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Javaherforooshzadeh F, Babazadeh Dezfoli A, Saki Malehi A, Gholizadeh B. The Efficacy of Dexmedetomidine alone or with Melatonin on Delirium after Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial. Anesth Pain Med 2023; 13:e138317. [PMID: 38024009 PMCID: PMC10664157 DOI: 10.5812/aapm-138317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 12/01/2023] Open
Abstract
Background One of the most common cognitive disorders after major surgery is delirium which can increase morbidity and mortality. This study compared the effect of dexmedetomidine with or without melatonin to reduce delirium following coronary artery bypass graft (CABG) surgery. Methods This trial was a double-blind, randomized, controlled clinical trial. Eighty patients in two different groups with the administration of dexmedetomidine alone or with melatonin undergoing CABG surgery in Golestan Hospital, Ahvaz, 2022 - 2023, were randomly allocated. This study evaluated the occurrence, onset, and length of delirium, haloperidol, the time required for weaning, and the duration of stays in the intensive care unit (ICU) and hospital. Results The occurrence of delirium was lower in the melatonin/dexmedetomidine group (15%) than in the dexmedetomidine group (30 %) (P = 0.09). Additionally, the melatonin/dexmedetomidine group had a significantly lower duration of delirium than the dexmedetomidine group (1.95 (0, 20) and 8.46 (0, 40) P = 0.04). However, no significant difference was observed in the onset of delirium between the two groups (P = 0.25). The length of hospital stays in the melatonin/dexmedetomidine group was significantly shorter than in the dexmedetomidine group (7.53 (7, 10) and 8.60 (7, 15), P = 0.03). However, the two groups demonstrated no significant difference between extubation (P = 0.38) and length of ICU stay (P = 0.19). Conclusions The administration of melatonin and dexmedetomidine reduced the incidence of post-cardiac surgery delirium, shortened its duration, and decreased the impact of many risk factors observed in those not receiving the added melatonin.
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Affiliation(s)
- Fatemeh Javaherforooshzadeh
- Department of Anesthesia, Pain Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Amal Saki Malehi
- Department of Biostatistics and Epidemiology, Pain Research Centre, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Behnam Gholizadeh
- Department of Cardiac Surgery, Pain Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Faraji-Khiavi F, Ghorbani Kalkhajeh S, Gholizadeh B, Dindamal B. Utilization obstacles to hypertension services provided at comprehensive health centers: a content analysis study. Health Res Policy Syst 2023; 21:37. [PMID: 37237314 DOI: 10.1186/s12961-023-00984-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/23/2023] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION Hypertensive patients' failure to refer to health centers for the management of their disease is the most fundamental public health challenge in most societies. The aim of this study was to identify the utilization obstacles to hypertension services provided at comprehensive health centers (CHCs) from the perspective of patients and the staff of health centers. METHODS This was a qualitative study using conventional content analysis which was conducted in 2022. Participants included 15 hypertensive patients referring to CHCs and 10 staff (including personnel of CHCs and expert staff) of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, southwest of Iran. Data were collected using semi-structured interviews. Interviews were analyzed using content analysis method, and coding was done manually. RESULTS In total, 15 codes and 8 categories were extracted from the interviews which were organized in two main themes of "individual problems" and "systemic problems". More particularly, the main theme of "individual problems" involved attitudinal obstacles, occupational obstacles, and economic obstacles. The main theme of "systemic problems" included educational obstacles, motivational obstacles, procedural obstacles, structural obstacles, and managerial obstacles. CONCLUSION In order to address individual problems associated with the patients' failure to refer to CHCs, we need to take appropriate measures. These include using motivational interviewing techniques and utilizing the effective activity of healthcare liaisons and volunteers in CHCs to increase patients' awareness and change their negative attitudes and misconceptions. To solve systemic problems, it is imperative that effective training courses be held for health center staff.
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Affiliation(s)
- Farzad Faraji-Khiavi
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.
| | - Sasan Ghorbani Kalkhajeh
- Healthcare Services Management, Department of Public Health, School of Health, Abadan University of Medical Sciences, Abadan, Iran
| | - Behnam Gholizadeh
- Department of Cardiac Surgery, Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Behnaz Dindamal
- Department of Health Services Management, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Jorairahmadi S, Javaherforooshzadeh F, Babazadeh M, Gholizadeh B, Bakhtiari N. Comparison of Nebulized Versus Intravenous Milrinone on Reducing Pulmonary Arterial Pressure in Patients with Pulmonary Hypertension Candidate for Open-cardiac Surgery: A Double-Blind Randomized Clinical Trial. Anesth Pain Med 2022; 12:e122994. [PMID: 36818483 PMCID: PMC9923341 DOI: 10.5812/aapm-122994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/06/2022] [Accepted: 07/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background Regardless of the cause, pulmonary hypertension can increase patient complications and mortality. This study compared the effect of nebulized versus intravenous (IV) milrinone on reducing pulmonary arterial pressure in patients with pulmonary hypertension candidates for open-cardiac surgery. Methods This double-blind, randomized clinical trial was performed on 32 patients undergoing elective on-pump cardiac surgery during January 2021-January 2022 in the Cardiac Operating Room of Golestan Hospital, Ahvaz, Iran. Patients were randomly divided into test groups nebulize milrinone (N = 16) and IV milrinone (N = 16). The medication was administered after the cross-clamp of the aorta opening. The outcome variables included hemodynamic data, cardiac output, cardiac index, stroke volume, mean arterial pressure (MAP), central venous pressure, mean pulmonary artery pressure (mPAP), systemic vascular resistance, pulmonary vascular resistance, MAP/mPAP ratio, time until extubation, duration of hospitalization in the Intensive Care Unit (ICU), and duration of hospital stay. Results In the nebulized group, MAP and MAP/mPAP were significantly higher than in the IV milrinone group (P = 0.09 and P < 0.0001, respectively). The time of extubation (P = 0.001), duration of hospitalization in the ICU (P = 0.009), and duration of hospital stay (P = 0.026) in the nebulized milrinone group were significantly shorter than in the IV milrinone group. Conclusions Nebulized milrinone administration before weaning off cardiopulmonary bypass (CPB) can be accelerated and facilitate weaning off CPB. Moreover, despite maintaining MAP, nebulized milrinone significantly reduces mPAP. According to the results of this study, nebulized milrinone is recommended in patients undergoing cardiac surgery with pulmonary hypertension.
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Affiliation(s)
- Sara Jorairahmadi
- Department of Anesthesiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Fatemeh Javaherforooshzadeh
- Department of Anesthesiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
- Corresponding Author: Department of Anesthesiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.
| | - Marziyeh Babazadeh
- Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Ahvaz Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Behnam Gholizadeh
- Ahvaz Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nima Bakhtiari
- Ahvaz Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Akiash N, Mombeini H, Gholizadeh B, Jazayeri SN, Azizidoost S. Primary mitral valve angiosarcoma: A multifaced ultra-rare tumor. Echocardiography 2021; 38:2100-2103. [PMID: 34820883 DOI: 10.1111/echo.15264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/18/2021] [Accepted: 11/04/2021] [Indexed: 11/30/2022] Open
Abstract
Malignant primary cardiac valve tumors are extremely rare neoplasms usually remaining silent up to late advanced stages. Getting to know the various features of this latent tumor, which needs prompt intervention, can assist in the earlier diagnosis. Herein we report a 24-year-old woman with angiosarcoma that originated from the mitral valve and manifested itself through dyspnea and pulmonary edema. The case is noteworthy with respect to appealing echocardiographic images.
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Affiliation(s)
- Nehzat Akiash
- Fellowship of Echocardiography, Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Science, Imam Khomeini hospital, Ahvaz, Iran
| | - Hoda Mombeini
- Fellowship of Echocardiography, Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Science, Imam Khomeini hospital, Ahvaz, Iran
| | - Behnam Gholizadeh
- Department of Cardiac Surgery, Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - S Nematollah Jazayeri
- Pars Medical Laboratory, Anatomical and Clinical Pathologist, 9th St, Kianpars, Ahvaz, Iran
| | - Shirin Azizidoost
- Atherosclerosis Research Center, Ahvaz Jundishapur university of Medical Science, Ahvaz, Iran
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Javaherforooshzadeh F, Abdalbeygi H, Janatmakan F, Gholizadeh B. Comparing the effects of ketorolac and Paracetamol on postoperative pain relief after coronary artery bypass graft surgery. A randomized clinical trial. J Cardiothorac Surg 2020; 15:80. [PMID: 32393370 PMCID: PMC7216617 DOI: 10.1186/s13019-020-01125-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/28/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction Pain management after coronary artery bypass graft (CABG) surgery remains challenging. Objective This study aimed to compare the effects of Ketorolac and Paracetamol on postoperative CABG pain relief. Method This double-blind randomized clinical trial study was conducted in Ahvaz, Iran, from September 2018–December 2019. Two consecutive groups of 60 patients undergoing elective on-pump coronary artery bypass graft surgery. Intervention The patients were divided into 0.5 mg/kg of ketorolac mg/dl and 10 mg/kg of Paracetamol after surgery for pain management. Primary outcomes were: visual analog pain scale (VAS) at the time point immediately after extubation (baseline) and at 6, 12, 24 and 48 h and the total dose of morphine consumption. Secondary outcomes included the hemodynamic variables, weaning time, chest tube derange, in-hospital mortality and myocardial infarction. Statistical analysis: The data were analyzed using SPSS version 22(SPSS, Chicago, IL). The Mann-Whitney U-test was used to compare demographic data, VAS scores, vital signs, and side effects. Repeated measurements were tested within groups using Friedman’s ANOVA and the Wilcoxon rank-sum test. Values were expressed as means ± standard deviations. Statistical significance was defined as a p-value < 0.05. Results Compared with baseline scores, there were significant declines in VAS scores in both groups throughout the time sequence (P< 0.05). The statistical VAS score was slightly higher in the Paracetamol group at most time points, except for the time of 6 h. However, at 24 and 48 h, the VAS score in group Paracetamol was significantly higher than in group Ketorolac. There were no significant differences between groups about hemodynamic variables. Conclusion The efficacy of ketorolac is comparable to that of Paracetamol in postoperative CABG pain relief. Trial registry IRCT20150216021098N5. Registered at 2019-09-12.
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Affiliation(s)
- Fatemeh Javaherforooshzadeh
- Department of Cardiac Anesthesia, Ahvaz Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hasan Abdalbeygi
- Department of Anesthesia, Ahvaz Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farahzad Janatmakan
- Department of Anesthesia, Ahvaz Anesthesiology and Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Behnam Gholizadeh
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Mozaffari Godarzi S, Valizade Gorji A, Gholizadeh B, Mard SA, Mansouri E. Antioxidant effect of p-coumaric acid on interleukin 1-β and tumor necrosis factor-α in rats with renal ischemic reperfusion. Nefrologia 2020. [PMID: 31892486 DOI: 10.1016/j.nefroe.2020.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND AND AIMS Renal ischemia-reperfusion occurs in some clinical conditions such as kidney surgery that can leads to acute renal failure. The aim of this study was to investigate the effect of p-coumaric acid (CA) on ischemia reperfusion (I/R) injury. METHODS Thirty rats were randomly divided into five groups; control, CA (100mg/kg), I/R, propylene glycol (10%)+I/R and CA+I/R, (n=6 each). CA and propylene glycol were administered orally for 2 weeks. Then, the rats were subjected to bilateral renal ischemia for 45min and followed by reperfusion for 24h. All rats were killed and kidney function tests, tissue malondialdehyde and activity of antioxidant enzymes were determined. Histopathological evaluations were also performed. In addition, renal expression of the tumor necrosis factor-α and interleukin-1β were determined using enzyme-linked immunosorbent assay and immunohistochemistry. RESULTS CA significantly improved the Cr and BUN levels in CA+I/R group compared to I/R group (p<0.005 and p<0.001, respectively). Reduction of tissue superoxide dismutase, glutathione peroxidase and catalase, were significantly improved by CA (p<0.01, p<0.01 and p<0.05). Treatment with CA also resulted in significant reduction in tissue MDA (p<0.05), TNF-α (p<0.001) and interleukin-1β expression (p<0.001) that were increased by renal I/R. Also, the rats treated with CA had nearly normal structure of the kidney. CONCLUSIONS The present findings suggest that, CA protects the kidneys against I/R injury via its antioxidant and anti-inflammatory effects.
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Affiliation(s)
- Shahin Mozaffari Godarzi
- Department of Anatomical Sciences, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Armita Valizade Gorji
- Cellular and Molecular Research Center, Department of Anatomical Sciences, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Behnam Gholizadeh
- Department of Cardiac Surgery, Atherosclerosis Research Center and Imam Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyyed Ali Mard
- Physiology Research Center (PRC), Research Center for Infectious Diseases of Digestive System, Department of Physiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Esrafil Mansouri
- Cellular and Molecular Research Center, Department of Anatomical Sciences, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Mozaffari Godarzi S, Valizade Gorji A, Gholizadeh B, Mard SA, Mansouri E. Antioxidant effect of p-coumaric acid on interleukin 1-β and tumor necrosis factor-α in rats with renal ischemic reperfusion. Nefrologia 2019; 40:311-319. [PMID: 31892486 DOI: 10.1016/j.nefro.2019.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/07/2019] [Accepted: 10/20/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND AND AIMS Renal ischemia-reperfusion occurs in some clinical conditions such as kidney surgery that can leads to acute renal failure. The aim of this study was to investigate the effect of p-coumaric acid (CA) on ischemia reperfusion (I/R) injury. METHODS Thirty rats were randomly divided into five groups; control, CA (100mg/kg), I/R, propylene glycol (10%)+I/R and CA+I/R, (n=6 each). CA and propylene glycol were administered orally for 2 weeks. Then, the rats were subjected to bilateral renal ischemia for 45min and followed by reperfusion for 24h. All rats were killed and kidney function tests, tissue malondialdehyde and activity of antioxidant enzymes were determined. Histopathological evaluations were also performed. In addition, renal expression of the tumor necrosis factor-α and interleukin-1β were determined using enzyme-linked immunosorbent assay and immunohistochemistry. RESULTS CA significantly improved the Cr and BUN levels in CA+I/R group compared to I/R group (p<0.005 and p<0.001, respectively). Reduction of tissue superoxide dismutase, glutathione peroxidase and catalase, were significantly improved by CA (p<0.01, p<0.01 and p<0.05). Treatment with CA also resulted in significant reduction in tissue MDA (p<0.05), TNF-α (p<0.001) and interleukin-1β expression (p<0.001) that were increased by renal I/R. Also, the rats treated with CA had nearly normal structure of the kidney. CONCLUSIONS The present findings suggest that, CA protects the kidneys against I/R injury via its antioxidant and anti-inflammatory effects.
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Affiliation(s)
- Shahin Mozaffari Godarzi
- Department of Anatomical Sciences, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Armita Valizade Gorji
- Cellular and Molecular Research Center, Department of Anatomical Sciences, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Behnam Gholizadeh
- Department of Cardiac Surgery, Atherosclerosis Research Center and Imam Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyyed Ali Mard
- Physiology Research Center (PRC), Research Center for Infectious Diseases of Digestive System, Department of Physiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Esrafil Mansouri
- Cellular and Molecular Research Center, Department of Anatomical Sciences, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Gholizadeh B, Arefazar A, Barikani M, Hemmati M. Polar/nonpolar gas transfer through PEO-based copolymers membranes. Journal of Macromolecular Science, Part A 2017. [DOI: 10.1080/10601325.2017.1336724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- B. Gholizadeh
- Polymer engineering and color technology department, Amir Kabir University, Tehran, Iran
| | - A. Arefazar
- Polymer engineering and color technology department, Amir Kabir University, Tehran, Iran
- Nano and smart polymers centre of excellence, Amir Kabir University, Tehran, Iran
| | - M. Barikani
- Iran polymer and petrochemical institute, Tehran, Iran
| | - M. Hemmati
- Polymer science & engineering department, Research Institute of Petroleum Industry, Tehran, Iran
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Affiliation(s)
- M. Afshari
- Department of Statistics, College of Science, Persian Gulf University, Bushehr, Iran
| | - F. Lak
- Department of Statistics, College of Science, Persian Gulf University, Bushehr, Iran
| | - B. Gholizadeh
- Department of Statistics, College of Science, Persian Gulf University, Bushehr, Iran
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Alizadeh-Ghavidel A, Basiri H, Totonchi Z, Mirmesdagh Y, Jalili-Shahandashti F, Gholizadeh B. A rare presentation of late right coronary artery spasm following aortic valve replacement. ARYA Atheroscler 2015; 11:50-3. [PMID: 26089931 PMCID: PMC4460353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 04/16/2014] [Indexed: 10/31/2022]
Abstract
BACKGROUND Coronary artery spasm (CAS) is defined as a reversible, sudden epicardial coronary artery stenosis that causes vessel occlusion or near occlusion. CASE REPORT In this article, we present a clinical case of CAS in a 48-year-old woman undergoing elective aortic valve replacement surgery for aortic stenosis. On the 3rd post-operative day, the patient suffered from chest pain and dyspnea. Emergent coronary angiography demonstrated a significant spasm of the ostium portion of the right coronary artery. CONCLUSION This case shows that delayed coronary spasm should be considered as a cause of hemodynamic instability after valvular surgery.
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Affiliation(s)
- Alireza Alizadeh-Ghavidel
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hosseinali Basiri
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ziae Totonchi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yalda Mirmesdagh
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Jalili-Shahandashti
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran,Correspondence to: Farshad Jalili-Shahandashti,
| | - Behnam Gholizadeh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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