Comparison of local anesthetic effects of tramadol and lidocaine used subcutaneously in minor surgeries with local anesthesia

In this study, the local anesthetic and post-operative analgesic effects of tramadol were compared to those of lidocaine in minor surgeries under local anesthesia. This double-blind clinical trial study included 70 patients in ASA physical status I and II, aging between 20 and 50 years, undergoing minor surgery [lipoma excision and revision of scars less than 4 cm within 30 minutes or less] under local anesthesia. The patients were randomly assigned to receive either 2 mg/kg tramadol [group T, n=35] or 1 mg/kg lidocaine 2% [group L, n=35] subcutaneously. Scores of the pain sensation were recorded as VAS [visual analogue scale 0-10] during injection, incision and 15, 30 and 45 minutes after incision, and then 2, 4 and 6 hours post-operatively at the ward. There was no significant difference between pain scores of the two groups during injection, incision and surgery or in the post-operative period at the ward [p=0. 181]. Incidence of nausea was 0% and 22. 8% in group L and group T, respectively. The difference was statistically significant [p=0.002]. Furthermore, 82. 9% of subjects in group L and 60% of subjects in group T needed acetaminophen to control their pain and the difference was significant [p=0.004]. Tramadol 2 mg/kg has local anesthetic and post-operative analgesic effect equal to lidocaine 1 mg/kg in minor surgeries performed subcutaneously. Therefore, we concluded that tramadol can be used as an alternative drug to lidocaine in local anesthesia and has the ability to decrease the demand for post operative analgesics

[Evaluation of the effect of progesterone on prevention of preterm delivery and its complications]

Preterm delivery is a major cause of prenatal mortality and morbidity in the world and results in increased obstetric and pediatric care costs. The purpose of this study was to evaluate the effects of prophylactic vaginal progesterone in decreasing the rate of preterm delivery and its complications in high risk women. This study included 150 asymptomatic women with high risk singleton pregnancies. The subjects were assigned randomly into two similar groups. One group received 100 mg of prophylactic vaginal progesterone therapy [n=75] daily between the 24th and 34th week of gestation and the other group received no treatment [n=75]. The two groups were similar regarding maternal age and preterm delivery risk factors. Uterine contractions were monitored by external tocodynamometer for 60 minutes and in case of true contractions, routine tocolytic drugs were started for the subjects. In some patients, in spite of receiving tocolytic drugs, delivery progressed and the related data were collected. Data were introduced into SPSS software and analyzed by means of chi square, exact Fischer, ManWitney U, and t tests. The results were reported with a confidence level of 95%. The mean gestational age at the time of delivery was higher in the interventional group [38.62 +/- 2.08 week vs. 35.88 +/- 3.5 week] [P=0.001]. Preterm delivery before the 37th week of gestation occurred in 11.6% and 31.9% of the subjects in the progesterone and control groups respectively [P=0.004] and preterm deliveries before the 34th week occurred in 22.2% and 2.9% of the women in the control and progesterone groups respectively [p=0.001]. Moreover respiratory distress syndrome, low birth weight, birth weight, need for oxygen, infant apgar,need for mechanical ventilator, and hospitalization in NICU were significantly different between the two groups [P<0.01]. Prophylactic vaginal progesterone reduced the frequency of uterine contractions which led to decreased rate of preterm delivery in women with high risk factors for preterm delivery

Study of relationship between nutritional status and duration of hospitalization in the children under 2 years old with gastroenteritis

Numerous studies indicate that diarrhea is more common in persons suffering from malnutrition, because malnutrition causes infections and infection leads to diarrhea which in turn it is a notorious defective cycle. Regarding the high prevalence of gastroenteritis, especially in less than 2 years old children, and relatively high prevalence of malnutrition in children in developing countries that cause impacted high expenses on government and families, because of long term hospitalization of children, this research was carried out to study relationship between nutritional status of children with gastroenteritis and their duration of hospitalization in Khorramabad Shahid Madani hospital in 2007. In this cross- sectional study, 100 children under 2 years old with gastroenteritis were investigated. They were divided into groups of 50 including " well nourished" and "mal nourished", then the duration of hospitalization in both groups was compared. Nutritional status of the children was measured by dividing their weight by their 50% of standard weight for their ages. Children with birth interval from previous child more than 2 years, birth weight over 2500 grams, mothers' age range of 20-35 years, lack of hospitalization during the last 6 months were selected. Data were collected using questionnaire. The effect of the other likely interfering variables, with 95 percent of confidence interval, were determined. A significant relation between mean time of hospitalization [in term of day] and nutritional status of the children was observed [P<0.001] mean time of hospitalization in well nourished group was 2.58 days, however in mal nourished group it was 3.86 days. Among interfering variables, only exclusive breast feeding showed a significant effect on the duration of hospitalization [P=0.001]. Most of the children suffering from gastroenteritis were between 7-12months of age. Mean age of mal nourished children was 8.96 months, while for well nourished children it was 10.18 months. According to our results, malnutrition leads to a significant increase in duration of hospitalization in children suffering from gastroenteritis disease