Effect of gabapentin pretreatment on myoclonus after etomidate: a randomized, double-blind, placebo-controlled study / Efeito do pré-tratamento com gabapentina sobre a mioclonia após etomidato: um estudo randômico, duplo-cego e controlado por placebo

Abstract Aim: To evaluate the effects of three different doses of gabapentin pretreatment on the incidence and severity of myoclonic movements linked to etomidate injection. Method: One hundered patients, between 18 and 60 years of age and risk category American Society of Anesthesiologists I-II, with planned elective surgery under general anesthetic were included in the study. The patients were randomly divided into four groups and 2 h before the operation were given oral capsules of placebo (Group P, n = 25), 400 mg gabapentin (Group G400, n = 25), 800 mg gabapentin (Group G800, n = 25) or 1200 mg gabapentin (Group G1200, n = 25). Side effects before the operation were recorded. After preoxygenation for anesthesia induction 0.3 mg kg−1 etomidate was administered for 10 s. A single anesthetist with no knowledge of the study medication evaluated sedation and myoclonic movements on a scale between 0 and 3. Two minutes after induction, 2 µg kg−1 fentanyl and 0.8 mg kg−1 rocuronium were administered for tracheal intubation. Results: Demographic data were similar. Incidence and severity of myoclonus in Group G1200 and Group G800 were significantly lower than in Group P; sedation incidence and level were appreciably higher compared to Group P and Group G400. While there was no difference in the incidence of myoclonus between Group P and Group G400, the severity of myoclonus in Group G400 was lower than in the placebo group. In the two-hour period before induction other than sedation none of the side effects related to gabapentin were observed in any patient. Conclusion: Pretreatment with 800 mg and 1200 mg gabapentin 2 h before the operation increased the level of sedation and reduced the incidence and severity of myoclonic movements due to etomidate.

Resumo Objetivo: Avaliar os efeitos de três doses diferentes de gabapentina como pré-tratamento sobre a incidência e a gravidade dos movimentos mioclônicos associados à injeção de etomidato. Método: Cem pacientes, entre 18-60 anos, estado físico ASA I-II, programados para cirurgia eletiva sob anestesia geral, foram incluídos no estudo. Os pacientes foram randomicamente divididos em quatro grupos e duas horas antes da operação receberam cápsulas orais de placebo (Grupo P, n = 25), 400 mg de gabapentina (Grupo G400, n = 25), 800 mg de gabapentina (Grupo G800, n = 25) e 1.200 mg de gabapentina (Grupo G1.200, n = 25). Os efeitos colaterais antes da cirurgia foram registados. Após pré-oxigenação para a indução da anestesia, etomidate (0,3 mg.kg−1) foi administrado por 10 segundos. Um único anestesista, cego para a medicação do estudo, avaliou a sedação e os movimentos mioclônicos com uma escala de 0 a 3. Dois minutos após a indução, fentanil (2 µgr.kg−1) e rocurônio (0,8 mg.kg−1) foram administrados para a intubação traqueal. Resultados: Os dados demográficos foram semelhantes. A incidência e a gravidade da mioclonia nos grupos G1.200 e G800 foram significativamente menores do que no Grupo P; a incidência e o nível de sedação foram consideravelmente maiores comparados com o Grupo P e o Grupo G400. Enquanto não houve diferença na incidência de mioclonia entre os grupos P e G400, a gravidade da mioclonia no Grupo G400 foi menor do que no grupo placebo. No período de duas horas antes da indução, nenhum dos efeitos colaterais relacionados à gabapentina, exceto sedação, foi observado em qualquer paciente. Conclusão: O pré-tratamento com 800 mg e 1.200 mg de gabapentina duas horas antes da operação aumentou o nível de sedação e reduziu a incidência e a gravidade dos movimentos mioclônicos associados ao etomidato.

[Evaluation of correlation between maternal serum level of beta-human chorionic gonadotropin during 16-20 weeks of pregnancy and preeclampsia incidence]

Most current hypotheses Background: regarding the pathophysiologic mechanisms of preeclampsia point to early placental abnormalities. Therefore, we attempted to determine whether maternal human chorionic gonadotropin [hCG] levels in second trimester predict preeclampsia. In this prospective study, 508 pregnant women who referred to Shahid Akbar Abadi prenatal clinic for prenatal care during 2007-2009 were enrolled. Maternal serum hCG was measured of all these women during 16-20 wks of gestational age. All these women were followed and evaluated for preeclampsia. In 47 women [9.3%], preeclampsia was detected. The mean of log serum hCG levels during second trimester of pregnancy were found to be significantly higher in severe preeclampsia, compared with controls [p<0.05]. Furthermore, increase of maternal age enhances risk of preeclampsia. Our finding indicates that a serum level of maternal hCG during weeks 16-20 pregnancy, could be a value for predicting of preeclampsia

[Evaluation of correlation between maternal serum level of beta-human chorionic gonadotropin during 16-20 weeks of pregnancy and preeclampsia incidence]

Background: most current hypotheses Background: regarding the pathophysiologic mechanisms of preeclampsia point to early placental abnormalities. Therefore, we attempted to determine whether maternal human chorionic gonadotropin [hCG] levels in second trimester predict preeclampsia

Materials and Methods: in this prospective study, 508 pregnant women who referred to Shahid Akbar Abadi prenatal clinic for prenatal care during 2007-2009 were enrolled. Maternal serum hCG was measured of all these women during 16-20 wks of gestational age. All these women were followed and evaluated for preeclampsia

Results: in 47 women [9.3%], preeclampsia was detected. The mean of log serum hCG levels during second trimester of pregnancy were found to be significantly higher in severe preeclampsia, compared with controls [p<0.05]. Furthermore, increase of maternal age enhances risk of preeclampsia

Conclusions: our finding indicates that a serum level of maternal hCG during weeks 16-20 pregnancy, could be a value for predicting of preeclampsia

Study of the realtionship between anemia and postpartum depression

Background and Purpose: Women are subject to postpartum depression in the childbearing age, which is associated with aerious somplications for the mother, infant and the family. Its cause is not known. Many studies have the effect of psychosocial factors in this regard but there is meager information on the biological grounds. Recently, anemia has been on the focus as causing depression. This study was conducted to determine the the relationship between anemia and postpartum depression

Methods and Materials: This prospective descripe-anlytical study was conducted on the population of women admitted to the Fatemiyyeh Health Center, affiliated to Hamadan University of Medical Sciences, Iran, in 2006. The study sample included 159 normal [non depressed confirmed by the Beck test] pregnant women who were selected by convenient non-probability methods. With a gestational age of 38-40 weeks, they were divided into two groups of anemics and non-anemics by their hemoglubin levels [measured by Cyan Matt]. They were homegenized as for the confounders. On the 7th and 28th days after labor, their hemoglubin was measred again. On the 28[th] day, they completed the Edinburgh Questionnaire. The realtionship between their postpartum depression and anemia was assessed three times. Chi-square, t-test, Mann Whitney and the relative risk tests were used in SPSS to analyze the obatained data

Results: 14.6% of the non-anemics and 38.6% of the anemic [measured on the 38-40 weeks] were found t obe depresed on the 28th day after delivery, and anemia had increased the chances of postpartum depression by 1.8 times, 14.8% of the non-anemics and 35.9% of the anemics [measured on the 7th day after labor] were depressed on the 28th day, and anemia had increased the chances of postpartum depression by 1.7 times. Also, 11.5% of the nonanemics and 46% of the anemics [measured on the 28th day after labor] were depressed after labor. Anemia had increased the chances of postpartum depression by 2.5 times

Conclusion: It seems that anemia in the 38-40 weeks of gestation, on the 7th and 28th days after labor can increase the likelihood of postpartum depression

comarative evaluation of sonourethrography versus urethrography with intraoperative findings in urethral phatologies prospective study

Purpose: To evaluate stricture and disruption of the male urethra with the help of sonography and to evaluate the efficacy of Sonourethrography [S.U.G.] and up and down Sonourethrography as compared to conventional radiographic procedures as retrograde urethrography [RUG] and up and down urethrography

Material and Methods: In the period of 25 months, we evaluated 35 patients [31 patients with urethral strictures and 4 patients with urethral disruption] with urethrography and S.U.G. Age of the patients varied between 12-85 years [mean 39 y]. We analyzed stricture length, depth of spongiofibrosis, urethral defect, and satisfaction and compared the results. We also analyzed the results of imaging with urethroscopic and surgical results

Results: The depths of spongiofibrosis concluded grade A in one [3.2%], grade Bin 12 [37.8%], grade C in 11 [35.4%], grade D in 2 [6.4%] and grade E in 2 [6.4%]. Spongiofibrosis wasn't valuable in 3 [9.6%] patients. The length of the stricture was better demonstrated by sonography [p= 0.000]. We didn't find important differences concerning results of up and down Sonourethrography and up and down urethrography in patients with urethral disruption [p= 0.18]. Patients were more satisfied from sonographic study than urethrography [p=0.000]

Conclusion: S.U.G. is a simple and available procedure without radiation exposure S.U.G. is more sensitive in defining the length and the depth of strictures. Grade B was the most common from of spongiofibrosis in our study. Patients were more satisfied from sonographic study than urethrography. Up and down Sonourethrography could be helpful in defining the length of defect in urethral disruption

[ effect of carbenoxolone on lipid peroxidation level during global ischemic-reperfusion in hippocampal rat slices]

Present studies have shown that gap junction channels could be a novel target to reduce brain damage during cerebral ischemia. Carbenoxolone, a gap junction channel blocker decreased the spread of cell death in in vitro brain ischemic model and inhibition of lipid peroxidation has been of much interest to ameliorate excitotoxic neuronal damage. Thus the aim of the present study was to determine the effect of carbenoxolone on lipid peroxidation in experimental global ischemicreperfusion in the rat hippocampus. The brain damages were determined using the measurement malondialdehyde [MDA]. Cerebral ischemia was induced by four-vessel-occlusion [4VO]. Carbenoxolone [50-200mg/kg], phenytoin [50 mg/kg] and normal saline [10 ml/kg] were administered intraperitoneally immediately after reperfusion. The malondialdehyde [MDA] was measured using the thiobarbituric acid [TBA] test. The MDA level was higher in the saline group during ischemic reperfusion than the sham group. The MDA levels recovered significantly upon phenytoin and carbenoxolone [100-200 mg.kg] therapy in the ischemicreperfusion. These results suggest that carbenoxolone may protect the brain against lipid peroxidation in cerebral ischemia

[ effect of thymoquinone on global ischemia-reperfusion in rats]

Thymoquinone is the major active constituent of the volatile oil of Nigella sativa seeds. It has been previously reported that thymoquinone prevents oxidative injury in various hepatotoxicity models and may prevent membrane lipid peroxidation. In order to clarify the effect of thymoquinone on lipid peroxidation in CNS, we induced cerebral ischemic/reperfusion injury in rats using four-vessel occlusion [4-VO] method and consequently determined malondialdehyde [MDA] levels in hippocampus based on its reaction with thiobarbituric acid [TBA]. Thymoquinone [2.5-10 mg/kg], phenytoin [50 mg/kg] and control [10 ml/kg] were administered immediately after reperfusion. The MDA level was higher in control group [normal saline] following ischemic-reperfusion than thymoquinone treated groups. The MDA levels recovered significantly upon phenytoin and thymoquinone [5, 10 mg/kg] therapy following ischemic/reperfusion. These results suggest that thymoquinone may exhibit neuroprotective effect through an inhibitory activity against lipid peroxidation during cerebral ischemia in rats