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Introduction: Postoperative nausea and vomiting is one of the most common problems in postoperative period. Patients' who are at high risk of PONV, may receive anti-nausea and vomiting drugs. The most common drug is Metoclopramide, but it,s extrapiramidal signs and side effects such as lethargy, dizziness and headache especially in children lead us to perform this study, in order to compare Dexamethasone and Metoclopramide effects in PONV prevention. Materials and Methods: This study was a double-blind randomized controlled clinical trial. 262 patients (2-25 years) in ASA class I,II which were candidates for ENT, eye and laparatomy surgeries, divided into two groups randomly. One group received 0.1 mg/kg Dexamethasone IV and the other group received 0.1mg/kg Metoclopramide IV, 10-15 minuets before operation ending time. During recovery, the frequency of PONV was assessed. Data was analyzed by Pearson test. Results: PONV frequency in the two groups had no significant difference. Also PONV rate in the two groups had no significant difference in male and female. Conclusion: In prevention and treatment of PONV, Dexamethasone effect was same as Metoclopramide. Considering low expense, avalibility and low side effects, Dexamethasone is a proper substitute for Metoclopramide in surgeries with high risk of PONV.

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Introduction: Spinal anesthesia is a conventional way of anesthesia for cesarean section (CS), which nausea and vomiting is a common complication of it. Metoclopramide is the standard medication used for preventing intraoperative nausea and vomiting (IONV). Because of extrapyromidal side effects of Metoclopramide and known antiemetic effects of low-dose Propofol and Dexamethasone, this study was performed to compare the effectiveness of these drugs for preventing IONV. Materials and Methods: This study, is a randomized clinical trial which is done on 144 parturients who were admitted for emergency CS. Patients were divided randomly into four groups and received: Metoclopramide 0.1 mg/kg IV, Dexamethasone 150 g/kg IV, Propofol 0.1mg/kg every 5 minutes from clamping umbilical cord till the end of operation and the fourth group received 2 ml distilled water. During the operation parturients were monitored for IONV. Data was analyzed using Kruskal-Wallis and one way ANOVA. Results: The Number of patients having nausea was lowest in Propofol and highest in Dexamethasone group. There was no statistical significant difference between Dexamethasone and placebo groups. The lowest rate of vomiting was in Metoclopramide and Propofol groups and there was no significant difference between them. Also the lowest level of retching was in the Prepofol group. Conclusion: According to results, the antiemetic effects of Propofol and Metoclopramide are similar. Amount of retching in Propofol was slightly lower than Metoclopramide and administration of Propofol was simple, cheap and without serious complications, so we recommend it for emergency CS.

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Introduction: Pain relief has been received the highest level of medical attempts continuously but still many patients suffer from it. Narcotics' side-effects have led investigators to apply other techniques for controling acute postoperative pain to reduce narcotics requirements. Recently, some concepts have been presented implying that Metoclopramide does have analgesic effects and this led us to conduct the present study in order to determine Metoclopramide's effect on alleviating pain after cesarean section. Materials and Methods: In this clinical trial, 80 patients who were candidates of elective cesarean section were studied in two groups. 10 minutes before the cesarean section's ending time, the control group was given 25 mg Pethidine accompanied by 10 mg Metoclopramide and control group 25 mg Pethidine and distilled water. Then when patients were conscious after cesarean section, for a period of 6 hours received after-care for their vital signs and side-effects of prescribed drugs. Their pain score (VAS) and nausea rate was measured and if necessary, Pethidine was injected with certain dose. Injection time for first dose of Pethidine and its required amount were recorded in a checklist within first 6 hours after cesarean section. Data was analyzed using ANOVA and T tests. Results: Prescription of Metoclopramide inhaunced analgesic effect of narcotics and a meaningful decrease was found in pain score (p=0.002) and nausea rate (p<0.005). Injection time for the first dose of Pethidine was also prolonged in the group who received Metoclopramide compared to control group (p=0.019) and an obvious decrease was occurred in received Pethidine's amount within the first hours after cesarean section (p<0.005). Drugs side-effects were not found in patients. Conclusion: The results indicate that use of Metoclopramide accompanied by Pethidine in ending time of cesarean section, does have considerable effects in controlling acute pain after surgery and increasing analgesic effect of narcotic drugs. Therefore, use of Metoclopramide as a proper supplement drug with low side-effects is recommended.

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Introduction: Type of anesthesia is important in the maternal and fetal well being. There are different informations about effect of general and spinal anesthesia on Apgar score, so in this study a comparision was made on Apgar scores of neonates following these two methods. Materials and Methods: This study is a clinical trial and 168 term pregnant women were selected from elective cesarean candidates and divided in to general and spinal anesthesia groups by randomized allocation method. Then Apgar scores in first, fifth and twentieth minutes were mesured in infants. Also maternal age, cause of cesarean, sex and duration of cesarean section time were all documented. Data was analyzed using T and Chi square tests. Results: Mean Apgar scores were 8.66±0.68, 9.8±0.42 and 9.970.15 at first, fifth and twentieth minutes in general anesthesia group, and 90.38, 9.880.32 and 10 at first and fifth and twentieth minutes in spinal group. The group differed significantly for first minute Apgar score (p<0.001) but there were no significant differences in fifth and twentieth minutes Apgar scores. Conclusion: First minute Apgar score of newborns of mothers under spinal anesthesia was more than those of mothers under general anesthesia but there was no difference between their five minute Apgar score.

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Background: Post-anesthetic shivering is the most common cause of patient discomfort during recovery with a prevalence of 5 to 65%. Post-anesthetic shivering can increase pain, oxygen consumption, and cardiac output. The aim of this study was to compare the efficacy of various classes of drugs for preventing post-anesthetic shivering.

Materials and Methods: In this double-blind clinical trial, patients undergoing elective laparotomy were randomly divided into six groups, 40 each. The patients, respectively, received hydrocortisone, ketamine, tramadol, magnesium sulfate, pethidine, and normal saline. All patients were observed for body temperature and shivering for 20 minutes after arrival to recovery room.

Results: Seventy patients in the pethidine group did not have shivering upon arrival to recovery room which was significantly higher than other groups (&chi2=0.00002). Also, the patients in the pethidine group did not shiver 10 and 20 minutes after arrival to recovery room that was significantly lower than other groups.

Conclusion: According to the results, it can be concluded that pethidine is more effective than other drugs in prevention of post-anesthetic shivering.

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Background: Caesarean section is one of the most common gynecologic surgeries. Nausea and vomiting after pain is the most common side effect of surgeries, today, we most widely use of serotonin receptor antagonists, that are most effective antiemetic and have less side effect rather than other drug. Ondansetron is typical serotonin antagonists.

Materials and Methods: This is a randomized, double-blind clinical trial on 162 women undergoing cesarean section. 4mg intravenous ondansetron was given to first group and 8mg oral ondansetron was given to second group and thired group recived placebo. Blood pressure and heart rate were measured before and immediately after performing spinal and every 5 minute until 20 minute. Post operative nausea and vomiting and APGAR score were recorded after operation in recovery and 2, 4, and 6 houres after surgery.

Results: There was no significant difference among 3 groups according to age, gravidity, mean atrial pressure and heart rate before and during surgery. Nausea and vomiting in oral and intravenous groups at recovery, 2 and 4 hours after surgery were significantly less nausea and vomiting than placebo group (p<0.05). Whereas there was no significant difference between oral and intravenous groups.

Conclusion: It was concluded that using oral ondansetron with the same antiemetic effect is more convience to women undergoing cesarean section with spinal anesthesia.

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Background: Head circumference (and its related morphologic factors such as head length and width) is one of the morphologic indices that people with autism spectrum disorders (ASD) have different developmental patterns in comparison to their peers. So the aim of this study is to assess head circumference indices in relation to cognitive factors in ASD children and adolescents.

Materials and Methods: In this cross-sectional study, the case group was consisted of 129 students with ASD aged 7-18 years old. The control group was consisted of 103 students with intellectual disability (ID) aged 7-18 years old. Head circumference, head length and width was measured by meter and caliper respectively. In addition, socio- cognitive factors questionnaire was responded by parents.

Results: Results showed that the head circumference, length and width of ASD group was significantly greater than ID group (p<0.001). Moreover, ASD group achieved lower score on SSIS questionnaire than ID group (p<0.001). Furthermore, results showed that in ASD group with increasing the size of head circumference the score on socio-cognitive abilites and skills decreased (p<0.05).

Conclusion: Generally, this study indicated that the developmental trajectory as well as the relation of anthropmetric indices of head circumference and socio-cognitive factors in children and adolescents with ASDs is different from ID population.

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Background: Metabolic syndrome, a concurrence of overweight and abdominal fat distribution, disturbed glucose and insulin metabolism, mild dyslipidemia and hypertension is among the most important issues that man deals with, in today's world. Probiotics are live microorganisms which, when administered in adequate amounts, can confer a health benefit on the host. The aim of the present study was to review the clinical evidence available regarding the role of probiotics in improvement of disorders associated with metabolic syndrome.

Materials and Methods: In this research, clinical trials performed between 2000-2014 were searched in two databases, Pubmed and ScienceDirect. In both databases “Probiotics”, “metabolic syndrome” and each of its elements were used as the key words.

Results: Probiotics may reduce body weight through manipulating the gut flora. Through reducing inflammation and immune-regulation, probiotics decrease insulin resistance. They also improve lipid profile through reducing cholesterol absorption and producing short chain fatty acids, as well as deconjugating bile acids and converting cholesterol to coprostanol. Moreover, probiotics have been suggested to have a hypotensive effect through release of angiotensin-converting enzyme inhibitory peptides, through proteolytic action. 

Conclusion: Although some clinical trials have failed to obtain beneficial effects of probiotics on metabolic syndrome related situations, a majority of the studies have shown positive results for these microorganisms in this regard. Thus, probiotics can be looked upon as a novel approach when either prevention or alleviation of metabolic syndrome is aimed.

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