Résumé
This study was carried out in 2003-2004 in Kermanshah Diabetes Research Center to assess the effect of diabetes on hearing. This is a case-control study. 82 diabetic cases [26 types I and 56 type 2 cases] were studied along with 82 controls matched both in age and sex. Cases were selected randomly, their range of age was 15 to 55 years and their duration of diabetes was more than 3 years. After completing questionnaires, all cases and controls undergone autoscopic examination. Those with other ear disease with hearing impairment were omitted. Audiometery including; pure tone audiometery, speech audiometery, and impedance audiometrey with well tone AD19 formed was done on 164 [diabetic and control] persons. Data was analyzed using t-test. Audiometric findings with different frequencies in the two groups revealed that there was a significant relationship between diabetes and hearing impairment [p<0.001]. This relationship was more significant in high frequencie, older age and type 2 diabetes, but there were no relationship between control of blood sugar [HbA1c], duration of diabetes, sex, microvascular and macrovasculur complications with hearing loss in diabetic patients. These finding demonstrate that diabetes can cause mild to moderate hearing impairment especially in high frequencies. The mechanism of this effect is unknown
Résumé
Pain relief has been received the highest level of medical attempts continuously but still many patients suffer from it. Narcotics' side-effects have led investigators to apply other techniques for controling acute postoperative pain to reduce narcotics requirements. Recently, some concepts have been presented implying that Metoclopramide does have analgesic effects and this led us to conduct the present study in order to determine Metoclopramide's effect on alleviating pain after cesarean section. In this clinical trial, 80 patients who were candidates of elective cesarean section were studied in two groups. 10 minutes before the cesarean section's ending time, the control group was given 25 mg Pethidine accompanied by 10 mg Metoclopramide and control group 25 mg Pethidine and distilled water. Then when patients were conscious after cesarean section, for a period of 6 hours received after-care for their vital signs and side-effects of prescribed drugs. Their pain score [VAS] and nausea rate was measured and if necessary, Pethidine was injected with certain dose. Injection time for first dose of Pethidine and its required amount were recorded in a checklist within first 6 hours after cesarean section. Data was analyzed using ANOVA and T tests. Prescription of Metoclopramide inhaunced analgesic effect of narcotics and a meaningful decrease was found in pain score [p=0.002] and nausea rate [p<0.005]. Injection time for the first dose of Pethidine was also prolonged hi the group who received Metoclopramide compared to control group [p=0.019] and an obvious decrease was occurred in received Pethidine's amount within the first hours after cesarean section [p<0.005]. Drugs side-effects were not found in patients. The results indicate that use of Metoclopramide accompanied by Pethidine in ending time of cesarean section, does have considerable effects in controlling acute pain after surgery and increasing analgesic effect of narcotic drugs. Therefore, use of Metoclopramide as a proper supplement drug with low side-effects is recommended