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Assessment of cognitive impairments following coronary artery bypass surgery with emphasis on working memory performance
Mohadeseh Mozafari , Seyyed Abolghasem Mehri Nejad , Jamshid Bagheri , Mehrangiz Peyvstegar , Masoud Saghafinia ,
Volume 78, Issue 3 (June 2020)
Abstract
Background: Previous researches have provided contradictory results about on working memory performance after the coronary artery bypass graft (CABG). In addition, studies have focused on the elderly community. For this reason and with regard to the importance and direct effects of working memory on the quality of life human. This study was designed to compare working memory of young CABG patients with age range of 30-55 years one year postoperatively with healthy subjects.
Methods: In this Case-control study, which was conducted from February 2017 to October 2018, two groups of people, 40 patient men with coronary artery bypass graft that admitted to the heart center of Tehran in last year and 64 healthy males were selected with using available sampling method. Both groups were tested with Wechsler's working memory scale.
Results: The results of the study showed that the mean and standard deviation of the age of coronary artery bypass graft patients were 52.65 and 5.559, respectively, and the mean and standard deviation of healthy subjects were 41.81 and 8.619, respectively. The results showed that The two group had significantly difference (P<0.01), in the sub scales of the working memory including of the forward auditory memory and reverse auditory memory, total score of auditory memory, reverse visual memory and auditory memory span and the two groups had significantly difference (P<0.05), in the total score of visual memory. But the two group had not significantly difference (P>0.05) in the forward visual memory (CABG [mean=5.40 & standard deviation=1.41] Healty people [mean=6.13 & standard deviation=3]) and visual memory span (CABG [mean=5.35 & standard deviation=1.12] Healty people [mean=5.56 & standard deviation=1.97]). The results showed that Patients with CABG than healthy people have overall poorer results for all sub scales the of working memory test.
Conclusion: The results of this study confirm the prevalence of relatively high cognitive decline, especially in working memory after CABG, and provide a pattern of persistence of cognitive decline after one year of coronary artery bypass surgery in young patients aged 30 to 55 years.

The effects of dry needling on flexibility & electrophysiological indices in healthy men with hamstring tightness: double-blind, randomized, placebo-controlled trial
Aref Sadat, Khadijeh Otadi, Zahra Fakhari, Noureddin Nakhostin Ansari , Hossein Bagheri, Arsalan Ghorbanpour,
Volume 78, Issue 7 (October 2020)
Abstract
 
Background: Studies have shown that 75% of men and 35% of women over the age of 10 have hamstring tightness. Hamstring tightness is one of the major causes of hamstring injury and loss of function. Dry needling which is a common intervention used by physiotherapists for the treatment of common various conditions can improve hamstring flexibility in less time than other interventions. So, the present study aimed to investigate the effect of dry needling on flexibility and electrophysiological indices in healthy men with hamstring tightness.
Methods: In this two-way blind clinical trial with a control group, which was performed from November 2018 to February 2019 in the laboratory of the Faculty of Rehabilitation of Tehran University of Medical Sciences, 30 healthy men with hamstring tightness were randomly divided into two groups of dry needling (n=15) and sham needle (n=15). In both groups, dry needling and sham needle, three points of hamstring muscle were needled, each point for one minute during a single session. Outcome measures included flexibility based on passive knee extension test, H-reflex latency, and motor neuron excitability, which were measured three times: before the intervention, immediately after the intervention, and one week after the intervention.
Results: The results revealed that the mean of passive knee extension test (P=0.54), the mean delay time of H-reflex (P=0.84) and the mean of excitability of the motor neuron (P=0.41) didn’t have significant different between two groups after intervention.
Conclusion: The findings of this study showed that dry needling had no effect on hamstring flexibility and electrophysiological indices recorded in the soleus muscle of healthy individuals with hamstring tightness.

The evaluation of clinical symptoms and underlying factors in infected patients with Covid-19
Mina Jaafarabadi, Maryam Bagheri, Mamak Shariat, Khadijeh Raeisie, Athareh Ranjbar, Faezeh Ghafoori, Fedyeh Haghollahi,
Volume 78, Issue 10 (January 2021)
Abstract
Background: The pandemic of Covid-19 is spreading around the world. Extensive research is needed to focus on identifying the underlying causes of the disease. This study aimed to investigate the clinical and etiological symptoms of the Covid-19.
Methods: This descriptive-analytical study, conducted on 510 infected patients in the infectious disease clinic of Imam Khomeini Hospital in Tehran from March 2019 to June 2020 for A period of Four months during the first wave of Covid-19 pandemic. The method of selecting patients was continuous and was divided into two groups of 179 inpatients and 331 outpatients based on lung scan and clinical symptoms. Demographic information, clinical signs, and risk factors were collected through a questionnaire and the data were statistically analyzed.
Results: Symptoms such as fever, chills and cough were reported in the majority of patients in both groups, to such an extent that they were present in 176 (52%) of outpatients and in 101 (59%) of inpatients. The mean hemoglobin measured in hospitalized patients was lower, P=0.001). Vitamin D3 supplementation was reported in 30% of outpatients and in 16.5% of hospitalized patients (P=0.001). This means that vitamin D3 consumption is higher in the outpatient group.
The results showed that Chronic diseases such as hypertension was 4.9 times more likely (OR=4.9, 95% CI2. 433-10.25, P=0.0001) and anemia with 22 times more likely (OR=22.905, 95% CI9. 355-56.083, P=0.000) to be effective in the severity of the disease. It seems Vitamin D3 intake has a supportive effect on reducing the severity of the disease and decreases the risk of the disease getting worse.
Conclusion: Fever, chills and cough were important symptoms in identifying infected patients with Covid-19. According to the results of the present study and the findings of other studies, the supportive effect of vitamin D3 in reducing the severity of infectious diseases should be considered. Clinical trials with appropriate sample size are recommended to investigate the functional role of this vitamin in Reducing the severity of viral diseases of the respiratory tract.
 

Isolation and purification of albumin from human plasma by direct and combined approach of ion-exchange chromatography and comparison of the final products quality obtained by both methods
Mariam Bagheri, Hashem Khorsand Mohammadpour, Kamran Mousavi Hosseini ,
Volume 78, Issue 12 (March 2021)
Abstract
Background: Due to multiple roles of albumin in the body, injection of its medicinal product as one of the therapeutic or management strategies under conditions such as severe bleeding, burns, liver failure, and neonatal hemolytic diseases is on the physicians' agenda. Considering that albumin is the most abundant plasma protein, designing an appropriate method to purify it is highly important. There are several methods such as human plasma fractionation, chromatographic, or Salting-out methods for the isolation and purification of the human albumin. The present study investigates a direct and combined ion-exchange chromatography approach for purification of albumin from human plasma and compares the quality of the final products obtained by both ion-exchange chromatographic methods.
Methods: This study was carried out from January 2019 to October 2019 at the Blood Transfusion Research Center, High institute for research and education in transfusion medicine, affiliated with the Iranian Blood Transfusion Organization. For this study, 10 human plasma bags were randomly collected. After thawing, all 10 human plasma bags were pooled, and in order to separate cryo paste, it was centrifuged at 4000 g for 10 minutes at the temperature of 1 Centigrade degree. Then the obtained cryo poor plasma was used to purify the albumin protein by direct and combined methods of ion-exchange chromatography. The purity of the final products was compared by cellulose acetate electrophoresis and SDS-PAGE tests. The sample obtained by the combined approach was pasteurized and HPLC analysis was performed to investigate any polymer aggregates.
Results: In contrast to the direct method, the final product obtained by combined ion-exchange chromatography had a good purity by the average of about 95% and the amount of polymer was estimated to be less than 5% by HPLC analysis (P<0.05).
Conclusion: By diluting the plasma and subsequently reducing the ionic strength, albumin can be separated from human plasma with a high degree of purity only by two steps of ion-exchange chromatography.
 

Using data mining techniques for predicting the survival rate of breast cancer patients: a review article
Hossein Bagherian, Shaghayegh Haghjooy Javanmard, Mehran Sharifi, Mohammad Sattari,
Volume 79, Issue 3 (june 2021)
Abstract
 
  This review was conducted between December 2018 and March 2019 at Isfahan University of Medical Sciences. A review of various studies revealed what data mining techniques to predict the probability of survival, what risk factors for these predictions, what criteria for evaluating data mining techniques, and finally what data sources for it have been used to predict the survival of breast cancer patients. This review is based on the Prism statement consisting of published studies in the field of predicting the survival of breast cancer patients using data mining techniques from 2005 to 2018 in databases such as Medline, Science Direct, Web of Science, Embase data and Scopus. After searching in these databases, 527 articles were retrieved. After removing duplicates and evaluating the articles, 21 articles were used. The three techniques of logistic regression, decision tree, and support vector machine have been most used in articles. Age, tumor grade, tumor stage, and tumor size are used more than other risk factors. Among the criteria, the accuracy criterion was used in more studies. Most of the studies used the Surveillance, Epidemiology, and End Results Program (SEER) dataset. Typically, in the field of survival probability prediction, data mining techniques in the field of classification are given more attention due to their adaptation to this field. Accordingly, data mining techniques such as decision tree techniques, logistic regression, and support vector machine were used in more studies than other techniques. The use of these techniques can provide a good basis for clinicians to evaluate the effectiveness of different treatments and the impact of each of these methods on patients' longevity and survival. If the output of these techniques is used to provide the data input required by a decision support system, clinicians can provide risk factors related to the patient, the patient's age, and the patient's physical condition when providing services to breast cancer patients. Through the outputs provided by the decision support system, they provided the most optimal decision to choose the best treatment method and consequently increase patient survival.

Association of Rs1676486 genetic polymorphism and lumbar disc degeneration in Iranian population
Homayoun Tabesh, Azadeh Keivani Borojeni , Mohammad Bagher Sadeghi , Maedeh Rouigari, Mohammad Hesamian, Bahram Aminmansour, Hamidreza Khani ,
Volume 79, Issue 4 (July 2021)
Abstract
Background: lumbar disc degeneration is a multifactorial degenerative disease which is affected by genetic inheritance and environmental factors. Type XI collagen is important for organization of the extracellular matrix and cartilage collagen construction. Rs1676486 is a SNP that causes the conversion of C-T, resulting in a change in the expression of the collagen 11 alpha chain. The T allele reduces the alpha 1 chain transcription of collagen 11 and ultimately leads to an imbalance in gene expression.
Methods: This study aims to determine the genetic variant of alpha1 type11 collagen is associated with the progress of intervertebral disc degeneration. All patients were selected from the AL-Zahra Hospital of medical university of Isfahan, Iran, between April 2016 and September 2017. SNP rs1676486 of alpha1 type11 collagen was genotyped in 100 patients and 100 healthy controls. The inclusion criteria for patients were: individuals who had typical clinical and imaging symptoms and signs of intervertebral disc degeneration. Exclusion criteria were: patients with trauma, metabolic and neuromuscular diseases, and congenital disorder of the spine. The Genomic DNA was extracted from peripheral blood samples by a Whole Blood Genomic DNA Extraction Kit. The chi-square test and fisher’s exact test were evaluated to determine differences of genotype and allele distributions between intervertebral disc degeneration patients and healthy controls. To compare the relationship between genotypes and clinical features the Mann-Whitney U test was used.
Results: The mean age was 39.54±9.52 years for the patients and 28.14±5.32 years for the controls, respectively. The mean BMI were 26.3±3.18 kg/m2 and 27.3±3.52 kg/m2 for the patients and the controls, respectively. In addition, the results showed that the prevalence of surgical disc in patients with L4-L5 levels was 52.1% and L5-S1, with 31.1%. This study showed, rs1676486 in alpha1 type11 collagen gene was associated with modified intervertebral disc degeneration at age ≤50 years and this gene increases intervertebral disc degeneration risk at age >50 years. SNP rs1676486 had the significant association with the intervertebral disc degeneration (P=0.019), and patients were found to have higher frequency of AA than the controls.
Conclusion: This observation shows that type XI collagen is related to age and genetic factor in intervertebral disc degeneration disease.

Detection of schizophrenia patients using convolutional neural networks from brain effective connectivity maps of electroencephalogram signals
Sara Bagherzadeh, Arash Maghsoudi, Ahmad Shalbaf,
Volume 79, Issue 10 (January 2022)
Abstract
Background: Schizophrenia is a mental disorder that severely affects the perception and relations of individuals. Nowadays, this disease is diagnosed by psychiatrists based on psychiatric tests, which is highly dependent on their experience and knowledge. This study aimed to design a fully automated framework for the diagnosis of schizophrenia from electroencephalogram signals using advanced deep learning algorithms.
Methods: In this analytic study, which is done from April to October 2021 in Tehran, 19-channel electroencephalogram signals from 14 schizophrenia patients and 14 healthy individuals were recorded and pre-processed. Then, the effective connectivity measure using the transfer entropy method is estimated from them and a 19×19 asymmetric connectivity matrix is constructed and represented by a color map as an image. Then, these effective connectivity images are used as inputs to the five pre-trained neural networks of AlexNet, Resnet-50, Shufflenet, Inception, and Xception. Finally, the parameters of these networks are fine-tuned to diagnose schizophrenia patients. All models are fine-tuned based on newly constructed images using the adaptive moment estimation optimizer algorithm and cross-entropy as the loss function. 10-fold cross-validation and subject-independent validation methods are used to evaluate the proposed method.
Results: The results of the study showed that the highest average accuracy, precision, sensitivity and F-score for classification of two classes of schizophrenia and healthy using the connectivity images and the Inception model achieved equal to 96.52%, 95.89%, 97.22% and 96.55%, respectively, in subject-independent validation method and 98.51%, 98.51%, 98.51% and 98.51% for the 10-fold cross-validation method. Also, there was less effective connectivity between schizophrenic patients than healthy individuals and these patients generally have much less information flow.
Conclusion: Based on our results, the proposed new model can effectively analyze brain function and be useful for psychiatrists to accurately diagnose schizophrenia patients and reduce the possible error and subsequently inappropriate treatment.
 

Evaluation role of beta-2 adrenoceptor agonist and antagonist in the expression of gap junction genes (connexin 37/43) in cumulus cells of women with poor ovarian response
Farideh Zafari Zangeneh , Samad Muhammadnejad, Mohammad Mehdi Naghizadeh, Maryam Bagheri, Elnaz Hekmat,
Volume 79, Issue 11 (February 2022)
Abstract
Background: Connexon is a membrane structural protein in the gap junctions. These cellular connections are responsible for transporting ions and messenger molecules to the oocyte. This study aimed to investigate the role of beta-2-adrenoceptors in the process of follicle growth based on the expression of the two connexins 37/43 in the gap junctions that have a primary role in the mitotic resumption and oocyte maturation.
Methods: This case-control study was conducted from April 2019 to November 2020 at the Reproductive Health Research Center of Tehran Imam Khomeini Hospital was performed on women with the poor ovarian response (POR) and control (women donate eggs) groups. Both groups had entry criteria with a body mass index under 28 m2/kg and 20-45 years old. Exit criteria were including no drug use except ovarian stimulants and no illness. The diagnosis was made agreeing to the Bologna model criterion. Ovulation stimulation cycle was performed, and then after the puncture, cumulus cells were isolated by enzyme and were freezing in -80 centigrade until the time of inserting into the cell culture medium. Isoproterenol (agonist) and propranolol (antagonist) at a concentration of 100 nM were added to the culture medium as the beta-2 adrenoceptors selective drugs. After culture, RNA extraction was performed and the concentration was read by Nanodrop, and then cDNA was synthesized. Gene expression was determined by real-time PCR.
Results: The findings of connexin expression in the three study groups: without the drug (P<0.001), propranolol (P<0.001), and isoproterenol (P<0.001) were significant compared to the control group. Isoproterenol decreased expression but propranolol increased it (P<0.001).
Conclusion: These findings confirm the important role of connexins 37 and 43 in cumulus cleft junctions that propranolol was able to increase its expression. Therefore, we suggest firstly these two connexins can be an effective target for oocyte growth and maturation. Secondly, propranolol could be a new treatment for women with POR and be effective in assisted reproductive technology (ART).
 

Secondary cancers during the radiotherapy of prostate cancer: a review article
Seyed Hamid Zoljalali Moghaddam, Reza Laripour, Ebrahim Hazrati, Hamed Bagheri, Nazila Eyvazzadeh, Hamid Reza Baghani, Emad Parvaneh Aval ,
Volume 79, Issue 12 (March 2022)
Abstract
Prostate cancer is the most common and second leading cause of death among men in the world. Nowadays, radiotherapy has been known as one of the most affecting methods for prostate cancer treatment. Nevertheless, radiotherapy is accompanied by the concern of developing secondary cancers by the scattered radiation to the neighbor  organs at risk. Several studies have shown that secondary cancers after the radiotherapy of prostate cancer treatment, occur in tissues such as the bladder and rectum which have been exposed to direct or indirect radiations. Therefore, this review study aimed to evaluate the influencing factors for developing secondary cancers after the radiotherapy of prostate cancer. To access the previously validated published studies, Persian and English keywords such as prostate cancer, secondary cancers, radiotherapy and organs at risk have been searched in ISID, Google Scholar, Science Direct, PubMed, and World Health Organization, between 1997 and 2021. Totally 246 pieces of literature have been selected which finally, by ignoring the similar and overlapping studies, only 40 studies were reviewed. In the present study, the most affecting factors for developing secondary malignancies including the anatomical status changes, dose variations, smoking and the impact of the various treatment techniques, have been studied. The results of the reviewed studies showed a reduction of secondary cancer risks with performing the modern modalities such as proton therapy to treat prostate cancer. Moreover, organ movements and anatomical status changes which vary from one patient to others, have been reported to make a significant difference in the relative risk of secondary cancers. It has been shown that smoking may increase the risk of secondary cancers after the radiotherapy of prostate cancer, so radiotherapy and smoking may cause genetic mutations. Despite the advantages of radiotherapy for prostate cancer treatment, developing secondary cancers after the radiotherapy should not be ignored. Assessments of the affecting factors for secondary cancers after the radiotherapy of prostate cancer require social and comprehensive studies which can result in an accurate modality with fewer side effects.

Evaluating conservative treatments to reduce coccydynia symptoms: a systematic review
Tannaz Ahadi , Nima Khaje , Bijan Forogh , Labaneh Janbazi, Masumeh Bagherzadehcham.m@iums.ac.ir,
Volume 80, Issue 4 (July 2022)
Abstract
Background: There are many conservative interventions to reduce the symptoms of coccydynia, but it is not clear which treatment can be more effective. The aim of this review study was to evaluate the types of conservative interventions and the effectiveness of each of them in reducing coccydynia symptoms.
Methods: This systematic review was carried out based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) instruction. A search for research studies published up to October 2021 was conducted in Neuromusculoskeletal Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran, using Scopus, Science Direct, Web of Knowledge and Cochrane without data constraints. The search was carried out in October 2021 and continued for seven months. The quality of the articles was evaluated using the Physiotherapy Evidence Database scale (PEDro). All prospective randomized clinical trial studies in which participants suffered from coccydynia  and were treated with nonsurgical treatments  were included.
Results: 945 articles were found in the primary search of the databases. After eliminating 493 repetitive papers, 452 studies remained which were screened by the two researchers of this study in terms of the title and abstract. 40 studies were selected for full-text evaluation. Finally, 12 articles were included in the review study. Two papers used extracorporeal shockwave, two papers used impar ganglion block, three papers manual therapy, and four studies injection. The remaining four studies used iontophoresis with ketoprofen, biofeedback therapy, acupuncture, and physiotherapy with Kinesio taping.
Conclusion: Treatment with extracorporeal shock wave and impar ganglion block significantly improve tailbone pain and show more permanent effects on patients' symptoms. Manual therapies are mostly used in cases where the tailbone is stable. It seems that achieving the desired response requires more than six sessions, which is not pleasant for patients. Injections, especially those performed under fluoroscopic guidance, require high skill in addition to being unpleasant and painful. However, this procedure is done in one session, so there is no need for the next visit.

Evaluation of the diagnostic function of shear wave elastography in the differentiation of malignant and benign breast masses and its relationship with histological factors
Parivash Parvasi, Zahra Fazelinejad, Fatemeh Mahdipour, Shahram Bagheri , Mohammad Momen Gharibvand ,
Volume 80, Issue 7 (October 2022)
Abstract
Background: Shear wave elastography (SWE) estimates the stiffness of a mass based on the velocity of shear wave propagation by sound waves. Due to higher cell density and angiogenesis, malignant masses have higher stiffness than benign ones.
Methods: The present study was a prospective study and was performed on patients who were referred to Ahvaz Golestan Hospital with breast mass during March 2020 to March 2021. Only patients with 4-5 BI-RAD were evaluated. Patients were graded based on ACR BI-RAD. All patients were subjected to ultrasound and selection of BI-RAD 4-5 patients for evaluation with SWE and sampling for pathology testing. In this study, in order to increase the maximum accuracy and take samples from the main location of the lesion, sampling was done by ultrasound-guided biopsy method. Tumor information was recorded by a specialist doctor after ultrasound and SWE. This information included tumor type, tumor size and grade, presence of metastasis, involvement of lymph nodes, average and maximum elasticity. SWE cutoffs were compared for mean and maximum elasticity to distinguish benign from malignant masses.
Results: In this study, 115 patients were evaluated. 63.5% (73) of the patients had benign mass and 36.5% (42) had malignant ones. There was a significant relationship between tumor size and mean and maximum elasticity (P<0.001 The results showed that the diagnostic accuracy of SWE in identifying malignant masses compared to benign ones was 100%, so that the mean (16.61±8.03 kPa) and maximum (21.14±8.88 kPa) elasticity in benign masses were significantly lower than the mean (32.21±7.59 kPa) and maximum (91.62±8.84 kPa) elasticity of malignant masses (P<0.001). There was also a significant difference between the 4 BI-RAD subgroups, so that in BI-RAD 4a, the lowest mean and maximum elasticity were seen (P<0.001).
Conclusion: The results showed that SWE parameters have sufficient diagnostic accuracy in diagnosing malignant breast masses. Therefore, the use of quantitative SWE parameters in conjunction with ultrasound and BI-RADS classification can avoid unnecessary biopsies.

The satisfaction of infertile patients with the quality of medical services in Tehran university of medical sciences hospitals during the year 2020-2021
Batool Hossein Rashidi, Maryam Bagheri., Ashraf Aleyasin, Ladan Kashani, Fatemeh Davari Tanha , Elham Feizabad , Fedyeh Haghollahi,
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).
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.

Comparing the rate of complications of sore throat and hoarseness caused by ETI support method with LMA method in surgical patients under general anesthesia
Farzaneh Boluki Moghaddam , Zhaleh Yousefi, Ali Baghery Hagh , Masoud Latifipour, Mahdi Raei,
Volume 81, Issue 3 (June 2023)
Abstract
Background: Respiratory support during the patient's anesthesia is done in different ways, such as endotracheal intubation and laryngeal mask. Endotracheal intubation is inevitably used for respiratory support in general anesthesia patients. The use of alternative methods for respiratory support during the process of general anesthesia is one of the most significant ways to control anesthesia complications. The laryngeal mask is placed around the larynx to allow spontaneous and controlled ventilation. Both of the respiratory support methods can cause complications. The purpose of this study is to compare the side effects of sore throat and hoarseness caused by two methods in surgical patients.
Methods: This study was conducted in the period from September to November 2022 on patients who were referred and underwent surgery at Baqiyatallah Hospital. The study is a cohort study that was conducted retrospectively on 60 patients who underwent any surgery with two methods of anesthesia by ETI and LMA. In order to evaluate hoarseness, the standard Voice Handicap Index (VHI-10) questionnaire was used. In order to evaluate the complication of sore throat caused by the respiratory support method, a 4-point pain checklist was used for 24 hours and 14 days after the surgery.
Results: The findings of our study showed that the average amount of sore throat 24 hours after surgery in the LMA and ETI groups was 2.13 and 2.2, respectively, and these values 14 days later were 1.17 and 1.07, respectively. The average level of hoarseness in the 24 hours after surgery in LMA and ETI groups was 2.66 and 3.13, respectively. The statistical comparison of the severity of side effects between the two groups showed that in the LMA method, the amount of sore throat and hoarseness is less than the ETI method, although this reduction does not have a significant difference.
Conclusion: The results of this study showed that the rate of complications of sore throat and hoarseness in the laryngeal mask group is reduced compared to the endotracheal intubation group, although this difference is not significant.

Investigating the incidence of complications caused by common national vaccinations in children and infants in Shahrood city
Fatemeh Saeedi, Mahdieh Zaki Zade , Mohammadbagher Sohrabi , Mostafa Enayat Rad , Sina Habib Zade , Mansooreh Fateh,
Volume 81, Issue 7 (October 2023)
Abstract
Background: With a national vaccination program, we have achieved success in the prevention of infectious diseases in the community especially in children. Despite this great success, the side effects of vaccination may not encourage some people in the community to get vaccinated. In this study, we investigate the prevalence of common side effects of vaccination in Shahrood city.
Methods: This study investigated the incidence of complications caused by vaccination in infants and children under seven years old in Shahrood city in a 5-year period from April 2016 to March 2020. We collected demographic and clinical information, by referring to the health centers and complications recorded after routine vaccinations such as fever, rash, diarrhea, swelling and other complications of vaccination were collected.
Results: Findings Among the 429 registered complications between 2016 and 2020, most complications were related to pentavalent and trivalent vaccines. Among the registered complications, high fever is the most common complication in both term and pre-term groups. (202 cases, 47.1%) other complications included maculopapular rash (59 cases), mild local complications (55 cases), vomiting (41 cases), and continuous screaming (36 cases), respectively. Among these, 123 cases were resolved without treatment, 297 cases were resolved with drug treatment on an outpatient basis, and only  eight cases required hospitalization.
Conclusion: In general, the vaccination program is highly effective despite having limited side effects.  Knowing this information, can increase vaccination in the country.

Prevalence of congenital heart disease among term infants with respiratory distress: a case study in Kerman
Mohammad Mehdi Bagheri , Fahimeh Sadeghi Zarandi ,
Volume 81, Issue 8 (November 2023)
Abstract

                                                            
Background: Congenital heart diseases (CHD) as one of the most common disorders in newborns are leading cause of perinatal mortality, also one of respiratory distress syndrome causes in newborns. This study aimed to determine the prevalence of congenital heart diseases in infants with respiratory distress syndrome.
Methods: This cross-sectional study is a retrospective study that surveyed congenital heart diseases in 145 term infants who were hospitalized in neonatal intensive care unit (NICU), Afzalipour hospital, Kerman. These infants were admitted to the neonatal intensive care unit from March 20, 2012 to the end of March 20, 2015 due to respiratory distress syndrome. Information was extracted from the medical records and then were entered in the checklist. Descriptive statistics (frequency, percentage), analytical (chi-square test) and SPSS version 20 software were used to analyze the data.
Results: Out of 145 infants with respiratory distress syndrome, 123 infants had congenital heart diseases. Therefore, the prevalence of congenital heart diseases in patients with respiratory distress syndrome was 84.83%. The most infants with congenital heart diseases were male (66.67%) and weighed between 3-4 kg (47.97%). More than 69% of newborns with congenital heart diseases were born by cesarean section and most of them were receiving medical treatment (85.37%). There was a significant difference between patient outcome and congenital heart diseases (P=0.018). The difference between sex, weight and type of delivery with congenital heart diseases was not significant. In terms of the prevalence of congenital heart diseases, atrial septal defect (ASD) was the most prevalent with 14.48%. After that, patent ductus arteriosus (PDA) was the most prevalent with 11.72%.
Conclusion: Due to the high prevalence of congenital heart diseases in term children with respiratory distress syndrome, all term infants with symptoms of respiratory distress syndrome need cardiac examination, especially echocardiography to diagnose the cause. In addition, due to the high mortality of infants with congenital heart diseases with symptoms of respiratory distress syndrome, the need for more, more accurate and complete care of these infants is suggested.


Comparative clinical and epidemiological analysis of waves during the corona epidemic based on a university surveillance system
Erfan Dehghani, Pezhman Bagheri, Zahra Montaseri , Niloofar Sohrabi , Mehdi Sharafi ,
Volume 82, Issue 1 (April 2024)
Abstract
Background: COVID-19 is one of the most recent known human infections that has resulted in a global pandemic, causing high rates of morbidity and mortality worldwide. This study evaluated the clinical and epidemiological characteristics of the waves of the corona epidemic within a university surveillance system in southern Iran.
Methods: This cross-sectional study analyzed data from 24,132 individuals with Covid-19 in the registered waves from the beginning of the Corona epidemic from March 2020 to March 2021 in one of the southern universities of Iran. Information on age, gender, number of infections, severity, hospitalization, recovery rate, dominant strain, and compliance with protocols separately for each wave from 2020 to 2021 was collected from the University's databases. After calculating the cumulative incidence rate, mean and standard deviation and drawing graphs, chi-square, Mann-Whitney and one-way ANOVA were used in SPSS26 at a significance level of 5%.
Results: The cumulative incidence of the disease was 11.36%, with a relative frequency of hospitalization at 11.7% and an average hospital stay of Seven days. The highest percentage of protocol compliance was applied in the initial waves. The highest frequency of infection was in the third wave, where men were more infected than women in all waves except the 4th and 5th waves. High blood pressure was the most common underlying disease in patients and the most lung involvement was observed in the fifth wave. Most of the patients have recovered, and the highest rate of recovery was observed in the sixth wave. Significant associations were found between hospitalization duration, underlying conditions, and clinical symptoms across different waves (P<0.001). Systemic symptoms were the most common, and there was a notable difference in radiological findings between waves (P<0.001).
Conclusion: The findings of this study emphasize the significant impact of underlying diseases and the severity of clinical symptoms on hospitalization outcomes. They also highlight the need for appropriate evidence-based management strategies and consideration of clinical changes and radiological patterns when evaluating diseases in different groups.

Comparing the effectiveness of compassion-focused treatment and emotion-focused treatment of female students with suicide attempts in high school
Fatemeh Parsa , Fariborz Bagheri, Hossein Mahdian,
Volume 82, Issue 3 (June 2024)
Abstract
Background: Considering the significant increase in suicidal tendencies and attempts during puberty, this study aims to investigate the effectiveness of compassion-focused therapy compared to emotion-focused therapy in increasing the resilience of female students who attempted suicide in the past has been was evaluated.
Methods: semi-experimental research was used with a pre-test and post-test design. The target population was female students of the first and second grade of high school who attempted suicide and referred to the counseling center of the General Directorate of Education, and the research was conducted from the time of data collection to the time of implementation from May 2022 to June 2023 was conducted in the counseling center under the supervision of the science and research department of Islamic Azad University, Tehran branch, was conducted and the available sampling method was selected and randomly and a total of 30 people were divided into two experimental groups (15 people) and control groups (15 people). First, Connor and Davidson's resilience questionnaire (2003) was taken from all three groups. The experimental group underwent eight 90-minute sessions of emotion-focused compassion therapy, while the control group received no intervention. After the end of the treatment sessions, the resilience questionnaire of Connor and Davidson (2003) was administered again and repeated after one month of follow-up. The collected data were analyzed using statistical tests (multivariate analysis of covariance and analysis of variance).
Results:  The results obtained from the data analysis showed a significant difference in the pre-test, post-test and follow-up resilience averages in the three groups. Resilience scores for the experimental groups were significant at P < 0.05, which indicates a significant difference. Additionally, the compassion-focused therapy group showed greater improvements in resilience compared to the emotion-focused group.
Conclusion: These findings confirm the positive effect of both types of treatment on the resilience of female students who have previously attempted suicide, and compassion-focused therapy was more effective than emotion-focused therapy

Assessment of studies on the use of platelet-rich plasma in shoulder tendinopathy: a review article
Nima Bagheri, Mahdieh Ghiasi, Khalil Pestehei,
Volume 82, Issue 4 (July 2024)
Abstract
Tendon ruptures may occur as a result of acute injuries or degenerative changes in the tendons caused by aging, excessive and long-term use of the shoulders, and sudden wear and tear. This tear may be partial or completely separate the tendon from its attachment to the bone. Rotator cuff tendinopathy of the shoulder is one of the common causes in patients that affect the daily performance and quality of life. Tendinopathy problems are one of the most common problems of people who refer to medical centers, and in some people, improvement is very important because of their job position. Platelet-rich plasma has received attention due to having growth factors involved in tissue repair in tendinopathy patients. This review study examined the clinical effect of platelet-rich plasma injection in rotator cuff tendinopathy, as well as other studies comparing it with corticosteroids. A literature search was conducted in various scientific databases to obtain articles up to 2022 examining the clinical effects of PRP injection on tendinopathy. Platelet-rich plasma (PRP) is one of the products derived from blood that contains a greater number of physiological platelets. PRP contains a large amount of growth factors such as TGF-β, platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF), which play an important role in cell proliferation, cell differentiation, chemotaxis and angiogenesis. These growth factors are significantly upregulated following tendon injury and are active at different stages of the healing process. Platelet-rich plasma is an autologous source of growth factors and has been shown to be beneficial in the treatment of tendinopathy and osteoarthritis. PRP injection can be recommended as a suitable and desirable method in tendinopathy and rotator cuff tear patients, especially in adults, and can be substituted for corticosteroids. PRP is a minimally invasive treatment method that is used to treat muscle diseases and tendon injuries. In this method, blood is taken from the person, and after that, the components of the blood are separated during a process, and the platelet-enriched plasma is re-injected into the muscles and tendons of the shoulder.

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