Journal of Isfahan Medical School
Year:2016 | Volume:34 | Issue:376|Papers Count:6

Background: Patients undergoing coronary surgery are usually treated by anti-thrombus [acetyl salicylic acid (ASA) and anti-coagulant] drugs that lead to emergence of some gastrological problems such as peptic ulcer without any symptom. The present study aims at comparing the effects of pantoprazole and ranitidine in reducing the incidence of gastrointestinal complications in patients undergoing coronary artery bypass graft surgery (CABG).Methods: In a clinical trial, 90 candidates for CABG surgery were randomly divided into two groups of 45 patients. In the first group, pantoprazole and in the second group, ranitidine was prescribed before and after surgery until releasing from intensive care unit (ICU). They were studied in terms of incidence of upper gastrological problems until releasing from ICU and the obtained data were analyzed by SPSS software.Findings: During hospitalization in ICU, 13 patients from pantoprazole and 15 patients from ranitidine group showed gastrological symptoms (28.9% on contrary to 33.3%); however, the difference between two groups was not significant (P=0.65). The mentioned gastrological symptoms include abdominal distention and vomiting and no case of hematomas and melena was observed in either of groups. The mean duration of hospitalization in ICU in pantoprazole and ranitidine groups were 44.1±12.9 and 51.0±28.1 hours, respectively; however, the difference between two groups was not significant (P=0.14).Conclusion: There is no advantage in using pantoprazole rather than ranitidine for patients hospitalized in ICU and ranitidine could be preferred due to economical matters.

Background: Momordica charantia (bitter melon) is known for its hypoglycemic effect and widely used for the treatment of diabetes. This study other than evaluating plant antioxidant and its effect on blood antioxidant capacity, examined the effects and safety of bitter melon fruit in laboratory mice.Methods: 70 male mice (2-3 weeks old, body weight 25-30 g) were randomly divided into 7 groups. The mice were acclimatized to laboratory conditions for 7 days and at day 8, they were dosed intraperitoneally (single dose groups: 0, 100, 500, 1000, 2000, 4000 mg/kg and the group which was treated for 7 days: 500 mg/kg/day). Mice were then observed for 72 hours before they were scarified, immediately livers were taken for histology. Serum samples were assayed for liver functions [alkaline phosphatase (ALT), serum glutamic-pyruvic transaminase (SGPT) and serum glutamic oxaloacetic transaminase (SGOT)]. Blood and bitter melon antioxidant activity was measured.Findings: All single dose groups showed normal behavior after the dosing and no statistical changes were observed in all liver parameters including for SGOT, SGPT or ALP (P>0.05). Lab data were shown as follow: ALP=204.7±88.0, SGOT=180.8±76.0, SGPT=80.6±54.0. Histological examinations revealed normal organ structures. Antioxidant activity of bitter melon was 68% and blood antioxidant activity was 564 gmmol/ml.Conclusion: Doses up to 4000 mg/kg did not have any effects on the mice liver functions nor its histology. We suggest more studies with different doses.

Background: Frozen shoulder is a painful condition in which surgery may be helpful in case of failure of conservative treatment. In this prospective study we tried to compare two common methods of surgical treatment.Methods: Between 2011 and 2012, 54 patients with frozen shoulder were treated by one of the two methods of arthroscopic release and manipulation under anesthesia. The variables studied were postoperative pain, American Shoulder and Elbow Surgeons (ASES) and Simple shoulder test (SST) scores, range of motion in different directions and pain in the last follow up.Findings: All the patients in the two groups had significant improvement in comparison to preoperative scores at the least follow up of one year. The difference between the two groups was not significant in internal rotation, forward flexion and pain in the last follow up, but among the other variables, the arthroscopy group showed more improvement. No statistically significant association was found among the variables and diabetes, age, dominant limb involvement and sex.Conclusion: Based upon the findings of the present study it seems that both manipulation under anesthesia and arthroscopic release are effective treatments for frozen shoulder.

Background: This study evaluated the analgesic and safety effects of intravenous acetaminophen versus intravenous morphine in management of pain in forearm and leg fractures.Methods: This study was a randomized double-blind clinical trial conducted on patients (15-60 years-old) with forearm and leg fracture and moderate to severe pain (pain score of 4 or more). Patients were randomized in to two groups, then, 1 g of intravenous acetaminophen or 0.1 mg/kg morphine was infused in 100 ml normal saline to either acetaminophen or morphine group. The pain severity was measured by Numeric Rating scale on arrival and 30 minutes after drug administration. The adverse reactions were also recorded.Findings: 55 patients were entered. There was no significant difference in analgesic effect between the Intravenous Acetaminophen and morphine groups (P=0.140), but, there was a significant difference in side effects between the two groups. (P=0.014).Conclusion: Intravenous acetaminophen appears to provide a similar level of analgesic comparable to intravenous morphine in limb fracture, however, further larger studies are required.

Caffeine -a methylxanthine derived from purine- is found in the various plants (coffee, tea, cola) all over the world and is widely used in cosmetics due to its ability to penetrate in skin barriers. In this paper, the mechanism of broad effects of caffeine on skin and hair is discussed. Commercial use of caffeine in the formulation of cosmetics (e.g. sunscreen products) can effectively reduce Ultraviolet (UV) irradiation side effects and devastating UV induced free radicals. It inhibits phosphodiesterase activity, increases the concentration of cyclic adenosine monophosphate (cAMP) and augments apoptosis in damaged keratinocytes of skin. Caffeine inhibits cell cycle and induces apoptosis by inhibition of ataxia-telangiectasia mutated and Rad3-related (ATR), cycle ATR-chk function. On the other hand, Caffeine is topically used in shampoo as an adjuvant for hair loss treatment. Increasing the cAMP concentration caused by caffeine reduces the tension in smooth muscle near the hair follicle and leads to easier delivery of nutrients through blood vessels. It also prevents negative effects of testosterone on hair follicles in men. Most of currently used hair products contain caffeine. Detailed mechanisms of other effects of caffeine in this field are also discussed.