Reviews in Clinical Medicine

4-7

Authors: Mehryar Taghavi Gilani1 ; Mohammad Sharifi2 ; Mona Najaf Najafi3 ; Mohamad Ghasem Etemadi Mashhadi* 1

The activation of oculucardiac reflex (OCR) is common during the strabismus surgeries. OCR is known as a trigemino-vagal reflex, which leads to the various side effects including bradycardia, tachycardia, arrhythmia, or in some cases cardiac arrest. This reflex could be activated during intraorbital injections, hematomas, and mechanical stimulation of eyeball and extraocular muscles surgeries. The incidence of OCR varies in a wide range, from 14% to 90%, that depends on anesthetic strategy and drug used for the surgery. The efficacy of various anticholinergic and anesthetic agents on declining the OCR reflex has been evaluated in different studies, especially in children. Although the detection of OCR goes back to 1908, its exact effect is not well recognized during strabismus surgery. In this review, we aimed to summarize the studies investigated the efficacy and potential of various anesthetic medications on inhibiting the OCR in children undergoing strabismus surgery.

13-17

Authors: Negar Khalighi* 1 ; Rahim Vakili1 ; Mohammad Ali kiani1 ; Seyed Ali Jafari1 ; Hamid Reza Kianifar1 2

Introduction: Cystic fibrosis is one of the most common autosomal recessive diseases that affects sweat glands and mucosa. CF is a hereditary disease with annual incidence of about 2500 new cases in United Kingdom. Insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 levels decrease in CF. The aim of this study was to assess the role of growth peptides in patients with CF. Method: We searched PubMed, Google scholar, IranMedex, and Scientific Information Database (SID) in September 2012 to April 2014. We included clinical studies with available abstracts and full texts that were in English or Persian languages. Manual searching was conducted within the reference lists of articles. Two reviewers independently applied eligibility criteria, assessed quality, and extracted data. Result: The earliest study was published in 1997 and the most recent one was in 2014. Study participants were adults in 3 studies (20%) and 12 studies (80%) were conducted in children. Patients with CF have lower levels of IGF-1 and there is a significant correlation between IGF-1 levels and growth index in patients with CF. Conclusions: IGF-1 decreases in children with CF and might be the cause of poor growth and low body mass index in these children.

23-27

Authors: Mohsen Akhondi1 ; Alireza Sabzevari1 ; Ali Rahdari* 1 ; Shabnam Imannezhad2

Introduction: Coughing is an airway complication that could affect the outcome of surgery following general anesthesia in adults. In this systematic review, we aimed to study the efficacy of applying laryngeal airway mask (LMA) compared with endotracheal tube (ETT) in reducing the postoperative cough in adults under general anesthesia. Method: PubMed was searched for the relevant articles. Inclusion criteria were all the randomized controlled clinical trials, which used LMA and ETT in adults under general anesthesia. Only English language articles were included in this study with no time limitation. Result: Overall, 15 articles were retrieved, which were relevant with the purpose of this study. Efficacy of LMA in reducing coughing was significantly different with ETT in adults under general anesthesia in various types of surgeries. Calculated number needed to treat (NNT) showed that using LMA would significantly reduce coughing even in one adult patient. Conclusions: Coughing has shown various adverse effects on postoperative main results in some surgeries such as cataract, cranial, etc. Applying LMA could positively decrease postoperative coughing in adults.

32-38

Authors: Ali Rahdari1 ; Reza Jalaeian Taghaddomi1 ; Alireza Sabzevari1 ; Shabnam Imannezhad* 2 ; Mohsen Akhondi1

Introduction: Cardiopulmonary bypass is associated with high risk of mortality and morbidity which should be investigated regarding the major risk factors related to this surgery. Temperature management can have a significant role on post operation cerebral and neurological complication; however the optimum temperature for cardiopulmonary surgery is not certainly detected. This systematic review investigated the difference between hypothermia and normothermia regarding postoperative mortality. Methods: PubMed was searched for the relevant articles. Only English language articles were included with no time limitation. Data regarding patients in-hospital death which were provided in each article mostly within 30 days after the surgery are extracted and compared based on specific effect size including: relative risk reduction, absolute risk reduction, number needed to treat. Results: Totally 28 articles are retrieved and extracted from PubMed as the most relevant articles. In 8/28 articles no mortality incidence was occurred in each group and the effects sizes could not be calculated. Conclusion: No significant difference was obtained between two studied groups. Similar patients death prevalence observed between hypothermia and normothermia might be due to the studies sample size, or the following cars performed the intensive care units which assist to reduce the postoperative mortality rate. According to the obtained results these to procedure might be as safe as each other regarding the patients mortality rate.

43-47

Authors: Mostafa Delshad1 ; Azita Fesharakinia2 ; Samaneh Eghbal* 2

Introduction: Urinary tract infection (UTI) that can affect any part of the urinary tract and may subsequently lead to kidney infection is linked with variety of causative factors such as oxidative stress. In this study, we aimed to systematically review the literatures to evaluate the effects of oxidative stress on UTI. Method: PubMed and Google scholar were searched systematically using the key terms, “oxidative stress” and “urinary tract infection” in the title, keywords, and abstract on February 2015 to find articles in which the oxidative stresses had been evaluated in children with urinary tract infection (UTI). Papers were excluded if they were unrelated to the purpose of this study, or in language other than English. Full texts of the relevant documents were fully reviewed for data extraction. Result: Of overall 50 articles from PubMed, and 6 records found in Google scholar, only 8 articles met the inclusion criteria for further assessment. Additionally, three papers were omitted due to full texts unavailability or language irrelevancy, and five articles, which fully met the inclusion criteria, were used for data extraction. The results showed that the level of antioxidant decreases significantly in patients with UTI, while the markers of oxidative stress increases. Conclusions: The results of the studies showed that the level of antioxidants decreases in patients with UTI, while lipid peroxidase and the level of oxidative stress biomarkers such as malondialdehyde and reactive oxygen species increase. These findings are suggestive of an association between oxidative stress and UTI. The role of oxidative stress in pediatric urinary tract infections: a systematic review