Tehran University Medical Journal

Investigating factors affecting happiness in postmenopausal women: a systematic review

Samira Ebrahimzadeh Zaghmi

Background: Menopause is one of the most important stages in women's lives. Today, menopause is an important phenomenon due to the increase in life expectancy, the number of postmenopausal women is expected to reach 1.2 billion by 2030. It is important for women to live healthy in these years as in the reproductive years. One of the main psychological needs of humans is happiness. According to studies, happiness decreases during menopause. As a result, considering the importance of the topic, this study was conducted with the aim of determining the factors affecting happiness in menopausal women.
Methods: In order to compile this review article, searching for articles using the keywords happiness, menopause, middle-aged women, alone and in combination with AND and OR operators in databases ,such as PubMed, Scopus, Science direct, ProQuest, SID, Magiran and Google Scholar search engine without time limit. At first, 125 articles were found. The inclusion criteria were all studies that had investigated the factors affecting happiness. The reviewed studies included clinical trials, cohort and cross-sectional, and finally the data of 29 articles were used.

Results: The results of this study led to the classification of factors affecting the happiness of postmenopausal women into five general categories. The first category includes physical factors (including the absence of: vasomotor symptoms, cardiovascular diseases, arthritis, osteoporosis, psychosomatic disorders and having a favorable condition. health). The second category includes psychological factors (including the absence of depression and anxiety, having a positive attitude towards menopause, optimism, self-esteem and resilience). The third category includes social factors such as (social support of family and friends, effective communication with colleagues). The fourth category is economic factors (including job changes, favorable income level and the absence of financial crises). The fifth category includes lifestyle (being non-smoker, having physical activity and regular exercise, marital satisfaction, stress management skills and herbal drugs) of menopausal women.
Conclusion: In order to improve the happiness of menopausal women, all physical, psychological, social, economic and lifestyle factors are important and should be considered in national planning and policies to improve the health of menopausal women.

The effects of preoperative prophylactic administration of enoxaparin on intraoperative and postoperative bleeding in hip fracture surgeries

Mohammad Golparvar

Background: Intraoperative bleeding is an unwanted and common complication in orthopedic surgeries, which can be aggravated by the preventive administration of anticoagulants to prevent deep vein thrombosis. The present study examines the effect of prophylactic enoxaparin to prevent thromboembolism on the amount of bleeding in femoral head surgeries where it is not possible to use a tourniquet.
Methods: A prospective descriptive-analytical study was conducted from July to March 2017 in Kashani Hospital, Isfahan, in 120 patients without a history of coagulation disorders who were candidates for reconstructive surgery for femoral head and neck fractures. Inclusion criteria involved age over 18, BMI less than 30, no history of coagulation disorders, no preoperative use of anticoagulant drugs, normal PT, PTT, and INR before starting enoxaparin. The patients didn’t have any coagulation disorder and all of them were under prophylactic dose of enoxaparin before surgery. The patients were subjected to spinal anesthesia with the same method. Signs related to degree of bleeding recorded during surgery and recovery care. Data were collected and entered into SPSS software version 20, and central tendency and dispersion indices were calculated for quantitative variables. Descriptive tables and charts were utilized for qualitative variables. Correlation coefficient and linear regression analyses were performed for the final interpretation of results.

Results: There was a significant relationship between mean arterial pressure and intraoperative bleeding (p-value=0.001). The dose of enoxaparin prescribed was associated with the volume of fluids received, the amount of bleeding, the amount of tranexamic acid, phenylephrine, labetalol, TNG and fentanyl administered during the operation with a p-value of less than 0.05. Also, there is a significant relationship between the prescribed dose of enoxaparin and the duration of surgery and duration of recovery care (p-value less than 0.05).
Conclusion: The study examines the impact of prophylactic enoxaparin on intraoperative bleeding, finding a significant correlation with dosage and duration. No notable difference in bleeding was observed in patients with a GFR below 30. Enoxaparin administration correlated with increased bleeding, MAP levels, fluid volume, tranexamic acid use, and hypotension medications during surgery.

Investigation the effect of nitric oxide on biofilm-producing uropathogenic Escherichia coli strains isolated from patients

Fateh Rahimi

Background: Biofilm producing uropathogenic Escherichia coli (UPEC) strains are of major concern in clinical settings which display increased resistance to conventional antimicrobial therapy. Nitric oxide (NO) has shown to exhibit anti-biofilm effects in a variety of bacterial species. In this study we aimed to evaluate the effectiveness of NO on the formation and eradication of biofilm of UPEC strains isolated from patients with urinary infection (UI) in Tehran.
Methods: During May 2022 to April 2023, a total of 3814 suspected isolates of UPEC were collected from a pathobiology laboratory in Tehran and confirmed as E. coli strains using specific primers for elongation factor Tu (tufA) gene. All strains were screened for the ability to form biofilm by the microtiter plate (MTP) and Congo red agar (CRA) assays, and also the presence of biofilm genes were detected among biofilm producing strains. Moreover, the effect of NO on biofilm formation and its dispersal was evaluated by the high (30 mM) and low (125 nM) concentrations of sodium nitroprusside (SNP) as NO donor.

Results: All collected isolates were confirmed by the polymerase chain reaction (PCR) using specific primers, in which 1309 strains (34%) were able to form colonies with red, dry and rough (rdar, curli and cellulose positive) (n=682, 52%), brown, dry and rough (bdar, curli positive and cellulose negative) (n=353, 27%) and pink, dry and rough (pdar, cellulose positive and curli negative) (n=274, 21%) morphotypes on CRA and selected as biofilm positive strains. Furthermore, 228 (17%), 402 (31%) and 679 (52%) strains were able to form a weak, moderate, and strong biofilm, respectively, and csgA, csgD, yedQ, and bcsA genes were found among 87, 98, 100 and 79% of biofilm-positive strains, respectively. The 30 mM concentration of SNP significantly decreased the biofilm formation (17-40%) and increased biofilm dispersal (20-45%) among UPEC strains.
Conclusion: These findings confirmed the applicability of nitric oxide as an anti-biofilm agent for UPEC strains. These findings contribute to the development of novel strategies for fighting biofilm-associated infections.

Evaluation of risk factors for cognitive disorders indication in patients undergoing coronary artery bypass graft surgery: a cross-sectional study

Fateme Omidi

Background: Cardiovascular surgery is sometimes associated with brain consequences such as cognitive disorders. Diagnosis of cognitive disorders risk factors in cardiovascular patients is important for increasing patient satisfaction and success after (CABG). In the present study, the frequency of cognitive disorders in cardiovascular patients and its effective factors were investigated.

Methods: In the current cross-sectional study that was conducted from September 2019 to the February 2022, 60 cardiovascular patients undergoing CABG surgery were selected by convenience sampling method. Demographic, clinical, and intraoperative information was recorded for participants in the data collection form. Mini–Mental State Examination quesionary.
Results: The results showed that 15% of participants had cognitive impairment. Gender and age were the actual variables on the incidence of cognitive disorders after CABG surgery. The frequency of cognitive disorders in women was 14 times higher than men and 6.5 times higher in the elderly. Elderely population was considered as 65 years old or above. The clinical variables such as blood transfusion under surgery and ejection fraction<40% were effective factor for incidence of cognitive disorders in cardiovascular patients.
Conclusion: The CABG surgery may be associated with cognitive disorders in cardiovascular patients, which is more common in women and the elderly. Further studies are recommended to confirm the results of the present study and identify the related risk factors.

Investigating the relationship between androgenetic alopecia and the thickness of the intima media of the carotid artery

Hamideh Mohammadzadeh

Background: Androgenetic alopecia is the most common cause of hair loss, and its prevalence increases with age. Different studies have reported different results regarding the association of cardiovascular diseases with androgenetic alopecia. The present study aimed to The present study aimed to Investigating the relationship between androgenetic alopecia and the thickness of the intima media of the carotid artery in the referrals to the specialized skin and hair clinic of Allameh Bohlool Gonabadi Hospital.

Methods: This case-control study was conducted from October 2021 to June 2022 on 100 patients referred to the Skin and Hair Clinic of Allameh Bahloul Hospital in two groups of 50 cases and controls, aged less than 40 years. The subjects were matched in terms of age and gender. Patients with alopecia were classified into three categories: mild, moderate, and severe based on the diagnosis of the treating physician. The thickness of the intima-media layer of the carotid artery was measured using ultrasound.
Results: There were 37 males and 13 females in both the case and control groups. The mean age in the case group was 29.50 and 30.28 years, respectively. In addition, the duration of alopecia in the case group was 6.9 years. Although the results indicated that the carotid artery intima-media thickness was higher in patients with androgenetic alopecia, no statistically significant relationship was found between androgenetic alopecia and carotid artery intima-media thickness (P=0.66). There was also a statistical relationship between the carotid artery intima-media thickness and the duration of alopecia (P=0.03).
Conclusion: Considering the relationship between the thickness of the intima media of the carotid artery and the duration of alopecia, it can be said that there is a possible relationship between alopecia and atherosclerosis, but to prove it, studies with a larger sample size are needed.

The effect of eight weeks of physical activity with vitamin D supplementation on endothelial indices in hypertensive patients

Mozaffar Jan Faza

Background: The aim of our study was to evaluate the effect of 8 weeks of aerobic exercise with vitamin D supplementation on indulin-1 and nitric oxide in patients with hypertension aged 30 to 50 years.
Methods: This study was conducted as a semi-experimental pre-test and post-test design, and was conducted from June 1401 at Seyyed Shohada Hospital in Urmia. 40 eligible men and women were randomly divided into four groups (supplement group, placebo + exercise group, a supplement + exercise group, and a control group). The training program of the experimental groups included eight weeks of aerobic exercise running on a treadmill (3 sessions/8 weeks). Blood sampling to evaluate biochemical variables was performed 48 hours before and after the intervention in a fasting state with a volume of 10 cc.

Results: The results of the study show that after 8 weeks of aerobic exercise, vitamin D, BMI, NO, ET-1 and weight were significantly affected (P < 0.05) and systolic blood pressure in the supplement, supplement + exercise and exercise + placebo groups changed compared to the control group(P < 0.05).
Conclusion: Based on the results of the present study, the results showed that taking eight weeks of vitamin D supplements along with aerobic activity reduced blood pressure indices in the subjects. Also, taking vitamin D supplements along with physical activity reduced BMI and increased NO, reduced ET-1 and body weight in the subjects in the study.

Defecation habits in children with rectal prolapse: a retrospective analysis

Khashayar Atqiaee

Background: Rectal prolapse, characterized by the extrusion of the rectal mucosa through the anal sphincter, is a relatively rare condition in children. This condition can be attributed to several anatomical and functional factors. This study aimed to investigate defecation habits in children with rectal prolapse.
Methods: This retrospective study was conducted from 2017 to 2021 in Akbar and Sheikh children's hospitals. The study population included 50 children under the age of 14 who were diagnosed with rectal prolapse and visited the hospitals. Data were collected using pre-prepared checklists and analyzed using SPSS version 24. Inclusion criteria were children under 14 years diagnosed with rectal prolapse, while exclusion criteria included incomplete data or other severe unrelated health conditions.

Results: The results showed that 67.4% of the sample were boys, and the most affected age group was children under 2 years (38.8%). A total of 57.1% of the children had daily bowel movements, and 68.2% reported consistently hard stools. Additionally, 48% of the children experienced pain or burning during defecation.
Conclusion: The findings of this study indicate that children with rectal prolapse often face challenges related to stool consistency and defecation pain, despite having frequent bowel movements. These results emphasize the need for targeted interventions to improve stool consistency and manage pain to effectively prevent and treat rectal prolapse.

Investigation of the causes of legal abortion in women referring to Amir al-Momenin Ali (AS) Hospital Zabol

Leili Rezaei Kahkhaei

Background: Abortion is the termination of pregnancy before the 20th week of pregnancy, which may be spontaneous or induced. In general, therapeutic abortion is defined as the termination of pregnancy before the 20th week of pregnancy in order to save the mother's life and prevent birth defects. The purpose of this study is to investigate the causes of legal abortion in women referring to Amir al-Mominin Ali hospital in Zabol city.
Methods: This study is a descriptive-cross-sectional study. The studied population included women who had a legal abortion on March 1, 2022 to September 1, 2022 at Amir al-Mominin Ali Zabol Hospital (Zabol-Iran). The tool used was a checklist made by the researcher and approved by the faculty members of Zabol University of Medical Sciences. The researchers collected the necessary information, including demographic information, obstetrics and mother's illness, fetal disorders, test results, ultrasound screenings, pathology results of patients and other conditions that led to the issuance of an abortion license.

Results: In the specified period of time, there were 100 abortion cases that were investigated, and 78 (78%) of these abortions had maternal causes and 22% had fetal causes. The most common maternal causes of abortion were cardiovascular problems (7%) and mothers' age. Also, the most fetal causes were cerebrospinal causes (23%). Mothers who had abortions of maternal origin were significantly older than mothers with abortions of fetal origin (p=0.009).
Conclusion: The present study showed that in Sistan region, most cases of legal abortion depended on fetal reasons and mothers' age.

Comparison of the danger zone thickness in the mesial canals of the mandibular first molar in CBCT images at intervals of 3, 4, 5 mm below the orifice of the canal

Marjan Kazeminia

Background: The mandibular first molar teeth are the most common teeth that undergo endodontic treatment and are anatomically very challenging. Adequate knowledge of the danger zone in the mesial root of the first mandibular molars helps reduce the risk of misdiagnosis of perforation during treatment. The aim of this study was to compare the dentin thickness of the danger zone in the mesial canals of the mandibular first molar in CBCT(Cone Beam Coomputed Tomography) images at intervals of 3, 4, 5 mm below the orifice canal.
Methods: In this study, CBCT images of 144 mandibular first molars from 74 patients aged 18 to 66 years were examined. Mean orifice to Furcation was calculated and mean distal dentin thickness of mesiobuccal and mesiolingual canals was measured at 3, 4 and 5 mm below the orifice. The mean thickness of the distal dentin was examined in terms of age, sex and maxillary side.
Results: The lowest mean distal wall thickness of mesiobuccal and mesiolingual canals was 5 mm below the orifice of the canal. The mean distal wall thickness of mesiobuccal and mesiolingual canals were higher in men than women (P <0.05). The mean distal wall thickness did not show a significant relationship with age. (P=0.745) except in the area of 3 and 5 mm below the orifice in the mesiobuccal canal which was significantly associated with age (P=0.01). No statistically significant difference was observed between the two mandibular sides (P=0.543) except in the 4 mm area below the orifice in the mesiolingual canal (P <0.05).

Conclusion: The present study showed that the danger zone is observed in the distal dentin of the mesiobuccal and mesiolingual canals of the mandibular first molar teeth in men and women 5 mm below the orifice of the canal. The mean dentin thickness of the distal wall was lower in women than in men.

بهینه‌سازی بازتوانی برای بازسازی رباط صلیبی قدامی: نامه‌ای به سردبیر

AmirAli Jafarnezhadgero