Sharifian M, Dalirani R, Moshari F, Hatamian B, Otukesh H, Nafar M, Einollahi B, Basiri A, Simforoush N,
Volume 32, Issue 2 (Summer 2008 2008)
Abstract
Background: Cystinosis is an inherited metabolic disease in which transfer of cystine out of lysosome is impaired. This phenomenon leads to accumulation of cystine in different organs and causes organ dysfunction. Growth retardation is seen in these patients and later they go on to develop renal failure needing dialysis or renal transplantation.
The aim of this study was to evaluate the outcome and complications of renal transplantation in patients with cystinosis.
Materials and methods: In this case series study in years 1996-2006 all patients with renal failure due to cystinosis who received renal transplantation, were followed for 43± 1/1 months. Before operation, all patients were examined to determine if they are appropriate candidate for renal transplantation and after operation DPTA scan was performed to evaluate graft function and in later follow up necessary lab tests were done. All patients received triple immunosuppressive therapy including cyclosporine, prednisolone and Mycophenolate Mofetil. In the presence of rejection symptoms such as fever and a rise in creatinine, graft rejection was confirmed by DPTA scan and sonography of transplanted kidney.
Results: Patient survival was 100% and 4 years graft survival was 86.7%. Mean creatinine level before operation was 5.44 ± 2.58 and post operation was 0.86 ± 1.03 and at the last follow-up was 1.51 ± 1.45 mg/dl, mean GFR at the last follow-up was 54.1 ± 31.2 ml/min/1.73m2. Six (40%) patients were on dialysis before operation, 5 (33%) had acute rejection and 5 (33%) suffered from UTI after the operation. Growth retardation was seen in all of patients. Thirteen patients (86%) were affected by CMV infection and 6 (40%) by CMV disease that were treated successfully by Ganciclovir for 2 weeks.
One patient was affected by vessel thrombosis in post operation period and one patient had graft loss due to kink of vessel after operation.
Conclusion: Renal transplantation in patients with cystinosis has favorable outcome. It is the treatment of choice for patients with cystinosis and End Stage Renal Failure (ESRF).
Dr Mohammadreza Moshari, Dr Minoo Yaghmaei, Dr Hadis Shahrami,
Volume 44, Issue 1 (3-2020)
Abstract
ABSTRACT
Background and Aim: Nausea and vomiting during cesarean section are common under spinal anesthesia. The aim of the present study was to investigate the prevalence of nausea and vomiting and the related factors during elective cesarean under spinal anesthesia.
Materials and Methods: A descriptive study was performed on 200 pregnant women who were candidates for elective cesarean section under spinal anesthesia in Taleghani Hospital between 2017-2018. For each participant, age, number of pregnancies, number of deliveries, history of previous cesarean section, nausea and vomiting in previous cesarean section(s), smoking during pregnancy, nausea and vomiting during the first trimester of pregnancy, premenstrual syndrome, and motion sickness were asked and BMI, duration of operation, the highest level of blocked dermatome, baseline pulse rate, and systolic pressure decreased by more than 20%, the incidence of nausea and severity, or vomiting during surgery, and the sex of the infant were recorded. Data were fed into SPSS column, version 21, and analyzed using descriptive statistics and independent t, Mann-Whitney, Chi-square, and Fisher exact tests. P-values less than 0.05 were considered significant.
Results: The prevalence of nausea and vomiting were 58% and 16%, respectively. The history of nausea and vomiting in the first trimester of pregnancy, pregnancy with the female fetus, and systolic pressure decreased by more than 20% in both groups of patients with nausea (P< 0.001) and vomiting (P<0.001) during cesarean section under spinal anesthesia were more prevalent than those without nausea and vomiting. Also, the prevalence of motion sickness (P <0.047) and history of nausea and vomiting during the previous cesarean section were significantly different in the non-nauseous group after spinal anesthesia (P <0.004) in patients with nausea during surgery. The highest level of blocked dermatome was significantly different in both groups with and without vomiting (p <0.001).
Conclusion: The currrent study showed once more that nausea and vomiting were common during cesarean section under spinal anesthesia. It seems that checking some factors in the medical history of a person may help in predicting this complication.
