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Volume 60, Issue 6 (15 2002)
Introduction: In this study, we reviewuated and compared three routine methods for the measurement of urinary protein concentrations with a view to find a suitable method to prevent, diagnose and monitor renal disease under circumstances with limited resources.
Materials and Methods: Two modifications of the Trichoroacetic acid (TCA) turbidimetric method read at 405 and 620 nm and the sulfosalicylic acid (SSA) turbidimetric method were considered. The reviewuated was carried out using a variety of control materials, calibrators and patients urine samples.
Results: The result indicated that the TCA method read at 405nm is appropriate for the measurement of protein in the range of 25-700 mg/L and the TCA "620nm method" is appropriate for the measurement of protein concentration in the range of 100-1000 mg/L. Of the two methods, the TCA at 405 nm was minimally influenced by the type of calibrator. The SSA method showed unacceptable performance in the measurement of protein, specially at lower concentration, in addition the results showed a large variation depending on the type of calibration.
Conclusion: For screening of high-risk populations e.g. diabetics and early diagnosis of microproteinuria the recommended method is the TCA at 405 nm calibrated with a serum-based mixed Albumin/Globulin standard. For routine testing the TCA method at 620 is suggested regardless of type of calibration, although the limitations at lower concentrations should be remembered.
Volume 62, Issue 1 (12 2004)
Background: There has been a little attention to pediatrics esophagus problems until recent years. The term esoghagitis can be used to described chemical, infectious, inflammatory, ischemic, immunologic and degenerative abnormalities. Prevalence of reflux esophagitis varies between 2 to 5 percent of general population but little data about its incidence in pediatric age groups. The aim of this study was to evaluate the epidemiology and prevalence of esophagitis and study of symptom, diagnostic measures, therapeutic intervention and prevention of its complication.
Materials and Methods: In this prospective and cross sectional study 500 patient under16 years with upper digestive complaints or alteration of their state of health under went upper endoscopy, with special attention paid to esophagus.
Results: Among 500 children (205 male, 207 female), pathology reported esophagi is in 325 cases. Majority of the patient were 8 to12 years. Most common complaints was abdominal pain (45/7%) and the second complaints was vomiting (13%), but most common complaints in severe esophagitis was melena (66%) and hematemes(18/8%). Most of patient (63% ) had a mild grade of esophagitis. When difference between endoscopy and pathology compared: Mild esophagitis in endoscopy (67%) ,but in pathology was (63%), moderate esophagitis (14/7%) in endoscopy was (17%) in pathology and severe form 2/8% in endoscopy but (4/9%)in pathology.
Conclusion: According to results of our study in children age group with chronic abdominal pain ,vomiting ,excessive regurgitation, failure to thrive, we noticed that esophagitis is common etiologic factor. Histological esophagitis frequently occur in the absence of gross endoscopic findings and we need biopsy and histological examination to confirm diagnosis.
Volume 64, Issue 3 (1 2006)
Background: Post-transplant erythrocytosis (PTE) is characterized by persistent hematocrit level above 51% that develops in 10-20% of kidney recipients, mostly 2 years after kidney transplantation. PTE is self limited in 25% of the patients but can be persistent in other patients with an increased susceptibility for thrombosis. The purpose of this study was to identify the risk factors for development of PTE in our center
Methods: We selected 45 patients who were transplanted at least 3 months before selection (minimum time required for detection of PTE) and were referred to the kidney transplantation clinic during 5 years (1998-2003) as the case group. At the same time, we considered 2 patients without erythrocytosis as control for each patient in the case group among kidney transplant recipients who were referred to the same clinic during 5 years (1998-2003). In total we had selected 135 patients, 45 patients with erythrocytosis as the case group and 90 patients without erythrocytosis as the control group. Patients who were affected by high hematocrit before transplantation (HC>51%),overt pulmonary disorder, and polycytemia Vera were excluded from this study. We collected basic information by using old charts and complementary information was added through phone conversations and physical examination in the clinic. All the information was entered in the digital questionnaire and was analyzed by the SPSS statistical package.
Results: There was no significant difference between the case and control group for age, history of hypertension, diabetes, pretransplant hematocrit, pretransplant transfusions, function of graft and source of kidney. A significantly higher proportion of PTE patients were male, also the case group had a significantly higher frequency for personal history of polycystic kidney disease , glomerulonephritis and higher frequency of azathioparine, prednisolone and cyclosporine regimen.
Conclusion: PTE is an important complication of kidney transplantation that can be fatal. There are multiple risk factors that should be addressed to prevent this complication.
Volume 64, Issue 3 (1 2006)
Background: There are several million new cases of peptic disease annually. The disease has a various range of presentations. Gram negative helicobacter pylori bacilli is considered as an etiologic factor in this disease. Goal of treatment in peptic disease is eradication of the helicobacter pylori (HP). Combination therapy has been implemented in the treatment of this disease. Different modalities have been recommended up to now. In order to lower adverse effects, cost and drug resistance, researchers have introduced a new combination therapy in which honey is substituted for metronidazole.
Methods: A step II of clinical trial was designed. The sample size was 15 children. Diagnosis of HP infection was confirmed with histopathology. Treatment regimen consisted of omeprazole, amoxicillin, bismuth and honey. After a 3-4 week follow- up, eradication was evaluated.
Results: 15 children completed the follow- up period. Mean age of patients was 9.4 years. Treatment effectiveness was 80 percent.
Conclusion: Combination therapy with 3 drugs along with honey has significant effectiveness on HP eradication.
Volume 64, Issue 8 (13 2006)
Background: Autosomal-dominant polycystic kidney disease (ADPKD), a common hereditary disease, is characterized by the progressive development and enlargement of multiple cysts in both kidneys, and typically resulting in end stage renal disease (ESRD) by the fifth decade of life. Post-transplant diabetes mellitus (PTDM), a common complication after transplantation with an incidence rate of 2.5-20%, is associated with poor graft and patient survival. In few studies, PTDM has been more frequent in ADPKD transplanted patients. In the present study, we investigated whether there is any association between PTDM and ADPKD in our patients.
Methods: In this prospective study, 140 non-diabetic and nonsmoker successfully transplanted patients (27 ADPKD and 113 non ADPKD patients) were enrolled during three years. Both groups were matched for age, sex, body mass index (BMI), duration of renal replacement therapy before transplantation and also immunosuppressive protocols after transplant. Post-transplant diabetes mellitus was defined as Clinical Practice Guidelines advocated by Canadian Diabetes Association. All patients were followed for 12 months.
Results: PTDM occurred in 11.1% of ADPKD patients and in 13.1% of control group which was statistically insignificant (P > 0.05). The development of PTDM in ADPKD group was not related to sex, age, and hypertension, duration of renal replacement therapy before transplantation, BMI and serum creatinine levels (P > 0.05).
Conclusion: Post-transplant diabetes mellitus appears not to be associated with autosomal-dominant polycystic kidney disease as an etiology of end stage renal disease.
Volume 65, Issue 2 (8 2008)
Background: The aim of this study was to review the frequency, histopathology and outcome in children with tumors of the liver.
Methods: Included in this retrospective/descriptive study were 30 children treated for liver tumors from 1375-1384 (ca. 1996-2005), at Children’s Hospital Medical Center, Tehran, Iran. We included the clinical, radiologic, and pathologic data of our patients, focusing on the frequency, etiology and outcome.
Results: Patient ages ranged from three months to 12 years (median 3.8 years), with 18 males (60%) and 12 females (40%). Of these, 17 patients had hepatoblastoma (55.66%), including 13 males and four females, with an age range of six months to five years. Four cases (13.33%) had neuroblastoma. Hepatocellular carcinoma (HCC) was found in three cases (10%), all of whom were carriers of hepatitis B. Two cases (6.66%) were diagnosed with mesenchymal hamartoma, two cases (6.66%) with hemangioendothelioma and two cases (6.66%) with rhabdomyosarcoma and leiomyosarcoma of the biliary tract. Abdominal swelling and hepatomegaly were seen in all of patients. Jaundice was observed in two cases. Serum alpha-fetoprotein levels greater than 500 ng/ml were seen in 17 cases (56.66%). All patients were receiving specific treatment. The three-year survival rate was 65% for hepatoblastoma and 2% for HCC
Conclusion: With the introduction of specific treatment, the survival rate for children with tumors of the liver has significantly increased. Further improvement can be achieved using diagnostic biopsy for hepatoblastoma, although it may result in complications, and preoperative chemotherapy followed by complete surgical excision (per International Society of Pediatric Oncology guidelines), yielding an outstanding survival rate of 80%.
Volume 65, Issue 6 (3 2007)
Background: Oral clefts are among the most common congenital anomalies. Infants with oral clefts often have other associated congenital defects, especially congenital heart defects. The reported incidences and the types of associated malformations and congenital heart defects vary between different studies. The purpose of this study was to assess the incidence of associated congenital heart defects in children with oral clefts.
Methods: All infants with cleft lip and palate referred to the Children's Medical Center and Bahramy the teaching Hospitals of the Tehran University of Medical Sciences from 1991 to 2005 were prospectively enrolled in this study group. All patients were examined and noted by an academic cleft team contain a pediatrician and a pediatric surgeon, and received cardiac consultation and echocardiography by a pediatric cardiologist. non cardiac associated anomalies, still born and patients without echocardiography were excluded from the study. Data including age, gender, exposure to contagions and high risk elements ,consanguinity and familial history of oral cleft, type of oral cleft, results of cardiac consultation and echocardiography and associated cardiac anomalies were cumulated and analyzed by SSPS version 13.5
Results: Among the 284 infants with oral clefts, 162 were male (57%) and 122 were female (43%). Seventy-nine patients (27.8%) had cleft lip, 84 (29.5%) had cleft palate and 121 (42.6%) had both cleft lip and palate. Of all the patients, 21.1% had congenital heart defects. the most common type Of these congenital heart defects(28.3%) was atrial septal defect.
Conclusions: For patients with cleft lip and palate, we recommend preoperative cardiac consultation, careful examination and routine echocardiography for associated cardiac anomalies, as well as appropriate management and prophylactic antibiotic therapy for those with associated congenital heart anomaly.
Volume 65, Issue 6 (3 2007)
Background: ABO incompatibility hemolytic disease of the newborn is a common cause of clinical jaundice and causes two-thirds of the hemolytic disease in newborns. This study was undertaken to determine the frequency of ABO incompatibility hemolytic disease and its complications in newborns undergoing exchange transfusion.
Methods: This prospective and descriptive study was performed in jaundiced newborn infants during a three-year period. Inclusion criteria were: maternal blood type O, newborn blood type A or B, rising indirect hyperbilirubinemia in the first two days of life, positive immunohematologic test for newborns and exchange transfusion. Exclusion criteria were: incomplete information, other accompanying diseases that induce hyperbilirubinemia. All newborn infants received phototherapy before and after exchange transfusion. We did not use intravenous immunoglobulin, hemoxygenase inhibitor drugs and blood products before exchange transfusion.
Results: Double-volume exchange transfusion via umbilical cord catheter was performed in 96 patients, 19 (20%) of whom suffered from ABO incompatibility. Of these 19 newborns, two-thirds (13) were preterm infants. The minimum level of serum bilirubin was 10 mg/dl and the maximum serum bilirubin level was 35 mg/dl. In six patients (32%) serum bilirubin levels were >25mg/dl. The most common blood group was type A for newborns. Immunohematologic tests were positive in 84% of the mothers. ABO incompatibility hemolytic disease was the fourth and second most common reasons for blood exchange transfusion in preterm and term infants, respectively. Laboratory complications were more common than clinical complications. The etiology of 48% of the alloimmunization and 42% of the hemolytic disease in these newborns was ABO incompatibility.
Conclusions: Mothers with blood group O and newborns with blood group A or B with positive immunohematologic tests in first hours of life are at high risk for hemolytic disease. Therefore, in this high-risk group, further therapy including prophylactic phototherapy, intravenous immunoglobulin and intramuscular protoporphyrins are necessary to prevent severe jaundice and decrease the need for exchange transfusion.
Volume 68, Issue 6 (6 2010)
Background: The relationship between Coronary Artery Disease (CAD) and the prevalence of Renal Artery Stenosis (RAS) has been demonstrated. Despite high incidence of heart diseases and high frequency of CAD risk factors among Iranian population, this relation has not been clearly determined. This study estimated the prevalence of RAS and its determinants in Iranian angiographic candidates. We also tried to find which risk factors of atherosclerosis are associated more frequently with renal artery stenosis.
Methods: In a cross-sectional study that was performed at the Tehran Heart Center, in Tehran, Iran, 146 patients who were candidate for angiography with suspected CAD were consecutively included. Selective renal angiography was performed following coronary angiography in all patients with established coronary artery stenosis and the presence and severity of RAS was evaluated.
Results: Prevalence of RAS in study patients was 25.3% (men, 13.7% and women 47.1%, (p<0.001). We found that only 6.2% of the patients had bilateral R.A.S. Also, RAS≥50% was found in 17.1% of patients. Regarding number of defected coronary vessels, two- and three-vessel diseases were found in 30.0% and 39.0% of participants, respectively. No significant relationship was found between the number of involved coronaries and the severity as well as side of RAS (p=0.716) Significant multivariate predictors of RAS were female gender (p=0.001), advanced age, (p=0.046) duration of hypertension (p=0.032) and baseline serum creatinine concentration (p=0.018).
Conclusions: Routine angiographic assessment of renal arteries following coronary angiography is recommended especially in women as well as those with long-term duration of hypertension or renal dysfunction.
Volume 69, Issue 8 (6 2011)
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Background: Neutrophil
Gelatinase Associated Lipocalin (NGAL) is a new biomarker which can predict acute kidney injury (AKI) in critically ill patients.
Usefulness of NGAL in the early diagnosis of all types of AKI is under question. We
hypothesized NGAL is an early predictive biomarker of contrast-induced nephropathy (CIN).
Methods: In this process evaluation study, we enrolled 122 patients (Mean age 59.7±10.8 years) undergoing elective
angiography/angioplasty with contrast media during April to September 2009. Serial urine samples were
analyzed in a double-blind fashion by NGAL enzyme-linked immunosorbent assay. CIN was defined as a 25% increase in baseline serum creatinine.
Results : The prevalence of CIN was 30.3%. Significant elevations in urinary NGAL concentrations were noted within 12-h and 24-h after the procedure in patients with CIN. NGAL concentrations after 12 hours was 90.62±105.63 vs. 27.6±45.8 ng/ml in patients with and without CIN, respectively P=0.0001, and 79.78±117.7 vs. 30.92±52.84 ng/ml, 24 hours afterwards P=0.002. Some patients had AKI after five days of exposure rather than the second day (P=0.0001). We found using a cut-off point
of 8
ng/ml with a sensitivity, specificity, negative predictive value and area under
the ROC curve
94%, 25%, 91% and
0.75 respectively
are good for the prediction of CIN in 12-h urinary NGAL and a cut-off point of 5.5 ng/ml with respective values of 97%,
24%, 95% and 0.70 for 24-h urinary NGAL.
Conclusion: Urine NGAL may represent a sensitive
early biomarker of acute AKI after angiography/angioplasty. We recommend the routine measurement
of NGAL in
high risk patients receiving contrast agents.
Volume 71, Issue 12 (March 2014)
Background: The mortality due to Coronary Artery Bypass Graft (CABG) in patients with chronic renal failure is more common than normal population. This study evalu-ates the impacts of prophylactic dialysis on decreasing mortality and morbidity of non- dialysis-dependent patients with renal failure after CABG surgery. Methods: In this study, fifty non-dialysis-dependent patients who were suffering from renal failure and needed to CABG, were selected by convenience sampling method. Se-quentially, they were allocated to prophylactic dialysis (n=20) and no prophylactic dialysis (n=30) groups, using a randomized block design. Exclusion criteria were under 18 year old patients and doing CABG for second time. Mortality rate and some complications such as acute renal failure, brain accident and atrial arrhythmias were compared between two groups after CABG. All cardiac surgeries were performed in a single centre and through a median sternotomy. P value less than 0.05 was considered as significant. Results: The mean age of patients was (65.3±9.9). The patients included %16 (n.8) of women and %84 (n.42) of men. There were 20 patients in intervention and 30 patients in control groups. Baseline characteristics were similar in two groups. Comparison be-tween intervention and control groups after surgery did not show any difference in mortality (P=0.14), acute renal failure (P=0.4), cerebrovascular accidents (P=1) and atrial arrhythmias (P=0.3), need to second surgery due to bleeding (P=1), need to dialysis (P=0.14), need to rehospitalization (P=1), duration of ventilator use (P=0.4), duration of need to hospitalization (P=0.11), duration of a patients stay in the Intensive Care Unit (P=0.4) and deep sternal infection (P=0.7) rates. Conclusion: According the results of this study, prophylactic dialysis, before conduct-ing CABG, does not have any significant effect on mortality and other complications. The only exception is lung complications in non-dialysis-dependent patients with renal failure.
Volume 75, Issue 1 (April 2017)
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Background: Breast cancer is the most common cancer among females in the world. Identifying the nutrients that modify the risk of the disease is one of the key strategies for improving the quality of life and reducing treatment costs. Epidemiological studies support the role of macronutrients and vitamins involved in one carbon metabolism in the etiology of the disease. This study aimed in investigation of the relationship between the intake of macronutrients and vitamins involved in one carbon metabolism with breast cancer risk. Methods: This case-control hospital base study was conducted at Shohada Hospital, Tehran from April to February 2015. Demographic data, physical activity level and nutrients’ intake from diet and supplements were collected through interview from 151 cases and 154 controls. Dietary intake was assessed by a valid and reliable 168-item semi-quantitative food frequency questionnaire. Then intake of macronutrients and B vitamins was assessed by Nutritionist 4 software (First Databank Inc., CA, USA). Comparing categorical variables between the two groups was done by Chi-squared test and the relationship between intake of studied nutrients and risk of breast cancer was determined using logistic regression test. Results: There were no difference in age, menarche age, menopause age, body mass index (BMI), number of live births between two groups. But the difference in physical activity, energy intake, marital status, educational level, occupation, oral contraceptives use was significant (P< 0.001). After modifying the effects of confounding variables, the risk of breast cancer was significantly lower in the highest intake quartile category relative to the lowest quartile category for total protein, total fiber, intake of vitamins B2, B6, B12 and folate (Ptrend< 0.001). Before modifying the effects of confounding variables, the risk of breast cancer was significantly higher in the highest intake quartile category relative to the lowest quartile category for carbohydrate and fat; but after modifying the effects of confounding variables, results were not significant. |
Conclusion: The results showed that high intake of protein, fiber, vitamins B2, B6, B12 and folate are associated with lower risk of breast cancer.
Volume 75, Issue 1 (April 2017)
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Background: The modern science of nanotechnology is an interdisciplinary science that has contributed to advances in cancer treatment. This study was performed to evaluate the therapeutic effects of biosynthesized silver nanoparticles on breast cancer cell of line MCF-7 in vitro. Methods: This analytical study was performed in Kerman and Bam University of Medical Sciences, Bam City, Kerman Province, Iran from March 2015 to March 2016. Silver nanoparticles suspension was synthesized using palm kernel extract. The resulting silver nanoparticles were studied and characterized. The ultraviolet-visible spectroscopy and transmission electron microscopy used for screening of physicochemical properties. The average particle size of the biosynthesized silver nanoparticles was determined by transmission electron microscopy. The properties of different concentrations of synthesized silver nanoparticles (1 to 3 μg/ml) and palm kernel extract (containing the same concentration of the extract was used for the synthesis of silver nanoparticles) against MCF-7 human breast cancer cells were determined by MTT assay. MTT is used to assess cell viability as a function of redox potential. Actively respiring cells convert the water-soluble MTT to an insoluble purple formazan. Results: The ultraviolet-visible spectroscopy showed strong absorption peak at 429 nm. The X-ray diffraction (XRD) and transmission electron microscopy (TEM) images revealed the formation of silver nanoparticles with spherical and octagon shape and sizes in the range between 1-40 nm, with an average size approximately 17 nm. The anti-cancer effect of silver nanoparticles on cell viability was strongly depends on the concentration of silver nanoparticles and greatly decrease with increasing the concentration of silver nanoparticles. The IC50 amount of silver nanoparticle was 2 μg/ml. Conclusion: The biosynthesized silver nanoparticles showed a dose-dependent toxicity against MCF-7 human breast cancer cells. |
Volume 75, Issue 8 (November 2017)
Methods: This experimental study was done in 2017, from March to September in the Bam Research Center of University of Medical Sciences Kerman, Iran. Green synthesis of zinc oxide nanoparticles was investigated using cumin seeds. The physicochemical characteristics of synthesized nanoparticles were studied by UV-visible ultraviolet spectrometer (Analytik Jena AG, Germany), X-ray diffraction and transmission electron microscope (TEM) (Carl Zeiss, Germany). Broth microdilution method was used to investigate the antimicrobial activity of zinc oxide nanoparticles. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of these nanoparticles were determined for Pseudomonas aerogenes and Enterococcus faecalis strains.
Results: The UV-visible ultraviolet spectroscopy showed an absorption peak in the range of 370 nm. Transmission electron microscopy shows the synthesis of zinc oxide nanoparticles, mostly spherical, with a size less than 50 nm. Minimum inhibitory concentration of zinc oxide nanoparticles against P. aerogenes and E. faecalis strains was determined at 6.25 and 12.5 μg/ml, respectively. Both bacteria were sensitive to zinc oxide nanoparticles. This sensitivity was higher for gram-negative bacteria.
Conclusion: Zinc oxide nanoparticles were produced using Iranian natural resources and our results showed significant antibacterial activity. Nanotechnology creates materials with novel properties every day, and creates new hope for improving environmental pollution. These nanoparticles can be used as a new generation of antimicrobial agents in various medical disciplines. For example, toothpaste containing zinc nanoparticles can be produced and prescribed for patients with immune deficiency to prevent the growth of microbial pathogens in the mouth and its transmission to the patient's body.
Volume 76, Issue 1 (April 2018)
Methods: A total of 4177 patients whom underwent renal angiography from April 2001 to March 2016, were randomly assigned to a development and a validation dataset in ratio of 2:1 respectively. The clinical and laboratory data of patients were analyzed by multivariate regression analysis. The factors of female sex, history of hypertension and glomerular filtration rate were determined as predicting factors and they were assigned a weighted integer, the sum of the integers was a total risk score for each patient. This model was examined at validation set.
Results: We retrospectively evaluated all patients undergoing renal artery angiography since 15 years ago. We extracted all risk factors of RAS including age, sex, height, weight, and history of diabetes, hypertension and hyperlipidemia. We also looked at coronary or peripheral vascular diseases and presence of heart failure. The age of patients was 63.5±11.2 years and 40% of the patients were female. The significant RAS was defined as 70% or more narrowing of renal artery. The prevalence of renal artery stenosis was 14.4% and 13.5% in development and validation dataset respectively. The area under curve and confidence interval for final mode in development dataset was 67.9% (65.0-70.8%). The rates of RAS increased with increasing risk score. In 1402 patients in validation dataset the model showed good discrimination power (cstatistic= 0.76)
Conclusion: This model simply assesses the risk of RAS using available information. This model can be used both in clinical and research purposes. The power of model for diagnosis of RAS is estimated to be 72.6% (68.8%-76.4%).
Volume 77, Issue 7 (October 2019)
Methods: In a descriptive, randomized/ cross-sectional study in the poisoning ward of Imam Reza Hospital in Mashhad from October 2013 to April 2015, all patients who referred to the emergency department because of their methadone toxicity or symptoms, had an ECG with 12 leads taken from them, at the time of the arrival. QT dispersion was calculated manually in comparison to other parameters. Also their blood sample were taken to the lab in order to measure different electrolytes (Mg, K, Ca). To ensure the accuracy of study, patient’s urine samples were taken and tested for methadone. There was no intervention in this study. The control group was also not considered QT scattering and dispersion was compared with normal reference in this study.
Results: In this study, 100 patients were studied, 65 of them males (65%) and 35 females (35%). Mean age of subjects entering the study was 33.87±14.5. The average dose of methadone in these cases was 35.5±35.7 mg. However, their usual dose was 1.11±4.85 mg prior to overdoses, and the average duration of use mentioned in patients who had a history of usage was 5.1 months, but 90% of the subjects did not mention any history. The average measured potassium was 3.99±0.5 meq/l, calcium was 8.94±0.5 meq/l, and magnesium was 1.98±0.26 mg/dl. Average measured oxygen saturation at the time of admission was 94.43±5.6%. Mean QT dispersion was 0.041±0.018 millisecond.
Conclusion: In our study, no significant correlation was found between QT dispersion and methadone poisoning.
Volume 79, Issue 5 (August 2021)
Methods: Based on the PRISMA checklist, a search for scientific records was done separately by two researchers. All the articles that had selection criteria were evaluated in terms of methodological quality. Medical malpractice was assessed in four main divisions including negligence, Lack of skill, Carelessness and non-compliance with government regulations). The bias test was performed using the Egger’s test. Revman software was used to analyze the data.
Results: In the present study, 25 studies that examined the country's medical malpractice from April 1994 to March 2018 were included in the meta-analysis. Negligence has been implicated in 1,105 cases of the 2,068 claims. Lack of skill in 255 out of 2068 cases, 432 cases of carelessness and 244 cases of non-compliance with government regulations Were recorded the results of the meta-analysis showed that OR negligence was 0.76 (CI 95%: 0.66-0.87), lack of skill was 0.61 (CI 95%: 0.49-0.76), carelessness was 0.62 (CI 95%: 0.50-0.76) and non-compliance with government regulations was 0.66 (95% CI: 0.60-0.73). In the review of the confirmed negligence ratio of the registered complaint files, only 19 studies mentioned this ratio. The results of the meta-analysis of these 19 studies showed that the OR ratio of the confirmed negligence of complaints was 0.6 (95% CI: 0.41-0.86). From all claims, General surgeons had OR of confirmed medical malpractices, equal to 0.47 (CI 95%: 0.37-0.60), gynecologists with OR equal to 0.49 (CI 95%: 0.36-0.66), general practitioners with OR equal to 0.43 (CI 95%: 0.30-0.63) and orthopedic specialists with an OR of 0.44 (CI 95%: 0.32-0.61).
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Conclusion: The results of this study help to understand the current position of medical negligence studies in the country to identify the cause of the malpractice and develop new studies for the future.
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Volume 79, Issue 10 (January 2022)
Methods: At Ilam Medical Center in Imam Khomeini Hospital, 20 patients with two similar donor graft sites were gradually selected to participate in a clinical trial from January to March 2017. The two regions have the same skin graft patients, an area of Honor conventional and other areas with the topical administration of platelet-rich plasma That immediately after surgery and in the days after the fifth and eleventh, eightieth and after washing the wound with a topical serum Physiology rubbed on the wound and thus treated The rate of wound healing clinically and using X-ray photo-checked and compared.
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Results: Seven are male and thirteen are female and the age range of patients is between 17 and 67 years. After collecting wound healing times in two groups, we used the means comparison method to evaluate the effect of PRP on wound healing rate and analyzed the results (T-Test). Because the data followed a normal distribution, we used the Independent T-test method, which resulted in 0.416, which was higher than the alpha level equal to 0.05.
Conclusion: In this study, we found that PRP had a positive effect on wound healing time and increased the speed of wound healing. It is suggested that the effect of the PRP method on various organs that have not been tested before, be discussed in future studies. |
Volume 80, Issue 1 (April 2022)
Methods: This case-control study was performed on 100 patients with clinical evidence of lead poisoning who were referred to Loghman-e-Hakim hospital in Tehran from April to December 2018. Also, another 100 participants with the matched sex and age, a history of opium use, and exposure to lead or non-work-related metals, and with normal lead levels, were considered as a control group. Demographic information was collected by a trained researcher by reviewing hospital records or interviewing participants. To monitor lead levels in the control group, 5 ml of venous blood was collected from the antecubital vein at 7 to 8 am in sterile tubes containing EDTA as an anticoagulant. Serum lead levels were assessed by GBC Avanta atomic absorption spectrophotometer. Values in the two groups were compared. SPSS version 16 (SPSS Inc. Chicago, Il, The USA) was used for data analysis. A P-value below 0.05 was considered statistically significant.
Results: The mean level of serum lead in case and control groups were 63.0±12.4 μg/dL and 6.0±2.1 μg/dL, respectively with a statistically significant difference (p<0.001). However, Alkaline phosphatase (ALKp), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes were significantly higher in cases compared to controls (p<0.001). The thyroid-stimulating hormone in patients with lead poisoning (0.3±0.04 MIU/L) was significantly lower than those in the control group (2.5±1.23) (P=0.04).
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Conclusion: Lead poisoning could potentially damage liver function and elevate liver enzymes. Moreover, it can also affect the levels of TSH and levothyroxine. Understanding the exact mechanisms might help to control The hepatotoxic effects of lead in patients. Also, knowing the pattern of elevated liver enzymes and thyroid hormones changes might help discriminate lead poisoning with other differential diagnoses.
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