ABSTRACT
In a significant number of the patients with hematochezia, colonoscopy turns out to be normal and therefore is unable to determine the cause of bleeding. This study investigates outcomes and possible necessity for further work up in cases of hematochezia with normal colonoscopy. Ninety-seven patients with normal colonoscopy were followed for at least one year from the time of colonoscopy by regular visits and phone calls. Mortality and recurrent bleeding were recorded as primary end points. Those with recurrent or continued hematochezia were invited for a new visit and further work up. Among the ninety seven patients, nine cases [9.3%] were lost at follow ups, 10 experienced rebleeding [10.3%], and the remaining 78 [80.4%] were apparently healthy and had no further complaints. There were two mortalities during the follow up, one due to gastric cancer and the other due to cerebrovascular accident. It is unusual for the cases of hematochezia with a normal initial colonoscopy to have recurrent bleeding as a result of a significant missed lesion in the colon
ABSTRACT
Background and Purpose: Lamotrigine is a novel potential antiepileptic drug, which is not structurally dependent on the current antiepileptic drugs; it has fewer side effects too. The present study intends to assess the effects of Lamotrigine on the antinociceptive activity, induced by morphine, by using the formalin test as a test of nociception
Methods and Materials: This experimental study was conducted on 56 adult male rats. The animals were divided into seven groups of eight rats, considered as one control, one sham and five experimental groups [one group receiving 2mg/Rat of morphine alone, three groups receiving 2mg/Rat morphine accompanied by Lamotrigine in doses of 25, 50 and 75 mg/Rat and the fifth group receiving only 75 mg/Rat of Lamotrigine alone]. The drugs were intraperitoneally injected 15 minutes before the formalin test. The sham group received the same volume of physiologic serum, and the control group received formalin alone. The study data were analyzed in SPSS using Tukey and Kruskal Wallis test; level of significance was considered to be 0.05
Results: Mean pain score following the injection of maximum dose of lamotrigine together with morphine was 0.08 +/- 0.001, which indicated more local analgesic effects at the acute phase in comparison with the injection of morphine alone [0.11 +/- 0.0005] [p<0.05]. Also, mean pain scores following the injection of different doses of lamotrigine [25, 50, 75 mg/rat] together with morphine were 0.08 +/- 0.007, 0.06 +/- 0.0004, and 0.06 +/- 0.002 respectively, which caused a significant reduction in the pain scored the chronic phase of formalin test in comparison with morphine alone [0.09 +/- 0.0005] [p<0.05]
Conclusion: Prescription of lamotrigine accompanied with morphine, in comparison with the prescription of each alone, has better effects on the process of pain score reduction
ABSTRACT
Background and Purpose: There have been variations on the response rate of microorganisms causing pyelonephritis to antibiotics in different studies. The present study was conducted to compare the drug resistance against Ceftriaxone and Cefazolin in adult acute pyelonephritis
Methods and Materials: In this phase-3 single blind clinical trial, 86 patients suffering from pyelonephritis were selected through successive sampling, and were randomly assigned into one of the two groups after they signed an informed consent: Ceftriaxone 1g every 12 hours and IV Cefazolin 1g every 8 hours. Seventy two hours after the onset of treatment, patients were examined for their clinical and laboratory resistance. The obtained data were analyzed in SPSS using chi-square test, independent sample t-test, and Kappa coefficient
Results: Mean fever alleviation time were 2.63 +/- 0.95 and 2.77 +/- 0.81 days in the ceftriaxone and cefazolin groups respectively [p=0.2]. Urinary culture 72 hours after treatment was positive in 7% of patients in both groups. In the ceftriaxone group, 51.2% of the patients were sensitive clinically and in the laboratory results. In total, 9.3% were sensitive in laboratory and clinically resistant; and 39.5% were sensitive in laboratory despite being clinically resistant. With the cefazolin group, 51.2% were both clinically and laboratory sensitive; and 7% were clinically and laboratory resistant; also, 11.6% were sensitive in laboratory but clinically resistant; but 30.2% were clinically sensitive despite being resistant in the laboratory results
Conclusion: In the treatment of non-complicated upper urinary infections, the therapeutic effect of cefazolin is not different from that of ceftriaxone, which is broad spectrum and more expensive