[Detection of A1430G mutation in SCN1A gene in a patient affected by GEFS-like epilepsy in Chaharmahal va Bakhtiari province]

Background and aim: SCN1A gene encodes for neuronal voltage-gated sodium-channel ?-subunit. Mutations in this gene are the major cause of severe myoclonic epilepsy of infancy [Dravet syndrome] and generalized epilepsy with febrile seizures plus [GEFS[+]]. GEFS[+] is a heritable benign type of epilepsy associated with febrile seizures which belongs to Idiopathic Generalized Epilepsies with a marked clinical and genetic heterogeneity. The main objective of this research is screening of mutations in scn1a gene in patients affected by GEFS[+] and Idiopathic Generalized Epilepsy [IGE]

Methods: Genetic counseling was carried out with 30 patients and their family. Peripheral blood samples were collected from patients and DNA was extracted using salting out method. Standard PCR on 16[th]-26[th] exons of scn1a gene was optimized by employment of specific primers. PCR products were analyzed by SSCP in denaturant condition and sequenced in the next step

Results: Results showed a 4289c>g missense mutation in one patient affected by idiopathic generalized epilepsy. This mutation changes the alanine residue in 1430 position to glycine [A1430G]

Conclusion: More studies are needed to identify the direct role of this mutation in pathogenesis, however, heterozygotic genotype of this mutation is consistent with dominant feature of inheritance of Epilepsy

[Effects of intravenous midazolam premedication on postoperative nausea and vomiting after cataract surgery under general anesthesia]

Background: postoperative nausea and vomiting is still a common and major complication after general anesthesia, which may delay post-anesthetic care unit [PACU] discharge, prolong hospital stay and thus increase the cost of hospitalization. Several drugs and techniques have been shown to be effective in reducing postoperative nausea and vomiting. In this study the effects of premedication with Intra venus midazolam on the incidence and severity of postoperative nausea and vomiting was investigated in a sample of adult patients undergoing Extra Capsular Cataract Extraction under general anesthesia

Material and Methods: one hundred adult patients undergoing general anesthesia for Cataract surgery were randomly divided into two groups to receive either midazolam [0.025mg/kg] or a same volume of normal saline intravenously two minutes prior to induction of anesthesia. Incidence and severity of Postoperative nausea and vomiting and the total amount of administered metoclopramide during the first postoperative day [24hours] were compared between the two groups

Results: there were no differences between the two groups regarding the age, sex, body mass index, NPO time, preoperative anxiety, and severity of post operative pain. Severity of nausea and frequency of vomiting were significantly lower in midazolam group during the first 24 hours after surgery compared with placebo group [nausea: 1.14 +/- 1.42 of a ten point visual analog scale vs. 3.18 +/- 2.43 in placebo group, P<0.05], and [vomiting: 0.08 +/- 0.340 vs. 0.8 +/- 0.948 in placebo group, P<0.05]. Midazolam group received a significantly less amount of metoclopramide during the first postoperative day [0.8 +/- 2.7 mg vs. 2.2 +/- 1.4 mg in placebo group; P<0.05] but recovery time in midazolam group was slightly longer than placebo group [20.80 +/- 4.88 minutes vs. 16.20 +/- 3.43; P<0.05]

Conclusion: the results of this study suggest the effectiveness of intravenous midazolam premedication to reduce the incidence and severity of postoperative nausea and vomiting

[Chronic incisional pain after open appendectomy]

Although appendectomy is the most common emergency abdominal surgery, there is no epidemiologic study on chronic pain after open appendectomy. The aim of this study was to evaluate the incidence and possible risk factors of chronic pain following this common surgical procedure. In this cross-sectional survey, a questionnaire was completed regarding the pain at the surgical site by calling available patients who had undergone open appendectomy from 1999-2004 in a hospital in Fasa. The patients records were checked for the results of pathology. Out of 1130 patients operated by open appendectomy, 155 were available. The mean time left after appendectomy was 28 months. At the time of study, 41 [26%] patients still had pain at the site of operation and 9.85% of them had severe pain at rest and 22% suffered from severe pain during daily activities. Chronic pain was significantly more common among patients who had the memory of severe acute post-operative pain and there was no significant difference in the chronicity of pain according to age, sex and positive appendectomy. Chronic post-appendectomy pain is provalent. It is more common in patients with severe acute post-operative pain but it seems not to be related with age, sex, and positive appendectomy

comparison between teacher centered and student centered educational methods

Various approaches to learning are suggested and practiced. The traditional medical education were more teacher centered oriented. In this method the students' involvement in the process of learning is not remarkable, but the new approach to medical education supports the students involvement. This study evaluated the various method of lecturing considering students involvements. One hundred two first year medical and nursing students involved in this stuck and their opinion about these two methods of learning were obtained by filling of a questionnaire. The subject of the lectures was [general psychology] which was carried out 50% by the students and 50% by the teacher. The statistical analysis was carried out by SPSS program. Considering students opinion in student-centered method the various aspect of learning such as mutual understanding, use of text books and references were significantly increased, whereas other aspects of learning such as self esteem, study time, innovation, and study attitude though were improved, but were not significant as compared with teacher centered method. In teacher-centered method the understanding of the subjects was significantly increased. Other aspects of learning such as motivation and concentration were improved but not significantly as compared with student-centered method. As the result showed student centered method was favored in several aspects of learning while in teacher centered method only understanding of the subject was better. Careful choice of teaching method to provide a comprehensive learning experience should take into account these differences

Effect of repeated electrical stimulation in Pentylenetetrazol-induced kindling in male rats

Kindling is an animal model of epilepsy induced by repeated stimulation of the brain. The amygdala has been the focus of interest, due in large part to its role in epilepsy induction and in fear conditioning in both human and rats. The purpose of the present study was to evaluate whether low electrical stimulation of foot pad of rats during fear can facilitate kindling susceptibility. In this experimental study 25 wistar male rats were trained for two way active avoidance learning in the shuttle box and on the basis of escape response were divided into fast and slow learning rats. Then each group was randomly assigned into two groups. Test groups received conditional and unconditional stimulus and control groups received conditional stimulus for ten days. To induce kindling pentylenetetrazole was administered to rats and seizure parameters were eveluated. Data were analyzed using one way ANOVA and Tukey's test. Results demonstrated that slow learning rats in comparison to fast learning ones were more prone to kindling. Repeated electrical stimulation of slow learning rats during fear conditioning facilitates kindling induction is comparison to fast learning group. It seems that slow learning rats when exposed to repeated electrical stimulation after fear conditioning have more susceptibility to show seizure as compared to fast learning groups. It seems that neurons in the amygdala of slow learning rats have more exibility