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Showing 10 results for Entezari

Masoud Entezari-Asl , Mohammadreza Ghodrati , Hamid Ebadizare , Khatereh Isazadehfar ,
Volume 2, Issue 2 (Summer 2002)

  Background & objective : Recovery state or post - anesthetic awakening is one of the most dangerous anesthetic stages . Respiratory, cardiovascular and other complications such as nausea, vomiting, shivering, pain and restlessness have been reported . This study designed to investigate prevalence of this complications and its probable risk factors in Ardabil Fatemi and Alavi hospitals.

  Methods : In this prospective study, 160 patients were selected in Alavi and Fatemi hospitals during winter of 2001. We completed a sheath for everybody about their history of medical diseases, pervious history of anesthesia, addiction, drug abuse, smoking, physical class of ASA, type of anesthesia, time and place of surgery . Data was analyzed by SPSS software.

  Results : These results were obtained in patients after surgery in recovery room: shivering
36.3 % , pain 26.9 % , restlessness 21.3 % , respiratory complications 13.8 % , cardiovascular complications 12 % , nausea and vomiting 8.8 % . We found significant correlation between some risk factors with complications, e. g: shivering with history of medical diseases, drug abuse and place of surgery and so, pain with restlessness, respiratory complication and place of surgery .

  Conclusion : This study according to similar studies revealed higher prevalence of some of post - anesthetic complications as shivering, pain and restlessness in our samples .

Masoud Entezari-Asl , Fariba Motamedi ,
Volume 3, Issue 2 (Summer 2003)

 Background & Objective: The quality of services given to emergency patients at a hospital as well as these patients ’ satisfaction of the services is an index of overall services in that hospital. This study is an attempt to evaluate the degree of satisfaction among the patients referring to the emergency rooms of the hospital of Ardabil University of Medical Sciences during fall and winter 2000.

 Methods: In this cross-sectional prospective study, 600 emergency patients referring to emergency rooms of Alavi, Fatemi, Buali and Aliasghar hospitals were selected. They filled a questionnaire. The data were analyzed by SPSS software.

 Results: The findings indicated that 78.1% of the whole subjects were generally satisfied with the services. The greatest degree of satisfaction belonged to specialty services (93.8%) and the physicians ’ and nurses ’ contact (92.3% and 91.8% respectively). The least degree of satisfaction belonged to hospital charges (40.2%), and unavailability of non-emergency drugs in hospital pharmacy (42.9%).

 Conclusions: According to the results of this study the medical centers need to offer more coverage of national health insurance services. Furthermore it seems necessary to equip these emergency rooms with round the clock pharmacies and provide the required drugs.

Ghodrat Akhavan Akbari , Masoud Entezariasl , Firooz Amani ,
Volume 6, Issue 3 (Autumn 2006)

  Background and Objectives: Laryngoscopy and tracheal intubation could lead to hemodynamic responses in the from of hypertension and tachycardia as well as arrhythmia and myocardial ischemia. This alterations can be life-threatening particularly in elderly people. This clinical trial compared the effects of two rapid-onset narcotics, Alfentanil and Remifentanil, on the hemodynamic responses to the induction and tracheal intubation in elderly patients.

  Methods: This double-blind clinical trial was conducted on 40 subjects aged 65 and above. They were candidate of cataract surgery under general anesthesia. The patients were randomly allocated to two groups of 20. The first group, was gaiven Alfentanil 10 m g/kg and for second group Remifentanil 0.5 m g/kg was injected prior to the induction of anesthesia. Both groups were similiar in the method of anesthesia except in narcotics. The first group was infused with Alfentanil 1 m g/kg/min and Remifentanil 0.1 m g/kg/min was used for the second group. Hemodynamic variations including heart rate, systolic, diastolic and mean arterial blood pressure were measured and recorded eight times (before induction, aften injection, after intubation and five times during anesthesia). Data were analyzed with SPSS software using descriptive and analytical statistics such as T-test, chi squre and ANOVA.

  Results: Immediately after injection of narcotic drugs, all hemodynamic variants decreased. Howerver diastolic blood pressure in Remifentantil group significantly more than Alfentanil group (P<0.05). After laryngoscopy and tracheal intubation all hemodynamic variants increased and slowly decreased in less than 10 minutes. Systolic, diastolic and mean arterial blood pressure decreased significantly in remifentanil group than alfentanil group (P<0.05). Although heart rate decreased during few minutes after intubation, there was not significant difference between two groups regarding this decrease (P>0.05). Ephedrin was used to treat severe hypotention in those under Remifentanil (11 patients) more than those under Alfentanil (4 patients) (P<0.05).

  Conclusions: According to the resukts of this study Remifentanil could prevent hemodynamic variation induced by laryngoscopy and treacheal intubation more than Alfentanil. However in some cases Remifentanil leads to hypotension during anesthesia. There is no important difference between two drugs in increasing heat rate after laryngoscopy and intubation.

Masoud Entezari Asl , Ahad Azami , Firooz Amani , Solmaz Khorasani ,
Volume 6, Issue 4 (Winter 2006)

  Background & Objectives : Most of the people who need blood and blood products transfusion, are the critic cases under transfusional therapy for their bleeding, chronic disease anemia, clotting disorders, platlet problems and so on. Considering the problems and high costs of providing safe blood and due to the transfusional complications, it is necessary for the blood products to be used based on scientific standards and only in the time of emergency. This study examined the cases of transfusion in a surgery and burning hospital and to determine the unnecessary cases of transfusion in a period of six months.

  Methods: This descriptive study was performed on 150 patients under blood and blood products transfusion in Ardabil Dr Fatemi hospital during 2003. Necessary and unnecessary cases of transfusion were categorized according to the patients clinical situations, laboratory criteria, the evidence existing in their records and on the basis of standards documented in the literature. The data were analyzed by SPSS software.

  Results: Among 150 cases transfused, 46 (25.7%) received whole blood, 92 (51.4%) packed cell, 36 (20.1%) FFP and 5 (2.3%) platlet. The ward of transfusion was ICU in 60 cases (40%), surgery ward in 31 (20.7%), operation room in 28 (18.7%), orthepedic ward in 11 (7.3%), burning ward in 10 (6.7%) and emergency ward in 9 (6%). Highest rate belonged to 20 to 40 age-group (32.7%). 67.3% of the cases were male transfusion, based on documented criteria, with regard to the necessary of 26.08% of the cases in whole-blood group, 30.44 in packed cell group, 47.22 in FFP group and 80% in platlet group received umecessary transfusion.

  Conclusions: Considering the high cost of preparation of safe blood and blood products and regarding the problems which can affect the patients after transfusion, these products should be used carefully and on the basis of the documented. The high rate of unnecessary transfusion of blood and its products at the present reseaech demands more attention in this regard.

Masoud Entezariasl, Khatereh Isazadefar , Ghodrat Akhavanakbari,
Volume 7, Issue 3 (Autumn 2007)

  Background & Objectives: Postoperative nausea and vomiting are among the main complication after anesthesia and various methods are used for the prevention of this complication. In this study, the effect of the pre induction use of 10mg Metoclopramide’ 8 mg Dexamethasone and the combination of the both, on decreasing in the rate of nausea and vomiting after cataract surgery in intravenous anesthesia is compared with placebo.

  Methods: In this double blind clinical trial, one hundred patients of cataract surgery who are appropriate for this study were, randomly divided in to four groups. In the group of placebo (P), 2cc normal saline, in group (M), 10mg metoclopramide, in group (D), 8mg Dexamethasone, and in group (M+D), 10mg metoclopramide and 8 mg Dexamethasone, one minute before the induction of anesthesia was injected. Patients were received the anesthetic drugs in the sameway and after the tracheal intubation infusion of propofol was started. After the end of surgical operation, the appearance of nausea and vomiting in the recovery room and also 6 and 24 hours after the surgery are recorded in the patients' information forms. Finally the data were analysed by statistical software of SPSS and the statistical tests.

  Results: After the use of these drugs, the rate of nausea in the recovery room decreased from 44% in placebo to 20% in metoclopromide group, 16% in Dexamethasone group, and 8% in combination of metoclopromide and Dexamethasone and the rate of vomiting decreased from 20% in placebo group to 4% in metoclopromide group, 4% in Dexamethasone group, and 0% in combination of these two drugs, both the nausea and vomiting the effect of combination of metoclopromide and Dexamethasone in decreasing of postoperative mausea and vomiting was significant (P<0.05). The 24 hour following of nausea and vomiting, also had the same results.

  Conclusion: With regrard to the results of this study, implication of the combination of 10mg metoclopromide and 8mg Dexamethasone before the induction of anesthesia remarkably decreased the rate of postoperative nausea and vomiting and is useful for the high risk groups for this complication especially in out patient surgery.

Masoud Entezariasl, Ghodrat Akhavan Akbari , Khatereh Isazadeh Far,
Volume 7, Issue 4 (Winter 2007)

  Background & Objective: With consideration the daily increased development of outpatient surgeries and high rate of these operations in elderly patients, rapid and safe recovery of patients for coming back to daily life is necessary. In this clinical trial study recovery time and nausea and vomiting after the use of two rapid-onset narcotic, alfentanil and remifentanil in elderly patients has been compared.

  Methods: In this double-blind clinical trial 40 elderly patients (age above 65) candidated to cataract surgery with general anesthesia were studied. The patients were divided randomly into two groups and for first group alfentanil was injected 10 m g/kg and for second group remifentanil 0.5 m g/kg during 30 seconds one minute before induction. Both two groups were under general anesthesia with same method and during the anesthesia first group took infusion of alfentanil 1 m g/kg/min and second group remifentanil 0.1 m g/kg/min. At the end of surgery the time intervals between end of anesthesia drug adminstration and autonomic respiration, eyes opening with stimulation, verbal response and discharge of recovery room, also the incidence of complications related to narcotic drugs especially nausea and vomiting were recorded. The data were analyzed in SPSS software using descriptive and analytical statistics as T-test, chi square and ANOVA.

  Results: The time of autonomic respiration in alfentanil group was 2 minutes and in remifentanil group 3.3 minutes,this time in alfentanil groupe1.3 minutes shorter but the difference was not significant. The time of eyes opening with stimulation, verbal response and discharge of recovery room were not significantly different. During recovery incidence of nausea and vomiting in remifentanil group (30% of patients) was significantly more than alfentanil group (5% of patients) (P<0.05).

  Conclusion: The time of recovery between alfentanil and remifentanil group was not significantly different, but incidence of nausea and vomiting in remifentanil group was higher than alfentanil group significantly.

Gholamreza Sharifirad , Aziz Kamran , Mohammadhasan Entezari ,
Volume 7, Issue 4 (Winter 2007)

  Background & Objective: Diabetes is one of diseases in which the main part of treatment depends on the patient's responsibility. Therefore their knowledge of the various aspects of nutrition has great importance. The aim of this study was to evaluate the effect of diabetic diet education on nutritional behaviors. FBS and BMI of patients with type II Diabetes mellitus in Iranian Diabetic Association.

  Methods: 88 type II diabetic patients from Iranian Diabets Association (Karaj Branch) participated in this study. The Patients were randomly divided into two groups as experimental (44) and control group (44). Data were collected with a valid and reliable questionnaire (58questions) and checklist in two stage of before and one month after intervention.

  Results: After the intervention in the experimental group regarding diabetes and nutritional behaviors, there was a significant increase in mean score of knowledge (from 57.50 to 80.18) and a significant decrease in the mean of BMI (from 28.3 to 27.9) and in the mean of fasting blood sugar (from 167.9 to 134.5) (p<0.001). However, there was no significant change in the control group.

  Conclusion: The finding of this study indicated the efficacy of education on FBS and BMI in patients with type II diabetes.

Akbar Pirzadeh , Masoud Entezari , Abdollah Mahdavi , Mohammadali Mohammadi,
Volume 8, Issue 4 (Winter 2008)

  Background and objectives : Voice problem is the most common problem in singers and the prevention of this problem and clearance of voice is the cause of voice quality improvement in these people. So this study was carried out to" determine the traditional methods for prevention of voice problem in religions singers at Ardabil city".

  Methods: This survey was a descriptive (cross-sectional) study. In this study 43 religious signers were selected. Then singers completed a questionnaire that consisted of data about age, sex, duration of singing, history of Voice problem and the prevention methods that they used. Data were analyzed with SPSS software and descriptive statistics.

  Results: The findings showed all of samples were male. Most of them were 24-44 years old. All of them used their voice in Moharram and 15 persons (34.4%) in Ramadan and 8 cases (18.6%) sang in other months. Clearance of voice was often seen in summer (79%) and Voice problem often was seen in winter (67.4%). 36 singers (83.7%) experienced Voice problem that in most of them (32.6%) its duration is 2 days. Resting and well nutrition were the common methods for prevention of voice problem. Most of singers used corticosteroids and changed singing method to a treble voice.

  Conclusions: The rate of voice problem in religious singers was higher than that of the general population, and it was often seen in special months. Duration of voice problem was low in most of them. Change of singing method and corticosteroid therapy was the common way of its treatment.

Ghodrat Akhavanakbari, Masoud Entezariasl, Khatereh Isazadehfar, Tiba Mirzarahimi,
Volume 12, Issue 4 (winter 2012)

  Background & Objectives: Uncontrolled postoperative pain can cause many adverse effects such as tachycardia, hypertension, myocardial ischemia, decreased alveolar ventilation and poor wound healing. In this study we evaluated the preoperative administration of pregabalin in relieving postoperative pain after lower limb orthopedic surgery and reducing the need for opioids and their possible side effects.

  Methods: This study is a randomized, double-blind clinical trial. It was performed on 60 patients under lower limb surgery in Fatemi Hospital. Patients were randomly allocated to two groups, one group has received a 150 mg pregabalin capsule 2 hours before surgery and the other group has received placebo as a control. In both groups at 2, 6, 12 and 24 hours after surgery, the patients were evaluated and the pain score by a visual analogue scale (VAS), the score of sedation by Ramsay sedation scale and the incidence of nausea and vomiting were recorded in the checklists. Then, the data were analyzed by SPSS v16. P <0.05 was considered significant.

  Results: In this study 51.7% of patients were male and 48.3% were female. The age averages of these patients in both group were similar (p=0.578). Visual analog pain scores at 2 h after surgery reduced in pregabalin group (p<0.0001). Similar reduction was observed in other studied hours (p<0.0001) too. In the pregabalin group nausea and vomiting scores at all hours, sedation levels at 2 h and 6 h postoperation, and pethidine consumption in all hours have significantly been reduced (p<0.05).

  Conclusion: Preoperative administration of pregabalin is an effective method for reducing postoperative pain for patients, and with reduction in pethidine consumption, it can decrease problems of opioid usage.

Masoud Entezariasl , Khatereh Isazadehfar, Zahra Noorani,
Volume 13, Issue 2 (summer 2013)

  Background & Objectives: Postoperative nausea and vomiting (PONV) is one of the most common complications of anesthesia and without prophylactic intervention occurs in about one-third of patients under general anesthesia. The aim of this study was to compare the efficacy of ondansetron and metoclopramide in reducing PONV after laparoscopic cholecystectomy.

  Methods : In this study, 90 patients undergoing laparoscopic cholecystectomy were randomly allocated into three equal groups (n=30) and in the first group 10 mg metoclopramide, in the second group 4 mg ondansetron and for placebo group 2 cc normal saline preoperatively were injected. Anesthesia complications in recovery and nausea and vomiting in recovery and 6 hours and 24 hours after surgery were evaluated. Data were analyzed by SPSS software with chi-square test and analysis of variance (ANOVA). P<0.05 was considered significant.

  Results: The incidence of nausea in placebo group was 66.7 %, in metoclopramide group was 43.3 % and in ondansetron group was 33.3 %. The difference only between placebo and ondansetron groups was significant (p=0.019). The incidence of vomiting in placebo group was 56.7%, in metoclopramide group was 20% and in ondansetron group was 26.7% and there was significant difference between placebo and ondansetron groups (p=0.035) and between placebo and metoclopramide groups (p=0.007), whereas there was not any significant difference between intervention groups (p=0.12). Also anti-emetic drug administration in ondansetron group (40%) in comparison with metoclopramide (63.3%) and placebo (66.7%) was lower, but this difference was not statistically significant (p= 0.07).

  Conclusion: For prevention of vomiting after laparoscopic cholecystectomy, both metoclopramide and ondansetron are effective. In comparing these two drugs, in preventing of nausea ondansetron is more effective than metoclopramide, whereas there was not any significant difference between two drugs in preventing of vomiting.

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