A randomized trial of topical mitomycin-C in the immediate post-operative period for the short and long-term prevention of granulation tissue in mastoid cavities.

BACKGROUND: Granulation tissue is a primary source of otorrhea in the ear, particularly after surgery, and may develop complications in patients. Hence, discovering an efficient treatment is crucial for this disorder. PURPOSE: This study aimed to evaluate the mitomycin drops efficacy for germination prevention during the recovery process after mastoidectomy. Our purpose was to introduce novel treatment options in some conditions in which we could not reconstitute the cavity to prevent the possible germination. MATERIALS AND METHODS: This clinical trial was performed on 52 patients undergoing mastoidectomy. Patients were randomly divided into two groups (26 patients in the mitomycin group and 26 patients in the placebo group). After drug administration, the granulation tissue and complications were recorded. All statistical analysis was performed using SPSS version 21. RESULTS: The results of our study showed that mitomycin administration in patients undergoing mastoidectomy significantly reduced the formation of the granulation tissue in the first and third months after surgery (P < 0.05), which is associated with increased patient satisfaction (P < 0.05). CONCLUSION: The germ formation after mastoidectomy is so common. Since mitomycin administration decreased the incidence of germ formation, it can be proposed as a suggestive treatment in all patients to increase surgical quality and decrease complications include granulation formation.

Opium-associated QT Interval Prolongation: A Cross-sectional Comparative Study.

BACKGROUND: Toxicity and side effects of long-term use of opioids are well studied, but little information exists regarding electrophysiological disturbances of opium consumption. While natural opium has been regarded safe to a great extent among traditional communities, concerns are emerging owing to the available evidence of QT prolongation that have been exposed during recent outcome surveillance of patients under opioid use. Potential QT prolonging interactions would raise a higher level of such concern in opium users during COVID pandemic and warrant attention. MATERIALS AND METHODS: This study was designed to detect the prevalence of QTc prolongation among opium users and nonusers. Two groups were compared with regard to gender, age, and median QTc interval. Normal and prolonged QTc intervals of user group were compared with respect to age, sex, dose of opium consumption, and duration of opium consumption. RESULTS: 123 opium users and 39 controls were investigated. Median QTc interval in opium user and non-user group was 460 vs 386 milliseconds, respectively (p value < 0.001). In all, 59.3%, (95% CI: 50.51-67.62%) of cases and none of non-user had prolonged QTc interval (p value < 0.001). There was no significance between normal and prolonged QTc intervals with respect to dose and duration of opium use. CONCLUSION: This study indicated that opium consumption is associated with QTc prolongation. This prolongation does not relate to dose and duration of opium use. Further study is propounded to assess the clinical significance of these results and to determine risk rating of opium compared to other opioids in this regard. HOW TO CITE THIS ARTICLE: Javadi HR, Mirakbari SM, Allami A, Yazdi Z, Katebi K. Opium-associated QT Interval Prolongation: A Cross-sectional Comparative Study. Indian J Crit Care Med 2021;25(1):43-47.

The association of hypercalciuria and hyperuricosuria with vesicoureteral reflux in children.

OBJECTIVES: One of the important complications of vesicoureteral reflux (VUR) is the development of urolithiasis. Identifying factors involved in development of urolithiasis in children with VUR is immensely important. This study was conducted to determine the association between hypercalciuria and hyperuricosuria with VUR in children. METHODS: One-hundred children with VUR (case group) were compared to 100 healthy children (control group) in terms of hypercalciuria and hyperuricosuria. To measure these markers, random morning fasting urine samples were used. Data were analyzed using statistical tests. RESULTS: Hypercalciuria and hyperuricosuria frequencies, and also urine calcium/creatinine (Ca/Cr) and urine uric acid/creatinine (UA/Cr) ratios were significantly higher in the case group compared to the control group (P < 0.05). A significant difference was found between hypercalciuria and hyperuricosuria in severity of VUR (P < 0.05). A positive correlation was observed between hypercalciuria and hyperuricosuria and severity of VUR (P < 0.05). CONCLUSIONS: The present study showed that there is association between hypercalciuria, hyperuricosuria and VUR in children. It is recommended to adopt measures to prevent the development of urolithiasis in VUR patients.

Sleep architecture and obstructive sleep apnea in obese children with and without metabolic syndrome: a case control study.

PURPOSE: Obesity and biochemical parameters of metabolic disorders are both closely related to obstructive sleep apnea (OSA). The aim of this study was to compare sleep architecture and OSA in obese children with and without metabolic syndrome. METHODS: Forty-two children with metabolic syndrome were selected as case group and 38 children without metabolic syndrome were matched for age, sex, and BMI as control group. The standardized Persian version of bedtime problems, excessive daytime sleepiness, awakenings during the night, regularity and duration of sleep, snoring (BEARS) and Children's Sleep Habits Questionnaires were completed, and polysomnography (PSG) was performed for all study subjects. Scoring was performed using the manual of American Academy of Sleep Medicine for children. Data were analyzed using chi-square test, T test, Mann-Whitney U test, and logistic regression analysis. RESULTS: Non-rapid eye movement (NREM) sleep and N1 stage in the case group were significantly longer than the control group, while REM sleep was significantly shorter. Waking after sleep onset (WASO) was significantly different between two groups. Severe OSA was more frequent in the control group. Multivariate logistic regression analysis showed that severe OSA (OR 21.478, 95 % CI 2.160-213.600; P = 0.009) and REM sleep (OR 0.856, 95 % CI 0.737-0.994; P = 0.041) had independent association with metabolic syndrome. CONCLUSIONS: Obese children with metabolic syndrome had increased WASO, N1 sleep stage, and severe OSA. But the results regarding sleep architecture are most likely a direct result of OSA severity. More longitudinal studies are needed to confirm the association of metabolic syndrome and OSA.

Sleep quality in long haul truck drivers: A study on Iranian national data.

PURPOSE: Iran has a high rate of road traffic accidents. Poor quality of sleep brings about loss of attention, which is an important cause of road traffic accidents particularly in monotonous roads. The causes of poor quality of sleep in occupational drivers are multifactorial. The objective of the present study was to assess the prevalence of poor sleep quality among occupational drivers with rotating work schedules and analyze its different risk factors. METHODS: 2200 professional long-haul truck drivers who had been referred to the Occupational Health Clinic for routine education course were invited. We obtained data from eight provinces from various parts of Iran during 2012-2013. Data were collected using a questionnaire including questions about demographic and job characteristics. Pittsburg Sleep Quality Index (PSQI) was used to assess drivers' sleep quality. RESULTS: Mean working (driving) time was (9.3±2.5) hours daily and (55.5 ± 18.29) hours weekly. About 23.5% of the drivers reported history of smoking, 14.5% had low job satisfaction and 60% had irregular work schedule. 16.4% of drivers had an accidents leading to injury during the past five years. The mean PSQI score was 4.2 ± 2.7; 54% had a PSQI>5 (poor quality of sleep). Multivariate logistic regression showed that smoking, job satisfaction, history of accidents, shift work and work hours per day were the most important risk factors for poor sleep quality. CONCLUSION: Results obtained from the current study showed a high prevalence of poor quality of sleep among professional drivers. It warrants more attention to this significant problem using some measures to improve working conditions in professional drivers, as well as health promotion interventions.

Traffic crash accidents in Tehran, Iran: Its relation with circadian rhythm of sleepiness.

PURPOSE: Road traffic accidents are one of main problems in Iran. Multiple factors cause traffic accidents and the most important one is sleepiness. This factor, however, is given less attention in our country. Road traffic accidents relevant to sleepiness are studied. METHODS: In this cross-sectional study, all road traffic accidents relevant to sleepiness, which were reported by police, were studied in Tehran province in 2009. RESULTS: The risk of road traffic accidents due to sleepiness was increased by more than sevenfold (odds ratio = 7.33) in low alertness hours (0:00-6:00) compared to other time of day. The risk of road traffic accidents due to sleepiness was decreased by 0.15-fold (odds ratio = 0.15) in hours with maximum of alertness (18:00-22:00) of circadian rhythm compared to other time of day. CONCLUSION: The occurrence of road traffic accidents due to sleepiness has significant statistical relations with driving during lowest point of alertness of circadian rhythm.

Evaluation of a new restricted transfusion protocol in neonates admitted to the NICU.

BACKGROUND: Although transfusion is a common procedure for treating anemia of prematurity, there is no specific protocol for blood transfusion in premature newborns. So in this study we investigate whether application of a strict protocol has any statistically significant effect on reduction of blood transfusion. METHODS: In this study, first group admitted in NICU during 2005 - 2006 and the second group admitted during 2006 - 2007. Whereas in the first group the blood transfusion performed based on neonatologists' opinion following consultations with a pediatric hematologist, blood transfusion in the second group was based on the Shannon's protocol. RESULTS: During 2005-2006, out of 206 cases, 71 cases (%34.5) underwent blood infusion. During 2006-2007, out of 211 cases, 56 (%26.5) received blood transfusion based on the Shannon's strict protocol. Although the number of cases decreased, no significant difference was found betweenthe two groups (p= 0.07). Conculsion: Applying strict criteria alone is not effective in reducing the frequency of transfusion in infants.

The Role of Extracellular Vesicles in Efferocytosis.

Efferocytosis is the physiological process of phagocytic clearance of apoptotic cells by both professional phagocytic cells, such as macrophages, and non-professional phagocytic cells, such as epithelial cells. This process is crucial for maintaining tissue homeostasis in normal physiology. Any defects in efferocytosis can lead to pathological consequences and result in inflammatory diseases. Extracellular vesicles (EVs), including exosomes, microvesicles (MVs), and apoptotic vesicles (ApoVs), play a crucial role in proper efferocytosis. These EVs can significantly impact efferocytosis by affecting the polarization of macrophages and impacting calreticulin (CRT), TAM receptors, and MFG-E8. With further knowledge of these effects, new treatment strategies can be proposed for many inflammatory diseases caused by efferocytosis disorders. This review article aims to investigate the role of EVs during efferocytosis and its potential clinical applications in inflammatory diseases.

Comparison of the effects of intranasal midazolam versus different doses of intranasal ketamine on reducing preoperative pediatric anxiety: a prospective randomized clinical trial.

PURPOSE: To compare the effects of intranasal midazolam versus different doses of intranasal ketamine on reducing preoperative pediatric anxiety. METHODS: The participants of this double-blinded clinical trial study consisted of 120 children aged between 2 and 8 years. They were chosen for elective surgery and randomly assigned to four equal groups. For reducing preoperative anxiety, in the first group midazolam 0.2 mg/kg, in the second group (K1) ketamine 0.5 mg/kg, in the third group (K2) ketamine 3 mg/kg, and in the fourth group normal saline 1 drop/5 kg were administered intranasally. After 15 min, severity of anxiety was assessed with the modified Yale preoperative anxiety score (m-Yale PAS), and level of sedation was evaluated by the Ramsay Sedation Scale before intravenous catheterization. All data were transferred to SPSS-10 software and analyzed statistically with ANOVA, Kruskal-Wallis, and Mann-Whitney tests. A p value < 0.05 was considered meaningful. RESULTS: The mean of m-Yale PAS in midazolam group was significantly lower than the other three groups (p < 0.05). Regarding this score, there was no significant statistical difference between K2 and normal saline groups (p = 0.944), but the differences between K1 and K2 (p = 0.034) and also between K1 and normal saline (p = 0.049) groups were significant statistically. The Ramsay Sedation Scale in the midazolam group was significantly higher than the other three groups (p < 0.05). By this scale, there was no significant statistical difference between (K2) and normal saline groups (p = 0.940). The differences between (K1) and normal saline (p = 0.045) and also between (K1) and (K2) groups (p = 0.009) were significant statistically. CONCLUSION: Intranasal midazolam was more effective than low- or high-dose intranasal ketamine in reducing preoperative pediatric anxiety. The lower dose of ketamine reduced preoperative anxiety more than a higher dose of ketamine, which may be clinically insignificant.

Validity and reliability of the Iranian version of the insomnia severity index.

BACKGROUND: The Insomnia Severity Index (ISI) is a short subjective questionnaire which helps physicians in making decisions about patients suffering from insomnia. The present study was an attempt to test the reliability and validity of the Iranian version of the ISI and to measure the correlation between ISI items and polysomnography results in chronic insomnia patients. METHODS: Two groups responded to the Persian translation of four questionnaires; ISI, Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and General Health Questionnaire (GHQ). The first group consisted of 135 patients diagnosed with chronic insomnia, and the second group was comprised of 55 normal people. After completing the questionnaires, the insomniac patients underwent standard overnight polysomnography. RESULTS: The internal consistency demonstrated by Cronbach's alpha coefficient was above 0.8 for both groups. The Intra-class correlation coefficient was above 0.7 after two weeks for both groups. The correlations between ISI, PSQI, ESS, and GHQ were high. In addition, close correlations were found between scores obtained from the ISI questionnaire items in insomniac patients with corresponding polysomnographic variables. CONCLUSION: The Iranian version of the ISI is a reliable and valid instrument. It is a valuable short and first-line questionnaire for insomnia research and clinical work.

The effect of treatment with melatonin on primary school aged children with difficulty in initiation and maintenance of sleep.

BACKGROUND: The present study was designed to evaluate the effect of melatonin on the sleep initiation, duration of sleep, quality of sleep and daily performance in healthy children suffering from insomnia. METHODS: This study was done as a double blind randomized clinical trial in the sleep clinic of Qods Hospital. Sixty healthy children between 7 and 12 years of age having sleep problems were chosen and randomly divided in interventional and placebo groups. Before the treatment, children`s sleep habits questionnaire (CSHQ) was filled in both groups. Then, both groups were taught about sleep hygiene. Afterwards, the intervention group was treated with 3mg nocturnal dose of melatonin for one month and the other group with a placebo. Then, CSHQ was filled again for both groups. The intervention was Melatonin. The mean analyzed results of the variants in pre-test and post-test were compared and p < 0.05 was regarded as significant. RESULTS: Results showed that Melatonin with no side effect is effective in improving: 1- The initiation and maintenance of sleep, 2- Sleep onset delay, 3- Sleep duration, 4- Sleep anxiety, 5- Nightly awakenings 6- Parasomnias and 7- daily performance; but is ineffective in bedtime resistance and sleep disordered breathing. CONCLUSIONS: Our results indicate that melatonin is more effective than placebo in improving the initiation and maintenance of sleep and most of its subscales in primary school aged children.

Relationship between Helicobacter pylori infection and serum ferritin level in primary school children of Tehran-Iran.

OBJECTIVE: To determine the relationship between serum Ferritin levels and Helicobacter pylori antibody titer (IgG) in primary school children with H.pylori infection. METHODS: This cross-sectional study was performed among 6-12 year old healthy primary schoolchildren in Tehran during the academic year 2005-2006. Specimen collection was done by cluster and randomization methods (multistage sampling) Personal information and laboratory results were compiled in questionnaires and data was analyzed by descriptive and analytical statistics via SPSSv.15 software. RESULTS: One thousand six hundred sixty five primary school children (43% boys, 57% girls) with mean age 9.2 +/- 1.5 years were enrolled into the study. H.pylori IgG antibody titer was positive in 26% (432 cases) with mean values of 0.79 +/- 0.42 ISR units in boys and 0.75 +/- 0.39 ISR units in girls, which showed a significant statistical difference (P = 0.004). H.pylori infection was more common among children of large families or those with low economic status (P = 0.002). Twenty nine percent of children (477 cases)had low serum Ferritin levels, which was significantly higher among boys (P > 0.05); 32 82 +/- 33.12 mg/dL in boys and 43.23 +/- 2.5 mg/dL in girls. Out of the children with low serum Ferritin levels, 71% (334 cases) had negative and 28% (132 patients) had positive H.pylori antibody titers (IgG levels). Also, 296 children (25%) with normal Ferritin levels had H.pylori infection. CONCLUSIONS: We did not find a significant relationship between H.pylori infection and low serum Ferritin or iron deficiency anaemia.

Occupational Difference in Association of Poor Sleep Quality and Metabolic Syndrome: Differences between Workers and Employees.

BACKGROUND: Regarding insufficient data about interaction of job in association of sleep quality with metabolic syndrome (MS), this study has been designed to evaluate this association in workers and employees. METHODS: This cross-sectional study was conducted on 448 municipal staff (employee group: N = 295; worker group: N = 153) referring for periodic examinations. The relationship between sleep quality and MS and their relevant components was investigated in both groups. RESULTS: In the worker group, poor sleep quality was independently associated with the risk of MS by 3.04 times (P < 0.01). Among the components of metabolic syndrome, hypertriglyceridemia was associated with a greater number of sleep disorder components. There was no association between metabolic syndrome and sleep quality in the employee group. CONCLUSION: Poor sleep quality exerts different effects on metabolic complications in employees and workers.

Sleep duration and its relationship with school performance in Iranian adolescents.

BACKGROUND: Inadequate or poor sleep quality is common problems in adolescent that affect on their learning, memory and school performance. The present study aimed to determine the association between sleep hours and academic performance in young adults. METHODS: This cross-sectional study was designed as a descriptive-analytic study. Samples of adolescents of 14-18 years old in Qazvin city were enrolled. The Pediatric sleep questionnaire and BEARS questionnaire used for all students to screen comprehensively major sleeps problems in them. Chi-square test, t-test, analysis of variance (ANOVA), and correlation were performed to determine the relationship between the data (P < 0.001). RESULTS: Between 653 adolescents, 40% were male and 60% were female. Sleep duration, sleep onset delay, sleep insufficient, rate of oversleeping and academic performance had a direct relationship with gender (P < 0.001). The sleep duration, rate of oversleeping and academic performance were significantly higher in boys, sleep onset delay and sleep insufficient was significantly higher in girls. Time of falling sleep at weekend nights and weekday nights have positively correlation with age (P < 0.001). Also, a significant relationship between students' sleep hours with academic performance was shown (P < 0.001). CONCLUSIONS: The overall result was that sleep duration, sleep onset delay, sleep insufficient and rate of oversleeping of students in this study had a significant influence on academic performance. Students without difficulty in falling asleep had good academic performance in compared to students with difficulty in falling asleep.

Comparative study of combination therapy with non-steroidal anti inflammatory drugs and different doses of low level laser therapy in acute low back pain.

According to various side effects of medication in low back pain, respecting conservative therapy, owing to the widespread use of laser therapy in recent decades, related therapeutic outcomes were different and contradictory. The current study aimed at comparing the effect of non-steroidal drugs and laser therapy with different doses in patients with acute low back pain. METHODS: The current randomized, placebo-controlled study was conducted on 65 patients randomly assigned to four groups. In group 1(N = 20), only drug therapy and in group 2(N = 15), laser therapy (3 J/cm 2) in addition to medication was administrated to the patients. For group 3(N = 15), a therapeutic plan similar to that of group 2 was given; however, the laser dose was 6 J/cm 2. Finally, drug therapy plus placebo laser therapy was applied to group 4(N = 15). Pain was compared among the groups using visual analogue scale and Oswestry low back pain disability questionnaire. RESULTS: Significant difference between baseline pain scores and those of the weeks 1, 2, 3, and 4 of laser therapy in all intervention groups. Also, the results of the intergroup analyses showed a significant difference between group 1 compared with groups 2 and 3. There was a significant ODI difference between the groups after laser therapy. CONCLUSION: Findings showed that laser therapy plus drug therapy in comparison with drug therapy alone was a more effective method to relieve pain and disability in patient with acute low back pain; however, evidence to support this finding is still inadequate.

Effects of Intravenous Lipid Emulsion on Tramadol-Induced Seizure; a Randomized Clinical Trial.

INTRODUCTION: There are numerous studies on the efficacy of intralipid emulsion (ILE) in various xenobiotic toxicities. This study aimed to evaluate the potential role of ILE as an antidote in tramadol-induced seizure. METHODS: A single-blind clinical trial was undertaken to establish the efficacy and safety of ILE in patients with acute tramadol intoxication, who referred to Booali Hospital in Qazvin. Patients were randomly assigned to 2 groups. The Control group received standard care while the intervention group received intralipid emulsion (ILE) 20% in addition to the standard care. The occurrence of in-hospital seizure was compared between the groups. RESULTS: 80 patients who abused tramadol and met the study criteria were randomly assigned to either the intervention (40 cases) or the control (40 cases) group. Seizure occurred in 44 (56%) patients before admission to the emergency department. There were not any statistical differences between the groups regarding sex distribution (p=0.513) and mean age (p=0.19), presenting vital signs (p < 0.05), laboratory findings (p < 0.05), and mean abused dose of tramadol (p = 0.472) as well as occurrence of prehospital seizure (p = 0.7). In-hospital seizure occurred in 15 (18.75%) cases (all in the control group; p < 0.001). The mean duration of admission was 2.01 ± 1.13 days in the control group and 2.15 ± 1.04 days in the intervention group (p = 0.6). The number needed to treat for ILE to prevent tramadol-induced seizure was 2.7 (37.5% absolute risk reduction). CONCLUSIONS: The findings of this study supported ILE administration, as an adjunct to standard antidote protocols, in tramadol intoxication to prevent tramadol-induced seizures.

Association of Evening Chronotype with Poor Control of Type 2 Diabetes: Roles of Sleep Duration and Insomnia Level.

BACKGROUND: Evening chronotype is usually associated with insomnia and short sleep duration. OBJECTIVES: To investigate the independent association of chronotype with diabetes control. METHODS: In this cross-sectional study, 140 patients with type 2 diabetes were studied. The insomnia score was examined by a 7-item questionnaire. Also, chronotype was assessed by a 19-item questionnaire, and using the questionnaire, the patients were divided into three groups of morning, intermediate, and evening. This questionnaire has been developed for evaluating the preference for performing mental and physical activities at a special time of day. The Multivariate hierarchical analysis was applied for investigating the independent association of chronotype and glycated hemoglobin (HbA1c). RESULTS: The fasting blood glucose and HbA1c levels were significantly different across all the three chronotype groups such that it had the highest value in the evening group and the lowest value in the morning group (FBS = 164.5 ± 34.1 mg/dL and HbA1c = 8.7% ± 1.7, in the evening group, and FBS = 132.7 ± 23.1 mg/dL and HbA1c = 6.9% ± 0.4 in the morning group, P < 0.001). The morning group had longer sleep duration and less insomnia than other groups. Results of the hierarchical regression analysis showed that the chronotype explained 28.4% of the variance of HbA1c. Results of the final model demonstrated that the chronotype had a relationship with HbA1c, independent of body mass index (BMI), time of going to bed, and insomnia score. CONCLUSIONS: Evening chronotype is associated with poorer control of diabetes, independent of BMI and sleep variables.

Thyroid Dysfunction in Children with Idiopathic Nephrotic Syndrome Attending a Paediatric Hospital in Qazvin, Iran.

OBJECTIVES: Nephrotic syndrome is a glomerular disease characterised by a loss of albumin and high-molecular-weight proteins such as thyroxine-binding globulin and thyroid hormones, potentially resulting in subclinical or even overt hypothyroidism. This study aimed to compare thyroid hormone levels between nephrotic children and healthy controls as well as between nephrotic children in the active phase of the disease and those in remission. METHODS: This case-control study was conducted between March 2016 and 2018 at a paediatric hospital in Qazvin, Iran. A total of 73 nephrotic children comprised the case group-including 49 with active disease and 24 in remission-while the control group included 74 healthy children. Thyroid function was assessed according to levels of thyroid-stimulating hormone (TSH), free triiodothyronine (T3), free thyroxine (T4), total T4, total T3 and anti-thyroid peroxidase. RESULTS: All of the controls had normal total T4 levels. Elevated TSH levels were more frequent in nephrotic children compared to controls (34.2% versus 10.8%; P = 0.001). A significantly lower number of patients with active disease were euthyroid compared to those in remission (51% versus 95.8%; P = 0.001). Moreover, 7 (9.5%) of patients in the active and no patient in remission phase had abnormal total T4 levels (P <0.001), while 14.3% and 0% had highly elevated TSH levels (P = 0.002). CONCLUSION: Due to the prevalence of subclinical and even overt hypothyroidism, thyroid screening tests may be required for nephrotic children. However, further research is needed to confirm these findings.

Comparison of non-steroidal anti-inflammatory drugs and knee kinesio taping in early osteoarthritis pain: A randomized controlled trial.

NSAID in knee OA impose many related adverse effects. Kinesio taping was recently suggested as a novel conservative treatment for reducing pain in OA, without adverse effects. This study aimed to compare kinesio taping and NSAID therapy for kn.ee OA. There were 37 participants in the first group (mean age, 53.72 ±â€¯8.91 years), 29 participants in the second group (mean age, 50.24 ±â€¯8.63 years), and 18 participants in the third group (mean age, 53.33 ±â€¯8.50 years). These groups were treated with NSAID therapy and kinesio taping, kinesio taping only, and sham taping with NSAID therapy, respectively. Taping was repeated three times a week at 1-day intervals. Participants reported pain each week, using visual analog scale scores. The main effect of group and the pain-group interaction were not statistically significant (P = 0.88 and 0.15, respectively). Pain reduction in different weeks was statistically significant (P < .001). Cohen's effect size values for pain reduction in the first to third groups were 0.70, 0.55, and 0.48, respectively. Pain reduction was observed in the three groups, but there was no significant difference among the various treatments. Kinesio taping as a pain relief method may reduce pharmacotherapy demands or at least delay NSAID prescriptions in patients with early OA.

Effect of Intervenous Magnesium Sulfate on Decreasing Opioid Requirement after Surgery of the Lower Limb Fracture by Spinal Anesthesia.

BACKGROUND: Magnesium is the calcium natural physiological antagonist; it also antagonizes N-Methyl-D-aspartate receptors, therefore, providing antinociceptive properties. The reason for effective role of treatment with magnesium on decreasing opioid usage, less dissatisfaction, and good sleep quality is proposed theoretically yet. This study aimed to evaluate the effect of magnesium sulfate on decreasing opioids requirement after surgery of the lower limbs fracture by spinal anesthesia. METHODS: A total of 60 patients aged from 45 to 75 years with the lower limb fractures (femur and hip) candidate for surgery by spinal anesthesia. In a randomized double-blind method, patients were divided into two groups as Magnesium Group (M) and Control Group (C). Group M received a bolus of 5 mg/kg magnesium sulfate plus (250 CC) normal saline and Group C received (250 CC) normal saline in the same condition. RESULTS: Pain score and the physical dissatisfaction were reduced at 12, 24, and 48 h after surgery in Group M as compared with Group C (P = 0.000). Total opioid requirement at the end of 48 h and at the first 24 h after surgery were reduced in Group M as compared with Group C (P = 0.001). The endurance of spinal block was increased in Group M as compared with Group C (P = 0.000). CONCLUSIONS: A low dose of magnesium sulfate reduced the pain score, opioid requirement, and physical dissatisfaction while increased endurance of spinal block.