Search results for: Amirhossein Moghanian

Authors: Sara Ataei, Molouk Hadjibabaie, Amirhossein Moslehi, Maryam Taghizadeh-Ghehi, Asieh Ashouri, Elham Amini, Kheirollah Gholami, Alireza Hayatshahi, Mohammad Vaezi, Ardeshir Ghavamzadeh

Abstract:

Acute kidney injury (AKI) is one of the complications of hematopoietic stem cell transplantation and is associated with increased mortality. N-acetylcysteine (NAC) is a thiol compound with antioxidant and vasodilatory properties that has been investigated for the prevention of AKI in several clinical settings. In the present study, we evaluated the effects of intravenous NAC on the prevention of AKI in allogeneic hematopoietic stem cell transplantation patients. A double-blind randomized placebo-controlled trial was conducted, and 80 patients were recruited to receive 100 mg/kg/day NAC or placebo as intermittent intravenous infusion from day -6 to day +15. AKI was determined on the basis of the Risk-Injury-Failure-Loss-Endstage renal disease and AKI Network criteria as the primary outcome. We assessed urine neutrophil gelatinase-associated lipocalin (uNGAL) on days -6, -3, +3, +9, and +15 as the secondary outcome. Moreover, transplant-related outcomes and NAC adverse reactions were evaluated during the study period. Statistical analysis was performed using appropriate parametric and non-parametric methods including Kaplan–Meier for AKI and generalized estimating equation for uNGAL. At the end of the trial, data from 72 patients were analyzed (NAC: 33 patients and placebo: 39 patients). Participants of each group were not different considering baseline characteristics. AKI was observed in 18% of NAC recipients and 15% of placebo group patients, and the occurrence pattern was not significantly different (p = 0.73). Moreover, no significant difference was observed between groups for uNGAL measures (p = 0.10). Transplant-related outcomes were similar for both groups, and all patients had successful engraftment. Three patients did not tolerate NAC because of abdominal pain, shortness of breath and rash with pruritus and were dropped from the intervention group before transplantation. However, the frequency of adverse reactions was not significantly different between groups. In conclusion, our findings could not show any clinical benefits from high-dose NAC particularly for AKI prevention in allogeneic hematopoietic stem cell transplantation patients.

Keywords: acute kidney injury, N-acetylcysteine, hematopoietic stem cell transplantation, urine neutrophil gelatinase-associated lipocalin, randomized controlled trial

Procedia PDF Downloads 434

Authors: Shekoufeh Behdad, Amirhossein Yadegari, Leila Ghodrati, Saman Yadegari

Abstract:

Context: Preoperative anxiety is a common psychological reaction experienced by all patients undergoing surgery. It can have negative effects on the patient's well-being and even impact surgical outcomes. Therefore, finding effective interventions to reduce preoperative anxiety is important in improving patient care. Research Aim: The aim of this study is to compare the effects of oral administration of zaleplon (5 mg) and alprazolam (0.5 mg) on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Methodology: This study is a double-blind, randomized clinical trial conducted after receiving approval from the university's ethics committee and obtaining written informed consent from the patients. The night before the surgery, patients were randomly assigned to receive either 0.5 mg of alprazolam or 5 mg of zaleplon orally. Anxiety levels, measured using a 10-cm visual analog scale, and hemodynamic variables (blood pressure and heart rate) were assessed before drug administration and on the morning of the operation after the patient entered the pre-operation room. Findings: The study found that there were no significant differences in mean anxiety levels or hemodynamic variables before and after administration of either drug in both groups (P value > 0.05). This suggests that both 0.5 mg of alprazolam and 5 mg of zaleplon effectively reduce preoperative anxiety in women undergoing abdominal surgery without serious side effects. Theoretical Importance: This study contributes to the understanding of the effectiveness of alprazolam and zaleplon in reducing preoperative anxiety. It adds to the existing literature on pharmacological interventions for anxiety management, specifically in the context of gynecological abdominal surgery. Data Collection: Data for this study were collected through the assessment of anxiety levels using a visual analog scale and measuring hemodynamic variables, including systolic, diastolic, and mean arterial blood pressures, as well as heart rate. These measurements were taken before drug administration and on the morning of the surgery. Analysis Procedures: Statistical analysis was performed to compare the mean anxiety levels and hemodynamic variables before and after drug administration in the two groups. The significance of the differences was determined using appropriate statistical tests. Questions Addressed: This study aimed to answer the question of whether there are differences in the effects of alprazolam and zaleplon on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Conclusion: The oral administration of both 0.5 mg of alprazolam and 5 mg of zaleplon the night before surgery effectively reduces preoperative anxiety in women undergoing abdominal surgery. These findings have important implications for the management of preoperative anxiety and can contribute to improving the overall surgical experience for patients.

Keywords: zaleplon, alprazolam, premedication, abdominal surgery

Procedia PDF Downloads 80

Authors: Amirhossein Dodankeh, Hadi Dabiryan, Saeed Hamze

Abstract:

Using fabrics to reinforce composites considerably leads to improved mechanical properties, including resistance to the impact load and the energy absorption of composites. Warp-knitted spacer fabrics (WKSF) are fabrics consisting of two layers of warp-knitted fabric connected by pile yarns. These connections create a space between the layers filled by pile yarns and give the fabric a three-dimensional shape. Today because of the unique properties of spacer fabrics, they are widely used in the transportation, construction, and sports industries. Polyurethane (PU) foams are commonly used as energy absorbers, but WKSF has much better properties in moisture transfer, compressive properties, and lower heat resistance than PU foam. It seems that the use of warp-knitted spacer fabric reinforced PU foam (WKSFRF) can lead to the production and use of composite, which has better properties in terms of energy absorption from the foam, its mold formation is enhanced, and its mechanical properties have been improved. In this paper, the energy absorption efficiency (EAE) of WKSFRF under low-velocity impact is investigated experimentally. The contribution of the effect of each of the structural parameters of the WKSF on the absorption of impact energy has also been investigated. For this purpose, WKSF with different structures such as two different thicknesses, small and large mesh sizes, and position of the meshes facing each other and not facing each other were produced. Then 6 types of composite samples with different structural parameters were fabricated. The physical properties of samples like weight per unit area and fiber volume fraction of composite were measured for 3 samples of any type of composites. Low-velocity impact with an initial energy of 5 J was carried out on 3 samples of any type of composite. The output of the low-velocity impact test is acceleration-time (A-T) graph with a lot deviation point, in order to achieve the appropriate results, these points were removed using the FILTFILT function of MATLAB R2018a. Using Newtonian laws of physics force-displacement (F-D) graph was drawn from an A-T graph. We know that the amount of energy absorbed is equal to the area under the F-D curve. Determination shows the maximum energy absorption is 2.858 J which is related to the samples reinforced with fabric with large mesh, high thickness, and not facing of the meshes relative to each other. An index called energy absorption efficiency was defined, which means absorption energy of any kind of our composite divided by its fiber volume fraction. With using this index, the best EAE between the samples is 21.6 that occurs in the sample with large mesh, high thickness, and meshes facing each other. Also, the EAE of this sample is 15.6% better than the average EAE of other composite samples. Generally, the energy absorption on average has been increased 21.2% by increasing the thickness, 9.5% by increasing the size of the meshes from small to big, and 47.3% by changing the position of the meshes from facing to non-facing.

Keywords: composites, energy absorption efficiency, foam, geometrical parameters, low-velocity impact, warp-knitted spacer fabric

Procedia PDF Downloads 171