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Introduction: The persistence of post-detoxification problems in drug addiction is one of the disadvantages of the ultra-rapid opioid detoxification (UROD) method. Transcranial direct current stimulation (tDCS) has been introduced in experimental addiction treatment for some years. Results of pilot studies suggest that it might be a promising method for addiction treatment. This study explores the adjunctive application of tDCS during treating opiate addiction with the UROD approach. Methods: This double-blind, sham-controlled clinical trial was carried out on patients with substance abuse admitted to the Bahman Clinic of Yazd City in Iran (from March to September 2014). Forty participants were randomly allocated to treatment and control groups. Two sessions of tDCS (real or sham) over dorsolateral prefrontal cortices (DLPFC) were applied, accompanied by UROD. Withdrawal symptoms and craving were assessed by the drug desire questionnaire and objective opiate withdrawal scale before UROD and for the 24-hour interval after. Results: Transcranial direct current stimulation optimized the opiate addiction treatment through craving and withdrawal syndrome alleviation. Conclusion: The study results indicate that prefrontal tDCS may promote the efficacy of the UROD method in opioid addiction. [ABSTRACT FROM AUTHOR]

In the present study, in order to calculate the movement of sand dunes in the period between 2001 and 2010, the ASTER (Advanced Space-borne Thermal Emission and Reflection Radiometer) images were used. The training samples were obtained from the field, and the images of the years 2001 and 2010 were classified using maximum likelihood algorithm and decision making tree. The study area was classified into four classes, including vegetated areas, urban areas, sand dunes, and bare lands. Accuracy of the created land cover maps was assessed using five hundred ground control points, Google Earth, and Landsat 7 satellite images. Based on the results, the overall accuracy and kappa coefficient for the maps of 2001 and 2010 were estimated 96%, 0.94 and 98%, 0.98, respectively. In the next step, the resulted land cover maps were used as input for Land Change Modeler (LCM) and Markov calculation. Statistical outputs and change map of this model show the extensive changes in the dunes during the study period. In addition, the area of sand dunes increased from 12,103 to 14,355 hectares. However, 6 hectares of vegetated areas around the Ashkezar and Zarch cities in the North West of Yazd changed to sand dunes. The highest probability of change in the dunes is the change of dunes to bare lands and the lowest probability is the change of dunes to vegetation lands. These results show the movement and change of the dunes in this arid zone. [ABSTRACT FROM AUTHOR]

Purpose: Atrial fibrillation (AF) is the most common type of arrhythmia following elective off-pump coronary bypass graft (CABG) surgery, occurring on the 2nd or 3rd postoperative day. Postoperative atrial fibrillation and early complications may be the cause of long term morbidity and mortality after hospital discharge. High sensitive C-reactive protein (hsCRP) seems to be most significantly associated with cardiovascular disorders. This study was designed to evaluate whether preoperative hsCRP (=3 mg/dl) can predict post-elective off-pump CABG, AF, and early complications in patients with severe left ventricle dysfunction (Ejection Fraction (EF)<30%). Methods: This study was conducted on 104 patients with severe left ventriclar dysfunction (EF < 30%), undergoing elective off-pump CABG surgery during April to September 2011 at the Afshar Cardiovascular Center in Yazd, Iran. Patients undergoing emergency surgery and those with unstable angina, creatinine higher than 2.0 mg/dl, malignancy, or immunosuppressive disease were excluded from the study. The subjects were divided into two groups: Group I with preoperative increased hsCRP (>3 mg/dl) (n=51) and group N with preoperative normal hsCRP (<3 mg/dl) (n=53). We evaluated post-CABG variables including incidence, duration, and frequency of AF, early morbidity (bleeding, infection, vomiting, renal and respiratory dysfunctions), ICU or hospital stay and early mortality. Data were then analyzed by Analysis of Variance (ANOVA), Chi-square and Fisher exact test for quantitative and qualitative variables. Results: The average age of the patients was 62.5 years, 75 cases (72.1%) were male, and 39 (37.5%) were female. Postoperative AF occurred in 19 cases (18.2%); 17 cases (33.3%) had hsCRP=3 mg/dl and 2 cases (3.8%) had hsCRP=3 mg/dl (P=0.03). Postoperative midsternotomy infection, respiratory dysfunction, and hospital stay were significantly higher in group I compared with group N (P<0.05). No statistical significant differences were identified between the two groups concerning other postoperative complications (bleeding, vomiting, renal dysfunction and ICU stay) (P>0.05). Conclusion: Preoperative hsCRP =3 mg/dl can predict incidence of postoperative atrial fibrillation and early complications such as midsternotomy infection, respiratory dysfunction, and hospital stay following elective off-pump CABG. [ABSTRACT FROM AUTHOR]

Background: One of the most important components of coronary artery bypass graft surgery is need for blood transfusion that increases morbidity and mortality. The aim of this study was to evaluate the factors affecting the need for blood transfusion during off pump coronary artery bypass (OPCAB) surgery. Methods: In this descriptive case control study 923 patients who had undergone OPCAB at Afshar Hospital in Yazd, Iran, from July 2008 to January 2010 were evaluated. The data was gathered from their records and was analyzed. Results: 54% of male and 79% of female patient need blood transfusion. Mean age in patients needed transfusion was 61.58±11.11 years and in other group was 60.27±10.98 years of the patients that needed transfusion (p= 0.08). 563 (61%) of the patients needed transfusion with the average of two units. The need for blood transfusion was higher in female gender (p< 0.0001), low hematocrit (p< 0.0001), diabetes (p< 0.001), hypertension (p< 0.025) and multiple grafts (p< 0.027). There were no significant differences in preoperative hemostasis tests, affection to hyperlipidemia, CVA or renal failure, antiplatelet drug administration and the application of left internal mammary artery between the transfusion and non transfusion groups. Conclusion: In this study preoperative hematocrit was most important risk factor in transfusion in patients that underwent OPCAB. Female gender, preoperative low hematocrit, multiple grafts, diabetes and hypertension increased the rate of blood transfusion. According to the high prevalence of blood transfusion in OPCAB, considering factors that affect the transfusion rate is essential. [ABSTRACT FROM AUTHOR]