Background: Postoperative pain control after cardiac surgery is usually based on Opioids. These drugs are associated with side effects, and the use of drugs with fewer side effects is important for analgesia. Dexmedetomidine and paracetamol have fewer side effects than opioids. Objectives: The aim of the study was to evaluate the adding paracetamol to dexmedetomidine continuous infusion pump for pain management after adult cardiac surgery. Methods: In this study, 100 patients were divided into two groups. One group received a continuous infusion of dexmedetomidine and paracetamol (DP), and the other received dexmedetomidine (D). These two groups were evaluated for MAP, HR, and the need for prescribing opioids before and after extubation. Also, duration of intubation and pain before extubation and 36 hours after every 4 hours. Results: Patients in the DP group had lower mean MAP and HR during intubation period than the D group and needed fewer opioids and doses of opioids in addition to drug study infusion pre- (P = 0.001) and post-extubation (P = 0.001 and P = 0.022, respectively). The DP group patients were extubated earlier (P = 0.001). After extubation, the DP group had less pain than the D group. Conclusions: This study showed that adding paracetamol to the dexmedetomidine infusion pump can provide better analgesia.

No abstract

Introduction: Pulmonary hypertension (PH) is quite common among patients with thalassemia, and it can lead to cardiac failure and even death in those patients. Methods: This current cross-sectional study was conducted with 155 patients with β-thalassemia major and thalassemia intermedia referring to Razi Hospital Rasht, Iran in a recent year. All patients underwent echocardiography and the data (including age, sex, thalassemia type, splenectomy history, deferoxamine usage, hydroxyurea usage, hemoglobin, and ferritin level) were collected by a researcher-made checklist. Data analysis was performed using SPSS software. Results: The prevalence of PH was 13.7% in this study. There was a correlation between sex, thalassemia type, deferoxamine usage, and ferritin level with a prevalence of PH. However, there was not a significant relationship between splenectomy history, hydroxyurea usage, and hemoglobin level with PH prevalence (P = 0.187, P = 0.035, and P = 0.178, respectively). Conclusions: The findings of the study represented that the proposed variables can cause and exacerbate cardiac complications and may have a correlation with the disease's side effects. By conducting more studies and designing a more promising interventional study with a higher sample size, using the results of this study and similar studies, a step could be taken to identify patients susceptible to exacerbation of cardiac complications earlier. By treating them, we may be able to increase their chance of survival in the long run.

Background- Congenital hypothyroidism (CH) is the most frequent cause of mental retardation in children. Despite the success of the screening programs in detecting CH cases, high recalling rate and false positive results impose a burden to the health system worldwide. Although cord blood thyroid stimulating hormone (CBTSH) is an accepted screening tool for CH, data about it are sparse in Iran. Therefore, we aimed to evaluate the umbilical cord blood TSH and Free T4 and its relationship with maternal and neonatal factors, as well as heel-stick TSH. Methods- This study included 120 mother-newborn pairs in Amir-Al-Momenin Hospital, Semnan, Iran from October 2021 to May 2022. The mean values of Free T4 and CBTSH were measured with respect to various maternal and neonatal factors. The heel-stick TSH on day 2-3 after birth were determined in all participants. Results- The mean CBTSH concentration was significantly higher in preterm newborns and male sex than term newborns and females (P=0.039 and P<0.001, respectively). Newborns born via cesarean section had lower CBTSH levels than those born by vaginal deliveries (P=0.040). The CBTSH was also positively correlated with heel-stick TSH (P<0.001). The mean umbilical cord blood Free T4 was significantly higher in multigravida newborns than primigravida cases (P=0.023). There was no statistically significant relation between umbilical cord blood Free T4 and TSH and maternal age, preeclampsia, gestational diabetes, twin or singleton delivery, 1- and 5- minutes Apgar scores, birthweight, and cord gases (P>0.05). The optimal cut-off point of CBTSH for discrimination of suspicious cases to hypothyroidism was 14.75 mIU/L. Conclusions- Method of delivery, gestational age, and male sex were influential variables on the umbilical cord TSH that must be considered when interpreting the results of the CBTSH. This study augments findings that CBTSH may be considered a predictive factor in CH screening programs.