Inhibitory effect of temozolomide on apoptosis induction of cinnamaldehyde in human glioblastoma multiforme T98G cell line.

Glioblastoma is the most common primary malignant brain tumor in adults. Temozolomide (TMZ) is an FDA-approved drug used to treat this type of cancer. Cinnamaldehyde (CIN) is a derivative of cinnamon extract and makes up 99% of it. The aim of this study was to investigate the in vitro combined effect of CIN and TMZ on human glioblastoma multiforme T98G cell line viability. In this study, we used 3-(4,5 dimethylthiazol-2-yl)-2,5-diphenyl-tertazolium bromide (MTT) method to evaluate the extent of IC50, acridine orange, Giemsa and Hoechst staining to evaluate the manner of apoptosis and the Western blotting method to examine the expression change of apoptotic proteins. Our results show that TMZ has an inhibitory effect on CIN when both used in combination at concentrations of 300 and 100 µM (P<0.05) and has a cytotoxic effect when used alone at the same concentrations (P<0.05). The western blotting result showed that TMZ at concentrations of 2,000 and 1,000 µM significantly increased Bax expression and decreased Bcl2 expression (P<0.05), indicating that TMZ induced apoptosis through the mitochondrial pathway. However, CIN had no effect on Bax and Bcl2 expressions, thus causing apoptosis from another pathway. Also, the Bax:Bcl2 expression ratio at concentrations combined was lower than that for TMZ 1,000 µM and higher than that for CIN 150 and 100 µM (P<0.05), which confirms the inhibitory effect of TMZ on CIN. From the present study, we conclude that TMZ in combination with CIN has an inhibitory effect on increasing the cytotoxicity rate.

Avicenna's pharmacopeia for the treatment of animal bites.

Envenomation is a common medical problem. The Canon of Medicine written by Avicenna is one of the reliable sources of Persian medicine. The present study aims to identify Avicenna's clinical pharmacology approach and the pharmacopeia used for the treatment of animal envenomations and also to evaluate the related data in light of the current medicine. The Canon of Medicine was searched using related Arabic keywords for the contents about the treatment of animal bites. A literature search was conducted in scientific databases including PubMed, Scopus, Google Scholar, and Web of Science to obtain relevant data. Avicenna recommended one hundred and eleven medicinal plants for the treatment of bites of vertebrate and invertebrate venomous animals including snakes, scorpions, spiders, wasps, and centipedes. He mentioned different methods of administrating these drugs including oral drugs, lotions, sprayed drugs, slow-dissolving tablets in the mouth, and enemas. Moreover, he paid special attention to pain relief in addition to specific treatments for animal bites. In the Canon of Medicine, Avicenna recommended several medicinal plants alongside analgesics for the management and treatment of animal envenomations. The current research elucidates the clinical pharmacology and pharmacopeia of Avicenna for the treatment of animal envenomations. Further research is encouraged to evaluate the efficacy of these therapeutic agents for the treatment of animal bites.

Avicenna's clinical toxicology approach and beneficial materia medica against oral poisoning.

Considering the rich background of Persian Medicine in the use of materia medica for the treatment of diseases, the huge burden of oral poisonings in the world, and the urgent need to find scientific solutions, the purpose of this study was to determine Avicenna's approach toward clinical toxicology and his proposed treatments for oral poisonings. In Al-Qanun Fi Al-Tibb, Avicenna addressed the materia medica for the treatments of oral poisonings after explaining the ingestion of different toxins and also elucidating the clinical toxicology approach toward poisoned patients. These materia medica were from different classes including emetics, purgatives, enemas, diaphoretics, antidiarrheals, inhaled drugs, sternutators, anticoagulants, antiepileptics, antitussives, diuretics, cooling drugs, stimulants, cardiotonic drugs, and heating oils. By applying different therapies, Avicenna endeavored to attain main goals in clinical toxicology that are comparable with modern medicine. They included removing the toxins from the body, decreasing the severity of the deleterious effects of toxins on the body, and counteracting the effects of toxins inside the body. Aside from introducing different therapeutic agents that played an important role in the treatment of oral poisonings, he emphasized the ameliorating effects of nutritive foods and beverages. Further research using other Persian medical resources is recommended to elucidate the applicable approaches and treatments for different poisonings.

Rhazes's methodology in the science of toxicology.

INTRODUCTION: Toxicology has been one of the most important topics throughout the history of medicine. Persian medicine (PM) textbooks such as Al-Hawi fi Al-Tib of Rhazes (Razi) can be a useful source for novel information about toxicology and thus we aimed to elucidate Rhazes's methodology in toxicology based on this textbook. METHODS: This research is a historical descriptive study. Data were obtained from the book Al-Hawi fi Al-Tib using keywords of poison, poisoning, and relevant terminologies in ArabicAQ1, Persian, and English and also from appropriate literature in PubMed, Scopus, Web of Science, Scientific Information Database (SID), Magiran, and IranDoc. RESULTS: After introducing the types of common poisons in his era, Rhazes categorized them into three main categories of plants, animals, and minerals, which cause human poisoning orally or via stings and bites. To identify the poison and make a diagnosis of the corresponding toxidrome, he conducted a thorough physical examination of the patient, carefully observing signs and symptoms, and then treated the poisoning using pharmaceutical and non-pharmaceutical modalities. In the book Al-Hawi fi Al-Tib, Rhazes has provided comprehensive information about the types of poisons, their effects on the human body, the signs and symptoms of poisonings, and relevant diagnostic and therapeutic methods. DISCUSSION: Rhazes had a great contributing role to the science of toxicology. We suggest future research on an in-depth analysis of other PM references for toxicology knowledge and how they may foster the science of toxicology.

The Effect of Lavender on Anxiety and Hemodynamic Status Before Septorhinoplasy and Rhinoplasty.

PURPOSE: Anxiety is one of the most common problems before surgery and surgery of the nose is one of the most concerning and challenging surgeries among the plastic surgeries. The aim of this research is to consider the impact of lavender fragrance on anxiety and hemodynamics status before the septorhinoplasty and rhinoplasty. DESIGN: Parallel randomized control trial. METHODS: This research was done by testing thirty-four candidates who were about to have the surgery in two groups of lavender (intervention) and control. The anxiety before and after surgery was examined by the Speilberger State Anxiety Inventory questionnaire and the hemodynamics status. For the analysis, the T- Test, Mann Whitney Test and the χ2 Test were used. FINDINGS: The demographic features of the two groups were similar. Anxiety after the experiment was meaningful. The obvious anxiety in the lavender category was 25.8% and the controlled group had that decreased to 1.8%. The latent anxiety was reduced by 24.3% in the lavender group and increased by 8% in the controlled group. The systolic, diastolic and the heart rate after the intervention was less in the lavender group. CONCLUSIONS: Due to the ease of the inhalation of lavender and the lack of any report for the existence of any kind of side-effects for the prevention of anxiety during nose surgeries, it can be suggested that this approach can be effective for the controlling of the consistency of the patients' hemodynamics.

Evaluation of Left Ventricular Longitudinal, Radial, and Circumferential Strains in Subjects with Normal Variations of Coronary Dominance: A Preliminary Comparative Study.

BACKGROUND: The aim of this study was to evaluate the contractile function of the left ventricular muscles in subjects with normal coronary artery and normal variations of coronary dominance. METHODS: This study was performed on 90 adult subjects with normal results of coronary arteries angiography, echocardiography, and electrocardiography. The participants were categorized into 3 groups of 30 with right-dominant, left-dominant, and codominant variations. Two-dimensional transthoracic echocardiography was performed with apical 2-, 3-, and 4-chamber views and parasternal basal, mid, and apical short-axis views. Then, images were analyzed offline using the velocity vector imaging method. In all studied groups, the mean and standard deviation of left ventricle coronary territorial longitudinal, circumferential, radial strains, and left ventricle global strains were determined. They were compared in 3 layers of sub-endocardial, myocardium, and sub-epicardial. RESULTS: In terms of longitudinal and circumferential strains, there were significant differences in the most coronary territories and global strain among the right-dominant, left-dominant and codominant groups (P < .05). No significant differences in terms of territorial and global radial strains were observed among the study groups (P > .05). CONCLUSION: Strain level decreased from endocardium to epicardium in all studied groups. Territorial and global contractile functions (longitudinal and circumferential strains) of the left ventricle vary depending on the variations of coronary arteries.

The impact of a structured handover checklist for intraoperative staff shift changes on effective communication, OR team satisfaction, and patient safety: a pilot study.

OBJECTIVE: Handover without a structured format is prone to the omission of information and could be a potential risk to patient safety. We sought to determine the effect of a structured checklist on the quality of intraoperative change of shift handover between scrubs and circulars. METHODS: We conducted a control intervention study on operating room wards of two teaching hospitals from 20 Feb to 21 Nov 2020. This research was conducted in three stages as follows: assessing the current situation (as a group before the intervention), performing the intervention and evaluating the effect of using a checklist on handover quality after the intervention in two groups: with and without checklist. We examined the quality of handover between scrub and circular personnel in terms of handover duration and quality, omission of information and improvement in OR staff satisfaction. RESULTS: A total of 120 handovers were observed and evaluated. After intervention in the group using the checklist, the percentage of information omission in surgical report was decreased from 19.5 to 12.1% between scrubs (P < 0.00) and from 16.8 to 14.1% between circulars (P < 0.03). Also, in the role of scrub, the mean overall score of handover process quality was significantly higher after the intervention (x̄ = 7 ± 1.5) than before it (x̄ = 6.5 ± 0.9) (p < 0.02). In the role of circulating, despite the positive effect of overall score checklist, no significant difference was observed (p < 0.08). The use of checklist significantly increased the handover duration between scrubs (p < 0.03) and circulars (p < 0.00). The overall mean percentage of handover satisfaction increased from 67.5% before the intervention to 85.5% after the intervention (p < 0.00). CONCLUSION: The implementation of a new structured handover checklist had a positive impact on improving the quality of communication between the surgical team, reducing the information omission rate and increasing the satisfaction.

Comparing muscle thickness and function in healthy people and subjects with upper trapezius myofascial pain syndrome using ultrasonography.

BACKGROUND: The reliability of the muscle function using ultrasonography is not reported in patients with myofascial pain syndrome and healthy individuals. The main aim of this study was to compare muscle thickness and function of two matched healthy and patients groups with neck pain due to upper trapezius myofascial pain syndrome. METHODS: 40 subjects (20 healthy and 20 patients) participated in this study. Two examiners measured the upper trapezius thickness and function 3 times by ultrasonography independently in the test and retest sessions. RESULTS: There were not significant differences between two groups with respect to demographic characteristics. The ICC values were good to excellent for both measurements. There were no significant differences between the two groups, in terms of upper trapezius muscle thickness in rest (p = 0.63), fair (p = 0.75) and normal (p = 0.73) contractions. On the other hand, % rest-thickness fair (p = 0.006), % rest-thickness normal (p = 0.006), % MVC-thickness (p = 0.02) showed significant differences between two healthy and myofascial pain syndrome groups. CONCLUSIONS: Ultrasonography is a reliable technique used to measure muscle thickness and function. Muscle thickness in rest, fair and normal contractions is not different between the matched groups of healthy people and myofascial pain syndrome subjects. Additionally, muscle function is less in myofascial pain syndrome subjects than healthy people specially % MVC thickness.

The risk of surgery-related pressure ulcer in diabetics: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: Postoperative pressure ulcers are known as the most important quality indicators of intraoperative care that create critical and costly complications during hospital care. Accordingly, this study was performed to determine the risk factor for diabetes in postoperative pressure ulcers. MATERIALS AND METHODS: The present study is a systematic review of PubMed, Scopus and the Web of Science databases with using standardized keywords of the performed English language articles between Jan 2010 to Jan 2020. The articles were searched independently by two related researchers to avoid possible biases. Then, all collected articles were reviewed, and articles with inclusion criteria were evaluated using a data collection table. It should be noted that the data were analyzed using STATA software version 11.1. RESULTS: Overall, the results showed that 19724 patients were identified from 15 studies conducted in Asia (six), the America (four), Europe (four), and Australia (one) from 1989 to 2019. The results showed that patients with diabetes were more likely to experience surgery-related pressure ulcers than patients without diabetes (The odds ratio of 1.52; the 95% confidence interval: 1.25-1.85). CONCLUSION: In general, patients with diabetes increased the risk of surgery-related pressure ulcers about 1.5 times more than others. Accordingly, the reduction of surgery-induced pressure ulcers should be more extensively considered in patients with diabetes.

A Comprehensive Review on the Ethnobotany, Phytochemistry, Pharmacology, and Toxicology of Mentha aquatic L (water mint) as a Wild Shallow Vegetable.

Mentha spp. are aromatic plants and have been used in the medical, cosmetics, and food industries. These plants have been used as a traditional herbal medicine for various types of diseases. Mentha aquatica L. (water mint) is a perennial plant used as a wild vegetable and a culinary herb. As its name suggests, it grows in the shallow margins and channels of streams, rivers, wet meadows, etc. It has been used as a tonic plant, sedative, and soothing for intestinal parasites, constipation, diarrhea, stomach troubles, biliousness, liver diseases, impotence, low or high blood pressure, and expelling intestinal worms in children, enhancing longevity. Researchers from all over the world have studied the chemical composition and pharmacological activities of this plant, such as its anti-microbial, anti-inflammatory, and anti-oxidant activities. In addition, the neurochemical properties, larvicidal activity, and phytochemical analysis of the plant have also been reported. However, there is no review article available that gathers all the information and provides insights for future studies on M. aquatica. Against this backdrop, the present research is conducted to categorize the published studies and to offer more suggestions to researchers for future studies.

The methanolic extract of Cinnamomum zeylanicum bark improves formaldehyde-induced neurotoxicity through reduction of phospho-tau (Thr231), inflammation, and apoptosis.

Accumulation of formaldehyde (FA) in the brain is linked to age-related neurodegenerative disorders, as it accelerates memory impairment through tau protein aggregation, inflammation, and nuclear damage. This study aimed to assess the possible effects of methanolic cinnamon extract (CE) on FA-induced neurotoxicity in rats. The animals were treated with CE (100, 200, and 400 mg/kg, P.O.) for 30 days following FA administration (60 mg/kg, I.P.) for 30 days. Briefly, spatial and inhibitory memory were examined by Morris water maze (MWM) and passive avoidance (PA) tasks, respectively. The Nissl, Hoechst, and Bielschowsky silver staining methods were also used to assess apoptosis and neurofibrillary tangles (NFTs) in the hippocampal CA1 region, respectively. Brain tissues were probed with an anti-phospho-tau (Thr231) monoclonal antibody to assess tau hyperphosphorylation. Inflammatory cytokines (IL-1ß, IL-6, and TNF-α) were also measured by ELISA assay. Western blotting was performed to quantify the amount of phospho-tau (Thr231), caspase-8, and caspase-9. The results showed that FA injection significantly caused tau hyperphosphorylation at Thr231 residue, which in turn disturbed the MWM performance. The ratio of apoptotic to intact neurons increased following FA treatment. The results of Western blotting indicated that the hippocampal levels of phospho-tau (Thr231) and caspase-8 were significantly higher in the FA group compared to the control group. The hippocampal levels of IL-1ß, IL-6, and TNF-α in the FA group were also higher than the control group. Administration of 200 mg/kg of CE significantly improved the rats' MWM performance, decreased the levels of phospho-tau (Thr231), caspase-8, IL-6, and TNF-α, and reduced the ratio of apoptotic to intact neurons. Overall, cinnamon improved cognitive performance in FA-treated rats by eliminating tau hyperphosphorylation, inflammatory cytokines, and nuclear damage.

Investigating the effects of drainage by hemovac drain on shoulder pain after female laparoscopic surgery and comparison with deep breathing technique: a randomized clinical trial study.

BACKGROUND: The incidence of shoulder pain following laparoscopic surgery has been reported to be high. This study was designed to investigate the effect of Hemovac drain on postoperative pain of women after laparoscopic surgery, dose of postoperative drug, duration of hospitalization as well as comparison with deep breathing technique. METHODS: In this clinical trial, one hundred and fourteen female patients treated by laparoscopy were randomly assigned to three groups of 38 patients. In our study group, the Hemovac drain was implemented from the secondary trocar site with a closed system. In the deep breathing group, the patient was asked to breathe slowly and deeply three time per hour at full vigilance after surgery. In the non-drain group, laparoscopic surgery was done routinely. The severity of abdominal and shoulder pain was measured with a visual scale of pain at 3, 6, 12, and 24 h after surgery. RESULTS: There were no significant differences in age, type of surgery, duration of hospitalization, postoperative nausea and vomiting between the groups after surgery. The severity of shoulder pain was significant between groups 3, 6, 12, and 24 h after surgery (p < 0.001). Consumption of diclofenac after operation was higher in the control group (p < 0.001). The pain level of laparoscopic surgery was not different between the three groups within the first 24 h after surgery (p = 0.841). CONCLUSIONS: The use of Hemovac drain in female laparoscopic surgery is beneficial for reducing the subsequent shoulder pain. Further studies are recommended to investigate the effects of deep breathing as a non-pharmacological and safe method in other laparoscopic areas.

A comparative study of the dose-dependent effects of low level and high intensity photobiomodulation (laser) therapy on pain and electrophysiological parameters in patients with carpal tunnel syndrome.

BACKGROUND: Carpal tunnel syndrome (CTS) is a common peripheral nerve disorder of the wrist. Nonsurgical treatments e.g. laser therapy may cause potential beneficial effects. AIM: To compare the dose dependent effects of low level laser therapy (LLLT) and high intensity laser therapy (HILT) on pain and electrophysiology studies in patients with CTS. DESIGN: Double-blind randomized controlled trial. SETTING: Outpatient physiotherapy clinic. POPULATION: Ninety-eight participants with CTS, aged between 20 to 60 years, were randomly assigned to five groups. METHODS: All participants undertook four standard exercises, with one group serving as exercise-only controls. Patients were randomly allocated to either high or low fluence LLLT or high or low fluence HILT received over 5 sessions. All patients were assessed by visual analogue scale, median compound muscle action potential (CMAP) and sensory nerve conduction studies before and 3 weeks after the interventions. RESULTS: VAS was significantly lower in all groups after 3 weeks (P<0.05). CMAP latency decreased in all groups. The interaction of group and time (5×2) was significant for pain (P<0.001), the latency of CMAP (P=0.001) and CMAP amplitude (P=0.02). The interaction of group and time was not significant for the CMAP conduction velocity, sensory nerve latency and amplitude (P>0.05). CONCLUSIONS: HILT with a power of 1.6 W and low fluence of 8 J/cm2 was superior in reduction of pain and improvement of the median motor nerve electrophysiological studies compared to LLLT and exercise-only control groups. CLINICAL REHABILITATION IMPACT: LLLT and HILT in conjunction with exercise program are effective in reducing pain and improving median motor nerve conduction studies of the patients with CTS. It seems that high power and low fluence laser therapy is better than LLLT and exercise interventions to treat these patients.

Improvement in histology, enzymatic activity, and redox state of the liver following administration of Cinnamomum zeylanicum bark oil in rats with established hepatotoxicity.

Formaldehyde (FA) is an environmentally-available pollutant. Since the liver acts as a detoxifier in the human body, it is the first and most affected organ in individuals exposed to higher-than-normal amounts of FA. FA mainly alters oxidant/antioxidant status and initiates oxidative stress, and by means, causes functional damage to the liver. Thus, it is important to identify natural bioactive compounds with antioxidant properties in order to be used as food additives. Cinnamon (Cinnamomum zeylanicum) is a popular flavor and also a medicinal plant with a variety of beneficial effects. In the present original study, cinnamon essential oil (CEO) has been administrated at doses of 10, 20, and 100 mg/kg, orally, to hepatotoxicity rat models caused by FA (10 mg/kg, intraperitoneally). Liver enzymes and its histology were assessed and oxidative stress biomarkers in the liver tissue were also examined. CEO administration caused a significant increase in superoxide dismutase, glutathione peroxidase, and catalase and a prominent decrease in nitric oxide levels in the liver tissue. Also, in serum samples, CEO significantly reduced the elevated amounts of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase. When assessed histologically, portal area and central vein fibrosis alongside with the hepatocytes' hypereosinophilia and swelling, focal inflammation, and necrotic areas were found to be prominently decreased in the CEO group. In conclusion, our study suggested that the CEO may have the potential for being used against FA-induced hepatotoxicity.

Melatonin-pretreated adipose-derived mesenchymal stem cells efficeintly improved learning, memory, and cognition in an animal model of Alzheimer's disease.

Currently, mesenchymal stem cells (MSCs) based therapy has extensive attraction for Alzheimer's disease (AD). However, low survival rate of MSCs after transplantation is a huge challenging. The current study aimed to improve adipose-derived MSCs (AD-MSCs)-based therapy by their pre-treatment with melatonin (MT) 'a well-known antioxidant' in an animal model of AD. In this study, after isolating rat AD-MSCs from the epididymal white adipose tissues, the cells were pretreated with 5µM of MT for 24 hours. Forty male Wistar rats were randomly allocated to control, sham, amyloid-beta (Aß) peptide, AD-MSCs and MT-pretreated ADMSCs groups. The novel object recognition, passive avoidance test, Morris water maze and open field test were performed two months following the cell transplantation. The rats were sacrificed 69 days following cell therapy. The brain tissues were removed for histopathological analysis and also immunohistochemistry was performed for two Aß1-42 and Iba1 proteins. It has been revealed that both AD-MSCs and MT-AD-MSCs migrated to brain tissues after intravenous transplantation. However, MT-ADMSCs significantly improved learning, memory and cognition compared with AD-MSCs (P<0.05). Furthermore, clearance of Aß deposition and reduction of microglial cells were significantly increased in the MT-ADMSCs compared with AD-MSCs. Although stem cell therapy has been introduced as a promising strategy in neurodegenerative diseases, however, its therapeutic properties are limited. It is suggested that pretreatment of MSCs with melatonin partly would increase the cells efficiency and consequently could decrease AD complication including memory and cognition.

Advances in stem cell treatment for sciatic nerve injury.

INTRODUCTION: The sciatic nerve is one of the peripheral nerves that is most prone to injuries. After injury, the connection between the nervous system and the distal organs is disrupted, and delayed treatment results in distal organ atrophy and total disability. Regardless of great advances in the fields of neurosurgery, biological sciences, and regenerative medicine, total functional recovery is yet to be achieved. AREAS COVERED: Cell-based therapy for the treatment of peripheral nerve injuries (PNIs) has brought a new perspective to the field of regenerative medicine. Having the ability to differentiate into neural and glial cells, stem cells enhance neural regeneration after PNIs. Augmenting axonal regeneration, remyelination, and muscle mass preservation are the main mechanisms underlying stem cells' beneficial effects on neural regeneration. EXPERT OPINION: Despite the usefulness of employing stem cells for the treatment of PNIs in pre-clinical settings, further assessments are still needed in order to translate this approach into clinical settings. Mesenchymal stem cells, especially adipose-derived stem cells, with the ability of autologous transplantation, as well as easy harvesting procedures, are speculated to be the most promising source to be used in the treatment of PNIs.

From dentistry students' points of view: do anatomy classes we took actually boost our learning during clinic?

The aim of medical education is to teach the essence of practical skills alongside with the theoretical knowledge. Teaching anatomy, as the center of medical education, should be leading to use this knowledge as a skill during clinical period. According to the rising numbers of dentistry faculties' experiences, inappropriate education results in misguidance during clinic. Thus, this study was conducted to find about the pre-clinical and clinical dentistry students' points of view on the helpfulness of anatomy classes in achieving clinical goals. Present descriptive cross-sectional study evaluated Guilan University of Medical Sciences' pre-clinical and clinical dentistry students' opinions on the effectiveness of anatomy classes during their clinical period in 2017. The sampling method used here was census via questionnaire and scoring was according to Likert scaling system. Analyses showed that anatomy of the nervous system was the most assistive course, which helped dentistry students during their clinical period (P<0.001). The least scored course was visceral organs and that means they did not use most of their learnings from classes with this topic (P<0.001). They also stated that other important factors such as using cadavers and moulages in practical sessions, teaching clinical skills theoretically before practical sessions and performing group activities are crucial for them to recall important details of the relevant courses during clinical period. Results of this study suggests that alongside with the various topics of anatomy courses, other factors like professors' characteristics and their teaching methods are also of important factors helping the dentistry students throughout clinic.

Analgesic Effects of Ketamine, Magnesium Sulfate, and Sodium-Thiopental on Propofol Injection Pain: A Single-Blind Randomized Clinical Trial.

BACKGROUND: Propofol is one of the most frequently used medications for inducing and maintaining anesthesia. However, propofol injection causes pain and discomfort in more than 70% of patients. This study was performed to determine the comparative effects of ketamine, sodium-thiopental, and magnesium sulfate on reducing pain at the onset of anesthesia induced by propofol injection. MATERIALS AND METHODS: This single-blind randomized clinical trial was conducted on a population of patients, requiring nonemergency surgeries. The sample size was determined as 25 patients per group. The eligible samples were randomly divided into three groups. An 18-gauge intravenous catheter was inserted in the dorsum of the hand for all patients. Three groups received 0.5 ml/kg of ketamine, 30 mg/kg of magnesium sulfate, and 0.5 ml/kg of sodium-thiopental, respectively. Next, 2.5 mg/kg of propofol 2% was administered at a rate of 1 ml/s. The verbal rating scale (VRS) was applied to assess the severity of pain during injection. RESULTS: According to the results, the prevalence of pain was 36% in the magnesium sulfate group, 16% in the sodium-thiopental group, and 4% in the ketamine group. The ordinal logistic regression test showed that patients from the ketamine group experienced less pain, compared to the magnesium sulfate group (OR, 0.045; P= 0.008). However, no significant difference was observed between the ketamine and sodium-thiopental groups (OR, 0.253; P= 0.283). CONCLUSION: Ketamine and sodium-thiopental can be effective medications in reducing pain caused by propofol injection. According to the results, magnesium sulfate is not recommended for reducing pain due to propofol injection.

Presenting the Students' Academic Achievement Causal Model based on Goal Orientation.

INTRODUCTION: Several factors play a role in academic achievement, individual's excellence and capability to do actions and tasks that the learner is in charge of in learning areas. The main goal of this study was to present academic achievement causal model based on the dimensions of goal orientation and learning approaches among the students of Medical Science and Dentistry courses in Guilan University of Medical Sciences in 2013. METHODS: This study is based on a cross-sectional model. The participants included 175 first and second students of the Medical and Dentistry schools in Guilan University of Medical Sciences selected by random cluster sampling [121 persons (69%) Medical Basic Science students and 54 (30.9%) Dentistry students]. The measurement tool included the Goal Orientation Scale of Bouffard and Study Process Questionnaire of Biggs) and the students' Grade Point Average. The study data were analyzed using Pearson correlation coefficient and structural equations modeling. SPSS 14 and Amos were used to analyze the data. RESULTS: The results indicated a significant relationship between goal orientation and learning strategies (P<0.05). In addition, the results revealed that a significant relationship exists between learning strategies[Deep Learning (r=0.37, P<0.05), Surface Learning (r=-0.21,P<0.05)], and academic achievement.The suggested model of research is fitted to the data of the research. CONCLUSION: Results showed that the students' academic achievement model fits with experimental data, so it can be used in learning principles which lead to students' achievement in learning.