Impact of propranolol on preventing renal dysfunction in patients with cirrhosis

Background: One of the earliest diagnostic signs of hepatorenal syndrome in patients suffering from liver cirrhosis is an increase in the renal vascular resistive index [RI]. In this study, the impact of propranolol on decreasing this index and to postpone the probability of hepatorenal syndrome has been investigated

Methods: In the current research, 30 patients with liver cirrhosis with different age and sexes have been enrolled. Demographic data and complete medical history have been collected using a specific questionnaire. At first, renal artery Doppler ultrasonography was performed to determine the RI. The patients were then treated with propranolol, and under supervision, the dose of the drug was increased gradually every 3 to 5 days to reach the target of 25% decrease in resting heart rate. One month after reaching the target dose of the medicine, Doppler ultrasonography was repeated for the patients and the second RI was compared with the pretreatment ones

Results: According to our results after treatment with propranolol, a significant decrease of RI was observed [p < 0.01]. However, there was no significant difference in the glomerular filtration rate [GFR] before and after treatment with propranolol [p = 0.290]. In our study, we found that administering propranolol was associated with significant changes in RI and GFR between the patients with compensated and decompensated cirrhosis [mean change: -0.005 +/- 0.017 vs. -0.058 +/- 0.045; p < 0.01 for RI and -4.226 +/- 17.440 vs. 13.486 +/- 12.047; p < 0.01 for GFR in patients with compensated and decompensated cirrhosis, respectively]

Conclusion: Propranolol reduces renal vascular RI in patients with cirrhosis. The response rates in the patients with decompensating cirrhosis were significantly higher than the patients with compensating cirrhosis

Comparison between the effect of group education and group counseling on emotional self-care in type II diabetics

Background and Aim: Diabetics are in need of assistance and education in order to know and understand their health status; decision making for health care, health behavior changes, and improving health care

According to WHO, education is the cornerstone of diabetes treatment. Key goals of diabetes education are behavior change and promotion of self-care. Emotional self-care, which requires special attention, is a type of self-feeling an individual has regarding himself/herself and his/her own abilities to manage different emotions; and fight against various problems

The current study aimed at comparing between the effect of group education and that of group counseling on emotional self-care in type II diabetics

Materials and Methods: In a clinical trial, 112 type II diabetics referring to Mashhad Parsian Diabetes Clinic in 2014 were selected through convenient sampling

They were randomly allocated into three groups; i.e. counseling [n=37], education [n=37], and control [n=38]. Group counseling and group education were held for five sessions [1.5 hours each] every three days; each group consisting of 8 to 10 patients. A researcher-designed diabetes emotional care questionnaire was filled out before and two months after the intervention per each subject

Finally the obtained data was analyzed by means of SPSS [V. 11.5] applying paired. T-Test and ANOVA at the significant level of P=0.05

Results: The groups did not show any significant differences in emotional self-care before the intervention [P=0.834]. After the intervention, however, self-care significantly decreased in patients who had group counseling [36.3+/-14.7] and group education [31.5+/-11.4] compared to the control group [50.5+/-19.1]; P=0.001

Conclusion: Regarding the results, one can say not only group education but also group counseling can improve emotional self-care in diabetics. Thus, it is recommended that with regard to ability, experience, and knowledge of nurses and capabilities of the subjects either of these two methods should be used in self- care of. type II diabetics

Cytotoxic assessment of silver nanoparticles in embryonic development and kidney tissue in pregnant mice

Background and Aim: Regarding the widespread use of silver nanoparticles in medecine and lack of a detailed study of toxicity effects of these particles on fetus, this study was carried out to investigate histopathological changes of the kidneys and also embryonic development following exposure to silver nanoparticles

Materials and Methods: In this experimental study, thirty five female NMRI mice were randomly divided into five equal groups; i.e. one control group and four experimental groups. The experimental groups intraperitoneally [IP] received silver nanoparticles at concentrations of 50, 100, 200 and 400 mg/ kg . .every other day. On the 17th day of pregnancy, the mice were dissected and their kidneys and embryos tissues were separated and stained with hematoxylin and eosin for histopathological examinations. Finally, the obtained data was fed into SPSS software [V:16] using statistical tests including Kolmogrof-Smearnof, oneway variance analysis, Dante, Mann-Whitney and Kruskal-Wallis; and P<0.05 was taken as the significant level

Results: Histopathological assessment of kidney tissue following IP administration of silver nanoparticle indicated pathological changes including congestion, necrosis, inflammatory cell infiltration, vacuolar degeneration compared to the control group. Our findings showed that silver nanoparticles during the gestation period affects fetal organogenesis, evolution of neural structure, liver lobulation and fetal growth retardation. Mean number of somites in groups receiving doses of 200 and 400 mg kg, . significantly reduced compared to the control group [P<0.05]

Conclusion: The obtained results suggest that passing of silver nanoparticles through placenta is possible and damage caused by the particles could lead to the deformity or developmental retardation of the fetus