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ABSTRACT Introduction & Objective : Elimination of local anesthetic from subarachnoid space is probably depends on rate of local diffusional surface of anesthetic and its vascular absorption. This study was designed to evaluate the relationship between the spread of hyperbaric spinal anesthesia and duration of spinal block. Materials & Methods: To determine the effects of hyperbaric local anesthetic extension on duration of spinal block we studied 40 ASA Class I, II patients whom were candidate for elective surgery (Inguinal hernia) . We randomly divided them into 2 equal groups . After performing spinal block with 2cc hyperbaric lidocaine 5% the first group was left in horizontal position and the second group in 30 torso elevated position. The patients was monitored for pulse oximetry, ECG and noninvasive BP. BP and HR were checked 5 minutes for 30 minutes and then every 15 minute until the end of study. Results: The decrease in MAP was significantly more obvious in horizontal group than 30 toros elevated group. Duration of block existing is less in horizontal group than 30 toros elevated group. Conclusion: Placing patients in 30 elevation of torso, after spinal injection, prolonged the duration of spinal block and lessen the hemodynamic changes of spinal anesthesia

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ABSTRACT: Introduction & Objective: Epidural anesthesia is an appropriate approach for surgical operations on lower limbs, abdomen region and painless delivery. Since the application of epidoural anesthesia is time-consuming and the onset of the effects of injected anesthetic drugs in epidoral space is slow (about 20 minutes), therefore, the time of occupying the operating room is prolonged and this results in wasting of time of the surgeon and staff in the operating room. This study was conducted to assess the effect of bupivacaine while used with ketamine on shortening the onset time. Materials & Methods: This double blind study was done on 40 patients. All the patients were physically ASA I, II and they underwent orthopedic and urologic surgical operations. The patients were randomly divided into two groups of 20 individuals, receiving the drugs as follows: study group: bupivacaine 0.5% - 20 ml + ketamine 25mg (0.5ml) + adrnaline 1/200000, control group: bupivacaine 0.5%, 20ml + ketamine 25mg(0.5ml) + saline 0.9%, 0.5ml + adrenaline 1/200000. After injecting the drug in epidoral space in L3-L4 or L4-L5 regions, blood pressure, heartbeat, onset of anesthesia and the level of anesthesia were evaluated in all patients. Results: Patients in both groups were compared with regard to their height, weight, sex, age and systolic blood pressure before the injection of the drugs and no significant difference was noted among them. The systolic blood pressure and heartbeat of patients in both groups were checked in 2nd, 5th , 10th, 15th, 20th, 25th and 30th minutes after drug injection and no significant differences were found in both groups compared to pre-anesthesia status. However, the onset and level of anesthesia was statistically significant in the two groups. The onset of anesthesia in study group was 3.5 to 4 minutes faster and the anesthesia level was two segments higher than that of the control group. Conclusion: Results of this study demonstrated that the addition of 25mg of ketamine to bupivacaine resulted in the acceleration of the onset as well the increase the level of anesthesia in extradural bupivacaine-induced anesthesia and this might be a useful approach in emergency surgical procedures.

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Introduction & Objective: Diabetes mellitus is the most common endocrine disorder of childhood which is caused by relative or absolute deficiency of insulin. Diabetes can cause alteration in some elements of the body such as magnesium. This study was conducted for further evaluation of this matter and also to find out any relationship between level of serum magnesium and duration of diabetes. Materials & Methods: In this study blood sample (2 ml) was taken from 27 diabetic and 27 healthy children. Blood samples were freezed till the end of sample collecting when they were checked for the level of magnesium. Results: Results of this study show that the level of magnesium in serum of diabetic children is lower than that in the healthy ones, but this difference is not statistically significant. In addition, no correlation was found between the duration of diabetes and the level of serum magnesium. Conclusion. Further study is needed to evaluate this matter in details by measuring the intracellular magnesium for example in blood cells by more sophisticated experiments.

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Background & aim: Chédiak–Higashi syndrome, a rare autosomal recessive disorder characterized by immune deficiency, bleeding diathesis, recurrent bacterial infections, albinism dynamic and progressive neurological disorder, as well as major organs such as the liver and spleen lymphocytic infiltration is determined. The aim of this study was to report a case of a rare manifestation of the disease.

Case Report: The case-study in the present report was a 4-month-old female that two months after vaccination had intermittent fever associated with fever, weakness, which lasted more than a week. After blood tests, ultrasound and examination of blood cells, Chédiak–Higashi syndrome diagnosis was made. In terms of blood cells, pancytopenia, platelets and fresh frozen plasma were administered to the patient to prevent bleeding. After Buttock infections, the patient was suffering from septicemia and septic shock followed by a lack of response to resuscitation and cardiopulmonary arrest and then died.

Conclusion: In this patient all Chediak Higashi syndrome, including long fever, loss of appetite, frequent infections, albinism variable and multiple neurological deficit was seen. Chdyak Higashi syndrome is treatable with early diagnosis and bone marrow transplantation.