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Sepideh Mahdavi, Mohammad Hassan Emamian , Zahra Kordi, Mansooreh Fateh, Mostafa Enayatrad,
Volume 83, Issue 2 (May 2025)
Volume 83, Issue 2 (May 2025)
Abstract
Background: Stomach cancer is the fifth most common cancer worldwide. This study aimed to investigate the trend in the incidence of stomach cancer in Shahroud and Meyami districts over a thirteen-year period.
Methods: This study is a cross-sectional study that examines the incidence of stomach cancer using data from the population-based cancer registry system in Shahroud and Meyami Districts in Semnan province over a thirteen-year period from the beginning of April 2010 to the end of March 2022. Age-standardized incidence rates were calculated using both the new and old-World Health Organization standard populations. Trend in cancer incidence were analyzed using Joinpoint regression.
Results: Between 2010 and 2022, a total of 474 new cases of stomach cancer were reported. The mean age at diagnosis was 69.3±12.8 years, with 70.3±12.7 years in men and 67.8±12.8 years in women. The age-standardized incidence rate based on the new WHO population was 15.1 per 100,000 people for the entire period, and 20.9 and 9.5 per 100,000 for men and women, respectively. The annual percentage change indicated a (APC: -4.60 % (95% CI: -0.08 to -9.36)) decrease per year, which was statistically significant (P=0.047), particularly in men (APC= -4.42%, (95% CI: -8.39 to -0.63, P=0.024)), whereas the decline in women was not statistically significant (APC= -4.28%, (95% CI: -10.45 to 1.79, P=0.150)). The incidence of stomach cancer increases with age, with the highest number of cases observed in the 75-79 years age group. The incidence trend in the age group 70-74 years (AAPC: -8.98% (95% CI: -2.75, -14.72 was significantly (P=0.005) decreasing.
Conclusion: The findings of this study showed that the age-standardized incidence rate of stomach cancer had a decreasing trend and that incidence increased with advancing age. Moreover, the incidence rate in men was approximately twice that in women. In men, the incidence trend showed a significant decline, whereas in women no significant change was observed.
Methods: This study is a cross-sectional study that examines the incidence of stomach cancer using data from the population-based cancer registry system in Shahroud and Meyami Districts in Semnan province over a thirteen-year period from the beginning of April 2010 to the end of March 2022. Age-standardized incidence rates were calculated using both the new and old-World Health Organization standard populations. Trend in cancer incidence were analyzed using Joinpoint regression.
Results: Between 2010 and 2022, a total of 474 new cases of stomach cancer were reported. The mean age at diagnosis was 69.3±12.8 years, with 70.3±12.7 years in men and 67.8±12.8 years in women. The age-standardized incidence rate based on the new WHO population was 15.1 per 100,000 people for the entire period, and 20.9 and 9.5 per 100,000 for men and women, respectively. The annual percentage change indicated a (APC: -4.60 % (95% CI: -0.08 to -9.36)) decrease per year, which was statistically significant (P=0.047), particularly in men (APC= -4.42%, (95% CI: -8.39 to -0.63, P=0.024)), whereas the decline in women was not statistically significant (APC= -4.28%, (95% CI: -10.45 to 1.79, P=0.150)). The incidence of stomach cancer increases with age, with the highest number of cases observed in the 75-79 years age group. The incidence trend in the age group 70-74 years (AAPC: -8.98% (95% CI: -2.75, -14.72 was significantly (P=0.005) decreasing.
Conclusion: The findings of this study showed that the age-standardized incidence rate of stomach cancer had a decreasing trend and that incidence increased with advancing age. Moreover, the incidence rate in men was approximately twice that in women. In men, the incidence trend showed a significant decline, whereas in women no significant change was observed.
Seyed Mohammad Hosseini , Saba Mohammadalizadeh , Sanaz Arvin,
Volume 83, Issue 2 (May 2025)
Volume 83, Issue 2 (May 2025)
Abstract
Background: Adenoid cystic carcinoma (ACC) is a rare neoplasm of the major salivary glands, characterized by a slow-growing tumor, wide local infiltration, perineural spread, a propensity to local recurrence and distant metastasis, and has a poor prognosis. Although surgery and radiotherapy are considered standard treatments, the role of systemic therapy in advanced and metastatic stages remains unclear and rarely results in complete remission. Due to the rarity and limited number of reported cases, here, we report a complete response with systemic treatment in a case of metastatic ACC of the salivary gland.
Case Presentation: The patient is a 50-year-old woman with a history of ACC of the submandibular salivary gland at 20 years old. No recurrence of the disease was observed until, at 47 years old, when metastatic adenocarcinoma with salivary gland origin was diagnosed. From the age of 47 to 50 years, multiple cervical lymph node involvement, multiple masses in the parotid gland and thyroid tissue, as well as distant metastasis to the breast, ovary, and lungs were observed. The patient underwent cervical lymphadenectomy, total parotidectomy, and several courses of radiotherapy and chemotherapy. After six cycles of the Bevacizumab + Adriamycin + Cisplatin regimen, radiologic evaluation confirmed a complete response to the treatment with the disappearance of pulmonary nodules and parotid lesions. The patient is currently under follow-up.
Conclusion: Our reported case shows the aggressive nature of recurrent metastatic ACC of the salivary gland and the positive effect and importance of systemic treatment in these patients. Because the metastasis can appear very slowly, early diagnosis is essential for a better prognosis. These rare malignant lesions should be followed up for a long time after initial treatment due to slow growth, frequent recurrence and late and distant metastasis possibility. This case highlights the potential of systemic therapy to induce complete response even in extensively metastatic disease, suggesting that further clinical trials may be warranted.
Case Presentation: The patient is a 50-year-old woman with a history of ACC of the submandibular salivary gland at 20 years old. No recurrence of the disease was observed until, at 47 years old, when metastatic adenocarcinoma with salivary gland origin was diagnosed. From the age of 47 to 50 years, multiple cervical lymph node involvement, multiple masses in the parotid gland and thyroid tissue, as well as distant metastasis to the breast, ovary, and lungs were observed. The patient underwent cervical lymphadenectomy, total parotidectomy, and several courses of radiotherapy and chemotherapy. After six cycles of the Bevacizumab + Adriamycin + Cisplatin regimen, radiologic evaluation confirmed a complete response to the treatment with the disappearance of pulmonary nodules and parotid lesions. The patient is currently under follow-up.
Conclusion: Our reported case shows the aggressive nature of recurrent metastatic ACC of the salivary gland and the positive effect and importance of systemic treatment in these patients. Because the metastasis can appear very slowly, early diagnosis is essential for a better prognosis. These rare malignant lesions should be followed up for a long time after initial treatment due to slow growth, frequent recurrence and late and distant metastasis possibility. This case highlights the potential of systemic therapy to induce complete response even in extensively metastatic disease, suggesting that further clinical trials may be warranted.
Bibi Mona Razavi, Tayyebeh Zarei, Seyed Mohammad Sadegh Ahmadi Rashti , Mehrdad Sayadinia,
Volume 83, Issue 3 (June 2025)
Volume 83, Issue 3 (June 2025)
Abstract
Background: The use of mesh is considered one of the most effective methods and is considered the method of choice in hernia repair. However, the debate about the choice of mesh type still persists. Therefore, in the present study, the results of using ultra-light Prolene mesh with standard Prolene mesh in hernia repair surgery were compared.
Methods: The present study is a double-blind, randomized, controlled clinical trial that was conducted at Shahid Mohammadi Hospital in Bandar Abbas. Demographic information including age, sex, height, and weight were recorded in a checklist. Patients were randomly assigned to two groups. Each group used Prolene mesh in the first group and ultra-light Prolene mesh in the second group for repair. Hernia repair was performed by the surgeon using the Lebakhstein method.
Results: 119 patients were included in the study. 70 patients (57.4%) had direct hernia and 52 patients (42.6%) had indirect hernia. The mean age of the Prolene group was 43.8±7.49 and the ultra-light Prolene group was 44.32±8.91 years (P=.713). The mean BMI in the Prolene group was 29.94±3.43 and in the ultra-light Parwan group was 29.66±3.76 (P=.673). Wound infection was not observed in either group. Chronic pain was 14.5 in the Prolene group and 10.3 in the ultra-light Prolene group (P=.490). Administrative retention was 6.3 in the Prolene group and 8.5 in the ultra-light Prolene group (P=.738). The recurrence rate 3 months after surgery was 0 in the Prolene group and 1 case (1.7%) in the ultra-light Prolene group (P=.487). The recurrence rate 12 months after surgery was 2 cases (3.2%) in the Prolene group and 3 cases (5.2%) in the ultralight Prolene group (P=. 672). The time to complete recovery was 6.94±1.63 days in the Prolene group and 6.68±1.64 days in the ultralight Prolene group (P=. 368). There was no significant difference in pain intensity at 2, 6, and 24 hours after surgery between the two study groups.
Conclusion: Both Prolene and ultralight Prolene mesh have relatively similar efficacy in inguinal hernia repair. Although the advantages of ultralight Prolene mesh, such as pain intensity, chronic pain, and faster onset of motion, were slightly different in the ultralight Prolene group, the recurrence rate was slightly higher in the ultralight Prolene group.
Methods: The present study is a double-blind, randomized, controlled clinical trial that was conducted at Shahid Mohammadi Hospital in Bandar Abbas. Demographic information including age, sex, height, and weight were recorded in a checklist. Patients were randomly assigned to two groups. Each group used Prolene mesh in the first group and ultra-light Prolene mesh in the second group for repair. Hernia repair was performed by the surgeon using the Lebakhstein method.
Results: 119 patients were included in the study. 70 patients (57.4%) had direct hernia and 52 patients (42.6%) had indirect hernia. The mean age of the Prolene group was 43.8±7.49 and the ultra-light Prolene group was 44.32±8.91 years (P=.713). The mean BMI in the Prolene group was 29.94±3.43 and in the ultra-light Parwan group was 29.66±3.76 (P=.673). Wound infection was not observed in either group. Chronic pain was 14.5 in the Prolene group and 10.3 in the ultra-light Prolene group (P=.490). Administrative retention was 6.3 in the Prolene group and 8.5 in the ultra-light Prolene group (P=.738). The recurrence rate 3 months after surgery was 0 in the Prolene group and 1 case (1.7%) in the ultra-light Prolene group (P=.487). The recurrence rate 12 months after surgery was 2 cases (3.2%) in the Prolene group and 3 cases (5.2%) in the ultralight Prolene group (P=. 672). The time to complete recovery was 6.94±1.63 days in the Prolene group and 6.68±1.64 days in the ultralight Prolene group (P=. 368). There was no significant difference in pain intensity at 2, 6, and 24 hours after surgery between the two study groups.
Conclusion: Both Prolene and ultralight Prolene mesh have relatively similar efficacy in inguinal hernia repair. Although the advantages of ultralight Prolene mesh, such as pain intensity, chronic pain, and faster onset of motion, were slightly different in the ultralight Prolene group, the recurrence rate was slightly higher in the ultralight Prolene group.
Mahsa Hojjati, Mahshid Rashidi, Ali Asghar Khaleghi, Maryam Nasirian, Seyed Hassan Faghihi, Masoud Mohammadi,
Volume 83, Issue 3 (June 2025)
Volume 83, Issue 3 (June 2025)
Abstract
Background: Trichomonas vaginalis is one of the main causes of vaginitis and cervical inflammation worldwide. Almost half of sexually transmitted and curable diseases worldwide can be assessed through the examination of this disease, so the aim of this study is to determine the prevalence of trichomoniasis in Iranian women.
Methods: This study is a review of the SID, PubMed, Science Direct, and Google Scholar databases, conducted up to September 2023. The extracted data were analyzed using CMA software (version 2). A search of articles in Science Direct, SID, PubMed, and Google Scholar databases was conducted in accordance with the PRISMA statement criteria, including systematic search, screening of articles, and selection of appropriate studies. The words used for the search and final review in this systematic review were determined based on MESH Terms in the PubMed database. These keywords that were used and selected in this study were in English and Persian. The final information obtained from the studies was reviewed and analyzed using the Comprehensive Meta-analysis (CMA, Version 2) software, and finally the heterogeneity of the studies was examined with the I2 test.
Results: Based on the search for studies and their screening, 22 studies were finally included in the meta-analysis. This study included a sample size of 49,990 Iranian women who were included in the study. In the heterogeneity analysis based on the studies obtained, the heterogeneity was 99.7. Due to the heterogeneity of the studies, the random effects method was used for the final analysis. The prevalence of Trichomonas vaginalis in Iranian women was reported to be 9.3 (95% CI: 4.6-18) based on the 22 final studies and meta-analysis. The publication bias analysis indicated the absence of bias in the studies (p: 0.175).
Conclusion: Based on the prevalence report in the meta-analysis, a relatively high prevalence was reported in Iranian women, and this situation requires more awareness raising through health centers to families, as well as care and screening of women in these centers and also in obstetric centers.
Masoome Pourmokhtari , Shahram Shafa, Nasim Nabizadeh, Reza Sahraei, Hasan Zabetian, Mansour Deylami, Navid Kalani,
Volume 83, Issue 3 (June 2025)
Volume 83, Issue 3 (June 2025)
Abstract
Background: Spinal anesthesia is an effective method for providing analgesia in surgery and a safe alternative to general analgesia; But despite its benefits, in many cases it is not free of side effects, including unwanted cardiovascular events such as hypotension and bradycardia. Ondansetron effectively reduces the incidence of nausea, vomiting, and bradycardia associated with spinal anesthesia Thus, the present study aimed to assess intravenous ondansetron's efficacy in preventing post-spinal hypotension among patients scheduled for lower extremity orthopedic surgery at Peymanieh Hospital in Jahrom, Iran.
Methods: This randomized double-blind clinical trial included 60 patients undergoing lower limb orthopedic surgery at Peymanieh Hospital, Jahrom, Iran, from March 2021 to February 2022. Patients were randomly allocated into two groups: the intervention group (receiving 8 mg intravenous ondansetron) and the control group (receiving distilled water). Systolic and diastolic blood pressure (SBP, DBP) and heart rate (HR) were measured before pre-spinal anesthesia, after spinal anesthesia and then every two minutes for the first ten minutes and at 15, 30, 45, 60 and 90 minutes after surgery. After spinal anesthesia, the patient was asked about pruritus every 10 minutes. Nausea and vomiting during surgery in case of incidence, recording and nausea after spinal anesthesia, the patient was asked every 10 minutes.
Results: The chi-square test indicated no significant differences between the study groups regarding age and sex distribution(P>0.05). Time before anesthesia, immediately after anesthesia, 10 minutes, 15 minutes, 30 minutes, 45 minutes, 60 minutes, 75 minutes, and 90 minutes after anesthesia, significant difference between ondansetron and placebo groups from There was no mean SBP and DBP and HR (P <0.05). No significant difference between ondansetron and placebo groups in the incidence of pruritus and nausea and vomiting at different times (p <0.05).
Conclusion: Dose of 8 mg of ondansetron in lower limb orthopedic surgery has no significant effect on hemodynamic symptoms as well as the prevention of postoperative nausea, vomiting and pruritus in these patients. Therefore, to achieve more results regarding the transient effect of this drug, it can be compared with other drugs in the class of HT3-5 receptor antagonists.
Nooshin Shirzad, Fateme Ziamanesh, Seyedahmad Seyedalinaghi , Alireza Esteghamati , Mahboobeh Hemmatabadi ,
Volume 83, Issue 3 (June 2025)
Volume 83, Issue 3 (June 2025)
Abstract
Background: Patients with type 2 diabetes mellitus (T2DM) are diagnosed with a wide range of renal damage, usually presenting with albuminuria and decreased estimated Glomerular Filtration Rate (eGFR). Some patients have only albuminuria and normal eGFR, while others have normoalbuminuria even in advanced stages of chronic kidney disease. This study investigated and followed the course of diabetic nephropathy in patients with T2DM.
Methods: 1107 patients with T2DM were enrolled in the study. This historical cohort was conducted between the years 2017 and 2022. Patients with confirmed type 2 DM, referred to the diabetes clinic of Vali-Asr Hospital, affiliated with the Tehran University of Medical Science. Complete medical history, blood pressure, and laboratory data were obtained in the first and follow-up visits. Follow-up was every 3 to 6 months for 30 months. Every year, 24-hour urinary albumin was measured, and eGFR was estimated based on the Cockcroft-Gault formula.
Results: Male sex, age, disease duration, weight, systolic blood pressure, 2 hours postprandial (2hpp) glucose, serum triglyceride, and uric acid significantly correlated with albuminuria. At the initiation of the study, the highest eGFR values occurred in microalbuminuric patients, followed by a sharp decrease. No significant correlation was found between eGFR and albuminuria in most patients, and more than half of them with eGFR of less than 60 ml/min/m2 still had normal albuminuria
Conclusion: This study showed that patients with microalbuminuria and normoalbuminuria had the highest eGFR values followed by macroalbuminuria, but patients with normoalbuminuria and microalbuminuria had an initial increase and then a decrease, and the macroalbuminuria group showed the sustained and greatest decrease during the follow-up period. Serial surveillance of both albuminuria and GFR is crucial in T2DM.
Methods: 1107 patients with T2DM were enrolled in the study. This historical cohort was conducted between the years 2017 and 2022. Patients with confirmed type 2 DM, referred to the diabetes clinic of Vali-Asr Hospital, affiliated with the Tehran University of Medical Science. Complete medical history, blood pressure, and laboratory data were obtained in the first and follow-up visits. Follow-up was every 3 to 6 months for 30 months. Every year, 24-hour urinary albumin was measured, and eGFR was estimated based on the Cockcroft-Gault formula.
Results: Male sex, age, disease duration, weight, systolic blood pressure, 2 hours postprandial (2hpp) glucose, serum triglyceride, and uric acid significantly correlated with albuminuria. At the initiation of the study, the highest eGFR values occurred in microalbuminuric patients, followed by a sharp decrease. No significant correlation was found between eGFR and albuminuria in most patients, and more than half of them with eGFR of less than 60 ml/min/m2 still had normal albuminuria
Conclusion: This study showed that patients with microalbuminuria and normoalbuminuria had the highest eGFR values followed by macroalbuminuria, but patients with normoalbuminuria and microalbuminuria had an initial increase and then a decrease, and the macroalbuminuria group showed the sustained and greatest decrease during the follow-up period. Serial surveillance of both albuminuria and GFR is crucial in T2DM.
Elham Rajaei, Tina Vosoughi, Forough Nokhostin, Hojatollah Yousefimanesh, Mahnaz Parvazi,
Volume 83, Issue 3 (June 2025)
Volume 83, Issue 3 (June 2025)
Abstract
Background: Osteonecrosis of the jaw has recently been reported in patients receiving denosumab for cancer treatment. Accordingly, the present study aimed to determine the frequency of osteonecrosis of the jaw in cancer patients receiving denosumab.
Methods: In the present descriptive-analytical study, 62 cancer patients receiving denosumab who referred to the oncology clinic of Golestan and Shafa Hospitals in Ahvaz in 1403 were studied. The prevalence of osteonecrosis of the jaw among the studied patients was investigated and its relationship with predisposing factors, including gender, type of cancer, comorbidity, and dental caries status, was recorded and analyzed in a checklist.
Results: The prevalence of osteonecrosis of the jaw was 1.6%. There was no significant association between the incidence of osteonecrosis of the jaw and gender and comorbidities (P<0.05), but females showed a 38% higher probability of developing osteonecrosis of the jaw (95% confidence interval; 1.62-1.18, r=1.386). Breast cancer was the most common type of cancer among the study participants (61.3%), but no significant association was found between the incidence of osteonecrosis of the jaw and the incidence of the cancers studied (P-value=0.986). No significant association was found between the incidence of osteonecrosis of the jaw and dental caries (P-value=0.741). The odds of developing osteonecrosis of the jaw in patients with or without dental caries risk were reported to be 1.1 (95% confidence interval; 1.205-1.021, r=1.109).
Conclusion: Despite the lack of a significant association between the incidence of osteonecrosis of the jaw and various factors such as gender, type of cancer, comorbidities, and dental caries, there was evidence of a relative increase in the risk of osteonecrosis of the jaw in women with cancer treated with denosumab, which highlights the need for further investigation.
Methods: In the present descriptive-analytical study, 62 cancer patients receiving denosumab who referred to the oncology clinic of Golestan and Shafa Hospitals in Ahvaz in 1403 were studied. The prevalence of osteonecrosis of the jaw among the studied patients was investigated and its relationship with predisposing factors, including gender, type of cancer, comorbidity, and dental caries status, was recorded and analyzed in a checklist.
Results: The prevalence of osteonecrosis of the jaw was 1.6%. There was no significant association between the incidence of osteonecrosis of the jaw and gender and comorbidities (P<0.05), but females showed a 38% higher probability of developing osteonecrosis of the jaw (95% confidence interval; 1.62-1.18, r=1.386). Breast cancer was the most common type of cancer among the study participants (61.3%), but no significant association was found between the incidence of osteonecrosis of the jaw and the incidence of the cancers studied (P-value=0.986). No significant association was found between the incidence of osteonecrosis of the jaw and dental caries (P-value=0.741). The odds of developing osteonecrosis of the jaw in patients with or without dental caries risk were reported to be 1.1 (95% confidence interval; 1.205-1.021, r=1.109).
Conclusion: Despite the lack of a significant association between the incidence of osteonecrosis of the jaw and various factors such as gender, type of cancer, comorbidities, and dental caries, there was evidence of a relative increase in the risk of osteonecrosis of the jaw in women with cancer treated with denosumab, which highlights the need for further investigation.
Artadokht Khoshooei, Seyedeh Fatemeh Hosseini Nejad , Armin Kia , Nadia Zergani ,
Volume 83, Issue 4 (July 2025)
Volume 83, Issue 4 (July 2025)
Abstract
Background: Nowadays, there is an increased emphasis on using safer and more modern anesthetic drugs. The addition of adjuvants not only enhances the anesthetic effect of the medication but also reduces the required dosage, thereby improving the safety margin. Effective postoperative pain control is a critical component in enhancing recovery and improving outcomes for orthopedic patients. Proper pain management not only facilitates early mobilization but also reduces complications and increases patient satisfaction. This study aimed to evaluate the impact of dexmedetomidine and ketamine as adjuvant drugs in supraclavicular nerve block for reducing postoperative pain following forearm orthopedic surgery.
Methods: This randomized, triple-blind clinical trial was meticulously conducted between April 2024 and March 2025 at Razi Hospital, a major teaching facility affiliated with Jundishapur University of Medical Sciences in Ahvaz, Iran. A total of 102 eligible patients were carefully enrolled and randomly assigned to three distinct groups: dexmedetomidine, ketamine, and control. Each patient received a standardized supraclavicular block using 2% lidocaine combined with the designated adjuvant drug to enhance analgesic efficacy. Vital signs, including heart rate, oxygen saturation, and Mean arterial pressure (MAP), were closely monitored every 15 minutes during surgery. Postoperative pain intensity was assessed using the Visual analog scale (VAS) at 1, 2, 6, 12, and 24 hours after surgery.
Results: Patients in the dexmedetomidine group showed significantly lower heart rate, MAP, and pain intensity compared to both ketamine and control groups at all measured time points (P<0.001). Ketamine also demonstrated better pain control and hemodynamic stability than the control group, although it was less effective than dexmedetomidine. Most differences in mean values between groups were statistically significant, confirming the superior performance of dexmedetomidine.
Conclusion: Dexmedetomidine, when used as an adjuvant in supraclavicular block for forearm orthopedic surgery, resulted in superior pain relief and greater hemodynamic stability compared to ketamine and standard care. These findings support its clinical use as an effective adjunct in regional anesthesia protocols.
Elham Shirvani Naghani , Leila Moradi, Alireza Jahanshahi, Homeira Rashidi, Alireza Sedaghat,
Volume 83, Issue 4 (July 2025)
Volume 83, Issue 4 (July 2025)
Abstract
Background: Thyroid disorders are common among young women, and hypothyroidism ranges clinically from subclinical to overt disease, potentially causing various maternal and fetal complications. Determining the appropriate levothyroxine (LT4) dose during pregnancy is crucial for maintaining maternal euthyroidism and optimising pregnancy outcomes. This study aimed to evaluate the dose requirements of LT4 in pregnant women with and without a prior history of hypothyroidism, and to investigate the association with Thyroid peroxidase antibody (TPO) levels.
Methods: This hospital- and clinic-based study was conducted from September 2022 to March 2023 among 146 pregnant women attending a private clinic or Golestan Hospital in Ahvaz, Iran. A total of 146 pregnant women diagnosed with subclinical hypothyroidism (SCH, n=62) or overt hypothyroidism (OH, n=84) were randomly selected. Participants were divided into groups based on their history of hypothyroidism and received LT4 treatment. LT4 requirements were determined according to trimester-specific TSH ranges: >10 mIU/L or 2.5-10 mIU/L in the first trimester, and 3-10 mIU/L in the second and third trimesters. Data analysis was performed using SPSS version 22, employing descriptive statistics (mean±SD, frequency, and percentage) and analytical tests, including the independent t-test and Mann-Whitney U test.
Results: Pregnant women with overt hypothyroidism showed a statistically significant difference in mean LT4 dose between those with and without a prior history of hypothyroidism (P<0.05). In contrast, no significant difference was observed in LT4 requirements among women with subclinical hypothyroidism. TPO Ab positivity was associated with higher LT4 requirements, particularly in women with overt disease. Dose adjustments were most frequent during the first trimester, with incremental increases observed in subsequent trimesters. These findings support individualized monitoring, iodine testing, adherence checks, and coordinated antenatal endocrinology care to improve maternal and neonatal outcomes.
Conclusion: Following the diagnosis of hypothyroidism in early pregnancy, LT4 dosing should be tailored according to disease severity, prior history of hypothyroidism, TPO Ab status, and study location to ensure optimal maternal and fetal outcomes.
Methods: This hospital- and clinic-based study was conducted from September 2022 to March 2023 among 146 pregnant women attending a private clinic or Golestan Hospital in Ahvaz, Iran. A total of 146 pregnant women diagnosed with subclinical hypothyroidism (SCH, n=62) or overt hypothyroidism (OH, n=84) were randomly selected. Participants were divided into groups based on their history of hypothyroidism and received LT4 treatment. LT4 requirements were determined according to trimester-specific TSH ranges: >10 mIU/L or 2.5-10 mIU/L in the first trimester, and 3-10 mIU/L in the second and third trimesters. Data analysis was performed using SPSS version 22, employing descriptive statistics (mean±SD, frequency, and percentage) and analytical tests, including the independent t-test and Mann-Whitney U test.
Results: Pregnant women with overt hypothyroidism showed a statistically significant difference in mean LT4 dose between those with and without a prior history of hypothyroidism (P<0.05). In contrast, no significant difference was observed in LT4 requirements among women with subclinical hypothyroidism. TPO Ab positivity was associated with higher LT4 requirements, particularly in women with overt disease. Dose adjustments were most frequent during the first trimester, with incremental increases observed in subsequent trimesters. These findings support individualized monitoring, iodine testing, adherence checks, and coordinated antenatal endocrinology care to improve maternal and neonatal outcomes.
Conclusion: Following the diagnosis of hypothyroidism in early pregnancy, LT4 dosing should be tailored according to disease severity, prior history of hypothyroidism, TPO Ab status, and study location to ensure optimal maternal and fetal outcomes.
Mandana Pouladzadeh, Fatemeh Khazaei, Saeid Bitaraf, Hossein Karimpourian, Mahsa Mombeyni, Mohammad-Reza Mahmoudian-Sani ,
Volume 83, Issue 4 (July 2025)
Volume 83, Issue 4 (July 2025)
Abstract
Background: Breast cancer is the most prevalent malignancy among women and remains a leading cause of cancer-related mortality worldwide. Early detection can markedly improve patient survival, yet existing screening methods often lack sufficient accuracy and sensitivity. lncRNA KCNQ1OT1 has been implicated in the initiation and progression of tumors in several cancers, including breast cancer. This study aimed to evaluate the diagnostic potential of serum lncRNA KCNQ1OT1 expression as a biomarker for early detection of breast cancer.
Methods: This case-control study was conducted at Ahvaz Jundishapur University of Medical Sciences, Shafa Hospital, Ahvaz, Iran, between September 2024 and March 2025. Serum samples were obtained from 30 patients with histologically confirmed breast cancer and 30 healthy women serving as controls. Total RNA was extracted from 500 µL of serum, and cDNA was synthesized using oligo (dT) primers. Real-Time PCR was performed in triplicate, with GAPDH as the internal control. Relative gene expression was calculated using the 2^-ΔΔCt method, and data were analyzed using the Mann-Whitney U test and ROC analysis.
Results: The patient and control groups were homogeneous for most demographic parameters, but showed significant differences in age (P=0.023) and ethnicity (P=0.004). Most patients were in stage I of the disease. The median expression of serum KCNQ1OT1 was significantly lower in patients (0.024, IQR 0.013-0.033) than in controls (0.039, IQR 0.027-0.051), indicating marked downregulation in the patient group (P=0.0003). The ROC analysis yielded an AUC of 0.82 (95% CI: 0.67-0.96, SE=0.07, P=0.0005). At an optimal cutoff value of >0.031, the sensitivity was 70%, the specificity was 95%, and the positive likelihood ratio (LR⁺) ≈ was approximately 14, demonstrating strong discriminative ability.
Conclusion: Serum KCNQ1OT1 exhibits promising diagnostic performance for identifying early-stage breast cancer and may serve as a reliable noninvasive biomarker. Larger multicenter studies incorporating molecular subtyping and tissue correlation are required to validate its clinical applicability and strengthen diagnostic accuracy.
Javad Hashemi, Hoseinali Soltani , Ali Esmaeili , Fatemeh Roshanravan Yazdi , Seyed Hassan Seyed Sharifi ,
Volume 83, Issue 4 (July 2025)
Volume 83, Issue 4 (July 2025)
Abstract
Background: Postoperative pain is a significant concern after cholecystectomy. Given the role of vitamin D in pain management, this study investigated the correlation between preoperative vitamin D levels and postoperative pain severity in patients undergoing laparoscopic cholecystectomy, with the aim of improving pain management and enhancing postoperative care.
Methods: This prospective observational study (January 2024- February 2025) was conducted on 87 patients undergoing laparoscopic cholecystectomy at Imam Ali Hospital of Bojnurd. Inclusion criteria were age 18-45, non-urgent laparoscopic cholecystectomy, and good physical status. Exclusion criteria were chronic pain, regular analgesic use, known psychiatric or neurological disease or treatment, substance abuse, emergency cholecystectomy, or conversion to open surgery. Participants fasted for 12 hours preoperatively. All received 1 g (IV) ceftriaxone one hour before and 12 hours after surgery. Anesthesia was induced with propofol and fentanyl and maintained with isoflurane, nitrous oxide, or oxygen. Anesthesia and surgical technique were standardized, with any deviations recorded. We collected demographic data and extracted perioperative details from records and interviews. Pre-induction venous blood samples were collected, processed, and stored at -20°C. Serum vitamin D concentrations were quantified via ELISA method, and participants were subsequently stratified into two groups based on these measurements. Postoperative pain was assessed on a Visual Analog Scale (0-10) at 6, 12, 18, and 24 hours. Analgesic regimens followed standard protocol under physician supervision and were unaffected by the study.
Results: Lower serum vitamin D levels were associated with higher postoperative pain scores (P<0.01), with this relationship being significant at 6, 12, and 18 hours postoperatively (P<0.01, P<0.01, and P<0.05, respectively). Insufficient vitamin D levels and female gender were also independent risk factors for acute pain after laparoscopic cholecystectomy (P<0.01).
Conclusion: Based on the results of the present study, preoperative vitamin D deficiency is associated with increased postoperative acute pain scores in patients undergoing laparoscopic cholecystectomy, especially in women. These findings may be useful for postoperative pain management in patients with vitamin D deficiency.
Navid Kalani , Arnoosh Ghodsian , Abdolali Sepidkar, Mehrdad Sayadinia, Reza Sahraei ,
Volume 83, Issue 4 (July 2025)
Volume 83, Issue 4 (July 2025)
Abstract
Background: Although abdominoplasty is cosmetically effective in patients with obesity or a history of significant weight loss, it can lead to serious complications. This case report highlights the role of elevated intra-abdominal pressure and delayed diagnosis of Abdominal compartment syndrome (ACS) in the development of multiorgan failure and patient mortality.
Case Presentation: A 49-year-old female patient with a history of appendectomy and hysterectomy in the past years was admitted to the hospital for cosmetic abdominoplasty. She had a history of hypothyroidism and was taking levothyroxine regularly. Occasional tobacco use was also mentioned in the patient's history. During the operation, in addition to abdominoplasty, liposuction and flank surgery were also performed. The patient was initially placed in the supine position and then in the prone position for the last two hours. During recovery, the patient complained of shortness of breath and developed tachycardia. Despite persistently elevated BUN and creatinine, and progressive acidosis, a surgical consultation was performed with suspicion of Abdominal compartment syndrome (ACS), but this diagnosis was rejected by the surgeon. Also, despite clinical suspicion of Abdominal compartment syndrome (ACS) by the anesthesia team, in the early stages, the surgeon responsible for the patient did not have sufficient clinical suspicion of this complication and accordingly, intra-abdominal pressure measurement via bladder catheter was not performed. Since monitoring intra-abdominal pressure via bladder catheter requires a specific technique and coordination between anesthesia, surgery, and critical care teams, and since the possibility of ACS had been ruled out by the surgeon at that time, this procedure was not performed. Ultimately, the patient was transferred to the dialysis unit, but during hemodialysis, he suffered respiratory arrest and, after tracheal intubation, subsequently suffered cardiac arrest. Unfortunately, despite cardiopulmonary resuscitation efforts, the patient died.
Conclusion: Although rare, abdominal compartment syndrome should be considered a critical differential diagnosis in high-risk patients following prolonged surgeries such as abdominoplasty with extensive plication. Monitoring intra-abdominal pressure and early intervention upon symptom onset may prevent fatal outcomes.
Case Presentation: A 49-year-old female patient with a history of appendectomy and hysterectomy in the past years was admitted to the hospital for cosmetic abdominoplasty. She had a history of hypothyroidism and was taking levothyroxine regularly. Occasional tobacco use was also mentioned in the patient's history. During the operation, in addition to abdominoplasty, liposuction and flank surgery were also performed. The patient was initially placed in the supine position and then in the prone position for the last two hours. During recovery, the patient complained of shortness of breath and developed tachycardia. Despite persistently elevated BUN and creatinine, and progressive acidosis, a surgical consultation was performed with suspicion of Abdominal compartment syndrome (ACS), but this diagnosis was rejected by the surgeon. Also, despite clinical suspicion of Abdominal compartment syndrome (ACS) by the anesthesia team, in the early stages, the surgeon responsible for the patient did not have sufficient clinical suspicion of this complication and accordingly, intra-abdominal pressure measurement via bladder catheter was not performed. Since monitoring intra-abdominal pressure via bladder catheter requires a specific technique and coordination between anesthesia, surgery, and critical care teams, and since the possibility of ACS had been ruled out by the surgeon at that time, this procedure was not performed. Ultimately, the patient was transferred to the dialysis unit, but during hemodialysis, he suffered respiratory arrest and, after tracheal intubation, subsequently suffered cardiac arrest. Unfortunately, despite cardiopulmonary resuscitation efforts, the patient died.
Conclusion: Although rare, abdominal compartment syndrome should be considered a critical differential diagnosis in high-risk patients following prolonged surgeries such as abdominoplasty with extensive plication. Monitoring intra-abdominal pressure and early intervention upon symptom onset may prevent fatal outcomes.
Yaser Sharafi, Mohammad Talebpour, Khosro Najari,
Volume 83, Issue 5 (August 2025)
Volume 83, Issue 5 (August 2025)
Abstract
Background: Dumping syndrome is a common complication after bariatric surgery and can adversely affect patients’ quality of life, particularly in those with diabetes. Although gastric bypass has traditionally been associated with a higher risk of dumping syndrome, evidence comparing its frequency with sleeve gastrectomy remains inconclusive. This study aimed to compare the frequency of dumping syndrome following these two procedures in patients with morbid obesity.
Methods: This prospective cohort study was conducted from April 2021 to July 2022 at Sina Hospital in Tehran. A total of 90 patients with morbid obesity who met the indications for bariatric surgery were not randomly assigned to two treatment groups: gastric bypass (n = 45) and sleeve gastrectomy (n = 45). Baseline assessments included medical history, physical examination, review of medical records, and necessary specialist consultations (including endocrinology and cardiology). All patients’ data were recorded in the Sina Bariatric Surgery Registry Database. Following surgery, patients received standard postoperative care and were evaluated for symptoms of dumping syndrome at one and three months postoperatively using the validated Sigstad questionnaire. Statistical analyses were performed using SPSS software.
Results: The results showed no statistically significant differences between the two groups in terms of age group, gender, excess weight, preoperative BMI, final BMI, and history of diabetes prior to surgery (P-value > 0.05). The final weight was significantly higher in the sleeve gastrectomy group (P-value = 0.033). There were no significant differences in the frequency of early and late dumping syndrome related to the consumption of sweets and other foods between the two groups at the first and third postoperative months (P-value > 0.05). Early dumping syndrome following the consumption of sweets and bread was significantly more frequent among diabetic patients (P-value = 0.037 and P-value = 0.045, respectively).
Conclusion: The prevalence of dumping syndrome was similar in both sleeve and bypass groups. Weight loss over time was significant (P < 0.001) and did not differ between groups (P = 0.211). The syndrome was significantly more common in diabetic patients, highlighting the importance of careful postoperative care and dietary guidance.
Methods: This prospective cohort study was conducted from April 2021 to July 2022 at Sina Hospital in Tehran. A total of 90 patients with morbid obesity who met the indications for bariatric surgery were not randomly assigned to two treatment groups: gastric bypass (n = 45) and sleeve gastrectomy (n = 45). Baseline assessments included medical history, physical examination, review of medical records, and necessary specialist consultations (including endocrinology and cardiology). All patients’ data were recorded in the Sina Bariatric Surgery Registry Database. Following surgery, patients received standard postoperative care and were evaluated for symptoms of dumping syndrome at one and three months postoperatively using the validated Sigstad questionnaire. Statistical analyses were performed using SPSS software.
Results: The results showed no statistically significant differences between the two groups in terms of age group, gender, excess weight, preoperative BMI, final BMI, and history of diabetes prior to surgery (P-value > 0.05). The final weight was significantly higher in the sleeve gastrectomy group (P-value = 0.033). There were no significant differences in the frequency of early and late dumping syndrome related to the consumption of sweets and other foods between the two groups at the first and third postoperative months (P-value > 0.05). Early dumping syndrome following the consumption of sweets and bread was significantly more frequent among diabetic patients (P-value = 0.037 and P-value = 0.045, respectively).
Conclusion: The prevalence of dumping syndrome was similar in both sleeve and bypass groups. Weight loss over time was significant (P < 0.001) and did not differ between groups (P = 0.211). The syndrome was significantly more common in diabetic patients, highlighting the importance of careful postoperative care and dietary guidance.
Ehsan Nasirai, Mehdi Bakhshaee, Bashir Rasoulian, Daryoush Hamidi Alamdari, Kiana Ketabi, Imaneh Roshanzamir,
Volume 83, Issue 5 (August 2025)
Volume 83, Issue 5 (August 2025)
Abstract
Background: To improve hemostasis and optimize the healing process, autologous fibrin sealant (FS) has been introduced in selected cases. However, the clinical benefits of FS in sinonasal surgery remain controversial and require further evaluation. This study aimed to investigate the effects of autologous FS on hemostasis, mucosal healing, postoperative clinical outcomes, and recurrence in patients undergoing bilateral FESS, compared with normal saline as the control.
Methods: This randomized clinical trial included 32 patients who underwent bilateral FESS at Ghaem and Imam Reza University Hospitals in Mashhad, Iran, between 2019 and 2021. For each patient, autologous FS was applied to one nasal cavity, while the contralateral cavity received normal saline. Postoperative outcomes including bleeding, crusting, adhesion formation, and infection were assessed at 1 week, 1 month, and 3 months after surgery. In addition, sinonasal symptom burden and endoscopic findings were evaluated using the Sinonasal Outcome Test (SNOT-22) and the Lund-Kennedy endoscopic score, respectively, both recorded preoperatively and three months postoperatively.
Results: Application of autologous FS significantly reduced immediate postoperative bleeding, and no further bleeding events were noted during follow-up. Pain severity was comparable between the two sides. No statistically significant differences were observed in crust formation, adhesion, infection, recurrence, or changes in Lund-Kennedy scores between the FS and control sides (p=0.08, p=0.8, p=0.17, and p=0.14, respectively).
Conclusion: Autologous fibrin sealant reduced early postoperative bleeding without adversely affecting pain control, mucosal healing, or recurrence after FESS. Larger randomized trials with extended follow-up are recommended to determine its definitive clinical value and potential for routine use in surgical practice.
Methods: This randomized clinical trial included 32 patients who underwent bilateral FESS at Ghaem and Imam Reza University Hospitals in Mashhad, Iran, between 2019 and 2021. For each patient, autologous FS was applied to one nasal cavity, while the contralateral cavity received normal saline. Postoperative outcomes including bleeding, crusting, adhesion formation, and infection were assessed at 1 week, 1 month, and 3 months after surgery. In addition, sinonasal symptom burden and endoscopic findings were evaluated using the Sinonasal Outcome Test (SNOT-22) and the Lund-Kennedy endoscopic score, respectively, both recorded preoperatively and three months postoperatively.
Results: Application of autologous FS significantly reduced immediate postoperative bleeding, and no further bleeding events were noted during follow-up. Pain severity was comparable between the two sides. No statistically significant differences were observed in crust formation, adhesion, infection, recurrence, or changes in Lund-Kennedy scores between the FS and control sides (p=0.08, p=0.8, p=0.17, and p=0.14, respectively).
Conclusion: Autologous fibrin sealant reduced early postoperative bleeding without adversely affecting pain control, mucosal healing, or recurrence after FESS. Larger randomized trials with extended follow-up are recommended to determine its definitive clinical value and potential for routine use in surgical practice.
Fatemeh Mollarahimi-Maleki , Pershang Nazemi, Maryam Yousefi,
Volume 83, Issue 5 (August 2025)
Volume 83, Issue 5 (August 2025)
Abstract
Background: One of the most common cancers in women is cervical cancer, which is the most preventable cancer leading to death among women worldwide. Among the causes related to cervical cancer, the human papillomavirus (HPV) is the main factor responsible for causing cervical intraepithelial neoplasia (CIN) and cervical cancer. The aim of this study was to investigate the prevalence of high-risk HPVs (HPV16 and HPV18) and to determine the immediate absolute risk of CIN2+ in individuals with a positive HPV test.
Methods: This cross-sectional study included women who tested positive for HPV and visited the Gynecologic Oncology Clinic at Tehran University of Medical Sciences from October 2022 to March 2025. Individuals with a positive high-risk HPV result were referred for colposcopy and biopsy. The immediate absolute risk of CIN2+ in HPV-positive patients with HPV16, HPV18, or concurrent HPV16/18 genotypes (Multi. HPV+) was evaluated across different cytologic grades, ranging from NILM (Negative for Intraepithelial Lesion or Malignancy) to SCC (Squamous Cell Carcinoma).
Results: A total of 727 patients participated in the study. The mean age and standard deviation of the participants were 35.99 and 8.48 years, respectively. Among all referrals, the number of women who were positive only for HPV 16 was 170 (23%), and 24 (3.3%) were positive only for HPV 18. The highest number of positive cases for HPV16 and HPV18 were in the age range of 30 to 39 years (45%). In the Multi. HPV+ group, the highest number was observed in individuals under 29 years old (50%). The calculated immediate absolute risk of CIN2+ in HPV16+ individuals was 14% for NILM and 8.6% for ASCUS, while in HPV18+ individuals, it was 8.3% for NILM.
Conclusion: Cytologic triage combined with HPV genotyping testing can be utilized firstly as an approach to identify cellular abnormalities in HPV-infected individuals and subsequently as an appropriate method to reduce referrals for colposcopy.
Methods: This cross-sectional study included women who tested positive for HPV and visited the Gynecologic Oncology Clinic at Tehran University of Medical Sciences from October 2022 to March 2025. Individuals with a positive high-risk HPV result were referred for colposcopy and biopsy. The immediate absolute risk of CIN2+ in HPV-positive patients with HPV16, HPV18, or concurrent HPV16/18 genotypes (Multi. HPV+) was evaluated across different cytologic grades, ranging from NILM (Negative for Intraepithelial Lesion or Malignancy) to SCC (Squamous Cell Carcinoma).
Results: A total of 727 patients participated in the study. The mean age and standard deviation of the participants were 35.99 and 8.48 years, respectively. Among all referrals, the number of women who were positive only for HPV 16 was 170 (23%), and 24 (3.3%) were positive only for HPV 18. The highest number of positive cases for HPV16 and HPV18 were in the age range of 30 to 39 years (45%). In the Multi. HPV+ group, the highest number was observed in individuals under 29 years old (50%). The calculated immediate absolute risk of CIN2+ in HPV16+ individuals was 14% for NILM and 8.6% for ASCUS, while in HPV18+ individuals, it was 8.3% for NILM.
Conclusion: Cytologic triage combined with HPV genotyping testing can be utilized firstly as an approach to identify cellular abnormalities in HPV-infected individuals and subsequently as an appropriate method to reduce referrals for colposcopy.
Mobina Zamanifard, Hamid Reza Norouzi, Fazilat Jokar Darzi , Malihe Safari,
Volume 83, Issue 5 (August 2025)
Volume 83, Issue 5 (August 2025)
Abstract
Background: Helicobacter pylori (H. pylori) is a human gastrointestinal pathogen that infects more than half of the world's population and leads to chronic gastritis and its role in the development of gastric ulcers, gastric cancer and gastric lymphomas is considered. However, eradication of this bacterium with triple therapy fails in more than 30% of cases. Therefore, efforts to find new treatment methods are increasing. As a result, this study was conducted to evaluate the effectiveness and tolerability of several drug regimens compared to the standard regimen.
Methods: This study is a randomized clinical trial in which patients with Helicobacter pylori infection were randomly selected in the endoscopy department of Amiralmomenin Hospital and the Gastroenterology Clinic of Professor Ghavamzadeh Clinic, Arak from October 2024 to March 2025 and were divided into three groups, including a control group and two intervention groups, with three different drug regimens. Four weeks after treatment, the rate of bacterial eradication in all three evaluation groups was assessed using fecal antigen testing and the treatment results were compared using appropriate statistical analyses.
Results: The frequency of negative test results in intervention group 2 was higher than in control and intervention group 1. (P<0.001) and the rate of Helicobacter pylori eradication was in intervention group 2 (94%), in control group (54%), and in intervention group 1 (20%). The chance of H.P eradication in intervention group 1 decreased by 84% compared to the control group and increased by 10.77 times in intervention group 2 compared to the control group. Also, a significant proportion of H.P eradication success was observed in people without diabetes (p-value = 0.022, Phi = -0.188, n = 150) and the rate of drug side effects was higher in intervention group 2 compared to the other two groups.
Conclusion: This study showed that compared to the standard regimen, a 2-week regimen of amoxicillin, omeprazole, and clarithromycin plus bismuth is a good, potent, and more cost-effective regimen for eradicating Helicobacter pylori.
Methods: This study is a randomized clinical trial in which patients with Helicobacter pylori infection were randomly selected in the endoscopy department of Amiralmomenin Hospital and the Gastroenterology Clinic of Professor Ghavamzadeh Clinic, Arak from October 2024 to March 2025 and were divided into three groups, including a control group and two intervention groups, with three different drug regimens. Four weeks after treatment, the rate of bacterial eradication in all three evaluation groups was assessed using fecal antigen testing and the treatment results were compared using appropriate statistical analyses.
Results: The frequency of negative test results in intervention group 2 was higher than in control and intervention group 1. (P<0.001) and the rate of Helicobacter pylori eradication was in intervention group 2 (94%), in control group (54%), and in intervention group 1 (20%). The chance of H.P eradication in intervention group 1 decreased by 84% compared to the control group and increased by 10.77 times in intervention group 2 compared to the control group. Also, a significant proportion of H.P eradication success was observed in people without diabetes (p-value = 0.022, Phi = -0.188, n = 150) and the rate of drug side effects was higher in intervention group 2 compared to the other two groups.
Conclusion: This study showed that compared to the standard regimen, a 2-week regimen of amoxicillin, omeprazole, and clarithromycin plus bismuth is a good, potent, and more cost-effective regimen for eradicating Helicobacter pylori.
Samaneh Arab, Mohammad-Reza Mahmoudian-Sani , Najmeh Fattahi , Zakiye Ekhlasi, Samira Asgharzade,
Volume 83, Issue 5 (August 2025)
Volume 83, Issue 5 (August 2025)
Abstract
Background: Retinal photoreceptor degeneration is a major cause of blindness. Stem cell therapies offer promise, and the miR-183/96/182 cluster, particularly miR-182 and miR-183, plays a crucial role in photoreceptor development and survival. Targeting these miRNAs may enhance human bone marrow–derived mesenchymal stem cells) hBMSCs (differentiation into photoreceptor-like cells, improving their therapeutic potential.
Methods: This in vitro study was conducted from April 2019 to March 2021 at the Clinical Biochemistry Research Center, Shahrekord University of Medical Sciences. hBMSCs were cultured in DMEM with fetal bovine serum and transfected with miR-182 and miR-183 mimics using Lipofectamine, with a scramble miRNA control. Transfection efficiency and miRNA overexpression were evaluated at 24 and 48 hours using real-time PCR. miRNA expression was normalised to Snord, while mRNA levels were normalised to GAPDH using the 2−ΔΔCt method. Photoreceptor-like differentiation was assessed by measuring the expression of retina-specific transcription factors and markers (OTX2, CRX, NRL, SLC1A1, PKCα, Recoverin, and RHO). Statistical analyses included the Shapiro–Wilk test for normality and the Mann-Whitney U test for group comparisons. Data were reported as Mean ± SEM, with 95% confidence intervals, and significance set at α = 0.05.
Results: Transfection of miR-182 and miR-183 significantly increased miRNA levels at 24–48 hours (P < 0.001) compared to the scramble control. This led to a marked upregulation of retinal-related genes, including CRX, OTX2, PKCα, Recoverin, NRL, and RHO, indicating activation of the photoreceptor gene network. Time-resolved analysis revealed stronger effects at 24–48 hours, supporting a transient window for pro-differentiation. RHO and CRX exhibited the most significant increases, while OTX2 and PKCα showed parallel rises, suggesting coordinated activation of early and intermediate photoreceptor programs. Scramble controls did not show comparable changes.
Conclusion: Transient overexpression of miR-182 and miR-183 in hBMSCs activates a photoreceptor-like gene expression program, promoting differentiation toward photoreceptor-like cells. This finding supports the potential use of miR-182/183 in stem cell-based therapies for retinal degeneration. Further studies should confirm protein expression, functional outcomes, and in vivo efficacy.
Hedayat Heydarizadeh, Hossein Seyedkhani, Zahra Mohebinajad, Ali Heydarizadeh,
Volume 83, Issue 5 (August 2025)
Volume 83, Issue 5 (August 2025)
Abstract
Background: Chronic abdominal pain, which is defined as long-term or intermittent abdominal pain, is a common problem in children. Helicobacter pylori infection is acquired in childhood and is one of the important causes of peptic ulcer disease (PUD) and stomach cancer, so this study was conducted with the aim of investigating the prevalence of Helicobacter pylori in children with chronic abdominal pain referred to Imam Hospital in 1402.
Methods: This study is descriptive-cross-sectional and the statistical population of children with chronic abdominal pain referred to Imam Khomeini Hospital in Ilam city in 1402 was tested for Helicobacter bacteria. Helicobacter pylori was checked using stool antigen test.
Results: This study was conducted on 140 children with chronic abdominal pain with an average age of 7.06 years in the age range of 2-16 years, the majority of children living in Ilam city were boys. The type of feeding was reported in all children as regular, and the majority of them were the result of cesarean delivery (67.9%). The prevalence of 40.7% showed HP positivity in children with chronic abdominal pain. The majority of children in the age group of 4-8 years had Helicobacter pylori positive, 20 people (35.7%) and in children older than 12 years, Helicobacter pylori had the lowest frequency. The prevalence of Helicobacter pylori was reported more in girls than in boys, and among the studied cities it was the highest. The outbreak was in the city of Ilam. There was no difference between the prevalence of Helicobacter pylori with age, sex, place of residence and type of delivery.
Conclusion: The general results of our study show that Helicobacter pylori is an important factor for chronic abdominal pain in children, but factors such as sex, place of residence and type of delivery do not affect its prevalence. It is suggested that in future studies, the family history, parents' infection with Helicobacter pylori and its relationship with transmission to the child should be measured.
Methods: This study is descriptive-cross-sectional and the statistical population of children with chronic abdominal pain referred to Imam Khomeini Hospital in Ilam city in 1402 was tested for Helicobacter bacteria. Helicobacter pylori was checked using stool antigen test.
Results: This study was conducted on 140 children with chronic abdominal pain with an average age of 7.06 years in the age range of 2-16 years, the majority of children living in Ilam city were boys. The type of feeding was reported in all children as regular, and the majority of them were the result of cesarean delivery (67.9%). The prevalence of 40.7% showed HP positivity in children with chronic abdominal pain. The majority of children in the age group of 4-8 years had Helicobacter pylori positive, 20 people (35.7%) and in children older than 12 years, Helicobacter pylori had the lowest frequency. The prevalence of Helicobacter pylori was reported more in girls than in boys, and among the studied cities it was the highest. The outbreak was in the city of Ilam. There was no difference between the prevalence of Helicobacter pylori with age, sex, place of residence and type of delivery.
Conclusion: The general results of our study show that Helicobacter pylori is an important factor for chronic abdominal pain in children, but factors such as sex, place of residence and type of delivery do not affect its prevalence. It is suggested that in future studies, the family history, parents' infection with Helicobacter pylori and its relationship with transmission to the child should be measured.
Alireza Eskandarifar, Zahra Taherkhani, Soleiman Mohammadzadeh , Rama Naghshizadian, Khaled Rahmani,
Volume 83, Issue 5 (August 2025)
Volume 83, Issue 5 (August 2025)
Abstract
Background: Primary nocturnal enuresis (PNE) is a common and distressing childhood disorder characterized by involuntary urination during sleep after the age when bladder control is normally achieved. It affects not only the child’s quality of life but also family dynamics and social relationships. Previous studies have suggested a possible link between PNE and psychological or behavioral problems, yet findings have been inconsistent across populations. The present study aimed to investigate and compare the prevalence and patterns of psychiatric disorders among children with primary nocturnal enuresis and healthy controls in Sanandaj, Iran.
Methods: This case-control study was conducted in Sanandaj from October 2024 to April 2025. The study population included children referred to the Medical, Educational, and Therapeutic Center of Kurdistan University of Medical Sciences. A total of 228 participants were enrolled, comprising 108 children diagnosed with primary nocturnal enuresis and 120 age- and sex-matched healthy controls selected through convenient sampling. Psychiatric assessments were performed using the parent version of the Child Symptom Inventory-4 (CSI-4) questionnaire, which evaluates a wide range of childhood behavioral and emotional disorders based on DSM-IV criteria. Statistical analysis was performed using Stata version 18, and comparisons between groups were made using the chi-square and Fisher’s exact tests. A p-value < 0.05 was considered statistically significant.
Results: Children with primary nocturnal enuresis had significantly higher frequencies of attention deficit disorder (ADD), hyperactivity disorder (HD), attention deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), generalized anxiety disorder (GAD), and tic disorder compared with the control group (p < 0.05). In contrast, the prevalence of phobia and obsessive-compulsive disorder (OCD) was slightly higher in the control group. No statistically significant difference was found regarding post-traumatic stress disorder (PTSD) between the two groups.
Conclusion: The findings suggest that primary nocturnal enuresis may serve as an indicator of increased vulnerability to certain psychiatric disorders in childhood. Early recognition and psychological evaluation of children with enuresis are recommended to improve long-term outcomes and mental well-being.
Methods: This case-control study was conducted in Sanandaj from October 2024 to April 2025. The study population included children referred to the Medical, Educational, and Therapeutic Center of Kurdistan University of Medical Sciences. A total of 228 participants were enrolled, comprising 108 children diagnosed with primary nocturnal enuresis and 120 age- and sex-matched healthy controls selected through convenient sampling. Psychiatric assessments were performed using the parent version of the Child Symptom Inventory-4 (CSI-4) questionnaire, which evaluates a wide range of childhood behavioral and emotional disorders based on DSM-IV criteria. Statistical analysis was performed using Stata version 18, and comparisons between groups were made using the chi-square and Fisher’s exact tests. A p-value < 0.05 was considered statistically significant.
Results: Children with primary nocturnal enuresis had significantly higher frequencies of attention deficit disorder (ADD), hyperactivity disorder (HD), attention deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), generalized anxiety disorder (GAD), and tic disorder compared with the control group (p < 0.05). In contrast, the prevalence of phobia and obsessive-compulsive disorder (OCD) was slightly higher in the control group. No statistically significant difference was found regarding post-traumatic stress disorder (PTSD) between the two groups.
Conclusion: The findings suggest that primary nocturnal enuresis may serve as an indicator of increased vulnerability to certain psychiatric disorders in childhood. Early recognition and psychological evaluation of children with enuresis are recommended to improve long-term outcomes and mental well-being.
Maryam Hajhashemi , Hedieh Bonakdarchian, Tahereh Khalili Borujeni , Minoo Movahedi , Roya Sahebi, Fedyeh Haghollahi,
Volume 83, Issue 6 (September 2025)
Volume 83, Issue 6 (September 2025)
Abstract
Background: Pelvic organ prolapse (POP) is a condition resulting from weakness or damage to the muscles, ligaments, and other supporting structures of the vagina, and it exposes affected women to reduced quality of life and sexual function. The present study examined the symptoms, sexual function, and quality of life of women one year after repair of pelvic organ prolapse.
Methods: This study was a prospective cohort before-after study that was conducted on 200 married women with pelvic prolapse grade 1-4 (POP-Q) in the age group of 47-75 years who underwent reconstructive surgery (anterior and posterior colporrhaphy) in Shahid Beheshti and Al-Zahra hospitals in Isfahan between October 2022 and March 2024. The data collection tools were three questionnaires: Female Sexual Function Index (FSFI), Pelvic Discomfort (PFDI-20) and Quality of Life (SF-36) which were completed before surgery and one year after surgery. Stata software version 17 was used to analyze the data. To compare the scores before and after, paired t-test or Wilcoxon statistical tests were used, to compare the severity of patients' clinical symptoms based on the levels before and after surgery, the symmetry/Bowker test was used, and to compare the status of the sexual function index (impairment/no impairment) before and after surgery, the McNemar test was used and the significance level was considered to be P<0.05.
Results: The mean age of the study participants was 59.5±12.6 years. The majority of the women (157 individuals; 78.5%) were housewives. The mean number of pregnancies was 4.3±2.1, and the mean number of live births was 3.75±1.89. All women included in the study were postmenopausal. The severity of clinical symptoms, sexual dysfunction index status, and median quality of life score were significant between before and after the intervention. The severity of clinical symptoms, the status of the sexual dysfunction index, and the median quality of life score showed significant differences before and after the intervention.
Conclusion: Pelvic prolapse surgery can significantly improve the quality of life and sexual function of patients one year after surgery, in addition to correcting the anatomical structure.
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