Iron deficiency anemia is the most prevalent micronutrient deficiency in the world, affecting 20-50% of the world's population. It is estimated that 10 and 20% of male and female athletes are iron deficient, respectively. Iron deficiency has deleterious effects on the physical performance of athletes. It decreases aerobic capacity, increases heart rate and elongates the recovery time after exercise. In this cross-sectional study, 42 semi-professional female athletes who had been playing in basketball, volleyball and handball super league teams served as subjects. Data on socioeconomic and fertility status as well as the type of sport were obtained through a questionnaire. Nutritional data were gathered with a 3 day dietary recall. Total intake of calorie, iron, zinc, folate, vitamin C and B12 were also analyzed. In addition, ferritin and TIBC were measured and a CBC test was done for each subject. The results showed that the mean total calorie intake of women was 2049.79 +/- 735.12 kcal, where their iron intake was 22.33 +/- 9.24 mg day(-1). There was a significant difference between the iron intake of basketball and volleyball players (p = 0.036). Of our subjects, 33.33% had low ferritin levels (< 30 ng mL(-1)) and it was lowest in handball players. Higher than normal ferritin levels were seen in 12.5% of the subjects. We saw a significant difference in ferritin levels of basketball and handball players (p = 0.047). We conclude that the intake of calorie and iron is low in female athletes and therefore, their hematological indices such as ferritin level are below standard values.

Methylnaltrexone is a peripheral opioid receptor antagonist that does not cross the blood-brain barrier; so without interference with pain relief, it could reverse the peripheral opioid side effects such as constipation, pruritus, postoperative ileus, and urinary retention. This study has been designed to evaluate the effect of methylnaltrexone on postoperative side effects of intrathecal morphine. In seventy-two 18- to 55-year-old patients scheduled for elective orthopedic operations under spinal anesthesia, neuraxial blockade was achieved using 10 mg 0.5% hyperbaric bupivacaine and 0.1 mg preservative-free morphine sulfate. The first group (M) received 12 mg methylnaltrexone, while the second group (P) received normal saline, subcutaneously, immediately after spinal block in a randomized, double-blind fashion. There was a significant decrease in the rate of nausea and vomiting in group M, but there was no significant difference in the rate of pruritus or urinary retention between the two groups. Pain score was significantly lower in group M. Respiratory depression or decreased level of consciousness was not reported in any patient. Subcutaneous administration of methylnaltrexone was not effective in decreasing postoperative urinary retention and pruritus, but lowered the rate of nausea and vomiting and pain score after intrathecal bupivacaine and morphine.

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Introduction: Many patients with emphysema will develop cystic air spaces in the lung parenchyma known as bullae. Positive pressure ventilation increases the pressure in a bulla and increases the risk of rupture and tension pneumothorax. Therefore, anesthesia management, for surgeries other than lung volume reduction surgery (LVRS), is challenging in these patients. Case Presentation: A 62-year-old male patient was brought to the emergency department due to a fall resulting in head trauma and a leak of CSF from a previous surgical site of a CP (cerebellopontine) angle tumor. The chest CT scan depicted bilateral bullae in the lungs. Anesthesia was induced and maintained with an inhalational method using Sevoflurane and spontaneous mask ventilation. Conclusions: Patients with bilateral bullae could be managed with spontaneous ventilation; one of the safe choices is inhalational induction and maintenance with Sevoflurane.

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