Oculocardiac reflex during strabismus surgery

The activation of oculucardiac reflex [OCR] is common during the strabismus surgeries. OCR is known as a trigemino-vagal reflex, which leads to the various side effects including bradycardia, arrhythmia, or in some cases cardiac arrest. This reflex could be activated during intraorbital injections, hematomas, and mechanical stimulation of eyeball and extraocular muscles surgeries. The incidence of OCR varies in a wide range, from 14% to 90%, that depends on anesthetic strategy and drug used for the surgery. The efficacy of various anticholinergic and anesthetic agents on declining the OCR reflex has been evaluated in different studies, especially in children. Although the detection of OCR goes back to 1908, its exact effect is not well recognized during strabismus surgery. In this review, we aimed to summarize the studies investigated the efficacy and potential of various anesthetic medications on inhibiting the OCR in children undergoing strabismus surgery

Prevalence and prognosis of cerebrovascular accidents and its subtypes among patients with systemic lupus erythematosus in Isfahan, Iran: a hospital clinic-based study

The aim of the present study was to determine the prevalence and prognosis of cerebrovascular accident [CVA] and its subtypes among Iranian patients with systemic lupus erythematosus [SLE]. In a cross-sectional study, medical records of 575 SLE patients were reviewed. The patients developing CVA in their course of disease were extracted. In these patients, data about demographic features, lupus anti bodies, duration of the disease until CVA, CVA manifestation[s] and follow-up duration were gathered. In the next step, patients with any kinds of CVA were summoned to Neurology clinic to identify the grade of disability in each patient with CVA. We identified 38 patients with CVA of which 6 [15.8%] were men and 32 [84.2%] were women. The most common subtype of CVA was small vessels thrombosis [21.05%] among the study patients and hemi paresis was the most prevalent initial presentation [39.47%]. In 11 [28.9%] patients, SLE was initiated with CVA and in 3 [7.9%] patients CVA had happened in the 1st year of SLE. Anti-phospholipid antibodies [APLA] were positive in 29 [76.3%] patients. Mean modified Rankin Scale in patient with positive and negative serology for APLA was 0.93 +/- 1.11 and 0.22 +/- 0.66 respectively [P = 0.006]. Our study shows that 6.6% of Iranian SLE patients have CVA during their course of the disease. Small vessels thrombosis is the most common CVA subtype and hemi paresis is the most prevalent initial presentation. Moreover, we showed that the prognosis of CVA in Iranian SLE patients is not unfavorable

Role of bax protein and caspase-3 at high glucose-induced apoptosis in human embryonic kidney [HEK] 293 cells

Hyperglycemia is the principal factor responsible for microvascular complications of diabetes. Diabetic nephropathy is a serious and common complication leading to end stage renal disease. The exact molecular mechanisms of high glucose-induced toxicity on renal cells are still incompletely understood. Therefore in the present study, glucose-induced toxicity was studied in HEK [human embryonic kidney] cells as an in vitro model for diabetic nephropathy. First, the viability of HEK 293 cells exposed to glucose was measured by MTT [Methyl Thiazolyl Tetra-zolium] assay. Caspase-3 activity was determined spectrophotometrically using enzyme specific substrate. Moreover, the alteration in expression of Bax, Bcl[2] and caspase-3 were measured by Western blotting. The results showed that high glucose significantly reduced cell viability after 48 h [p<0.05]. In Western blot analysis, the ratio of Bax/Bcl-2 protein expression in cells treated with high glucose was significantly increased compared to controls [p<0.001]. The activity of caspase-3 was significantly increased in treated cells compared to control [p<0.01]. Moreover, high glucose exposure induced a significant decrease in protein level of procaspase-3 [p<0.01], indicating conversion of pro-form into the mature caspase. On the current data, it could be concluded that high glucose can cause HEK cell death, in which apoptosis plays an important role possibly by the mitochondrial pathway through higher expression of Bax pro-apoptotic protein and also by activation of caspase-3 related pathways

Health related quality of life and pain characteristics among Iranian patients suffering non-malignant chronic pain

Chronic pain is a frequent disability that negatively affects patient's quality of life. Understanding of the possible relation between sociodemographic and medical variables with Health Related Quality of Life [HRQL] may help identifying the multidimensionality of pain and risk factors that limit physical and psychological adjustment of the patients. The present study was done to find these possible relationships, based on using Medical Outcomes Survey-Short Form [SF-36]. Among the patients who were referred to pain clinic of Iranian Pain Society, 101 consecutive outpatients were select based on the defined inclusion and exclusion criteria. All the participants in this study orally satisfied and were fully informed by a check list and SF-36 questionnaire. The possible impact of demographic variables, characteristics, diagnosis, analgesic use, smoking and opium addiction were collected as the first part of a routine pretreatment evaluation. Our findings showed significant relation between HRQL and gender [P<0.05], the rate of chronic pain in female was higher than male, and same results found for elderly patients compared to younger ones. Our findings also showed significant relation between employment and intensity of pain [p=0.001] as, employed patients showed less physical and psychotic problems than unemployed ones. The mean average of intensity of pain in these patients was 7.5 +/- 2.2; few patients used alcohol [4%], opium [1%] and cigarette [10%]. Large number of participants used analgesic [%78.2]. No significant difference between sociodemographic features with pain duration and quality of life was found. In contrast our data showed significant difference between pain intensity and quality of life [p<0.001]. Based on our findings it could be concluded that chronic pain in Iranian patients certainly leads to poor HRQL, the state is more serious in the elderly and female patients. Thus, in order to re-socialize the patients suffering chronic pain and decrease the impact of their pain on their life, these findings should be considered in any kind of pain relief therapy

effect of fetal liver-derived cell suspension allotransplantation on patients with diabetes: first year of follow-up

Stem cell-based therapies have recently opened up new horizons for treatment of various types of diseases including diabetes mellitus. However, long-term efficacy and safety of these novel modalities still remain a serious question. Hereby, we aim to report the one-year follow-up results in the diabetic patients who underwent fetal liver-derived hematopoietic stem cell allotransplantation. Fifty six patients with type one [n=30] and type two [n=26] diabetes, aged 10-58 years old [32.8 +/- 16.3] were divided into the intervention and placebo group. The patients in the intervention group underwent fetal liver-derived hematopoietic stem cell transplantation while the patients in the placebo group received 5 ml of normal saline both via an intravenous route. The patients were visited at regular intervals to evaluate the efficacy of transplantation in glycemic control as well as possible complications. In the 6[th] month of the follow-up, there was a significant decrease in HbA[1]c levels in all groups without any rise in the fasting c-peptide. However, none of the precipitants transiently or continuously became insulin free in the first year after transplantation. It can be concluded that, in this study, fetal liver-derived hematopoietic stem cell transplantation had no significant effects on glycemic control. The heterogeneity of our patients might account for the negative results. Hence, longer follow-up results will be reported in the near future.

[Relation between social support and coping with stress in nurses in psychiatric ward]

Stress is the most common cause of mental and physical problems in employers. Nurses experience high level of stresses due to the nature of their job. Stress coping strategies effect on reaction against stresses. Social support has protective and effective role on stress coping strategies. Detect the relation between coping with stress and social support in the nurses who worked in psychiatric ward. This descriptive analytic study was done on 47 nurses of the psychiatric wards of Isfahan training hospitals. The demographic data checklist and stress coping strategies and Saratoz social support questionnaire were filled. Statistical methods such as t-student, Spearmen-Pearson correlation were used to analyze data. The mean age of the studied persons was 39.9 years old and the mean score of social support of them was 10.59 +/- 2.24. There was a reverse and significant relation between the social support and the age and duration of service, while there was a direct and significant relation between the social support and the education. There was a significant relation between sex and social support [more in singles] too. There was a direct relation between the social support and the ways of coping with stress [social-emotional support], a reverse and significant relation between social support and the reception and hopeful through. If there is more social support, increased using effective coping strategies and reduced using ineffective coping strategies. Considering the importance of the social support in high stress jobs such as nursing to increase the person's capacity against stress, increase social support by improving administrative relations and social security for the nurse personnel could be useful

Combined maximum levator resection and septal sling in correction of severe blepharoptosis with poor levator function: a novel surgical technique

The aim of this study is to present a novel surgical technique in the management of severe blepharoptosis with poor levator function. Four patients [five eyes] were included in this study. Mean age of the patients was 15.3 years [range, 3-28 years]. Preoperative levator function averaged 3.4_0.9 mm. All of the patients underwent combined maximum levator resection and septal sling in the ptotic eye. The follow-up ranged from 4 to 10 months [mean, 8 months]. Preoperative palpebral apertures averaged 4.4 +/- 0.7 mm and postoperative apertures averaged 8.5 +/- 0.4 mm [P<0.001]. There was marked improvement in the aperture [4.1 mm]. The mean of margin reflex distance-1 [MRD-1] was increased from 0 +/- 1 preoperatively to 4.1 +/- 0.4 postoperatively [P<0.001]. All the patients demonstrated symmetry of the upper eyelid position [less than 1 mm], good lid crease position, and acceptable cosmetic outcome. All of the patients revealed some degree of lid lag and lagophthalmus. One patient developed exposure keratopathy associated with lagophthalmus which was treated successfully with lubrication. This preliminary study shows that this new technique may be a useful alternative in the management of severe blepharoptosis associated with poor levator function

Study of correlation between systolic blood pressure and angiotensin converting enzyme [ACE] activity in STZ induced diabetic rats

Diabetes mellitus is a worldwide health problem affecting 1-2% of the population. It is responsible for numerous morbidity and mortality consequences due to vascular events such as hypertension, nephropathy and retinopathy. The precise mechanism of hyperglycemia-induced vascular damage is not clearly known. Alteration in Rennin Angiotensin-Aldosterone System [RAAS] and increased Angiotensin Converting Enzyme [ACE] activity is known to be involved in pathogenesis of vascular disorders. This study sought to investigate correlation between systolic blood pressure and ACE activity in STZ induced diabetic rats. Two groups of 8 male Sprauge Dawely rats including control [C] and diabetic group [D] were used in this study. Diabetes induced by injection of 60 mg/kg STZ intraperitoneally. Blood pressure was measured using tail cuff method. ACE activity was determined by HPLC method. At the end of study [four weeks after induction of diabetes] systolic blood pressure increased significantly in D group compared to control rats. ACE activity was increased in aorta, heart, lung and serum of D group which this increment was more pronounced in aorta and heart. Renal ACE activity reduced significantly in this group compared to control. It is concluded that increased ACE activity particularly cardiovascular ACE, could be involved in the diabetes induced hypertension and vasculopathy