Medicine
Giti Dehghan Manshadi; Nina Pilehvar
Abstract
Introduction: Anesthesia for elective neurosurgery requires a comprehensive understanding of the unique considerations and challenges associated with neurophysiology, cerebral perfusion, and the prevention of complications. This systematic review aims to provide a comprehensive synthesis of the current ...
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Introduction: Anesthesia for elective neurosurgery requires a comprehensive understanding of the unique considerations and challenges associated with neurophysiology, cerebral perfusion, and the prevention of complications. This systematic review aims to provide a comprehensive synthesis of the current evidence regarding anesthesia management in elective neurosurgical procedures. Material and Methods: Two independent reviewers screened the titles and abstracts of the identified studies for eligibility. Any discrepancies were resolved through discussion and consensus. Full-text articles of potentially relevant studies were then assessed for inclusion based on the predetermined criteria. Data extraction was performed using a standardized form, including study characteristics (e.g., study design, sample size), patient demographics, type of neurosurgical procedures, anesthesia techniques, intraoperative monitoring methods, hemodynamic management strategies, pain control methods, and reported outcomes. Results: Optimal hemodynamic management was crucial in maintaining cerebral perfusion and preventing ischemic or hemorrhagic complications. Individualized blood pressure targets, guided by cerebral autoregulation monitoring or transcranial Doppler, were associated with improved outcomes compared to general blood pressure targets. Goal-directed fluid therapy, guided by stroke volume variation or cardiac output monitoring, facilitated appropriate fluid administration and reduced the risk of cerebral edema. Conclusion: This systematic review provides valuable insights into anesthesia management in elective neurosurgery. The findings suggest that tailored approaches, such as TIVA, volatile anesthetics, and balanced anesthesia, can be employed based on patient-specific factors. Intraoperative monitoring techniques, including EEG, SSEPs, MEPs, and cerebral oximetry, contribute to patient safety and guide anesthesia management.
Medicine
Mirmohammadtaghi Mortazavi; Sina GHasemi
Abstract
Introduction: This systematic review will contribute to the existing body of knowledge by synthesizing the available evidence regarding the effects of morphine injection during anesthesia on hemodynamic status and acute pain intensity after tibia plate implantation surgeries in the elderly. The findings ...
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Introduction: This systematic review will contribute to the existing body of knowledge by synthesizing the available evidence regarding the effects of morphine injection during anesthesia on hemodynamic status and acute pain intensity after tibia plate implantation surgeries in the elderly. The findings may have implications for perioperative pain management strategies, ultimately leading to improved patient outcomes and enhanced quality of care for this vulnerable patient population.Material and Methods: Data extraction will be performed independently by two reviewers using a standardized data extraction form. The extracted data will include study characteristics (author, publication year, country), study design, sample size, patient demographics (age, gender), intervention details (morphine dosage, timing of administration), comparison groups, outcome measures assessed, follow-up duration, and relevant statistical analyses.Results: The results of this analysis revealed that higher doses of morphine were associated with more pronounced effects on hemodynamic parameters, including a greater decrease in MAP and heart rate.Conclusion: this systematic review suggests that morphine injection during anesthesia may have favorable effects on hemodynamic stability and acute pain intensity in elderly patients undergoing tibia plate implantation surgeries. The administration of morphine during anesthesia appears to reduce blood pressure and heart rate fluctuations and provide effective analgesia in the immediate postoperative period.
Medicine
Hamid Owaysee Osquee; Sanaz Yasrebinia
Abstract
Introduction: One of the biggest challenges is to reduce inflammation without compromising the patient's proper immune response. In this hypothesis, science should focus on medicine and nutrition. The importance of proper nutritional status and eating habits has been widely recognized in the Covid-19 ...
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Introduction: One of the biggest challenges is to reduce inflammation without compromising the patient's proper immune response. In this hypothesis, science should focus on medicine and nutrition. The importance of proper nutritional status and eating habits has been widely recognized in the Covid-19 pandemic. Therefore, the present study answers the question of what is the role of nutrition on Covid-19 in pediatric. Methodology: The present study is a systematic review that was conducted during the third quarter of 2022 at Tabriz university of medical sciences. Therefore, at first the keywords were determined and then the search was performed among all Persian and English language databases. Results: The covid-19 epidemic has had a wide impact on the health, economy and livelihood of people in the past and has caused sudden changes in the way of life of people through social distance and quarantine at home with irreparable mental consequences. Optimizing public health during this epidemic requires not only the knowledge of medical and biological sciences, but also all sciences related to lifestyle, social and behavioral studies, including food habits and lifestyle. Conclusion: Changing the eating style and choosing a healthy diet rich in nutrients can lead to strengthening the immune system and overcoming diseases, including corona disease.
Medicine
Saeid Charsouei; Mehrdad Zamani Esfahlani
Abstract
Introduction: There do not appear to be any distinct, accepted clinical or investigative standards for the diagnosis or, more importantly, the selection of cervical radiculopathy patients for surgery. To decide who to operate on and to give our patients a realistic prognosis estimate, it is critical ...
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Introduction: There do not appear to be any distinct, accepted clinical or investigative standards for the diagnosis or, more importantly, the selection of cervical radiculopathy patients for surgery. To decide who to operate on and to give our patients a realistic prognosis estimate, it is critical that we can pinpoint the subgroup most likely to benefit from surgery. The purpose of this study is to determine whether electromyography (EMG) studies can be used to pinpoint the subgroup that will recover more favorably from surgery.Material and Methods: The latency of muscle contractions is measured by recording MEPs, and the CMCT is calculated by subtracting the latency of nerve conduction from the cerebral cortex to the muscle via the corticospinal tract from the latency of nerve conduction between the spinal nerve root and the muscle where an electrode was attached. For BB-CMCT, APB-CMCT, and TA-CMCT, the cut-off values are 8 to 9 ms, 18 ms, and 20 ms, respectively.Results: In the entire sample, there was a 40% agreement between NPS, MRI, and the level or levels that had undergone surgery. In group A, two patients' sensory nerve conduction studies show associated evidence of median nerve compression at the wrist. In group B, none of the patients had evidence of nerve root compression on preoperative NPS, but all of the patients had evidence of disc bulge and narrowing of the exit foramina on MRI scans.Conclusion: This study has shown that preoperative NPS is useful in determining which cervical radiculopathy patients will benefit most from surgery. Patients who undergo preoperative abnormal needle EMG examination will likely benefit from surgical decompression and fusion much more than those who undergo preoperative normal EMG. Therefore, whenever evaluating a patient with cervical radiculopathy.
Medicine
Parisa Mehrasa; Tala Pourlak
Abstract
Introduction: This is because the development of cytokine release syndrome (CRS) as the pathologic basis for the progression of severe Covid-19 disease is possible. Material and Methods: A two-step selection process that involved first screening studies based on their titles and abstracts and then reading ...
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Introduction: This is because the development of cytokine release syndrome (CRS) as the pathologic basis for the progression of severe Covid-19 disease is possible. Material and Methods: A two-step selection process that involved first screening studies based on their titles and abstracts and then reading the full texts of those studies was carried out independently by the two reviewers. Studies were considered if they were RCTs, observational cohorts, or case-control in design, described two or more patients diagnosed with Covid19, and reported measures of cytokine levels (with a focus on IL-6). The use of standardized data extraction tables allowed for the duplication of the data extraction process. Data were taken from the text of the article, the tables, and the graphs.Results: In all of the studies that were included, elevated IL-6 levels were found in Covid-19 patients. Numerous studies specifically found that patients with more severe (complicated) diseases had higher levels of IL-6 descriptions of other inflammatory markers, such as ferritin and IL2R. Six studies in total compared the levels of IL-6 in patients with complicated disease (those with ARDS, needing ICU admission, or having "severe" or "critical" presentations according to the Chinese New Coronavirus Pneumonia Prevention and Control Program score) and noncomplicated disease (those without the aforementioned criteria present).Conclusion: In this systematic review and meta-analysis, we show that elevated serum IL-6 levels are associated with complicated Covid 19 disease and that these elevated IL-6 levels are also significantly associated with poor clinical outcomes. This implies that an excessive host immune response and autoimmune injury may be the result of an initial SARS-CoV2 infection that progresses to a complicated disease. These results underline the necessity of continuing, carefully designed clinical studies to clarify the function of immunomodulation, specifically IL-6 inhibition, in the treatment of severe Covid-19.
Chemistry
Lida Saboktakin
Abstract
Introduction: The purpose of this study was to assess the contribution of digital education to the enhancement of knowledge, skills, attitudes, and satisfaction of medical students learning communication skills in comparison to various controls. Material and Methods: In order to find randomized controlled ...
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Introduction: The purpose of this study was to assess the contribution of digital education to the enhancement of knowledge, skills, attitudes, and satisfaction of medical students learning communication skills in comparison to various controls. Material and Methods: In order to find randomized controlled trials (RCTs) and cluster RCTs (cRCTs) published between January 1990 and September 2018, we conducted a systematic review and searched seven electronic databases and two trial registries. Two reviewers independently examined the citations, gathered information from the studies that were included, and determined the bias risk. The Grading of Recommendations, Assessment, Development, and Evaluations assessment (GRADE) was used to evaluate the quality of the evidence as well. Results: The quality of the evidence varied from moderate to very low, and the overall risk of bias was high. A meta-analysis of four studies comparing the effectiveness of blended digital education (i.e., online or offline digital education plus traditional learning) and traditional learning revealed no statistically significant difference in postintervention skills scores between the groups for the skills outcome. Conclusion: We found low-quality evidence demonstrating the effectiveness of digital education in the development of communication skills in medical students as compared to traditional learning. For knowledge and communication skills, blended digital education appears to be at least as effective as traditional learning and possibly even more so.
Covid
Ramesh Baradaran Bagheri
Abstract
Introduction: This review addresses some of the issues that doctors encounter when treating a brain tumor in a patient who is pregnant, with a focus on radiation oncology viewpoints. Pregnancy and its effects on cancer survivors are outside the purview of this discussion.Material and Methods: Using the ...
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Introduction: This review addresses some of the issues that doctors encounter when treating a brain tumor in a patient who is pregnant, with a focus on radiation oncology viewpoints. Pregnancy and its effects on cancer survivors are outside the purview of this discussion.Material and Methods: Using the terms " brain " " tumors" " brain tumors " " pregnancy " "pregnancy-related brain tumors " "pregnancy-related tumors " and " brain tumors in pregnancy " we searched the literature in Pubmed, Cochrane Library, Ovid, and Google for articles in English, Portuguese, and Spanish published in the previous 20 years or older, as appropriateResults: Since there are no established management guidelines and there are numerous moral and ethical conundrums, the link between brain tumors and pregnancy presents a difficult challenge for the management team. Only small retrospective series of literature are currently available. It is necessary to develop a multidisciplinary plan with individualized management and thorough patient and family counseling at every stage. Conclusion: This task should only be taken on by large centers with the resources to manage every aspect of therapy related to obstetrics, neonatology, and oncology. The creation of central registries might improve data collection and interpretation to inform future strategies.
