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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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Introduction: Oral Ketamine is used as a low side effect analgesic in comparison with opioids, in different pain syndromes. This study is designed to evaluate the effect of oral Ketamine in renal colic treatment. Materials and Methods: In this clinical trial study 104 patients with renal colic, hospitalized in emergency department, were divided in to two groups by Random block design. Group B received Pethidine (1 mg/kg up to 100 mg) and placebo, and group A received Pethidine with the same dose and Ketamine (0.5 mg/kg). All patients were assessed for pain by using VAS chart, for nausea by a 0-3 scale and for the number of vomiting at baseline and 1, 2 and 3 hours after taking drug. The results were analyzed by t-test. Results: Average pain score and vomiting in all times and nausea score in one and three hours after receiving drugs were reduced significantly in patients who took Pethidine and Ketamine comparing patients who took Pethidine and placcbo(p < 0.05). Conclusion: Regarding the significant effect of Ketamine in reduction of pain, nausea and vomiting without side effects, it is possible to use Ketamine as an adjuvant drug in treatment of renal colic and to reduce narcotic dosage.

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Background: Post operative nausea and vomiting (PONV) is a very common and distressing complication after surgeries which may result in more serious problems such as incisional hernia wound dehiscence and aspiration. Cataract surgery following increase in intraocular pressure is sensitive to POVN. This study was designed to evaluate the effect of capsicum ointment on Korean acupressure points in reducing PONV and the amont of anti- emetic medications was used. Methods and Materials: This study is a double-blinded clinical trial which was done on 200 patients who were referred to Amir Kabir hospital for cataract surgery. The patients were randomized assigned to two groups, one who received capsicum ointment and the other placebo (vaseline ointment) at the pressure points (K-K9 and K-KD2). After applying the ointments and during the first 12 hours after the operation the patients were assessed for the incidence and intensity of PONV. Results: The incidence of nausea and vomiting during the first 6 and 12 hours was higher in the placebo group in compare to the capsicum group (p=0.001). Nausea scores were also higher in the 6 and 12 hours in the placebo group (p=0.0005). Uses of metoclopramide was significant higher in the placebo group in compare to the capsicum group (p=0.001). There was no significant difference between the two groups for vomiting during first 12 hours ofter opration. Conclusion: Stimulating of both K-D2 & K-K9 Korean acupressure points simultaneously is a simple, noninvasive, cheap and effective method for reducing PONV.

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Background: Postoperative shivering is a common problem with multiple complications. This study was compared effect of low doses of Ketamine with Pethidine for controlling postoperative shivering. Methods and Materials: This clinical trial was done on 189 elective cesarean section with ASA class I or II who had postoperative shivering. Patients with grade 2 or higher were divided in three groups and were injected 0.3mg/kg Ketamine and 0.5mg/kg Pethidine intravenously. In 5th and 10th minutes after injection, they were investigated for shivering intensity. Results: After 5 minute of injection drugs rate and intensity of shivering in Pethedine group was less than ketamine group. Ketamine with 0.5 mg/kg was more effective than 0.3mg/kg dose of it and Ketamine(p=0.041). In group with 0.5mg/kg dose of Ketamine, rate and intensity of postoperative shivering was more reduce than group with 0.3mg/kg of it in recovery(p=0/007). In Pethedine group rate and intersity of shivering was more reduce then 0.5mg/kg dose of Ketamine(p<0/001). This demonstrated that Pethedine is more effective than Ketamine. Conclusion: Although 0.5mg/kg dose of Ketamine has considerable effect on control of shivering but Pethedine is still a better choice for this side effect.

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Background: Postoperative pain brings about undesirable effects such as medical complications, increased healthcare costs, and the need for opioids administration. The aim of this study was to determine the effect of low dose (0.15 mg/kg) ketamine in comparison with the placebo on postoperative pain and analgesics consumption after cesarean section. Materials and Methods: In a randomized clinical trial, 120 women undergoing elective cesarean section were randomly divided into case and control groups. Ketamine (0.15 mgkg-1) or an equal volume of normal saline were administered intravenously immediately after initiating spinal anesthesia to the case and control groups, respectively. The anesthesia and surgery techniques were the same for both groups. Data were analyzed using SPSS version 11. Results: Means of age in the case and control groups were 28.85±4.81 and 28.87 ±5.62 years, respectively. Analgesics consumption, pain scores, homodynamic signs, drowsiness of the mothers, and the neonates’ Apgar scores after cesarean section were similar in both groups and no significant differences were found between them (P>0.05). The mean of postoperative arterial pressure in the early hours in the ketamine group showed a significant decrease compared to the placebo group (P>0.03). The means of the first time of request for analgesics after surgery in the ketamine and placebo groups were 99.75±68.88 and 96.1±52.59 minutes, respectively (P>0.05). Conclusion: It seems that the administration of 0.15 mg/kg dose of ketamine (0.15mg/kg) does not have a significant impact on decreasing the postoperative pain in cesarean section. Therefore, in order to obtain the desirable analgesic effects of this drug, further studies should be conducted with greater doses of this drug and its use in combination with other opioids.

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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: Unpleasant side effect of awareness within general anesthesia is potentially an important concern in patients. The patient may sleep during anesthesia and feels the pain due to loss of pain suppression of sensory perception of pain during surgery. The aim of this study is to determine the effect of BIS monitoring on level of awareness during anesthesia in women undergoing elective caesarean section.

Materials and Methods: In this double-blind, randomized clinical trial, 214 ASAI–II patients, over 15 years of age, candidate for elective cesarean section were included in the study. Patients randomly divided to two groups of anesthesia with and without BIS monitoring. Patients were assessed for awareness within anesthesia immediately, 24 hours, and 3-6 days after operation.

Results: From 107 patients without BIS monitoring, 8 patients (7.4%) suffered from awareness during anesthesia and their awareness score was two and greater than two. While none of the patients in the BIS group experienced awareness during anesthesia. Level of awareness during anesthesia in the control group was significantly more than the BIS group (p<0.0000).

Conclusion: The incidence of awareness during anesthesia is significantly lower in BIS monitored group than the control group.

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Background: Maturation of oocytes and fertilization in vitro can be considered as one of the most important steps to treat infertility. In this study maturation medium was enriched with Platelet extraction (PL) which has high concentration of growth factors. Meiosis resumption and maturation was monitored after 18 hours of maturation.

Materials and Methods: In this experimental study, oocytes at germinal vesicle stage were obtained from mature NMRI female mice. Maturation medium was &alphaMEM and the control groups had 5-10% FBS and the medium in the experimental groups was enriched by 5, 10% PL and the combination of 5% PL and 5% FBS. Meiosis resumption and maturation were observed after 18 hours.

Results: The rate of matured oocytes in the experimental group 5% PL for both COC and DO group was significantly higher than the control groups (P<0.05). The maturation rate for 5% PL was 61% for the COC group and 72% for the DO group while this rate for 5% FBS control group was 53% and 50% respectively.

Conclusion: PL had a significant effect on meiosis resumption and maturation of oocyte at germinal vesicle stage. Based on these results, PL could be used as a maturation promoting factor.

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Background: The evidence suggests that obesity causes the chronic inflammation. Chemerin is a new adipokine which is associated with obesity and metabolic syndrome. The effects of combined training on levels of inflammatory markers specialy chemerin and serum amyloid-A has been less studied.The present study aims to examine the effect of six weeks combined training on plasma levels of chemerin, CRP and SAA and plasma lipid in obese men.

Materials and Methods: 18 obese men were divided into control and experimental groups. General characteristics of subjects serum levels of chemerin, CRP and SAA were examined (by ELISA method), before and after one session training. Endurance training protocol was performed on the large muscles included in 6 weeks running around the track with 60 to 75% HRmax, 4 sessions per week, intense resistance training for 25 to 30 minutes with 50 to 70% of one repetition maximum of 6 stations (2 sets, 12 Reps). Data analysis was performed by T-independent test for comparison of two control and training groups, T-paired test for comparison of two groups before and after the test and significant level of p≤0.05 was considered.

Results: The results show that 6 weeks combined training significantly decrease the plasma levels of chemerin (p=0.004), and SAA (p=0.009), but there was not any significant decrease on CRP levels(p=0. 476). So, it can be concluded that combined training will affect on some inflammatory markers in obese men and improve them.

Conclusion: One session combined training for 6 weeks significantly affects on plasma levels of chemerin and serum amyloid-A, however, it doesn't decrease the plasma levels of C-reactive protein (CRP).