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Anatomical and anthropological study of hyoid bones could be used in the sex prediction from skeletal remains. The aim of this study is to examine the morphometrical parameters of the hyoid bone individuals of the Iranian population. The study was carried out on 248 hyoid bones taken from cadavers Referred to Kahrizak Legal Medicine Center in 2020. Four anthropometric indices of hyoid bone were studied and have been associated with the sex and height of the individuals. The study included 179 (72.2%) males and 69 (27.8%) female cases. No significant difference was observed between the two gender groups in terms of age (P=0.678). The indexes of hyoid bones measured were compared between male and female genders, and the results show that the transverse distance between the tubercle of the greater horn, the Anterior/posterior dimension of the body, the distance between the upper and lower margin of the body in the middle (height) and the maximum depth of concavity on the posterior surface of the body, was associated with the sex determination (P

Dyspnea and decreased O2 saturation are the most common causes of hospitalization in noncritical COVID-19 patients. Breathing exercises and chest physiotherapy are used for managing the patients. These treatments are, however, not well supported by scientific evidence. In a randomized controlled trial, 80 patients were randomly assigned to planned breathing exercises (n=40) and control groups (n=40). The participants in the intervention group were instructed to blow into a balloon five times a day while lying down. Other therapies were similar in both groups. The severity of dyspnea at rest/after activity and peripheral oxygen saturation (SpO2) with/without O2 therapy were compared between the two groups on the first, second, and third days. The study findings showed no statistically significant difference in SpO2 with/without O2 therapy on the first, second, and third days between the two groups. Although the severity of dyspnea showed no significant difference between the two groups, the mean score of dyspnea at rest (2.72±2.25 vs. 1.6±1.21, P=0.007) and after activity (4.53±2.04 vs. 3.52±1.66, P=0.017) improved in the intervention group on the third day. Balloon-blowing exercise improves dyspnea in noncritical Covid-19 patients, but it does not significantly improve oxygenation.

Continuous body temperature monitoring during anesthesia in children is very important. Hypothermia in children may lead to higher morbidity and mortality. Measurement points to detect the temperature of core body are not simply accessible. In this study we measured the skin temperature over the carotid artery and compared it with the nasopharynx. Totally, 84 children of 2-10 years undergoing elective surgery were selected. Temperature over the carotid artery and nasopharynx was measured during anesthesia. Mean temperature of these points was compared which each other, and the effects of age, sex, and weight change of temperature during anesthesia were evaluated. The mean age of patients was 5.4±2.6 years s. 37% of patients were female, and 63% were male. The mean weight was 20±7 kg. The mean duration of surgery was 60.45±6.65 min. The temperature of the skin and nasopharynx was decreased during surgery as after 60 min, the deference between skin over the carotid artery and the nasopharyngeal area was 1° C. The bodyweight has a significant effect on carotid skin temperature in regression model. Skin temperature over the carotid artery, with a simple correction factor of+1° C, provides a viable noninvasive estimate of nasopharyngeal temperature in children during elective surgery with a general anesthetic.

Nonalcoholic fatty liver disease (NAFLD) is one of the most common cause of liver test abnormality and chronic liver disease in the world and can increase liver related mortality. Association of NAFLD with metabolic syndrome increase mortality due to cardiovascular disease too. NAFLD is categorized histologically into the nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). Liver biopsy has been known as gold standard of evaluating NAFLD, but this procedure is invasive. It is time to replace available and easier way to diagnose, and predict the prognosis for better management of NAFLD. This study was comparing the result of transabdominal ultrasonography with Fibroscan as a new and accurate method for evaluating severity of fatty liver disease. This was a cross-sectional study that was conducted using 101 patients with NAFLD. All patients who had TUS by one experienced radiologist and fibro scan at the same time were included. Visual liver echogenicity was basis of grading in TUS. Fibro scans results are based on controlled attenuation parameters (CAP) which is not operator dependent. Other information, such as age, waist, and BMI, were also gathered. TUS has a low value for the diagnosis of liver fibrosis in NAFLD patients and predicting prognosis. TUS has a good correlation with fibroscan in grade 0 and 1of fatty liver, but in grade 2 and 3 of fatty liver, we can not rely on TUS for accurate grading.

Pituitary suppression by depot GnRH agonist may be excessive for ovarian stimulation. This study compares the efficacy of a single half-dose depot triptorelin and reduced-dose daily buserelin in a long protocol ICSI/ET. METHODS: A total of 182 patients were randomized into two groups using sealed envelopes. Pituitary desensitization was obtained in group 1 (91 patients) with half-dose (1.87 mg) depot triptorelin in the mid-luteal phase of their menstrual cycle, and in group 2 (91 patients) with standard daily dose (0.5 mg) buserelin, which was then reduced to 0.25 mg at the start of human menopausal gonadotropin (HMG) stimulation. RESULTS: No significant differences were found among those who received HCG in terms of clinical pregnancy rate (34.4% in both groups), implantation rate (14.8% in group 1 versus 11.1% in group 2), fertilization rate (93.3 versus 95.6%), poor response rate (11.1 versus 6.7%), and miscarriage rate (11.1 versus 7.8%). No significant differences were seen in number of HMG ampoules used, follicles at HCG administration, and oocytes retrieved. The number of days of stimulation was significantly reduced in group 2 (11.2 +/- 1.8 in group 1 versus 10.6 +/- 1.9, p = 0.030). CONCLUSION: A half-dose of depot triptorelin can be successfully used in ovarian stimulation instead of reduced-dose daily buserelin, with more patient comfort and reduced stress and cost of injections.

The major difference between Iranian traditional medicine and allopathic medicine is in the application of evidence and documents. In this study, criteria for evidence-based practice in Iranian traditional medicine and its rules of practice were studied. The experts’ views were investigated through in- depth, semi-structured interviews and the results were categorized into four main categories including Designing clinical questions/clinical question-based search, critical appraisal, resource search criteria and clinical prescription appraisal. Although the application of evidence in Iranian traditional medicine follows Evidence Based Medicine (EBM) principles but it benefits from its own rules, regulations, and criteria that are compatible with EBM.

Anatomical and anthropological study of hyoid bones could be used in the sex prediction from skeletal remains. The aim of this study is to examine the morphometrical parameters of the hyoid bone individuals of the Iranian population. The study was carried out on 248 hyoid bones taken from cadavers Referred to Kahrizak Legal Medicine Center in 2020. Four anthropometric indices of hyoid bone were studied and have been associated with the sex and height of the individuals. The study included 179 (72.2%) males and 69 (27.8%) female cases. No significant difference was observed between the two gender groups in terms of age (P=0.678). The indexes of hyoid bones measured were compared between male and female genders, and the results show that the transverse distance between the tubercle of the greater horn, the Anterior/posterior dimension of the body, the distance between the upper and lower margin of the body in the middle (height) and the maximum depth of concavity on the posterior surface of the body, was associated with the sex determination (P<0.001). The four hyoid bone indexes measured in this study were higher in males compared with females, which indicates that hyoid bone morphometry can be used for sex determination in the Iranian population. [ABSTRACT FROM AUTHOR]

To compare the efficacy of acupressure wrist bands, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery. Two hundred patients, ASA physical status I or II, aged between 10 and 60 years, undergoing strabismus surgery in Farabi Hospital in 2007-2008 years, were included in this randomized, prospective, double-blind and placebo-controlled study. Group I was the Control, group II received metoclopramide 0.2 mg/kg, group III received ondansetron 0.15 mg/kg iv just before induction, in Group IV acupressure wristbands were applied at the P6 points. Acupressure wrist bands were placed inappropriately in Groups I, II and III. The acupressure wrist bands were applied 30 min prior to the induction of anesthesia and removed six hours after surgery. Postoperative nausea and vomiting (PONV) was evaluated within 0-2 hours and 2-24 hours after surgery by a blinded observer. Results were analyzed by X2 test. A P value of < 0.05 was taken as significant. The incidence of PONV was not significantly different in acupressure, metoclopramide and ondansetron during the 24 hours. Acupressure at P6 causes a significant reduction in the incidence of PONV 24 hours after strabismus surgery as well as metoclopramide 0.2 mg/kg and ondansetron 0.15 mg/kg iv for patients aged 10 or more.

Nonalcoholic fatty liver disease (NAFLD) is one of the most common cause of liver test abnormality and chronic liver disease in the world and can increase liver related mortality. Association of NAFLD with metabolic syndrome increase mortality due to cardiovascular disease too. NAFLD is categorized histologically into the nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). Liver biopsy has been known as gold standard of evaluating NAFLD, but this procedure is invasive. It is time to replace available and easier way to diagnose, and predict the prognosis for better management of NAFLD. This study was comparing the result of transabdominal ultrasonography with Fibroscan as a new and accurate method for evaluating severity of fatty liver disease. This was a cross-sectional study that was conducted using 101 patients with NAFLD. All patients who had TUS by one experienced radiologist and fibro scan at the same time were included. Visual liver echogenicity was basis of grading in TUS. Fibro scans results are based on controlled attenuation parameters (CAP) which is not operator dependent. Other information, such as age, waist, and BMI, were also gathered. TUS has a low value for the diagnosis of liver fibrosis in NAFLD patients and predicting prognosis. TUS has a good correlation with fibroscan in grade 0 and 1of fatty liver, but in grade 2 and 3 of fatty liver, we can not rely on TUS for accurate grading. [ABSTRACT FROM AUTHOR]

The bleeding during dacryocystorhinostomy (DCR) surgery is one of the main complications that led to the surgeon's dissatisfaction and increased the duration of the operation. The current study aimed at comparing the effects of labetalol and nitroglycerine (TNG) on blood loss and the surgeon's satisfaction during DCR. The current prospective and randomized study enrolled 60 patients candidate for DCR under local anesthesia and sedation and divided into two groups. When the surgeon dissatisfied with bleeding during the operation, patients in the labetalol group received labetalol infusion at a rate of 0.5-2 mg/kg and compared with the subjects in the TNG group that received TNG infusion at a rate of 0.1 µg/kg/min. Additionally, the surgical condition was assessed by the surgeon using the average category scale (ACS) and surgeon's satisfaction by a scoring system. The average bleeding in the labetalol group was 140.5±24.5 ml versus 170.4±24.6 ml in the TNG group, respectively (P=0.001). The average category scale for the labetalol group was better than the TNG group during all the time of operation. The surgeon satisfaction score during the operation was more in the labetalol group (3.4 in the labetalol group versus 2.8 in the TNG group, respectively). Labetalol was better than TNG for controlling bleeding during DCR procedure because of decreasing surgical blood loss and optimum operative condition. [ABSTRACT FROM AUTHOR]

Topical anesthesia (TA) may accompany more discomfort for some patients during cataract surgery. We aimed to evaluate the potential factors that can be used for predicting patient's cooperation during phacoemulsification surgery under TA. One hundred sixty consecutive cases that were candidate for phacoemulsification surgery were enrolled in this prospective study. Patients' sex, age, place of residence (urban or rural), education level (literate and illiterate) and physical examination variables (visual acuity, reaction to eye drop, cooperation during tonometry, and reaction to press on the lacrimal sac before surgery) evaluated. Patients' cooperation during surgery was classified as successful (good and satisfactory) or failed (weak) groups. In this study, 103(64.4%) cases showed good or satisfactory cooperation, and others had weak cooperation. There was no correlation between patients' cooperation during surgery and sex (P=0.2), age (P=0.7), place of residency (P=0.3), and education level (P=0.3). The successful group showed a higher rate of non-reaction to eye drop (P=0.0001), good cooperation during tonometry (P=0.0001), non-reaction to press on lacrimal sac (P=0.0001), and lower visual acuity (P=0.045). In the multi-logistic regression, nonreaction to eye drop (OR=66.4), good cooperation during tonometry (OR=21.2, good vs. bad and OR=7.2, satisfactory vs. bad), lower visual acuity (OR=7, <0.1 vs. 0.1-0.4 d) are the significant predictors for the success of TA. This study showed that some ocular examination tests before surgery (visual acuity, reaction to eye drop, cooperation during tonometry, and reaction to press on the lacrimal sac) could predict patients' cooperation during phacoemulsification surgery under TA. [ABSTRACT FROM AUTHOR]

CD40 deficiency yield to an autosomal recessive subtype of hyper-immunoglobulin M syndrome (HGIM type 3), presenting with an almost identical clinical picture to X-linked CD40L deficiency (HIGM type 1) with profound T-cell dysfunction yielding to opportunistic infections as well as neutropenia, autoimmunity, and malignancy. We presented a girl with recurrent upper respiratory tract infections and lymphoid hyperplasia which was diagnosed with type 3 hyper IgM syndrome due to CD40 gene mutation. Otitis media with opportunistic germs and no evidence for an X-linked pattern of inheritance were diagnostic keys to type 3 hyper IgM syndrome in our patient. [ABSTRACT FROM AUTHOR]

Esophageal atresia (EA) is a rare congenital anomaly that may be isolated or associated with other anomalies requiring prompt medical and surgical planning for optimal result. This study was conducted to show our recent experience on the outcome of treated patients in two hospitals affiliated to Tehran University of Medical Sciences (TUMS). From January 2008 to May 2013 records of 43 neonates patients (23 male) with EA admitted in 2 children centers and all related data including demographic, diagnostic associated anomalies, surgical approaches, birth weight, mortality, and complications were collected. Inability of feeding and swallowing was the most common symptoms (in 90,6%), associated CHD (44%), and Type C (EA) was the most common type of EA observed in 86% patients, The mortality rate was 4.7% and most common complication was anastomotic stricture (AS) in 60% of patients. Our study showed that despite improvements in management and survival of an infant with (EA), still sepsis, aspiration pneumonia, prematurity, and low birth weight and severe Congenital Heart Disease (CHD) were independent etiology of death and birth weight < 2.500 gr has a significant effect on the occurrence of postoperative complications. © 2018 Tehran University of Medical Sciences. All rights reserved. [ABSTRACT FROM AUTHOR]

Spinal manipulation is a manual technique commonly used for the treatment of low back pain. The physiologic mechanisms of the spinal manipulation are largely unknown. One basic physiologic response for spinal manipulation is an alteration in motoneuronal activity, as assessed by the Hoffmann reflex (H-reflex) technique. The purpose of this study was to determine the effect of spinal manipulation on the amplitude and onset latency of H-reflex and on H/M amplitude ratio in patients with low back pain. Fifty-Eight patients with low back pain aged between 20-60 years, who had no exclusion criteria were included. Tibial nerve H-reflex and M wave were recorded before and after Lumbosacral spinal manipulation. Lumbosacral manipulation significantly decreased the amplitude of the H-reflex and H/M amplitude ratio (P<0.05). It had no significant effect on H-reflex latency or M wave amplitude and latency (P>0.05). Lumbosacral manipulation produces attenuation of alpha motoneuronal excitability. These findings support this theory that manual spinal therapy can lead to a reduction in muscle tone. [ABSTRACT FROM AUTHOR]

Inflammatory elements and genetics have major roles in febrile seizures (FS) pathogenesis. Seventy patients were enrolled and compared with 139 controls. The allele and genotype frequency of the IL- 2 gene at -330 and +166 positions and the IFN-γ at +874 position were determined. A significant positive association with GG genotype at position -330 in the patient group was found (P=0.003). Further, a positive association was detected in simple and complex FS groups at the same position (P=0.03, P=0.004). IL-2 GT haplotype was significantly more common in the patients compared to controls (P=0.0008). Higher frequency of GT haplotype was detected in simple FS patients in comparison to controls (P=0.0003). Contrary, IL-2 TG haplotype frequency was lower in complex FS group (P=0.005). Overrepresentation of certain alleles, genotypes and haplotypes in IL-2 gene in FS patients could predispose individuals to this disease. [ABSTRACT FROM AUTHOR]

To investigate the effect of anisometropic and strabismic amblyopia on the nerve fiber layer thickness. This cross-sectional study was done on 54 amblyopic subjects, equally in both strabismic and anisometropic groups. The thickness otonerve fiber layer measured in superior, inferior, nasal, temporal quadrants and as a whole in both eyes of both groups. The means of thickness were compared in amblyopic and sound eyes. In strabismus group, the average nerve fiber layer thickness of the sound eye , in superior, inferior, nasal and temporal quadrants and as a whole were 113.23±14, 117.37±25, 68.96±6, 69.55±14 and 93.40±8 microns respectively. In amblyopic eyes of the same group, these measurements were 103.11±18, 67.74±11, and 69.59±16 and 89.59±12 microns in superior, inferior, nasal, temporal quadrants and as whole respectively. In anisometropic groups, the sound eye measurements were as 130.96±22, 129.07±29, 80.62±12, and 83.88±20 and 107.7±13 microns in superior, inferior, nasal and temporal quadrants and as a whole orderly. In amblyopic eyes of this group the mean thicknesses were 115.63±29, 133.15±25, 78.8±15, 80.2±16 and 109.17±21 microns in superior, inferior, nasal, temporal quadrants and as a whole respectively. Statistically, there were no significant differences between amblyopic and sound eyes (P>0.5). Our study did not support any significant change in a nerve fiber layer thickness of amblyopic patients; however, decreased thickness in superior and nasal quadrants of strabismic amblyopia and except inferior quadrant and as a whole. These measurements may be a clue for management and prognosis of amblyopia in old age. [ABSTRACT FROM AUTHOR]

Nowadays, improvement of thinking skills of students is one of the universally supported aims in the majority of medical schools. This study aims to design longitudinal theme of reasoning, problem-solving and decision-making into the undergraduate medical curriculum at Tehran University of Medical Sciences (TUMS). A participatory approach was applied to design the curriculum during 2009-2011. The project was conducted by the contribution of representatives of both basic and clinical faculty members, students and graduates at Tehran University of Medical Sciences. The first step toward integrating cognitive skills into the curriculum was to assemble a taskforce of different faculty and students, including a wide variety of fields with multidisciplinary expertise using nonprobability sampling and the snowball method. Several meetings with the contribution of experts and some medical students were held to generate the draft of expected outcomes. Subsequently, the taskforce also determined what content would fit best into each phase of the program and what teaching and assessment methods would be more appropriate for each outcome. After a pilot curriculum with a small group of second-year medical students, we implemented this program for all first-year students since 2011 at TUMS. Based on findings, the teaching of four areas, including scientific and critical thinking skills (Basic sciences), problem-solving and reasoning (Pathophysiology), evidence-based medicine (Clerkship), and clinical decisionmaking (Internship) were considered in the form of a longitudinal theme. The results of this study could be utilized as a useful pattern for integration of psycho-social subjects into the medical curriculum. [ABSTRACT FROM AUTHOR]

Upper endoscopy is a common procedure for the diagnosis and treatment of upper digestive tract diseases. The increasing number of pediatric gastrointestinal procedures has led to increasing attention on the safety and efficacy of medications used for sedation during the procedure. This randomized blinded interventional study was designed to compare the effect of oral midazolam with intravenous (IV) midazolam as a sedative medication in 119 children undergoing endoscopy. The mean time to sedation was 2.2±0.7 in IV midazolam group and 30.9±0 in oral midazolam group which was statistically significant difference between two groups. Separation from parents in oral midazolam group was as follow: 2 patients were high resistant (3.5%), 2 patients were resisted first and then relaxed (3.5%) and 55 patients were separated from their parents without any resistance (93%); whereas in IV midazolam group, 8 patients were high resistant (13.3%), 29 patients were relatively resistant (48.3%) and 23 patients were separated from their parents without any resistance (38.3%) that shows significant differences between the two groups. In terms of patient comfort during endoscopy, there was also a significant difference between the two groups. In oral midazolam, group parents were more consent, compared with the other group. The present study showed that oral midazolam is a safe and effective sedation during upper endoscopy in pediatrics. Oral midazolam reducing patients' anxiety during separation from parents leads the easy use of endoscopy and comfort of patients during endoscopy as compared with IV midazolam. Oral or IV midazolam were not able to put most patients in deep sedation level. [ABSTRACT FROM AUTHOR]

Metastatic neoplasms to the ocular surface are extremely rare. Here, we describe a case of A 56- year-old man developed simultaneously a limbal and parotid gland masses in his left side. He underwent excisional biopsy of limbal mass, parotidectomy, and systemic evaluation. Histopathologically, multislice sections of both limbal and parotidal masses disclosed an undifferentiated carcinoma of both sites. Further evaluation revealed no other site of involvement and metastasis. The patient underwent systemic chemotherapy and local radiotherapy for parotid gland tumor. Distal metastasis from undifferentiated carcinoma of the parotid gland to ocular surface is very rare and to the best of our knowledge has not been previously reported. This is the first report of the manifestation of metastasis from undifferentiated carcinoma of parotid gland origin to the limbus. The limbal mass may be the initial manifestation of metastasis from this origin and should be considered in the differential diagnosis of a metastatic limbal tumor. [ABSTRACT FROM AUTHOR]

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is produced by inflammatory cells, bound to LDL and other lipoproteins, and hydrolyzes oxidized phospholipids in LDL. Type 2 diabetes is the most common form of diabetes some investigations show the association of lipoprotein-associated phospholipase A2 mass and activity with the incidence of cardiovascular disease (CVD) in populations with high prevalences of insulin resistance and diabetes. This study is a cross-sectional descriptive and analytic study on 80 individuals with diabetes referring to the Tehran Diabetes Association. Patients divided into two groups (well-controlled and poorly controlled) based on their HbA1C. Personal information, anthropometric assessments (including height, weight, waist circumference and hip circumference) and semi-quantitative 147 items FFQ was used and vein blood samples were taken. After plasma separation, blood sample used for FBS, HbA1c and LP-PLA2 measurement. The independent sample T test was used for comparing means. Data analyses showed a significant difference between weight and WHR (waist to hip ratio) means in two studied groups, also there was a statistically significant difference in food intake (Energy, carbohydrate, protein, micronutrients percent and some of the micronutrients). FBS, HbA1C and LP-PLA2 means showed statistically significant difference (P<0/001) between two groups. This study showed LP-PLA2 is elevated in poorly-controlled patients compared to well-controlled diabetic patients, which may suggest some nutritional factors contributing to the regulation of this enzyme. [ABSTRACT FROM AUTHOR]

The major difference between Iranian traditional medicine and allopathic medicine is in the application of evidence and documents. In this study, criteria for evidence-based practice in Iranian traditional medicine and its rules of practice were studied. The experts' views were investigated through indepth, semi-structured interviews and the results were categorized into four main categories including Designing clinical questions/clinical question-based search, critical appraisal, resource search criteria and clinical prescription appraisal. Although the application of evidence in Iranian traditional medicine follows Evidence Based Medicine (EBM) principles but it benefits from its own rules, regulations, and criteria that are compatible with EBM. [ABSTRACT FROM AUTHOR]

Osteoporosis is a common health concern in both developed and developing countries. In this study the association between anthropometric measures and osteoporosis was investigated in 3630 males and females visiting BMD clinic of Shariati Hospital, Tehran, Iran, a teaching hospital and referral center for osteoporosis affiliated to the Tehran University of Medical Sciences. Anthropometric measurements obtained and also Bone Mineral Density (BMD) measurement was done using a Lunar DPXMD densitometer. Data were analyzed using SPSS with Chi-square and ANOVA with post-hoc tests. Results showed that the weight, BMI and age had the strongest correlation with the BMD values in the studied people. While age is negatively correlated with BMD in all the studied people, a positive association was noted between weight, height and BMI and BMD parameters (P<0,01). It was concluded that certain anthropometric parameters (BMI and weight) can considerably affect one's risk of developing osteoporosis. Further research on the effect of these variables on the association of weight and BMD is needed. [ABSTRACT FROM AUTHOR]

Phlomis lanceolata is a medicinal plant that has long been used to treat various conditions such as diabetes, gastric ulcer, hemorrhoids, inflammation and wounds. As most of Phlomis species have shown cytotoxic activity against proliferation of different cell lines, a biological investigation of P. lanceolata was carried out in this study. The aim of this study was to find out the in vitro cytotoxic activity of total extract and different fractions of Phlomis lanceolata on four cell lines. Cytotoxic activity of the metanolic total extract and partition fractions of chloroform, ethyl acetate and petroleum ether of flowering aerial parts of Phlomis lanceolata on the HT29, Caco2, T47D and NIH3T3 cell lines is examined by MTT. Petroleum ether fraction showed high cytotoxic activity against proliferation of all four cell lines. Presence of heavy triterpens and lipophil compounds recognized by TLC test in Petroleum ether fraction is responsible for high cytotoxic activity. The results emphasize the importance of phytochemical studies which could lead to the discovery of new active compounds. [ABSTRACT FROM AUTHOR]

Peribulbar anesthesia is widely applied in cataract surgeries. The aim of this study was comparing the effect of using Atracourium, cis-Atracourium, and placebo as adjuvant agents to the local anesthetic substance on peribulbar--induced akinesia in cataract surgeries. The study was double-blind randomized clinical trial, among the patients candidate for the cataract surgery who were hospitalized in ocular surgery ward in Farabi Hospital between 2006 and 2007. 90 patients were subcategorized into 3 groups randomly. Group I received a mixture (8 ml) containing equal parts of Marcaine 0.5%, Lidocaine 2% and Hyaluronidase 90 IU plus 0.5 ml normal saline; group II received the mixture (8 ml) plus 0.5 ml Atracourium 5 mg, and group III received the mixture (8 ml) plus 0.5 ml cis-Atracurium with the help of peribulbar blockage technique. The score of akinesia were evaluated in the 1st, 3rd, 5th, 10th minutes after administration of the medications. 10 minute after drug administration, 25 (92.6%) reached the total akinesia with Atracourium, 23 (85.2%) with cis-Atracourium, and 23 (85.2%) with the placebo (P>0.05). Addition of low-dose Atracourium and cis-Atracourium to the anesthetic drug is recommended in order to accelerate the onset of akinesia resulted by the peribulbar block, and in order to enhance the quality of akinesia especially when Hyaloronidaze is not added. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to determine the role of medial prefrontal cortex (mPFC) dopaminergic system in fear conditioning response considering individual differences. Animals were initially counterbalanced and classified based on open field test, and then were given a single infusion of the dopamine agonist, amphetamine (AMPH) and antagonist, clozapine (CLZ) into the medial prefrontal cortex. Rats received tone-shock pairing in a classical fear conditioning test and then exposed to the tone alone. Freezing responses were measured as conditioned fear index. The results showed that both AMPH and CLZ infusion in mPFC reduced the expression of conditioned fear. This finding indicates that elevation or reduction in the dopaminergic activity is associated with the decrease of fear responses, despite preexisting individual-typological differences. [ABSTRACT FROM AUTHOR]