[ assessment of lorazepam effectiveness to reduce acute and delayed nausea and vomiting among chemotherapy patients: a randomized clinical trial]

Cancer is defined as one of the most leading causes of death in Iran, as well as the whole world. Chemotherapy as a common modality might have several consequences such as nausea and vomiting. Metoclopramide, anti-5Hl3, antagonist and benzodiazepines are used to decrease vomiting symptoms. However, the effectiveness of benzodiazepine is unknown so far. This study aimed to evaluate the role of Lorazepam in decreasing of metoclopramide dosage. Seventy consecutive patients were sampled to assess the outcome. Lorazepam was randomly added to premedication drugs in one of two chemotherapy courses for all patients. The lorazepam proscribed one night before chemotherapy and continued for three days after chemotherapy every 12 hours. The frequency and severity of nausea showed a significant decrease with lorazepam vs. grade II + acute decrease from 85% to 53% [p<0.0001], grade II + delayed nausea decrease from 86.2% to 55% [p<0.0001], grade II+ delayed vomiting decrease from 69.14% to 13% [p<0.0001]. Despite previous studies the results of this study show a clear impact of lorazepam benefits on the decrease severity and frequency of nausea and vomiting

Development of novel budesonide pellets based on CODES[TM] technology: In vitro/in vivo evaluation in induced colitis in rats

Budesonide is the drug of choice for treatment of active inflammatory bowel disease [IBD]. The aim of this study was to develop budesonide pellets based on a novel colon drug delivery system [CODES]. Pellet cores containing lactulose or mannitol were prepared by extrusion/spheronization and coated with an acid soluble polymer [Eudragit E100], hydroxypropylmethyl cellulose [HPMC] and an enteric coat [Eudragit FS 30D] sequentially. In vitro drug release of coated pellets was studied using USP dissolution apparatus type II in buffers of pH 1.2 [2 hrs], pH of 7.4 [4 hrs] and pH of 6.8 containing 8% rat cecal contents [RCC] [18 hrs]. The efficacy of the optimized formulation [containing 50% lactulose coated with Eudragit E [30% w/w] and Eudragit FS 30D [12% w/w]] was evaluated against 2, 4, 6-trinitrobenzenesulfonic acid [TNBS]-induced colitis in rats. The results of the kind of bacteria in vitro dissolution tests indicated absence of drug release in pHs of 1.2 and 7.4 and controlled release in buffer of pH 6.8 containing RCC. It was found that release rate was controlled by the type and amount of polysaccharide and the thickness of the acid soluble layer. The prepared formulation showed promising results in alleviating the conditions of experimental model of colitis. The results of this study suggest that pellets based on CODES technology could be useful for colonic delivery of budesonide

Primary hydatid disease of the ilium: a case report

Bone hydatid disease is endemic in several regions worldwide and lacks a typical clinical appearance and image characteristics; therefore, its diagnosis is very difficult. A 49-year-old rural woman was referred with purulent discharge from sinus tract in the left ilium. X-ray and CT scan showed multiple lytic lesions with cortical destruction. She was scheduled for sequestrectomy with impression of chronic osteomyelitis but destroyed hydatid cysts were detected intraoperatively. Iliac wing excision from the iliac crest to the sacroiliac joint and supraacetabulum area was performed. Pathologic findings were in favor of bone hydatidosis. Postoperatively, albendazole and antibiotics were prescribed

effect of diclofenac on tendon healing: An experimental study in guinea pigs

Whether non-steroidal anti-inflammatory drugs have a detrimental effect on tendon regeneration is still a matter of debate. As such, the purpose of this study is to determine the effect of diclofenac on tendon healing. Sixty four guinea pigs were randomly divided into two main groups [group A: histological study, group B: biomechanical study]. Then tenotomy and repair of right Achilles tendon were done. Half of the animals in each group received diclofenac [1 mg/kg/bid] and the other half received placebo. Half of the animals in each group were sacrificed at 2 weeks and the remaining animals at 6 weeks post-operation. In group A, histological study for determining maturity of healing of tendons in diclofenac and control groups was done, and in group B, tensile force to failure of tendons at two and six weeks of post tenotomy was determined. After two weeks, of the group A1, four animals in the experimental and five in the control group were labeled as relative immature. Four of the animals in the experimental and two in the control subgroups were labeled as relative immature. These differences were not significant. In group A2, five animals in the experimental and three in the control group were in the relative mature and three of those in the experimental and four of the control group were labeled as relative immature group. In group A1, the tensile force to failure was 24.175 N and 25.371 N in the experimental and control groups, respectively. In group B2, mean force to failure was 41.019 N in the experimental and 39.743 N in the control group. There was no significant difference between both groups. Diclofenac at the dosage of 1 mg/kg/bid did not appear to affect histological and biomechanical characteristics of tendon healing

rapid and sensitive modified HPLC method for determination of diclofenac in human plasma and its application in pharmacokinetic studies

A sensitive, accurate and rapid reverse phase HPLC method was developed to quantitate plasma levels of diclofenac sodium in human plasma. The drug, internal standard [naproxene] and orthophosphoric acid 1 M, were added to plasma samples and vortexed for 20 sec. A mixture of hexane /isopropyl alcohol [90:10] was then added and vortexed for 2 min. Samples were centrifuged and the supernatant layer was separated, evaporated to dryness under nitrogen gas stream, reconstituted in mobile phase and an aliquot of 50 micro l was analyzed on a micro-bondapack C18 [150 - 4.6mm] column, with 45% acetonitrile in deionised water and 0.5% orthophosphoric acid, [pH = 3.5] at 276 nm. The standard curve covering 0.005 - 4 micro g/ml concentration range, was linear, relative errors were within 0.13 to 16% and the CV% ranged from 1.24 to 8.75. The limits of quantitation and detection of the method were 0.005 ?g/mL and 0.002 microg/mL, respectively. The method was suitable for bioavailability and pharmacokinetic studies of diclofenac in humans and applied in a randomized, two-way cross over bioequivalance study of two different diclofenac sodium preparations with twelve subjects and with a one-week washout period

Q-angle: an invaluable parameter for evaluation of anterior knee pain

Patellofemoral pain syndrome is a descriptive term applied to patients with nonspecific anterior knee pain, and is the most common knee problem. The pain in most patellofemoral disorders is generalized to the anterior part of the knee. One important concept in patellofemoral joint function is the quadriceps angle [Q-angle]. Theoretically, a higher Q-angle increases the lateral pull of the quadriceps femoris muscle of the patella and potentiates patellofemoral disorders. This study was undertaken to evaluate the relationship between the anterior knee pain and Q-angle. This prospective study was performed on two groups; the case group consisted of 100 outpatients [44 men, and 56 women] aged between 15 and 35 years, with anterior knee pain. The control group consisted of 100 outpatients [50 men, and 50 women] with the same age distribution, who presented with different problems in the upper extremities and no knee problems. The Q-angle of each knee was measured in all participants, using a universal goniometer. The mean Q-angle for men, women, and all participants in the case group was 15.2, 20.1, and 18.0 degrees, respectively. In the normal control group the angles were12.1, 16.7, and 14.9 degrees, respectively. All these differences were statistically significant [P<0.001]. These results substantiate the fact that patients with anterior knee pain have larger Q-angles than healthy individuals

Evaluation of ECG changes after radiotherapy of left chest wall by electron in patients with left breast cancer who receive anthracycline based chemotherapy of following mastectomy

Cardiovascular damage after Radiotherapy of left chest wall for left breast cancer is a potential fear, therefore studing both the possible causes of radiation-induced heart damage and preventive measures are crucial issues in radiation therapy of breast cancer. The present study investigates noninvasively the possible acute and chronic ECG changes and their incidences after Radiotherapy in patients with left sided breast cancer who have received 6-8 courses of Anthracycline based chemotherapy following mastectomy. 56 patients with breast cancer [invasive ductal carcinoma] who had been undergone modified radical mastectomy, adjuvant Anthracycline based chemotherapy, and left sided chest wall electron therapy with direct field, have been evaluated. All patients investigated with physical examination and standard 12 leads ECG before, and immediately after completion of radiation therapy, and 6 months afterward. New electrocardiographic changes after therapy were seen in 3 patients [5.35%] and reduced to 2 cases [3.57%] after 6 months. there was no significant difference in T wave findings before and after radiation therapy[P=0.521].Also there wasn't any correlation between stage of cancer and any changes in ECG findings after radiation therapy [P=0.56]. There were no clinical cardiac symptoms or signs after Radiotherapy. Most affected leads in ECG were V1-V4 and the main abnormality was Inverted T wave. This findings suggest that the most acute and chronic electrocardiographic effect of irradiation on heart is repolarization abnormality. This study suggests that there are no significant ECG changes after Radiotherapy of left chest wall by electron beam in patients with left sided breast cancer who has received Anthracycline based chemotherapy following mastectomy. Also Radiotherapy by electron doesn't induce any clinical cardiac symptoms and signs in these patients. Therefore, we recommend using electron beam for Radiotherapy of patients with left sided breast cancer after radical mastectomy if Anthracycline based chemotherapy, has been administered

[Radiation effect on the number of circulating blood cells in patients receiving pelvic radiotherapy]

There is considerable controversy in scientific literature regarding the need to monitor the complete blood count of patients undergoing radiation therapy. While some advocate weekly examination of the peripheral blood, others deem it unnecessary. Since reduction in the number of blood cells has considerable effect on the treatment outcome, this study evaluates the effect of pelvic radiation therapy on the number of blood cells. This study designed as a cohort study of pre- and post-treatment evaluation. After excluding patients who didn't complete treatment or had problem in first blood count, 51 patients who had received radiation therapy in pelvis area selected, evaluated by taking a blood sample before and 24-48 hours after completion of the radiation course, thus comparing the mean count of the circulating blood cells before and after therapy. The average of hemoglobin and white blood cell count compared by t-test and after stratified patients according to dose and volume to "low", "moderate" and "high" groups, averages compared by ANOVA. Fifty-one patients included 25 male and 26 female evaluated. The mean of white blood cells, red blood cells and platelets decreased. However, a significant difference in white and red blood cells was found. In despite of significance difference between means of red and white blood cells, there is no need for blood transfusion or increase risk of infection due to this reduction, so this reduction isn't clinically significant. It is recommended that weekly monitoring of CBC in patients with normal CBC before radiotherapy is non necessary

In vitro - in vivo evaluation of sustained - release lithium carbonate matrix tablets: influence of hydrophilic matrix materials

Background: conventional Lithium carbonate [LC] tablets produce rapid and relatively high peak blood levels resulting in adverse effects. These drawbacks can be overcome by designing a suitable sustained or controlled-release LC preparation

Methods: sustained-release matrix tablets were therefore developed using different types and ratios of polymers including carbomer [CP], Na carboxymethylcellulose [Na CMC] and hydroxypropylmethylcellulose [HPMC], to assess the release profiles and in vivo performance of the formulations. The tablets were prepared by either direct compression [DC] or wet granulation [WG]. In the DC method, 69% [450 mg] LC, 5, 10 or 15% CP or Na CMC [of total tablet weight], lactose and /or Avicel [to maintain constant tablet weight] were mixed and directly compressed. In the WG method, 450 mg LC and 10, 20, or 30% HPMC were granulated with Eudragit S100 solution, dried, and then compressed to formulate the tablets. In vitro and in vivo, newly formulated sustained-release LC tablets were compared with sustained-release commercial tablets [Eskalith® and Priadel®]. In vivo studies were conducted in nine healthy subjects in a cross-over design, with a 3x3 Latin square sequence, and pharmacokinetic parameters were estimated using classical methods

Results: the matrix tablets containing 15% CP exhibited suitable release kinetics and uniform absorption characteristics comparable to that of Eskalith®. In vivo, this formulation produced a smooth and extended absorption phase very much similar to that of Eskalith® with the identical elimination half-life and extent of absorption

Conclusion: the matrix tablets containing 15% CP reduces the incidence of side effects often associated with high serum concentration of Lithium and blood level variations. Direct correlation between the dissolution profiles and the relative bioavailability of the formulations could be observed

effect of bone marrow graft on bone healing: a radiological and biomechanical study

There are multiple methods for acceleration of bone healing. Bone marrow has been shown to contain osteoprogenitor cells. To determine the effect of percutaneous bone marrow injection on bone healing. 15 mature, 2-kg-weighing white New Zealand rabbits from both sexes were randomized into 3 groups: Group I: Only osteotomy of right radius was performed and a 5 mm bony defect was made. Group II: Same as group I, with the defect filled by bonegraft, taken from the iliac crest. Group III: Same as group I plus percutaneous bone marrow injection 5 days after the operation. 45 days post-operation, the rabbits were sacrificed. The radii of both forelimbs were isolated and tested by tensile testing machine. There was a significant difference between groups I and III [p<0.001] for toleration of maximum load and bending stiffness. No significant difference was observed between groups II and III for these parameters. Bone marrow injection has an effect on bone healing comparable to bone grafting. This technique is non-invasive and simple without any significant complication

Epidemiology of low back pain in women

The prevalence of low back pain [LBP] in a randomly selected sample of 1,000 women with five different jobs was studied over a 2-year period. The selected jobs comprised of farmers, manual workers, nurses, clerks, and housewives. Each group consisted of 200 cases. The rate of LBP was found to be different in various occupations [p=0.0001]. The study was based on interviews and the completion of a questionnaire followed by clinical examination. The overall prevalence rate of LBP during a lifetime and over a one-year period in women aged 25-45 years were 27.4% and 12.7%, respectively. The lifetime prevalence was 35% in farmers, 32.5% in manual workers, 28.5% in housewives, 26% in nurses and 15% in clerks. The obvious risk factor for LBP was age and the number of working years. The most prominent physical risk factor for LBP was "stooping". Remaining in a sitting position for more than 4 hours daily was also a clear risk factor. We found accentuated lordosis and positive straight-leg raising test as the most prevalent clinical signs. The salient plain radiological findings were traction spur, disc-space narrowing, and hyperlordosis

normal carrying angle of the elbow in shiraz

The normal carrying angle in Shiraz population was measured on the basis of sex and age. The right elbow angle of 4266 cases was examined from birth to 30 years old. This study found the carrying angle in 2540 females to be 7.2° [range 2-19] and in 1726 males to be 6.40 [range 2-11], a 0.8° difference. A significant difference [p= 0.05] was found in relation to age. There is a gradual increase in the carrying angle with skeletal maturation

effect of physical activity on tendon healing

It has been documented that normal tendons and ligaments are responsive to changes in mechanical stimuli, but there is little experimental data showing the effect of mild physical activity or restricted exercise on the treatment of tendon or ligament injuries. As such, the effect of free exercise, cage confinement and external fixation on healing of a standard induced tendon injury in the superficial distal flexor tendon of the rabbit were evaluated by light and electron microscopy. The lesions in the exercise group were well organized and showed a greater degree of crimp formation at the histological level The tenoblasts were more mature and the inflammatory cells were fewer in the lesions. Whereas the animals with cage confinement and external fixation exhibited a disorganized arrangement of collagen fibrils with a large population of active tenoblasts and inflammatory cells. Electron microscopic quantification showed mean fibril diameter higher in the exercised group as compared to others. Mobilization in the early stage following tendon injury might accelerate wound healing and thus he advised in management of tendon injuries