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Background: Ketamine, a non-competitive NMDA (N-Methyl-D-Aspartate) receptor antagonist, is recognized as an intraoperative anesthetic agent. Increasing interest in the use of low-dose ketamine for postoperative analgesia has developed in part because of its NMDA-antagonistic properties, which may be important in attenuating central sensitization and opioid tolerance. Despite of many trial evaluations which have been done on the effect of low-dose ketamine in postoperative pain, the role of ketamine, as a component of perioperative analgesia, remains unclear. We evaluated the analgesic effect of low-dose ketamine during anesthesia induction in painful ophthalmic surgery. Materials and Methods: After institutional approval and written informed consent, 88 patients undergoing retinal detachment, strabismus, and keratoplasty surgery aged 18-80 years old were randomly divided intoequal case and control groups. Anesthesia was induced with sodium thiopental, fentanyl, atracurium, and liducaine, and maintained with N 2 O, O 2 , and propofol. Ketamine 0.5 mg/kg was administered intravenously to patients in the case group during anesthetic induction. Mean blood pressure and pulse rate were listed in questionnaire every 5 minutes. The consumption of anesthetic, perioperative additional analgesic, extubation time, postoperative pain and nausea scores (based on Visual Analog Scale), vomiting frequency, and the recovery time were recorded. Results: There were no differences in the recovery time (17.3 ± 3.4 in the case group vs. 16.3 ± 3 in the control group, P < 0.05), postoperative pain scores (5 ± 1 in the case group vs. 5.6 ± 2 in the control group, P < 0.05), the consumption of anesthetic (9376.9 ± 1245.8 in the case group vs. 9012.9 ± 1620 in the control group, P < 0.05), the analgesic requirements (1000 in the case group vs. 940.9 ± 135.6 in the control group, P < 0.05), and perioperative additional analgesic (63.4 ± 26.5 in the case group vs. 69.4 ± 25.6 in the control group, P < 0.05) between two groups. The extubation time in the case group (13.59 ± 4.83) was significantly shorter than in the control group (15.9 ± 3.6) (P = 0.01). Conclusion: This study demonstrates that a low dose administration of ketamine during anesthesia induction in retinal detachment, strabismus, and keratoplasty surgery improves the extubation time but have no effect on postoperative pain, nausea and vomiting, and perioperative additional analgesic requirements.

"nBackground and Aims: Despite the significant improvement in dentistry, pain after endodontic therapy is still of concern for patients. Non-steroidal anti-inflammatory drugs are the most commonly prescribed oral analgesics used for dental pain relief after root canal treatment. The purpose of this study was to compare the effectiveness of Ibuprofen versus slow-released Diclofenac Sodium in controlling pain following root canal treatment. "nMaterials and Methods: In this randomized clinical trial, mandibular molars with irreversible pulpitis in 90 patients were selected. The patients were divided into three groups (Ibuprofen, slow-released Diclofenac Sodium and placebo). After examination patients filled in the consent form. Then they received one of the mentioned drugs. After inferior alveolar nerve block, access cavity was prepared and the root canals were prepared using passive step back method. The canals were dried and temporary filling material was placed. Then the pain evaluation form (visual analog scale) was explained and delivered to the patients. Data were analyzed using Repeated Measurement ANOVA, Kruskal-wallis and Man-Whitney U tests. "nResults: The mean pain intensity in slow-released Diclofenac Sodium group was 0.87 0.95, 1.17 1.10 for Ibuprofen group, and 2.14 1.70 for placebo group. The differences between groups were statistically significant (P

BACKGROUND: Narcotics and sedatives can reduce intraocular pressure. This study was performed to evaluate the effect of remifentanil plus ketamine on intraocular pressure and sedation quality in comparison with fentanyl plus ketamine during and after operation in patients undergoing phacoemulsification with topical anesthesia.METHODS: Forty four patients were randomized into two groups to receive either a continuous infusion of remifentanil (0.2 µg/kg/min for 4 min and then 0.1 µg/kg/min: Group R, n=22) or bolus intravenous fentanyl (1.5 µg/kg: Group F, n=22) for sedation. Patients in both groups received low dose ketamine (0.15 mg/kg) intravenously. Topical anesthesia was performed using tetracaine 0.5% eye drop in both eyes. Intraocular pressure was measured in non-operative eye before sedation (baseline), 2 minutes after sedation, before intraocular lens insertion, at the end of operation and 15 minutes after the end of operation using Schiötz tonometer. Sedation, cooperation, satisfaction and pain scores and also postoperative nausea and vomiting were recorded in all patients. Surgeon satisfaction scores were evaluated at the end of operation.RESULTS: The intraocular pressure did not differ significantly between the two groups throughout the study. The mean (SD) intraocular pressures 2 minutes after sedation, before intraocular lens insertion, at the end of operation and 15 minutes after the end of operation in recovery room were all less than that of baseline in both groups, but the baseline value was decreased only significantly (P < 0.05) in recovery room [13.75 (3.46) to11.91 (3.43) in group R, respectively and 13.74 (3.05) to11.57 (2.33) in group F, respectively]. The incidence of postoperative nausea and vomiting in group R was higher than that of group F (7 patients in group R and no patient in group F, P = 0.009).CONCLUSIONS: Combination of remifentanil infusion and intravenous ketamine did not offer any advantages over the combination of intravenous fentanyl and ketamine in order to prevent intraocular pressure rising during phacoemulsification. The lower incidence of postoperative nausea and vomiting and higher rate of appropriate sedation in fentanyl group suggested fentanyl as a more suitable medication for systemic sedation compared with remifentanil.KEY WORDS: Fentanyl, remifentanil, intraocular pressure, phacoemulsification, topical anesthesia.

Background: This study′s aim was to design and validate a semi-quantitative food frequency questionnaire (FFQ) for assessment of fruits and vegetables (FV) consumption in adults of Isfahan by comparing the FFQ with dietary reference method and blood plasma levels of beta-carotene, vitamin C, and retinol. Methods: This validation study was performed on 123 healthy adults of Isfahan. FV intake was assessed using a 110-item FFQ. Data collection was performed during two different time periods to control for seasonal effects, fall/winter (cold season) and spring/summer (warm season). In each phase a FFQ and 1 day recall, and 2 days of food records as the dietary reference method were completed and plasma vitamin C, beta-carotene and retinol were measured. Data was analyzed by Pearson or Spearman and intraclass correlations. Results: Serum Lipids, sex, age, body mass index (BMI) and educational level adjusted Pearson correlation coefficient of FV with plasma vitamin C, beta-carotene and retinol were 0.55, 0.47 and 0.28 in the cold season (p < 0.05) and 0.52, 0.45 and 0.35 in the warm season (p < 0.001), respectively. Energy and fat intake, sex, age, BMI and educational level adjusted Pearson correlation coefficient for FV with dietary reference method in the cold and warm seasons were 0.62 and 0.60, respectively (p < 0.001). Intraclass correlation for reproducibility of FFQ in FV was 0.65 (p