Tehran University Medical Journal

Background: 2-phenylethanol is a colorless and aromatic compound with antimicrobial effects which is used extensively in perfumes and cosmetics, as well as in the food industry. Chronic vulvovaginal candidiasis is a vulvovaginal inflammation which is caused by Candida spp. Resistance to clotrimazole which is one of the most common drugs in the treatment of this disease was reported in many patients. In order to improve the treatment, the effect of 2-phenyl ethanol was investigated in combination with clotrimazole on Candida species isolated from chronic vulvovaginal candidiasis.
Methods: This interventional study was performed in Iran University of Medical Sciences from February, 2016 until December, 2016 on Candida species isolated from women with chronic candidial vulvovaginitis who had been referred to Lolagar Hospital of Tehran. All specimens were examined by direct microscopy, culturing on Candida CHROMagar medium (to primary identification), sabouraud dextrose agar medium) to preservation the isolates) and determining the internal transcribed spacer (ITS) sequence (in order to final determination of Candida species). Then clotrimazole and 2-phenyl ethanol alone and in combination, was examined on isolated species, according to Clinical and Laboratory Standards Institute (CLSI) M27-A3 protocol (micro-broth dilution method). Finally, findings were analyzed.
Results: From 40 detected strains of Candida species in this study, 95% were Candida albicans and 5% were Candida africana. The mean minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of clotrimazole were 24.73±28.87 µg/ml and 30.18±33.004 µg/ml, respectively and the mean MIC and MFC of 2-phenylethanol were 2580±932.38 µg/ml and 3200±1403.29 µg/ml, respectively. The MIC50 and MIC90 of clotrimazole were 16 and 64 µg/ml, respectively. The MIC50 and MIC90 of 2-phenylethanol were both 3200 µg/ml. Most of the isolates were resistant to clotrimazole (82.5%). In combination test, the mean MIC of 2-phenylethanol and clotrimazole alone were 3200±0 µg/ml and 56±40.16 µg/ml, respectively. The fractional inhibitory concentration index (FICI) range was 0.14-0.37. Also, there was a significant difference between clotrimazole MIC values alone and in combination (P= 0.021).
Conclusion: The synergistic effect was observed in combination of clotrimazole and 2-phenylethanol.

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.

Background: Probiotics are living organisms that are beneficial for human health. Lactobacillus species has been considered as probiotic bacteria due to their adjustment of human immune responses and therapeutic effects in inflammatory disorders. The aim of the present study was to evaluate the effects of Lactobacillus probiotic strains on toll-like receptors (TLR2 and TLR4) expression in HT29 cell line (a human colon cancer cell line) infected with S. enteritidis.
Methods: This experimental study was done in Food Microbiology Research Center of Tehran University of Medical Sciences, Iran, from March 2016 to February 2017. In this study, two strains of Lactobacillus acidophilus PTCC 1643 and Lactobacillus casei PTCC 1608 were used. HT29 cells were cultured in RPMI medium containing fetal bovine serum and antibiotics. Then, the cells were treated with the Lactobacillus strains, after or before challenge with S. enteritidis. After total RNA extraction and cDNA synthesis, the capacity of probiotic lactobacilli to modulate TLR2 and TLR4 expression on treated and un-treated HT29 cells were assessed quantitatively using Real-time polymerase chain reaction technique with specific primers.
Results: Our findings indicated that after treatment of non-infected HT29 cells, with both the probiotics, the expression of TLR2 and TLR4 genes significantly increased. In contrast, the expression of these two genes in HT29 cells which were infected with S. Enteritidis was significantly reduced before and after treatment with each one of the probiotic bacteria. The anti-inflammatory effect of probiotic lactobacilli on S. enteritidis were confirmed in tests. This study showed that L. acidophilus and L. casei play a major role in boosting the innate immune responses, the TLR2 and TLR4 expression levels also decreased, pre and post-infection with S. enteritidis.
Conclusion: According to the results, both Lactobacillus strains have remarkable anti-inflammatory effect in pathogenicity of S. enteritidis, but L. acidophilus display greater anti-inflammatory activity than L. casei in this work. Additional in vivo and in vitro studies are required to further elucidate the mechanisms underlying this anti-inflammatory effect.

Background: Nowadays, cardiovascular diseases (CVDs) are among the most common causes of mortalities worldwide. Parathyroid hormone (PTH) has an important role in the pathogenesis of CVDs. The aim of the current study was to compare serum PTH levels between patients with acute myocardial infarction (MI), unstable angina, and normal coronary function.
Methods: This descriptive and analytic study was performed on patients with acute MI, unstable angina, and normal coronary function visiting Imam Ali Hospital of Kermanshah city in Iran, during years 2016 to 2017. Data collection was done from December 2017 to March 2018. Of the patients who met inclusion criteria, 120 were selected by accessible sampling and were allocated into three groups. Serum level of PTH was determined in the three groups.
Results: Among the studied subjects, females and males comprised 43 (35.8%) and 77 (64.2%) respectively. Among those with normal coronary function, 22 (55%) and 18 (45%) were females and males respectively. In acute MI group, women and men comprised 8 (20%), and 32 (80%) respectively. Finally, males and females constituted 13 (32.5%) and 27 (67.5%) in unstable angina group. Based on this study, the overall mean serum PTH level was obtained 18.32 pg/ml. The highest PTH level was observed in individuals with normal coronary function, while the lowest level was recorded in patients with unstable angina. There was a significant difference in mean serum parathyroid hormone levels between the study groups in those with no history of smoking.
Conclusion: Our results indicated that parathyroid hormone serum level can be associated with cardiovascular diseases including unstable angina. There were significant differences in the means of parathyroid hormone level between the studied groups depending on the presence or absence of hyperlipidemia. In vitro evaluation of parathyroid hormone level in suspected subjects should be performed in the case of myocardial infarction, unstable angina and normal coronary, prevented from these diseases by testing.

Background: Amphotericin B is one of the most useful therapeutic modalities for the treatment of patients with invasive fungal infections, in spite of serious side effects, namely kidney injury, electrolyte imbalances, and infusion-related reactions. The goal of this study was to assess the different aspects of premedication practice and the incidence and types of infusion-related reactions in patients receiving amphotericin B.
Methods: This observational study was performed on 70 hospitalized patients who received amphotericin B in different departments of two university hospitals, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, from January 2017 to February 2018. Information on physicians’ performance regarding premedication administration for amphotericin B, including the types and doses of medications administered prior to amphotericin B infusion, as well as patients’ clinical data including infusion-related side effects were collected and then analyzed in comparison with the standard practice guidelines.
Results: The study population consisted of 70 patients with the mean age of 51.6±18.3 years, who received amphotericin B for 8.2±3.5 days. From 70 evaluated patients, 21 patients (30%) had encountered the infusion-related reactions, including chills, fever, urticaria, headache, and hypotension. These side effects were evident in 19 patients (27%) who received no premedication and 2 patients (3%) who received only one drug as premedication, before amphotericin B administration. Twenty patients (28%) experienced chills, fever and headache, while 7 patients (10%) had nausea and vomiting during amphotericin B infusion. Hydrocortisone 50-200 mg, was the most prescribed agent for premedication (in 67% of patients), while chlorpheniramine 10 mg (in 50% of patients) and promethazine 10 mg (in 35% of patients) were the second and third prescribed ones, respectively.
Conclusion: In this study, the patients who received no or only one drug as premedication experienced infusion-related side effects. This emphasizes the necessity for standard premedication practices to prevent this type of adverse reactions. Considering the higher price of liposomal form of Amphotericin-B, if prescribed correctly, even the conventional form would be an effective and tolerable treatment for invasive fungal infections.

Background: Changing the mental structure of students and identifying creativity inhibitors are essential for academic survival and the pursuit of innovation. This study aimed to identify the inhibitory cognitive factors in medical students.
Methods: This study was a directional qualitative content analysis that conducted based on scientific literature review and opinions of experts in a semiformal expert panel by using semi-structured interviews ranging from 20 to 70 minutes from February 2015 to October 2016. Seventeen talented students were interviewed and conversations were recorded with a digital voice recorder at the Exceptional Talent Development Center (ETDC). The extraction and content analysis was continuously done by listening and writing through several times. The students were in various medical disciplines, and most of them were first rank students in scientific performance and they were collaborating with ETDC.
Results: The inhibition variables of creativity were classified in the four main subcategories according to the semantic relationship and after compression, these classes of inhibitory factors included: teacher-related inhibitors, teaching and assessment methods related inhibitors, student barriers and inhibitors of the university's educational system. Finally, 10 codes were extracted from the 4th categories, which were mentioned as inhibitory variables of creativity. The teachers' lack of enthusiasm with the new ideas, the lack of creativity in the academic context and the lack of motivation among the students were the main inhibitors of creativity that were extracted from interviewing with talented students.
Conclusion: In this study, the most important cognitional inhibitory factors in creativity promotion were the inhibitors related to the teacher’s character and his attitude to creativity, methods of teaching and the university environment. Planning for the removal of these barriers in medical students recommended.

Background: Pentoxifylline, a valuable medication with promising clinical characteristics and considerable profile of safety is used in many conditions namely chronic kidney diseases (CKD). However, the decision to prescribe pentoxifylline for anemia in CKD should be based on evidence accrued from randomized controlled trials (RCTs). Yet, substantial heterogeneity exists in studies performed to evaluate pentoxifylline therapy, particularly in relation to classification of patients, the different quality and research design, sample size, baseline parameters, clinical outcome measures, and definition of endpoints and clinically meaningful improvements. As a result, assessment of pentoxifylline in treating anemia of CKD by conducting a systematic review and meta-analysis of the published relevant clinical studies seems rational and promising.
Methods: The present systematic review was done in accordance with the PRISMA guideline for systematic reviews and meta-analysis. Peer-reviewed RCTs with at least four weeks of follow-up were including in the meta-analysis. Online databases (PubMed/Medline, ISI Web of Science, Embase, and Scopus) were searched to December 2017 using selected MeSH terms related to the studied topic. Data was extracted independently by two reviewers using a standard form and then cross-checked. Statistical analyses were carrying out with Stata Software, version 7.0 (Stata Corp., College Station, TX, USA). P value of less than 0.05 was considered statistically significant. Data are presented as standard mean difference (SMD) and confidence interval (CI) 95%.

Background: Intravenous (IV) injection of drugs is one of the most common methods of drug prescription in hospitals, which is a complex, potentially hazardous and erroneous method; accordingly, it requires control methods to reduce the potential risks. This study focused on determining the frequency and types of different medication errors while preparing and administering mostly used IV drugs in three intensive care units (ICU) and one general department in AL-Zahra hospital, Isfahan, Iran.
Methods: This cross-sectional observational study was conducted for 6 months from September 2017 to March 2018. To determine the frequency of different medication errors, a quoting sampling method was applied to select and observe 400 cases of IV drug administrations. All nurses from any studied department were included in this study. Different stages of preparation and administration of the observed drugs were compared to an instructed checklist prepared by the clinical pharmacist.

Background: Marital satisfaction is considered to be the feelings and understanding of the couple about their marital relationship and their two-way relationship. Many factors play a role in creating marital satisfaction, and on the other hand, marital satisfaction is one of the concepts that cause sexual health in a person. Sexual health has many dimensions and includes coordination and adaptation of physical, emotional, intellectual, and social aspects of sexual affairs in humans. This study was conducted to assess the marital satisfaction of working women in Iran through meta-analysis.
Methods: In this meta-analytic study, the issue of marital satisfaction amongst Iranian working women which has been published in local articles was evaluated. To find pertaining studies, Magiran, IranDoc, SID, Iranmedex, and Pubmed websites were used. Statistical society in this research consists of all studies in Iran in regard to the relationship between being a working woman and having marital satisfaction that has been accomplished since 2001-2018 and was indexed in one of the scientific informative websites.
  To access desired articles we used the English keywords of ‘Sexual dysfunction’, ‘Iran’, ‘Sexual function’, ‘Marital satisfaction’, ‘Working women’ and ‘women’ and their Persian equivalents. After the selection process of articles related to the research objectives, 10 articles were selected and assessed as final samples.

Background: Short children face many problems throughout their lives. Consumption of growth hormone and the drugs such as Letrozole, Oxandrolone, and Anastrozole can increase the growth of children and adolescents. There is not an overall estimate of the effects of Letrozole, Oxandrolone, and Anastrozole on the growth of children and adolescents with Idiopathic Short Stature (ISS). There are different estimates of the effect of growth hormone and the drugs Letrozole, Oxandrolone, and Anastrozole on growth in children and adolescents with Idiopathic Short Stature. Therefore, the aim of this study was to compare the efficacy of growth hormone, Letrozole, Oxandrolone, Anastrozole, and a combination of growth hormone and aromatase inhibitors on height gain in children and adolescents with idiopathic short stature using meta-analysis method.
Methods: Search was done in databases such as; Scopus, Web of Science(ISI), and PubMed using keywords: Idiopathic, Short Stature, Body Height, Aromatase Inhibitors, Growth hormone, Letrozole, Oxandrolone, Anastrozole. Randomized clinical trial studies ,that have investigated the efficacy of growth hormone and aromatase inhibitors on height gain in children and adolescents with short stature, were selected. Height standard deviation score (HSDS) before intervention and after treatment has been used to measure the rate of height increase in various studies. This study was written based on the PRISMA checklist and the heterogeneity of this study was evaluated using the Q statistic and I² index.

Background: Rheumatoid Arthritis patients are evaluated during treatment for various inflammatory factors such as C-reactive protein, Erythrocyte Sedimentation Rate, and Disease Activity Score, and other immune system-related factors. In the follow-up of patients with rheumatoid arthritis, hematologic factors associated with the immune system especially Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio are important. In this study, platelet to lymphocyte ratio and Neutrophil to lymphocyte ratio were compared in two groups of patients with and without ocular complications.
Methods: This cross-sectional study was performed on 246 patients with rheumatoid arthritis who were referred to the rheumatology clinic of Kermanshah from December 2018 to May 2019. This study was carried out in accordance with the approval of the ethics committee (IR.KUMS.REC1397.311) at Kermanshah University of Medical Sciences. Of these patients, 191 had no ocular complications and 55 patients had ocular complications and were matched for age and sex. The blood samples were taken from patients and blood cell count was measured by Sysmex KX-21 hematology analyzer. The Spearman correlation test was used to evaluate the relationship between platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in both groups of patients without ocular complications and with ocular complications. The Disease Activity Score was compared between the two groups using the Mann-Whitney test.

Case Presentation: A 35-year-old man who had a history of Wolff-Parkinson-White syndrome from 8 years ago and suffered from dilatation and reduced left ventricular ejection fraction in recent years was presented with a pre-excited atrial fibrillation attack at the emergency department. The initial surface ECG showed positive delta wave in all precordial leads and negative QRS complexes in interior leads with QRS duration of about 200 ms. He had undergone electrophysiology study and ablation at the left postero-lateral accessory pathway. After ablation of accessory pathway within the months (from November 2022 until June 2023), left ventricular function was gradually improved and the symptoms of the patient's shortness of breath were also decreased. Conclusion: The existence of heart failure in patients with Wolff-Parkinson-White syndrome can be due to various reasons including the presence of an accessory pathway and the dyssynchrony of intraventricular contraction which is caused by premature excitation of the connected part of the left ventricle by accessory atrioventricular pathway. Although in order to rule out the possibility of the incidental association of the accessory pathway with primary dilated cardiomyopathy and to investigate the segmental dyskinesia, it is necessary to perform diagnostic measures such as echocardiography and cardiac computerized tomography and magnetic resonance imaging, ablation of such accessory pathway not only controls arrhythmic attacks but also leads to the improvement of the left ventricular systolic function even in a middle age patient.

Background: Developmental disorders in children include a group of problems and limitations in learning and acquiring specific skills of each age group. The term global developmental delay is used to describe developmental disability in children under five years of age, which is in at least two areas of major development. Neuroradiological imaging such as brain MRI provides important information for physicians. The purpose of this study is to determine the role of brain MRI in predicting the clinical outcome of global developmental delay in children.
Methods: In this cross-sectional study, from 79 - from September 2013 to September 2018 at Motahari Clinic of Shiraz University of Medical Sciences, Shiraz Iran - eligible children with developmental disabilities, 37 patient who had brain MRI were selected as a sample and children scores in five ASQ clinical areas and MRI findings were reviewed and compared. Patients suffering from metabolic, genetic, trauma, infection and neoplasms problems and diseases were excluded from the study.

Results: Out of 37 patients studied, 23 were female and 14 were male with a dispersion of three 3 to 60 months of age. 31 of these children had at least one abnormal finding in brain MRI images and the other six were completely normal. In relation to the imaging findings, the highest frequency is related to abnormal head circumference with a prevalence of 54% and the lowest frequency is related to abnormal myelinization with a prevalence of 10.8%. Results of MRI findings correlation with developmental domains demonstrated that Children with white matter disorder on MRI show severe gross motor abnormality (P<0.049) and who had MRI finding of cortical problems suffer from developmental delay in fine motor area. (P<0.001). Conclusion: Considering the mentioned findings; brain MRI can be a useful diagnostic tool in children with developmental delay and also focusing on the developmental area that is more likely to be affected, MRI can help with treatment and rehabilitation process of these children in the future.

Results: A considerable rise in sperm concentration was noted in both the selenium-fed group and the astaxanthin-fed group when compared to the spinal cord injury group (P=0.001). Supplementation with selenium and astaxanthin improved sperm concentration, progressive motility, and viability, bringing these parameters close to control levels (P<0.001). However, neither of these substances had an effect on abnormal sperm morphology (P>0.05). Both selenium and astaxanthin supplementation enhanced the motor and sensory functions of the injured rats (P<0.001), with selenium showing a greater role in promoting repair compared to astaxanthin (P<0.001). Conclusion: Selenium and astaxanthin supplements improved sperm parameters, except for sperm morphology, and were effective in enhancing motor and sensory functions after spinal cord injury. Selenium was found to be more effective than astaxanthin in promoting spinal cord repair.

Background: The exact cause chronic lymphocytic leukemia (CLL) is still unknown. Cytomegalovirus (CMV) may play a role in the development of CLL, Therefore, the aim of this study is to investigate the frequency of CMV in patients with CLL and its relationship with blood and genetic factors.
Methods: This cross-sectional study was conducted between April 2020 and October 2022 on 40 CLL patients that referred to Dr. Daneshbod Pathobiology Laboratory (Shiraz, Iran). After taking blood and separating the buffy coat, viral DNA was extracted using a commercial DNA extraction kit and the CMV burden was measured using Real-time PCR assay. Moreover, a blood cell count test was performed. The amount of lactate dehydrogenase of the serum was measured using the kit. Also, common chromosomal disorders and CD38 marker related data were extracted from the file patients. SPSS software and Student's t-test were used to result analysis.
Results: The mean age of the patients was 62.25 ± 10.49 years. Of the 40 patients, 28 were men (70%). The average number of white blood cells was 46.06±1.49* 10⁹, which was significantly higher in women than in men (p=0.031). Real-time PCR results showed that two patients (5%) have detectable amounts of CMV virus genome. The level of lactate dehydrogenase, CD38 marker, and the number of malignant cells in male and female patients did not differ significantly (p=0.362). Moreover, chromosomal abnormalities include deletions in 11q (ATM) and 17P (TP53), were observed in 3 (7.5%) and 4 (10%) patients, respectively.
Conclusion: Our finding indicated the CMV might not involve in the pathogenesis of CLL disease. More studies are recommended for clarify this finding.

Background: Coagulopathy is one of the most common causes of mortality in the intensive care unit. This study was designed and implemented to investigate the relationship between acidosis and coagulation disorders in patients undergoing laparotomy in the intensive care unit.
Methods: This retrospective study reviewed the files of 121 patients undergoing laparotomy in the intensive care unit of Imam Khomeini Hospital of Ahvaz during 2024. Demographic and clinical records and blood test results were extracted to measure parameters related to acidosis and coagulation tests. Then, the rates of coagulopathy, thrombocytopenia, acidosis, and patient outcome were calculated. The data obtained were analyzed using SPSS version 27 software.
Results: Most patients studied were male (72 (59.5%)) with a mean age of 54.18±21.1 years and a mean length of stay of 6.78±5.87 days. Hypertension (34 (28.1%)) was the most important comorbidity and peritonitis (54 (44.6%)) was the most important cause of hospitalization. The incidence rates of coagulopathy, thrombocytopenia, and acidosis were reported to be 29 (24%), 27 (22.3%) and 115 (95%), respectively. A total of 44 (36.5%) patients died during the study period. Although the rates of coagulopathy and thrombocytopenia were higher in patients with acidosis, these differences were not significant (P<0.05). The mortality rates among those without thrombocytopenia, mild, moderate, and severe thrombocytopenia were reported as 27 (28.7%), 4 (33.3%), 9 (81.1%), and 4 (100%), respectively, showing a significant difference (P=0.001). The mean pH in deceased patients was significantly lower than in others (0.13±7.19 vs. 0.88±7.25; P=0.005). The mortality rate in patients with coagulopathy was also significantly higher than in others (20 (69%) vs.24 (26.4%); P=0.000).
Conclusion: The incidence of acidosis and coagulation disorders in patients undergoing laparotomy and admitted to the intensive care unit is significant and is linked to poorer outcomes for these patients. However, acidosis was not found to be an independent risk factor for coagulation disorders in this population. Further research is necessary to confirm or refute these findings.

Background: The duration of hospitalization of patients is considered an important indicator in health resource management and patient evaluation. This study investigated the frequency and causes of readmission in cardiovascular patients
Methods: This was a retrospective study of 105 patients with cardiovascular diseases referred to Imam Khomeini Hospital in Ahvaz who were readmitted from April 2024 until August 2024 within 30 days after discharge due to recurrence of symptoms. Demographic (including age and gender) and clinical information (including duration of hospitalization, regular medication use, regular physician visits, disease diagnosis and dietary adherence) of the patients was extracted from electronic records using a researcher-made checklist.
Results: From 105 patients, 43 (41%) were admitted in the first trimester and 62 (59%) in the second trimester. The mean age of patients in the first trimester was higher than in the second trimester with a statistically significant association with readmission (P=0.038). Most patients were male and their number was higher in the second trimester than in the first trimester and a statistically significant association was observed between the gender of patients with readmission in the first trimester compared to the second trimester (P=0.015). 72 patients with acute coronary syndrome (68.6%) and 33 patients with heart failure (31.4%) were readmitted. The mean length of stay in the first trimester was 1.6 ± 1.15 days and 2.9 ± 2.7 days in the second trimester. A significant association was observed between the duration of hospitalization and readmission (P=0.003). However, no association was observed between regular medication use and regular physician visits in readmitted patients. However, a significant association was observed between dietary adherence in readmitted patients (P=0.045).
Conclusion: Readmission of cardiovascular patients follows a seasonal pattern and is associated with factors such as age, sex, length of stay, and dietary adherence. Routine disease management measures are not sufficient to counteract these effects, and targeted educational programs are necessary at the threshold of high-risk periods.
 

Background: Since multiple factors contribute to the occurrence of postoperative complications and these risk factors are generally more prevalent among elderly individuals compared to younger patients this study was conducted to compare the complications of hemorrhoidectomy between elderly and non-elderly patients.
Methods: For each patient, a data collection form was completed, including demographic characteristics (age, sex, body mass index, ASA class, and comorbidities), as well as laboratory and disease-related information. Postoperative complications assessed were bleeding, anal fissure, rectal stenosis, anal pain, hemorrhoid recurrence, reoperation, postoperative infection, pruritus, and urinary tract infection.
Results: The findings indicated that the lymphocyte-to-monocyte ratio LMR Lymphocite to Monocye Ratio) was associated with a reduced incidence of complications, whereas both the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein CRP (c_reactive protein) levels were associated with an increased incidence of complications. Furthermore, hemorrhoid grade, disease duration, number of hemorrhoidal nodules, preoperative pain severity, and chronic preoperative pain were all significantly associated with a higher likelihood of postoperative complications in elderly patients.
Conclusion: This study demonstrates that several factors including hematologic ratios (LMR, NLR), CRP (c_reactive protein) levels, hemorrhoid grade, disease duration, number of hemorrhoidal nodules, preoperative pain severity, and chronic preoperative pain are significantly associated with the occurrence of postoperative complications following hemorrhoidectomy in elderly patients.