Action of epidural xylazine on ketamine anesthetic requirements in laparoscopic ovariohysterectomy in the dog

This experimental study was performed to evaluate if epidural administration of xylazine could decrease the effective dose of intravenous ketamine for maintenance of general anesthesia in laparoscopic procedures and to assess intra-anesthetic complications. Twenty healthy female dogs (21?±?3?kg, 18?±?1.2?months) were selected. Animals were randomly divided into two groups (n?=?10). All dogs were premedicated with acepromazine. Anesthesia was induced by a combination of ketamine and diazepam. In one group, xylazine, and in the other group, normal saline were injected epidurally, and then all the dogs were spayed by the same laparoscopic method. Repeated doses of ketamine were applied for maintenance of anesthesia. Reflexes and cardiopulmonary parameters such as SpO2 and ETCO2 were recorded during the operation. There were no significant differences in weight and age between the two groups. The mean of ketamine administration in group 1 was 640?mg and 270?mg in group 2 (epidural administration of xylazine). Data analysis showed that epidural administration of xylazine decreased the amount of ketamine needed to maintain anesthesia (P?<?0.05), with no significant difference in cardiopulmonary parameters during laparoscopic operation. Epidural injection of xylazine could be used as a concurrent medication in general anesthesia without significant complications. Analgesic effects of xylazine decrease the use of ketamine (P?<?0.05) based on intraoperative pain reflex during anesthesia.     

Cardiopulmonary manifestations of typhoid fever: a prospective analysis of 65 cases in Iran

For an evaluation of cardiopulmonary manifestations in typhoid in Iran, we studied 65 patients with positive blood or bone marrow culture for Salmonella typhi during a 2-year period.Cardiac complications were seen in 4.6% (myocarditis, pericarditis, pulmonary emboli) and pulmonary complications in 6.2%.     

Religious beliefs and HIV-related stigma: Considerations for healthcare providers

Globally, the stigmatic behavior toward people living with HIV(PLHIV) has marginalized them. The aim of this study was to determine the effects of religious beliefs and demographic variables on healthcare providers’ stigmatic perspectives towards PLHIV. A total of 575 healthcare providers in Shiraz completed a structured questionnaire. Data were analyzed using the STATA package. The findings indicated a significant association between the stigmatic perspective of healthcare providers and their religious beliefs (p?p?=?0.001). In addition, social class and marital status were predictors, but they had a significant association with stigmatic view (p?>?0.05).

To reduce stigma and discrimination, training healthcare providers is inevitable. Thus, a program with a focus on the rights of PLHIV should be implemented to help healthcare providers deal with PLHIV without any stigma or discrimination.     

Medical history and the risk of biliary tract cancers in Shanghai, China: implications for a role of inflammation

Several lines of evidence suggest that inflammation may play a role in the etiology of biliary tract cancers. To examine further the role of inflammation, we evaluated the associations between self-reported inflammatory-related medical conditions and the risk of biliary tract cancers in a population-based case-control study in Shanghai, China. Our analysis included 368 gallbladder cancer cases, 191 bile duct cancer cases, 68 ampulla of Vater cancer cases, and 959 healthy subjects. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for biliary tract cancers in relation to six inflammation-related conditions. Gallbladder cancer was significantly associated with cholecystitis occurring at least 5 years prior to interview (OR = 1.7, 95% CI 1.1-2.9). Even though biliary stones did not significantly modify the associations between cholecystitis and gallbladder cancer, 90% of the gallbladder cancer cases with cholecystitis also had biliary stones, indicating that stones likely play an important role in the link between cholecystitis and gallbladder cancer. Among subjects who smoked and drank alcohol, a history of gastric (OR = 4.3, 95% CI 1.2-15.0) or duodenal ulcers (OR = 3.7, 1.2-12.0) was associated with an excess risk of gallbladder cancer. Although the mechanisms are unclear, our results further support the role for inflammation in the etiology of biliary tract cancers.