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Afsaneh Amirabi, Samira Mashhadi Alipouri , Elghar Khanchi,
Volume 82, Issue 10 (January 2025)
Volume 82, Issue 10 (January 2025)
Abstract
Background: Ectopic pregnancy (EP) is a leading cause of maternal mortality globally. Early diagnosis and treatment has been associated with reduction in maternal mortality and has shifted treatment to conservative methods. The most widely used drug for Medical treatment is methotrexate (MTX). This study aimed to investigate the predictive value of early changes (day 1/4) in serum β-HCG levels in managing tubal pregnancy with single-dose MTX.
Methods: In this cross-sectional analytical study, 135 eligible women with tubal pregnancy who received a single dose of methotrexate, were included. Methotrexate was administered intramuscularly (50 mg/m²), and serum β-HCG levels were measured on days 1, 4, and 7 following the injection. The percentage change in serum β-HCG levels compared to the initial values was calculated. Treatment failure was defined as the need for surgery and/or additional dose of methotrexate.
Results: The treatment success rate was 67% while the treatment failure rate was 33%. Among patients whose β-HCG levels increased on day 4 compared to day 1, the treatment failure rate was 86%. In contrast, for patients with decreased β-HCG levels, the failure rate was only 19%. The changes in β-HCG levels from day 1 to day 4 indicated that a decrease of less than 20% in β-h-CG levels on day 4 compared to day 1 was associated with a sensitivity of 72.2% ( CI95%: 62.2% to 82.4%) and a specificity of 80% (CI95%: 66.18% to 89.1%). This change in β-HCG levels also exhibited a positive predictive value of 60% and a negative predictive value of 88% for predicting treatment failure.
Conclusion: Based on the findings of this study, changes in β-HCG levels on days four and seven may serve as predictive factors for the failure of single-dose methotrexate treatment in patients with tubal pregnancy.
Methods: In this cross-sectional analytical study, 135 eligible women with tubal pregnancy who received a single dose of methotrexate, were included. Methotrexate was administered intramuscularly (50 mg/m²), and serum β-HCG levels were measured on days 1, 4, and 7 following the injection. The percentage change in serum β-HCG levels compared to the initial values was calculated. Treatment failure was defined as the need for surgery and/or additional dose of methotrexate.
Results: The treatment success rate was 67% while the treatment failure rate was 33%. Among patients whose β-HCG levels increased on day 4 compared to day 1, the treatment failure rate was 86%. In contrast, for patients with decreased β-HCG levels, the failure rate was only 19%. The changes in β-HCG levels from day 1 to day 4 indicated that a decrease of less than 20% in β-h-CG levels on day 4 compared to day 1 was associated with a sensitivity of 72.2% ( CI95%: 62.2% to 82.4%) and a specificity of 80% (CI95%: 66.18% to 89.1%). This change in β-HCG levels also exhibited a positive predictive value of 60% and a negative predictive value of 88% for predicting treatment failure.
Conclusion: Based on the findings of this study, changes in β-HCG levels on days four and seven may serve as predictive factors for the failure of single-dose methotrexate treatment in patients with tubal pregnancy.
Hamed Zamanian, Ahmad Shalbaf,
Volume 82, Issue 10 (January 2025)
Volume 82, Issue 10 (January 2025)
Abstract
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Background: Nonalcoholic fatty liver disease (NAFLD) represents a growing global health burden, strongly associated with rising rates of obesity, diabetes, and metabolic syndrome. This study introduces a machine learning framework to precisely diagnose NAFLD, classify disease severity, and stratify risk using routine clinical data. Our model improves early detection and risk prediction, supporting evidence-based clinical decisions. Leveraging predictive analytics, this scalable approach identifies high-risk patients and enables personalized interventions. The data-driven strategy optimizes NAFLD management by extracting maximal value from standard healthcare records, delivering both clinical and operational advantages.
Methods: This study examined 181 NAFLD patients across disease stages. The dataset was compiled from February 2010 to January 2019 at Eheim University Hospital, comprising general volunteers who were diagnosed with or without fatty liver based on histopathological evaluation of liver biopsy samples. Forward selection and mutual information identified predictive features, applied in classification models (e.g., random forest) to assess steatosis severity. Explainable AI (XAI) improved model interpretability. Combining robust feature selection, machine learning, and XAI ensured accurate, clinically actionable NAFLD severity evaluation. Results: The XGBoost classifier with forward feature selection attained a classification accuracy of 69.23%±5.5% for steatosis severity. Interpretability analysis highlighted age, Body Mass Index (BMI), High-Density Lipoprotein (HDL), Low-Density Lipoprotein (LDL), A1c Hemoglobin (HbA1c), and glutamate pyruvate transaminase (GPT) as the most impactful variables across three severity classes. Furthermore, GPT, age, BMI, HDL, HbA1c, LDL, triglycerides, and cholesterol were critical to model performance, emphasizing their diagnostic significance in NAFLD progression. These findings suggest their utility in clinical assessments and risk stratification. Conclusion: This study developed a machine learning model for accurate NAFLD diagnosis and severity stratification using routine clinical data. Accessible biomarkers reliably predicted disease progression, enabling gastroenterologists to facilitate early intervention. This cost-effective approach reduces healthcare costs while improving outcomes through precision medicine. Implementing such predictive tools in clinical practice could optimize resource allocation and enhance long-term NAFLD management. The framework supports timely diagnostics and targeted therapies, advancing patient-centered care. |
Farahnaz Bidari Zerehpoosh , Mahdieh Saffari, Shahram Sabeti , Kaveh Ebrahimzadeh, Mahbobeh Taheri,
Volume 82, Issue 11 (February 2025)
Volume 82, Issue 11 (February 2025)
Abstract
Background: This study aimed to investigate the markers ACTH, KI67, CAM5.2, GH, PRL, FSH, LH, TSH in pathological samples of patients with pituitary neuroendocrine tumors by IHC staining.
Methods: In this retrospective study, all patients with PitNETs who had undergone surgery at Loghman Hospital from 2020 to 2022 were included in the study. The slides were prepared by IHC staining and with the markers ACTH, KI67, CAM5.2, GH, PRL, FSH, LH, TSH were evaluated. IHC staining for SF1-PIT1-TPit transcription factors was performed for 16 patients with negative initial markers.
Results: 424 patients participated in this study. The mean and standard deviation of the age of the patients studied were 43.7 and 13.7 years, respectively. LH and FSH markers had the highest and TSH marker had the lowest proportion of positive cases. The possibility of LH and FSH markers being positive in men was significantly higher than in women, and conversely, the possibility of GH and ACTH markers being positive in women was significantly higher than in men. The possibility of LH and FSH markers being positive in patients over 40 years of age was significantly higher than in patients 40 years of age and younger, and conversely, the possibility of GH and PRL markers being positive in patients 40 years of age and younger was significantly higher than in patients over 40 years of age. Most cases (66.3%) were treated during the follow-up period.
Conclusion: The findings indicate that accurate pathological identification of tumors plays an important role in the selection of treatment methods, especially drug and surgical treatment, and can lead to improved patient management.
Ramyar Rahimi Darehbagh , Sara Moradian , Afshin Hajihasanzadeh, Masood Moradi, Farhang Safar Nejhad ,
Volume 82, Issue 11 (February 2025)
Volume 82, Issue 11 (February 2025)
Abstract
Background: Acute pancreatitis is a common and challenging disease that can develop local and systemic complications. It is divided into biliary and non-biliary pancreatitis, based on ultrasonographic findings. This study aimed to evaluate the clinical and paraclinical findings of patients with acute pancreatitis and related factor.
Methods: This cross-sectional study included all patients hospitalized with a diagnosis of acute pancreatitis in Besat and Towhid hospitals of Sanandaj from March 2016 to March 2018. All patients admitted with a confirmed diagnosis of acute pancreatitis during the mentioned period were enrolled. Inclusion criteria were a definitive diagnosis of acute pancreatitis based on clinical features (characteristic abdominal pain), laboratory findings (serum amylase or lipase elevated more than three times the normal level), and/or imaging evidence. Patients with chronic underlying conditions such as diabetes, chronic renal or hepatic failure, advanced cardiac disease, or neoplasms were excluded to reduce confounding effects.
Results: Of the 150 patients, 89 were female (59.33%), and 61 were male (40.67%). The mean age of the patients was 53.11 years old. 62% of patients had biliary pancreatitis, and 38% had non-biliary. The prevalence of alcoholic pancreatitis in the population was 5.33%. The age of people with biliary pancreatitis was more than non-biliary. According to Ranson's criteria, 6% of patients had severe acute pancreatitis, all of whom were over 60.
Conclusion: Acute pancreatitis was more prevalent among women, particularly in the fifth decade of life, with gallstones being the leading cause. Patients with biliary pancreatitis were significantly older, and advanced age was associated with increased disease severity. Moreover, blood glucose, AST, and LDH were significantly higher in severe cases. These findings highlight the importance of early diagnosis, accurate severity assessment, and special attention to elderly patients and those with biliary pancreatitis to reduce complications and improve clinical outcomes.
Methods: This cross-sectional study included all patients hospitalized with a diagnosis of acute pancreatitis in Besat and Towhid hospitals of Sanandaj from March 2016 to March 2018. All patients admitted with a confirmed diagnosis of acute pancreatitis during the mentioned period were enrolled. Inclusion criteria were a definitive diagnosis of acute pancreatitis based on clinical features (characteristic abdominal pain), laboratory findings (serum amylase or lipase elevated more than three times the normal level), and/or imaging evidence. Patients with chronic underlying conditions such as diabetes, chronic renal or hepatic failure, advanced cardiac disease, or neoplasms were excluded to reduce confounding effects.
Results: Of the 150 patients, 89 were female (59.33%), and 61 were male (40.67%). The mean age of the patients was 53.11 years old. 62% of patients had biliary pancreatitis, and 38% had non-biliary. The prevalence of alcoholic pancreatitis in the population was 5.33%. The age of people with biliary pancreatitis was more than non-biliary. According to Ranson's criteria, 6% of patients had severe acute pancreatitis, all of whom were over 60.
Conclusion: Acute pancreatitis was more prevalent among women, particularly in the fifth decade of life, with gallstones being the leading cause. Patients with biliary pancreatitis were significantly older, and advanced age was associated with increased disease severity. Moreover, blood glucose, AST, and LDH were significantly higher in severe cases. These findings highlight the importance of early diagnosis, accurate severity assessment, and special attention to elderly patients and those with biliary pancreatitis to reduce complications and improve clinical outcomes.
Mohammad Shojaie, Afshin Avazpour, Navid Kalani ,
Volume 82, Issue 12 (March 2025)
Volume 82, Issue 12 (March 2025)
Abstract
Background: Coronary artery disease (CAD) is among the most common life-threatening cardiovascular diseases, in which blood supply to the heart muscles is reduced or completely blocked. Coronary artery disease has various treatment options, one of which is PCI (Percutaneous Coronary Intervention) or stent placement via angioplasty. Dabigatran etexilate is the only orally available direct thrombin inhibitor, which is actually a prodrug that is rapidly converted to its active form and absorbed through the gastrointestinal tract. The purpose of this study is to compare mortality in patients with Atrial Fibrillation (AF) with a history of Percutaneous coronary intervention (PCI) treated with a low dose (110 mg). In contrast, it was treated with a high dose (150 mg).
Methods: The present study was a systematic review and meta-analysis on 4 online databases PubMed, Scopus, Web of Science and EMBASE to find articles that the rate of long-term complications related to bleeding or Thrombotic events were performed in AF patients who underwent PCI and were treated with dabigatran. STATA software was used for data analysis.
Results: Nine RCTs or prospective studies with 5694 participants were included. The studies showed that when comparing dabigatran (110 and 150 mg) with warfarin (with/without dual antiplatelet), dabigatran 110 mg was associated with a significant reduction in major bleeding (OR=0.46, 95% CI: 0.24-0.86, P=0.01), while the 150 mg dose was not statistically different (OR=0.12, 95% CI: 0.01-1.32, P=0.08). Also, comparing dabigatran 150 with 110 mg showed a higher risk of bleeding at the higher dose (OR=0.77, 95% CI: 0.64-0.92, P<0.001). On the other hand, dabigatran 110 mg was associated with a significant increase in mortality (OR=1.33, P=0.01) and myocardial infarction (OR=1.61, P=0.01) compared with combination therapy of warfarin and antiplatelet, but the 150 mg dose did not show a statistical difference. Heterogeneity was high in some analyses (I2 up to 99.49%), but funnel plots and Egger's test rejected publication bias.
Conclusion: There seems to be strong evidence that bleeding complications in dabigatran are less than old antiplatelet and anticoagulation drugs, but in terms of efficacy in reducing mortality, although we did not obtain strong evidence for analysis, older drugs are more effective in preventing death from any cause.
Methods: The present study was a systematic review and meta-analysis on 4 online databases PubMed, Scopus, Web of Science and EMBASE to find articles that the rate of long-term complications related to bleeding or Thrombotic events were performed in AF patients who underwent PCI and were treated with dabigatran. STATA software was used for data analysis.
Results: Nine RCTs or prospective studies with 5694 participants were included. The studies showed that when comparing dabigatran (110 and 150 mg) with warfarin (with/without dual antiplatelet), dabigatran 110 mg was associated with a significant reduction in major bleeding (OR=0.46, 95% CI: 0.24-0.86, P=0.01), while the 150 mg dose was not statistically different (OR=0.12, 95% CI: 0.01-1.32, P=0.08). Also, comparing dabigatran 150 with 110 mg showed a higher risk of bleeding at the higher dose (OR=0.77, 95% CI: 0.64-0.92, P<0.001). On the other hand, dabigatran 110 mg was associated with a significant increase in mortality (OR=1.33, P=0.01) and myocardial infarction (OR=1.61, P=0.01) compared with combination therapy of warfarin and antiplatelet, but the 150 mg dose did not show a statistical difference. Heterogeneity was high in some analyses (I2 up to 99.49%), but funnel plots and Egger's test rejected publication bias.
Conclusion: There seems to be strong evidence that bleeding complications in dabigatran are less than old antiplatelet and anticoagulation drugs, but in terms of efficacy in reducing mortality, although we did not obtain strong evidence for analysis, older drugs are more effective in preventing death from any cause.
Fatemeh Habibollahi, Ghazaleh Eslamian, Kiana Hasibi , Sepehr Khoshbaf Khiabanian , Bentolhosna Dehghan Nayeri , Aref Adeli Mosabbeb ,
Volume 82, Issue 12 (March 2025)
Volume 82, Issue 12 (March 2025)
Abstract
Background: Infertility is defined as the failure to achieve pregnancy after one year or more of regular unprotected sexual intercourse. Assisted reproductive technologies (ART) represent a key therapeutic approach for infertile couples. Bisphenol-A (BPA), a compound found in plastic polymer products, has been associated with increased infertility risk. This systematic review addresses whether BPA affects ART outcomes.
Methods: A comprehensive and systematic literature search was conducted across PubMed, Google Scholar, Web of Science, and Scopus up to December 2024 without any language or time restrictions. The search strategy combined relevant keywords and medical subject headings such as “bisphenol A,” “infertility,” “assisted reproductive technology,” “in vitro fertilization,” and “embryo implantation.” All human studies assessing the relationship between BPA exposure and ART outcomes were considered. After removing duplicates and screening titles and abstracts, 23 studies that met the inclusion criteria were reviewed in detail. The selected studies included cross-sectional and prospective cohort designs, and data on sample size, BPA measurement methods, and reproductive endpoints were extracted for qualitative synthesis.
Results: The reviewed studies consistently indicate that exposure to BPA is associated with adverse reproductive outcomes, particularly in women undergoing IVF treatment. Evidence suggests that higher BPA levels correlate with fewer retrieved oocytes, reduced oocyte maturation rates, and impaired ovarian response to hormonal stimulation. Several studies also observed reduced estradiol concentrations and lower fertilization and cleavage rates, leading to decreased implantation success and clinical pregnancy rates. In addition, diminished ovarian reserve markers, such as anti-Müllerian hormone and antral follicle count, have been negatively influenced by BPA exposure. Male factors were also affected, with reports of decreased sperm motility, abnormal morphology, and increased DNA fragmentation, which could compromise embryo quality and early development. Variability in study methodologies, small sample sizes, and differences in BPA detection techniques, however, make direct comparison challenging.
Conclusion: Current evidence supports an inverse association between BPA exposure and fertility outcomes, but further prospective studies with larger sample sizes and more precise measurement methods are needed.
Methods: A comprehensive and systematic literature search was conducted across PubMed, Google Scholar, Web of Science, and Scopus up to December 2024 without any language or time restrictions. The search strategy combined relevant keywords and medical subject headings such as “bisphenol A,” “infertility,” “assisted reproductive technology,” “in vitro fertilization,” and “embryo implantation.” All human studies assessing the relationship between BPA exposure and ART outcomes were considered. After removing duplicates and screening titles and abstracts, 23 studies that met the inclusion criteria were reviewed in detail. The selected studies included cross-sectional and prospective cohort designs, and data on sample size, BPA measurement methods, and reproductive endpoints were extracted for qualitative synthesis.
Results: The reviewed studies consistently indicate that exposure to BPA is associated with adverse reproductive outcomes, particularly in women undergoing IVF treatment. Evidence suggests that higher BPA levels correlate with fewer retrieved oocytes, reduced oocyte maturation rates, and impaired ovarian response to hormonal stimulation. Several studies also observed reduced estradiol concentrations and lower fertilization and cleavage rates, leading to decreased implantation success and clinical pregnancy rates. In addition, diminished ovarian reserve markers, such as anti-Müllerian hormone and antral follicle count, have been negatively influenced by BPA exposure. Male factors were also affected, with reports of decreased sperm motility, abnormal morphology, and increased DNA fragmentation, which could compromise embryo quality and early development. Variability in study methodologies, small sample sizes, and differences in BPA detection techniques, however, make direct comparison challenging.
Conclusion: Current evidence supports an inverse association between BPA exposure and fertility outcomes, but further prospective studies with larger sample sizes and more precise measurement methods are needed.
Saeideh Baghaei Barjini , Mozhgan Masoudi , Soheila Pirdadeh Beiranvand , Ashraf Moieni , Soodabeh Zare,
Volume 82, Issue 12 (March 2025)
Volume 82, Issue 12 (March 2025)
Abstract
Background: Intracytoplasmic sperm injection (ICSI) is one of the infertility treatments that may lead to various levels of stress and anxiety in women at different stages. Multiple factors may contribute to these psychological disorders. This study aimed to assess the levels of stress, anxiety, and depression before embryo transfer in women undergoing ICSI.
Methods: This cross-sectional analytical study was conducted from July to October 2024 on 70 women candidates for ICSI at Arash Women's Hospital in Tehran, prior to embryo transfer. Participants were selected through convenience sampling. Inclusion criteria included at least three years of infertility, no background in psychology or attendance in counseling sessions, no major physical or mental illnesses, and no severe stressful events in the past six months (such as the death of first-degree relatives or major accidents). Participants could withdraw from the study at any time. The DASS-21 (Depression, Anxiety, Stress Scale) was used to assess stress and anxiety levels. Based on the DASS-21, stress scores of 0-14 were considered normal or mild, 15-18 mild, 19-25 moderate, 26-32 severe, and ≥33 very severe. For anxiety, scores of 0-7 were considered normal or mild, 8-9 mild, 10-14 moderate, 15-19 severe, and ≥20 very severe. The validity of the tool was confirmed by Antony and validated in Iran by Sahebi.
Results: Among the 70 participants, 92.8% experienced stress and anxiety. The mean stress score was 20.77±4.87, and the mean anxiety score was 11.70±4.23, indicating moderate levels. Women over 42 years old had significantly lower stress scores compared to others (P<0.001). Conversely, women under 30 showed significantly higher anxiety scores (P<0.01). No significant associations were found between stress/anxiety and other demographic or infertility-related factors (P>0.05).
Conclusion: The findings indicate that women undergoing embryo transfer in ICSI procedures commonly experience stress and anxiety. Therefore, appropriate psychological interventions are recommended to support this group during treatment.
Methods: This cross-sectional analytical study was conducted from July to October 2024 on 70 women candidates for ICSI at Arash Women's Hospital in Tehran, prior to embryo transfer. Participants were selected through convenience sampling. Inclusion criteria included at least three years of infertility, no background in psychology or attendance in counseling sessions, no major physical or mental illnesses, and no severe stressful events in the past six months (such as the death of first-degree relatives or major accidents). Participants could withdraw from the study at any time. The DASS-21 (Depression, Anxiety, Stress Scale) was used to assess stress and anxiety levels. Based on the DASS-21, stress scores of 0-14 were considered normal or mild, 15-18 mild, 19-25 moderate, 26-32 severe, and ≥33 very severe. For anxiety, scores of 0-7 were considered normal or mild, 8-9 mild, 10-14 moderate, 15-19 severe, and ≥20 very severe. The validity of the tool was confirmed by Antony and validated in Iran by Sahebi.
Results: Among the 70 participants, 92.8% experienced stress and anxiety. The mean stress score was 20.77±4.87, and the mean anxiety score was 11.70±4.23, indicating moderate levels. Women over 42 years old had significantly lower stress scores compared to others (P<0.001). Conversely, women under 30 showed significantly higher anxiety scores (P<0.01). No significant associations were found between stress/anxiety and other demographic or infertility-related factors (P>0.05).
Conclusion: The findings indicate that women undergoing embryo transfer in ICSI procedures commonly experience stress and anxiety. Therefore, appropriate psychological interventions are recommended to support this group during treatment.
Ramyar Rahimi Darehbagh , Ebrahim Khajeh, Daem Roshani , Farhang Safarnejhad,
Volume 82, Issue 12 (March 2025)
Volume 82, Issue 12 (March 2025)
Abstract
Background: Surgical site infections (SSIs) represent one of the most common and significant complications following surgical interventions. These infections not only prolong hospital stay and recovery but also impose a considerable economic burden on healthcare systems and patients. Reducing the risk of SSIs is therefore a major focus of perioperative care, and several strategies have been proposed to minimize their occurrence. One of the most widely practiced preventive measures is preoperative skin antisepsis, aimed at lowering the microbial load at the surgical site. Among available antiseptics, chlorhexidine has been shown to have broad-spectrum antimicrobial activity and sustained effectiveness. This study was designed to evaluate the effect of preoperative chlorhexidine showers on the incidence of SSIs in patients undergoing elective inguinal hernia surgery.
Methods: A randomized clinical trial was carried out in 2019 at Kowsar Hospital, Sanandaj. A total of 300 patients scheduled for elective inguinal hernia repair were enrolled and randomly assigned into three groups of 100 participants each. The intervention group was instructed to take a shower with 4% chlorhexidine solution on the night before surgery. Control group 1 took a routine bath using regular detergents, while control group 2 did not bathe prior to the operation. All patients were monitored for the occurrence of superficial SSIs for up to 30 days postoperatively.
Results: Among the 300 patients included in the study, 12 cases (4%) of superficial SSIs were documented. The distribution of infections varied significantly across the groups: one case in the chlorhexidine group, three cases in the regular detergent group, and eight cases in the group that did not shower. Statistical analysis confirmed that the difference in infection rates among the groups was significant (P=0.034).
Conclusion: The findings of this clinical trial demonstrate that preoperative showers with 4% chlorhexidine solution are effective in reducing the incidence of SSIs in patients undergoing elective inguinal hernia surgery. Implementing this simple, low-cost intervention may therefore be a valuable strategy in routine surgical practice to enhance patient outcomes and reduce postoperative complications.
Banafsheh Mashak, Reza Payami, Fatemeh Javaheri, Alireza Babajani, Mohammad Hossein Shakeri,
Volume 82, Issue 12 (March 2025)
Volume 82, Issue 12 (March 2025)
Abstract
Zakieh Vahedian Ardakani , Mehran Zarei-Ghanavati , Hamid Riazi-Esfahani , Seyed Mehdi Tabatabaei , Mohammad Reza Mehrabi Bahar, Sadegh Ghafarian, Ahmad Masoomi,
Volume 83, Issue 1 (April 2025)
Volume 83, Issue 1 (April 2025)
Abstract
Artificial intelligence (AI) has emerged as a transformative force in modern medicine, with ophthalmology standing at the forefront of its clinical integration. Among ophthalmic disorders, glaucoma—a leading cause of irreversible blindness worldwide—presents unique opportunities and challenges for AI-based solutions due to its chronic, progressive nature and reliance on multimodal data, including structural and functional assessments. This review article offers a comprehensive synthesis of the current and emerging roles of AI in the detection, monitoring, and management of glaucoma. AI algorithms, particularly deep learning and machine learning models, have demonstrated exceptional capabilities in interpreting fundus photographs, optical coherence tomography (OCT) images, and visual field data to identify glaucomatous damage. These systems often approach or even exceed the diagnostic performance of human experts. Moreover, AI has shown significant promise in facilitating large-scale population-based screening, improving early detection rates, and addressing disparities in access to subspecialty care, particularly in low-resource and remote settings. In the monitoring of disease progression, AI tools are being developed to detect subtle structural or functional changes over time, predict future visual outcomes, and support more precise and individualized treatment decisions. Despite these advancements, the widespread clinical adoption of AI in glaucoma care faces several critical barriers. Key limitations include poor generalizability of models across diverse populations, imaging devices, and clinical settings; scarcity of well-annotated, high-quality, and demographically representative datasets; and a lack of transparency and interpretability in algorithmic decision-making—commonly referred to as the “black box” problem. Ethical concerns, regulatory uncertainty, integration challenges within existing healthcare infrastructures, and medico-legal accountability also require thoughtful resolution before AI can be reliably deployed in clinical practice. This review critically evaluates the strengths, limitations, and real-world potential of AI technologies in glaucoma. It provides clinicians, researchers, and healthcare policymakers with a balanced and up-to-date perspective, highlighting promising avenues for future research, including explainable AI, federated learning, multi-modal data integration, and longitudinal validation studies. By fostering a deeper understanding of both the opportunities and challenges associated with AI, this article aims to guide the responsible, equitable, and evidence-based integration of AI into comprehensive glaucoma care.
Tahereh Parsajam , Behnam Reza Makhsoosi, Ali Najafpour, Kimia Fathi,
Volume 83, Issue 1 (April 2025)
Volume 83, Issue 1 (April 2025)
Abstract
Background: Thyroid hormones play a key role in the development of various organs of the body. The breast and thyroid are hormone-responsive organs that are closely related to changes in endocrine activity and glandular diseases. Breast cancer is the most common cancer in women and the second leading cause of cancer-related death. Due to the inconsistencies in the relationship between breast cancer and thyroid diseases and the lack of regional data, the present study was designed and conducted with the aim of investigating the prevalence of various thyroid disorders in patients with breast cancer and its relationship with the type of breast cancer and age.
Methods: In this prospective study, we examined 50 women with breast cancer who had undergone surgery after surgery. The location of this study was Imam Reza Hospital in Kermanshah and the duration of this study was 12 months from the beginning of March 2023 to the end of March 2024. Patient information included: age, histopathological type of cancer, and thyroid test results including serum TSH, FT4, and ATPO levels, were recorded and reviewed.
Results: Based on the results obtained, it was shown that the average age of people with thyroid disorders in patients with breast cancer was 42.88 and the standard deviation was 11.313. Also, there was no significant difference between the age of people and thyroid disorders in patients with breast cancer (P-value < 0.89). In the study of thyroid disorders in patients with breast cancer, it was shown that there was a significant relationship between patients with breast cancer and the amount of TSH and the amount of FT4. This means that people with breast cancer had an increase in the amount of TSH and the amount of FT4. However, there was no significant relationship between patients with breast cancer and the amount of ATPO (P-value < 0.319).
Conclusion: Thyroid disorders are more prevalent in patients with breast cancer than in the normal population, and given the relationship between the types of thyroid disorders and the type of breast cancer histopathology, these results can be used and screening methods can be used more effectively in those who have risk factors for breast cancer for early diagnosis and treatment of the disease.
Methods: In this prospective study, we examined 50 women with breast cancer who had undergone surgery after surgery. The location of this study was Imam Reza Hospital in Kermanshah and the duration of this study was 12 months from the beginning of March 2023 to the end of March 2024. Patient information included: age, histopathological type of cancer, and thyroid test results including serum TSH, FT4, and ATPO levels, were recorded and reviewed.
Results: Based on the results obtained, it was shown that the average age of people with thyroid disorders in patients with breast cancer was 42.88 and the standard deviation was 11.313. Also, there was no significant difference between the age of people and thyroid disorders in patients with breast cancer (P-value < 0.89). In the study of thyroid disorders in patients with breast cancer, it was shown that there was a significant relationship between patients with breast cancer and the amount of TSH and the amount of FT4. This means that people with breast cancer had an increase in the amount of TSH and the amount of FT4. However, there was no significant relationship between patients with breast cancer and the amount of ATPO (P-value < 0.319).
Conclusion: Thyroid disorders are more prevalent in patients with breast cancer than in the normal population, and given the relationship between the types of thyroid disorders and the type of breast cancer histopathology, these results can be used and screening methods can be used more effectively in those who have risk factors for breast cancer for early diagnosis and treatment of the disease.
Ali Mohammad Mosadeghrad, Shabnam Afraz,
Volume 83, Issue 1 (April 2025)
Volume 83, Issue 1 (April 2025)
Abstract
Shahram Shafa, Mehrdad Sayadinia, Bibi Mona Razavi, Tayyebeh Zarei , Maryam Ziyaei , Mansour Deylami,
Volume 83, Issue 2 (May 2025)
Volume 83, Issue 2 (May 2025)
Abstract
Background: Controlling patients' anxiety before surgery reduces the possibility of postoperative problems and increases the possibility of patient participation and cooperation in the postoperative care and treatment plan.
Methods: This study uses a review approach to investigate non-pharmacological methods of anxiety management in patients undergoing orthopedic surgery. The systematic search involves several key steps. Literature search: A thorough search was conducted in PubMed, Sciences Direct, Scopus, Magiran, Sid, and Google Scholar databases. The search was refined using keywords such as “aromatherapy,” “music therapy,” “massage,” “educational intervention,” “educational film,” and “sound of the Quran” and their English equivalents to identify relevant studies published in the past ten years. Inclusion criteria included studies on orthopedic surgery, Persian and English articles, and original articles. Exclusion criteria included studies outside the specified time frame or studies that deviated from the defined focus. In this review, we conclude by summarizing key aspects of the review process, emphasizing the rigorous approach applied in study selection, data extraction, and synthesis.
Results: The results of the present study showed that the non-pharmacological methods used to control or reduce anxiety in orthopedic surgery include methods; Music therapy, the sound of the Quran, relaxation techniques, back massage, educational intervention, educational video, awareness and training before surgery and aromatherapy (chamomile, lemon, rose, valerian, cardamom, cinnamon, calendula, lavender, lemon sour).
Conclusion: The results of numerous and reputable research findings clearly show that the use of non-pharmacological methods plays an effective role in reducing the level of anxiety of patients before, during and after orthopedic surgery. These methods, which are generally low-cost, low-complication, and applicable in various clinical settings, include techniques such as preoperative education, music therapy, breathing and relaxation techniques, mindfulness-based interventions, psychological support, and the creation of a calm and reassuring environment. Since anxiety is a known factor in weakening the immune system, increasing postoperative pain, prolonging the recovery period, and reducing overall patient satisfaction, its management is of great importance. Therefore, by integrating and utilizing such non-invasive methods into nursing care protocols and holistic patient care programs, the detrimental and undesirable effects of anxiety after orthopedic surgery can be significantly reduced and faster recovery, a better patient experience, and more favorable clinical outcomes can be achieved.
Mohsen Ghoryani, Mohsen Ahmadi, Mahdi Atabaki, Jalil Tavakkol-Afshari , Mojgan Mohammadi,
Volume 83, Issue 2 (May 2025)
Volume 83, Issue 2 (May 2025)
Abstract
Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder marked by persistent inflammation, progressive joint destruction, functional disability, and systemic complications. Key inflammatory mediators, such as tumor necrosis factor-alpha (TNF-α) and interleukin-17 (IL-17), play critical roles in disease progression and tissue damage. Mesenchymal stem cells (MSCs) have recently gained attention as a therapeutic approach for autoimmune diseases because of their abilities in self-renewal, immune modulation, and tissue repair. Considering the role of pro-inflammatory cytokines in the pathogenesis of RA, this study investigated the effect of autologous bone marrow-derived MSCs (ABMSCs) on the gene expression of TNF-α and IL-17A in patients with refractory RA.
Methods: The study utilized archived RNA from the research team's previous clinical trial. In this study, 13 patients with refractory RA who underwent MSC transplantation (MSCT) at an intravenous dose of 1×10⁶ ABMSCs per kilogram of body weight were evaluated at baseline and at 1, 6, and 12 months post-injection. Between November 2023 and March 2024, archived RNA samples were converted into cDNA at the Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Then, the expression levels of TNF and IL-17A were analyzed using SYBR Green-based real-time PCR.
Results: TNF-α gene expression declined significantly 1 month after MSCT (mean±SEM: 1.00±0.00 at baseline vs. 0.38±0.11 at 1 month, P=0.045). However, no significant differences were observed at 6 months (1.21±0.38) or 12 months (0.61±0.18) compared to baseline (P>0.05). IL-17A gene expression remained statistically unchanged across all time points (baseline: 1.00±0.00; 1 month: 0.87±0.31; 6 months: 1.19±0.42; 12 months: 1.79±0.92; P>0.05).
Conclusion: The results of this study suggest that ABMSCs may exert an anti-inflammatory effect by modulating TNF-α in patients with refractory RA. However, the findings related to IL-17A do not support the hypothesis that ABMSC injection exerts anti-inflammatory effects through modulation of IL-17A gene expression in these patients.
Methods: The study utilized archived RNA from the research team's previous clinical trial. In this study, 13 patients with refractory RA who underwent MSC transplantation (MSCT) at an intravenous dose of 1×10⁶ ABMSCs per kilogram of body weight were evaluated at baseline and at 1, 6, and 12 months post-injection. Between November 2023 and March 2024, archived RNA samples were converted into cDNA at the Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Then, the expression levels of TNF and IL-17A were analyzed using SYBR Green-based real-time PCR.
Results: TNF-α gene expression declined significantly 1 month after MSCT (mean±SEM: 1.00±0.00 at baseline vs. 0.38±0.11 at 1 month, P=0.045). However, no significant differences were observed at 6 months (1.21±0.38) or 12 months (0.61±0.18) compared to baseline (P>0.05). IL-17A gene expression remained statistically unchanged across all time points (baseline: 1.00±0.00; 1 month: 0.87±0.31; 6 months: 1.19±0.42; 12 months: 1.79±0.92; P>0.05).
Conclusion: The results of this study suggest that ABMSCs may exert an anti-inflammatory effect by modulating TNF-α in patients with refractory RA. However, the findings related to IL-17A do not support the hypothesis that ABMSC injection exerts anti-inflammatory effects through modulation of IL-17A gene expression in these patients.
Majid Vatankhah, Saeed Kashani, Mohsen Sarafikhah, Bibi Mona Razavi, Mehrdad Sayadinia, Mehrdad Malekshoar,
Volume 83, Issue 2 (May 2025)
Volume 83, Issue 2 (May 2025)
Abstract
Background: Aspiration pneumonia is a significant and potentially preventable cause of morbidity and mortality in critically ill ICU patients. Prophylactic pharmacological interventions, particularly antiemetics like metoclopramide (a prokinetic agent) and ondansetron (a 5-HT3 receptor antagonist), are commonly employed to reduce gastric aspiration and subsequent pneumonia. Despite their widespread use, comparative efficacy data remains limited. This randomized controlled trial was specifically designed to rigorously compare the effectiveness of these two distinct antiemetic strategies in preventing aspiration pneumonia among high-risk, mechanically ventilated patients, aiming to provide evidence-based guidance for clinical practice.
Methods: This double-blind randomized clinical trial involved 116 individuals admitted to the ICU at Shahid Mohammadi Hospital, Bandar Abbas from March 2024 to March 2025. Subjects were randomly assigned to metoclopramide or ondansetron groups. Enrollment criteria consisted of patients between 17 and 70 years old in the ICU requiring intubation and mechanical ventilation. Monitoring continued for 72 hours, with evaluation utilizing the Clinical Pulmonary Infection Score (CPIS), chest X-ray (CXR) results, and physical assessments. Data were analyzed with SPSS version 21 employing descriptive statistics (mean, standard deviation, percentage, frequency) and inferential tests with significance set at P<0.05.
Results: Chi-square analysis indicated no statistically significant gender difference between groups (P=0.947). Mean age was 30.6±10.5 years for metoclopramide recipients and 32.9±6.12 years for ondansetron recipients. Further analysis revealed no significant differences in age or BMI between cohorts. No significant difference emerged between metoclopramide and ondansetron groups regarding aspiration pneumonia occurrence, with similar incidence rates in both arms. Multiple logistic regression demonstrated that statistically, no variables influenced aspiration pneumonia development.
Conclusion: The results of this randomized trial clearly demonstrate no statistically significant difference in efficacy between metoclopramide and ondansetron for preventing aspiration pneumonia in intubated ICU patients. Both agents showed comparable effectiveness in our study population, suggesting that either drug represents a clinically acceptable prophylactic option. This finding provides clinicians with valuable therapeutic flexibility based on individual patient characteristics, drug availability, and cost considerations. However, further multicenter studies with larger sample sizes are recommended to confirm these findings across diverse patient populations and settings.
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.
Saeed Kafrashi, Hamidreza Norouzi, Malihe Safari,
Volume 83, Issue 3 (June 2025)
Volume 83, Issue 3 (June 2025)
Abstract
Background: In this study, Botox method is compared with sleeve gastrectomy as one of the endoscopic methods in the treatment of obesity for patients who are not effective in lifestyle and drug modification methods and do not have the interest or necessary conditions for bariatric surgery.
Methods: This Cross-sectional study was conducted in eligible patients who were outpatients at the gastroenterology clinics of Amir al-Momenin Hospital, Arak, in June 2014 for one year in the gastroenterology clinic after obtaining informed consent, demographic information, and anthropometric measurements. After 12 weeks, patients in both groups were visited again. In patients in group A (Botox group), endoscopy was performed by an experienced gastroenterologist under sedation after a 10-hour fast, and in patients in group B (sleeve gastrectomy) under general anesthesia, a partial and longitudinal gastrectomy was performed. The BAROS questionnaire was used to assess the quality of life of patients.
Results: The mean age of the subjects in the endoscopic botulinum neurotoxin group was 30.88±11.89 years and the sleeve gastrectomy group was 29.88±11.06 years. In this study, 12 subjects (24.0%) were male and 38 subjects (76%) were female. There was a significant difference in the mean body mass index and weight at four measurements in the two study groups (endoscopic botulinum neurotoxin and sleeve gastrectomy). There was no statistically significant difference in the mean blood pressure, laboratory results, and mean quality of life in the study groups.
Conclusion: Endoscopic botulinum injection in the stomach is an effective and safe method for short-term weight loss, but its long-term effect on weight and the occurrence of complications or metabolic effects requires long-term follow-up.
Methods: This Cross-sectional study was conducted in eligible patients who were outpatients at the gastroenterology clinics of Amir al-Momenin Hospital, Arak, in June 2014 for one year in the gastroenterology clinic after obtaining informed consent, demographic information, and anthropometric measurements. After 12 weeks, patients in both groups were visited again. In patients in group A (Botox group), endoscopy was performed by an experienced gastroenterologist under sedation after a 10-hour fast, and in patients in group B (sleeve gastrectomy) under general anesthesia, a partial and longitudinal gastrectomy was performed. The BAROS questionnaire was used to assess the quality of life of patients.
Results: The mean age of the subjects in the endoscopic botulinum neurotoxin group was 30.88±11.89 years and the sleeve gastrectomy group was 29.88±11.06 years. In this study, 12 subjects (24.0%) were male and 38 subjects (76%) were female. There was a significant difference in the mean body mass index and weight at four measurements in the two study groups (endoscopic botulinum neurotoxin and sleeve gastrectomy). There was no statistically significant difference in the mean blood pressure, laboratory results, and mean quality of life in the study groups.
Conclusion: Endoscopic botulinum injection in the stomach is an effective and safe method for short-term weight loss, but its long-term effect on weight and the occurrence of complications or metabolic effects requires long-term follow-up.
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.
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.
Ali-Akbar Shafiei , Saeed Rahmani , Abbas Riazi, Alireza Akbarzadeh Baghan ,
Volume 83, Issue 4 (July 2025)
Volume 83, Issue 4 (July 2025)
Abstract
Background: This study investigates the use of color filters, which represent a scientific and standardized approach to assist individuals with visual impairment. Although there is no fixed protocol for prescribing color filters, these filters, which are often prescribed by ocular care providers in a trial-and-error manner today, help improve visual performance, control glare, and enhance motor skills in affected individuals. Given the absence of formal guidelines and standardized protocols in this area, this study tested common diseases leading to visual impairment against various color filters.
Methods: The study population consisted of patients visiting the Optometry Clinic of Labbafi Nejad Hospital. Participants were voluntarily referred from retinal and corneal departments to this clinic. This quasi-experimental study evaluated acuity at distance and near and contrast sensitivity function with and without color filters, and compared the results. After analysis, filter(s) suitable for each participant were identified and applied clinically, with one-month monitoring and re-evaluation.
Results: A total of 99 participants (54 male, 45 female) with a mean age of 32.19±15.41 years were included. The results showed that after using color filters, distance visual acuity (BCVA) improved significantly in most diseases (P<0.001). However, in albinism and diabetic retinopathy patients, there was no significant improvement in distance vision. At near distance, there was generally a significant improvement in near vision in most diseases after applying the filters (P=0.001). Exceptions included albinism and glaucoma, where no significant difference was observed (P=0.073). For contrast sensitivity (CSF), most patients showed improvement and increased contrast sensitivity (P<0.001), but this increase was not significant in albinism and glaucoma (P=0.483).
Conclusion: The study suggests that the use of certain color filters in visually impaired patients leads to significant improvements in both distance and near acuity and contrast sensitivity function, potentially enhancing quality of life. Based on the quantitative results, selecting the appropriate filter should be disease-specific and done with greater precision. However, the diversity and severity of diseases, the degree of vision loss, and genetic differences among individuals require greater attention to practical experiences and statements from this patient group. Additionally, patients with more than one ocular condition often changed the type and color of the filter.
Methods: The study population consisted of patients visiting the Optometry Clinic of Labbafi Nejad Hospital. Participants were voluntarily referred from retinal and corneal departments to this clinic. This quasi-experimental study evaluated acuity at distance and near and contrast sensitivity function with and without color filters, and compared the results. After analysis, filter(s) suitable for each participant were identified and applied clinically, with one-month monitoring and re-evaluation.
Results: A total of 99 participants (54 male, 45 female) with a mean age of 32.19±15.41 years were included. The results showed that after using color filters, distance visual acuity (BCVA) improved significantly in most diseases (P<0.001). However, in albinism and diabetic retinopathy patients, there was no significant improvement in distance vision. At near distance, there was generally a significant improvement in near vision in most diseases after applying the filters (P=0.001). Exceptions included albinism and glaucoma, where no significant difference was observed (P=0.073). For contrast sensitivity (CSF), most patients showed improvement and increased contrast sensitivity (P<0.001), but this increase was not significant in albinism and glaucoma (P=0.483).
Conclusion: The study suggests that the use of certain color filters in visually impaired patients leads to significant improvements in both distance and near acuity and contrast sensitivity function, potentially enhancing quality of life. Based on the quantitative results, selecting the appropriate filter should be disease-specific and done with greater precision. However, the diversity and severity of diseases, the degree of vision loss, and genetic differences among individuals require greater attention to practical experiences and statements from this patient group. Additionally, patients with more than one ocular condition often changed the type and color of the filter.
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