[Comparison of fentanyl and combination of pethedine and midazolam for pain control during extracorporeal shock wave lithotripsy]

Background and aim: Shock wave during extracorporeal lithotripsy causes pain for which analgesic drugs are prescribed most often. The aim of this study was to compare the efficacy and adverse effects of fentanyl and combination of pethedine and midazolam for pain control during extracorporeal shockwave lithotripsy [ESWL]

Methods: In this single blind clinical trial study, 89 patients older than 18 years with renal or upper urethral stones who were candidates for ESWL were randomly allocated into Intervention [45 patients] and control groups [44 patients]. First group [Intervention] was given I.V. fentanyl [1 mg/kg] and control group was given I.V. pethedine [0.7 mg/kg] and [0.02 mg/kg] midazolam before starting ESWL. Then ESWL was performed in two groups with guidance of fluoroscopy by standard technique. During operation every 20 minutes and 2 hours after operation severity of pain was checked according to visual analogue scale. Efficacy of operation was evaluated in two groups according to follow up KUB and ultrasonography. Data were analyzed by SPSS software using Chi square test

Results: Frequency of painless operation and mild pain in fentanyl group were found 26.6 and 24.4 percents, respectively. Although severe pain was more observed in the control group [32.5%], but it was not significantly different [P>0.05]. Efficacy of operation didn't show significant difference between two groups of patients [P>0.05]

Conclusion: Similar pethedine and midazolam lower dose of intravenous fentanyl provides adequate analgesia with minimal side effects and suitable efficacy for pain control during ESWL, which can be used in outpatients, without need to monitoring in adult patients

[ effect of Pistacia khynjuk on humoral immune system of wistar rats]

Plants from the genus Pistacia family such as Pistacia atlantica, Pistacia vera and Pistacia khynjuk are considered as herbal medicines. Antibacterial and anti-inflammatory effects of these plants have been confirmed. The aim of the current study was to find the effect of Pistacia khynjuk on humoral immune system of Wistar rats. This is an experimental study which was conducted at Yasuj University of Medical Sciences in 2009. Forty male Wistar rats were randomly allocated into four groups of ten animals and orally received 10 mg/kg of the extract of nucleus, cutin and fruit of Pistacia khynjuk respectively, every day for two weeks. The control group received only placebo. Immuno-reactivity was induced using BCG vaccine [IP] with Freund's complete adjuvant [CFA]. The titer of IgG and IgM were measured after the treatment using ELISA method. Moreover, the cervical lymph nodes and spleen of animals were excised and the volume and density of the primary and secondary follicle was evaluated by steriology. The collected data were analyzed by the SPSS using one-way ANOVA. The differences in the mean level of IgG and IgM between the treated and the control animals were not significant [p>.05]. Also, the mean volume of the spleen and cervical lymph nodes of the first three groups in comparison with the control animals were not significantly [p>/05]. Findings of this study showed that the Pistacia khynjuk did not have any direct effect on the activity of humoral immune system and the increasing of antibody level among Wistar rats

[ effect of silybum marianum on GFAP and spatial memory in a mouse model of alzheimer's disease]

Studies have shown that Silybum marianum have high levels of antioxidant polyphenolic substances and have neuro-protective effects on neurodegenerative diseases. Accordingly, this study was conducted to determine the possible effect of Silybum marianum on expression of and spatial memory in a mouse model of Alzheimer's disease. This experimental study was conducted at Yasuj University of Medical Sciences in 2009. Thirty adult male Wistar rats were allocated in three groups: sham group, experimental group, and lesion group, each consisting of ten rats. The experimental and lesion groups received Ibotonic acid of the NBM nucleus in stereotaxic apparatus whereas the sham group underwent surgical procedure without any injection. The experimental group received 200mg/kg of Silybum mirianum extract orally, diluted in 1% Arabic gum. Also the sham group received 1% Arabic gum every day for four weeks. The lesion group did not receive anything. The behavioral assessment was measured, after treatment, by using of Y maze test on day 7 and 28 in all groups. The ELISA method was used to measure the GFAP level in Hippocamp at the end of behavioral assessment. The collected data was analyzed by the SPSS software using ANOVA and Repeated Measures of Analysis Variance tests. Improvement of behavioral performance of the experimental animals compared to the lesion and sham groups were increased significantly on day 7 and 28 [P<0.01 and P<0.001 respectively]. The ELISA method showed that the level of the GFAP synthesis decreased in the experimental group compared to the lesion and sham groups [P<0.001]. The Silybum marianum plant has a protective effect on the nerve tissue in a mouse model of Alzheimer's disease by decreasing of the GFAP synthesis and lead to the improvement of behavioral performance

[ role of relaxation training to pregnant mothers on health index of infants]

Investigations have shown that the emotional stress during the pregnancy period could have sustainable effects on the embryo. Different factors such as family members, spouse, supporting friends could relive these effects, but coping skills especially relaxation could be more effective on stress. This study was conducted to investigate the effect of relaxation training to pregnant mothers on health index such as Apgar index, weight, height, and cowlick grade in infants. This is a clinical trail in which 100 pregnant women who referred to health center of Yasuj [2006-2008] were selected using simple sampling method and assigned randomly to case and control groups. The relaxation was taught to the case group whereas nothing was taught to control groups. At the time of delivery the above mentioned indices were assessed. The gathered data was analyzed using SPSS software. The results showed a significant difference between two groups in weight, height, cephalic index, and colic grade [with better situation in case group]. There was no significant difference between two groups in Apgar scores. Considering the results of this study, it seems that teaching of relaxation to pregnant women could be effective in health index of children especially in the time of delivery. Therefore attention should be paid to different methods for reducing the stress in this group of mothers

[ effect of sub conjunctive injection of 2 percent mitomicin-C in prevention of recurrence of pterygium]

Pterygium is a wing-shaped fold of conjunctiva and fibrovascular tissue invades the superficial cornea. The occurrence of pterygia is strongly correlated with UV exposure, although dryness, inflammation, and exposure to wind and dust or other irritants are also important factors. Pterygium is usually asymptomatic, but it can cause photophobia, tearing, and foreign body sensation. It can also decrease vision by inducing with the regular and irregular astigmatism. Unfortunately, the recurrence rate is high; averaging approximately 40% in various studies. Recurrences generally occur rapidly, within 2 to 3 months of surgery. The aim of the present study was to evaluate the effect of subconjunctivaly injection of mitomicin-C in preventing the recurrence of pterygium. This study was a simple randomized clinical trial which was carried out at Imam Sajjad Hospital of Yasuj, Iran. In this study, 157 eyes [48 men, 64 women] with primary pterygium were allocated in intervention [83 eyes, 54 patients] and control [74 eyes, 58 patients] groups. The mean age of the patients was 48. In the inversion group we injected .1 ML of mitomycin C. 2% subconjunctivally in to the pterygium body, 1 month before pterygium excision. After the pterygium was excised, the bare sclera was covered by sliding adjacent superior conjunctiva in both groups. The follow up period was 3 months. Recurrence was defined as the postoperative re-growth of fibrovascular tissue crossing the cornea. The data was analyzed by the SPSS software using Fisher's exact test and Chi-square test. The recurrence rate was 1.2% [1 eye] and 9.45% [7 eyes] in intervention and control groups, respectively, with significance difference between groups [P=0.027]. The mean degree of astigmatism was improved with surgery in both groups. Both subconjunctival mitomycin C injection before pterygium excision and conjunctival auto graft are safe and are effective treatments in reducing of pterygium recurrence. Regarding the reduction of pterygium recurrence after subconjunctivaly Mitomicin-C injection, it can be concluded that this method is an effective treatment in pterygium surgery