Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101Comparison between intravenous and intramuscular administration of ketamine in children sedation referred to emergency department14337310.17463/RCM.2015.01.001ENBehnaz Boroumand RezazadehDepartment of Emergency Medicine, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranHamid Zamani MoghadamDepartment of Emergency Medicine, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammad GharavifardDepartment of Anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140423Ketamine, among wide variety of sedative drugs, has shown beneficial effects when using during the procedural sedation, specifically in pediatrics. Various parameters should be considered in order to perform a safe and effective procedural sedation including optimum dosage of the sedative, administration methods of sedation, and need for applying any adjuvant drug. In this study, we aimed to review the studies, which have compared the efficacy of the different ways of the injection of ketamine such as intravenous or intramuscular ketamine application. Based on data obtained from the related articles, efficacy and safety of these two methods of ketamine usage in the pediatric procedural sedation were widely similar, but the intravenously administration of the ketamine can be proposed as the preferable mode.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101Peripheral arterial stenosis and coronary artery disease coincidence58337410.17463/RCM.2015.01.002ENReza GhasemiDepartment of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMostafa DastaniDepartment of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranAlireza AbdolahiDepartment of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranHamid Reza RahimiStudent Research Committee, Department of Modern Sciences & Technologies, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140403Atherosclerosis is a chronic slow-developing condition affecting medium-size and large blood vessels. It is the principal underlying pathology of coronary heart disease and stroke. In some countries, coronary artery disease (CAD) is the cause of nearly half (48%) of the deaths and, loss of productivity life. Peripheral arterial disease (PAD) is defined as atherosclerosis in peripheral arteries instead of coronary arteries. CAD and PAD have same risk factors and underlying pathophysiological processes. Therefore, patient with CAD should be considered for PAD. Ankle brachial index (ABI), duplex sonography, and some other non-invasive techniques are recommended for PAD diagnosis in patients with the history of CAD. Pharmacotherapy, endovascular interventions, and surgical management could be chosen according to the patient’s situation. Cardiologists and general practitioners should consider PAD in a patient with CAD or DM as a strong correlated disease. Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101Methamphetamine psychosis, the efficacy of atypical antipsychotics914337510.17463/RCM.2015.01.003ENAmir Rezaei ArdaniPsychiatry & Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, IranAzam Motamedi NasabPsychiatry & Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140223Worldwide growing methamphetamine abuse is one of the most serious health problems with several different consequences for victims, especially in developing countries. Chronic methamphetamine abuse is associated with several psychiatric problems in all countries which are faced to epidemic methamphetamine abuse. Methamphetamine-induced psychosis is a major medical challenge for clinical practitioner from both diagnostic and therapeutic viewpoints. Stimulant psychosis commonly occurs in people who abuse stimulants, but it also occurs in some patients taking therapeutic doses of stimulant drugs under medical supervision. The main characteristic of meth psychosis is the presence of prominent hallucinations and delusions. Other drugs, such as cocaine and marijuana, can trigger the onset of psychosis in someone who is already at increased risk because they have “vulnerability”.<br/>The current literature review attends to explain several aspects of MIP epidemiologically and clinically. Investigators proposed pharmacologically treatment based on recently published data.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101A review of the literature on the association between vitamin D status and the risk of preeclampsia1518365910.17463/RCM.2015.01.004ENAmeneh MovahedianDepartment of Gynecology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranNayereh GhomianDepartment of Gynecology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranSamaneh SoltaniDepartment of Gynecology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranNushin ChalakiniaDepartment of Gynecology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140410Complications related to pregnancy and childbirth are the leading causes of disability and death among women of reproductive age in developing countries, constituting at least 18% of the global burden of disease in this age-group. Preeclampsia is a serious, pregnancy-specific disorder that affects up to 8% of pregnant women. Preeclampsia may lead to maternal and offspring mortality and it increases the risk of premature birth and fetal growth restriction. Vitamin D is a potent immunomodulatory agent. There is an evidence pointing toward an association between the vitamin D status and preeclampsia risk. <br/>The purpose of the present study is to review the available literature investigating the role of serum levels of vitamin D in preeclampsia.<br/>The study findings further highlight the possibility that vitamin D deficiency is a strong, independent risk factor for preeclampsia and vitamin D supplementation may be a simple step to reduce the risk of adverse pregnancy outcomes providing lifelong benefits both to the mother and her developing child.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101Laparoscopic splenectomy advantages over open surgery1923344210.17463/RCM.2015.01.005ENMajid SafarpanahDepartment of General surgery, Imam Reza hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMehran HiradfarDepartment of Pediatric surgery, Imam Reza hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140313In recent years, laparoscopy has become a popular surgical method. Laparoscopy is a minimally invasive surgery, which results in minor traumas in comparison with conventional open surgeries. There are several risk factors associated with laparoscopy based on the involved organ and the patient’s general situations. Due to the improvements of clinical approaches, laparoscopic splenectomy has been known as a gold standard method for spleen removal as a result of various diseases, such as ITP. The human spleen plays a key immunologic role in defense against a number of organisms, particularly encapsulated bacteria. The spleen can cause significant morbidity and/or hematologic disturbance if it becomes hyperfunction (hypersplenism) or hypertrophied (splenomegaly). Laparoscopic surgery for cancer is also an appropriate procedure if good tissue handling techniques are maintained. In this study, we attempted to review the results obtained from recent articles about the beneficial features of the laparoscopic splenotectomy in comparison with conventional open surgery.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101Medical treatment of nasal polyps: a review2427344410.17463/RCM.2015.01.006ENMohammad Saleh SoltankhahSinus and Surgical Endoscopic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IranMohammad Reza MajidiSinus and Surgical Endoscopic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IranShahaboddin ShabaniSinus and Surgical Endoscopic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140313Nasal polyp is macroscopic edematous mass and it is a most common nasal complaint of the patients. The exact etiology is still unknown and controversial, but the main causes are assumed to be the inflammatory conditions and allergy. Their clinical presentations are obstruction, rhinorrhea, postnasal drip. Nasal polyp is more common in allergic patients with asthma. Treatment of this complication is associated with both medical treatment and surgery. Corticosteroids (systemic and topical) are shown to be beneficial in reducing the size of nasal polyp. Corticosteroids are also used as a primary treatment and postoperative management for avoiding recurrence. The rate of leukotrienes is increased in polyps. It is reported that leukotriene receptor antagonists (antileukotriene) have a beneficial effect on nasal polyp treatment. Montelukast is an antileukotriene. It can be used to modify the symptoms of nasal polyp. There is no significant difference between corticosteroids and montelukast clinical efficacy.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101Evaluating different sedative drugs applied in procedural sedation2831344610.17463/RCM.2015.01.007ENAzadeh TafakoriDepartment of Emergency Medicine, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammad GharavifardDepartment of Anesthesia, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranHamid ZamaniDepartment of Emergency Medicine, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140401There are various criteria that affect the efficacy of the procedural sedation strategies required for performing different processes in emergency departments. Selecting the most effective and the safest sedative with or without analgesic effect for every individual patients and intervention is one of the main parts of the each emergency department practices. Based on previous studies, various sedative agents have been proposed, which have different benefits and adverse effects including propofol, ketamine, etomidate etc. Different side effects of administrating each drug, alone or in combination with each other, have been proposed such as vomiting, respiratory depression, hypoxia, hypotension and cardiac arrest. In this study we aimed to briefly review the properties of applied sedatives in different studies and also mention few related clinical trials with proper blinding, which were conducted to evaluate the efficacy of the sedative in procedural sedation.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101Coronary arteries bypass grafting stenosis3236366010.17463/RCM.2015.01.008ENMahmoud EbrahimiCardiovascular Research Center, Department of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranAzamat Sabouri ArtehCardiovascular Research Center, Department of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranHamid Reza RahimiStudent Research Committee, Department of Modern Sciences & Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140320Coronary artery disease (CAD) is a major global problem. In addition, it is higher risk of mortality for women more than men are when develop in female gender Atherosclerotic plaques consist of deposits of fatty material in the tunica intima. The role of inflammatory process in CAD has been known from 1980’s. Several studies investigated the innate immunity and adaptive immunity roles in atherosclerosis and they concluded that it plays a key role in atherosclerosis. Coronary artery bypass grafting (CABG) is a widely used method for the treatment of CAD. Based on the literature, CABG is the most common surgical operation done worldwide. In During the first 10 years after CABG, up to 50% of saphenous grafts will occlude. Graft restenosis is beginning with acute thrombosis, intima hyperplasia, and plaque formation. In this review, some molecular pathways of graft failure and restenosis such as apoptosis and nuclear factor kappa B (NF-ĸB) are described.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101Preventive and therapeutic effects of tranexamic acid on postpartum bleeding3741366110.17463/RCM.2015.01.009ENSamaneh SolltaniDepartment of Gynecology & Obstetric, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMasoumeh MirteimouriDepartment of Gynecology & Obstetric, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranAmeneh MovahedianDepartment of Gynecology & Obstetric, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranNushin ChalakiniaDepartment of Gynecology & Obstetric, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140422Postpartum hemorrhage is among the leading causes of maternal mortality throughout the world. Severe blood loss contributes to the increased blood transfusion risk with its concerned inherent adverse events and therefore increased rate of emergency re-operative interventions such as arterial ligation or hysterectomy. It also can lead to protracted anemia, particularly in low or median income countries. Extended application of antifibrinolytic agents such as tranexamic acid has been customary for long years to stop or reduce blood loss in postpartum period. However, there are not enough reliable evidence to approve the real efficacy of these drugs. In this brief and summary review, we pointed to a few conducted studies. The PubMed was searched for keyword including postpartum hemorrhage, tranexamic acid, cesarean section, vaginal delivery, and blood loss prevention. The articles with language other than English were excluded from our review. We concluded that more convincing information is needed to determine the precise effects of tranexamic acid, and its benefits against adverse effects.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101Nicorandil in patients with acute coronary syndrome and stable angina undergoing percutaneous coronary intervention: literature review4244366210.17463/RCM.2015.01.010ENNeda PartoviDepartment of Cardiology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranHoma FalsoleimanDepartment of Cardiology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140323Percutaneous coronary intervention is an option for the treatment of coronary artery disease such as acute coronary syndrome and stable angina.Acute coronary syndrome has two groups including acute myocardial infarction and unstable angina.<br/>Periprocedural myocardial infarction is a frequent and prognostically important complication of percutaneous coronary intervention and can be easily monitored by measuring myocardial enzymes. Coronary microvascular dysfunction in patients undergoing primary percutaneous coronary intervention for the treatment of ST-segment elevation myocardial infarction is associated with poor prognosis. Even after recanalization, reperfusion injury often occurs including no-reflow or slow-flow in which sufficient myocardial blood flow cannot be obtained and results in a poor outcome of cardiac function in the long term.<br/>Nicorandil is the opener of the adenosine triphosphate-sensitive potassium channel and is known to have an antiarrhythmic effect and myocardial protective functions such as reduction of the coronary microvascular resistance by relaxing the smooth muscles of blood vessesl and preconditioning.In this literature review, we evaluate articles about acute coronary syndrome and stable angina undergoing PCI. Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101Risk factors associated with surgical site infection after breast surgery4548366310.17463/RCM.2015.01.011ENSeyed Esmael NezhadhoseiniDepartment of General Surgery, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranKazem FotohiDepartment of General Surgery, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammad VejdaniDepartment of General Surgery, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140420Breast surgical site infection is not only one of the main causes of the morbidity and mortality of cases under different types of surgeries, but also it results in longer hospitalization and additional expenses. Identifying various potential parameters related to the occurrence of surgical site infection after the surgery and getting accurate knowledge about them can be beneficial in preventing the surgical site infection. Various types of studies have been conducted to evaluate the possible risk parameters of surgical site infection in every surgery. In this study, we tried to provide a brief review of the available literature regarding the risk factors associated with breast surgical site infection. To this end, we searched the Pubmed database for the relevant articles. We selected eight articles, which have studied the parameters with statistically significant association with the breast surgical site infection. According to our review, further studies with larger sample size can be effective in better evaluating the associated risk factors and presenting the exact effect of some uncertain risk factors of the surgical site infection after breast surgeries.Mashhad University of Medical SciencesReviews in Clinical Medicine2345-62562120150101Epicardial adipose tissue and coronary artery disease: an article review4951366410.17463/RCM.2015.01.012ENSareh MousaviDepartment of Cardiology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranFereshteh GhaderiDepartment of Cardiology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranAli EshraghiDepartment of Cardiology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140410Adipose tissue surrounding the heart may contribute in the progression of coronary atherosclerosis due to its proximity to the coronary arteries. In addition, epicardial adipose tissue has paracrine and endocrine functions. It can secrete numerous bioactive molecules. Most previous studies examined the relation between coronary artery disease and epicardial adipose tissue have used echocardiography and have reported controversial results, probably due to differences in measurement techniques and study populations. This study aimed to give a brief review on the value of echocardiographic assessment of epicardial adipose tissue in the prediction of coronary artery disease severity.<br/>Epicardial adipose tissue, easily and non-invasively evaluated by transthoracic echocardiography, can be considered as an adjunctive marker to classical risk factors despite all the limitations. Moreover, it might be recommended as a useful quantitative screening examination for the prediction of the presence and the severity of coronary artery disease and the extent of atherosclerosis.