Showing 22 results for Mohammad Javad
Mohammad Javad Zehtab , Ahmad Reza Mirbolook , Babak Syavashi , Mostafa Shahrezayi , Mostafa Mirmostafa ,
Volume 67, Issue 10 (1-2010)
Abstract
Background : Open fractures are associated with an increased risk of infection and healing complications. Management of open fractures is based on the following principles: assessment of the patient, classification of the injury, antibiotic therapy, debridement and wound management, Fracture stabilization, early bonegrafting, and supplemental procedures to achieve healing.
Methods : In a case- control retrospective study we evaluated 33 patients with open tibial fracture (type two gustillo) who were admitted in sina General hospital in Tehran, Iran during years 1999-2009 and were treated uniformly with external fixation as primary treatment in our center as case group and the other 33 patients with the same method and another 33 patients who had not been infected as control group. W e compared the folders of case and control groups retrospectively.
Results : There was no statisticant difference between two groups in mean age, gender, the mechanism of trauma and body mass index (p >0.05 ), while statistically significant difference between them in smoking habitus, blood transfusion, first debridment time, diabet mellitus, femoral shaft fracture (p <0.05 ).
Conclusions: Accompanying femoral fracture is the sign of high energy trauma and it is logical that it is an important risk factor for infection. In our study the time of the first debridment stablished as a significant factor influencing the infection rate in tibial open fracture. In some studies smoking had been recognized as a significant factor influencing in tibial bone open fracture our study reveals the same.
Mohammad Javad Fatemi , Amir Asadollah Khajerahimi , Babak Nikoumaram , Maryam Sakhaei , Shabnam Mostafavi , Amir Atashi , Mirsepehr Pedram , Seyed Hamid Reza Aghayan, Shirin Araghi , Majid Soltani , Majid Mossahebi Mohammadi ,
Volume 72, Issue 6 (September 2014)
Abstract
Background: Stem cells are applied in the treatment of wide range of diseases and can be separated from different tissues of the body. These cells can treat diseases by cytokine and growth factor secretion and also cell differentiation. Burn wound is a challenging problem of reconstructive surgery and stem cells may help wound healing process. We designed this study to evaluate the beneficial effect of fat derived stem cells for coverage of 3rd degree burn wound.
Methods: This study was experimental and has been done in Burn Research Center of Iran University of Medical Sciences during January 2012 to April 2013. Thirty rats randomly divided to three equal groups. Inguinal fat of 10 rats (one group) were used for preparation of autologous adipose-derived mesenchymal stem cells. Acellular amnion was used as a scaffold for stem cell transfer. Each of the thirty rats had been exposed to a cm deep 3rd degree burn on back area. 24 hours after surgery, the wound was excised and it had been covered by three methods: conventional dressing in the first group, acellular amnion in the second group and acellular amnion seeded with adipose-derived stem cell in the third group. The rate of wound healing and pathologic characteristics was compared in all three groups.
Results: Healing rate and decrease in wounds size was significantly better in acellular amnion seeded with adipose-derived stem cells compared with other two groups at 3rd and 15th days after surgery P<0.01.
Also in histopathology examination, fibroplasia and neovascularization of wounds were significantly better in stem cells group than the other two groups P<0.001.
Conclusion: Acellular amnion seeded with adipose-derived stem cell can result in faster wound healing and better histopathology characteristic. The amnion as a scaffold and the fat derived stem cells as healing accelerator are recommended for coverage of the 3rd degree burn wounds after excision and it may reduce the need for skin graft.
Jalal Moludi , Seyedali Keshavarz , Hosseinzadeh-Attar Mohammad Javad, Abas Rahimi Frooshani , Ali Sadeghpour , Sajad Salarkia , Farhad Gholizadeh ,
Volume 73, Issue 2 (May 2015)
Abstract
Background: Atrial fibrillation (AF) is the most common arrhythmia after cardiac surgery. AF leads to longer duration of hospitalization, thromboembolism, and impaired hemodynamics after heart surgery. One of the most important causes of postoperative AF, inflammation, and oxidative stress status. For this reason, it is useful to control the dysrhythmia. Coenzyme Q10 (CoQ10) as an antioxidant that has an important role in reducing the incidence of postoperative AF. The present study aimed at administering CoQ10 as a way to reduce the incidence of post-CABG atrial fibrillation.
Methods: In this double-blind randomized controlled trial study, 80 patients with coronary artery disease who underwent coronary artery bypass graft surgery (CABG) in Rajaie Cardiovascular, Medical and Research Center from April to November 2014, randomized are divided into intervention and control groups to receive placebo or CoQ10 The surgical characteristics of the patients in two groups were similar. The intervention group will receive the oral CoQ10 supplement 150 mg/d for 7 days before surgery. After operation two groups were compared regarding important outcomes such as postoperative arrhythmia, intensive care unite (ICU) stay and hospital stay. Atrial arrhythmias are considered significant If more than 10 minutes duration atrial and with a shorter duration of arrhythmia, but with recurrence again.
Results: Thirty-eight women and forty-two men with a mean age of 58.37±7.98 years were enrolled in the study in two CoQ10 and placebo groups (each consisting of 40 patients). The incidence of postoperative AF was 45% in the control group to 20% in the intervention group decreased after supplementation (P=0.030). ICU stay and length of in-hospital stay did not significant. The incidence of arrhythmias ventricular tachycardia (VT) and VF in this period was not significant (P=0.865).
Conclusion: Q10 supplements have low side effects. Due to the reduction in the incidence of AF in patients after, CABG, these supplements can be recommended for the prevention of AF.
Abolfazl Abbas Zadeh, Tayebeh Mahzooni , Seyed Abolhasan Emami , Hossein Akbari , Mohammad Javad Fatemi , Mohsen Saberi , Tooran Bagheri , Mitra Niazi , Shirin Araghi ,
Volume 73, Issue 9 (December 2015)
Abstract
Background: Coriander with the binominal name of Corianda Sativum, is one of the oldest medicinal plants ever known to man. Anti-inflammatory, anti-microbial, and anti-fungal effects of its oil has been mentioned in numerous studies. This study examines the impact of coriander cream on wound healing of the second-degree singe burn.
Methods: In this experimental study which was performed in the animal lab of the Hazrat Fatemeh Hospital in Tehran, 48 adult male rats with an approximate weight of 250-300 grams, with deep burns of 2 cm 4×2 dimensions were prepared and divided into 4 groups of 12. We used silver sulfadiazine cream, alpha ointment, coriander cream and vaseline gauze (control group) dressings in burn wound of the groups 1 to 4 respectively. At the end of the study (30 days), rats were euthanized with a high dose of thiopental and the wounds were evaluated on days 10 and 17 with a punch biopsy. Samples were fixed with 10% formalin on histopathology slide using haematoxylin and eosin (H&E) staining (to assess and determine the presence of inflammatory cells). The amount of fibrin and collagen at the site were evaluated using a software program ImageJ, version 1.45 (National Institutes of Health, Bethesda, Maryland, USA).
Results: The mean of wound surface area in the first photography was no significant (P= 0. 135). The rate of wound healing in alpha ointment and coriander cream had better outcomes than either of the other two groups (P= 0.000). The healing of the wound in silver sulfadiazine group was significantly less than other groups. Pathology results showed a statistically significant difference between the four groups (coriander, alpha, SSD and control), based on the Kruskal-Wallis test. These relate to (1) polymorphonuclear in the first (P= 0.032) and the second series (P= 0.003), (2) Angiogenesis in the second series (P= 0.004). (3) Fibrosis in the first series (P= 0.024) and the second series (P= 0.000).
Conclusion: The results of this study showed that wound healing improvement in coriander cream group was better than the control group and silver sulfadiazine group and similar to alpha ointment group.
Mohammad Javad Fatemi , Farzin Pakfetrat , Mohammad Reza Akhoondinasab Akhoondinasab , Kourosh Mansouri , Seyed Jaber Moosavi , Seyed Aboozar Hosseini , Mitra Niazi ,
Volume 73, Issue 10 (January 2016)
Abstract
Background: Peripheral nerve injury is one of the most challenging of modern surgical problem. Recent advances in understanding the physiological and molecular pathways demonstrated the important role of growth factors in peripheral nerve regeneration. Platelet-rich plasma (PRP) is a biological product that has many growth factors. The aim of this study was to investigate the effect of PRP in the regeneration of sciatic nerve crush in the rat model.
Methods: In this experimental study that established in the animal lab of the Hazrat Fatemeh Hospital in Tehran from September to October 2013, Twenty-four healthy male Sprague-Dawley rats (200-250 g) were randomly divided into two groups. In all rats the sciatic nerve was cut and then carefully repaired by the tension free method under a light microscope. In group 1, after the repair, 0.05 µL of PRP was injected below the epineurium to the proximal and distal parts of the repaired area. In group 2 the same amount of normal saline was injected to the proximal and distal of the repaired area. After six weeks footprint analysis, neurophysiologic and histopathology evaluations were performed.
Results: Significant differences existed between the two groups footprint analysis (P= 0.001). Also the nerve conduction latency test was significantly shorter in PRP group. (1.0233 ms in PRP group and 1.7375 ms in control) (P< 0.001). The average amplitude in the first group and the second group was 7.6250 mv (control) 6.3667 mv that does not show a statistically significant difference (P= 0.093). Significant differences between the two groups in the number of axons of the proximal portion of the study was not seen (P= 0.29). The parameters included number of axons of the proximal and the distal part of axons, the diameter of the distal and proximal axons in the two groups were compared. In the two groups there was statistically significant difference between the above parameters. (P= 0.298).
Conclusion: It seems that PRP may have an important role in peripheral nerve regeneration and functional recovery after nerve laceration and repair. Further clinical evaluation recommended.
Noorahmad Latifi , Navid Rezvani , Mohammad Javad Fatemi , Majid Nourian , Shirin Araghi , Tooran Bagheri,
Volume 73, Issue 11 (February 2016)
Abstract
Background: Graft survival has been considered the major problem in reconstructive surgery. Clinical studies have helped us to understand the role of PRP in increasing skin survival. Our goal in this study was to examine the treatment effects of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) on autologous full thickness skin graft survival in male rats.
Methods: This experimental study was performed on 36 rats of Sprague-Dawley race with weighing approximately 250 to 300 gr on May 2015 in animal laboratory of Hazrat Fatima Hospital. After anesthesia, rats were divided into 3 groups. We injected platelet-rich plasma (PRP) in the first group, platelet-rich fibrin (PRF) in the second and saline in the third group after removing the skin. Microscopic analysis was performed with camera (Canon powershot SX200, Tokyo, Japan) on days 7, 14, 21 and 28 after surgery. We used image analysis system (ImageJ, ver. 1.45) to examine necrosis and survival rate. Samples were studied with H&E staining on day 28 microscopically for histological analysis of vascular density and angiogenesis.
Results: Our findings showed the area of necrosis in animals injected with PRP on days 7 and 14, was meaningfully less than control group (P= 0.0001). There was no meaningful difference between control and PRP groups (P> 0.05). The area of necrosis in animals injected with PRF did not have any significant difference with control group from beginning to 21st day (P< 0.0001). there was no meaningful difference in vascular density between control and PRP group, whereas in animals injected with PRF the vascular density was significantly less than control group (P= 0.002).
Conclusion: According to our results in this study, we can conclude that using autologous PRP can enhance the process of healing soft tissue injury and be affective at increasing graft survival. This method is suggested to be conducted for patients highly at risk of graft loss and also for those who are in need of early treatments.
Mohammad Reza Ebadi , Mohammad Javad Fatemi , Farhad Hafezi , Mitra Niazi , Mohammad Ali Fatemi ,
Volume 74, Issue 7 (October 2016)
Abstract
Background: In recent years the use of diced cartilage grafts in reconstructive surgery particulary rhinoplasty have been considered by most plastic surgeons. However, long-term resorption usually occurs. Stem cells are a powerful tool for reconstructive surgery to rebuild and maintain tissue with reduced complications. Since the adipose tissue-derived stem cells (ADSCs) can rebuild a wide variety of tissues such as skin, fat, bone and cartilage are used, this is a very good chance for cosmetic surgery. The aim of this study was to examine the effects of adipose-derived stem cells on the viability of diced cartilage grafts.
Methods: This interventional study was performed on May 2014 in animal laboratory of Hazrat Fatima Hospital on 10 New Zealand white male rabbits, weighing 2000-2500 grams, approximately 12 to 16 weeks of age. Stem cells was harvested from inguinal adipose tissue of each rabbits. After completely removing the skin and perichondrium, cartilage became divided into two equal pieces using a scalpel. Then place the ear amputation was restored by nylon 4 zero. After weighing cartilages, on either side of the center line on the back of each rabbits, left and right, subcutaneous pocket created equal weight and each piece of cartilage was placed in an envelope. Stem cells were injected in one side and the other side was control. The cartilage weights were recorded both before implantation and after explantation. Evaluation of living chondrocytes was conducted 12 weeks after implantation.
Results: The mean difference of cartilage weights was varied between two groups (intervention and control sides), So that the average was significantly higher in stem cell side than that in the control side (P= 0.021). The average number of live chondrocytes was significantly higher in the intervention side than the control side (P< 0.001).
Conclusion: Despite the unclear mechanism, these results suggest that adipose-derived stem cells can maintain the viability of diced cartilage. Because adipose-derived stem cells are autologous and easy to harvest, they can be use to improve the long-term outcomes of diced cartilage grafting.
Abbas Kazemi Ashtiani , Peyman Khoshnood , Mohammad Javad Fatemi , Seyed Jaber Mousavi , Seyed Aboozar Hoseini ,
Volume 74, Issue 10 (January 2017)
Abstract
Background: The use of random flaps is one of the most common methods of reconstructive surgery because they are easy to use and quick to do. However, the absence of axial vessels especially in the distal areas can cause ischemia and loss of total or part of the flap. Different methods and systemic and topical medications have been recommended to prevent ischemia in random flaps. The aim of this study was to evaluate the effect of stem cells derived from umbilical cord blood in random flap survival in rats.
Methods: This experimental study was conducted in Animal Laboratory of Hazrat Fatemeh Hospital in 2012. In this study twenty Sprague-Dawley male rats weighing approximately 300 to 350 g were selected and divided randomly into two groups. In both groups after anesthesia, a flap was created in the posterior part of each rat with a size of 2 x 6 cm. In the intervention group we injected stem cells derived from umbilical cord blood into the flap, and after eight days the effects on the survival of flaps were examined by digital photography and then pathological examination was performed.
Results: The mean of viable flap in the stem cell group was 6.57 cm2 and in control group 4.71 cm2. The minimum and maximum flap survival in the intervention group were 4.71 and 8.75, and the minimum and maximum flap survived in control group were 1.86 and 7.77. This difference was significant and showed that the viable parts of flap were more in the intervention group (P=0.49). In pathologic examinations epidermal and muscle necrosis of the skin were reported in 3 cases in the intervention group and 5 cases in control group.
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Conclusion: This study showed that cord blood stem cells can be effective somehow in reducing ischemia and increasing random flap survival. However, similar studies are recommended in order to compare the results of this drug and placebo or other proven effective drugs.
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Soraya Shahrokh , Seyed Abolhasan Emami , Mohammad Javad Fatemi , Mir Sepehr Pedram , Saeid Farzad Mohajeri , Seyed Jaber Mousavi , Seyed Aboozar Hoseini , Tooran Bagheri , Shirin Araghi ,
Volume 75, Issue 1 (April 2017)
Abstract
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Background: Cartilage grafts is one integral component in the various fields of plastic surgery particular rhinoplasty. Surgeons usually use from various sources, including the septum of the nose, ears and rib. Complications such deformity and reabsorbtion may be created with use of the cartilage. Area of the removal of cartilage can prevent these complications. The aim of this study was to compare the absorption rate and viability of cartilage autograft between two common donor site, the rib and the concha.
Methods: This experimental study was performed on October 2014 in animal laboratory of Hazrat Fatima Hospital, Tehran, Iran. In this study, 15 New Zealand white male rabbits, weighing 2000-2500 g, approximately 12 to 16 weeks of age were used. In each rabbit, a piece of one ear and one cartilage was excised. After careful weighting of grafts, we implanted the rib cartilage graft into the left pocket and the conchal cartilage graft into the right one. After 8 weeks, the grafts were removed and weighed precisely and photography was carried out. The specimens were fixed in 10% formalin solution for histologic examination was. An example of hematoxylin and eosin staining and cut (H&E) were performed and samples of live chondrocytes and fibrosis were examined by a pathologist.
Results: We lost 3 rabbits during our study. The results showed that the average weight of a graft from the ear within 2 months, but this increase was not statistically significant (P= 0.152). In the rib graft weight loss over 2 months, and this reduction was statistically significant (P= 0.009). The resorption between two group was not significant but the amount of fibrosis was more in conchal cartilage graft.
Conclusion: According to the study it can be concluded that absorption rib cartilage is somewhat better results than the cartilage of the ear. More studies, in addition to cartilage implants longer human studies can contribute to more accurate conclusions.
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Maryam Roham , Mohammad Javad Fatemi , Mitra Niazi , Mahnoush Momeni ,
Volume 75, Issue 5 (August 2017)
Abstract
Background: Albumin is one of the most important proteins in the body by several important functions, it is essential in the maintenance of normal plasma colloid oncotic pressure and is the primary serum binding protein responsible for the transport of various substances in the circulation including fatty acids, hormones, and drugs. Decrease in the amount of serum Albumin (Hypoalbuminemia) is a common finding in the burn patients, but its relationship with mortality is not accurately clear. Our purpose of this study was to measure the amount of Albumin serum in burn patients and find out its relationship between the burned area and length of hospital stay.
Methods: This cross-sectional study was conducted on patients aged over 16 years who referred to the Motahari Hospital of September 2014 to February 2015 in the first 24 hours of their referral. The amount of Albumin was measured in two groups of discharged patients and patients who died while hospitalized, one week after hospital stay and in the time of discharge and death; and its relationship in terms of each other was determined by statistical analysis. We also assessed the relationship between burn and duration of hospital stay with the amount of Albumin on the day of patient’s admission.
| Results: This study showed that the average amount of albumin in the group of discharged patients in the time of admission, one week after and during admission was significantly higher than the group of expired patients (P<0.0001). Also there was a significant relation between the burned area and the amount of albumin (P<0.0001). The more the burned area, the less the amount of Albumin. But there was no significant relationship between the amount of albumin with age and length of hospital stay. |
Conclusion: Measuring the level of Albumin is one of the yardsticks that can be used for prognosis of recovery or death of burn patients, and its assessment at regular intervals in burn patients is essential.
Mohammad Javad Yazdanpanah , Zohreh Yousefi , Amir Hosein Jafarian , Laya Shirinzadeh , Mina Baradaran ,
Volume 75, Issue 6 (September 2017)
Abstract
Background: Pyoderma gangrenosum (PG) (ulcerating neutrophilic dermatosis) is a rare disease that about of half of these patients have a systemic disorder, particularly Crohn's and ulcerative colitis. In addition, inflammatory lesions play key role in its pathogenesis. In early diagnosis of disease, we will further prevent of serious consequences of the disease. In this report, a case of PG after the vaginal surgery with history of ulcerative colitis was introduced.
Case presentation: A 37-years old woman was admitted in an University Hospital of Mashhad University of Medical Sciences, Iran, in 2016 two weeks after genital surgery. The chief complaints were fever, painful tenderness, ulcerative lesion and inflammatory papule on surgical site and thigh. She suffered of fever despite received oral and then wide spectrum intravenous antibiotic therapy. Blood cultures and wound culture were negative. In addition to two deferent intravenous antibiotics, topical wound debridement was performed. Despite this course of treatment which did not improve the lesion, biopsy was performed. Histopathology features of biopsy specimen indicated prominent neutrophils mixed inflammation and lymphocytic vasculitis indicated as pyoderma gangrenous. The patient's medical history included associated ulcerative colitis from 18 years ago and she was under irregular oral receiving of Asacol (mesalamine). Intravenous corticosteroid therapy was administered which led to response of skin of right thigh and surgical site inflammation. After 6-months follow-up, the patient is still in good condition.
| Conclusion: Based on major variable clinical manifestations and no diagnostic serologic test of pyoderma gangrenosum, diagnosis of this disease is difficult. Increased awareness about PG and exclusion of other etiologies such as inflammatory and immunologic disease will aid in prompting of pyoderma gangrenosum diagnosis and proper management of the disease. |
Tooran Bagheri , Mohammad Javad Fatemi , Seyed Aboozar Hosseini , Seyed Jaber Mousavi , Shirin Araghi , Mitra Niazi ,
Volume 75, Issue 9 (December 2017)
Abstract
Background: High costs of treatment and rehabilitation lead to increased tendency of researchers in complementary therapies and using the compounds which have natural origin and are cheaper. Sheep ghee, known as yellow oil, is one of the compounds used in many parts of Iran for wound healing. Considering that few studies have been performed on the effect and rate of these materials on burn wound healing, the present work is aimed to investigate the effect of ghee on burn wound healing in rats.
Methods: In this experimental study which was performed in the animal lab of the Hazrat Fatemeh Hospital in Tehran, 36 adult male Sprague-Dawley rats with the relative weight of 250-300 g were selected and second-degree burn with the area of 2×4 cm was induced in them. Then, they were randomly divided into 3 groups, 12 in each. To dress the burn point in 1 to 3 groups, silver sulfadiazine cream, ghee, and Vaseline were used, respectively. The evaluation process was monitored by photography with 5 days intervals using an accurate ruler and ImageJ software, version 1.45 (National Institutes of Health, Bethesda, Maryland, USA). On the 17th and 30th days, Tissue biopsies was performed for the epithelialization rate, degree and arrangement of collagen, and chronic and acute inflammatory cells, the sample of burn wound was sent for pathological investigation.
Results: Results showed that, wound area was significantly reduced in ghee, and Vaseline groups compared with silver sulfadiazine cream on days 5th, 15th, and 25th (P= 0.001). however, the difference between ghee and Vaseline group was not significant. In the 17-day time period, results of collagen arrangement (P= 0.000) and epithelialization results (P= 0.04), acute inflammatory cells (P= 0.001), and fibroplasias (P= 0.000) in 30th day were significantly better in ghee, and Vaseline groups.
Conclusion: This study showed that, in contrast to the public belief in some regions in Iran, ghee could not accelerate healing of burn wound and promote histopathological indices. Therefore, they are not recommended.
Mohammad Mehdi Saghafi, Mohammad Javad Fatemi , Tooran Bagheri , Mohammad Hasan Hablolvarid, Mitra Niazi, Mohsen Saberi, Shirin Araghi ,
Volume 75, Issue 11 (February 2018)
Abstract
Background: Burns is a major health problem due to severe side effects and limited financial resources. Some herbs are cheap and available, such as Arnebia euchroma can be effective treatment of burn wounds and reduce recovery time. The aim of this study was to evaluate the effect of Arnebia euchroma ointment on healing of deep second-degree burn wound in rats.
Methods: This experimental study was conducted in animal laboratory of Hazrat Fatemeh Hospital in 2015, Tehran. In this study 24 male Sprague-Dawley rats weighing approximately 300 to 350 g were selected. After general anesthesia, back of each rat was shaved with clipping device. Then second-degree burn with the area of 2×4 cm was induced on them. Rats were randomly divided into 2 groups, 12 in each. The surface of the wound in the first group was covered with Arnebia euchroma ointment and in the second group with Vaseline. Dressing was done daily until complete recovery and the wound healing process was monitored by photographing every five days. On day 20, the samples were sent for pathological evaluation of the amount of collagen and inflammatory cells.
Results: Results showed that, during days from 5 to 15 the extent of the wounds reduced in both groups (P= 0.000). The reduction of wound size was significantly higher in Vaseline group compared to Arnebia euchroma ointment group (P= 0.040). The results of the pathological examination showed no significant difference in the amount of collagen and inflammatory cells in the two groups.
Conclusion: It seems Arnebia euchroma ointment to some extent reduced the extent of the wound especially in superficial burns compared to other dressings. However, it is better to conduct more similar studies with a larger sample size and different method and change in timing of dressing.
Mahboobeh Sadat Hosseini , Mohammad Javad Bahoosh , Gholamhossein Alishiri , Nahid Khalili , Habib Yaribeygi ,
Volume 75, Issue 11 (February 2018)
Abstract
Background: The prevalence of diabetes mellitus due to existence of various factors is growing rapidly. The insulin resistance phenomenon is one of the main underlying causes of this disease, due to various reasons such as a decrease in serum levels of vitamin D3. In this study, we evaluated the relationship between plasma level of vitamin D3 and some other main plasma factors.
Methods: This clinical trial study carried out on type 2 diabetes mellitus subjects who referred to diabetes clinic of Baqiyatallah Hospital in Tehran city during June to September 2016. First demographic data of all patients were collected. Then the blood samples for evaluation of blood glucose, HbA1c, triglyceride, cholesterol, HDL, LDL and vitamin D3 were obtained. Based on plasma level of vitamin D3, diabetic subjects were divided into two separate treatment groups (with and without vitamin D3 deficiency) and then above-mentioned factors were compared between these two groups. Afterward, in group with vitamin D3 deficiency, treatment by vitamin D3 triggered (50000 unit per week for eight weeks orally) until plasma level of vitamin D3 reached above 30 ng/mL. Then, treatment continued by vitamin D3 (50000 Unit per week orally) and calcium (1.5 g/day PO) until 60 days. Finally, the patients were evaluated about fasting blood glucose, HbA1c, HDL, LDL and blood pressure.
Results: In total, 187 subjects (99 men and 88 women) were evaluated in this study. Total hypovitaminose incidence was 0.65% which was higher in subjects with higher body mass index (BMI). Serum content of vitamin D3 and calcium, significantly changed the values of fasting blood sugar (FBS), HbA1c, HDL and TG, but has no significant effects on other factors.
Conclusion: Our results clearly revealed that hypovitaminose vitamin D3 is one of the main factors that can leading to rise in plasma glucose and dyslipidemia occurrence. Also, our data are demonstrated that treatment by vitamin D3 and calcium can modify fasting blood glucose and dyslipidemia in type 2 diabetes mellitus subjects.
Babak Mostafazadeh , Mohammad Javad Amirian , Saeed Shabani ,
Volume 77, Issue 10 (January 2020)
Abstract
Background: Medical malpractice is one of the most important legal issues in medicine committed more or less by physicians. The medical staff has inadequate or deficient awareness of medical errors and their importance. Therefore, this study investigated the frequency of medical malpractices/errors resulting in death in files referred to the Iranian Legal Medicine Organization.
Methods: The study population in this descriptive cross-sectional research consisted of all doctors who had been sued in Tehran's Legal Medicine Organization (Forensic Committees of Tehran Province) from the first day of July 2018 to the end of December 2018. The study was carried out in and under supervision and support of the Legal Medicine Research Center. Data were collected using a checklist of the files from Tehran's Legal Medicine Organization.
Results: The results showed that most medical errors are of organizational types. Major medical failures occur in university-affiliated hospitals among the male technical staff aged 41-50 years with a work experience less than 6 years. Most complaints were recorded against general practitioners, general surgeons, and anesthesiologists, respectively. The smallest percentage of the complaints related to orthopedics, urologists, and ear, nose, and throat (ENT) specialists.
Conclusion: The results of the study indicated that most of medical failures have of an organizational nature and occur in university hospitals among male technical officials who are in the fifth decade of life with a low work experience. So, paying attention to these issues can help the better selection of technical officials. The technical authorities of the hospitals must be careful about the responsibilities given to them. In order to reduce the failure of the technical authorities of the hospitals, doctors with a high standard of service should be appointed as technical officers. These doctors ought to possess legal knowledge and be familiar with the course of complaints filed in the judiciary.
Awat Feizi, Mojgan Mortazavi , Shirinsadat Badri, Mohammad Javad Norouzi ,
Volume 78, Issue 4 (July 2020)
Abstract
Background: Pentoxifylline, a valuable medication with promising clinical characteristics and considerable profile of safety is used in many conditions namely chronic kidney diseases (CKD). However, the decision to prescribe pentoxifylline for anemia in CKD should be based on evidence accrued from randomized controlled trials (RCTs). Yet, substantial heterogeneity exists in studies performed to evaluate pentoxifylline therapy, particularly in relation to classification of patients, the different quality and research design, sample size, baseline parameters, clinical outcome measures, and definition of endpoints and clinically meaningful improvements. As a result, assessment of pentoxifylline in treating anemia of CKD by conducting a systematic review and meta-analysis of the published relevant clinical studies seems rational and promising.
Methods: The present systematic review was done in accordance with the PRISMA guideline for systematic reviews and meta-analysis. Peer-reviewed RCTs with at least four weeks of follow-up were including in the meta-analysis. Online databases (PubMed/Medline, ISI Web of Science, Embase, and Scopus) were searched to December 2017 using selected MeSH terms related to the studied topic. Data was extracted independently by two reviewers using a standard form and then cross-checked. Statistical analyses were carrying out with Stata Software, version 7.0 (Stata Corp., College Station, TX, USA). P value of less than 0.05 was considered statistically significant. Data are presented as standard mean difference (SMD) and confidence interval (CI) 95%.
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Results: According to the predefined criteria, a total of ten studies (parallel group or cross-over trials, and case-control studies) were included and screened for data extraction by two reviewers, separately. The preliminary results extracted from meta-analysis have shown that pentoxifylline can significantly increase transferrin saturation (SMD: 0.348; CI95%: 0.008, 0.688), but there were no conclusive effects of pentoxifylline on hemoglobin (SMD: 0.171; CI95%: -0.390, 0.732), hematocrit (SMD: 0.466; CI95%: -1.426, 2.357), ferritin (SMD: -0.010; CI95%: -0.346, 0.326), and administered dose of erythropoietin (SMD: 0.114; CI95%: -0.232, 0.460), in pooled analyses.
Conclusion: There is uncertainty about therapeutic effects of pentoxifylline on anemia of CKD patients. Since these patients has many diverse complications and receive multiple drug therapy, the results of such meta-analysis regarding outcomes of pentoxifylline therapy may have beneficial effects on rational drug prescription.
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Jalal Saeidpour, Mohammad Javad Kabir, Amrollah Roozbehi, Mehran Pozesh, Moslem Sharifi,
Volume 78, Issue 9 (December 2020)
Abstract
Background: Health insurance literacy is a nascent concept that has emerged mainly after the implementation of the law known as Obamacare in the United States. This study seeks to identify the themes of health insurance literacy in Iranian society.
Methods: The study approach is qualitative. Data were collected using nine semi-structured interviews, ten focal group meetings with the presence of 86 experts of an insurance organization and a specialized meeting with fifteen academic experts, from September to December 2018 at the organization's location. MAX QDA10 software was used to organize the data. Qualitative data analysis was performed using continuous comparison analysis and in the form of directional qualitative content analysis based on the conceptual model (Paez et al 2014). Coding was performed independently by two researchers and then collected. Results were reviewed by an external observer. Finally, in a specialized meeting with the participation of representatives of specialized (groups secretaries) and academic experts(participants in the initial interviews), the findings of the study were re-examined and confirmed
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Results: By reviewing the collected texts, 264 initial codes, 21 components, 10 sub-themes, and five themes were extracted. Based on the conceptual model of the study, the data were organized in three axes. In the knowledge axis, the themes of health insurance knowledge (including health insurance knowledge and attitude toward health insurance) and awareness of insured rights and assignments (including insured assignments and insured rights), in the axis of skill, themes of information search and services (including information acquisition and service search) and utilization of insurance coverage (including receiving insurance coverage and benefiting from benefits), and in the axis of self-confidence, the theme of self-efficacy (including Timely decision making and environmental awareness) have been identified.
Conclusion: Health insurance literacy for Iranian society, instead of being able to choose the type of insurance, focuses on its application in improving decision-making behavior and seeking insured treatment in the health market.
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Elham Tabesh, Zahra Iravani , Mohammad Jafari, Maryam Soheilipour, Mohammad Javad Tarrahi ,
Volume 80, Issue 9 (December 2022)
Abstract
Background: Gastrointestinal bleeding is one of the consequences of COVID-19, which is associated with increased hospitalization and patient mortality. This study was conducted to determine the prevalence of endoscopic findings and the outcome of gastrointestinal bleeding in patients with COVID-19 who were hospitalized from September to December 2019 in Al-Zahra Hospital, Isfahan.
Methods: In this cross-sectional study, out of 5800 patients who were admitted to Al-Zahra Hospital in Isfahan from September to December 2019 due to COVID-19 (according to the positive PCR test result), 87 patients who underwent endoscopy due to upper gastrointestinal bleeding by a skilled gastroenterologist, were selected and studied. Demographic characteristics, underlying diseases, use of anticoagulants, and laboratory findings were studied and evaluated and finally, the disease was evaluated and compared based on endoscopic findings.
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Results: Based on the results obtained from this research, the patients with endoscopic lesions had higher average age (P=0.041), lower blood oxygen saturation percentage (P=0.028), and higher bleeding intensity (P=0.018). The frequency of using anticoagulant drugs in the group whose endoscopy results were abnormal was higher but insignificant. Hemoglobin, platelet, lymphocyte, and CRP levels were higher in the group whose endoscopy was normal, and NLR, LDH, and D-dimer levels were higher in the group whose endoscopy was abnormal (P<0.050). Three people (11.55%) from the group with normal endoscopy and 18 people (29.5%) from the group with abnormal endoscopy died, but the frequency of death was not significantly different between the two groups (P=0.070).
Conclusion: The findings of the present study showed that the COVID patients with upper gastrointestinal bleeding who had endoscopic lesions had significant differences in some characteristics such as age, bleeding intensity, and blood oxygen saturation percentage with patients with normal endoscopy. Also, the frequency of death in patients with endoscopic lesions was relatively higher. Therefore, COVID patients with gastrointestinal bleeding should undergo endoscopy as soon as possible and necessary measures should be taken to control and prevent gastrointestinal bleeding.
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Sedigheh Safari, Akram Eidi, Mehrnaz Mehrabani, Mohammad Javad Fatemi , Ali Mohammad Sharifi ,
Volume 81, Issue 1 (April 2023)
Abstract
Background: Osteoarthritis (OA) is the most common form of arthritis characterized by progressive loss of articular cartilage, causing pain and loss of articular function. High glucose is a crucial inflammatory factor playing a pivotal role in the pathogenesis of OA that induces ROS production. Since most of the current therapies for OA are short-term benefits, hence, there is high demand for finding novel therapeutic agents for OA treatment. Recent studies have demonstrated that mesenchymal stem cells secrete important therapeutic factors that protect chondrocytes. In the current study, we investigated the protective potential of Adipose-derived stem cell conditioned medium (CM-ADSC) as an alternative to cell therapy in high glucose-mediated oxidative stress in C28I2 human chondrocytes.
Methods: This experimental study was performed in the Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran from May 2018 to August 2020. Adipose-derived stem cells were cultured until they reached 90% confluence then washed with PBS and cultured in a FBS-free medium for 48 hours. The conditioned medium was collected and centrifuged. The protective effect of the concentration of conditioned medium on high glucose (75mM)-induced oxidative stress in C28I2 cell viability was evaluated by WST-1 assay. Total RNA was isolated from the treated and untreated cells with TRIzol reagent. The mRNA expression of antioxidant enzymes including, glutathione S-transferase-P1 (GSTP1), catalase (CAT), and superoxide dismutase1 (SOD1) was evaluated by reverse transcription-polymerase chain reaction in treatment and non-treatment groups.
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Results: Adipose-derived stem cell conditioned medium pretreatment remarkably protected C28I2 cells against high glucose. The expression of mRNA of CAT, GSTP1, and SOD1 significantly increased following treatment with the conditioned medium (50%) for 24 hours in high glucose-exposed cells as compared to the control.
Conclusion: Present study indicates that the Adipose-derived stem cell conditioned medium can reduce oxidative stress. It seems that the conditioned medium may protect cartilage in the progression of osteoarthritis.
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Yasamin Kaheni, Ali Mirsadeghi, Mohammad Ali Raisolsadat , Mohammad Javad Ghamari , Mohammad Barhemmat , Tooraj Zandbaf,
Volume 81, Issue 4 (July 2023)
Abstract
Background: Due to the prevalence of laparoscopic cholecystectomy, controlling common problems after this surgery is essential. This study aimed to determine the factors affecting pain after laparoscopic cholecystectomy.
Methods: In this cross-sectional study, 222 patients over 18 years old with symptomatic gallstones who underwent laparoscopic cholecystectomy from March 2021 to February 2022 in Mashhad Medical Sciences of Islamic Azad University Hospitals, were included. The amount of analgesic received after surgery was the same for all patients (Acetaminophen 1 gram intravenously every 8 hours and diclofenac 100 mg rectal every 8 hours). Demographic information of patients, body mass index, history of abdominal surgery, duration of surgery, carbon dioxide pressure, type of surgery (elective or emergency), number of surgical incisions, and pain intensity six and 24 hours after surgery (using a visual analog scale) were collected, and finally, the findings were statistically analyzed by SPSS version 26.
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Results: Out of 222 patients, 179 cases were women (80.6%), and their average age and body mass index were 44.68±12.27 years and 27.08±4.7 kg/m2, respectively. In our study, 110 people (49.5%) had a history of abdominal surgery, of which cesarean section was the most common delete. Pain six and 24 hours after the operation was more common in women than in men, and surgery with three incisions was more painful than surgery with four incisions (P<0.05). In patients with a history of surgery, the pain was greater in six hours after surgery (P<0.05). Pain 24 hours after the operation in patients with gas pressure less than or equal to 14mmHg was greater than in patients with gas pressure greater than 14 mmHg (P<0.05). Pain six and 24 hours after surgery according to age, body mass index, type of surgery (emergency or elective), and duration of surgery had no statistically significant difference (P>0.05).
Conclusion: In our study, female gender, use of three incisions for surgery, and history of previous surgery were associated with more pain after laparoscopic cholecystectomy.
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