The Effect of Adding Memantine to Clonidine in Reducing Withdrawal Symptoms in Opioid-Dependent Patients: A Double-Blind Randomized Controlled Trial.

OBJECTIVE: Addiction is a complex condition and a brain disease manifested by compulsive substance use despite its harmful consequence. Addicted individuals have an intense focus on using substances. This study aimed to investigate the effect of adding memantine to clonidine and buprenorphine in reducing withdrawal symptoms, compared with placebo, in drug-dependent patients (opium and heroin). MATERIALS AND METHODS: In this double-blind, randomized clinical trial study, 60 patients using opium or heroin were assigned to the intervention (n = 30) and control (n = 30) groups. Both groups were treated with buprenorphine and clonidine at the same dose in the detoxification process. The intervention group received memantine 10 mg daily for 10 days and then 20 mg daily for 21 days, and the control group received a placebo prepared in the same shape and size as memantine tablets. The severity of withdrawal symptoms was measured using the Short Opioid Withdrawal Scale over 3 weeks. Data analysis was performed using SPSS and descriptive and inferential tests. RESULTS: The results showed that despite memantine's superiority in controlling some withdrawal symptoms such as feeling sick, stomach pain, muscle spasm, and feeling cold, no significant difference was found between the 2 groups. There was also no statistically significant difference between the 2 groups in the total score of symptoms. CONCLUSIONS: No specific advantage of memantine was found for reducing the symptoms of withdrawal syndrome in the present study. However, this drug was well tolerated without any evidence of serious or significant adverse effects.

Comparison on frequencies of pericardial effusion and tamponade following open heart surgery in patients with or without low negative pressure suction on chest tube.

INTRODUCTION: Pericardial effusion and tamponade are accounted as the two most important complications following open-heart surgeries which are known to increase mortality and morbidity rates. Putting a low negative pressure suction on the chest tube of patients might be a useful way for better drainage and also reducing the occurrence of pericardial effusion and tamponade. In the present study, we aimed to compare the prevalence of pericardial effusion and tamponade in patients undergoing open-heart surgeries with and without low negative pressure suction on the chest tube. METHODS: This clinical trial was performed in 2018-2019 in Tehran, Iran. 100 patients who were candidates for open-heart surgery were entered. After surgeries, patients were divided into two groups: group 1 had a low negative pressure suction on their chest tube and group 2 had no suction. Patients were then observed for clinical and imaging characteristics of pleural effusion and tamponade. Data were gathered and analyzed using SPSS software. RESULTS: In the present study, we indicated that the prevalence of pericardial effusion is significantly lower in patients with low negative pressure on their chest tube (P=0.04). No significant differences were observed between two groups regarding to: frequency of tamponade and post-operative ejection fraction (P> 0.05). CONCLUSION: The usage of a low negative pressure suction on the chest tube following open cardiac surgeries is associated with a lower prevalence of pericardial effusion. We suggest that such systems could be commonly used in cardiac surgeries or surgeries of the thorax.

Frequencies of accessory renal arteries in 129 Iranian patients.

INTRODUCTION: Anatomical variation of accessory renal artery has a great clinical importance especially in surgical operations. This issue might bring different complications during surgeries. The prevalence of these variations have been reported differently among populations. Here in this paper, we aimed to have a study on frequencies of anatomical variation of renal arteries. METHODS: This cross-sectional study was performed on 129 patients who were referred to Imam Khomeini hospital-Tehran in order to perform multislice computed tomography angiography using multiple detector computed tomography (MDCT) of kidneys in 2018-2019. Data were assessed by expert radiologists regarding to renal arteries, characteristics of both side arteries, number of accessory arteries and locations of these arteries based on patient's gender. RESULTS: Here we reported at least one accessory artery in 15.5 percent of right and 17.1 percent of left kidneys. The diameter of left accessory artery was in 14.3 percent of cases equal to the main artery and in 85.7 percent of cases, smaller. We also showed that all of the right accessory arteries were smaller than the main renal artery. We indicated no significant difference between frequencies of total arteries of right and left kidneys. CONCLUSION: There was a large variety of renal accessory arteries with high frequency among our study population. This issue has a great surgical importance especially for urologists and we suggest further studies on larger populations should be performed in order to assess frequency of accessory renal artery in Iranian population.

How is the association between urinary prostate cancer antigen 3 (PCA3) levels and Gleason scores in patients suspicious of prostate cancer?

INTRODUCTION: Prostate cancer is one of the most common cancers in men which is mostly slow growing and responses well to treatments if early diagnosed. Urinary prostate cancer antigen 3 (PCA3) assay is a new method with effective results in diagnosing prostate cancer. The aim of this present study was evaluate the correlation between urinary PCA3 and Gleason scores in patients who are suspicious of prostate cancer and undergo tissue biopsies. METHODS: This is a cross-sectional study which was performed in 2017-2018. The patients included this study complain of prostate problems and were selected from Nour hospital, Ali-Asghar hospital and Ordibehesht clinic in Tehran, Iran. Urinary PCA3 levels were checked in all patients and then they went under prostate biopsies. Amounts of PCA3 and Gleason scores were collected and analyzed using SPSS software. FINDINGS: We evaluated a total number of 80 patients. 40 patients had prostate cancer and 40 had no cancer. We indicated that no significant relation was reported between Gleason scores and urinary PCA3 levels. Levels of urinary PCA3 were higher in patients with prostate cancer than in patients with no cancer (P=0.007). DISCUSSION: Generally, urinary PCA3 test is indicated as a non-invasive method to improve the specificity of prostate cancer diagnosis and its potential predictive value was studied in numerous clinical researches, but here we found higher PCA3 levels in patients with prostate cancer than in patients with and other prostate problems. We conclude that PCA3 functions as a diagnostic test and its changes in prostate cancer need to be further studied in different populations and races.