ABSTRACT
BACKGROUND: In some cases, permanent reduction in cerebral functioning affects a high percentage of patients undergoing cardiovascular surgery. We studied the relationship between the results of preoperative bilateral carotid artery colour Doppler sonography and regional cerebral oxygen saturation (rSO2) during coronary artery bypass graft surgery (CABG). MATERIALS AND METHODS: This study was a cross-sectional analytical study conducted with 96 candidates for off-pump CABG. This study determined the percentage of the correlation of rSO2 with demographic information, diabetes, hyperlipidemia, hypertension, myocardial infraction (MI), and smoking, and also provided information on the presence and type of plaque, intima-media thickness (IMT), and percentage of stenosis of carotid artery detected through colour Doppler sonography. Data were analyzed by the t-test, the Chi-square test, and simple linear regression. RESULTS: In this study, the mean value of rSO2 increased after intubation compared to the mean before intubation, the difference being statistically significant (P = 0.005). A comparison of the mean rSO2 of the right side of the brain and the percentage of right carotid obstruction (stenosis of less than 50% vs. stenosis with a range of 50-69%) revealed that the mean rSO2 at the time of the partial-clamp between carotid stenosis less than 50% and carotid stenosis with a range of 50-69% was statistically significant (P = 0.043). CONCLUSIONS: There is no statistically significant correlation between rSO2 and percentage of carotid artery stenosis less than 70%. It is advised that rSO2 and carotid stenosis of greater than 70% be studied in future.
ABSTRACT
INTRODUCTION: Pelvic masses are among most the common causes of patient admission into gynecology clinics and one of the most common reasons for referral to gynecologic oncology departments due to the risk of uterine or ovarian malignancies. The aim of this study is to compare the four indices of the risk of malignancy index (RMI 1-4), as a combination of menstrual status, radiological findings, and serum CA125 concentration, for discrimination of benign from malignant pelvic masses. METHODS: This retrospective descriptive and analytic study was conducted on 200 patients with pelvic mass, post-surgery, and who were referred to the oncology department in Shahid Sadoughi hospital of Yazd (Iran) between June 2007 and September 2011. Data regarding demographics, pathology reports, paraclinical and clinical tests were analyzed. The four RMI indices were separately used for determination of benign vs. malignant masses using the optimized cutoff points, ROC curve, sensitivity, specificity, predictive value of positive and negative, and accuracy. Finally, p value for each index was calculated, and a final discrimination power was measured by using SPSS version 17 software. RESULTS: The calculated p values in the four RMI indices in ultrasound findings indicated statistical significance, and the RMI 2 showed the highest level of accuracy or diagnostic performance. RMI 2 had a cutoff point of 90, an under-chart area 86.7, 79.36% sensitivity, 78.95% specificity, 58.44%, positive predictive value, 90.08% negative predictive value, and 78.93% accuracy, and a p value of 0.004. However, this relationship was found not to be meaningful using CT scan images. CONCLUSIONS: Using RMI 2 for differentiation of malignant from benign pelvic masses is a reliable method with ultrasound findings.
ABSTRACT
We conducted this single blind randomized clinical trial to compare the efficacy and safety of oral chloral hydrate and intranasal midazolam for induction of sedation for computerized tomography scan of brain in children. Participants aged 1-10 years (n=60) were randomized to receive 100 mg/kg chloral hydrate orally with intra nasal normal saline OR intranasal midazolam 0.2 mg/kg with oral normal saline. Adequate sedation (Ramsay sedation score of four) was obtained and CT scan completed successfully in 76.7% of chloral hydrate group and in 40% of midazolam group (P=0.004). No significant difference was seen for side effects frequency between the two drugs (10% in chloral hydrate, 3.3% in midazolam group; P=0.34). We conclude that oral chloral hydrate can be considered as a safe and effective drug for sedation in children undergoing CT scan of brain.
