Résumé
Background: Electroconvulsive therapy (ECT) is one of the available and the most effective therapies for the treatment of resistant depression. Considering the crucial role of seizure duration on therapeutic response in patients treated with ECT, this study aimed to compare the effect of ketamine and sodium thiopental anesthesia during ECT for treatment of patients with drug‑resistant major depression (DRMD). Materials and Methods: In a double‑blind randomized clinical trial, 160 patients with DRMD were selected consequently and were assigned randomly into two groups including ketamine 0.8 mg/kg and sodium thiopental 1.5 mg/kg. The seizure duration, recovery time, and the side effects of anesthesia were evaluated after 1‑h after anesthesia. Data of recovery time and complication collected in 2nd, 4th, 6th, and 8th ECT. Depression was assessed by Hamilton depression scale. Results: The results indicated that ketamine and sodium thiopental had a significant effect on the reduction of depression scores in patients with DRMD (P < 0.05). Complications such as a headache, nausea, pain at the injection site, short‑term delirium, and long‑term delirium were higher in ketamine group (P > 0.05). But ketamine was more effective in improvement of depression score and increasing systolic and diastolic blood pressure (P < 0.05). The mean of seizure duration showed a decreasing trend and was significant between two study groups (P < 0.05). Conclusion: Anesthesia induced by ketamine during ECT therapy increased blood pressure and seizure duration. Therefore, due to lower medical complication and attack rate of seizure, ketamine is an appropriate option for anesthesia with ECT in patients with DRMD.
Résumé
BACKGROUND: Chronic myeloid leukemia (CML), is the first malignancy that related to the chromosomal abnormality and include 15‑20% of all adulthood leukemia. AIMS: This study aimed to compare the hematologic, breakpoint cluster region‑abelson (BCR‑ABL) and liver function enzymes changes during treatment period of Imatinib. SETTINGS AND DESIGN: A noncurrent clinical trial study. MATERIALS AND METHODS: New incident CML patients received Iranian made or Indian‑made Imatinib after baseline measurement. Hematologic, BCR‑ABL, electrolytes and liver function enzymes measured again after 24 weeks. STATISTICAL ANALYSIS USED: Paired t‑test and independent t‑test was used to assess the effect of treatment in within and between groups, respectively. RESULTS: Imatinib has a decreasing impact on white blood cells and placates. While an increasing effect on hemoglobin concentration. Iranian made and Indian‑made Imatinib has a same effect on improvement of hematologic, BCR‑ABL, electrolytes in CML patients. However, the liver changes of Imatinib were not clinically significant. CONCLUSION: The Iranian‑made Imatinib can be used as a replacement for Indian made ones without any statistical and clinical significant difference on Improvement of CML patients.