Journal of Cellular & Molecular Anesthesia

Introduction: Amphetamine (AT) is used to treat some medical conditions and also known to be abused recreationally. It is a potent central nervous system stimulant that is capable of producing damaging effects to the central dopaminergic pathway. Most of AT users are treated clinically for symptomatic treatment which is associated with neurological side effects. To date, there is growing interest in naturally occurring compounds which have lesser side effects to treat health problems. One of the potential compounds is thymoquinone (TQ), an active compound of Nigella sativa which is known for its cellular protective effects. Objective: The objectives of this study were to determine the IC₅₀ values of AT and TQ on differentiated SH-SY5Y neuronal cells and to evaluate the changes of dopamine (DA) level in the cells exposed to AT after co-administering with TQ. Methodology: Differentiated SH-SY5Y cells were grown in cell culture flask containing DMEM/F12 medium supplemented with 10% (v/v) fetal bovine serum and 1% (v/v) penicillin/streptomycin. The IC₅₀ value of TQ and AT in differentiated SH-SY5Y cells was determined by using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The DA level was determined by using the Enzyme-Linked Immunosorbent Assay (ELISA) kit. Result and Discussion: The IC₅₀ values of AT and TQ were 1596 µM and 926 µM respectively. Co-administration of 40 µM of AT and 30 µM of TQ demonstrated a significant increase in DA level at 48 hours of exposure when compared to the administration of AT group (P≤0.05). Conclusion: These findings suggested that TQ has a role in maintaining the DA activity after a long-term AT exposure.

Background: Congenital factor XIII (FXIII) deficiency is an extremely rare bleeding disorder (RBD) with different clinical coagulation disorders and great impacts on the perioperative patient outcome. Its prevalence in Southeast Iran is approximately 4,000 times higher than the worldwide prevalence, with Trp187Arg (c.559T> C as the only causative mutation of FXIIID there. We investigated the founder effect of rs1742924, rs4960181, rs3778360 and rs4142290 using haplotype analysis to define the genetic phenomenon in this geographic region. Materials and Methods: In a case-control study, 10 patients with FXIIID and 10 healthy individuals were assessed. Initially, Trp187Arg (c.559T> C) mutation was assessed in all study populations using a PCR-RFLP technique, then haplotype analysis was performed by assessing rs1742924, rs4960181, rs3778360 and rs4142290 polymorphisms. Data were analyzed using a two-proportion z-test. Results: All patients were homozygote for Trp187Arg (c.559T>C), and this mutation was not observed in any form of homozygote or heterozygote in the control group. Polymorphisms in rs1742924, rs4960181, and rs377836 were homozygote (TT, GG, GG, respectively) and T, G, and G alleles distribution in cases and controls with significant difference (P<0.001, P<0.001, and P=0.01 respectively). Rs4142290 polymorphism showed no significant difference between patients and controls (P=0.3). Two types of haplotypes were observed in the case group, and haplotype number 1* was observed among 90% of them, while not observed in the control group. Conclusion: It seems that founder effectors of haplotype number *1 have more antiquity versus other haplotypes, and probably founder effect is responsible for this high prevalence of FXIIID in the southeast of Iran.

Background:

Scalp block with bupivacaine has shown to provide perioperative analgesia with subsequent decrease in intraoperative opioids consumption. We performed a prospective randomized controlled study to evaluate the efficacy of preemptive scalp block in preventing Postoperative nausea and vomiting (PONV) after elective supratentorial craniotomy

Methods:

40 patients were randomly allocated to either control group or preemptive scalp block group. Postoperative nausea & vomiting incidence & severity during 1^st 24 hours after operation were recorded.

Results:

We found that PONV% was statistically insignificant between the 2 groups; 50% in control group, 45% in Scalp block group. On the other hand, Scalp block blunted response of both mean arterial blood pressure and heart rate with noxious stimuli during pinning and skin incision together with improvement in recovery profile.

Conclusions:

Scalp block, combined with general anesthesia provided good hemodynamic stability  and better recovery profile during craniotomy but on the other hand,  had no effect on PONV incidence during 1^st 24 h.

Acute respiratory distress syndrome (ARDS) is considered a major cause of death in the world. ARDS is defined by life-threatening pulmonary edema and hypoxemia with a mortality rate of up to 40%. Recent advances in understating cellular aspects of the syndrome have shed light on possible new treatments and reduction of mortality. Toll-like receptors (TLRs) are pattern recognition receptors (PRRs) involved in adaptive and innate immunity. They are present in the alveoli and their activation can lead to inflammatory responses and finally acute lung injury. Among them, Toll-like receptor 4 (TLR4) is abundantly available on the epithelial cells of the alveoli and also on resident monocytes. TLR4 is one of the players that can promote alveolar damages during ARDS. Here, we focus on the TLR4 role in ARDS pathophysiology. We also present the potential therapies for the syndrome based on TLR4 inhibition.

Early and appropriate management of brain insults has significantly reduced patient morbidity and mortality. Neuromonitoring, neuroprotection and secondary brain injury prevention are the essential principals of brain injury management.

In this literature review we have elaborated the neuroprotective role of dexmedetomidine (DEX), predominantly in different animal models of brain insults and reports in patients cared in a neurocritical care setting.  We undertook an electronic literature search of articles published in English prior to July 2019. This search resulted in inclusion of 59 studies from medical databanks such as PubMed, Scopus, EMBSCO, CINAHL, ISC and the Cochrane Library. The keywords used were brain, α₂ agonist, neurocritical care and dexmedetomidine.

DEX may have a neuroprotective effect in a broad spectrum of brain pathologies such as traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), ischemic stroke, intracerebral hemorrhage (ICH), and cerebral hypoxia. However, its neuroprotective role in status epilepticus (SE) is less clear. Further animal and human studies are needed before we could consider DEX as a neuroprotective agent in this patient population. Due to its favorable properties outlined in this review, DEX could be considered a favorable sedative agent in the neurocritical care settings.

This study is aimed to review the documents and clarify the relation between music therapy and surgical procedures.

Surgical procedures are often accompanied by psychological feelings such as fear and anxiety, which can affect the anesthesia process and lead to increased sedation and undesirable physiological and metabolic changes. These changes can cause deleterious effects when exaggerated.

According to neuroscience-based evidences, music can activate limbic and paralimbic brain structures, which play a role in changing the emotional state. In conclusion, music could help to alleviate unwanted feelings and control surgical stress.

A novel beta-coronavirus was reported in Wuhan, Hubei Province, China, which in December 2019, named SARS-CoV-2.  It causes Coronavirus Disease 2019 (COVID-19) that can affect lung tissue and airways. The immune system can respond to SARS-CoV-2 infection via various mechanisms. Cytokines play crucial roles in COVID-19. In the present study, the latest information on the immune responses, transmission, symptoms, diagnosis, and treatment of COVID-19 is reviewed.

Covid-19 has officially declared a pandemic by the World Health Organization.  Various societies around the world have given their recommendation for the safe conduct of anesthesia and surgery during the pandemic, but little has been discussed regarding the various positions of surgery and their implications. We report our experience of managing a COVID suspect patient in an emergency operation theater in a prone position.

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is declared a pandemic disease by the World Health Organization. Although the respiratory and cardiovascular systems are preferentially affected by SARS-CoV-2, many patients have been presented with neurologic symptoms. In this report, we describe COVID-19 patients with neurological manifestations.

Case Presentation: We present 14 patients referred to Semnan Kowsar Hospital. The mean age at presentation was 54.25 ± 20.01 years with a range of 24-84 yr. At admission, they had mild symptoms of respiratory involvement. In contrast, they had a wide range of neurological conditions like impaired consciousness, seizure, stroke, ataxia, and muscle numbness. After hospitalization, they developed overt respiratory symptoms. They were positive for COVID-19 confirmed by real-time PCR. All cases received standard care of COVID-19.

Conclusions: During the SARS-CoV-2 pandemic disease, patients with neurological manifestations might be affected by coronavirus. Such patients should be thoroughly evaluated and followed-up.

The confirmed cases of COVID-19 is showing exponential increase every day. Healthcare workers throughout the work are giving their best to contain the spread of disease. COVID-19 has not only affected common people, but healthcare workers are also getting infected despite following full precaution. In this article we suggest that brief ultraviolet C irradiation before doffing may help to decrease the incidence of infection among healthcare workers due to error in doffing process.

SARS-CoV-2 that causes Coronavirus disease 2019 (COVID-19) is a spreading global threat. COVID-19 declared as a pandemic by the WHO. COVID-19 is transmitted by direct contact or droplets and can infect the respiratory tract which resulting in acute respiratory distress syndrome (ARDS) and pneumonia in most of cases. IL-4 as a Th2 cytokines has different roles in coronaviruses infections. In this article we focused on function of IL-4 in COVID-19.

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