Showing 24 results for Shoja
D Shojaiezadeh ,
Volume 55, Issue 1 (30 1997)
Abstract
This study is a review of the causes of depression among disabled soldiers (Janbazan) with severity of disability more than 40 percent. In this study, the total population is 1186. This population is classified based on the percentage of severity of the disability (40-49%, 50-69% and >70%). There are respectively in each. Classes 680, 272 and 234 cases. 10 percent of each class (totally 12 persons) were selected randomely. It must to be mentioned that 4 cases was absent because of different reasons. The results of this study showed that the depression is more prevalent among cases with high percentage of disabilities. The result of this research indicated that 56% of the study group are involved in depression, and from them 32.7% are involved in serious depression. Threr is a close correlation between intensity of depression and special factors such as financial, educational and occupational problems.
D Shojaiyzadeh ,
Volume 55, Issue 5 (1 1997)
Abstract
This inverstigation is a quasi-experimental study comparing the effects of two methods of health education on student's knowledge and attitudes about AIDS. The target population consisted of 218 male undergraduates studying in Payame Noor University in Saghez, Iran. A random sample of 106 students was selected using sample random sampling method. The students were randomly divided into two experimental groups. One group was educated about AIDS using a direct method of health education and indirect method was used for the other group. Using pretest/posttest method of data collection, analysis of the data showed a significant difference between each group's knowledge and attitudes before and after the educational programs. Comparison of the two educational methods showed no significant difference on student's knowledge about AIDS. However, method one (using a direct method of health education) was significantly more effective in changing student's attitudes towards AIDS than method 2 (using an indirect method of health education).
D Shojaiezadeh ,
Volume 55, Issue 6 (1 1997)
Abstract
In this quasi-experimental study, we have evaluated the effects of an educational program on the level of knowledge, attitude and practice methods of experimental assistant dentists in Shiraz, regarding AIDS and HIV transmission. These variables were assessed before and after an educational program, by a questionnaire and a checklist. The educational program consisted of lectures and group discussions, held in 4 sessions during one month. The second assessments of knowledge, attitude, and of practice methods were performed six weeks and three months after the completion of the educational program, respectively. The scores were significantly different before and after the educational program, which can therefore be considered effective in improving knowledge, attitude and practice methods in the cases under study.
S Tahvildary , D Shojaeizadeh , K Mohammad , M Mohagheghi ,
Volume 57, Issue 3 (8 1999)
Abstract
In this research 600 staff of an educational office (distric seven) were being studied before and after they were educated about breast self-examination. Necessary information was gathered before and after they were educated through questionnaires. The result of the study showed that the average scores of their awareness before and after they were educated was 42.3 and 44.2, respectively. Hence, there was a significant difference because of the education of self-examination women's breasts (P<0.0001). There was no difference between family members nor between those who had different marital status, concerning the awareness of breast self-examination. However, there was a large difference between the educational level of women who were studied and the educational level of their spouses, according to their knowledge concerned about monthly breast self-examination (P=0.04).
M Zafarqandi , M Moeeni , A Shojaeefar ,
Volume 57, Issue 4 (9 1999)
Abstract
Intestinal obstruction is a significant disease specially in patients with previous surgery. Patients symptoms and signs usually are abdominal pain, vomiting, abdominal distention and obstipation. Adhesion bands secondary to previous abdominal surgery is the most common cause of small bowel obstruction and in USA up to 70% of small bowel obstruction is caused by adhesions. In our study adhesion is also the most common cause but 23% of patients have obstruction secondary to adhesion. In the literature colorectal cancers are the most common cause of colonic obstruction and volvulus is the third common cause of colonic obstruction after obstruction from compressive effect of other primary abdominal or pelvic tumors. In our study vuvulus was the most common cause of colonic obstruction and colorectal cancer was the second most common cause. The most common previous surgery that lead to obstruction in our study was appendectomy. From 112 patients 75% of patients had complete and 25% had partial obstruction. Frequency of mortality was six from 112 patients or 5.3%. Seventy percent of our patients had small bowel obstruction and 30% had colonic obstruction. Patients with hypertension before surgery for obstruction had greater risk of mortality in the postoperative period than other patients. Patients with intestinal gangrene had greater risk of postoperative complication and morbidity than other patients.
Salimi J, Taghavi M, Shojaeefar A, Shadman F,
Volume 64, Issue 8 (13 2006)
Abstract
Background: A plan for management of infected arterial pseudoaneurysm has evolved from our experience with forty two cases of such aneurysms treated between 1378 and 1382.
Methods: Clinical data of 42 patients with femoral pseudoaneurysm resulting from addictive drug injection who presented in emergency department of Sina Hospital between 1378 and 1383 were retrospectively reviewed.
Results: All patients were men with the mean age of 36.9 years. Twenty eight patients were referred from other medical centers. The mean time of delay in presentation was 17.3 days. The mean duration of drug injection was 14 months. Primary repair and emergent vascular bypass were performed in 3(7.1%) and 2(4.8%) patients, respectively. 5(11.9%) patients undergone delayed revascularization. Thirty two (76.2%) patients returned to their normal lifestyle without any vascular bypass. One patient required amputation and one patient died due to sepsis and acute renal insufficiency.
Conclusion: Management of infected femoral pseudoaneurysms is simple ligation of the external iliac or femoral artery. When Doppler is not available “Operation Room and postoperative Direct Observation” is recommended in such patients to avoid unnecessary revascularization surgery.
Shoja Mr, Mahdavi M, Manaviat Mr, Besharati M.r,
Volume 64, Issue 11 (7 2006)
Abstract
Background: Diabetes Mellitus is the most common endocrinologic disease in human and retinopathy is one of the most common complications. Etiology of this complication is yet unknown but one of the factors that can be effective on its production or progression is serum lipid. We aim to study the relationship between different degrees of diabetic retinopathy and serum lipids levels.
Methods: An observational cross-sectional study designed to study over 37 patients with diabetes mellitus type one and 157 patients with diabetes mellitus type two. Former was selected as sensus and latter was selected randomly from diabetic patients attending the diabetes clinic in Yazd during 2002. Inclusion criteria was duration of diabetes at least seven years from diagnosis. Statistical analysis performed by SPSS package edition 11 and wit statistical tests as Chi square, Fisher Exact and ANOVA.
Results: Among 194 cases, 74 cases were males and 120 females. 90 cases (46.4%) have normal total serum cholesterol and 104 (53.6%) hypercholestrolemia. In case of triglyceride 94 cases (48.4%) have normal serum triglyceride and 100 (51.6%) hypertriglyceridemia. Distribution of different degrees of diabetic retinopathy was statistically significant due to cholesterol and triglycerides (P-Value<0.05). In different groups of sex, diabetic retinopathy was more prevalent if there was hypertriglyceridemia or hypercholesterolemia. This was correct about different groups of age and type of diabetes. This means that in different groups of age and type of diabetes, diabetic retinopathy was more prevalent if there was hypertriglyceridemia or hypercholesterolemia.
Conclusion: Prevalence of diabetic retinopathy is higher in cases with hypertriglyceridemia or hypercholesterolemia than cases with normal serum triglyceride or cholesterole.
Amari A, Razavi Al, Jamali A, Aminisardrod Aa, Motamedi M, Shojaee S, Ansaripour B, Pourgholaminejad A, Hadjati J,
Volume 67, Issue 9 (6 2009)
Abstract
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Background: Dendritic Cell (DC) is an important
antigen-presenting cell that present tumor antigen to CD8+ and CD4+ T- Lymphocytes and
induce specific anti-tumor immunity. In
order to induce effective anti-tumor response, an option is increasing the
efficiency of antigen presentation of dendritic cells and T cell activation capacity. The aim of the present study was to investigate the effect of dendritic cell maturation with protein components of toxoplasma gondii on cytotoxic T lymphocyte
activity and their infiltration in to the tumor.
Methods: For DC generation, bone marrow cells were cultured in the
presence of GM-CSF and IL-4 for five days. After that, LPS, protein
components and whole extract of toxoplasma gondii were added to the culture
media and incubated for another two days for DC maturation. To generate tumor,
mices were injected subcutaneously with WEHI-164 cell line. For immunotherapy 106 DCs
matured with different compounds were injected around the tumor site.
Infiltration of CD8+ T cells were determined by flow cytometry and cytotoxic
activity was measured by LDH detection kit.
Results: Immunotherapy with DCs treated with protein components of toxoplasma gondii
led to a significant increase in the activity of cytotoxic T cells and
infiltration of CD8+ T cells in to the tumor. Immunotherapy using protein
components of toxoplasma gondii significantly improved the survival of the mice
compared with other groups (p<0.0001).
Conclusion: Protein components of toxoplasma are able to increase DC capability in
induction of CTL-mediated
anti-tumor response and
increase infiltration of these
cells in to the tumor.
Aghaei M, Gharibdost F, Zayeni H, Akhlaghi M, Sedighi S, Rostamian Ar, Aghdami N, Shojaa M,
Volume 68, Issue 12 (6 2011)
Abstract
Background: Systemic scleroderma (SSc) is a generalized
connective tissue disorder of unknown origin which most notably is
characterized by skin thickening and organ damage. Endothelin-1
(ET-1) antibody plays a role in skin fibrosis. The
aim of this study was to determine the prevalence and correlation of different
manifestations of SSc with ET-1
plasma levels.
Methods: This cross-sectional analytical study was conducted on 95
patients (91 women and four men)
with scleroderma in 2006. The patients had
been referred to the Rheumatology Clinic of Shariati Hospital in Tehran, Iran.
The demographic data and signs and symptoms were entered in a questionnaire and
endothelin-1 concentrations were measured.
Results: The mean age of the patients was 38±12.29 years.
Diffuse cutaneous SSc (dcSSc)
was diagnosed in 52 and limited cutaneous
SSc (lcSSc)
in 43 patients. Raynaud's phenomenon (91%)
was the most common manifestation in the patients. The relationship between the
resorption of terminal phalanges due to fibrosis with the plasma concentration
of Endothelin-1 was statistically significant (p=0.001).
Pitting ulcers had significant relationships with endothelin-1 concentrations
too (p<0.05). No other significant relationships
were found between the other manifestation of the disease and Endothelin-1
concentration.
Conclusion: In
this study, Reynaud's phenomenon was the most frequent sign in patients with
scleroderma. Thus, it could serve as a tool for the diagnosis of scleroderma.
As there were no significant relationships between the other manifestations of
scleroderma with endothelin-1, a cohort study with a
larger sample size is suggested.
Aghaei M, Sedighi S, Behnam Pour N, Hezar Khani Sh, Jamshir M, Agh A, Shojaa M,
Volume 70, Issue 7 (6 2012)
Abstract
Background: Low bone mass is a serious health problem mostly seen in postmeno-pausal women with rheumatoid arthritis. The purpose of this study was to determine the prevalence of osteoporosis and some related risk factors in postmenopausal women with rheumatoid arthritis.
Methods: The data for this descriptive analytical study was extracted from the medical records of 98 postmenopausal women with rheumatoid arthritis who had attended the 5th of Azar Teaching Hospital affiliated to Gorgan University of Medical Sciences, in Iran, in 2009.
Results: The mean durations of menopause and rheumatoid arthritis were 9.39 and 5.13 years, respectively. The overall prevalence of osteoporosis was 13.3%. We found a significant correlation between age, disease duration, and duration of menopause with bone mineral density (P<0.05).
Conclusion: Our results indicate a high prevalence of osteoporosis at the lumbar spine of postmenopausal women with rheumatoid arthritis.
Ali Zahedian, Mohsen Shoja , Hadi Mollazade, Masoomeh Taiebi ,
Volume 72, Issue 2 (May 2014)
Abstract
Background: Laparoscopic cholecystectomy is a way of removing the gallbladder. But like other surgeries, this procedure has some side effects such as postoperative shoulder pain. This study evaluates the effect of different gas flow rates into the abdominal cavity on postoperative shoulder pain in laparoscopic cholecystectomy patients.
Methods: The study as a randomized clinical trial was conducted on laparoscopic chol-ecystectomy patients in Imam Khomeini Hospital- Esfarayen 2011-2012. One hun-dred participants were selected by available sampling, and were divided randomly into two groups of 50 patients. In group I flow rate of CO2 gas was two liters per minute and in group II flow rate of CO2 gas was five liters per minute. After reversing anesthe-sia, six, 12 and 24 hours post operative, shoulder pain was evaluated by Visual Ana-logue Scale (VAS) pain questionnaire. The study findings analyzed by independent t-test.
Results: The mean age of participants was 48.8±7.5 years and mean surgery duration was 36.5±13.1 minutes, and there was no significant differences between two groups (P>0/05). However, the mean shoulder pain scores in group I (blowing with low pres-sure) was differed significantly with group II (blowing with high pressure) (P<0.05). In group I, pain was lower than group II.
Conclusion: Results showed if CO2 gas flow rate is two liters per minute (blowing with low pressure), the patients complain less shoulder pain. Therefore low pressure gas in-sufflation for laparoscopic surgery is recommended. Further studies in this field should be considered.
Soror Roozafzay , Khadijeh Hekmat , Kobra Shojaei , Pourandokht Afshari , Mohammad Bahadoram ,
Volume 72, Issue 5 (August 2014)
Abstract
Background: Bacterial vaginosis (BV) is the most prevalent causes of abnormal secre-tion in women at fertility age. Also, Bacterial vaginosis is one of the most common dis-eases in women who refer to gynecology clinic. The main cause of the pathogenesis is increasing pH of vagina due to reduced number of lactobacillus and growth of anaero-bic bacteria. Prevalence of BV varies between 10 to 30 percent in different societies. Amsel criteria is used as diagnostic test in BV. This interventional study was designed to assess the impact of vaginal lactobacillus suppository and metronidazole compared to metronidazole alone on the recovery and recurrence of bacterial vaginosis.
Methods: This study was a prospective, randomized, double-blind clinical trial which was conducted on 130 women with bacterial vaginosis to compare the effects of vagi-nal lactobacillus suppository and metronidazole. Bacterial vaginosis was diagnosed us-ing Amsel criteria that based on some clinical symptoms. Patients were divided into two groups, first group were treated with oral metronidazole plus lactobacillus and second group were treated with metronidazole alone. Patients were followed-up one week and four weeks after initiation of the treatment.
Results: One hundred and thirty women completed the study. Patients were followed at one and four weeks after initiation of intervention. Amsel criteria and recovery rate in both groups compared before treatment one and four weeks after treatment. The crite-ria and treatment were significantly improved, but this improvement was higher and statistically significant in the metronidazole plus Lactobacillus group compared to sec-ond group (P< 0.0001).
Conclusion: The protective effects of lactobacillus in dealing with anaerobic patho-gens as well as the negative impact of metronidazole on lactobacillus of vaginal flora, use of lactobacillus along with metronidazole especially in patients with recurrent infec-tions is recommended. In other words, using lactobacillus with metronidazole for treatment of bacterial vaginosis is more effective than metronidazole alone.
Mahdieh Shojaa, Mehrdad Aghaie , Mahsa Amoli , Patricia Khashayar , Naemeh Javid, Fatemeh Shakeri, Mostafa Qorbani , Ramin Mohebbi,
Volume 73, Issue 2 (May 2015)
Abstract
Background: Cytotoxic lymphocyte antigen-4 (CTLA-4) plays an important role in regulating T cell activation. CTLA-4 gene polymorphisms are related with genetic susceptibility to various autoimmune diseases, including systemic lupus erythematosus (SLE). We analyzed the role of CTLA-4 polymorphisms at positions -318CT in patients who suffer from SLE.
Methods: This study was performed on 180 SLE patients referred to 5th Azar University Hospital in Gorgan, Iran. Three hundred and four ethnically-and age-matched healthy controls with no history of autoimmune diseases entered the study between 5th May 2008 and 23rd October 2009. DNA was extracted from blood samples according to the standard procedure. Polymerase chain reaction- restriction fragments length polymorphism (PCR-RFLP) was used to analyze the genotype and allele frequencies of this polymorphism. PCR was carried out using the following primers: forward 5′-AAATGAATTGGACTGGATGGT-3′ and reverse 5′-TTACGAGAAAGGAAGCCGT G-3′. The frequency of alleles and genotypes were assessed using direct counting. Chi-square test and Fisher’s exact test were used to compare the association between the alleles and genotype frequencies and SLE. P<0.05 were considered statistically significant.
Results: The CC genotype was observed in 94.5% of the SLE patients and 82.4% of the controls the difference was statistically significant (P=0.0001, OR=3.51, CI95%=1.77-7.53). The CT genotype, on the other hand, was more frequently observed in the control group (17.1% vs. 5.5%, P=0.0001, OR=0.28). T allele was significantly more common in the controls compared to SLE patients (P=0.0001, OR=0.26, CI95%=0.13-0.53).
Conclusion: Our results suggest that the -318C/T polymorphism of CTLA-4 gene might play a significant role in the genetic susceptibility to SLE. Therefore, further studies on populations, especially from other Middle East countries, are needed to confirm our results.
Hussein Kheirandish, Ehsan Shojaeeefar , Alipasha Meysamie ,
Volume 74, Issue 12 (March 2017)
Abstract
Background: Cupping is one of the most common traditional medical procedures in Iran, which is widely used and prescribed from long time ago. Putting a cup on the skin with induction of negative pressure, causes an artificial inflammation with collection of some body fluids under the skin which can be extracted by scarification. Different mechanisms and effects are attributable to cupping based on several assumptions and theories. Regarding to the vast use of this traditional therapeutic method and relatively different point of views about the effects of cupping, this study was performed to systematically assess published studies in this field and also to find probable indications of cupping.
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Methods: In this systematic review, according to search via Google Scholar, PubMed, Scopus databases and Iranian databases (IranMedex and SID), 99 different scientific articles about cupping and it`s positive and negative effects were assessed. Different diseases categorized in 19 groups according to the pathophysiology and organ similarities for better presentation
Results: More than 50 different disorders have been studied in randomized or nonrandomized clinical trials. 84.9% of reviewed papers have reported significant positive effects of cupping. The most common disorders studied in the reviewed papers were musculoskeletal, pain and skin disorders, especially low back pain has been studied more with positive results of cupping.
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Conclusion: In Iran the prevalence of cupping performance is really high. The reported positive effects and also complications especially infection were also dramatic. It seems performing systematic studies on cupping effects in different disorders and designing and implementing an active surveillance system for cupping in our country is essential. According to the type of studies, authors concluded that cupping have been reported as an effective intervention for some diseases such as musculoskeletal and skin disorders, but further methodologically elaborated studies with larger sample sizes should be considered for recommending this intervention scientifically.
Saeed Nouri , Anahita Zoghi , Mohammad Reza Sharif , Najla Farhang , Maziar Shojaei ,
Volume 76, Issue 7 (October 2018)
Abstract
Background: Each toxic agent results in unique presentations, depending on what neurophysiological changes occur following exposure. Scientific understanding of lead toxicity in the organ systems and at low levels of exposure continues to evolve. However, effects of lead poisoning on the thyroid gland function are controversial. In this descriptive study, changes in thyroid hormones in patients with lead poisoning were compared with patients with opioid addiction and healthy individual who were matched for age and sex.
Methods: In this descriptive study, which was conducted from March 2016 to February 2017 in Loghman Hakim Hospital in Tehran, ninety patients were evaluated using convenient sampling method for lead and thyroid hormones levels. The levels of lead and thyroid hormones were evaluated using standard laboratory method, in thirty male patients with lead poisoning, thirty male patients with opioid addiction referring to addiction treatment center and thirty healthy male referring to a blood donation center who were matched for age. Thyroid function parameters in patients with lead toxicity were compared with those of control groups.
Results: The lead level in the lead toxicity group was 57.5±23.5 µg/dl, in the first control group with opium addiction 7.8±3.8 µg/dl and in the healthy male referring to a blood donation center, 5.9±9 µg/dl. Thyroid stimulating hormone (TSH) was significantly lower in patients with lead poisoning (0.2±0.01 Milli-International Units Per Liter (mIU/L) than in the patients with opioid addiction (2.4±1/05 mIU/L) and healthy male referring to a blood donation center (2.3±0.01 mIU/L) (P= 0.04), and thyroxine hormone (T4) was significantly higher in patients with lead poisoning (17.8±2.6 µg/dl) than in the patients with opioid addiction (8.8±1/9 µg/dl) and healthy male referring to a blood donation center (7.4±3.5 µg/dl) (P= 0.02).
Conclusion: Lead toxicity has an effect on thyroid function and it reduces thyroid stimulating hormone and increases thyroxin levels. Clinicians should be aware of the potential hazardous effects of lead on the thyroid and mechanisms through which lead causes these effects on thyroid function need to be elucidated.
Roghaye Ghasemi, Azadeh Shojaei, Behnaz Karimi,
Volume 77, Issue 2 (May 2019)
Abstract
Background: Prostate cancer is currently the third malignant disease in Iran and fifth common cancer worldwide. The aim of this study was to determine the expression of GPRC6A, E.cadherin, and ZEB1 genes in prostate cancer in comparison with benign tumor. Since early detection of cancer plays an important role in treatment, this study aims to identify the role of GPRC6A, E.cadherin and ZEB1 genes in screening of prostate cancer.
Methods: In this case-control study, 30 samples including 15 samples of malignant prostate cancer and 15 samples of benign tumor were collected from the patients. RNA was extracted from the tissues, followed by cDNA preparation. In the last step, expression of GPRC6A, E.cadherin and ZEB1 genes was measured using the Real-time polymerase chain reaction (PCR) technique and the Relative expression software tool (REST), Version 2009 (http://rest.gene-quantification.info/).
Results: In this study, the expression of GPRC6A genes compared to its benign tumor increased 3-fold, ZEB1 expression in prostate cancer, compared to its benign tumor, increased 2-fold, and expression of E.cadherin gene in cancerous samples compared to benign tumor declines 10 was equal. In this study, there was no significant relationship between the expression of genes in benign and malignant samples with common diagnostic factors in this type of disease such as age, Prostate-specific antigen (PSA), pathologic stage and Gleason score.
Conclusion: According to this study and similar studies, increased expression of GPRC6A in prostate cancer cells can stimulate the progression of cancer cells by regulating cell proliferation and invasive response to various ligands. Increasing the expression of ZEB1 and decreasing the expression of E.cadherin is also due to the lack of binding of cells and spread of metastasis. As a result, tumors express ZEB1 with absence of E.cadherin is associated with advanced disease or metastases, which indicates that ZEB1 induces EMT and tumor progression in clinical cancers. Therefore examined genes have potential for screening prostate cancer and they can be used as a diagnostic marker for prostate cancer with further investigation.
Mohsen Shoja, Mohadese Soleimani, Maryam Ameriyan , Niloufar Asbaghipour , Peyman Hejazi Hejazi ,
Volume 77, Issue 2 (May 2019)
Abstract
Background: Today, with the increasing use of ionizing radiation like X-rays in diagnosis and treatment of diseases, the risk of fetal exposure in pregnant women also increases. Therefore, protecting pregnant women from ionizing radiation is essential and is considered as the standard criterion for Medical Radiation Center. So the aim of this study was to investigate the observance of protective principles and 10-day rule in imaging of susceptible women.
Methods: This cross-sectional study was carried out at the Radiography Centers of Semnan University of Medical Sciences, Iran, from July 2017 to September 2017. First, patients who were under radiography, were asked about the knowledge of the radiographers about the 10-day rule and radiation protection. Then a questionnaire with 12 questions was given to the radiographers in radiology and CT scan center. Finally, the existence of protection guidelines for pregnant women was determined by asking manager and checking at the moment.
Results: The patient's question about pregnancy failed about 19%, which did not have a significant relationship with patients' singleness (P=0.0004). Also the mean scores for the knowledge of radiographers about radiation protection were 14.21±0.96, which did not have a significant relationship with their work record and place of employment and their educational level (P=0.09). On the other hand, in half of the radiography centers, the written radiation protection guidelines were not available.
Conclusion: Principles of radiation protection and 10-day rule for radiography of women who were prone to pregnancy were desirable but due to importance of radiation protection, the rules should be more carefully implemented.
Mohammad Taghi Najafi , Mohammad Hossein Shojamoradi , Farzanehsadat Minoo ,
Volume 78, Issue 2 (May 2020)
Abstract
Background: Resistant hypertension is defined when the blood pressure remains elevated above the therapeutic target levels despite the use of three antihypertensive agents including calcium channel blocker (CCB), renin-angiotensin system (RAS) blocker and a diuretic. These drugs should be used at maximally tolerated doses and white coat effect and non-adherence should also be excluded. In this article, by describing a case of resistant hypertension, we discuss a diagnostic and therapeutic approach to resistant hypertension.
Case Presentation: A 59 years old man, known case of diabetic nephropathy with a serum creatinine level of 1.2 mg/dL and proteinuria of about 3300 mg in 24 hours referred to Hypertension Clinic of Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, for evaluation of resistant hypertension. The patient was under treatment by losar-H, diltiazem, and furosemide, which are not appropriate combinations of antihypertensive agents. The ambulatory blood pressure monitoring (ABPM) of the patient revealed daytime and nighttime hypertension and also the non-dipping status of blood pressure. Dihydropyridine CCB was prescribed in combination with RAS blocker (Exforge 50 mg/ 160 mg) and the diuretic was changed to thiazide-like agents. In the next step, spironolactone and carvedilol were added for better control of blood pressure. The patient referred to the sleep clinic for polysomnography and evaluation of obstructive sleep apnea. Following three months prescription of these medications, ABPM revealed relatively appropriate control of blood pressure, so the average 24-hour blood pressure decreased from 157/91 mm Hg to 136/83 mm Hg.
Conclusion: The complications and mortality of hypertension would be increased dramatically in patients with resistant hypertension. So, an appropriate diagnostic and therapeutic approaches should be considered for these patients. Choosing appropriate diuretic agents would be important in the management of resistant hypertension.
Parham Mardi, Sorour Shojaeian, Nooshin Taherzadeh-Ghahfarokhi, Ghazaleh Molaverdi, Maedeh Amiri Roudy , Ali Salahshour, Mahmood Bakhtiyari, Sayed-Hamidreza Mozhgani ,
Volume 78, Issue 11 (February 2021)
Abstract
SARS-CoV-2 emerging from Wuhan, China is a member of the Coronaviridae family, which has so far infected and killed many people. The SARS-CoV-2 pandemic affected various aspects of life in Iran and Worldwide, and governments have imposed quarantines and travel bans on an unprecedented scale. The virus causes COVID-19, which can spread through close contact with the infected person, contaminated equipment, and suspended air droplets. The most common symptoms of the disease include fever, cough, shortness of breath, gastrointestinal symptoms, and diarrhea. In severe cases, the lung infection can occur, which causes Severe Acute Respiratory Syndrome that leads to ICU admission and even death.
Besides, this infection can cause gastrointestinal, neurological, and renal impairments. Not merely, this new coronavirus has infected many more people worldwide in comparison to MERS and SARS, but also it has killed more people. Patients with underlying diseases such as hypertension, diabetes, respiratory problems, kidney disease, heart disease and Immunodeficiency are at higher risk of infection and potential death. Also, the risk of death and complication increases in older adults, while most of the infected children are asymptomatic. Some infected people may have mild or no symptoms but can still transmit the disease and spread it to others.
To diagnose COVID-19, serology tests, and level of ESR, CRP and other acute-phase reactants are helpful, whereas molecular tests, such as RT-PCR tests, that detect the virus’s genetic material are still the golden standard. Also, CT scan detects lung involvement; Ground-glass opacification, especially in lower lobes and subpleural region, is the most common CT characteristic, although it is not specific for COVID-19. Because the disease is difficult to diagnose, hard to prevent and challenging to treat, it has become a major concern for many countries. This review aims to gather existing information in the fields of virology, molecular pathogenesis, disease symptoms, epidemiology, clinical presentations, diagnosis, treatment, and the spread of the disease. This study also provides evidence-based prevention and treatment strategies for health policymakers, doctors, nurses, and practitioners in the field of public health, including researchers and students.
Kambiz Javadzadeh Siahkelrodi , Shahpour Shoja, Karim Naseri, Farzad Sarshivi, Shahrokh Ebnerasouli, Mohamad Aziz Rasouli , Shaho Shoja ,
Volume 79, Issue 7 (October 2021)
Abstract
Background: Bier block is a reliable technique used in extremity surgeries. Typically, angiocatheters are palced in the distal portion of the extremity that is going to be operated. Although, it is not the case in every operation. Therefore, determining the effectiveness of the local anesthetic injection site on the quality of the upper-extremity block can be helpful.
Methods: In this double-blinded randomized clinical trial that took place in Kowsar Hospital (Sanandaj, Iran) at 2020, 60 patients after complete monitoring and sedation were assigned randomly into proximal bier block (32 in experimental) and distal bier block (28 in control) groups. 10ml/kg Ringer serum was prescribed for patients in both groups on the non-surgical hand. Depending on the patients’ placement in either group, an angiocatheter (22 or 24) was attached to the ante-cubital area (proximal bier block group) or on the back of the patient's hand (distal bier block group). Respectively, after blood was drained by a Smarch band from the extremity that was to be operated, the tourniquet was inflated up to 150mmHg above the patient’s systolic pressure and the smarch band is untied from the hand. For every patient regarding the group they were assigned, 3mg/kg lidocaine 0.5% was administered through an angiocatheter. After 5 minutes, the depth of patient's anesthesia and pain intensity were measured. Sensory and motor recovery was assessed every 10 minutes after surgery. Patient satisfaction with anesthesia was measured after the surgery and characterized by excellent, good, moderate (pain relief), and unsuccessful (need for pain medications) indicators. In case insufficient depth was reached, intravenous Remifentanil was injected.
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Results: According to the results of the chi-squared test, there were no significant differences in gender distribution (p=0.063), anesthesia class type (p=0.964), type of surgery (p=0.694), anesthesia satisfaction (p=0.578), sensory block of hand (p=0.529), motor block of hand (p=0.059), pain intensity (p= 0.634), pain relief medication requesting (p=0.755) and also body mass index (T-test used P=0.099) variables comparing both groups together. Additionally; according to the T-test results no significant differences were reported in the mean systolic pressure, mean diastolic pressure and mean heart rate variable in designated times.
Conclusion: There is no significant difference between the two groups. Therefore, using a distal Bier block can be an alternative if needed.
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