Search published articles
Showing 460 results for Ahi
Naser Ebrahimi Daryani , Mohammad Reza Pashaei ,
Volume 80, Issue 6 (September 2022)
Volume 80, Issue 6 (September 2022)
Abstract
Nonalcoholic fatty liver disease (NAFLD) is defined by steatosis in more than 5% of liver cells, in the absence of a secondary cause such as drugs, alcohol, or other causes. The incidence of NAFLD is increasing every day; almost a quarter of the world's adult population is affected by this disease. The burden of NAFLD is affected by the epidemics of obesity and type 2 diabetes (T2DM), and therefore, we do not expect the prevalence of this disease to decrease in the future. The world is now in the process of passing on health to non-chronic diseases, like NAFLD. The most common cause of chronic liver disease worldwide is non-alcoholic fatty liver disease. About 25 percent of the world's population is affected by the disease, and it ranges from simple steatosis to cirrhosis. 1 in 4 individuals with NAFLD is a person with non-alcoholic steatohepatitis, which is associated with complications and significant mortality and morbidity due to complications such as liver cirrhosis and hepatocellular carcinoma. Non-alcoholic fatty liver disease is closely related to metabolic syndrome, and it can be said that the liver is an integral part of obesity. Diagnostic methods for this disease include laboratory tests, imaging studies and liver biopsy. Although NAFLD is observed predominantly in obese persons or type 2 diabetes, an estimated 7% to 20% of people with NAFLD have lean body habitus. Recent studies have shown that fatty liver can occur in lean individuals, even without abdominal and visceral fat. Fatty liver in lean people (Lean NAFLD) is a relatively new concept that has attracted many people to find the differences between lean and obese people. The pathophysiological mechanisms of lean NAFLD are still poorly understood. Studies have shown that NAFLD without obesity is more closely related to factors such as environmental, genetic susceptibility, and epigenetic regulation. In addition to lifestyle modifications such as weight loss, diet and physical activity, only a few NAFLD-specific drug treatment options such as vitamin E and pioglitazone are considered. This article discusses the pathogenesis of fatty liver in lean individuals, its treatment, prognosis, and its relationship with metabolic syndrome.
Kouros Divsalar, Sara Hesami, Majid Mahmoodi, Navidreza Giahi, Fatemeh Divsalar , Mohammad Pour-Ranjbar , Amin Honarmand,
Volume 80, Issue 7 (October 2022)
Volume 80, Issue 7 (October 2022)
Abstract
Background: Based on the studies, variation in the mitochondrial DNA (mtDNA) copy number in peripheral blood leukocytes is associated with increased susceptibility to diseases including cancer. Opiate abusers are at high risk for diseases. In this study, we measured the mtDNA copy number in peripheral blood leukocytes in a group of opiate abusers compared with those in healthy individuals.
Methods: In a case/control study, three groups were selected consisting of 32 opium abusers, 24 heroin addicts and 25 healthy individuals. The amount of 5 ml of whole blood was collected from each individual who participated in the study and stored at -20 centigrade. The sample collection was performed from November 2018 to February 2020. Case groups were recruited from the Methadone maintenance therapy center. Contro group had no history of drug use and cigarette smoking. DNA was extracted from the whole blood samples using the salting out method. The DNA from a mitochondrial gene, dehydrogenase subunit1 (-ND1 gene) and a nuclear gene, human globulin (HGB gene), were quantified by a real-time PCR-based method to measure the relative mtDNA copy number of each group number.
Results: There was no significant difference in demographic characterization between the three study groups, opium abusers, heroin addicts and healthy individuals. We found that opium users had a higher mean of mtDNA copy number than those in the healthy control group (P=0.11). Heroin addicts had also higher mean of mtDNA copy number than those in healthy group (P=0.21). The mean mtDNA copy number in opium abusers was higher than that in heroin addicts (P=0.22), although the difference was not statistically significant.
Conclusion: The results of this study indicated that mtDNA copy number increased in a group of opiate abusers. Considering that alteration of mtDNA copy number is associated with increased susceptibility to several diseases including cancer, further research on mtDNA copy number with a high number of volunteers of opiate addicts may clear the effect of opiate abuse on the human genome.
Methods: In a case/control study, three groups were selected consisting of 32 opium abusers, 24 heroin addicts and 25 healthy individuals. The amount of 5 ml of whole blood was collected from each individual who participated in the study and stored at -20 centigrade. The sample collection was performed from November 2018 to February 2020. Case groups were recruited from the Methadone maintenance therapy center. Contro group had no history of drug use and cigarette smoking. DNA was extracted from the whole blood samples using the salting out method. The DNA from a mitochondrial gene, dehydrogenase subunit1 (-ND1 gene) and a nuclear gene, human globulin (HGB gene), were quantified by a real-time PCR-based method to measure the relative mtDNA copy number of each group number.
Results: There was no significant difference in demographic characterization between the three study groups, opium abusers, heroin addicts and healthy individuals. We found that opium users had a higher mean of mtDNA copy number than those in the healthy control group (P=0.11). Heroin addicts had also higher mean of mtDNA copy number than those in healthy group (P=0.21). The mean mtDNA copy number in opium abusers was higher than that in heroin addicts (P=0.22), although the difference was not statistically significant.
Conclusion: The results of this study indicated that mtDNA copy number increased in a group of opiate abusers. Considering that alteration of mtDNA copy number is associated with increased susceptibility to several diseases including cancer, further research on mtDNA copy number with a high number of volunteers of opiate addicts may clear the effect of opiate abuse on the human genome.
|
|
Monireh Rahimkhani,, Zahra Rajabi,
Volume 80, Issue 7 (October 2022)
Volume 80, Issue 7 (October 2022)
Abstract
Background: Considering the frequency of MRSA strains in hospitals and medical centers as well as in different communities, it seems necessary and important to observe the use of appropriate drugs in order to reduce antibiotic resistance and reduce the economic costs of treatment. This study aimed to investigate the antibiotic resistance pattern of MRSA isolated from blood and wound samples of patients. The study patients were hospitalized in different departments in a number of Tehran University of Medical Sciences hospitals.
Methods: In this descriptive cross-sectional study from September 2021 to February 2022, the blood and wound samples of the patients were collected and referred to laboratory. Staphylococcus aureus had identified by phenotypic and biotypic tests. MRSA isolates were screened by showing resistance to Cefoxitin by disc diffusion method and finally confirmed by examining the mecA gene by PCR. The microbial resistance pattern of MRSA was also measured by disk diffusion method and resistance to Vancomycin was confirmed by E.test.
Methods: In this descriptive cross-sectional study from September 2021 to February 2022, the blood and wound samples of the patients were collected and referred to laboratory. Staphylococcus aureus had identified by phenotypic and biotypic tests. MRSA isolates were screened by showing resistance to Cefoxitin by disc diffusion method and finally confirmed by examining the mecA gene by PCR. The microbial resistance pattern of MRSA was also measured by disk diffusion method and resistance to Vancomycin was confirmed by E.test.
|
Results: 41 isolates from 87 Staphylococcus aureus samples were confirmed as MRSA by present the mecA gene. The mecA gene was detected in all MRSA by PCR method. The antibiotic resistance pattern showed the highest sensitivity to Vancomycin and Linezolid with 100% sensitivity and the highest resistance to three antibiotics Erythromycin, Ceftriaxone and Cloxacillin with 97.57%by disk diffusion method. The most MRSA strains were isolated from the ICU department with 13 cases and the least MRSA strains were isolated from the two NICU and pediatric departments with one case.The majority of the population infected with MRSA belonged to the age group of 40-65 years.
Conclusion: The prevalence of microbial resistance with high dispersion was obtained among MRSA strains isolated from clinical samples; which indicates a significant increase in resistant strains and requires a quick and timely diagnosis to prescribe the appropriate antibiotic. |
Elham Tabesh, Zahra Iravani , Mohammad Jafari, Maryam Soheilipour, Mohammad Javad Tarrahi ,
Volume 80, Issue 9 (December 2022)
Volume 80, Issue 9 (December 2022)
Abstract
Background: Gastrointestinal bleeding is one of the consequences of COVID-19, which is associated with increased hospitalization and patient mortality. This study was conducted to determine the prevalence of endoscopic findings and the outcome of gastrointestinal bleeding in patients with COVID-19 who were hospitalized from September to December 2019 in Al-Zahra Hospital, Isfahan.
Methods: In this cross-sectional study, out of 5800 patients who were admitted to Al-Zahra Hospital in Isfahan from September to December 2019 due to COVID-19 (according to the positive PCR test result), 87 patients who underwent endoscopy due to upper gastrointestinal bleeding by a skilled gastroenterologist, were selected and studied. Demographic characteristics, underlying diseases, use of anticoagulants, and laboratory findings were studied and evaluated and finally, the disease was evaluated and compared based on endoscopic findings.
Methods: In this cross-sectional study, out of 5800 patients who were admitted to Al-Zahra Hospital in Isfahan from September to December 2019 due to COVID-19 (according to the positive PCR test result), 87 patients who underwent endoscopy due to upper gastrointestinal bleeding by a skilled gastroenterologist, were selected and studied. Demographic characteristics, underlying diseases, use of anticoagulants, and laboratory findings were studied and evaluated and finally, the disease was evaluated and compared based on endoscopic findings.
|
Results: Based on the results obtained from this research, the patients with endoscopic lesions had higher average age (P=0.041), lower blood oxygen saturation percentage (P=0.028), and higher bleeding intensity (P=0.018). The frequency of using anticoagulant drugs in the group whose endoscopy results were abnormal was higher but insignificant. Hemoglobin, platelet, lymphocyte, and CRP levels were higher in the group whose endoscopy was normal, and NLR, LDH, and D-dimer levels were higher in the group whose endoscopy was abnormal (P<0.050). Three people (11.55%) from the group with normal endoscopy and 18 people (29.5%) from the group with abnormal endoscopy died, but the frequency of death was not significantly different between the two groups (P=0.070).
Conclusion: The findings of the present study showed that the COVID patients with upper gastrointestinal bleeding who had endoscopic lesions had significant differences in some characteristics such as age, bleeding intensity, and blood oxygen saturation percentage with patients with normal endoscopy. Also, the frequency of death in patients with endoscopic lesions was relatively higher. Therefore, COVID patients with gastrointestinal bleeding should undergo endoscopy as soon as possible and necessary measures should be taken to control and prevent gastrointestinal bleeding. |
Mohammad Bakhtiar Hesam Shariati , Fahimeh Rajabi , Ehsan Motavasel ,
Volume 80, Issue 9 (December 2022)
Volume 80, Issue 9 (December 2022)
Abstract
Background: Congenital malformations of the kidney and urinary tracts happen in 3-6 per 1000 live births and these abnormalities are the reason, for (ESRD) in children and also the reason for subsequent kidney problems such as kidney stones, infections and hypertension in adulthood. One of the most common anomalies of the renal system is the double collecting system. Knowledge of anatomical variations and disorders before surgery can make the surgical procedure smoother for the surgeon and prevent unwanted mistakes. Imaging through radiology, computed tomography, and MRI is the best way to diagnose early, follow-up, and planning for surgery, diagnosis of complications and extra kidney abnormalities.
|
Case Presentation: Our report in this article is about four years old girl who went to the MRA center of Baath Hospital in Sanandaj due to flank pain in December 2019. After abdominal imaging, signs of an abnormality of the double collecting system were revealed. Abdominal and pelvic ultrasound revealed abnormalities of the UVJ, and the distal part of the right urethral duct was approximately 2 mm in size. Also, the anterior-posterior diameter of the right renal pelvis was reported to be 2 mm and the upper calyx of the right kidney was quite dilated. This incomplete integration leads to complete or incomplete forms of the renal collecting system. The prevalence of this anomaly is also mostly unilateral, but our report, in this case, is about bilateral ureters.
Conclusion: We reported a rare case of bilateral Y-shaped bifid ureter, that's in this kind of anomaly 2, pyelocaliceal systems connect at the junction of the ureter to pelvic (bifid pelvis), and this abnormality was accidentally detected on ultrasound and MRI examinations. However, since duplex kidneys are often asymptomatic and therefore mainly diagnosed incidentally in patients, the actual number of patients with symptoms is probably lower. |
Vahid Varmazyari , Amirreza Rashti, Ali Darakhshandeh, Ayda Moghaddas, Azadeh Moghaddas,
Volume 80, Issue 10 (January 2023)
Volume 80, Issue 10 (January 2023)
Abstract
Background: Since numerous chemotherapy regimens for the treatment of patients suffering from acute lymphoid leukemia (ALL) have been recently developed, having basic information about the previous results of using the Hyper-CVAD regimen in order to compare with other common chemotherapy regimens is essential. The aim of this study was to evaluate demographic, clinical and outcome of ALL patients receiving Hyper-CVAD regimen.
Methods: In this retrospective study, nighty eligible ALL patients treated with the Hyper-CVAD chemotherapy regimen in Omid Hospital, Isfahan, Iran during April 2016 till April 2019 were considered. We evaluated the demographic variables, pathological data and other clinical factors by an information sheet designed by main investigator. The main purpose of this study was to evaluate overall survival, progression-free survival, and overall response rate of patients along with patients’ clinical characteristics and other relevant factors using Kaplan-Meier or Cox-regression and other statistical analyses.
Methods: In this retrospective study, nighty eligible ALL patients treated with the Hyper-CVAD chemotherapy regimen in Omid Hospital, Isfahan, Iran during April 2016 till April 2019 were considered. We evaluated the demographic variables, pathological data and other clinical factors by an information sheet designed by main investigator. The main purpose of this study was to evaluate overall survival, progression-free survival, and overall response rate of patients along with patients’ clinical characteristics and other relevant factors using Kaplan-Meier or Cox-regression and other statistical analyses.
|
Results: The mean overall survival and the median survival of patients were 44.8±2.93 and 36.7±7.47 months; respectively. Also the mean progression free survival of patients was 44.44±3.30 months. More than 84.4% of patients encountered complete remission (CR) after receiving Hyper-CVAD regimen. Reaching to CR had positive significant effects on patients’ overall survival and median survival. However, the bone marrow transplantation variable alone did not affect the patients’ overall survival. The variables such as being B/T Cell ALL, Philadelphia, myeloid marker, and central nervous system involvement did not affect the overall survival of patients but the relapse index indicated the significant effects. The median survival time is higher in patients with no relapse episode. None of the initial lab data had any significant effects on patients’ overall survival.
Conclusion: For the first time in Iran, we have obtained the mean survival outcome of ALL patients after applying the Hyper-CVAD regimen. According to the results, the mean overall survival, progression free survival and other survival items in Iranian patients suffering from ALL and receiving Hyper-CVAD regimen were in consistent with previous studies in the world. |
Seyed Kamal Eshagh Hossaini , Javad Hakimelahi, Mohammad Aghaali, Zahra Mehrabi, Rasool Karimi Matlob , Saeed Karimi Matlob,
Volume 80, Issue 10 (January 2023)
Volume 80, Issue 10 (January 2023)
Abstract
Background: Idiopathic thrombocytopenic purpura (autoimmune), the most common cause of acute onset of thrombocytopenia in children who are otherwise healthy. This study was conducted with the aim of investigating the factors affecting the response to treatment in hospitalized children.
Methods: This retrospective study was conducted by examining the files of patients hospitalized due to ITP in Hazrat Masoumeh (S) Hospital from April 2009 to March 2019. The criteria for inclusion in the study included confirming the diagnosis of ITP and the age of 1 month to 14 years, and the exclusion criteria included cases of discharge with personal consent and not completing the patient's treatment course, the presence of pancytopenia or bicytopenia, the presence of moderate or severe splenomegaly or severe in clinical examinations, BMA based on the presence of a diagnosis other than ITP, not receiving any of the ITP treatment protocols, and patients whose first visit with the diagnosis of ITP was in another center or city. The information about age, sex, clinical symptoms on arrival, initial platelets and the platelets of days 3, 5, 14 and 180 were extracted from the patients' files. The type of treatment protocol, the need to repeat the treatment, the recurrence of the disease and the major complications of the treatment were extracted from the patients' files and finally the data were analyzed with SPSS software.
Results: The response to the treatment on different days was unrelated to the age, gender, and initial platelets (except for one exception) (P>0.05). In relation to clinical symptoms, the response to treatment on days three and five was related to the clinical symptoms at the time of presentation and on days 14 and 180 it was unrelated. Response to treatment on days 3 and 5 in different treatment protocols had a significant relationship (P<0.05), but there was no significant difference on days 14 and 180.
Methods: This retrospective study was conducted by examining the files of patients hospitalized due to ITP in Hazrat Masoumeh (S) Hospital from April 2009 to March 2019. The criteria for inclusion in the study included confirming the diagnosis of ITP and the age of 1 month to 14 years, and the exclusion criteria included cases of discharge with personal consent and not completing the patient's treatment course, the presence of pancytopenia or bicytopenia, the presence of moderate or severe splenomegaly or severe in clinical examinations, BMA based on the presence of a diagnosis other than ITP, not receiving any of the ITP treatment protocols, and patients whose first visit with the diagnosis of ITP was in another center or city. The information about age, sex, clinical symptoms on arrival, initial platelets and the platelets of days 3, 5, 14 and 180 were extracted from the patients' files. The type of treatment protocol, the need to repeat the treatment, the recurrence of the disease and the major complications of the treatment were extracted from the patients' files and finally the data were analyzed with SPSS software.
Results: The response to the treatment on different days was unrelated to the age, gender, and initial platelets (except for one exception) (P>0.05). In relation to clinical symptoms, the response to treatment on days three and five was related to the clinical symptoms at the time of presentation and on days 14 and 180 it was unrelated. Response to treatment on days 3 and 5 in different treatment protocols had a significant relationship (P<0.05), but there was no significant difference on days 14 and 180.
|
Conclusion: The best response was in the combined treatment group with methylprednisolone and IVIg, and the lowest response to treatment was observed in those receiving methylprednisolone alone.
|
Alireza Jahanshahi , Alireza Kheradmand, Mehrnoosh Zakerkish, Homeira Rashidi, Narges Goudarzian Khozani ,
Volume 80, Issue 10 (January 2023)
Volume 80, Issue 10 (January 2023)
Abstract
Background: The treatment of male hypogonadotropic hypogonadism leading to infertility in men and caused by gonadotropin is the subject of the current thesis. In this research, particularly, the fertility rate has been noticed. However, changes in the secondary traits of testes size, induction of spermatogenesis, and hormonal activity have also been considered. this project is to investigate the effectiveness of the mentioned treatment in creating fertility in the spouses of patients and comparing it with other researches conducted in other centers of the world.
|
Methods: In this retrospective and descriptive-analytical study, men with isolated hypogonadotropic hypogonadism based on the normality of other pituitary axes who had a tendency to be fertile were studied. From November 2017 to February 2020, these patients had been referred to the doctor at the endocrinology and urology clinics of Ahvaz for fertility purposes. The initial test was based on clinical examinations and testosterone measurement and sperm count for the patients was recorded after the treatment. The treated patients simultaneously received HMG 75 units every other day (three times a week) and HCG 5000 units every other day. Hormonal evaluation and clinical examinations were assessed again.
Results: This research showed that the size of the testicles increased in 54.8% of these patients. Secondary characteristics (secondary hair growth) were developed in 88.9% of the patients. Spermatogenesis induction occurred in 36 patients, 29 of whom became fathers. Meanwhile, in 67.3% of patients, sexual desire and in 69.4% of them hormonal activity increased. In addition, it was observed that the response time to replacement therapy is more than 12 months in 47.5% of the patients. Moreover, 6.6% of the study samples had used assisted reproductive methods. Conclusion: The results of this research indicate the timely initiation of treatment to improve infertility and treat hypogonadism among men.According to the results, it seems that the use of HMG and HCG in the treatment of hypogonadotropic hypogonadism disease is effective in creating secondary sexual characteristics and increasing hormonal activity and fertility. |
Yunus Soleymani, Amir Reza Jahanshahi, Davood Khezerloo ,
Volume 80, Issue 11 (February 2023)
Volume 80, Issue 11 (February 2023)
Abstract
Background: Atrophy of hippocampal subfields is one of the diagnostic biomarkers of Alzheimer's disease, which has also been observed in many patients with mild cognitive impairment. There is still no clear understanding of the atrophy pattern of hippocampal subfields in Alzheimer's disease and its differentiation from mild cognitive impairment. In this cross-sectional study, hippocampal subfield atrophy in Alzheimer's patients were compared with patients with early (EMCI) and late (LMCI) cognitive impairment and the control group.
Methods: This was a cross-sectional study conducted from September 2021 to September 2022 in the radiology department of Tabriz Paramedical Faculty. MRI images of Alzheimer's patients, EMCI patients, LMCI patients, and normal controls (NCs) were obtained from the ADNI database. Different hippocampus subfields of hippocampal fissure, dentate gyrus head, dentate gyrus body, first cornu ammonis body, cornu ammonis head, subiculum body, and subiculum head were isolated using the hippocampus segmentation tool in FreeSurfer 7.0 software. The volume of all subfields was calculated bilaterally and normalized. The volume difference of each hippocampus subfield between the groups participating in the study and the pair volume difference between the groups was analyzed using the Kruskal-Wallis H Test and post-hoc Dunn's test. The P<0.05 was considered as the significance level.
Methods: This was a cross-sectional study conducted from September 2021 to September 2022 in the radiology department of Tabriz Paramedical Faculty. MRI images of Alzheimer's patients, EMCI patients, LMCI patients, and normal controls (NCs) were obtained from the ADNI database. Different hippocampus subfields of hippocampal fissure, dentate gyrus head, dentate gyrus body, first cornu ammonis body, cornu ammonis head, subiculum body, and subiculum head were isolated using the hippocampus segmentation tool in FreeSurfer 7.0 software. The volume of all subfields was calculated bilaterally and normalized. The volume difference of each hippocampus subfield between the groups participating in the study and the pair volume difference between the groups was analyzed using the Kruskal-Wallis H Test and post-hoc Dunn's test. The P<0.05 was considered as the significance level.
|
Results: The most significant volume difference between the four groups participating in the study was related to the whole hippocampus, DG body, subiculum body, and subiculum head subfields (P<0.0001). Also, when examining pairs, the most significant difference was observed between the NC/AD pair (P<0.0001) and the least significant difference between the pair of LMCI/AD group (P<0.05) and in the subfield subiculum body showing the progressive course of hippocampal subfield atrophy with cognitive progress towards Alzheimer's disease.
Conclusion: In most subfields of the hippocampus, a significant difference in atrophy can be seen, increasing the severity of atrophy as the disorder progresses toward Alzheimer's. Such findings can help guide future studies to improve diagnostic performance to identify individuals at high risk of Alzheimer's disease. |
Zahra Asadi-Piri , Ebrahim Jaafaripooyan,
Volume 80, Issue 11 (February 2023)
Volume 80, Issue 11 (February 2023)
Abstract
Background: Access to healthcare is a fundamental right of every individual, regardless of their geographic location or socioeconomic status. In many countries, deprived areas often face a shortage of physicians and other healthcare professionals. This study aimed to investigate the approaches essential to attract and retain physicians in the deprived and rural areas.
|
Methods: The present study is a systematic review using appropriate keywords in Persian and English language. The main databases including Google Scholar, Scopus, Web of Science, PubMed, SID, and IranMedex were searched from May 2005 to September 2022 in both languages. Different approaches implemented by countries to attract and retain doctors were classified using thematic analysis.
Results: A total of 18 articles were selected for inclusion in the study. Educational, regulatory, motivational, and personal and professional support drivers have been used to attract and retain physicians. The successful interventions implemented were mainly educational and supportive; such as admitting native medical students, providing relevant curricula on working in the deprived and rural areas, and conducting training courses in these regions. Those studying the topics and courses related to serving in the rural areas during their academic education or internship and residency programs had served more time in these areas. Assimilating the topics related to providing services in rural areas into the curriculum, holding fellowship courses and related graduate studies, awarding scholarships to the physicians working in deprived areas, providing free amenities, reducing working hours, and considering special holidays are considered among the recommended solutions. Conclusion: Various drivers were used for attracting and retaining physicians in the deprived and rural areas. Besides, the challenge to retain doctors in such areas was fairly common. Most countries have put more priority on the use of financial incentives, nevertheless, a combination of interventions was preferred. It is worth mentioning that a range of economic, political, and social factors could play a key role in the success of recommended interventions. |
Yunus Soleymani, Amir Reza Jahanshahi, Hamed Rezaeejam, Davood Khezerloo,
Volume 80, Issue 12 (March 2023)
Volume 80, Issue 12 (March 2023)
Abstract
Background: Radiomics is a noninvasive method that reveals information from medical images that are not recognizable by the naked eye. Radiomics has shown a high potential in the accurate diagnosis and prognosis of liver lesions in ultrasound images. Despite this high potential, changes in imaging parameters affect the reproducibility of ultrasound radiomics results. Therefore, the present study aims to investigate the reproducibility of the radiomics features extracted from the images of patients with hepatocellular carcinoma under changes in ultrasound scan parameters.
Methods: This was a cross-sectional study conducted from July 2020 to July 2021 in the radiology department of Tabriz Paramedical Faculty. The images of 20 patients with hepatocellular carcinoma were obtained from the Cancer Imaging Archive database. These images were taken under different imaging conditions and parameters. The areas related to the lesion were manually extracted from the images with software tools. Then, in order to radiomics analysis, different radiomics features, including 24 gray level co-occurrence matrix (GLCM) and 16 gray level run length matrix (GLRLM), were extracted from the images. Then, using the coefficient of variation (CV%) and intraclass correlation coefficient (ICC) statistical tests, the reproducibility of radiomics features under changes in scan parameters was investigated. The values of ICC≥0.90 and CV<20% were considered reproducible in this study.
Methods: This was a cross-sectional study conducted from July 2020 to July 2021 in the radiology department of Tabriz Paramedical Faculty. The images of 20 patients with hepatocellular carcinoma were obtained from the Cancer Imaging Archive database. These images were taken under different imaging conditions and parameters. The areas related to the lesion were manually extracted from the images with software tools. Then, in order to radiomics analysis, different radiomics features, including 24 gray level co-occurrence matrix (GLCM) and 16 gray level run length matrix (GLRLM), were extracted from the images. Then, using the coefficient of variation (CV%) and intraclass correlation coefficient (ICC) statistical tests, the reproducibility of radiomics features under changes in scan parameters was investigated. The values of ICC≥0.90 and CV<20% were considered reproducible in this study.
|
Results: Among the 40 features extracted from ultrasound images, eight showed high reproducibility in both CV% and ICC tests. These features were joint entropy, Idmn, Imc2, correlation, MCC, sum entropy, gray level non-uniformity normalized, and run entropy in which the two features, Idmn and gray level non-uniformity normalized, showed the highest (CV%=0.24) and the lowest (CV%=14.90) stability against the changes of ultrasound scan parameters, respectively. The average ICC value of these features was obtained at 0.977.
Conclusion: Despite the high potential of radiomics in diagnosing liver lesions, changes in imaging parameters directly affect the reproducibility of results. However, some radiomics features still show high stability and reproducibility under changes in imaging parameters. |
Arezoo Mehrabian, Hamed Ghaffari, Soheila Refahi , Mohammad Haghparast , Abolhasan Rezaeyan,
Volume 80, Issue 12 (March 2023)
Volume 80, Issue 12 (March 2023)
Abstract
|
|
Seyed Hossein Hosseini, Hossein Karimi Moonaghi , Seyed Masoud Hosseini, Hassan Gholami, Vahid Ghavami,
Volume 80, Issue 12 (March 2023)
Volume 80, Issue 12 (March 2023)
Abstract
Background: According to numerous research related to learning styles and also the difference of these styles in students, this study was designed in order to determine the status of learning styles in medical students in Iran.
Methods: This study was conducted as a systematic review and meta-analysis. Searching for articles in this study was done from September 24 to October 15, 2022 in databases: Proquest, PubMed, Iran medex, Scopus, Sid, Magiran, Google Scholar, Eric and medical education journals. The research environment of Iran has been Mashhad. Using the PICOTS model, the keywords: learning styles, clubs, medical students were used to search the mentioned databases. OR, AND operators and possible combinations of keywords were used when searching for articles in databases. The extracted articles were first evaluated in terms of the research title, then the abstract of the article, and finally the text of the article using the "PRISMA Checklist". In each stage, repetitive articles and articles that did not mention the percentage of learning styles were excluded from the study, and the articles that met the inclusion criteria were stored in the (EndNote software, version 20, Clarivate, USA), and at the end, 53 articles were analyzed.
Methods: This study was conducted as a systematic review and meta-analysis. Searching for articles in this study was done from September 24 to October 15, 2022 in databases: Proquest, PubMed, Iran medex, Scopus, Sid, Magiran, Google Scholar, Eric and medical education journals. The research environment of Iran has been Mashhad. Using the PICOTS model, the keywords: learning styles, clubs, medical students were used to search the mentioned databases. OR, AND operators and possible combinations of keywords were used when searching for articles in databases. The extracted articles were first evaluated in terms of the research title, then the abstract of the article, and finally the text of the article using the "PRISMA Checklist". In each stage, repetitive articles and articles that did not mention the percentage of learning styles were excluded from the study, and the articles that met the inclusion criteria were stored in the (EndNote software, version 20, Clarivate, USA), and at the end, 53 articles were analyzed.
|
Results: The results of the study showed that the most used learning styles among students of medical sciences in Iran was convergent learning style (32% with 95% confidence interval). In the investigation of the adaptive learning style in the fields of basic sciences during the years 2006 to 2021, the percentage of using this style increased and this trend was statistically significant (P=0.0078).
Conclusion: According to the findings of the study, the most used learning style in medical sciences in Iran is convergent learning style, and considering the characteristics of convergent people, it is necessary to provide effective and efficient training in medical sciences to Students' learning styles should be given special attention so that training can be guided based on their learning styles. |
Maryam Tajvar, Parisa Pourfarokh, Najmeh Bahmanziari, Ebrahim Jaafaripooyan, Maryam Nazari , Haniye Sadat Sajadi ,
Volume 81, Issue 1 (April 2023)
Volume 81, Issue 1 (April 2023)
Abstract
Background: Nowadays, beauty practices have attracted the attention of people following the change in lifestyle and social values. Therefore, the present study was conducted with the aim of examining the opinion of experts regarding the challenges and management solutions of the aforementioned practices in Iran.
Methods: This qualitative study was conducted through interviews with 26 policymakers and cosmetic surgery service providers in Tehran from April to September 2022. Sampling was purposeful and snowball. The interviews were semi-structured and thematic analysis was used to analyze the data obtained from the interviews. The inclusion criteria for the interviewees' entry were knowledge and experience in the subject and willingness to participate.
Methods: This qualitative study was conducted through interviews with 26 policymakers and cosmetic surgery service providers in Tehran from April to September 2022. Sampling was purposeful and snowball. The interviews were semi-structured and thematic analysis was used to analyze the data obtained from the interviews. The inclusion criteria for the interviewees' entry were knowledge and experience in the subject and willingness to participate.
|
Results: Challenges under the four categories of service providers (improper education, non-specialist providers, moral hazards, deficiencies in the way laws are written, and the ineffectiveness of the complaint handling process), service receivers (being influenced by deceptive advertisements, low level of public health literacy and lack of mental health), the place of providing services (performing surgeries in non-standard places and non-integrated information system) and medicines, products and medical equipment (insufficient control over supply, distribution and use and price fluctuations) were categorized. Experts considered the major part of the challenges to be related to the service providers. In the category of service recipients, "being influenced by deceptive advertisements" was the main problem mentioned by the experts. Performing surgeries in non-standard places, including limited surgery centers, non-sterile places, and unauthorized places, is among the unsolved problems regarding the place of providing services. In relation to medicines, products, and medical equipment, the main problem was insufficient supply, distribution, and use supervision.
Conclusion: The main effective measure to solve the challenges is to strengthen the supervision of the health system administrator with internal and external coordination and cooperation. In this regard, it is recommended to develop educational, ethical, and legal frameworks, regulate regulatory laws, public awareness, clinical interviews and psychological counseling, especially before cosmetic surgery, and the establishment of an integrated electronic health record system. |
Batool Hossein Rashidi, Maryam Bagheri., Ashraf Aleyasin, Ladan Kashani, Fatemeh Davari Tanha , Elham Feizabad , Fedyeh Haghollahi,
Volume 81, Issue 1 (April 2023)
Volume 81, Issue 1 (April 2023)
Abstract
Background: Patient satisfaction is considered as one of the most important elements of the evaluation of healthcare centers. In this research, the level of satisfaction of infertile patients was evaluated.
Methods: This study is a cross-sectional descriptive study. The research population is infertile patients who referred to the infertility clinic (at least 4 visits) and hospitalized in four hospitals affiliated with the Tehran University of Medical Sciences. The satisfaction questionnaire was valid researcher-made which included 56 questions in 9 areas, and were collected from May 2021 to September 2022. In order to comply with the ethical principles in research, hospitals were named 1-4.The results were analyzed using the chi-square test or Fisher's exact test for qualitative variables and analysis of variance for quantitative variables in SPSS software, version 24 (SPSS Inc., Chicago, IL, US).
Results Three hundred–four infertile women in four hospitals were studied. The mean age of the participants was 33.8 years, with a standard deviation of 5.8 years. The average satisfaction with admission and discharge services, medical services, nutrition, accounting, and insurance services in the number-1 Hospital had the highest score, and the average satisfaction with nursing or midwifery services, diagnostic and therapeutic services (radiology/laboratory), hospital services, charter patient rights, management services, paid expenses in Hospital 4 received the most points. The mean score of satisfaction was the highest among those who visited the infertility clinic of Hospital 3 (161.54±21.41). Average satisfaction with admission and discharge services, medical services, nutrition, accounting, and insurance services in Hospital No. 1 had the highest score, and average satisfaction with nursing or midwifery services, medical diagnostic services (radiology/laboratory), hospital services, respecting the patient's rights, management services, paid expenses in hospital number 4 got the most points. The average of nursing or midwifery services, respecting the patient's rights, and hotelling in all hospitals received the highest score, respectively, and nutrition services and paid expenses received the lowest points (most dissatisfaction) (P<0.05).
Methods: This study is a cross-sectional descriptive study. The research population is infertile patients who referred to the infertility clinic (at least 4 visits) and hospitalized in four hospitals affiliated with the Tehran University of Medical Sciences. The satisfaction questionnaire was valid researcher-made which included 56 questions in 9 areas, and were collected from May 2021 to September 2022. In order to comply with the ethical principles in research, hospitals were named 1-4.The results were analyzed using the chi-square test or Fisher's exact test for qualitative variables and analysis of variance for quantitative variables in SPSS software, version 24 (SPSS Inc., Chicago, IL, US).
Results Three hundred–four infertile women in four hospitals were studied. The mean age of the participants was 33.8 years, with a standard deviation of 5.8 years. The average satisfaction with admission and discharge services, medical services, nutrition, accounting, and insurance services in the number-1 Hospital had the highest score, and the average satisfaction with nursing or midwifery services, diagnostic and therapeutic services (radiology/laboratory), hospital services, charter patient rights, management services, paid expenses in Hospital 4 received the most points. The mean score of satisfaction was the highest among those who visited the infertility clinic of Hospital 3 (161.54±21.41). Average satisfaction with admission and discharge services, medical services, nutrition, accounting, and insurance services in Hospital No. 1 had the highest score, and average satisfaction with nursing or midwifery services, medical diagnostic services (radiology/laboratory), hospital services, respecting the patient's rights, management services, paid expenses in hospital number 4 got the most points. The average of nursing or midwifery services, respecting the patient's rights, and hotelling in all hospitals received the highest score, respectively, and nutrition services and paid expenses received the lowest points (most dissatisfaction) (P<0.05).
|
Conclusion: The level of satisfaction of women referring to the infertility clinic in 35.9% of cases was considered to be at an appropriate and exceptional level, in 49.3% of cases it was at a partially appropriate level, and in 14.8% at an inappropriate level.
|
Zeinab Khazaeeshir , Kobra Mirzakhani, Golnaz Sadat Ahmadinezhad, Fatemeh Sadat Naderi, Nahid Jahani Shoorab ,
Volume 81, Issue 1 (April 2023)
Volume 81, Issue 1 (April 2023)
Abstract
Background: The rate of exclusive breastfeeding in Iran at the ages of 3 and 6 months is estimated to be 44% and 27%, respectively, which is still far from the optimal index of the World Health Organization until 2030 (70% in the first six months). In order to monitor breastfeeding counseling centers, which have been set up with the aim of promoting breastfeeding and supporting mothers who have problems with breastfeeding.
Methods: This is a descriptive-retrospective study and all the mothers who were referred to the Health and Treatment Center No. 2 in Mashhad between April 2019 and March 2019 were examined. This health center has two active counseling clinics and the collection of information is based on documents registered in offices and computers. The inclusion criteria for study were not having breast diseases, having an infant child, being able to read and write and living in Mashhad city. The exclusion criteria were also the unwillingness to participate in the study and the newborn suffering from diseases that are incompatible with breastfeeding. Therefore, census sampling was done. The data were analyzed using SPSS 16 software and the significance level was less than 0.05.
Methods: This is a descriptive-retrospective study and all the mothers who were referred to the Health and Treatment Center No. 2 in Mashhad between April 2019 and March 2019 were examined. This health center has two active counseling clinics and the collection of information is based on documents registered in offices and computers. The inclusion criteria for study were not having breast diseases, having an infant child, being able to read and write and living in Mashhad city. The exclusion criteria were also the unwillingness to participate in the study and the newborn suffering from diseases that are incompatible with breastfeeding. Therefore, census sampling was done. The data were analyzed using SPSS 16 software and the significance level was less than 0.05.
|
Results: In 42.8% of cases, mothers had started feeding combined formula with breast milk before visiting, and in 28.1% of cases, when referring to counseling milk clinics, it was reported that the baby was fed only with formula. After breastfeeding consultations and follow-ups at the end of six months, the rate of exclusive breastfeeding is 34.1% (12% increase compared to the initial reference) and combined formula feeding with breastmilk is 27.8% (a 22% decrease compared to the first visit). And feeding with powdered milk alone was calculated to be 36.5% (an increase of 8.4% compared to the first visit).
Conclusion: The positive role of breastfeeding counseling center in reducing the cases of artificial feeding is clear, and it is recommended to prepare written instructions based on the challenges in breastfeeding for breastfeeding counseling in the first month after delivery. |
Hadis Soleimanzadeh, Nahid Nasiri ,
Volume 81, Issue 2 (May 2023)
Volume 81, Issue 2 (May 2023)
Abstract
|
Thalassemia is an autosomal recessive hereditary disease that occurs due to a decrease in the synthesis of Please recheck. In beta thalassemia, defects in β-globin synthesis lead to an imbalance of β- and α-globin chains and the accumulation of α4 chains in the erythroid precursor which leads to ineffective erythropoiesis, shortened red blood cell survival, and finally clinical symptoms such as delayed sexual and physical maturation, endocrine dysfunction, cardiomyopathy, liver disease, bone deformities and hepatosplenomegaly. Current treatments such as transfusion, iron chelating agents and allogeneic stem cell hematopoietic transplantation have limitations in their use, including iron overload, lack of a human leukocyte antigen (HLA) matched compatible donor, and graft versus host disease (GVHD). Gene therapy is a new therapeutic option for beta thalassemia patients that induces the continuous expression of beta globin chains in the patient’s hematopoietic stem cells. The idea of gene therapy was first proposed in the early 1970s, and the ultimate goal of this treatment method is to express the defective gene in the target cell in a way that can reduce the symptoms of the disease or eliminate them (symptoms) altogether. There are two general methods for gene therapy: the integrating vector, in which the desired gene is inserted into the genome of the target cell and its lifelong expression follows, is the non-integrating method, in which the vector doesn’t integrate into the genome of the target cell and the cytoplasmic form enables gene expression. The first beta thalassemia gene therapy was performed in France in 2006, and in this clinical trial, the first patient with the E/β0 thalassemia was treated at the age of 18. Gene therapy for beta-thalassemia has been approved by the food and drug administration in 2022 for patients aged 12 years and older who have a non β0/β0 phenotype. It seems that this therapeutic option is the definitive treatment method for blood transfusion-dependent beta-thalassemia patients. However, this treatment method still has limitations: high cost, sensitivity of lentiviral vector production, and the possibility of integration of the vector near the proto-oncogene and its activation are some of them.
|
Tayebeh Lakzaei, Niloofar Khoshnam-Rad , Maryam Edalatifard , Hamidreza Abtahi,
Volume 81, Issue 3 (June 2023)
Volume 81, Issue 3 (June 2023)
Abstract
Background: Despite the progress of medical science and organ transplantation, lung transplantation is associated with significant complications and mortality. In Iran, the first lung transplant was performed in 2000 at Imam Khomeini Hospital in Tehran. So far, there has been no assessment of the patients. The main purpose of this study is to investigate the status of lung transplantation status at this center.
Methods: In this retrospective longitudinal study, all lung transplant patients referred to the Lung Transplantation Center of Imam Khomeini Hospital in Tehran from April 2000 to March 2022 were examined. Demographic and clinical data, and information related to their current status, including pulmonary function tests, transplant-related complications, pharmacotherapy, and drug-related adverse events were recorded. Appropriate statistical analysis was applied.
| Results: During the study, 20 lung transplants were observed, 20 percent of transplant recipients were women, and 80 percent were men. The mean age of the patients at the time of transplantation was 39.3±11.4 years. The youngest patient at the time of transplantation was 22, and the oldest was 60 years old. The most common indication for transplantation was interstitial lung disease (70%) followed by chronic obstructive respiratory disease. The average forced expiratory volume in one second (FEV1) value of the patients in the first year was about 50%, which gradually decreased to less than 20 percent in the fifth year. The average survival after transplantation was 5.75±4.6 years. The post-transplant one month, three months, one year, three years, and five years survival were 80, 75, 70, 60, and 50 percent, respectively. Chronic lung allograft dysfunction and serious infections are the most common causes of mortality. Conclusion: The transplant center at Imam Khomeini Hospital is one of the most important lung transplant centers in Iran. The survival status and transplant outcome are comparable with those reported around the world. More attention should be paid to infection control, patient selection, and perioperative care to improve the outcomes of lung transplantation. |
Masoume Mirteimouri, Seyyedeh Azam Poorhosseini , Maliheh Rakhshanifar, Seyede Houra Mousavi Vahed , Fedyeh Haghollahi,
Volume 81, Issue 3 (June 2023)
Volume 81, Issue 3 (June 2023)
Abstract
Background: The success of labor induction depends on the condition of the cervix at the time of delivery. This study examines the effect of labor induction with an intra-cervical Foley catheter and oxytocin compared to a Foley catheter and misoprostol on cervical preparation and delivery rate in the first 24 hours after induction.
Methods: In a randomized clinical study, pregnant women with a singleton pregnancy and a gestational age of more than 40 weeks, with a Bishop score less than 4 and an intact amniotic sac referred to Umm al-Binin Hospital in Mashhad from 2017 to 2018 were included in the study. They were randomly divided into two groups of Foley catheter and oxytocin (1) or Foley catheter and misoprostol (2). In the first group, immediately after placing the Foley catheter; Oxytocin was started with a dose of 2 milliunits per minute, and every 20 minutes, 2 milliunits were added to reach the maximum dose of 30 milliunits per minute (induction method with a low dose). In the second group, after Foley catheter insertion, sublingual misoprostol was prescribed at a dose of 25 micrograms every 4 hours up to a maximum of 6 doses.
Methods: In a randomized clinical study, pregnant women with a singleton pregnancy and a gestational age of more than 40 weeks, with a Bishop score less than 4 and an intact amniotic sac referred to Umm al-Binin Hospital in Mashhad from 2017 to 2018 were included in the study. They were randomly divided into two groups of Foley catheter and oxytocin (1) or Foley catheter and misoprostol (2). In the first group, immediately after placing the Foley catheter; Oxytocin was started with a dose of 2 milliunits per minute, and every 20 minutes, 2 milliunits were added to reach the maximum dose of 30 milliunits per minute (induction method with a low dose). In the second group, after Foley catheter insertion, sublingual misoprostol was prescribed at a dose of 25 micrograms every 4 hours up to a maximum of 6 doses.
|
Results: 74 pregnant women were randomly evaluated in two groups of 37 people. There is no statistically significant difference in the demographic variables in the two groups. There was a significant difference in the labor rate in the first 24 hours, and it was higher in the oxytocin group (P=0.009). Bishop's score after 24 hours of induction was not significantly different in the two groups. Reaching the active phase was significantly shorter in the oxytocin group. (P=0.01). The time of catheter removal in both groups and the rate of cesarean section and the occurrence of complications were the same in both groups.
Conclusion: The use of oxytocin with a Foley catheter inside the cervix can accelerate the preparation of the cervix and increase the chance of labor in the first 24 hours, but it does not affect labor complications. |
Mahdieh Jamshidi, Vahid Jamshidi,
Volume 81, Issue 4 (July 2023)
Volume 81, Issue 4 (July 2023)
Abstract
Background: Due to the fact that various factors are involved in the development of chronic kidney disease, this disease appears with different clinical and laboratory symptoms. The variety in type and number of clinical symptoms often misguides the treating physician. The aim of this study is to extract the key features of the disease and find the best data mining methods to improve the accuracy of kidney disease diagnosis.
Methods: This cross-sectional study was conducted from September 2021 to March 2023 for 30 months at Rafsanjan Ali Ebn Abi Taleb Hospital. Predictive models were developed and tested using different combinations of disease characteristics and seven data mining methods in RapidMiner Studio software. The limitations of the study are as follows: 1) The models were based on 40-year-old and older patients records, which may limit the generalization of results to a wider age group. 2) Despite the high accuracy and comprehensiveness of the method, the models were based only on the information of kidney disease patients at Ali Ibn Abi Talib Rafsanjan Hospital. 3) The climate parameter has not been considered in the data set of the investigation to discover the hidden relationships of this parameter with the kidney disease.
Methods: This cross-sectional study was conducted from September 2021 to March 2023 for 30 months at Rafsanjan Ali Ebn Abi Taleb Hospital. Predictive models were developed and tested using different combinations of disease characteristics and seven data mining methods in RapidMiner Studio software. The limitations of the study are as follows: 1) The models were based on 40-year-old and older patients records, which may limit the generalization of results to a wider age group. 2) Despite the high accuracy and comprehensiveness of the method, the models were based only on the information of kidney disease patients at Ali Ibn Abi Talib Rafsanjan Hospital. 3) The climate parameter has not been considered in the data set of the investigation to discover the hidden relationships of this parameter with the kidney disease.
|
Results: The results of the experiments in this study showed that the proposed prediction model using the Bayes method and eight identified key features (age, renal biopsy, uremia, sedimentation, albumin, edema, nocturnal enuresis, and urine-specific gravity), can detect kidney disease in people of different clinical characteristics, with 99.38% accuracy.
Conclusion: Considering that the early diagnosis of kidney disease and the adoption of appropriate treatment methods can prevent the progression of kidney damage, in this study, an attempt has been made to achieve this goal by using new statistical methods and artificial intelligence techniques. Based on the proposed method and the conducted experiments, the most important features and the best data mining method were obtained, and finally, kidney disease prediction was possible with high accuracy. |
Related Websites
Site Keywords
Cardiology, Anatomy, Biology, Epidemiology, Immunology, Neuroscience, Physical therapy, Physiology, Dermatology, Endocrinology and metabolicSite Statistics
- Registered users: 7727 users
- Online users: 6 users
- Guest users: 197 users
- All visits: 15255473 visits
- Visits in 24 Hours: 8617 visits
- Total articles: 11211 articles
- Published articles: 4922 articles
© 2024 , Tehran University of Medical Sciences, CC BY-NC 4.0
Designed & Developed by : Yektaweb