Efficacy of laryngeal airway mask compared with endotracheal tube in reducing coughing following general anesthesia in adults

Introduction: Coughing is an airway complication that could affect the outcome of surgery following general anesthesia in adults. In this systematic review, we aimed to study the efficacy of applying laryngeal airway mask [LMA] compared with endotracheal tube [ETT] in reducing the postoperative cough in adults under general anesthesia

Method: PubMed was searched for the relevant articles. Inclusion criteria were all the randomized controlled clinical trials, which used LMA and ETT in adults under general anesthesia. Only English language articles were included in this study with no time limitation

Result: Overall, 15 articles were retrieved, which were relevant with the purpose of this study. Efficacy of LMA in reducing coughing was significantly different with ETT in adults under general anesthesia in various types of surgeries. Calculated number needed to treat [NNT] showed that using LMA would significantly reduce coughing even in one adult patient

Conclusions: Coughing has shown various adverse effects on postoperative main results in some surgeries such as cataract, cranial, etc. Applying LMA could positively decrease postoperative coughing in adults

Hypothermia and normothermia effects on mortality rate of cardiopulmonary bypass

Introduction: Cardiopulmonary bypass is associated with higher risk of mortality and morbidity, thus it should be investigated regarding the major risk factors. Temperature management have a significant role in postoperative cerebral and neurological complications; however the optimum temperature during cardiopulmonary surgery is not certainly detected. This systematic review has investigated the differences between hypothermia and normothermia regarding postoperative mortality

Method: PubMed was searched for the relevant articles. Only English language articles were included with no time limitation. Data regarding in-hospital patient deaths provided in each article mostly within 30 days after the surgery, were extracted and compared based on relative risk reduction [RRR], absolute risk reduction [ARR], and number needed to treat [NNT]

Result: Totally, 28 articles were retrieved and extracted. The mortality rate was zero in hypothermic and normotehrmic groups of 8/28 included studies, thus the RRR, ARR, and NNT could not be calculated. There were no significant differences between investigated groups of each included studies regarding the patients' age, gender, and preoperative conditions

Conclusions: No significant difference was obtained between two studied groups. Similar prevalence of death observed between hypothermic and normothermic groups might be due to the sample size of studies, or the subsequent cares performed in intensive care units that assist to reduce the postoperative mortality rate. According to the obtained results, both of these procedures might be similarly safe regarding mortality rate

relation between oxygen saturation level and retionopathy of prematurity

Introduction: Oxygen therapy used for preterm infant disease might be associated with oxygen toxicity or oxidative stress. The exact oxygen concentration to control and maintain the arterial oxygen saturation balance is not certainly clear. We aimed to compare the efficacy of higher or lower oxygen saturations on the development of severe retinopathy of prematurity which is a major cause of blindness in preterm neonates

Methods: PubMed was searched for obtaining the relevant articles. A total of seven articles were included after studying the titles, abstracts, and the full text of retrieved articles at initial search. Inclusion criteria were all the English language human clinical randomized controlled trials with no time limitation, which studied the efficacy of low versus high oxygen saturation measured by pulse oximetry in preterm infants

Result: It can be suggested that lower limits of oxygen saturations have higher efficacy at postmesetural age of

Discussion: Applying higher concentrations of oxygen supplementations at mesentural age >/=32 weeks reduced the development of retinopathy of prematurity. Lower concentrations of oxygen saturation decreased the incidence and the development of retinopathy of prematurity in preterm neonates while applied soon after the birth

Conclusions: Targeting levels of oxygen saturation in the low or high range should be performed cautiously with attention to the postmesentural age in preterm infants at the time of starting the procedures

Diagnostic value of performing endocervical curettage at the time of colposcopy procedure; a systematic review

Introduction: The importance of high-grade cervical intraepithelial neoplasia [CIN] as a precursor to invasive cervical cancer suggests a considerable need for accurate screening of the patients for the risk of these lesions. This systematic review aimed to study the diagnostic significance of endocervical curettage [ECC] at the time of colposcopy in the detection of CIN 2, 3, and preinvasive lesions

Methods: PubMed was searched to obtain the relevant articles based on the following search term: [endocervical curettage OR ECC] AND colposcopy. The most relevant articles were included after studying the title, abstract, and full text of the obtained articles at initial search. Only English language articles published after 1992 with at least 500 patients were included in this study

Result: Among 300 articles identified by the first search, only seven articles were in line with the purpose of this systematic review. Majority of the included studies were retrospective observational studies

Conclusion: Performing ECC has higher sensitivity in women older than 40 years and those with unsatisfactory colposcopy results. However exact diagnostic usefulness of ECC at the time of colposcopy needs to be investigated in further studies

Efficacy of methylene blue for on vasoplegic syndrome

Introduction: Administration of methylene blue has been proposed as a therapeutic strategy in the treatment of vasopelgic shock following cardiac surgery. Major aims of this systematic review were to evaluate the effect of methylene blue on mortality rate, duration of vasoplegic syndrome, and further complications of patients with vasoplegic syndrome following cardiac surgery

Methods: PubMed was searched to obtain the most relevant articles. All the randomized control trials and cohort studies were included

Result: A total of 54 articles were retrieved at the initial search. After studying the titles, abstracts, and full text of the articles, only five articles consisted of two randomized controlled trials [RCTs] and two observational studies were included

Discussion: Based on included RCTs, the mortality rate and duration of the disease decreased in patients applied methylene blue in the treatment of vasoplegic syndrome compared with those did not receive this medication

Conclusions: Bbased on included articles, application of methylene blue could be suggested as a treatment for vasoplegic syndrome, but further large multicenter RCTs are needed to certainly evaluate the efficacy of methylene blue