Repeated Administration of Orexin into the Thalamic Paraventricular Nucleus Inhibits the Development of Morphine-Induced Analgesia.

BACKGROUND: Hypothalamic neuropeptides, orexins, play pivotal roles in nociception and pain modulation. OBJECTIVE: In this study, we investigated the effect of the administration of orexin into the paraventricular nucleus (PVT) on the development of morphine-induced analgesia in rats. METHOD: Male Wistar rats weighing 250-300g received subcutaneous (s.c.) chronic morphine (6, 16, 26, 36, 46, 56 and 66 mg/kg, 2 ml/kg) at an interval of 24 hours for 7 days. Animals were divided into two experimental groups in which the orexin (100 µM, 200 nl) and its vehicle were microinjected into the PVT nucleus for 7 days before each morphine injection. Then, the formalin test was performed for the assessment of pain-related behaviors. RESULTS: The results demonstrated that the rats pretreated by intra-PVT orexin exhibited higher pain-related behaviors than the morphine-treated group. The analgesic effects of morphine were significantly lower in orexin plus morphine-treated rats than the vehicle plus morphine-treated ones. CONCLUSION: Our findings suggested that the animals receiving the prolonged intra-PVT application of orexin before morphine injection demonstrated a significant increase in the development of nociceptive behaviors in all phases. There fore, the present study highlighted a new area of the brain involved in the effect of orexin on analgesia induced by morphine.

Traditional uses of medicinal plants to prevent and treat diabetes; an updated review of ethnobotanical studies in Iran.

BACKGROUND: Obesity and physical inactivity are currently on the rise due to industrialization of the communities, which has recently led to increased incidence of different diseases such as diabetes. Epidemiological studies and figures have demonstrated the growing incidence of diabetes. Relevantly, the side effects of chemical drugs have led patients to use medicinal plants and traditional approaches despite advances in development of chemical drugs. The aim of this review article is to report the medicinal plants and their traditional uses to prevent and treat diabetes according to the findings of ethnobotanical studies conducted in different regions of Iran. EVIDENCE ACQUISITIONS: The search terms including ethnobotany, ethnomedicine, ethnopharmacology, phytopharmacology, phytomedicine, Iran, and traditional medicine in combination with diabetes, blood sugar and hyperglycemic were searched from scientific databases. RESULTS: The results of this article can be a comprehensive guideline, based on ethnobotany of different regions of Iran, to prevent and treat diabetes. According to this review article, certain plant species such as Urtica dioica L., popularly called nettle, in eight regions, Teucrium polium L., popularly called poleigamander, in five regions, and Trigonella foenum-graecum L., Citrullus colocynthis (L.), Schrad., and Juglans regia L. in four regions, were reported to be frequently used to prevent and treat diabetes. CONCLUSIONS: The introduced medicinal plants in this review can be investigated in further research and produce new drugs with limited side effects.

Diagnostic value of fetal movement counting by mother and the optimal recording duration.

INTRODUCTION: Fetal movement counting is a method used by mother to quantify her baby's movements. However, the optimal number of movements and the ideal duration of counting them have not been recognized. The aim of this study was to determine the diagnostic value of the two common fetal movements counting methods by mother including "ten fetal movements counting in two hours" and "three fetal movements counting in one hour" and to compare the required mean time for counting fetal movements in the two methods. METHODS: 300 subjects were selected by random sampling among clients with complains of decreased fetal movements referring to AL-Zahra teaching hospital in Tabriz, Iran. Full training about how to perform the two methods of fetal movements counting and how to record in related tables was instructed by researcher. Immediately after counting movements, biophysical profile test was performed. RESULTS: Among 291 mothers in the two groups, 99.7% had active fetuses based on both methods of fetal movement counting. 96.9% of these active fetuses obtained score of 10 in biophysical profile. There was a statistically significant relation between the results of both two methods of fetal movement counting and the biophysical profile as the gold standard. Sensitivity, specificity, positive and negative predictive values of both methods were equally 100%, 96%, 10% and 100%, respectively.Mean time (SD) for ten movement counting was 22.1(4.6) and for three movementcounting was 8.0(2.8) minutes CONCLUSION: The findings of this study showed that fetal movement counting test can be used as an initial screening method in predicting fetal health.

The effects of intravenous hydration on amniotic fluid volume and pregnancy outcomes in women with term pregnancy and oligohydramnios: a randomized clinical trial.

INTRODUCTION: Amniotic fluid is an important factor in the prediction of fetal survival. The aim of this research was to evaluate the effects of intravenous hydration of mothers on amniotic fluid volume and in turn on pregnancy outcomes. METHODS: The current single blind controlled clinical trial was conducted on 20 pregnant mothers with amniotic fluid index of lower or equal to 5 cm and gestational age of 37-41 weeks. The subjects were divided into two groups of case and control through simple random sampling. Amniotic fluid index was measured in all participants. The case group received one liter of isotonic saline during 30 minutes by the bolus method. Reevaluations of amniotic fluid index in both groups were made 90 minutes after baseline measurement. Independent t-test and paired t-test were used to compare the two groups and mean amniotic fluid index before and after treatment, respectively. RESULTS: Hydration of mothers significantly increased the amniotic fluid index in the case group (mean change: 1.5 cm; 95%CI: 0.46 - 2.64; P = 0.01). The mean change of amniotic fluid index in the control group did not significantly increase (P = 0.06). The elevation of amniotic fluid index in the hydration group (32%) was significantly higher than the control group (1%) (P = 0.03). CONCLUSION: In this study intravenous hydration increased amniotic fluid index of mothers with term pregnancy and oligohydramnios. Since it caused no complications for the mother and the fetus, it can be used as an effective method in management of oligohydramnios.

Accuracy of 64-multidetector computed tomography in diagnosis of adnexal tumors.

BACKGROUND: Adnexal cancers are in fifth place among the tumors with the highest mortality in the female population. The aim of the present study was to evaluate the accuracy of Multi-detector computed tomography (MDCT) on a 64-multislice CT scanner in the detection and differentiation of adnexal masses stages. METHODS: During the present prospective study, 95 women with a primary diagnosis of ovarian mass in base of clinical examination and ultrasonographic findings underwent preoperative evaluation by a 64-slice MDCT with a section thickness of 0.6 mm, 50% overlap and reconstructed images. Afterward, results of MDCT were compared with surgical and histopathological findings, and the sensitivity, specificity, positive and negative predictive value and accuracy were determined. RESULTS: The mean age of patients was 48.63 ± 13.93 years. MDCT diagnosed 25 (26.3%) masses to be benign and 70 (73.7%) to be malignant (sensitivity, specificity, positive and negative predictive value and accuracy were 92.8%, 88.0%, 95.5%, 81.4% and 91.5% respectively). The sensitivity and specificity of MDCT in determining local extension was 72.2% and 93.4% respectively. And the sensitivity and specificity of MDCT in determining peritoneal seeding and liver extension was 81.8% and 93% respectively. Estimated stage was significantly agreed with the surgical (Cohen's Kappa (κ) = 0.891) and histopathological findings (κ = 0.858). CONCLUSION: MDCT is a highly sensitive and specific diagnostic method in evaluation of adnexal masses and successfully stage the tumor in consistent with surgery and histopathology.

Doppler waveform indices of fetal middle cerebral artery in normal 20 to 40 weeks pregnancies.

BACKGROUND: One of the main methods for evaluation of fetal well-being is analysis of Doppler flow velocity waveform of fetal vessels. Evaluation of Doppler wave of the middle cerebral artery can predict most of the at-risk fetuses in high-risk pregnancies. In this study, we tried to determine the normal ranges and their trends during pregnancy of Doppler flow velocity indices (resistive index, pulsatility index, systolic-to-diastolic ratio, and peak systolic velocity) of middle cerebral artery in 20 - 40 weeks normal pregnancies in Iranians. METHODS: In this cross-sectional study, 1037 women with normal pregnancy and gestational age of 20 to 40 weeks were investigated for fetal middle cerebral artery Doppler examination. RESULTS: Resistive index, pulsatility index, and systolic-to-diastolic ratio values of middle cerebral artery decreased in a parabolic pattern while the peak systolic velocity value increased linearly with progression of the gestational age. These changes were statistically significant (P<0.001 for all four variables) and were more characteristic during late weeks of pregnancy. The mean fetal heart rate was also significantly (P<0.001) reduced in correlation with the gestational age. CONCLUSION: Doppler waveform indices of fetal middle cerebral artery are useful means for determining fetal well-being. Herewith, the normal ranges of Doppler waveform indices for an Iranian population are presented.

Endometrial and follicular development following letrozole intervention in unexplained infertile patients failed to get pregnant with clomiphene citrate.

PURPOSE: This study is designed to evaluate and compare follicular phase parameters during ovarian stimulation with the clomiphene citrate (CC) and letrozole (LET) in unexplained infertile patients who failed to get pregnant following frequent CC-treated cycles. METHODS: A total of 64 unexplained infertile women who failed to get pregnant following frequent CC-treated cycles were studied for one CC-treated cycle (100 mg/day), 2 washout cycles, and then 1 LET-treated cycle (5 mg/day). Number of follicles over 14 mm in diameter, diameter of the largest follicles, endometrial thickness, serum estradiol (E2) and LH levels were measured when one mature follicle over 18 mm in diameter detected during transvaginal ultrasonography. RESULTS: The mean value of the largest follicle diameter, number of developed follicles >14 mm, endometrial thickness and LH in LET-treated cycle was significantly higher than CC-treated cycle (P values were 0.007, <0.001, <0.001, and 0.004, respectively), whereas mean level of E2 showed a significantly lower level during LET-treated cycle (P < 0.001). CONCLUSIONS: About 5 mg/day of LET is associated with better follicular phase parameters, endometrial development, serum E2 and LH levels in women with unexplained infertility who failed to get pregnant following frequent CC-treated cycles.

Serendipitous diagnosis of aortic coarctation by bilateral parvus et tardus renal Doppler flow pattern.

BACKGROUND: Aorta Coarctation (AC) is uncommon condition that in most adult patients is asymptomatic. Diagnosis of AC is made during routine physical examination by detection of Blood Pressure (BP) difference between arm and leg. AIM: To describe a novel renal artery Doppler flow pattern pathognomonic of aortic coarctation. METHODS: We enrolled 4 consecutive patients referred to renal artery Doppler Ultrasonography (DU) for diagnostic work-up of secondary arterial hypertension. All met the following inclusion criteria: 1) arterial hypertension at age <30 years; 2) referred for renal DU to rule out renovascular hypertension. RESULTS: We found in all 4 patients (age range 10 to 27 years) a bilateral "parvus-tardus" renal Doppler flow pattern. In all, echocardiographic and angiographic work-ups showed aortic coarctation. CONCLUSION: Careful physical examination should be performed in all hypertensive patients. Furthermore, the suspicion of AC can be raised by a bilateral renal arteries "parvus-tardus" Doppler flow pattern in young hypertensive patients screened for secondary hypertension.