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1.
Iranian Cardiovascular Research Journal. 2010; 4 (1): 28-32
in English | IMEMR | ID: emr-168360

ABSTRACT

Open heart surgery is associated with acute perioperative changes in plasma levels of neurohormonal stress factors, cortisol, interleukin-6 and C-reactive protein. Human studies involving cardiopulmonary bypass have shown that very low doses of ketamine can attenuate the markers of inflammation without adverse effects. The aim of this study was to investigate whether, low dose infusion of ketamine when administered during 48 hours after induction, have anti-inflammatory effect and attenuate stress factors, in on-pump coronary artery bypass graft surgery. In this prospective randomized-controlled trial, 50 patients undergoing on-pump coronary artery bypass graft were randomly assigned to receive either 1.25mcg/kg/min of ketamine [Ketamine group, n=25] or normal saline [Control group, n=25] infusion during and for 48 hours after surgery. Inflammatory and stress response markers including C-reactive protein, cortisol, White blood cell count and differential, glucose and lactate level were measured ,before induction [T1], 4 hours after surgery [T2], and on the first and the second days after surgery [T3 and T4]. The level of lactate were higher in ketamine compared with control group four hours after operation [P< 0.05] without any significant differences detected in other measurements. Low dose ketamine did not cause any change in C-reactive protein, cortisol, White blood cell count and glucose level, however lactate level was higher compared to control group

2.
Iranian Journal of Epidemiology. 2010; 6 (2): 48-55
in Persian | IMEMR | ID: emr-122306

ABSTRACT

Cardiopulmonary bypass often causes a stress hormonal response with subsequent changes in hemodynamic and organ perfusion. Human studies involving cardiopulmonary bypass have shown that very low doses of ketamine can attenuate inflammatory and stress markers, without adverse effects. The aim of this study was to investigate whether low dose infusion of ketamine have hemodynamic stability effect in coronary artery bypass surgery. In this double blind-controlled trial, 50 patients undergoing on-pump CABG were randomly assigned to receive either 1.25mcg/kg/min of ketamine infusion [Ketamine group, n=25] or normal saline infusion [Control group, n=25] during 48 hours after induction of anesthesia. hemodynamic measurement including blood pressure, heart rate, central venous pressure, cardiac output, cardiac index, systemic venous resistance, arterial blood gas and lactate were measured previous to induction [T1], 4 h, 24h, and48h after the surgery [T2,T3 and T4]. The data were evaluated with using of variance analyzing test and repeated measurement. There were significant interaction effect between time [pre operation, 4, 24 and 48 hours after operation] and group of study [ketamine and placebo] in assessment of systolic blood pressure [p=0.0001], diastolic blood pressure[p=0.0001], heart rate [p=0.004], central venous pressure [p=0.0001] and lactate [p=0.035]. These indicate that ketamine caused decrement in tissue perfusion. Those interactions were not statistically significant for other parameters [p>0.05]. low dose ketamine during and 48 hours after operation not only didn't show hemodynamic stability effect but also decreased tissue perfusion slightly


Subject(s)
Humans , Coronary Artery Bypass , Hemodynamics/drug effects , Double-Blind Method
3.
Iranian Journal of Epidemiology. 2010; 6 (3): 50-56
in Persian | IMEMR | ID: emr-108493

ABSTRACT

Oral disease is a significant burden to all countries of the world. Since there is little know about this in Iran we decided to identify of oral mucosal disease in patients referred to Oral Medicine Center affiliated to Tabriz Dental School. A consecutive sample of admitted patients to OMC between April to June 2007 were included in this study. We employed a standard questionnaire in order to. Eight hundred two patients were completed the requested questionnaire. Seventy percent was female. The mean age of the study sample was 32.68 [SD=12.25] years. Approximately 70% of subjects had oral lesion,%19.2 had normal mucosa and%21.60 of patients had oral mucosal lesions that need to follow and control. The most common lesions were ankiloglossia [%29.7] then fissural tongue [%25.7] and coated tongue [%23.7]. Many patients attending the center were unaware of oral lesions in their soft oral tissue which needed to follow up. This emphasizes that examination of soft oral tissue should be considered by health policy makers in oral health agenda at national level


Subject(s)
Humans , Male , Female , Adult , Stomatitis/epidemiology , Tongue, Fissured/epidemiology , Surveys and Questionnaires
4.
Journal of Guilan University of Medical Sciences. 2005; 13 (52): 41-47
in Persian | IMEMR | ID: emr-200872

ABSTRACT

Introduction: Laryngoscopy and endotracheal intubation result in severe homodynamic changes in patients, which in CAD patients are more severe and they need more prompt controls


Objective: Considering the effects of magnesium in coronary vessels, myocardium, cardiac conduction system and whole body vasculature, our purpose in this research was to make a comparison of mg Sulfate, fentanyl and lidocaine in attenuating homodynamic responses to laryngoscopy in patients with coronary artery disease


Materials and Methods: We evaluated mg-sulfate ability in attenuating homodynamic responses to laryngoscopy and intubation, in a double blind, prospective study with fentanyl and lidocaine which are used commonly in this regard. We randomly selected 60 patients and arranged them in 3 groups. All patients had EF more than 45%. In group A, 1.5mg/kg lidocaine, group B, 2 micro g/kg fenanyl, and in group C, 30mg/kg mg sulfate were administered intravenously 3 minutes before laryngoscopy and mean arterial pressure [MAP] and heart rate [HR] were measured on arrival [base values], immediately before and after laryngoscopy and 1 min and 3 min after laryngoscopy. Induction of anesthesia in 3 groups was the same


Results: After laryngoscopy, increases in MAP and HR in group B and C [fentanyl and magnesium] were less than those in group A [p<0.05] with no significant difference between group B and C [p>0.05]


Conclusion: Magnesium sulfate is completely preferable and superior to lidocaine in attenuating homodynamic responses to laryngoscopy and has equal efficacy and value with fentanyl

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