Background and Objective. The injuries caused by reperfusion of blood can lead to significant adverse effects after surgery. This study aimed to compare the effects of spinal and general anesthesia on inflammatory cytokines following changes in ischemic reperfusion due to tourniquet in lower limb surgeries. Methods. In this randomized controlled clinical trial, 34 patients with lower limb surgery admitted at the orthopedic ward of Imam Reza Hospital, Birjand, Iran, were selected by the available sampling method. They were randomly divided into two groups as follows: general anesthesia (n = 17) and spinal anesthesia (n = 17). Venous blood samples were taken from the patients of both groups at baseline (before the use of tourniquet) and 12 and 24 hours after reperfusion. Interleukin-6 (IL-6), tumor necrotizing factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and ferritin were measured and recorded. The data were analyzed using independent t-test, chi-square, and repeated measure at the significant level of 0.05. Results. The results showed that hs-CRP and IL-6 significantly increased during the study ( p < 0.001 ); however, the mean changes of TNF-α and ferritin were not significant during the study. Moreover, none of the inflammatory cytokines indicated significant differences between these two study groups ( p < 0.05 ). Conclusion. According to the results, the use of tourniquet can lead to inflammation, and the inflammation is similar in both groups.

In this research, the frequency of frost is analysed from 95 synoptic stations for the period 1990-2015. This information was categorised by a fuzzy c-approach clustering algorithm and indicated that Iran is classified into five clusters with the aid of the frost-occurrence frequencies. The greatest frequency of days with frost prevalence is located in Cluster 1 that consists of Sarab station with an average annual frequency of 141.1 days over the period 1990-2015. The least frequent is found in Cluster 5 that consists of the stations positioned along the south and north coasts. Spatial association for the frequency of incidence of frost days also includes a dependence on elevation and latitude of stations, as well as their situation inside the course of external synoptic systems, bodily and geomorphological features and local climate. Also, a study of daily minimum temperature displays a widespread warming trend at some stage during this period, and has discovered an increase in the index of the number of tropical nights, warmest nights and coldest nights and decreasing trends have been determined in the number of frost days, cool nights and cold spell period index over most regions of Iran.

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