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Showing 17 results for Yazdani
Long term results of 5-Fluorouracil in glaucoma operation
M Hashemian , Sh Yazdani ,
Volume 56, Issue 6 (9 1998)
Abstract
This prospective study evaluated the long-term results of intraoperative 5-FU in glaucoma patients undergoing trabeculectomy. 14 patients categorized as high risk (10 patients) or medium risk (4 patients) underwent trabeculectomy with 5-FU and were followed for a mean period of 32 months. Patients were evaluated for visual acuity, cup-disc ratio and IOP. The number of medications was also taken into consideration 78% (n=11) of patients achieved controlled IOP, (mean IOP of less than 21 mmHg) with or without medication. There was statistically significant reduction of IOP and number of medication after the operation. There was no significant complication observed during the follow up period.
Neuroendocrine Carcinoma: Immunohistochemistry Department Of Cancer Institute 1996 - 2000
Tirgary F, Jahan Zad I, Yazdani F,
Volume 61, Issue 2 (14 2003)
Abstract
Dispersed neuroendocrine system (D.N.S) consists of a wide variety of cells that are present in the central and peripheral nervous system and in many classic endocrine organs and different tissues such as respiratory and gastrointestinal tracts, skin, prostate, breast and also their neoplasm show neuroendocrine differentiation by electron microscopy, immunohistochemistry or biochemical techniques:
Materials and Methods: The present study has been carried out by case-series method in order to evaluating the characteristics of all types of neuroendocrine carcinoma: different anatomical locations during 5 years period in immunohistochemistry department of cancer institute.
Results: The diagnosis of 109 cases of neuroendocrine carcinoma consisting of neuroendocrine carcinoma, small cell carcinoma, medullary carcinoma of thyroid, carcinoid tumor and merkel cell carcinoma are confirmed that among them the most common diagnosis was related to neuroendocrine carcinoma (50.5 percent). The most prevalent age group was 40-49 years and male to female distribution were 56 percent and 44 percent respectively. Anatomical distribution of tumor show that about 30 percent of cases were metastatic carcinoma, 30 percent in thyroid, respiratory tract and head and neck region and remainder in a variety of tissues. In over 50 percent of cases one of endocrinoid patterns as trabecular, organoid or mixed of them were seen.
Conclusion: Immunohistochemically N.S.E (Neuron Specific Enolase) show high sensitivity with 96 percent positive reaction and more specific endocrine markers as chromogranin A in 80 percent and synaptophysin only in 24 percent because of lesser application of the latter. Also epithelial markers such as cytokeratin and E.M.A.
(Epithelial Membrane Antigen) were positive in 69 percent and 74 percent respectively. Mean survival rate of all neuroendocrine carcinoma reached to 4.8 years with lowest survival of 4.3 years among small cell carcinoma and highest in merkel cell carcinoma with 5.5 years.

 


Study Of The Effect Of Nasal- Septal Deviation On The Middle Ear Pressure
Motesaddi Zarandi M, Amirabadi M, Yazdani N, Mohammadi Ardehali M, Torkashvand Z,
Volume 61, Issue 5 (15 2003)
Abstract
Eustachian tube connects middle ear space to the nasopharyngeal space. Upper airway obstruction, with any cause, can derange Eustachian tube function. Nasal septal deviation is one of the prevalent causes of upper airway obstruction which can affects the ventilation function of Eustachian tube.
Materials and Methods: This study was conducted on the patients who underwent septoplasty due to severe septal deviation leading to unilateral nasal obstruction in Amiraalam hospital from summer of 1378 till the spring of 1379.
Results: There was 140 patients whose data were as: female patients 34 (24.3%) male patients 106 (75.7%), mean age (22.7). Median age (20) years and mode of age (18) years of age. they were from 12 to 40 years of age.
Conclusion: Comparison between preoperative and postoperative middle ear pressures shows no any significant statistical difference (p=0.798).
Efficacy of single-dose methotrexate in the treatment of ectopic pregnancy: a clinical trial
Behnamfar F, Yazdani Sh, Sakhaee M,
Volume 65, Issue 8 (3 2007)
Abstract

Background: The use of serial quantitative beta-human chorionic gonadotropin (β-HCG) with transvaginal ultrasound to enhance early diagnosis of ectopic pregnancy (EP) improves options for conservative treatment with methotrexate (MTX). The aim of this study was to evaluate the outcome of unruptured EP treated with a single dose of intramuscular MTX injection.

Methods: This clinical trial included 41 EP patients with specific inclusion criteria for medical treatment. For each patient, MTX (50 mg/ml) was administered intramuscularly and a repeat dose was given if the weekly decrease in the level of β-HCG was less than 15%. The therapy was considered successful if the level of β-HCG fell below 10 mIU/cc without surgical intervention.

Results: Overall, 78% of the patients were successfully treated, among whom 18.7% received second doses of MTX. Of the patients who were successfully treated, 60% presented with vaginal bleeding without pelvic pain however, of those patients in whom the treatment failed, 88% presented with pelvic pain together with vaginal bleeding. Furthermore, the presence of free peritoneal fluid on vaginal ultrasound was a significant predictor of treatment failure (p<0.005). There was no relation between the women's age, gravidity or parity, the size of the conceptus, gestational age, pretreatment serum β-HCG titer, endometrial thickness on vaginal ultrasound and the efficacy of treatment.

Conclusions: With a reasonably high success rate, we found systemic single-dose MTX treatment to be a safe, conservative therapy for EP. However, when free peritoneal fluid is noted upon transvaginal ultrasound or when the patient presents with pain, the threshold for surgical intervention may be lower.


Lower limb amputation rate in diabetic foot patients: a five year study
Mofid A, Yazdani T, Dulabi H, Seyyed Alinaghi S A, Zandieh S,
Volume 65, Issue 13 (Vol 65, Supplement 1 2008)
Abstract
Background: Diabetes mellitus is a common endocrine disorder with increasing prevalence. Diabetic foot is a costly and serious chronic complication of diabetes mellitus that if it does not controlled will cause severe morbidities in patients with diabetes mellitus. Based on the study of center of management and prevention of diseases about 230 milliard Rials were expended for direct costs of diabetes annually and instruction of patients about protection of foots in some countries, decrease rate of amputation between 44 to 85% and infact instruction of diabetic patients is the base of treatment and prevention of complications of diabetes mellitus.
Methods: In a cross sectional study with attention to one of important causes of refer of diabetic patients to hospitals diabetic ulcers of foots, we discuss about risk factors and ways of treatment and prevention of them. The study done on patients admitted in endocrinology unit of Imam Khomeini hospital. For analysis we used SPSS 11.5 program. Although the costs for patients are calculated.
Results: In this study from 245 patients that admitted because of diabetic foot (63.26% male and 36.73% female), 74 patients have done amputation. From these 74 patients (30.2%), 65.67% were male and 24.32% were female. Age average was 58.24+12.29 years And the mean duration of DM was 10.56+8.32 years and the past history of diabetic foot was present in 45.95% of them. Past history of smoking was present in 66.21% of patients.
Conclusion: From 245 patients from 1996 to 2001 that admitted because of diabetic foot, 155 patients (63.26%) were male and 90 patients (36.73%) were female. From this numbers the most of them were in 60-70 years old and the least were 20-30 years old. Gender of most of them was male. For treatment of this complication a lot of costs were necessary and instruction of patients decrease this complications.
Evaluation of biologic markers in squamous cell carcinoma biopsy samples of the tongue and correlation with neck lymph node metastasis
Madani Kermani Z, Khorsandi Mt, Yazdani N, Mirashrafi F,
Volume 67, Issue 7 (7 2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Neck lymph node metastasis has the prognostic role in SCC of the tongue and the importance of the biologic markers in tumor invasion and metastasis has been stated in the medical literature. The aim of this study was to evaluate the relationship between two biomarkers, p53 and EGFR (which had the main role in cell proliferation) and two other biomarkers, CD44 and E-cadherin, in lymph node metastasis.
Methods: In an analytic descriptive study fifty three patients with SCC (Squamous Cell Carcinoma) of the tongue who underwent the resection of tumor and dissection of neck lymph nodes were assessed during the year of 2002-2009. Histological samples from 53 patients were immunohistochemically stained and the analysis of these markers were performed due to clinicopathological variable and metastasis of the neck lymph nodes.
Results: The result showed that among the clinicopathological factors, the relationship between Age (p=0.01), history of having risk factors (p=0.002), clinical lymphadenopathy (p=0.002), the size of the tumor (p=0.001), decreasing of CD44 (p=0.02) and lymph node metastasis of the neck were statistically significant. No significant relationship were found between sex and other biomarkers including p53, EGFR, E-cadherin.
Conclusion: CD44 is an important indicator of prognostic markers that can also be used as an indicator of clinocopathological markers.


The CD14 gene Polymorphism in nasal polyposis
Yazdani N, Mohammad Amoli M, Mersaghian A, Bagheri Hagh A, Sayyahpour F, Fotuhi R,
Volume 68, Issue 7 (7 2010)
Abstract

Background: CD14 is known as a receptor for bacterial LPS (Lipopolysaccharides) and is followed by inflammatory reactions. This receptor on macrophage surface has a major role for recognition and clearance was happen without inflammatory reaction. Prolonged exposure to microbial products decreases the risk of allergic reactions. This is related to high level of CD14 in blood cells. Although the causes of nasal polyposis is not obviously determined but allergy is a potential risk factor for nasal polyposis. CD14 is in 5q31 chromosomal position and CD14 variants have association with asthma. We try to assay association between CD14 polymorphism and nasal polyposis and severity of this disease.

Methods: We had 106 patients with nasal polyps with mean age 41 y old in case group and 87 with mean age 36.7 in control group. We obtained 3 ml whole blood from each patient and then extract DNA by PCR-RFLP method and determined variant genotypes of CD14. Although there is no previous study in this field, the results of this pilot study shown in more detailed below.

Results: There is significant relationship between C allele (CC + CT) in comparison with TT (p= 0.03, odds ratio= 1.87, CI 95% (0.99- 3.55)) and nasal polyposis. Further-more another significant relationship had been shown between asthmatic patients and C allele (CC) in comparison with (CT + TT). (p= 0.01, odds ratio= 3.8, CI (0.99- 13.9). In asthmatic patients with C allele of CD14 incidence of nasal polyposis increased.

Conclusion: Based on the results of this study, C allele of CD14 could play a role in nasal polyposis.


Evaluation of IL-17 gene expression in peripheral blood and sputum of asthma patients and healthy individuals
Reza Yazdani , Mazdak Ganjalikhani Hakemi, Roya Sherkat , Abbas Rezaei , Rahim Farahani , Behrouz Beiranvand ,
Volume 72, Issue 9 (December 2014)
Abstract
Background: Asthma as an airway disease is identified by increase network respon-siveness of the trachea and bronchus to a specific stimulus. Th17 cells through produc-tion of IL-17 have important role in inflammation and autoimmune diseases .In some studies has been shown which IL-17 as major cytokine of Th17 probably has im-portant role in the pathogenesis of allergy and asthma. Methods: Total mRNA extracted from whole blood samples and sputum of 23 asthma patients and 23 normal controls. Then, total RNA was converted into cDNA according to the manufacturer’s instructions. Finally, the transcript levels of IL-17 were quanti-fied by the real-time quantitative PCR. Twenty-three patients with asthma were diag-nosed and selected according to the global initiative for asthma (GINA) and none of the patients had taken the medication at least three week before sampling. Healthy in-dividuals did not have any history of allergy, asthma and other inflammatory diseases at the time of sampling. All of experiments have done in Isfahan University of Medical Sciences, Iran during May to February, 2013. Results: This study showed a significant increase in transcript levels of IL-17 in the blood (287±79 versus 1/18±0/13) and sputum samples of the patients (64±28 versus 0/9±0/1) in comparison with normal individuals (P= 0.000, P= 0.029 respectively). It al-so revealed that the expression levels of the cytokines in the serum samples of the asthmatics were significantly more than their levels in patient’s sputum samples (P= 0.000). However, there was no significant difference between the cytokines expression levels in serum samples and sputum samples of the controls (P> 0.05). Conclusion: In this study, we showed which the expression of IL-17 was increased in serum and sputum of asthmatic patients compared to healthy controls, this could re-sult in elevation of neutrophils population and activation of pulmonary neutrophil.
Simple tube thoracostomy versus surgical debridement in complicated parapneumonic empyema management
Mohsen Sokouti , Behnam Yazdani , Shima Jafari Jebeli ,
Volume 76, Issue 9 (December 2018)
Abstract
Background: Approach to treat empyema following pulmonary infection, especially in the second stage, is disputed. Therefore, this research aimed to compare the effect of simple tube thoracostomy versus surgical debridement in complicated parapneumonic empyema management.
Methods: This prospective randomized trial was conducted in Thoracic Surgery Department of Imam Khomeini Hospital of Tabriz and Dr. Shariati Hospital of Isfahan cities, Iran from March 2003 to September 2015. 104 patients with stage II empyema, divided into two groups (52 patients in each group). Group 1 was treated with simple tube thoracostomy and group 2 with surgical debridement with thoracotomy or thoracoscopy and patients had at least 2 referral after discharge. Personal information, medical history and information of complications and recurrence were recorded in two forms. Finally, data analysis was done by SPSS software version 22 (IBM SPSS, Armonk, NY, USA) and methods of Chi-square test and independent sample t-test.
Results: The age-mean of patients under study was 48.17±11.13 years in group 1 and 46.21±13.58 years in group 2 and the most patients were middle-aged (between 40 to 50 years). The number of men in both groups was more than women. 44.23% of patients in group 1 and 38.46% of patients in group 2 had a history of smoking. Duration of hospitalization (P=0.005), a chest tube duration (P=0.004) and duration of treatment (P=0.005) in group 2 was significantly higher than group 1. The complications (P=0.172) and recurrence (P=0.324) in group 2 are non-significantly more than group 1. The complications of treatment, after a week in group 1, are non-significantly higher than group 2 (P=0.690), but complications of treatment after a month in both groups were equal (P=1).
Conclusion: Duration of hospitalization, chest tube insertion time and duration of treatment in simple chest tube drainage treatment is shorter than surgery treatment (thoracoscopy or thoracotomy) and simple chest tube drainage treatment is more effectiveness way to treat patients with complicated parapneumonic empyema in stage 2.

Establishment of national primary immunodeficiency network, requisite of health organization and final stage of polio eradication: review article
Asghar Aghamohammadi , Mohammadreza Shaghaghi , Hassan Abolhassani , Reza Yazdani , Seyed Mohsen Zahraie , Mohammad Mehdi Goya , Susan Mahmoudi , Nima Rezaei , Shohreh Shahmahmoodi ,
Volume 78, Issue 1 (April 2020)
Abstract
Primary immunodeficiency diseases (PIDs) is a diverse group of diseases, characterized by a defect in the immune system. These patients are susceptible to recurrent respiratory infections, gastrointestinal problems, autoimmune diseases, and malignancies. In most cases, patients with primary immunodeficiency disorders have genetic defects and are monogenic disorders that follow a simple Mendelian inheritance, however, some PIDs recognize a more complex polygenic origin. Overall, almost 70 to 90 percent of patients with primary immunodeficiency are undiagnosed. Given that these patients are exposing to respiratory infectious agents and some live-attenuated vaccines, thus they have a high risk to some clinical complications. The administration of oral polio vaccine in patients with PIDs especially can increase the possibility of acute flaccid paralysis. These patients will excrete the poliovirus for a long time through their feces, even though they are not paralyzed. Long-term virus proliferation in the vaccinated individuals causes a mutation in the poliovirus and creates a vaccine-derived polioviruses (VDPVs), which is a major challenge to the final stages of the worldwide eradication of polio. 
To increase the diagnosis and identification of patients with immunodeficiency and carrying out a national plan for screening patients with immunodeficiency from the fecal excretion of the poliovirus, a possible polio epidemic can be prevented during post-eradication. Development of laboratory facilities in provincial and city centers, improvement of communications among physicians regarding medical consultation and establishment of referring systems for patients by national network lead to improve status of diagnosis and treatment of patients with primary immunodefiicencies. In this context, launching and activating the national network of immunodeficiency diseases is essential for improving the health of children and reducing the cost of the health system of the country. A national network of immunodeficiency can lead to increase awareness of physicians regarding primary immunodeficiency disorders, improve collaboration among physicians about genetic consultation and establish a practical referral system in Iran that results in increased diagnosis and improve treatment of patients with primary immunodeficiency disorders.

Comparing transcutaneous bilirubin versus serum bilirubin measurement using spectrophotometry for jaundice screening of full-term neonates
Fariba Hemmati, Zahra Hashemi, Negar Yazdani,
Volume 78, Issue 12 (March 2021)
Abstract
Background: Neonatal jaundice is an almost common problem among neonates that may cause complications such as kernicterus in severe cases. Since early diagnosis and proper treatment of neonatal jaundice is vital to prevent the related complications, it is necessary to check bilirubin before discharging the neonates. There are several evaluating and diagnostic methods to measure the level of bilirubin. Thus, this study aimed to compare the transcutaneous method versus measurement of serum bilirubin, using spectrophotometry for jaundice screening of full-term neonates before discharge from hospital.
Methods: This observational analytic study was conducted on six hundred neonates with birth weight more than 2000 grams and gestational age more than 35 weeks from September 2012 to March 2013 in Hafez hospital, Shiraz University of Medical Sciences. Parameters such as bilirubin level of neonates were measured and compared, using spectrophotometry and transcutaneous by Bili check with multi waves.
Results: Six hundred neonates were enrolled in this study. The Pearson correlation test showed that there was a significant correlation between the two methods of the transcutaneous versus measurement of serum bilirubin, using spectrophotometry (r=0.63), (P>0.05). There was no significant difference between the mean of measured bilirubin, using each method in some demographic variables such as the different groups of gender (P=0.896), birth weight (P=0.419), and type of feeding in neonates (P=0.323), but it was significant in other demographic variables such as the different groups of gestational age and post-neonatal age (P<0.0001). Also, the results revealed that there was a significant correlation between two methods of the trans cutaneous versus measurement of serum bilirubin, using spectrophotometry based on demographic variables (P<0.0001).
Conclusion: In general, the bilirubin measurement using trans-cutaneous method may estimate bilirubin significantly less than the serum bilirubin measurement method, and this difference can be more obviously noticeable in infants with less gestational age and also less post-natal age.
 

Pivotal exigencies of dental services and related professions, in COVID-19 pandemic: a systematic literature review
Ghasem Janbabai, Amir Hashem Shahidi Bonjar , Abtin Heidarzadeh, Mahdi Shadnoush , Ghasem Sadeghi, Mohsen Dalband, Amir Reza Rokn, Hamid Samadzadeh, Ali Tajernia, Said Sai, Reza Masaeli, Gholamreza Heydari, Ali Yazdani , Behzad Houshmand ,
Volume 79, Issue 2 (May 2021)
Abstract
Background: The advent of Severe Acute Respiratory Syndrome Coronavirus 2 (so-called SARS-CoV-2) causing Coronavirus Disease 2019 (so-called COVID-19) occurred in Dec. 2019 in Wuhan, China. Having an inconceivable worldwide contagion, the outbreak was labeled a pandemic by the WHO. Dental services and related professions (including dentists, dental assistants, dental hygienists and the personnel of cleansing, remedial, triage, dental laboratories, radiographic laboratories and other related paraclinicals), facing galore aerosol and droplets, are in the topmost risk groups exposed to the queer virus. This study was fulfilled to round up evidence-based data to break a link at any part of the virus transmission chain in dental services and related professions.
Methods: Relevant online databases, as PubMed, MEDLINE, Embase, Scopus, Google Scholar and TripDatabase were searched meticulously and evaluated for relevant published original research papers. Subsequently, to fulfill the investigation, ADA, CDC and WHO websites were reviewed to gain relevant guidelines and protocols. Consequently, 476 resources were included considering the canonical inclusion criteria. For the sake of quality assessment of the resources, an authentic checklist was exploited to score the resources from 1 to 15, wherein the admissible score was 10. After deliberation of resources, 366 of them were excluded and finally, 110 resources were selected and overhauled to attain a comprehensive perception on the subject of the investigation.
Results: Transmission of SARS-CoV-2 includes direct transmission (via droplet and aerosol inhalation) and indirect transmission (via surface and instrument contamination), which can amply occur in dental services and related professions. Therefore, an all-inclusive evidence-based miscellany was rallied on several exigent topics, containing genuine esteem in reputable scientific authorities, to present a consummate report for the dental clinicians and related practitioners, working in the course of the running pandemic.
Conclusion: Contemplating the ongoing crisis, undertaking a set of miscellany elected guidelines and protocols, is indispensable in this vital interval of history to bridle the current pandemic, which has been abridged via this systematic perusal.

The diagnostic value of ultrasound for ovarian mature cystic teratoma and accordance of it with postoperative histopathologic findings
Mohammad Ranaei, Fereshteh Gharavi, Azita Ghanbarpour, Mina Galeshi, Shahla Yazdani ,
Volume 79, Issue 8 (November 2021)
Abstract
Background: Mature cystic teratoma of the ovary is one of the most common benign ovarian tumors, which may be confused with other adnexal lesions due to its extensive manifestations on ultrasound. Therefore, in this study, we tried to reduce the need for pathology frozen sections by examining more accurate preoperative ultrasound results and classifying ovarian lesions based on them.
Methods: In this study, 200 female patients with a definitive diagnosis of mature cystic teratoma of the ovary who have undergone surgery at Ayatollah Rouhani Hospital, February 2009 March 2019 were evaluated. After reviewing the files, demographic information, Ultrasound, intraoperative findings and final pathology were extracted and finally, the data were analyzed using statistical tests.
Results: The age range of patients who were diagnosed with mature cystic teratoma of the ovary in the final pathology was 14-71 years. Most cysts were 5-10 cm in size. 86% of patients had unilateral right-sided ovarian involvement. The most common components of this cyst in the macroscopic report were hair (81%) and fat (80%). The diagnostic value of ultrasound for the diagnosis of mature teratoma of the ovary was 74.5%. The frozen section was used to diagnose and rule out the malignancy in 32.5% of patients.
Conclusion: The results of this study show that the prevalence of these tumors is higher in the reproductive age range. According to this study, these tumors have been seen in single people and pregnant women, Due to youth and fertility in the future, a good decision must be made about the surgical method. These tumors have a wide range of sizes. In addition, their most common complaint is abdominal pain, but it has been reported extensively in periodic ultrasounds for infertility. The diagnostic value of ultrasound for mature ovarian teratoma was high due to the presence of fat and hair in them. Therefore, the use of the frozen section (intraoperative pathology) can be reduced in more often unnecessary in cases.
 

Automated detection of coronavirus disease (COVID-19) by using data-mining techniques: a brief report
Seyed Ali Akbar Arabzadeh, Vahid Jamshidi , Masoud Saeed, Rostam Yazdani, Mahdieh Jamshidi,
Volume 79, Issue 10 (January 2022)
Abstract
Background: The clinical field has vast sick data that has not been analyzed. Discovering a way to analyze this raw data and turn it into an information treasure can save many lives. Using data mining methods is an efficient way to analyze this large amount of raw data. It can predict the future with accurate knowledge of the past, providing new insights into disease diagnosis and prevention. Several data mining methods exist but finding a suitable one is very important. Today, coronavirus disease (COVID-19) has become one of the causing deadly diseases in the world. The early diagnosis of pandemic coronavirus disease has a significant impact in preventing death. This study aims to extract the key indications of the disease and find the best data mining methods that enhance the accuracy of coronavirus disease diagnosis.
Methods: In this study, to obtain high accuracy in diagnosing COVID-19 disease, a complete and effective workflow over data mining methods was proposed, which includes these steps: data pre-analyzing, indication selection, model creation, the measure of performance, and display of results. Data and related indications of patients with COVID-19 were collected from Kerman Afzalipour Hospital and Rafsanjan, Ali Ebn Abi Taleb Hospital. Prediction structures were made and tested via different combinations of the disease indications and seven data mining methods. To discover the best key indications, three criteria including accuracy, validation and F-value were applied and to discover the best data mining methods, accuracy and validation criteria were considered. For each data mining method, the criteria were measured independently and all results were reported for analysis. Finally, the best key indications and data mining methods that can diagnose COVID-19 disease with high accuracy were extracted.
Results: 9 key indications and 3 data mining methods were obtained. Experimental results show that the discovered key indications and the best-operating data mining method (i.e. SVM) attain an accuracy of 83.19% for the diagnosis of coronavirus disease.
Conclusion: Due to key indications and data mining methods obtained from this study, it is possible to use this method to diagnose coronavirus disease in different people of different clinical indications with high accuracy.
 

Surgical competence in general surgery assistance: a brief report
Leila Sadati, Peigham Heidarpoor, Babak Sabet , Shahram Yazdani ,
Volume 80, Issue 5 (August 2022)
Abstract
Background: The training and education of competent and qualified surgeons have been one of the challenges of the surgical profession. The concept of surgical competence has been affected widely due to a series of developments in the new disease emergence, various surgical techniques and the introduction of advanced tools and equipment into the operating. The development of surgical competence and achieving this goal requires accurate identification and analysis of the dimensions of competence. This study was done to explain the concept of surgical competence using the 8-step Walker and Avant approach.
Methods: This study is a qualitative study that was conducted from May- October 2016 at Shahid Beheshti University of Medical Sciences. The present study is a qualitative and conceptual analysis study, which is done with Walker&Avant's eight-step approach to determine the defining characteristics of the concept of surgical competence. A systematic search was conducted between 1990 and 2020 by keywords search such as surgery, surgical, operation OR laparoscopy AND competence competency development competency proficient, proficiency, expertise, clinical, in the database like Google Scholar, PubMed, SID, Magiran, Scopus, Web of Science. Twenty articles were included in the study based on inclusion and exclusion criteria. Moreover, the defining features of the concept were extracted from it.
Results: Based on the results of this study, the concept of surgical competence was defined and the four dimensions of elements, goals, components and the process of developing surgical competence were identified. Then, by clarifying the characteristics of surgical competence, a model of surgical competence development was drawn. Surgical competence development depends on the acquisition of specialized knowledge and numerous skills that are acquired through experience and deliberated practice under the supervision of others in the surgical community of practice and over time.
Conclusion: Surgical competence is a set of observable and measurable skills that allows a surgeon to manage the surgical process independently pbt while maintaining the patient's safety. It includes specialized knowledge, communication skills, cognitive and technical skills, and basic surgical skills.

Assessment of success factors in normal vaginal delivery in late term pregnant women
Sargol Movagharnejad, Maryam Javadian , Hoda Shirafkan, Shahla Yazdani,
Volume 80, Issue 8 (November 2022)
Abstract
Background: The aim of this study was to find the causes of failure of natural childbirth in late-term pregnancy that can be useful for managing childbirth in these pregnant mothers and to design a solution to increase natural childbirth.
Methods: This cross-sectional study was conducted in the community of pregnant women with a late-term pregnancy of more than 41 weeks. The studied sample includes 148 pregnant mothers who were referred to Ayatollah Rouhani Hospital in Babol from March 2018 to February 2020. Mother's age, Body Mass Index, gestational age, number of pregnancies, number of deliveries, length of hospitalization, the state of the cervix and preparation method of the cervix for termination of pregnancy were extracted and recorded from patients' files. Data were compared in two groups of pregnancy termination methods (natural childbirth and cesarean delivery). Statistical analysis was done using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and Chi-square test and Student’s t-test statistical tests and logistic regression model fitting. P-value less than 0.05 was considered significant.
Results: In this study, 167 pregnant women with late-term pregnancy were studied. The age of pregnant women is reported with mean of 26.03 and standard deviation 5.98 of years. The high Bishop variable, with odds ratio of 0.44, is a variable protective factor for cesarean delivery (P=0.001). Higher body mass index with odds ratio of 1.09, is also known as a risk factor for cesarean delivery (P=0.01), so that for each unit of increase in Bishop score, the chance of cesarean delivery decreases by 56% and for each unit of increase in body mass index, the chance of cesarean delivery increases by 9%.
Conclusion: This study showed that nearly half of cases of late pregnancies lead to normal delivery. High body mass index reduces the chance of normal delivery in late term pregnancies. But a higher Bishop score can be effective in the success of natural delivery.

Comparison of the effectiveness of three drugs, rosuvastatin, atorvastatin, and simvastatin, on lipids using network meta-analysis: a meta-analysis study
Aso Yazdani, Hamed Tavan, Kourosh Sayehmiri,
Volume 82, Issue 5 (August 2024)
Abstract
Background: One of the main causes of death in the world is cardiovascular disease. While there is no denying that lipids play a risk factor in cardiovascular disease, statins are effective medications for treating this condition. We used network meta-analysis to compare the impact of three drugs atorvastatin, simvastatin, and rosuvastatin on lipids.
Methods: Type of study of this research was a systematic review and network meta-analysis. Databases such as Scopus, PubMed, ISI, Science Direct, Google Scholar, SID, MagIran, web of Science, and Cochrane Library were searched. Keywords atorvastatin, simvastatin, and rosuvastatin were used in the search strategy. We did both standard meta-analyses and network meta-analyses. Consistency was checked by comparing direct and indirect effect sizes. The time period for searching articles was from 2000 to June 2024. All relevant articles published in English or Persian were reviewed. Paired wised comparisons were made using the intervalplot command in STATA. The surface under the cumulative ranking (SUCRA) was used to rank the efficacy of treatments. The Q test and I2 index were used to assess the heterogeneity of the studies.  Data were analyzed using STATA Ver. 17.
Results: From the 61 articles that were included in the network meta-analysis (atorvastatin 43 studies, rosuvastatin 22 studies, simvastatin 21 studies, and placebo 15 studies). The total sample size was 62178 patients.  The results showed that the effect of, atorvastatin, rosuvastatin, and simvastatin with placebo on fat lipids was significant (P<0.001). Still, there was not a substantial difference between the effects of the three drugs. The best treatment for reducing LDL was atorvastatin (standard mean difference (SMD) =-5.18, 95% confidence interval (CI);-7.42,-2.95, P<.001). SMD LDL for rosuvastatin and simvastatin were -4.35(95% CI; -6.81,-1.89), and -3.44(95% CI;-5.89,-.98) respectively.  The surface under the cumulative ranking (SUCRA) showed that the probability that Rosuvastatin was the best drug for reducing triglycerides was 82.4% and the likelihood that atorvastatin was the best drug for reducing cholesterol was 80.3%.
Conclusion: Atorvastatin, rosuvastatin, and simvastatin have a better effectiveness than placebo in reducing fat lipids. Atorvastatin was the best treatment to reduce LDL, and TC and increase HDL. Rosuvastatin was the best drug to reduce TG. Atorvastatin, rosuvastatin, and simvastatin were the effective treatments to reduce fat lipids respectively.

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