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   Table of Contents - Current issue
Coverpage
January-March 2020
Volume 5 | Issue 1
Page Nos. 1-26

Online since Thursday, March 19, 2020

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RESEARCH ARTICLES  

Relationship of body mass index, abdominal obesity, and metabolic parameters with depression among reproductive-age women p. 1
Gulsah Kaner, Ezgi Bellikci-Koyu, Nilgun Seremet-Kurklu, Kubra Tel-Adiguzel
DOI:10.4103/2542-3932.280611  
Background and objective: Obesity has been widely regarded as a public health concern because of its adverse impact on health. The aim of this study is to examine the relationship of body mass index, abdominal obesity, and metabolic parameters with depression among reproductive-age women. Subjects and methods: Two hundred and seventy-one women who admitted to the Endocrine and Diet Polyclinic of İzmir Bozyaka Training and Research Hospital, Turkey were included. Sociodemographic characteristics were gathered using a data collection form. Biochemical findings were examined in fasting blood samples and anthropometric measurements were taken. Depressive symptoms of participants were measured with Beck Depression Inventory. This study was performed with the permission from Chief Physician of Izmir Bozyaka Training and Research Hospital (No. 4.35.94.02-003) and approval from the Senate Ethics Committee of Hacettepe University Faculty of Medicine (Decision No. 431-1305). Results: Mean score of participants for Beck Depression Inventory was 17.8 ± 11.8. Body weight, body mass index and waist circumference were higher in the group with high level of depressive symptoms than in the group with low level of depressive symptoms (P < 0.05). Fasting blood glucose, fasting insulin, Homeostasis Model Assessment-Insulin Resistance value, triglyceride and low-density lipoprotein cholesterol were also higher in the group with high level of depressive symptoms than in the group with low level of depressive symptoms; but only HOMA-IR and triglyceride differences were statistically significant (P < 0.05). Being overweight or obese was associated with increased risk of high level of depressive symptoms (OR = 4.853, 95% CI: 2.646–8.903). Although the ratio of having high level of depressive symptoms was higher in women with abdominal obesity (50.3%) compared to women without abdominal obesity (39.5%), the difference was not statistically significant (P = 0.078). Conclusion: In this study, it was determined that the level of depressive symptoms was higher in overweight or obese women than women with normal body weight. It may be useful to monitor women who apply for weight control in terms of risk of depression.
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Effects of aerobic exercise on cognitive function in patients with bipolar disorder: a parallel randomized controlled clinical trial p. 6
Kangguang Lin
DOI:10.4103/2542-3932.280612  
Background and objectives: Exercise can be used to treat mild to moderate depression. Although previous studies have shown that aerobic exercise may have a therapeutic effect on patients with bipolar disorder, no studies have reported on the effect of aerobic exercise on cognitive function in this patient group. This clinical trial will explore the effects of aerobic exercise on cognitive function in patients with bipolar disorder. Participants and methods: This parallel randomized controlled clinical trial will be conducted at The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), China. A total of 210 bipolar disorder patients will be recruited and randomly assigned to an aerobic exercise group or a control group (n = 105). In the aerobic exercise group, the patients will perform 30 minutes of bicycling, 4 days per week, for 30 consecutive days. The exercise intensity will be 50–70% of the maximum heart rate (220–age). In the control group, the patients will perform recreational activities with a normal intensity, such as making handicrafts, reading, singing, and walking, for 30 minutes, 4 days per week, for 30 consecutive days. This trial was designed in June 2017 and was approved by the Ethics Committee of the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), China on July 24, 2017 (approval No. 2017026). Patient recruitment began on December 1, 2017 and will be finished in November 2020. This trial will be complete in December 2020. Protocol version (1.0). Outcome measures: The primary outcome measure will be the improvement in the MATRICS Consensus Cognitive Battery (MCCB) score 12 months after the exercise intervention. The secondary outcome measures will be the MCCB score at baseline and at a 3-month follow-up assessment, the recurrence rate at 12 months, depressive and manic symptoms at baseline, 4-week, 4-month, and 12-month follow-up assessments, and the incidence of adverse events within 12 months of the follow-up assessment. Discussion: This clinical trial will provide evidence regarding the effect of aerobic exercise on cognitive impairment in patients with bipolar disorder. Trial registration: This trial had been registered in the ClinicalTrials.gov (identifier: NCT03353337) on November 27, 2017.
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Effects of dexmedetomidine on perioperative brain protection in patients undergoing craniocerebral surgery under inhalation anesthesia with sevoflurane: a randomized controlled study p. 12
Yong-Pan Liu, Xiao-Fang Gong
DOI:10.4103/2542-3932.280613  
Background and objective: The inhalational anesthetic sevoflurane is often used in craniocerebral surgery for its advantages of quick onset, stable circulation, high safety, and few adverse reactions. However, it can also lead to abnormal blood pressure and heart rate, as well as restlessness and pain. Therefore, an auxiliary anesthetic is needed to help reduce adverse reactions. Dexmedetomidine is a potent and highly selective α2 adrenergic receptor agonist that has anti-anxiety, hypnotic, analgesic, sedative, and sympatholytic properties. Dexmedetomidine has been shown to reduce restlessness after sevoflurane inhalation anesthesia and minimize perioperative hemodynamic fluctuation. However, its application in craniocerebral surgery should be validated. The purpose of this study was to investigate the efficacy of dexmedetomidine in craniocerebral surgery under sevoflurane inhalation anesthesia. Subjects and methods: The prospective, single-center, randomized, controlled study will be performed in Taihe Hospital (Shiyan, China). The 1308 patients to be included in this study will be randomly divided into a trial group and control group (n = 654 patients per group) based on a table of random permutations. In both groups, sevoflurane will be used for induction of anesthesia for craniocerebral surgery. In the trial group, 1 μg/kg dexmedetomidine will be injected intravenously for 10 minutes commencing 15 minutes before anesthesia induction, and then continuously pumped at 0.3 μg/kg per hour until 30 minutes before surgery. In the control group, 0.9% sodium chloride injection will be administered in the same way and at the same injection rate. This trial was approved by the Ethics Review Committee of Taihe Hospital on December 8, 2015 (approval No. 2015GJJ-087). Protocol version: 1.0. Participants will not be blind to the study protocol or procedure, and will provide signed informed consent. Results: The primary outcome of this study is recovery time. Secondary outcomes of this study include anesthesia, recovery, and adverse events, as well as vital signs, stress index, and cerebral metabolic rate of oxygen consumption at different time points (before and after administration of the loading dose of dexmedetomidine, during anesthesia induction, at the beginning of craniocerebral surgery, during craniocerebral surgery, at the end of craniocerebral surgery, and at the time of recovery). A pilot study involving 190 patients who underwent craniocerebral surgery was performed between March 2016 and February 2017. These 190 patients randomly received either sevoflurane anesthesia (n = 95, control group) or dexmedetomidine and sevoflurane anesthesia (n = 95, trial group). Results of the pilot group showed that anesthesia time, intraoperative bleeding volume, intraoperative infusion volume, recovery time, and extubation time were similar between trial and control groups (P > 0.05). However, compared with the control group, the administered dosages of vasoactive drugs ephedrine and esmolol were significantly lower (P < 0.05) in the trial group. Heart rate and electroencephalography bispectral index after administration of the loading dose of dexmedetomidine, during anesthesia induction, at the beginning of craniocerebral surgery, during craniocerebral surgery, at the end of craniocerebral surgery, and at the time of recovery were significantly higher in the trial group compared with the control group (P < 0.05). At the beginning of craniocerebral surgery, during craniocerebral surgery, at the end of craniocerebral surgery, and at the time of recovery, mean arterial pressure in the trial group was significantly higher compared with the control group (P < 0.05). After administration of the loading dose of dexmedetomidine, during anesthesia induction, at the beginning of craniocerebral surgery, during craniocerebral surgery, at the end of craniocerebral surgery, and at the time of recovery, blood glucose level in the trial group was significantly higher compared with the control group (P < 0.05). After administration of the loading dose of dexmedetomidine, during anesthesia induction, and at the be-ginning of craniocerebral surgery, cortisol concentrations in the trial group were significantly lower compared with the control group (P < 0.05). During craniocerebral surgery, at the end of craniocerebral surgery, and at the time of recovery, jugular bulb venous blood oxygen saturation, difference in oxygen content between arterial and jugular venous blood, and cerebral metabolic rate of oxygen consumption in the trial group were significantly higher compared with the control group (P < 0.05). Conclusion: Findings from this study will help determine whether dexmedetomidine can reduce hemodynamic fluctuation, lower stress index, and protect the brain in patients who undergo craniocerebral surgery under inhalation anesthesia with sevoflurane. The results can provide evidence to support clinical application of dexmedetomidine combined with sevoflurane for craniocerebral surgery. Trial registration: This study was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2000030459).
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INSTRUCTION Top

Information for authors – Asia Pacific Journal of Clinical Trials: Nervous System Diseases p. 21

DOI:10.4103/2542-3932.280995  
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