexamethasone was ordered. At the end of the operation, after removing tracheal tube, prevalence of nausea and vomiting in both groups was considered after 2 h and results were analyzed with t-test and Chi-square. Ratio of nausea and vomiting after operation in the first group was 24% and in the second 8%. So results show that prevalence of nausea and vomiting in the second group was considerably lower than the first group (p < 0.004). According to the results of this study our conclusion, Dropridol with dexamethasone given at the before of general anesthesia was more effective in decreasing the prevalence of nausea and vomiting in patients compared with metoclopramide with dexamethasone.     

Comparison of ketamine and fentanyl for postoperative pain relief in children following adenotonsillectomy

Adenotonsillectomy has a high incidence of postoperative pain. Therefore, the purpose of this study was to evaluate the effectiveness and safety of either ketamine or fentanyl for postoperative pain relief in children following adenotonsillectomy. Sixty children aged 3-12 years, scheduled for adenotonsillectomy, were enrolled in this randomized, double-blind study. Patients were divided into two groups of 30 cases and received intravenous ketamine (0.5 mg kg(-1)) or fentanyl (1 microg kg(-1)). Modified Hannallah pain scale or Observational Pain Scores (OPS), nausea, vomiting, bleeding, rescue analgesia, sedation and post-anesthesia recovery scores were recorded both at first and 15th minute postoperatively. Moreover, patients receiving ketamine (group 1) or fentanyl (group 2) had comparable OPS and sedation score both on arrival and at 15th minute in the recovery room (p > 0.05). Although rescue analgesics were similarly required in both groups (p > 0.05), the time to reach rescue analgesia was shorter in group 1 (p = 0.001). Only one patient in fentanyl group had nausea and vomiting in the first 15 min that needed antiemetic in the recovery room. In conclusion, intravenous fentanyl (1 microg kg(-1)) compared with intravenous ketamine (0.5 mg kg(-1)) might provide extended time to first analgesic in children undergoing adenotonsillectomy. Interestingly, fentanyl and ketamine did not differ in post-operative vomiting.     

Comparing analgesic effects of a topical herbal mixed medicine with salicylate in patients with knee osteoarthritis

Knee osteoarthritis is the most common cause of disability among people and it is a common disease of joints that can lead to cartilage damage. In this study the analgesic effects of a herbal ointment containing cinnamon, ginger, mastic (Saghez) and sesame oil is compared with Salicylate ointment in patients suffering from knee osteoarthritis. It was a double-blind randomized controlled trail study. Patients with diagnosed arthritis were involved in the study and they were divided in two groups via block randomization method. For six weeks, twice a day, intervention group applied herbal ointment and control group used Salicylate ointment. The severity of pain, morning stiffness and limited motion were measured using Visual Analog Pain Scale. In order to analyze the trends of these three indexes, repeated measurement test was used. Ninety two participates with the mean age of 52.2 (+/- 12.4) years and with the mean disease period of 30.45 (+/- 30.3) months were involved in the study. There was no significant difference between two groups regarding the distribution of sex, weight, height, BMI and the duration of illness. No statistical difference was observed between two groups regarding pain relief, morning stiffness and limited motion; nevertheless in repeated measurements during second, forth and sixth weeks in both groups the decreasing trend of these three indexes had been statistically significant (p < 0.0001). It seems that using this herbal combination is clinically effective for patients suffering from knee osteoarthritis in order to decrease their pain, morning stiffness and limited motion; its effect is comparable with Salicylate ointment.     

The effects of methanolic extracts of ginger (Zingiber officinale) on human sperm parameters; an in vitro study

This study was conducted on Zingiber officinale or ginger on motility, grading and morphological aspects of human sperm. Thirty human semen samples were obtained from the local hospital. The samples were swim up by Ham's F10. The samples (0.9 mL) were treated by 0.1 mL of ginger methanolic extracts (0.1, 0.2, 0.4 and 0.6% concentration). Sperm motility, grading and morphology parameters were assessed using light microscope at 0, 2, 4, 8 and 24 h after treatment. Dose and time-dependent decreases in motility accompanied by concomitant decrease in grading 3 and 4 were noticed. Morphologic profiles of the sperms were changed under different doses of ginger on the basis of time of assess. These data indicate that some exhibits a lower percentage of motility and grading when methanolic ginger is added to semen fluid. According to the results it would be concluded that ginger can induce the toxic effects on sperm parameters.     

Effects of combination of intrathecal lidocaine and two doses of intrathecal midazolam on post-operative pain in patients undergoing herniorrhaphy: a randomized controlled trial

Assessment of the effect of combination of intrathecal midazolam and lidocaine on postoperative pain was the aim of this study. This randomized controlled trial was performed during 2007 in a teaching hospital of Arak University of Medical Sciences. Forty five male patients who were candidates for elective inguinal herniorrhaphy entered the study and randomly divided into three groups of control (lidocaine 5% plus normal saline), M 0.5 (lidocaine 5% and midazolam 0.5 mg) and M 1.0 (lidocaine 5% and midazolam 1 mg) according intrathecal solution injected for spinal anesthesia. Mean arterial blood pressure, heart rate, post-operative pain, narcotic requirements and complications (nausea, vomiting, pruritic, headache, hypotension and bradycardia) were recorded. The severity of post-operative pain was lowest in M 1.0 group in all postoperative measurements except at 2 h after operation. With regard of complications, only there was significant difference in vomiting between three groups which had the highest frequency in M 0.5 group. No severe hypotension was seen; though, bradycardia occurred in one patient in M 0.5 group which needed treatment. Present findings suggest that administration of intrathecal midazolam (especially 1 mg) together with lidocaine is effective in reducing post-operative pain in patients undergoing open inguinal herniorrhaphy and is not associated with adverse effect.     

The effect of Zingiber Officinale Extract on Preventing Demyelination of Corpus Callosum in a Rat Model of Multiple Sclerosis

Background:Multiple sclerosis is the most prevalent neurological disability of young adults. Anti-inflammatory drugs have relative effects on MS. The anti-inflammatory and antioxidative effects of Zingiber officinale (ginger) have been proven in some experimental and clinical investigations. The aim of this study was to evaluate the effects of ginger extract on preventing myelin degradation in a rat model of MS. Methods: Forty nine male Wistar rats were used in this study and divided into four control groups: the normal group, cuprizone-induced group, sham group (CPZ + NaCMC), standard control group (fingolimod + cuprizone), including three experimental groups of CPZ, each receiving three different doses of ginger extract: 150, 300, and 600mg/kg /kg/day.Results:Ginger extract of 600 mg/kg prevented CC from demyelination; however, a significant difference was observed in the fingolimod group (p < 0.05). Difference in the CPZ group was quite significant (p < 0.05).Conclusion:Treatment with ginger inhibited demyelination and alleviated remyelination of corpus callosum in rats. Therefore, it could serve as a therapeutic agent in the MS.Key Words: Corpus callosum, Demyelination, Ginger extract, Multiple sclerosis, Rat     

Effects of Agave fructans (<Emphasis Type="Italic">Agave tequilana</Emphasis> Weber var. azul) on Body Fat and Serum Lipids in Obesity

Obesity affects millions of people worldwide, constituting a public health problem associated with premature mortality. Agave fructans decrease fat mass, body and liver weight, and generate satiety in rodents. In the present study the effects of agave fructans on weight control, lipid profile, and physical tolerability were evaluated in obese people. Twenty-eight obese volunteers were randomly divided into two groups. In the first group, 96 mg/bw of agave fructans was administered for 12 weeks; in the second group, maltodextrin as a placebo was administered for 12 weeks. All participants consumed a low-calorie diet of 1500 kcal/day. Anthropometric and biochemical measurements were taken at baseline and at the end of the study. The body mass index (BMI) of the agave fructans treated group was reduced significantly from the baseline to the final measurements. Hip and waist circumferences decreased statistically in both groups. A decrease of 10% in total body fat was observed in the agave fructans treated group, resulting in a statistically significant difference in the final versus baseline measurements between the Agave fructans treated group and the placebo treated group. Triglycerides were reduced significantly in the agave fructans treated group. Glucose values did not change in either group. Agave fructans intake was safe and well tolerated throughout the study. The results showed that the ingestion of agave fructans enhanced the decrease in BMI, the decrease in total body fat, and the decrease in triglycerides in obese individuals who consume a low-calorie diet.     

INTER-VARIETY VARIATION IN RHODES GRASS (CHLORIS GA YANA KUNTH)

The characters in 25 varieties of Rhodes grass introduced from Africa have been studied with a view to improving on Australian Commercial. Only the diploid Katambora and a tetraploid variety from Kenya appeared to possess a higher yield potential than Commercial. Sixty per cent of the varieties are tetraploid, the rest diploid. A degree of association occurred between the level of ploidy and some Rhodes grass characters.
Although Rhodes grass appears to be xenogamous, all the critical evidence points to an apodictic form of reproduction. Viable caryopses were extracted from harvested "seed" and the percentage of florets setting caryopses was low. Rhodes grass caryopses germinate fairly well and have a higher resistance than usual to irradiation by gamma rays.     

Pythium soft rot of ginger: Detection and identification of the causal pathogens,and their control

Ginger is considered by many people to be the outstanding member among 1400 other species in the family Zingiberaceae. Not only it is a valuable spice used by cooks throughout the world to impart unique flavour to their dishes but it also has a long track record in some Chinese and Indian cultures for treating common human ailments such as colds and headaches. Ginger has recently attracted considerable attention for its anti-inflammatory, antibacterial and antifungal properties. However, ginger as a crop is also susceptible to at least 24 different plant pathogens, including viruses, bacteria, fungi and nematodes. Of these, Pythium spp. (within the kingdom Stramenopila, phyllum Oomycota) are of most concern because various species can cause rotting and yield loss on ginger at any of the growth stages including during postharvest storage. Pythium gracile was the first species in the genus to be reported as a ginger pathogen, causing Pythium soft rot disease in India in 1907. Thereafter, numerous other Pythium spp. have been recorded from ginger growing regions throughout the world. Today, 15 Pythium species have been implicated as pathogens of the soft rot disease. Because accurate identification of a pathogen is the cornerstone of effective disease management programs, this review will focus on how to detect, identify and control Pythium spp. in general, with special emphasis on Pythium spp. associated with soft rot on ginger.     

Morphological changes of rabbit lacrimal gland cells from amiodarone administration

Background: Amiodarone is a drug that is used for treatment of cardiac arrhythmia after cardiac ischemia. This drug as beta blocker decreases arrhythmia rate but it has many side effects on different tissues. Since there are rare reports about changes of lacrimal glands, this research has been carried out to study the morphological and ultrastructural changes of lacrimal gland cells after amiodarone administration. Methods: Male rabbits (n = 14) were divided into control and experimental groups. Experimental group were intra peritoneally injected with a daily single dose of 80 mg/kg amiodarone for two weeks. The control group only received normal saline. At the end of the injection period, the two groups were anesthetized and perfused with Karnovsky's fixative. The lacrimal glands were removed, fixed and then prepared for light and electron microscopic studies. Quantitative studies on lacrimal gland cell micrographs were performed by point counting method. The results were statistically compared between the two groups. Results: Light microscopic observation showed many secretory granules in the cytoplasm of the lacrimal gland cells, which were also seen in the lumen of acini. Ultrastructure study of these cells showed the presence of inclusions in their cytoplasm with homogenous and dense structure. In quantitative analysis, the volume fractions (Vv) of mitochondria and nucleus to the cell showed no differences between the two groups but the Vv of euchromatin to the nucleus was different (P<0.05 ). Conclusion: The presented results show adverse effects of amiodarone on rabbit lacrimal gland cells.     

Metformin as an adjunct to insulin for glycemic control in patients with type 2 diabetes after CABG surgery: a randomized double blind clinical trial

Perioperative hyperglycemia is common in patients with type 2 diabetes undergoing Coronary Artery Bypass Graft (CABG) surgery and there is a direct relation between postoperative hyperglycemia and mortality rate in these patients. The aim of the present study is to determine the efficacy of metformin on glycemic control in diabetic patients after CABG surgery. In a randomized double blind clinical trial, 100 patients with type 2 diabetes admitted in open heart ICU after CABG surgery in Mazandaran Heart Center were enrolled. They were randomly assigned to two intervention and control groups. Three hours after extubation, therapeutic antiglycemic regimens were applied in these two groups and continued for three days. Intervention group received regular insulin infusion along with two metformin 500 mg tablets per twelve hours while control group received regular insulin infusion with two placebo tablets per twelve hours. Blood glucose level and other parameters were measured and recorded in determined intervals. To analyze the data, independent T-test, paired T-test, Mann-Whitney and repeated measure ANOVA tests were employed. Mean blood glucose level was not significantly different in the two groups at the beginning of the ICU admission; however, mean glucose level in insulin-metformin group, twelve hours after the initiation of the study, was significantly lower than insulin group (p < 0.05). In addition, mean doses of potassium and insulin demand as well as mean number of episodes of hyperglycemia, hypoglycemia and glucose levels out of the accepted range were significantly lower in insulin-metformin group (p < 0.05). Alterations in mean levels of lactate, BE, pH and creatinine were not statistically significant in these two groups. It seems that adding metformin to insulin leads to a better glycemic control in type two diabetic patients undergoing CABG surgery without causing metabolic acidosis. Therefore, it might be a potential option in blood glucose control protocol in this group of patients.     

Cardiac involvement of major thalassemia and evaluation of total serum creatine kinase and creatine kinase-mB isoenzyme and cardiac troponinI in these patients

The goal of this study was the evaluation of specific markers of myocardial injury that includes CK-MB and troponin I in major thalassemic patients. Regular blood transfusion is the main treatment in major thalassemia. One of the most important complications of regular blood transfusion is iron overload that eventually involves many organs like heart and cause myocardial injury. Sixty patients with transfusion-dependent major thalassemia, at the age range of 8 to 15 years in Tabriz Pediatric Medical Center were chosen. Measurement of Hb, Hct and serum ferritin were performed in hospital laboratory, but total serum Creatine Kinase (CK) by photometric and isoenzyme of CK-MB by immunologic DGKC and cardiac troponin I (cTnI) were tested by ELISA methods in Shaheed Madani heart center laboratory before blood transfusion. For all patients echocardiography and ECG assessment of cardiac function were done by a pediatric cardiologist and results were statistically analyzed. Forty nine patients (group A) had normal left ventricular ejection fraction (LVEF = 50-70%) and 11 patients (group B) had reduced LVEF (20-45%). There was no statistical difference between two groups in average volume of blood transfusion (p = 0.074). Although total CK and CK-MB isoenzyme were higher in group B but there was no statistically meaningful difference between two groups (p = 0.123, p = 0.111). Troponin I also was higher in group B but statistically analysis showed no correlation between cardiac function and troponin I level in these groups (p = 0.827). This study showed that cardiac markers are not helpful for recognition of cardiac involvement in major thalassemia.     

Optimization of Physical Conditions for the Aqueous Extraction of Antioxidant Compounds from Ginger (<Emphasis Type="Italic">Zingiber officinale</Emphasis>) Applying a Box-Behnken Design

Since ancient times, ginger (Zingiber officinale) has been widely used for culinary and medicinal purposes. This rhizome possesses several chemical constituents; most of them present antioxidant capacity due mainly to the presence of phenolic compounds. Thus, the physical conditions for the optimal extraction of antioxidant components of ginger were investigated by applying a Box-Behnken experimental design. Extracts of ginger were prepared using water as solvent in a conventional solid–liquid extraction. The analyzed variables were time (5, 15 and 25 min), temperature (20, 55 and 90 °C) and sample concentration (2, 6 and 10 %). The antioxidant activity was measured using the 2,2-diphenyl-1-picrylhydrazyl method and a modified ferric reducing antioxidant power assay while total phenolics were measured by Folin & Ciocalteu’s method. The suggested experimental design allowed the acquisition of aqueous extracts of ginger with diverse antioxidant activity (100–555 mg Trolox/100 g, 147–1237 mg Fe²⁺/100 g and 50–332 mg gallic acid/100 g). Temperature was the determining factor in the extraction of components with antioxidant activity, regardless of time and sample quantity. The optimal physical conditions that allowed the highest antioxidant activity were: 90 °C, 15 min and 2 % of the sample. The correlation value between the antioxidant activity by ferric reducing antioxidant power assay and the content of total phenolics was R²?=?0.83. The experimental design applied allowed the determination of the physical conditions under which ginger aqueous extracts liberate compounds with antioxidant activity. Most of them are of the phenolic type as it was demonstrated through the correlation established between different methods used to measure antioxidant capacity.     

平贝母新：炮制品开发研究报告I—总生物碱提取工艺的优化及新炮制品分析

目的优化平贝母总生物碱提取工艺,分析不同新炮制品的总生物碱变化情况,为其开发利用提供理论依据。方法参考前人的研究成果。采用正交实验法优化平贝母总生物碱提取工艺：采用传统中药的炮制方法（醋炙、酒炙、姜炙、蜜炙）加工平贝母新产品。结果75％乙醇提取2次。每次提取时间2h,总生物碱得率最高;与传统加工品中的总生物碱含量（0．191％）相比,醋炙、酒炙分别为0．242％、0．204％：姜炙、蜜炙分别为0．186％、0．167％。结论平贝母中总生物碱的最佳提取工艺为：75％乙醇提取2次,每次提取时间2h。醋炙、酒炙能有效地提高平贝母的有效成分含量;姜炙、蜜炙则相反。     

Effect of adding ketamine to pethidine on postoperative pain in patients undergoing major abdominal operations: a double blind randomized controlled trial

To determine the effect of adding ketamine to pethidine in reducing post-operative pain in patients undergoing major abdominal operations, in a double blind randomized controlled trial, 100 patients aged 15-60 years who were candidate for elective major abdominal surgery allocated into two groups of pethidine + ketamine group (5 mg pethidine and 0.25 mg kg(-1) ketamine) or pethidine and placebo group (10 mg pethidine and NS) according to the regimen prescribed in postanesthesia care unit. Severity of pain (using visual analogue scale), prescribed dose of pethidine and side effects were recorded until 24 h after operation. Regarding post-operative pain, pethidine + ketamine group showed significant lower scores in all the times except 0 min, 2, 6 and 16 h. Nausea was significantly less frequent amongst pethidine + placebo group at times of 0, 15, 30 and 45 min (p < 0.05). Comparison of two groups did not show significant differences in prescribed pethedine dose in 0, 9, 12, 16, 20 and 24 h (p > 0.05). Yet, the mean dose of administered pethidine as rescue analgesic was significant lower in pethidine + ketamine group compared to pethidine + placebo group (112 +/- 31.5 mg vs. 133.5 +/- 24.5 mg, p < 0.001). In conclusion, our results showed that co-administration of ketamine and pethidine in postanesthesia care unit will improve postoperative pain and reduce narcotic consumption. It may, however, increase rate of postoperative nausea in the first hour after operation.     

The hypolipidemic effect of Citrullus colocynthis on patients with hyperlipidemia

Citrullus colocynthis is one of the medical herbs that traditionally have been used as an antidiabetic medication in tropical and subtropical countries. The aim of this study was to investigate the hypolipidemic effect of Citrullus colocynthis beyond the hypoglycemic impact on human. One hundred dislipidemic patients were randomly divided into two groups namely treated (n = 50) group and placebo (n = 50) group. The subjects were treated daily by powdered seeds of Citrullus colocynthis (300 mg) and placebo for 6 weeks. The serums, TG, Chol, LDL-C, HDL-C, SGOT and SGPT were measured with enzymatic methods at the beginning and the end of the project. The significance of differences within these groups was calculated by Paired T-test and by analysis of covariance between them. There were significant differences within and between treated and placebo groups during our treatment in TG and in Cholesterol after intervention (p < 0.05). A daily intake of 300 mg day(-1) of powdered seeds of Citrullus colocynthis can lower the triglyceride and cholesterol concentration significantly in nondiabetic hyperlipidemic patients.     

全周期间作模式胶园内间作生姜的生长及抗性生理特征

研究南北行向的全周期间作模式胶园宽行间间作生姜的生长及其抗逆生理变化。结果表明：在宽行中间12 m宽的区域内,不同位置间作的生姜产量间存在一定差异,以宽行东侧约3 m宽区域的生姜株高、茎粗和叶片SPAD值表现最好,产量最高,其次为西侧区域,在宽行中间6 m宽的区域则不适宜生姜生长;不同位置间作生姜叶片的游离脯氨酸(Pro)含量、丙二醛(MDA)含量、超氧化物歧化酶(SOD)和过氧化物酶(POD)活性总体上无显著性变化(P＞0.05)。综上所述,在全周期间作模式胶园宽行中靠近橡胶树的两侧较适宜生姜种植(特别是东侧),不同位置间作对生姜抗逆生理的影响不大。     

Comparison of topical triamcinolone and oral atorvastatin in treatment of paederus dermatitis Northern Iran

Dermatitis caused by stimulation of beetle paederus, is a common health problem in Northern and some southern parts of Iran. Since by now, traditional medicine and some corticosteroid agents have been used for treatment of dermatitis caused by beetle paederus. Because, there are few researches about classical treatment of the disease at academic level, this study planned to compare the effectiveness of triamcinolone ointment and atorvastatin tablet with placebo in treatment ofpaederus dermatitis in Northern Iran. A randomized double-blind clinical trial was carried out on 30 patients referred to the hospital and clinics at Sari and Neka countries in Northern Iran during 6 months. Patients were randomly divided into two therapeutic equal groups. The first group was triamcinolone ointment twice a day and a placebo atorvastatin tablet daily. The second group was oral atorvastatin one tablet (20 mg) daily and a placebo triamcinolone ointment twice a day. In Seventh day of visits, therapeutic response of the patients in triamcinolone and atorvastatin group were 93.33 and 80%, respectively. No significant differences were found in therapeutic outcome between the two groups (p > 0.05). The results showed both oftriamcinolone ointment and oral atorvastatin had similar effect on paederus dermatitis. Because the paederus dermatitis is a self-limited disease use of topical therapy for treatment of the disease is recommend.     

索引

以海南富硒地区产沙姜为原材料，通过实验室水培强化制备富硒沙姜芽，为海南开发高端富硒产品提供依据。结果表明：沙姜芽富集硒元素的能力较强，实验室制备出的富硒沙姜芽的总硒含量为1.581 mg/kg，可高达培养液硒浓度的54倍。