Showing 10 results for Mashhadi
Poshtmashhadi M, Molavi Nojomi M, Malakout S.k, Bolhar J, Asgharzadeh Amin S, Asgharnejad Farid Aa,
Volume 65, Issue 4 (3 2007)
Abstract
Background: Psychosocial stressors and the quality of the support system are important factors in attempted suicide. This research has studied these stressors and the condition of the support system in suicide attempt cases in Karaj, Iran.
Methods: This is a part of the Iranian section of the widest multisite study on suicide prevention (SUPRE-MISS) proposed and directed by the WHO in eight countries, including Iran. Here we present data obtained from 632 suicide attempters presenting in emergency centers over a period of ten months.
Results: According to the time lapse from the stressor to the suicide attempt, proximal stressors are considered to be precipitating while distal stressors are considered to be perpetuating factors. Although, family conflicts were found to increase the risk of suicide one year after the conflict, conflicts with family (25%) and spouse (35%) were the most frequent stressors one month before the attempt, acting as proximal factors. Conflict with spouse was more prominent for people who had been married less than seven years. Conflict with family was the most important stressors for 15-25 year-old attempters. Though it is not clear which areas of conflict are more crucial in a suicide attempt, especially considering gender differences, educational and financial problems were more prominent one year before the suicide attempt. The support system was more crucial for female attempters: Although they received more practical support than males, females complained more of deficiencies in support.
Conclusions: The roles of different psychological stressors in attempted suicide vary according to the time lapse from the stressor until the suicide. Family and marital conflicts can be precipitating and perpetuating factors, while educational and financial problems appear to be perpetuating factors. Family is considered to be an important support system for a great number of attempted suicide cases, especially since it offers practical support. Support systems are crucial in preventive programs for suicide, especially among women.
Abdollahi A, Bagheri R, Maddah Gh, Rajabi Mashhadi Mt,
Volume 66, Issue 6 (5 2008)
Abstract
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Background: Stromal tumors of the gastrointestinal tract (GISTs) are uncommon and
the cell of origin is actually mesenchymal. Stemming from smooth muscle, 90% of GISTs, or
leiomyomas, are found in the lower two thirds of the esophagus. Typically
solitary, multiple tumors (leiomyomatosis) are occasionally reported. Remaining
intramural during their growth, most of their bulk protrudes toward the
esophageal outer wall, with a freely-movable, normal-looking overlying mucosa. In
this study, we report a rare case of esophageal leiomyomatosis treated by
esophagectomy.
Case
Report: A 70-year-old man presented with discomfort upon
swallowing, dysphagia, nausea, belching and weight loss. After a barium
swallow, only dilatation of the esophagus from the retained food and saliva was
seen. CT
scan revealed a 10-cm
dilatation of the thoracic esophagus. An endoscopy and upper GI series was performed,
but no pathology was found. Esophageal manometry and pH monitoring for
gastroesophageal reflux were normal. Upon endoscopic ultrasonography, a thickening
of the esophageal wall was identified 20-30 cm from the dental arch. The patient was diagnosed with
a GIST,
referred to surgeon and a transhiatal esophagectomy was performed. The patient was
discharged from the hospital in good condition and has had no problem during
the one-year period of follow up.
Bagheri R, Tavassoli A, Sadrizadh A, Rajabi Mashhadi M, Shahri F,
Volume 66, Issue 9 (5 2008)
Abstract
Background: Penetrating thoracoabdominal stab wounds may cause diaphragmatic and abdominal organ laceration. However, 15-20% of these cases who are stable and managed by conservative treatment might have hidden diaphragmatic injuries, which could ultimately lead to chronic diaphragmatic hernia. Therefore, a safe and exact diagnostic method for the detection of occult diaphragmatic injuries is very valuable. In this study we have assessed the diagnostic value of thoracoscopy in occult diaphragmatic injuries resulting from penetrating thoracoabdominal stab wounds.
Methods: From March 2005 to October 2007, 30 hemodynamically stable patients with penetrating thoracoabdominal injuries, not requiring emergent exploration, were enrolled in this study. All subjects underwent thoracoscopy to evaluate probable diaphragmatic injury. Diaphragmatic injuries were repaired via thoracoscopy or laparatomy. All patients were evaluated for chronic diaphragmatic hernia by CT-scan six months later.
Results: The mean patient age was 26.2 years, with a male/female ratio of 5:1. Using thoracoscopic exploration, we observed five (16.7%) hidden diaphragmatic injuries, three (9.9%) of which were repaired using the thoracoscopic approach and two (6.6%) by laparatomy. Lung parenchymal laceration was seen in two patients (6.6%), for whom the repair was performed using thoracoscopy. Intra-abdominal injury was seen in one patient (3.3%), which was repaired by laparatomy. After thoracoscopy, there were no complications or evidence of chronic diaphragmatic hernia in the chest and abdominal CT-scans performed six months later. Therefore, the diagnostic accuracy of thoracoscopy in occult diaphragmatic injuries in our study was 100%.
Conclusion: With its high degree of diagnostic accuracy, low degree of invasiveness, as well as its utility in treatment, we recommend thoracoscopy for all clinically stable patients with penetrating thoracoabdominal stab wounds.
Marsosi V, Mashhadian M, Ziaei S, Faghihzadeh S,
Volume 67, Issue 11 (4 2010)
Abstract
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Background: Preterm delivery is a relevant public health problem since it is an
important factor determinant of morbidity and the main reason for neonatal
mortality. Many publications have pointed at clinical methods, biological,
biochemical and ultrasonographic markers, which applied in combination or on
their own, aim at predicting spontaneous preterm delivery. Transvaginal
sonography is an effective method for the study of uterine cervix during
pregnancy since it permits to assess the cervical morphology and biometry in
detail with a high degree of reliability. The aim of this study
was to evaluate the association between spontaneous preterm delivery (SPTD) before 35 and 37 weeks of gestational age, in high risk population and the measurement of
the cervix length and cervical funneling.
Methods: A prospective cohort of 200 women carrying high
risk pregnancies were evaluated by transvaginal sonography between 14th and 28th weeks of gestation.
Results: Cervical length less than 18mm before 35th and 37th weeks of gestational age and the presence
of cervical funneling presented a satistically significant association with
spontaneous preterm delivery before 35 weeks. The cervical length with less 18 mm demonstrated a strong association with SPTD before 37 weeks (p<0.005 OR=92.15) and before 35 weeks' gestation (p<0.001 OR=32.33). The logistic regression analysis suggested the
cervical length with less than 18mm as the only variable that revealed satistically significance association
with SPTD.
Conclusion: The results seem to indicate
that the assessment of cervical length is an important ultrasound marker for
predicting spontaneous preterm delivery.
Mashhadian M, Marsosi V, Ziaei S, Asghari Jafar Abadi M,
Volume 68, Issue 10 (5 2011)
Abstract
Background: Preterm delivery is a relevant public health problem. The aim of this study was
to evaluate the association between spontaneous preterm delivery (SPTD)
before 35 and 37
weeks of gestational age and the measurement of the cervix length, cervical
funneling and Cervical Gland Area (CGA),
in high risk pregnant population.
Methods: A prospective cohort of 200
women carrying high risk pregnancies was evaluated by transvaginal
sonography between 14th and 28th gestational weeks. The data were analyzed using statistical methods.
A multiple linear regression model was estimated
in order to examine the relationship between the gestational age at delivery
and the cervical markers. A multiple logistic
regression was estimated in order to analyze the factors associated to
spontaneous preterm delivery and the transvaginal sonographic markers.
Results: Cervical length less than 18 mm and the presence
of cervical funneling presented a statistically significant association with
spontaneous preterm delivery before 35 weeks.
The nondetection of Cervical Gland Area demonstrated a strong association with
spontaneous preterm delivery before (p=0.0001,
OR=169.1, CI=2.6-3.1) and 35th and 37th gestational week (p=0.001, OR=115,
CI=2.12-3.5). The multiple logistic regression
analysis suggested the non-detection of CGA as
the only variable to reveal statistically significance association with
spontaneous preterm delivery.
Conclusion: Based on results of present study the absence of
cervical gland area (CGA) can be a new and important ultrasound marker for predicting spontaneous
preterm delivery and needs to confirm with future multicenter investigations.
Reza Bagheri , Seyed Ziaollah Haghi , Mohammadtaghi Rajabi Mashhadi , Alireza Tavassoli , Davoud Attaran , Saeed Akhlaghi , Neusha Barekati , Maryam Esmaeeli ,
Volume 71, Issue 9 (December 2013)
Abstract
Background: Acquired paralysis of the diaphragm is a condition caused by trauma, surgical injuries, (lung cancer surgery, esophageal surgery, cardiac surgery, thoracic surgery), and is sometimes of an unknown etiology. It can lead to dyspnea and can affect ventilatory function and patients activity. Diaphragmatic plication is a treatment method which decreases inconsistent function of diaphragm. The aim of this study is to evaluate the outcome of diaphragmatic plication in patients with acquired unilateral non-malignant diaphragmatic paralysis. Methods: From 1991 to 2011, 20 patients with acquired unilateral diaphragmatic paralysis who underwent surgery enrolled in our study in Ghaem Hospital Mashhad University of Medical Science. Patients were evaluated in terms of age, sex, BMI, clinical symptoms, dyspnea score (DS), etiology of paralysis, diagnostic methods, respiratory function tests and complication of surgery. Some tests including dyspnea score were carried out again six months after surgery. We evaluated patients with SPSS version 11.5 and Paired t-test or nonparametric equivalent. Results: Twenty patients enrolled in our study. 14 were male and 6 were female. The mean age was 58 years and the average time interval between diagnosis to surgical treatment was 38.3 months. Acquired diaphragmatic paralysis was mostly caused by trauma (in 11 patients) and almost occurred on the left side (in 15 patients). Diagnostic methods included chest x-ray, CT scan, ultrasonography and sniff. Test prior to surgery the average FVC was 41.4±7 percent and the average FEV1 was 52.4±6 percent and after surgery they were 80.1±8.6 percent and 74.4±1 percent respectively. The average increase in FEV1 and FVC 63.4±4, 61.1±7.8. Performing surgery also leads to a noticeable improvement in dyspnea score in our study. Conclusion: In patients with acquired unilateral non-malignant diaphragm paralysis diaphragmatic plication is highly recommended due to the remarkable improvement in respiratory function tests and dyspnea score without mortality and acceptable morbidity.
Hossein Mashhadinezhad , Babak Ganjeifar ,
Volume 73, Issue 3 (June 2015)
Abstract
Background: Sciatic pain in association with lumbar disc herniation may require surgical intervention in the form of lumbar discectomy. Yet, the optimal time for this operation has not been specified in medical literature.
Methods: In a Cross-sectional study, 147 patients (100 men and 47 women) with radiological and clinical signs of L4-L5 or L5-S1 disc herniation were entered to our registry prior to March 2009. They were all examined, diagnosed and operated on (lumbar discectomy) in Ghaem General Hospital, Mashhad, Iran. Patients were all subsequently followed for one year. The follow-up continued in a number of 126 cases, whose satisfaction was rated via phone interview for an extra year. The patients’ assessments were implemented employing three scaling systems, both before and following lumbar discectomy, to name the Modified Oswestry Disability Index (MODI), Visual Analogue Scale (VAS) and Prolo Functional Economic Outcome Rating Scale (PORS). The former two were used for pre-operative and post-operative assessments whereas the latter was applied during the first year of follow-up. The focus of the investigation during second year was on patients’ satisfaction.
Results: Mean age of our cases were 34±7.4 years. According to the duration of the sciatica, patients were divided into 4 groups. <3 months, 3 to <6 month, 6 to <12 months and >12 months. Statistical analysis revealed a significant difference between patients having undergone lumber discectomy with a history of sciatica for less and more than three month before the operation in terms of pre-and post-operative visual Analogue Scale (P= 0.022). However, there could be found no such disparity in other clinical scores (P= 0.63 for MODI, P= 0.85 for Prolo scale and P= 0.73 for satisfaction).
Conclusion: Patients with less than three months of sciatica may seem to enjoy a better clinical outcome after one year, there could be found no correlation between the duration of sciatica and the satisfaction after two years.
Gholamreza Pourmand , Mohsen Ayati , Ali Razi , Aliakbar Karami , Rashid Ramazani , Ayat Ahmadi , Parvin Akbari Asbagh, Rahil Mashhadi , Shadi Pourmand ,
Volume 73, Issue 5 (August 2015)
Abstract
Background: Prostate-Specific Antigen (PSA), also known as gamma-seminoprotein or kallikrein-3 (KLK3), is the best marker for early diagnosis of prostate cancer. Since age and race are affecting PSA levels, determining age-specific reference ranges of PSA in every community is necessary for increasing the efficiency rate of PSA. The aim of the present study was to evaluate the normal distribution of total prostate-specific antigen (TPSA) and free prostate-specific antigen (FPSA) and determine age-specific reference ranges of PSA in Iranian men.
Methods: In this cross-sectional study, 1200 normal men with the age range of 50 to 79 referred to Shahid Rajaie Hospital, Qazvin Province in Iran, from 2011 to 2013. After excluding patients with prostate cancer and urinary tract infection, 1020 men were included in this study. Then, their blood samples were collected and after the extraction of serum from blood, serum levels of FPSA and TPSA were measured using commercial kits the reference range of PSA was specified for each age group and compared with reference ranges of other populations.
Results: The mean age of the patients was 61.03±7.5 years and the mean values of FPSA and TPSA were 0.47±0.6 ng/ml and 1.56±2.05 ng/ml, respectively. PSA serum levels (95th percentile range) in 50 to 59, 60 to 69 and 70 to 79-year age groups were 0-3.6 ng/ml, 0-5.7 ng/ml and 0-6.8 ng/ml, respectively. TPSA (r= 0.2, P< 0.001) and FPSA (r= 0.22, P< 0.001) were significantly associated with age. In addition, a significant relationship was found between TPSA serum levels and alcohol consumption (P= 0.017), smoking (P< 0.001) and family history of prostate cancer (P= 0.014).
Conclusion: Findings of the present study showed that PSA levels are correlated with age. It was also revealed that the PSA age-specific reference range obtained in this study is different from other races and is specific to Iranian men. Therefore, age-specific reference ranges of PSA obtained in the present study can increase PSA test sensitivity and specificity by reducing unnecessary diagnostic procedures and early detection of prostate cancer in Iranian men.
Leila Pourali, Atiyeh Vatanchi , Arezoo Sedaghati, Farnaz Hadavi , Mohammad Taghi Rajabi Mashhadi,
Volume 79, Issue 12 (March 2022)
Abstract
Background: Sigmoid volvulus is a rare complication in pregnancy. The clinical presentation is similar to that of non-pregnant volvulus, although the symptoms can be masked by the enlarged uterus and physiological changes during pregnancy and it can be challenged and delayed in diagnosis and treatment. Delay in diagnosis can also lead to ischemia, necrosis and perforation of the intestine, which can have adverse maternal and fetal outcomes.
Case Presentation: A primigravid woman with gestational age of 31 weeks was admitted to a 3rd level center with abdominal pain and abdominal distention. From the beginning of pregnancy, the patient complained of bloating and epigastric pain, And had used herbal medicine for defecation. The patient's constipation had worsened since six days before admission to the hospital. She had no vomiting and her general condition was good. Abdominal Supine X-rays were reported completely dilated sigmoid and she was treated with a possible diagnosis of ileus. Due to the progression of symptoms and abdominal distension, rectosigmoidoscopy was performed for her, and scattered mucosal erythema was seen. Discoloration of the purple mucosa was seen from a distance of about 35 cm from the annulus and the secretions inside the sigmoid lumen were seen as blood. Ischemic necrosis and sigmoid volvulus were strongly suggested for the patient and she was immediately transferred to the operating room. The abdomen was opened with a midline incision. A 30 weeks uterus was seen and sigmoid volvulus was confirmed. Detorsion and colostomy were done. Due to the unprepared intestine and the possibility of leakage from the site of anastomosis, sigmoidectomy was not performed. After 4 days, the patient was discharged in a good general condition and became a candidate for sigmoid colon resection after delivery.
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Conclusion: All abdominal signs and symptoms during pregnancy, especially in late pregnancy have a complex interpretation and management, due to the impossibility of accurate abdominal examination. The most important factors in the proper management of sigmoid volvulus in pregnancy are fast diagnosis and treatment, hydration and antibiotic therapy.
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Majid Salmanian Mashhadi , Anoushe Haghighi, Nahid Kianmehr, Marjan Mokhtare, Sara Zarasvandnia, Parna Hosseini Meigoni , Seyede Maryam Mirghorbani ,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Liver fibrosis is a major concern associated with long-term side effects among patients with rheumatoid arthritis (RA) treated with methotrexate. The aim of the present study was to compare the fibrosis-4 (FIB-4) index and the results of liver fibrosis severity derived from FibroScan device in rheumatoid arthritis patients who were treated with methotrexate.
Methods: The present cross-sectional study was conducted in 70 RA patients referred to rheumatology clinic of Hazrat Rasool Akram Hospital, Tehran, from July 2022 to July 2023. First, FIB-4 was calculated and the data from transient elastography, which was performed using a FibroScan device to diagnose liver fibrosis for each patient, will be compared with the results of the FIB-4 of each patient. Furthermore, the correlation between FIB-4 index and FibroScan grade with demographic characteristic, methotrexate dose and disease duration was also evaluated.
Results: The average age of patients was 59.59±11.75 and most of them (74.3%) were women. Most patients (75.71%) with a normal to mild FIB-4 index stage had a normal to mild elastography stage. of patients had normal to mild liver fibrosis. FibroScan grade were not related to the age, gender, body mass index, methotrexate dose and duration of the disease (P>0.05). The average FIB-4 was 1.25±0.6, which was not significantly related to gender, body mass index, disease duration and methotrexate dose but directly related to the age of patients (P<0.001, (CL95%, 0.51-0.53)).The correlation between FIB-4 and FibroScan grade of the patients showed a positive association, which was not statistically significant (P=0.594, r=0.06, CL95%, -0.24-0.4). The FIB-4 in normal to mild grade was 85% rejecting the moderate to severe grade in FibroScan but none of them were statistically significant (P=0.146).
Conclusion: Overall, the FIB-4 was incapable of predicting the FibroScan result. On the contrary, this case was also inconclusive and the results of FibroScan did not justify FIB-4 results of the patients. The FIB-4 cannot replace in RA patients. It is recommended to conduct future studies with a larger sample size in RA patients. |
