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Showing 4 results for Atash Khoii

Simin Atash Khoii,
Volume 3, Issue 2 (Summer 2003)

  Background and Objective : Today, laparoscopic surgeries, because of reducing postoperative complications, are increasingly developing. Intraperitoneal insufflations of CO2and systemic absorption of it during laparoscopy results in hypercarbia. Using N2O during maintenance of anesthesia in these patients can enhance hypercarbia. This is because N2O increases the volume of pneumoperitoneum. This study was performed to determine the effect of N2O in enhancing hypercarbia during laparoscopy.

  Methods : Sixty Patients, with physical status I or II, undergoing outpatient diagnostic gynecologic laparoscopy according to ASA (American Society of Anesthesiology) scaling took part in this clinical and single blind trial, and were randomly divided in to two groups, each with 30 patients. In all patients, general anesthesia with end tracheal intubation was administered. The technique of anesthesia and ventilation were the same in all patients. Only, during the maintenance of anesthesia, N2O was not administered to group I (control) of patients, but in group II (case), patients received N2O, in 50% concentration in oxygen. The variables under study were evaluated and recorded at certain times and finally the data were analyzed using chi-square test, student t-test and EPI-5software.

  Results : There was no significant difference between two groups in terms of demographic data, homodynamic variables (heart rate, mean arterial pressure, and electrocardiogram changes), oxygen saturation, and the use of any additional analgesic drug (instead of N2O in group I). Comparing the End tidal CO2 (Etco2) in two groups indicated that Etco2 increases in those patients who used N2O during maintenance of anesthesia (p=0.02).

  Conclusions : With regard to significant difference between two groups in the enhancement of intraoperative hypercarbia (although it was not associated with homodynamic changes in this study), it is better not to use N2O in general anesthesia for laparoscopic procedures.

Farnaz Moslemi Tabrizi, Soosan Rassooli , Simin Atash Khoii , Rasool Azarfarin ,
Volume 4, Issue 2 (Summer 2004)

  Background & Objectives: Nitroglycerin is found to have vasodilatory effect. It has also a relaxing effect on the smooth muscles of other organs including uterus. This study investigates the effect of intravenous nitroglycerin in emergency cesarean sections in which rapid and transient uterine relaxation for rapid and nontraumatic extraction of the fetus is necessary.

  Methods: Sixty pregnant women who were candidated for emergency cesarean and needed rapid uterine relaxation for different reasons were selected. These subjects underwent spinal anesthesia and at the time of uterine incision, 100 micrograms of nitroglycerin was injected to them intravenously. The time lapse between nitroglycerin administration and fetal extraction, the degree of uterine relaxation, the amount of intraoperative hemorrhage, uterine tone after fetal delivery and APGAR scores of the infants were all controlled and recorded. Also with regard to the vasodilatory effect of nitroglycerin and probably its resultant homodynamic problems, blood pressure, heart rate and arterial O2 saturation were recorded before and after nitroglycerin injection and throughout the surgery.

  Results: The results showed that in 53 (88.3%) of the patients the uterus was acceptably relaxed and the fetus was delivered very easily. Only in 7 patients (11.7%) uterine relaxation was not acceptable. The mean decrease in systolic and diastolic blood pressures after nitroglycerin administration compared with before injection BP was 12.97 mmHg (12.210 %) and 7.86 mmHg (12.208 %), respectively. There was not seen any prolonged effect of the drug such as uterus relaxation tone or abnormal bleeding. Also, none of the delivered infants had low APGAR scores. Besides, in patients with acceptable uterine relaxation the first and fifth minute APGAR score of infants were higher (p = 0.008, p = 0.000).

  Conclusion: This study shows that nitroglycerin can relax uterine smooth muscles very rapidly and transiently and in emergencies it can be an appropriate alternative to the other tocolytic agents with prolonged effect or onset time.

Simin Atash Khoii , Mehri Jafari Shobayri , Sohrab Negargar ,
Volume 5, Issue 1 (spring 2005)

 Background and Objectives: Pre-eclampsia is one of the common causes of maternal mortality. A main problem with induction of general anesthesia in these patients is exagergted increase of blood presscure during laryngoscopy and intubation that is associateed with a significantly increased intracranial pressure with the risk of cerebral hemorrhage. There are some strategies to minimize extreme increase in blood pressure during laryngoscopy and intubation. The aim of this study was to evaluate the effect of Fentanyl-Droperidol combination (Talamonal) on reducing cardiovascular responses due to laryngoscopy and intubation in preeclamptic parturient.

 Methods: Thirty preeclamptic parturients who were admitted for emergency caesarean section under general anesthesia were studied. All patients had diastolic pressures sustained at ≥ 100 mmHg, and had received antihypertensive therapy. A standard general anesthesia was induced in all patients. Fentanyl-Droperidol combination was used only in the case group five minutes before induction of anesthesia.

 Results: Arterial pressure and heart rate increases, improved in approximately 86.6 % of the case group. The mean increase in systolic pressure, and heart rate following laryngoscopy and intubation was significantly different in two groups (P=0.0001). There was no significant difference in the mean Apgar score of the neonates at 1 and 5 minutes after delivery in two groups.

 Conclusion: Using Fentanyl-Droperidol Combination during induction of anesthesia produced a clinically significant decrease in sympathetic response to laryngoscopy and intubation in most mothers, without any adverse effect on the neonates.

Mehri Jafari Shobeiri , Simin Atash Khoii ,
Volume 5, Issue 2 (Summer 2005)

  Background & Objectives: It is estimated that as many as 75% of women experience at least one episode of vulvovaginal candidiasis during the lifetime and about 5% will have recurrent infections. There are clear association between vaginal candidiasis and uncontrolled diabetes mellitus. The purpose of this study was to determine whether non-diabetic women with recurrent vaginal candidiasis have an impaired glucose metabolism.

  Methods: This case-control study was carried out with 32 patients suffering from recurrent vulvovaginal candidiasis as case group and 30 control patients who had negative history of vaginal candidiasis during the previous year and had referred to the clinics for reasons other than vaginal candidiasis. The case group had referrd to the gynecology clinics three times during the previous year and were recognized to have vaginal candidiasis. They were being treated by antifungal drugs and had at least one positive candida culture. Both groups underwent standardized oral glucose tolerance test with 75-gram dose of glucose. The data were analysed using Chi-square and t-test.

  Results: Women with recurrent vaginal candidiasis had a mean body mass index greater than the control subjects (23.4 versus 21.5, p=0.001). They had no more incidences of overt or preclinical diabetes mellitus than the control subjects, but a greater proportion of them had at least one glucose concentration above the 95th percentile (p=0.015). Glucose concentrations were significantly higher in recurrent vaginal candidiasis cases than in control subjecs at 30, 60 and 75 minutes after the intake of 75-gram dose of glucose (p<0.05). This amount of glucose led to a 15.8% increase in serum glucose level in case group compared to the control group.

  Conclusion: Glucose tolerance test was mildy impaired in women with recurrent vaginal candidiasis. The plasma glucose concentration increased in 2 hours after 75 g glucose intake. Although the obtained results were not in the range of occult diabetes, it can designate the important of glucose tolerance test in women with recurrent vaginal candidiasis.

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مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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