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Comparison of two nosocomial infection surveillance in a neonatal ward
Masomeh Abedini , Nahid Ghotbi , Navid Hadavi , Delnia Chavoshi , Nahid Asgharian ,
Volume 71, Issue 10 (January 2014)
Abstract
Background: Nosocomial infection is one of the major causes of death in neonates. In recent years, the results of nosocomial infection control committee, which carried out, based on a protocol of National Nosocomial Infection Surveillance (NNIS) is not consistent with neonatal review articles. This study was performed to determine the prevalence and incidence of nosocomial infection with an active, prospective method based on definitions and characteristics of Center for Disease Control and prevention (CDC) and comparing it with routine method of NNIS. Methods: This cross-sectional and prospective study was independent from Beasat Hospital nosocomial infection control committee and preformed by daily active visiting of neonatal ward (that is level-II) for six month period. The results of this study were compared with the results of the NNIS committee of nosocomial infection. Collected data were statistically analyzed by SPSS software. Results: From all hospitalized neonates, 369 cases (1292 patients / day) were enrolled in the study. The overall rate of nosocomial infection (frequency) was 2.71% and the overall incidence of nosocomial infection was 7.73 cases per 1,000 patients / day. The most common nosocomial infection in this study was skin and soft tissue infections totally 50%. The incidence of Central Line-Associated Bloodstream Infection (CLA-BSI) was 14.2 per 1000 central catheter/day for the six months of study. Nosocomial infection rate preformed by Beasat Hospital nosocomial infection control committee (based on NNIS) was 0.1 % and incidence of nosocomial infection 0.3 per 1,000 patients/ day at the same 6 month study. Conclusion: It seems that a large part of this considerable differences between the results of this study compared to NNIS based study, is this fact that, for nosocomial infection surveillance in the neonatal field, the presence of a specialist as a performer and leader of the team, is necessary.
Relationship between s alleles of vacA gene of Helicobacter pylori and gastroduodenal diseases in Iran: a brief report
Saeid Latifi-Navid, Shiva Mohammadi , Saber Zahri ,
Volume 71, Issue 11 (February 2014)
Abstract
Background: Helicobacter pylori has been classified as the class I carcinogenic agent by world health organization. Colonization of the human stomach with H. pylori is a risk factor for gastroduodenal diseases. The secreted vacA toxin is an important H. pylori virulence factor that causes multiple alterations in gastric epithelial cells and T cells. Several families of vacA alleles have been described, and H. pylori strains containing certain vacA types (s1 and m1) are associated with an increased risk of gastric disease, compared to strains containing other vacA types (s2 and m2). We examined the association between H. pylori vacA s alleles and gastroduodenal diseases in Iran. Methods: A total of 149 H. pylori strains were obtained from patients with gastritis, peptic ulcer, and gastric cancer referring to endoscopy units of several cities in Iran. Biopsy culture and DNA extraction were performed and the frequency of vacA s alleles was investigated by using PCR amplification. Linear regression and binary logistic regression models were used to analyze the association between vacA (vacuolating cytotoxin A) s alleles and gastroduodenal diseases. Results: There was no significant association between the frequency of vacA s alleles and gastroduodenal diseases (gastritis or peptic ulcer disease and gastric adenocarcinoma (P> 0.05)). Conclusion: It is proposed that the H. pylori vacA s1 genotype could not be considered as an important determinant of gastroduodenal diseases in Iranian population and probably if s1 allele is associated with other virulence alleles of this gene, it will cause diseases.
Helicobacter pylori virulence genes and microevolution in host and the clinical outcome: review article
Seyedeh Zahra Bakhti, Saeid Latifi-Navid , Saber Zahri ,
Volume 72, Issue 9 (December 2014)
Abstract
Helicobacter pylori (H. pylori) is the causative agent in development of gastroduode-nal diseases, such as chronic atrophic gastritis, peptic ulcers, mucosa associated lym-phoid tissue (MALT) lymphoma, and gastric cancer. H. pylori has been associated with inflammation in cardia, showing the fact that infection with this bacterium could also be a risk factor for gastric cardia cancer. Gastric cancer is the fourth most common cancer worldwide. This is the second leading cause of cancer-related deaths, and ap-proximately 700,000 people succumb each year to gastric adenocarcinoma. It has been estimated that 69% of the Iranian population currently harbor H. pylori infection. The prevalence of duodenal ulcer and gastric cancer is high in Iranian populations. However, this has been largely influenced by geographic and/or ethnic origin. Epidemi-ology studies have shown that host, environmental, and bacterial factors determine the outcome of H. pylori infection. The bacterium contains allelic diversity and high genet-ic variability into core- and virulence-genes and that this diversity is geographically and ethnically structured. The genetic diversity within H. pylori is greater than within most other bacteria, and its diversity is more than 50-fold higher than that of human DNA. The maintenance of high diversification makes this bacterium to cope with particular challenges in individual hosts. It has been reported that the recombination contributed to the creation of new genes and gene family. Furthermore, the microevolution in cagA and vacA genes is a common event, leading to a change in the virulence phenotype. These factors contribute to the bacterial survival in acidic conditions in stomach and protect it from host immune system, causing tissue damage and clinical disease. In this review article, we discussed the correlation between H. pylori virulence factors and clin-ical outcomes, microevolution of H. pylori virulence genes in a single host, microevolu-tion of H. pylori during primary infection and progression of atrophic gastritis to ade-nocarcinoma, and H. pylori infection status in Iran. Finally, we put forward the hy-pothesis that if the pattern of nucleotide sequence evolution shifts from recombination (r) to mutation (m) and the r/m ratio is reduced, bacterial pathogenicity may be re-duced while maintaining the bacterial life. However, this hypothesis should be further studied with future experiments.
Relationship of Helicobacter pylori vacA i1 and i2 alleles with gastric cancer risk, Iran: brief report
Batool Mottaghi , Reza Safaralizadeh , Morteza Jabbarpour Bonyadi, Saeid Latifi-Navid, Mohammad Hossien Somi, Majid Mahdavi ,
Volume 72, Issue 9 (December 2014)
Abstract
Background: Helicobacter pylori vacA (vacuolating toxin A) gene is comprised of mid- (m), intermediate- (i) and signal-regions. Recently, the vacA-i region genotype has been suggested to be a better predictor of disease severity than either the s- or m-region. The main aim of the present study was to determine the associations of i region poly-morphisms of vacA gene with gastric cancer (GC) and peptic ulcer disease (PUD) in Azerbaijan Province patients. Methods: A number of 89 patients were enrolled. The biopsy samples were taken from patients referring to the endoscopy units of Imam Reza and Shahid Madani Hospitals, Tabriz, Iran from August 2012 to May 2013. The genotype frequencies of vacA-i1 and i2 in were studied using polymerase chain reaction (PCR). Results: The frequency of vacA-i1 and i2 was 51.68% and 48.31%, respectively. The genotypic frequency of vacA-i1 in patients with GC (21/24, 87.5%) was significantly higher than in those with non-atrophic gastritis, NAG (19/48, 39.58%). In contrast, the genotypic frequency of vacA-i2 in patients with NAG, PUD, and GC was 60.42%, 64.70%, and 14.28%, respectively. The results of multiple linear and logistic regression analyses confirmed the intensity of correlation of vacA-i1 allele with GC compared with control group (NAG). No significant correlation was found between the vacA-i-region alleles and PUD risk. Conclusion: We have proposed that the H. pylori vacA-i1 genotype could be an im-portant biomarker for predicting the gastric cancer risk in Azerbaijan Province in Iran. However, due to the difference in the allelic frequency of this gene in H. pylori strains from different parts of the world, the vacA-i1 genotype usefulness in predicting the gas-trointestinal diseases is dependent to the geographic origin of the strains.
Examining the effects of platelet-rich plasma and platelet-rich fibrin on autologous full thickness skin graft survival in rats
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.


A review on the types of immunotoxins and their use in cancer treatment: review article
Saber Soltani , Abolfazl Davoodabadi, Abbas Farahani, Mahsa Dastranj , Masomeh Amini , Navid Momenifar , Shirin Poorabdi , Hojat Veisi ,
Volume 76, Issue 1 (April 2018)
Abstract
Immunotoxins such as pseudomonas exotoxin are Molecules with a unique structure like toxin-antibody part. These immunotoxins are two functional which crossing the cell membrane and enters the target cell and destroy the cell. Toxin-based treatments are a widespread research field and can have broad applications in the biology and public health. Immunotoxins act selectively against cancer cells and have a good potential for detecting and targeting cancer cells. Specific immunotoxins to target immune cells due to the selection type antibody and antibodies are responsible for the identification of the target cells. Cancer is becoming a major cause of death in most developed countries. In order to have a strong factor in cancer repression, that agent must target the cancer cells directly and specifically. Often, but not always, immunotoxins are produced for disabling and killing cancer cells, that this issue is one of new therapeutic approaches in recently. Clinical aims to designing and create new cancer therapies focused with this approach, a lot of information about the toxin and intracellular pathways have been obtained. So, toxins in medicine are useful for the treatment of human disease and study of professional cellular functions. So, immunotoxins have a high potential for cancer treatment. Other applications of immunotoxins, including immune system regulation and treatment of viral diseases and parasites diseases. More research is needed to improve the immunotoxin effects and to reduce their side effects. On the whole, with design creative, clever and experienced programs, many human diseases, particularly cancers can be in a short period of time and faster than other methods of treatment that the treatment of long, to be treated. Following the design and implementation of clinical trials, the effects of immunotoxins on animal tumorigenic models were performed. In fact, in this study, we focus on the use of protein-bound toxins with bacterial and herbal sources and more specifically Pseudomonas immunotoxins which attached to antibodies to target cancer cells.

The study on the knowledge, attitude and practice of Tehran citizens about Health and Disease in 2011 (KAP): overview of methodology and primary results
Masoud Ahmadzad-Asl , Shayan Mostafaei , Shahram Rafiefar , Navid Mohammadi , Malihe Farid , Kourosh Kabir ,
Volume 76, Issue 4 (July 2018)
Abstract
Background: The study of their knowledge, attitude, and behavior toward health is an essential step for health planning. In the urban area, there are several concerns about environmental pollution, health status, the dangers of insecurity, and bad dietary habits. The aim of the study was the determination of knowledge, attitude, and behavior of Tehran citizens in order to plan better municipal services.
Methods: This descriptive, cross-sectional study was conducted on 13000 participants between 15-84 years in 22 districts of Tehran, Iran University of Medical Sciences, in August and September of 2011. Cluster sampling and self-administered reliable and valid questionnaire were used for data gathering. The inclusion criteria are all of citizens of Tehran. Age, sex, marital and job status, obesity, physical activity, hypertension, myocardial infarction, accidents, diabetes, nutrition, stroke, psychological behavior, smoking, addiction and drugs, musculoskeletal, sexual behavior, anemia, physical environment, fat blood, cancer, chronic obstructive pulmonary disease, dietary habits and socioeconomic status were measured under standard protocols and by using calibrated instruments. 
Results: From 13000 participants in the study, 11753 (90%) was fulfilled the questioners. Nonresponse rate from 11753 participants was 8.6%. The proportion of obesity/overweight was 50% and 29.5% of people had appropriate physical exercise, 37.6% reported a tobacco consumer in their family and 4.5% reported an experience of substance misuse. Also, 29.2% and 24.8% from these had anomalistic consuming of salt and soft drink, respectively. Of the participants, 44.8%, 89.1% had a good knowledge and attitude, respectively. Cronbach alpha coefficient was 0.82 and 0.79 for knowledge, attitude and behavior, respectively. In additional, the correlation coefficient between test and re-test questions was 0.91. 
Conclusion: This study was a comprehensive study to measure the knowledge, attitude and practice of Tehran citizens using reliable and valid questionnaires about general health status. A considerable percentage of Tehran citizens suffering from overweight, obesity, hypertension, diabetes, high blood lipids and smoking consuming and using anomalistic from TV and computer. The results can be used as a framework and guide to prioritize problems and planning health education interventions in Tehran

Bacterial and tissue biomarkers of gastric cancer: new findings and future perspectives: review article
Esmat Abdi , Saeid Latifi-Navid , Hamid Latifi-Navid , Saber Zahri, Abbas Yazdanbod ,
Volume 76, Issue 6 (September 2018)
Abstract
Gastric cancer (GC) is the second leading cause of cancer-related deaths worldwide. It has been proposed that the specific genotypes of Helicobacter pylori (H. pylori) are the causative agents in the development of gastroduodenal diseases, such as chronic atrophic gastritis, peptic ulcerations, and GC. However, disease progression to GC occurs in only a small proportion of infected patients. Recently, we identified a novel polymorphic site in the 3ʹ-end region of H. pylori vacA gene. The vacA c1 genotype increased the risk of GC. This association was independent of and larger than the associations of the m-, i-, and d-type of vacA or cagA status with GC. Therefore, treatment of H. pylori infection may be an effective way to prevent GC. Expression of cytokines and their associations with inflammatory responses has been shown. Several cytokine polymorphisms, such as IL-1B, IL-8, IL-10, and TNF-α have been considered as risk factors for GC. It has been shown that the interaction of bacterial genotypes and host factors plays an essential role in developing GC. Several altered molecular pathways are involved in the pathogenesis of GC. Micro-RNAs are small, non-coding RNAs of 18-25 nucleotides in length that regulate the expression of target mRNAs. Expression pattern of cancer cells is different compared with the normal cells. Micro-RNAs plays a critical role in apoptosis and classified in two groups: pro- and anti-apoptotic agents. Recent studies have confirmed the oncogenic or tumor suppression role of micro-RNAs in cancer cells. They play a significant role in the GC cell physiology and tumor progression, by translational suppression of target genes. These small RNAs have therefore emerged as a new type of GC biomarker with immeasurable clinical potential. Generally, a variety of micro-RNAs involved in different stages of cancer, including tumorigenesis, angiogenesis, and metastasis. Considering to this issue more than 50% of cancers can be cured, if they were diagnosed in the early stages. Hence, identifying the biomarkers of GC could play an important role in prevention, early diagnosis and rapid treatment of patients. In this review article, we have reviewed the latest findings about bacterial and tissue biomarkers of GC

Following a patient with breast cysts using thermal imaging: case report
Hossein Ghayoumi Zadeh , Mostafa Danaeian , Ali Fayazi , Cyrus Ahmadi Toussi , Nasrin Ahmadinejad , Mitra Navid ,
Volume 76, Issue 7 (October 2018)
Abstract
Background: Breast cancer is a common malignancy in which early breast cancer detection by the help of imaging can improve the treatment outcome. Thermography utilizes infrared beams which are fast, non-invasive, and non-contact and the output created images by this technique are flexible and useful to monitor the temperature of the human body.
Case presentation: Our patient is a 25-year-old woman who was referred to Tehran's Imam Khomeini Hospital, Tehran University of Medical Sciences, in October 2014 and June 2017 to perform clinical examinations of breast cancer at the Invasive and New Radiology Research Center of Tehran. The results of the sonography for the left breast and bilateral axillary regions and sonography guided biopsy from the left axillary region indicated that:  it was consistent with the tangential prominence at 11-12 O’ clock in the left breast tissue and echo gene was found without any suspected findings. Then, using the non-contact infrared imaging camera VisIR 640 (Thermoteknix Systems Ltd, Cambridge, UK), the feasibility of thermography method in the patient's follow-up was investigated.
Conclusion: Thermography can be used to detect abnormal areas in the breast tissue that may have cystic origin. The results indicated that the accuracy of the identification and matching of patient cysts in mammography and ultrasonography with the results of thermography in both periods of October 2014 and June 2017. Considering the results, it is noteworthy that the diagnostic clock of the breast cysts in the patient is consistent with the results of the clinical trials with the thermography. Moreover, in a 2 years intervals, the status of thermal morphology status of the cystic region did not considerably change which showed a relatively stable status.

A systematic review and meta-analysis of medical malpractice studies in Iran
Navid Kalani, Naser Hatami, Mohammad Zarenezhad, Alireza Doroudchi , Mahdi Foroughian, Esmaeil Raeyat Doost ,
Volume 79, Issue 5 (August 2021)
Abstract
Background: Medical malpractice is a serious problem in the health care system. This study aimed to review the medical negligence in Iran.
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).
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.

Assessment of mitochondrial DNA copy number in peripheral blood leukocyte of opiate abusers and healthy individuals
Kouros Divsalar, Sara Hesami, Majid Mahmoodi, Navidreza Giahi, Fatemeh Divsalar , Mohammad Pour-Ranjbar , Amin Honarmand,
Volume 80, Issue 7 (October 2022)
Abstract
Background: Based on the studies, variation in the mitochondrial DNA (mtDNA) copy number in peripheral blood leukocytes is associated with increased susceptibility to diseases including cancer. Opiate abusers are at high risk for diseases. In this study, we measured the mtDNA copy number in peripheral blood leukocytes in a group of opiate abusers compared with those in healthy individuals.
Methods: In a case/control study, three groups were selected consisting of 32 opium abusers, 24 heroin addicts and 25 healthy individuals. The amount of 5 ml of whole blood was collected from each individual who participated in the study and stored at -20 centigrade. The sample collection was performed from November 2018 to February 2020. Case groups were recruited from the Methadone maintenance therapy center. Contro group had no history of drug use and cigarette smoking. DNA was extracted from the whole blood samples using the salting out method. The DNA from a mitochondrial gene, dehydrogenase subunit1 (-ND1 gene) and a nuclear gene, human globulin (HGB gene), were quantified by a real-time PCR-based method to measure the relative mtDNA copy number of each group number.
Results: There was no significant difference in demographic characterization between the three study groups, opium abusers, heroin addicts and healthy individuals. We found that opium users had a higher mean of mtDNA copy number than those in the healthy control group (P=0.11). Heroin addicts had also higher mean of mtDNA copy number than those in healthy group (P=0.21). The mean mtDNA copy number in opium abusers was higher than that in heroin addicts (P=0.22), although the difference was not statistically significant.
Conclusion: The results of this study indicated that mtDNA copy number increased in a group of opiate abusers. Considering that alteration of mtDNA copy number is associated with increased susceptibility to several diseases including cancer, further research on mtDNA copy number with a high number of volunteers of opiate addicts may clear the effect of opiate abuse on the human genome.

Determining the prevalence of positive cases of IgM and IgG antibodies against Cytomegaloviruses in Shahid Motahari clinic in Shiraz during the years 2019 to 2023
Navid Omidifar, Reza Masoumzadeh , Mansoureh Shokripour, Yousef Nikmanesh,
Volume 81, Issue 9 (December 2023)
Abstract
Background: Cytomegalovirus (CMV) stands out as a significant contributor to congenital viral infections, exhibiting a prevalence ranging from 40% to 90%. Cytomegalovirus has different effects on people, such that it appears without symptoms in people with a healthy immune system, but it leads to severe symptoms in infants and those with a weak immune system. To comprehend the disease's societal prevalence, seroepidemiological investigations are imperative. This study aims to ascertain the serum prevalence of cytomegalovirus and explore potential correlations between age, sex, and the prevalence of CMV in patients attending Shahid Motahari Clinic in Shiraz
Methods: A cross-sectional descriptive study was undertaken on 2,469 individuals who assessed their cytomegalovirus antibody levels between March 2019 and February 2023 at Shahid Motahari clinic in Shiraz. The ELISA method was employed to evaluate CMV, and the obtained data were analyzed using SPSS version 19 software. Chi-square tests and Fisher's exact test were applied to examine the correlation between positive antibody results and age as well as gender.
Results: Among the 2469 surveyed people, 658 people (26.65%) were men and 1811 people (73.35%) were women. Based on ELISA test, antibody titer was reported positive in 1157 people (46.9%), including 315 men and 842 women, and 1312 people (53.1%) had negative antibody titer. The highest number of positives is related to IgG, and in IgM, the test results are mostly negative. IgM prevalence showed no gender correlation but demonstrated a significant association with patient age. Meanwhile, IgG prevalence exhibited significant relationships with both age and gender
Conclusion: Considering that the city of Shiraz is considered as one of the centers of treatment in the country and a large number of patients from all parts of the country and even neighboring countries come to this city for treatment and especially for the purpose of organ transplantation; also with Considering the 46.9% prevalence of CMV infection in the region, it is recommended to use preventive methods such as vaccine and immunotherapy against CMV infection in patients

Comparison of 2% dexmedetomidine and lidocaine in analgesia control and hemodynamic changes in cataract surgery with local anesthesia
Reza Sahraei, Ahmad Bostani , Mousa Zare, Navid Kalani, Fatemeh Eftekharian,
Volume 82, Issue 3 (June 2024)
Abstract
Background: Cataract surgery is the most common surgery in the world. The prevalence of age-related cataract increases with age, and its prevalence increases with each decade of age after forty years. Various drugs are used to control analgesia and hemodynamics in patients undergoing cataract surgery. The purpose of this study is to compare dexmedetomidine and 2% lidocaine in the control of analgesia and hemodynamic changes in cataract surgery with local anesthesia.
Methods: In this double-blind clinical trial study, 52 patients with anesthesia class I and II underwent cataract surgery. Patients were randomly assigned to two groups: lidocaine (three cc) and dexmedomedin (five μg/kg + lidocaine). The information collection checklist in this study included: age, gender, history of aspirin use, systolic and diastolic blood pressure, heart rate, intraocular pressure, postoperative complications, and postoperative pain.
Results:  The Mann-Whitney U test showed that the Dex-Metomedin group had less pain than the Lidocaine group in the first hour after the intervention (P=0.012). Two hours after the intervention, the dexmedemodin group had less pain than the lidocaine group (P=0.001). In the investigation of IOP after retrobulbar block in the dexmedetomidine group, we saw a significant increase in IOP from 16.56±3.12 to 17.96±2.68 mmHg compared to before the block (P=0.001). In the lidocaine group, we also saw a significant increase in IOP from 16.18±3.66 to 19.66±4.67 mm Hg compared to before the block (P=0.001). Before and after retrobulbar block, there was no significant difference between the two groups (P=0.694 and P=0.108, respectively). To investigate the effect of these interventions more precisely, the amount of IOP pressure change was also compared between the two groups, and we saw a greater increase in the lidocaine group than in the dexmedetomidine group (P=0.002).
Conclusion: The results of the present study showed that dexmedetomidine + lidocaine in retrobulbar form compared to lidocaine was able to control the pain level of patients after surgery and systolic and diastolic blood pressure during surgery. It is suggested to use this drug as local anesthesia in cataract surgery.

Comparison of serum vitamin D levels in children with nephrolithiasis and healthy children: a cross-sectional study
Navid Qaraei, Mohammad Ali Jafari, Maedeh Jafari , Fatemeh Karami Robati , Saeedeh Parvaresh,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Nephrolithiasis is one of the oldest known systemic diseases of kidney and urinary tract in children. This study aimed to compare the serum level of vitamin D in children with nephrolithiasis and healthy children.
Methods: The present descriptive-cross-sectional study was conducted from October 2017 to September 2019. 74 children with kidney stones and 63 healthy children referring to Afzalipour Hospital in Kerman were selected by simple sampling method. Healthy children who were considered as the control group were matched with the case group in terms of age and gender. All patients underwent kidney and urinary tract ultrasound. The diagnosis of kidney stones was based on the radiologist's opinion. Demographic characteristics of patients (age and sex) were recorded. Patients' blood tests were checked for vitamin D and calcium. Descriptive and analytical methods and SPSS software version 21 were used to analyze the data.
Results: The average age of children with kidney stones and healthy children was 5.41±1.8 and 10.06±0.41 years old, respectively (P=0.971). The most number of patients were boys (58.1%). 29.7% of patients and 15.9% of healthy children had a family history of kidney stones (P=0.056). 71.6% of patients had unilateral kidney stones and 28% had bilateral kidney stones. The mean serum level of vitamin D was higher in healthy children (P=0.021). The average calcium was higher in children with kidney stones (P=0.001). The average calcium was higher in children with kidney stones who had a family history of kidney stones (P=0.018). Average calcium was higher in children with bilateral kidney stones (11.4±1.1) (P=0.033). The mean calcium was higher in children with kidney stones with vitamin D deficiency (P=0.001) and sufficient vitamin D levels (P=0.037).
Conclusion: The average level of vitamin D serum in healthy children was significantly higher than that of children with kidney stones, and the average level of calcium in children with kidney stones was significantly higher than that of healthy children. Larger studies with more patients are needed to investigate these relationships.

The effect of adding two doses of epinephrine along with intrathecal bupivacaine and fentanyl on hemodynamic in lower extremity orthopedic surgery: a double-blind randomized clinical trial study
Navid Kalani , Hasan Zabetian, Shahram Shafa, Erfaneh Alirezai, Fatemeh Eftekharian, Reza Sahraei ,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Recently, epinephrine is used to increase the depth and duration of local anesthetic pain, and it is widely used topically to reduce local anesthetic release and reduce bleeding caused by surgery.
Methods: This study was a randomized, double-blind clinical trial on 30 patients aged 18 to 85 years undergoing lower limb orthopedic surgery referred to Peymaniyeh Hospital in Jahrom from September to December 2022. Patients were randomly assigned to two groups, A (epinephrine+fentanyl+bupivacaine) and B (bupivacaine+fentanyl). Systolic blood pressure, diastolic pressure, mean arterial pressure, arterial blood oxygen saturation percentage, and pulse rate were measured and recorded before drug administration, before spinal anesthesia, after anesthesia, and then every half hour until the end of surgery (15, 45, 30, 60, 75, 90, 120) and during recovery. Data analysis was performed using SPSS version 21 software and descriptive (mean, standard deviation) and inferential statistics (t-test, chi-square, Mann-Whitney, Friedman) at a significance level of P<0.05.
Results: Thirty patients aged 18 to 85 years (in two groups of 15) with anesthesia class I and II undergoing lower limb orthopedic surgery were evaluated. The study groups are matched in terms of age and gender variables. There was no significant difference in mean systolic, diastolic, mean arterial blood pressure, and heart rate before and after anesthesia, 15, 45, 30, 60, 75, 90, and 120 minutes after drug injection, and at entry and exit from recovery between the Epinephrine+Fentanyl+Bupivacaine and Fentanyl+Bupivacaine groups. There was a significant difference in mean O2SAT before anesthesia, 15, 30, and 75 minutes after drug injection between the epinephrine+fentanyl+bupivacaine and fentanyl+ bupivacaine groups (P<0.05).
Conclusion: The use of the combination of epinephrine+fentanyl+intrathecal bupivacaine compared to the combination of fentanyl+bupivacaine did not have a significant difference in the studied variables of patients' vital signs.

Investigating the effect of intravenous dexmedetomidine on bleeding rate and surgeon satisfaction in septorhinoplasty patients
Mojtaba Ghaedi, Mojtaba Sohrabpour, Gholamreza Motazedian, Navid Kalani , Reza Sahraei , Mohammad Sadegh Sanie Jahromi,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Rhinoplasty is a challenging and complex surgery because it is designed to meet the unique needs of the patient. In rhinoplasty surgery, many factors contribute to achieving the desired result. These factors include the surgeon's care and observation, analysis of the existing anatomy, choice of surgical technique, degree of soft tissue and cartilage trauma, amount of bleeding, quality of surgical instruments and anesthesia, and anything that helps reduce bleeding.
Methods: This double-blind study was conducted on 50 patients aged 18 to 45 years undergoing septorhinoplasty surgery referred to Motahari Hospital in Jahrom city in 2022. Patients were randomly divided into dexmedetomidine and control groups. The degree of sedation, bleeding and surgeon satisfaction were evaluated and recorded. Data analysis was performed using SPSS software, version 21 (IBM SPSS, Armonk, NY, USA) and descriptive statistics (mean, standard deviation, percentage, number, frequency) and inferential statistical tests (Mann-Whitney U test, Kruskal-Wallis, t-test, chi-square test). The significance level in all tests was considered P<0.05.
Results: The majority of patients in the study groups were female and the mean age of patients in the dexmedetomidine group was 34.36±7.33 years and in the control group was 36.60±9.59 years. The study groups were similar in terms of age and body mass index (P<0.05). The frequency of patient sedation in the dexmedetomidine group was lower than the control group, but it was not statistically significant (P<0.05). The results showed that at the beginning of the operation and 90 minutes later, the satisfaction level of the patient surgeon in the dexmedetomidine group was significantly better than the control group (P<0.001). In the dexmedetomidine group, the field of view of the surgeon was relatively clear and completely clear. The amount of bleeding in the dexmedetomidine group was lower than the control group, but it was not statistically significant (P<0.05).
Conclusion: Dexmedetomidine increased the surgeon's satisfaction by reducing bleeding and improving the surgeon's visual field. Therefore, this drug can be used as an anesthetic aid in surgery.

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