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Showing 21 results for Hamidi
Pajand O, Ziyaeyan M, Mousavi A, Hojabri Z, Kazemi B, Bahador A, Hamidian M, Mousavi A, Hashemi F B,
Volume 64, Issue 11 (7 2006)
Volume 64, Issue 11 (7 2006)
Abstract
Background: Human Cytomegalovirus (HCMV) infections are a significant challenge in patients with Hematopoietic Cell Transplant (HCT). Acute Graft vs. Host (GVHD) is recognized as a predisposing factor for increased incidence of HCMV reactivation. Availability of rapid and accurate tests for HCMV detection in HCT recipients is of foremost importance in developing countries, such as Iran.
Methods: A total of 201 peripheral blood leukocyte (PBL) and plasma specimens from 26 allogeneic HCT recipients were examined for HCMV DNA by polymerase chain reaction (PCR) assay. Densitometric analysis of 257bp PCR products from clinical samples and 101-106 "cloned plasmid" per µg DNA containing a HCMV specific fragment were analyzed using LabWorks software (v3.0.02). Optical density of amplicons was plotted, and calculated HCMV viral loads were compared with the patients' antigenemia results.
Results: HCMV viral loads ranged between <102 to 1.35×102 copies per µg DNA among 7 HCT patients. In addition, 14 episodes of positive antigenemia assay in 7 patients in which peak HCMV load were compared with GVHD grade II-IV patients. Significant correlation was also detected between HCMV DNA load in PBL and plasma samples, as well as HCMV DNA load in PBL samples and antigenemia results. Receiver–Operating Characteristic analysis determined that 2,200 HCMV copies in PBL samples as the threshold value for initiation of Ganciclovir therapy.
Conclusion: This report shows that rapid and sensitive assays, like quantitative PCR, are extremely valuable for detection of active HCMV infection, and life-threatening HCMV disease in HCT recipients during the post transplant period. Furthermore, high HCMV DNA load among GVHD grade II-IV patients confirms the high risk of HCMV reactivation among these HCT recipients. Tests such as quantitative PCR also helps physicians initiate timely preemptive therapy and for a shorter period, which may lead to better clinical outcome in HCMV-infected transplant patients.
Mirsalehian.a, Nakhjavani.f, Peymani.a, Jabalameli.f, Mirafshar.s M, Hamidian.m,
Volume 65, Issue 1 (5 2008)
Volume 65, Issue 1 (5 2008)
Abstract
Background: The incidence of ESBL producing species have been steadily increased in recent years, resulting in limitation of infection control issues and therapeutic options.The purpose of this study was to evaluate prevalence of Enterobacteriaceae and also assess epidemiology ESBL producing strains isolated from patients admitted in ICUs.
Methods: A total of one hundred fifty isolates were collected from urine, sputum, blood, wound and other clinical samples from patient admitted in ICU and then were identified by biochemical tests .All of the samples were screened by DAD method according to The NCCLS Guideline. The species that met NCCLS screening criteria was further tested for Clavulanic Acid effect by confirmatory method.
Results: A total of one hundred fifty isolates,133(89.3%) were found to be resistant at least on of the indicators cephalosporin tested according to NCCLS Guideline. 121(80.6%) of the isolates were resistant to all the indicators tested .89(59.3) isolateds were confirmed as ESBL producers. The number of isolates ESBL producing was as follow: Klebsiella pneumoniae 33 (76.74%), E.coli 20 (60.60%), Enterobacter cloacae 8 (47.05%), Citrobacter diversus 6 (54.54%), Enterobacter aerogenes 7 (53.84%), Citrobacter freundii 4 (40%), Klebsiella oxytoca 6 (62.5%), Proteus mirabilis 4 (50%), Serratia marcescens 2 (40%), Proteus Volgaris 0%.All of the isolates sensitive to imipenem.
Conclusion: The present study shows high prevalence of ESBL producing Enterobacteriaceae from patients admitted in ICU .The increased rate of these species in most cases due to the administration of inadequate and irrational antimicrobial therapy .To overcome this problem, it needs to develop new antimicrobial agents, limiting the Unnecessary Use of antimicrobial and increasing compliance with infection control issues.
Ashrafi M, Hamidi Beheshti Mt, Shahidi Sh, Ashrafi F,
Volume 67, Issue 5 (6 2009)
Volume 67, Issue 5 (6 2009)
Abstract
Background: Kidney transplantation had been evaluated in some
researches in Iran mainly with clinical approach. In this research we
evaluated graft survival in kidney recipients and factors impacting on
survival rate. Artificial neural networks have a good ability in
modeling complex relationships, so we used this ability to demonstrate
a model for prediction of 5yr graft survival after kidney
transplantation.
Methods: This retrospective study was done on 316 kidney
transplants from 1984 through 2006 in Isfahan. Graft survival was
calculated by Kaplan-meire method. Cox regression and artificial neural
networks were used for constructing a model for prediction of graft
survival.
Results: Body mass index (BMI) and type of transplantation
(living/cadaver) had significant effects on graft survival in cox
regression model. Effective variables in neural network model were
recipient age, recipient BMI, type of transplantation and donor age.
One year, 3 year and 5 year graft survival was 96%, 93% and 90%
respectively. Suggested artificial neural network model had good
accuracy (72%) with the area under the Receiver-Operating
Characteristic (ROC) curve 0.736 and appropriate results in goodness of
fit test (κ2=33.924). Sensitivity of model in identification of true
positive situations was more than false negative situations (72% Vs
61%).
Conclusion: Graft survival in living donors was
more than cadaver donors. Graft survival decreased when the BMI
increased at transplantation time. In traditional statistical approach
Cox regression analysis is used in survival analysis, this research
shows that artificial neural networks also can be used in constructing
models to predict graft survival in kidney transplantation.
Hassan Boskabadi , Maryam Zakerihamidi , Fatemeh Bagheri ,
Volume 71, Issue 12 (March 2014)
Volume 71, Issue 12 (March 2014)
Abstract
Background: Normal vaginal delivery is the best method of delivery. Vaginal delivery is followed by the best pregnancy outcomes. Reducing the rate of cesarean delivery has been a health goal for the United States with economic and social advantages. This study has been conducted with aim of maternal and neonatal outcomes of Normal Vaginal Delivery (NVD) and comparing with cesarean delivery. Methods: This descriptive- analytic study was conducted in Ghaem University Hospital in Mashhad during years 2007 until 2013. Five hundred thirty six full term infants aged 3- 14 day, born either by NVD as control group or cesarean delivery as case group par-ticipated in this study. Sampling was a convenient method. The data in questionnaire containing maternal information (maternal age, mode of delivery, maternal weight, du-ration of delivery, duration of maternal hospitalization, let down reflex, breast feeding status) and neonatal information (age, sex, Apgar score, urination frequency and defe-cation frequency) were collected by a researcher. Results: According to the findings of this study, the infant’s age (P=0.425), admission weight (P=0.278), jaundice access (P=0.162), urination frequency (P=0.165), maternal weight (P=0.869) showed no statistically significant difference between two delivery methods. Time of the first breast feeding after childbirth (P=0.000), defecation fre-quency (P=0.000), maternal age (P=0.000), maternal parity (P=0.003), duration of de-livery (P=0.000), duration of maternal hospitalization (P=0.025), feeding position (P=0.029), let down reflex (P=0.012), mastitis (P=0.025) and breast problems (P=0.027) showed statistically significant difference between the groups. It means defecation frequency, duration of maternal hospitalization, Apgar score, mastitis and breast problems were more in cesarean group, but early breast feeding after delivery, duration of delivery, proper breastfeeding position and let down reflex were more in NVD group. Conclusion: The results of this study showed in comparison with cesarean delivery, normal vaginal delivery provides better outcomes in terms of breast problems, breast feeding status, duration of labor and duration of maternal hospitalization for both mother and infant. So, adopting careful instructions in management and administration of deliveries will help the prevalence of making decisions for normal vaginal delivery and the recovery of delivery outcomes.
Hassan Boskabadi , Maryam Zakerihamidi , Fatemeh Bagheri , Abbas Boskabadi ,
Volume 73, Issue 10 (January 2016)
Volume 73, Issue 10 (January 2016)
Abstract
Background: Jaundice is the most common cause of neonatal admission within the first month after birth. Therefore, by identifying the causes of jaundice based on the infant’s age at disease onset and age at hospital admission and providing the required training, jaundice can be managed and its associated complications can be prevented. This study was performed to evaluate the causes of neonatal jaundice, based on the infant’s age at disease onset and age at hospital admission.
Methods: In this cross-sectional study, out of 3,130 infants with jaundice, referring to Ghaem Hospital, Mashhad, Iran, from 2003 to 2015, 2,658 newborns were selected. Causes of jaundice are determined based on hematocrit, direct and indirect bilirubin, Coombs test, reticulocyte count, blood group and Rh of mother and neonate, thyroid tests, glucose-6-phosphate dehydrogenase (G6PD) enzyme testing, urinalysis, urine culture, and If necessary, Na, blood urea nitrogen, creatinine and other tests depending on the doctor's supervision. After confirming jaundice in infants, based on the physician’s diagnosis and laboratory results, a researcher-made questionnaire including the infant’s characteristics, was completed.
Results: Based on our study, 27.9% of infants had identified as causes of jaundice. Known causes of jaundice were blood group incompatibility (40%), infection (19%), G6PD enzyme deficiency (12%), endocrine disorders (8%), neonatal hypernatremic dehydration (7%), polycythemia (6%), congenital heart disease (CHD) (4%), occult bleeding (3%) and Crigler-Najjar syndrome (2%). The most common time of hospital admission of jaundice was 4-6 days after birth due to blood incompatibilities, occult bleeding, endocrine disorders, hypernatremic dehydration, CHD, polycythemia and G6PD enzyme deficiency. Moreover, the most common time of admission due to infection was after the first week of birth.
Conclusion: The most common age of onset of jaundice was first three days of birth for blood incompatibility, although they were admitted two days later. Therefore, neonatal admission at appropriate time at onset of jaundice and receiving prompt treatments can reduce the probable complications (e.g., kernicterus).
Hassan Boskabadi, Maryam Zakerihamidi, Fatemeh Bagheri,
Volume 75, Issue 2 (May 2017)
Volume 75, Issue 2 (May 2017)
Abstract
|
Background: Hyperbilirubinemia is the most common cause for readmission in the early neonatal period 5 to 36 percent of healthy term infants who are discharged from hospital are again hospitalized due to severe to moderate hyperbilirubinemia. Detection of major and minor risk factors associated with neonatal jaundice helps to identify high-risk infants and prevent neonatal jaundice. This study was performed aiming to evaluate the major and minor risk factors associated with jaundice in infants hospitalized. Methods: This cross-sectional study was performed on 2207 term infants (<15 days) with hyperbilirubinemia (>15 mg/dl) in neonatal clinic or emergency unit or neonatal intensive unit, of Mashhad Ghaem Hospital, Iran, from April 2010 to May 2016. The jaundice of infants was confirmed by the pediatrician and laboratory tests. Then the researcher-made questionnaire containing maternal information and neonatal characteristics was completed. Values were expressed as mean±SD. Student t-test and Mann-Whitney test were used as appropriate. P-value less than 0.05 was considered significant. Results: Sixty one percent of neonates had major risk factors and 80% of neonates had minor risk factor for jaundice. For neonatal jaundice, the most common major risk factors were significant weight loss (27.5%), jaundice visible in the first 24 hours (16.3%), history of treatment with phototherapy and exchange transfusion in sibling (14.8%), Gestational age of 35 to 36 week (9.9%), ABO incompatibility (9.2%), RH incompatibility (3.3%) and G6PD deficiency (3.33%), and the most common minor risk factors were age over 25 years (51.4%), male (49.7%), history of hyperbilirubinemia in sibling (22.3%), diabetic mother's infants (1.5%). Conclusion: The major risk factors for neonatal hyperbilirubinemia were significant weight loss, jaundice visible in the first 24 hours, history of treatment with phototherapy and exchange transfusion in sibling, gestational age of 35 to 36 week, ABO incompatibility, RH incompatibility and G6PD deficiency. |
Hassan Boskabadi , Maryam Zakerihamidi , Abbas Boskabadi ,
Volume 75, Issue 4 (July 2017)
Volume 75, Issue 4 (July 2017)
Abstract
Background: Jaundice is the common cause of hospitalization of infants in the first month after birth. Therefore, detection of risk factors associated with jaundice can effect on its process and complications. This study aimed to determine the prevalence and characteristics of diabetic mother's infants and comparing with infants with unknown jaundice.
Methods: In this cross-sectional study, among 2,800 infants with jaundice in Ghaem hospital in Mashhad during the 2007 to 2014, features of 59 infants of diabetic mother's (case group) and 78 infants with unknown jaundice (control group) were analyzed. After confirming of jaundice (Bilirubin ≥ 17 mg/dl) in newborns based on examination of pediatrician and laboratory results, a researcher made questionnaire containing maternal demographic data, (maternal age, parity, maternal problems during pregnancy, route of delivery). Also neonatal characteristics including age, sex, birth weight, current weight, duration of hospitalization, current age, age of recovery and laboratory data (Bilirubin, direct bilirubin, hematocrit, platelet, sodium, potassium, blood urea nitrogen, Cr, TSH, T4) were assessed. After data collection and recording information in SPSS software, version 19.5 (IBM SPSS, Armonk, NY, USA), by using tables, charts and statistical indices, the study was evaluated. Data were analyzed using statistical tests such as Mann-Whitney, Chi-square tests after normality control. Comparison of the two groups in normal distribution with t-test and for non-standard data with Mann-Whitney test. Also for definitive variables Chi-square test was used. P-value less than 0.50 was the significant level minimum.
Methods: In this cross-sectional study, among 2,800 infants with jaundice in Ghaem hospital in Mashhad during the 2007 to 2014, features of 59 infants of diabetic mother's (case group) and 78 infants with unknown jaundice (control group) were analyzed. After confirming of jaundice (Bilirubin ≥ 17 mg/dl) in newborns based on examination of pediatrician and laboratory results, a researcher made questionnaire containing maternal demographic data, (maternal age, parity, maternal problems during pregnancy, route of delivery). Also neonatal characteristics including age, sex, birth weight, current weight, duration of hospitalization, current age, age of recovery and laboratory data (Bilirubin, direct bilirubin, hematocrit, platelet, sodium, potassium, blood urea nitrogen, Cr, TSH, T4) were assessed. After data collection and recording information in SPSS software, version 19.5 (IBM SPSS, Armonk, NY, USA), by using tables, charts and statistical indices, the study was evaluated. Data were analyzed using statistical tests such as Mann-Whitney, Chi-square tests after normality control. Comparison of the two groups in normal distribution with t-test and for non-standard data with Mann-Whitney test. Also for definitive variables Chi-square test was used. P-value less than 0.50 was the significant level minimum.
| Results: In this study, the prevalence of jaundice due to maternal diabetes was 2.10 percent. Birth weight (P=0.02), current age (P=0.003), parity (P=0.000), maternal age (P=0.000), age of recovery (P=0.04), cesarean section (P=0.001), prematurity (P=0.000), maternal problems during pregnancy (P=0.000), abnormal physical examinations (P=0.001) in diabetic mother's infants and Bilirubin (P=0.000), length of hospitalization (P=0.003), in infants with unknown jaundice were higher. Conclusion: The infant of diabetic mother are at increased risk of maternal and neonatal complications. Neonatal complications consist of high birth weight, preterm labor, more jaundice and late recovery, abnormal physical examinations. Also, maternal complications during pregnancy and cesarean section were high. |
Hassan Boskabadi , Maryam Zakerihamidi ,
Volume 75, Issue 10 (January 2018)
Volume 75, Issue 10 (January 2018)
Abstract
Background: The length of maternal hospitalization in uncomplicated delivery has declined and it has become common event around the world. With the expansion of early maternal discharge from hospital in recent years, the identification, follow-up and proper treatment of neonatal problems such as jaundice have been confronted with challenges. Hyperbilirubinemia is the most common disease among neonates especially preterm neonates during the first week of life. This study was performed aiming to investigate maternal hospitalization duration after delivery and its effect on neonatal jaundice level.
Methods: In this descriptive-analytical study, 1347 newborns with the jaundice hospitalized in neonatal clinic or emergency unit or neonatal intensive units of Ghaem Hospital, Mashhad, during May 2011 to November 2017 were investigated. The data collection tool was a researcher-made questionnaire containing three parts. First part was maternal demographic information (age, long hospitalization, and mode of delivery), Second part was neonatal information (serum bilirubin, hematocrit and platelet) and third part was laboratory information (serum bilirubin, hematocrit, and platelet). The relationship between the severity of jaundice in hospitalized infants and maternal hospitalization duration were evaluated. Values were expressed as mean±SD. Student t-test, chi-square and Pearson coefficient tests were used as appropriate. P-value less than 0.05 was considered significant.
Results: 752 (fifty six percent) of mothers are discharged from the hospital at the end of first day. The mean maternal hospitalization duration was 1.31±0.57 days in normal delivery and 1.73±0.65 days in cesarean delivery (P=0.000). Pearson correlation test showed that increasing the duration of maternal hospitalization, some issues were observed including as decreasing serum bilirubin level (P=0.000) in newborns, increasing the admission age in hospital (P=0.045), decreasing daily weight loss rate (P=0.012) and decreasing the percentage of daily weight loss (P=0.002).
Conclusion: By increasing the hospitalization duration of the mother in hospital, serum bilirubin level, rate and percentage of daily weight loss in the newborns would be decreased.
Methods: In this descriptive-analytical study, 1347 newborns with the jaundice hospitalized in neonatal clinic or emergency unit or neonatal intensive units of Ghaem Hospital, Mashhad, during May 2011 to November 2017 were investigated. The data collection tool was a researcher-made questionnaire containing three parts. First part was maternal demographic information (age, long hospitalization, and mode of delivery), Second part was neonatal information (serum bilirubin, hematocrit and platelet) and third part was laboratory information (serum bilirubin, hematocrit, and platelet). The relationship between the severity of jaundice in hospitalized infants and maternal hospitalization duration were evaluated. Values were expressed as mean±SD. Student t-test, chi-square and Pearson coefficient tests were used as appropriate. P-value less than 0.05 was considered significant.
Results: 752 (fifty six percent) of mothers are discharged from the hospital at the end of first day. The mean maternal hospitalization duration was 1.31±0.57 days in normal delivery and 1.73±0.65 days in cesarean delivery (P=0.000). Pearson correlation test showed that increasing the duration of maternal hospitalization, some issues were observed including as decreasing serum bilirubin level (P=0.000) in newborns, increasing the admission age in hospital (P=0.045), decreasing daily weight loss rate (P=0.012) and decreasing the percentage of daily weight loss (P=0.002).
Conclusion: By increasing the hospitalization duration of the mother in hospital, serum bilirubin level, rate and percentage of daily weight loss in the newborns would be decreased.
Leila Pourali , Atiyeh Vatanchi, Sedigheh Ayati , Anahita Hamidi , Akram Zarei Abolkheir ,
Volume 76, Issue 1 (April 2018)
Volume 76, Issue 1 (April 2018)
Abstract
Background: Complete molar twin pregnancy with coexisting fetus is a rare and important diagnosis in obstetrics. Preeclampsia, preterm labor and life-threatening vaginal bleeding are the serious complications of this type of pregnancy. Gestational trophoblastic neoplasia should be ruled out after termination of pregnancy. In this study we reviewed a molar twin pregnancy with a live coexisting triple x fetus which has not been reported till now.
Case Presentation: Our case was a 22-year-old primigravida woman and 17-18th week of pregnancy, who referred to an University Hospital in Mashhad, Iran with complaint of vaginal bleeding On October 2016. Her first trimester ultrasonography in 13th week of gestational age, reported a live single fetus with an anterior great placenta and cystic formation regarding molar pregnancy. According to above-report, Amniocentesis was done in 15th weeks of pregnancy and its result was triple X. After severe and life-threatening vaginal bleeding, she underwent an emergent hysterotomy. A fetus with no obvious anomaly and a great hydropic and vesicular placenta delivered. Episodic crisis of her blood pressure was best controlled with anti-hypertensive drugs. In our case, chemotherapy with methotrexate was started after poor decline of βHCG titration and definite diagnosis of gestational trophoblastic neoplasia. Remission was completely achieved after four courses of chemotherapy.
Conclusion: Differentiation between complete molar pregnancy with live fetus and partial mole is always challenging in obstetrics. Serious complications as preeclampsia and severe vaginal bleeding may become life-threatening. Coexisting molar pregnancy should be ruled out in a pregnancy associated with frequent and unexpectant vaginal bleeding. Amniocentesis and an expert radiologist can help to differentiate them. Following these patients is very important to reveal any trophoblastic neoplasia.
Case Presentation: Our case was a 22-year-old primigravida woman and 17-18th week of pregnancy, who referred to an University Hospital in Mashhad, Iran with complaint of vaginal bleeding On October 2016. Her first trimester ultrasonography in 13th week of gestational age, reported a live single fetus with an anterior great placenta and cystic formation regarding molar pregnancy. According to above-report, Amniocentesis was done in 15th weeks of pregnancy and its result was triple X. After severe and life-threatening vaginal bleeding, she underwent an emergent hysterotomy. A fetus with no obvious anomaly and a great hydropic and vesicular placenta delivered. Episodic crisis of her blood pressure was best controlled with anti-hypertensive drugs. In our case, chemotherapy with methotrexate was started after poor decline of βHCG titration and definite diagnosis of gestational trophoblastic neoplasia. Remission was completely achieved after four courses of chemotherapy.
Conclusion: Differentiation between complete molar pregnancy with live fetus and partial mole is always challenging in obstetrics. Serious complications as preeclampsia and severe vaginal bleeding may become life-threatening. Coexisting molar pregnancy should be ruled out in a pregnancy associated with frequent and unexpectant vaginal bleeding. Amniocentesis and an expert radiologist can help to differentiate them. Following these patients is very important to reveal any trophoblastic neoplasia.
Seyede Houra Mousavi Vahed , Maliheh Afiat, Fahimeh Alizadeh, Anahita Hamidi Laien , Zeynab Khademi, Azin Nikoozadeh,
Volume 77, Issue 2 (May 2019)
Volume 77, Issue 2 (May 2019)
Abstract
Background: Ovarian fibroma is the most common benign solid tumor of the ovary. The most common symptoms are abdominal discomfort and pain. Ovarian fibroids are associated with Meigs syndrome in 1% to 10% of cases. The aim of study is report of a case of Meigs syndrome
Case presentation: A 65-year-old menopausal woman who complained of abdominal pain was referred to our academic hospital of Mashhad, Iran, in April 2018. In abdominal examination, a soft mass with size of 200×100 mm, was detected. Also leukocytosis and increase in CRP was observed. Marker CA125 was higher than 200. In CT scan in right adnexa heterogeneous mass 170×100 mm with enhancement was reveled. pleural effusion was reported in the both lungs and collapse of underlying lung tissue in Chest X-ray. Explorative laparotomy was performed. Ascites and inflamed omentum covered the surface of right ovary was detected. The huge solid-cystic hemorrhagic, irregular mass with a specific pedicle that enclosed in the capsule in right adnexa was seen. Right salpingo-oophorectomy was performed. The result of final pathologic was benign proliferative lesions of mitotic fibroblasts were reported according to ovarian fibroma.
Conclusion: In case of accompanying ovarian mass with ascites and pleural effusion, after the exclude of ovarian malignancies, Meigs syndrome should be considered in differential diagnosis.
Case presentation: A 65-year-old menopausal woman who complained of abdominal pain was referred to our academic hospital of Mashhad, Iran, in April 2018. In abdominal examination, a soft mass with size of 200×100 mm, was detected. Also leukocytosis and increase in CRP was observed. Marker CA125 was higher than 200. In CT scan in right adnexa heterogeneous mass 170×100 mm with enhancement was reveled. pleural effusion was reported in the both lungs and collapse of underlying lung tissue in Chest X-ray. Explorative laparotomy was performed. Ascites and inflamed omentum covered the surface of right ovary was detected. The huge solid-cystic hemorrhagic, irregular mass with a specific pedicle that enclosed in the capsule in right adnexa was seen. Right salpingo-oophorectomy was performed. The result of final pathologic was benign proliferative lesions of mitotic fibroblasts were reported according to ovarian fibroma.
Conclusion: In case of accompanying ovarian mass with ascites and pleural effusion, after the exclude of ovarian malignancies, Meigs syndrome should be considered in differential diagnosis.
Shahrbanoo Keihanian , Nafiseh Koochaki , Majid Pouya , Maryam Zakerihamidi ,
Volume 77, Issue 8 (November 2019)
Volume 77, Issue 8 (November 2019)
Abstract
Background: Breast cancer is the most commonly diagnosed and the leading cause of cancer death among females worldwide. The rate of breast cancer incidence among Iranian women is 17% of all cancers, it has been ranked first in Iran. This study aimed to investigate the factors affecting axillary lymph node involvement in female patients with breast cancer.
Methods: A cross-sectional study was conducted on 167 patients with breast cancer diagnosed between March 2012 and March 2015 at Shahid Beheshti of Babol, Shahid Rajaei of Tonekabon and Imam Sajad of Ramsar hospitals. A researcher-made questionnaire was used to collect information on the patients and pathology report of tumor and lymph nodes was completed.
Results: The rate of axillary lymph node involvement was observed in 117 patients (70.1%). Mean age was 49.64±11.62 years in the patients with breast cancer. The highest frequency of lymph node involvement was observed in the 40-49 age group (24%). The average size of tumor was 3.39 cm and the majority of patients had a tumor 2-5 cm (T2) but the most involvement was related to T3 (>5cm). The most common type of cancer and grading were invasive ductal carcinoma (93.4%) and tumor grade 2 (52.1%), respectively. Most lymph node involvement was observed in invasive ductal carcinoma and 85.1% of patients had tumor degree 3. 22.2% of patients with vessels involvement had axillary lymph node involvement. 63% of patients’ tumors had receptors of estrogen and progesterone. A statistically significant association was observed between axillary lymph node involvement and tumor size (P=0.031), tumor type (P=0.007), tumor grade (P=0.011), estrogen receptor (P=0.008) and progesterone receptor (P=0.038).
Conclusion: There was a statistically significant association between axillary lymph node involvement and tumor size, type and grade, estrogen and progesterone receptor status, but there was no statistically significant association between axillary lymph node involvement and age and estrogen as well as progesterone receptor status.
Methods: A cross-sectional study was conducted on 167 patients with breast cancer diagnosed between March 2012 and March 2015 at Shahid Beheshti of Babol, Shahid Rajaei of Tonekabon and Imam Sajad of Ramsar hospitals. A researcher-made questionnaire was used to collect information on the patients and pathology report of tumor and lymph nodes was completed.
Results: The rate of axillary lymph node involvement was observed in 117 patients (70.1%). Mean age was 49.64±11.62 years in the patients with breast cancer. The highest frequency of lymph node involvement was observed in the 40-49 age group (24%). The average size of tumor was 3.39 cm and the majority of patients had a tumor 2-5 cm (T2) but the most involvement was related to T3 (>5cm). The most common type of cancer and grading were invasive ductal carcinoma (93.4%) and tumor grade 2 (52.1%), respectively. Most lymph node involvement was observed in invasive ductal carcinoma and 85.1% of patients had tumor degree 3. 22.2% of patients with vessels involvement had axillary lymph node involvement. 63% of patients’ tumors had receptors of estrogen and progesterone. A statistically significant association was observed between axillary lymph node involvement and tumor size (P=0.031), tumor type (P=0.007), tumor grade (P=0.011), estrogen receptor (P=0.008) and progesterone receptor (P=0.038).
Conclusion: There was a statistically significant association between axillary lymph node involvement and tumor size, type and grade, estrogen and progesterone receptor status, but there was no statistically significant association between axillary lymph node involvement and age and estrogen as well as progesterone receptor status.
Hassan Boskabadi, Fatemeh Bagheri , Maryam Zakerihamidi ,
Volume 77, Issue 10 (January 2020)
Volume 77, Issue 10 (January 2020)
Abstract
Background: dehydration fever is a common problem during the first week of life. This study aimed to compare the characteristics of neonates with fever due to dehydration and healthy infants.
Methods: This cross-sectional study was performed on 324 neonates including 120 neonates with normal body temperature and 204 neonates with fever due to dehydration (hyperthermia) referred to Ghaem Hospital in Mashhad, Iran from 2017 to 2019, using a convenience sampling method and a researcher-made questionnaire. Infants presenting with elevated body temperature and having an axillary temperature above or equal to the rectal temperature and with no clinical or laboratory evidence of infection were considered as fever due to dehydration (case group). Infants who were referred for a routine examination or had jaundice but did not require treatment were considered as controls. Infant characteristic (neonatal age, sex, Apgar score, defecation frequency, the first defecation, breastfeeding frequency, urinary frequency, duration of feeding, birth weight, daily weight loss, daily weight loss percentage, lethargy, irritability, mucosal dryness, status fontanelles, hyperthermia, convulsion, apnea, decreased consciousness and infant hospitalization) and maternal information (age, weight, parity, hospital stay, breast problems, mode of delivery, breastfeeding position, delayed breastfeeding, and pregnancy problems. The data were analyzed using Student’s t-test, Chi-square and SPSS software, version 20 (IBM SPSS, Armonk, NY, USA).
Results: In dehydration fever of newborn, admission weight, frequency and duration of feeding, defecation frequency, maternal age were low, but time to first feeding were high (P<0.05). In fever of dehydration: restlessness, mucosal dryness, fontanel status, seizure, apnea, decreased consciousness, breastfeeding with traditional remedies, inappropriate breastfeeding position, lack of let-down reflex, delayed onset of lactation, breast problems and jaundice were more frequent.
Conclusion: Infants with fever of dehydration were more likely to weight loss, delayed in first feeding, shorter feeding times and lower duration of feeding, higher sodium, urea, creatinine, and blood glucose levels. According to the results of this study, breast problems, inappropriate breastfeeding position, absence of reflux, delayed lactation, less frequent breastfeeding, consumption of breast milk with dextrose, manna, and clay tap were risk factors for dehydration fever.
Methods: This cross-sectional study was performed on 324 neonates including 120 neonates with normal body temperature and 204 neonates with fever due to dehydration (hyperthermia) referred to Ghaem Hospital in Mashhad, Iran from 2017 to 2019, using a convenience sampling method and a researcher-made questionnaire. Infants presenting with elevated body temperature and having an axillary temperature above or equal to the rectal temperature and with no clinical or laboratory evidence of infection were considered as fever due to dehydration (case group). Infants who were referred for a routine examination or had jaundice but did not require treatment were considered as controls. Infant characteristic (neonatal age, sex, Apgar score, defecation frequency, the first defecation, breastfeeding frequency, urinary frequency, duration of feeding, birth weight, daily weight loss, daily weight loss percentage, lethargy, irritability, mucosal dryness, status fontanelles, hyperthermia, convulsion, apnea, decreased consciousness and infant hospitalization) and maternal information (age, weight, parity, hospital stay, breast problems, mode of delivery, breastfeeding position, delayed breastfeeding, and pregnancy problems. The data were analyzed using Student’s t-test, Chi-square and SPSS software, version 20 (IBM SPSS, Armonk, NY, USA).
Results: In dehydration fever of newborn, admission weight, frequency and duration of feeding, defecation frequency, maternal age were low, but time to first feeding were high (P<0.05). In fever of dehydration: restlessness, mucosal dryness, fontanel status, seizure, apnea, decreased consciousness, breastfeeding with traditional remedies, inappropriate breastfeeding position, lack of let-down reflex, delayed onset of lactation, breast problems and jaundice were more frequent.
Conclusion: Infants with fever of dehydration were more likely to weight loss, delayed in first feeding, shorter feeding times and lower duration of feeding, higher sodium, urea, creatinine, and blood glucose levels. According to the results of this study, breast problems, inappropriate breastfeeding position, absence of reflux, delayed lactation, less frequent breastfeeding, consumption of breast milk with dextrose, manna, and clay tap were risk factors for dehydration fever.
Nafiseh Saghafi , Leila Pourali , Elham Hamidi ,
Volume 78, Issue 3 (June 2020)
Volume 78, Issue 3 (June 2020)
Abstract
Background: Nonpuerperal uterine inversion is a rare medical condition that many gynecologists might not be encountered even with one case during their entire medical practice. It refers to the expulsion of uterine corpus from the dilated cervix resulting in uterus being turned inside out. There are two kinds of uterine inversion, puerperal and non-puerperal, which the second condition is less common. Acute uterine inversion usually presented by crampy abdominal or pelvic pain, vaginal bleeding, anemia, and even symptoms of severe sepsis. We describe a case of uterine inversion in a postmenopausal woman.
Case Presentation: A 66 years old grand multiparous woman (6 normal vaginal delivery) who was menopause since 15 years ago, was referred to the emergency unit of an academic hospital of Mashhad University of Medical Sciences at October 2016 due to postmenopausal uterine bleeding, cramp-like abdominal pain and mass protrusion from the vagina. The vital sign was stable at the first visit but a big non-necrotizing red vaginal mass was protruded from vaginal opening that connected to other soft intravaginal mass. Abdominal ultrasonography revealed the dilated vaginal cuff and some air-fluid levels in the uterine cavity. The patient referred to the operative room and vaginal myomectomy was done with diagnosis of pedunculated submocusal leiomyoma. Then, total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed after the correction of uterine inversion by abdominoperineal approach.
Conclusion: Acute uterine inversion is a potentially dangerous condition (due to vaginal bleeding, severe abdominal or pelvic pain, and the possibility of uterine necrosis and even systemic infection). This condition should be considered as an important differential diagnosis as a vaginal mass in the post-menopausal period.
Case Presentation: A 66 years old grand multiparous woman (6 normal vaginal delivery) who was menopause since 15 years ago, was referred to the emergency unit of an academic hospital of Mashhad University of Medical Sciences at October 2016 due to postmenopausal uterine bleeding, cramp-like abdominal pain and mass protrusion from the vagina. The vital sign was stable at the first visit but a big non-necrotizing red vaginal mass was protruded from vaginal opening that connected to other soft intravaginal mass. Abdominal ultrasonography revealed the dilated vaginal cuff and some air-fluid levels in the uterine cavity. The patient referred to the operative room and vaginal myomectomy was done with diagnosis of pedunculated submocusal leiomyoma. Then, total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed after the correction of uterine inversion by abdominoperineal approach.
Conclusion: Acute uterine inversion is a potentially dangerous condition (due to vaginal bleeding, severe abdominal or pelvic pain, and the possibility of uterine necrosis and even systemic infection). This condition should be considered as an important differential diagnosis as a vaginal mass in the post-menopausal period.
Emad Behboudi, Vahideh Hamidi-Sofiani,
Volume 78, Issue 3 (June 2020)
Volume 78, Issue 3 (June 2020)
Abstract
[Full text in Persian]
Emad Behboudi, Vahideh Hamidi-Sofiani,
Volume 78, Issue 8 (November 2020)
Volume 78, Issue 8 (November 2020)
Abstract
No
Behnam Askari, Mojgan Hajahmadi-Poor Rafsanjani , Parin Hamidi-Azar ,
Volume 79, Issue 3 (june 2021)
Volume 79, Issue 3 (june 2021)
Abstract
Background: Several scoring systems are available to evaluate the cardiac surgery risk. Frailty increases the risk of adverse outcomes after surgery. The Frailty evaluation system is a relatively new method, and in this study, we compared the frailty scoring method with the conventional Euroscore method.
Methods: This cross-sectional study was performed on 88 elderly patients (over 65 years of age) undergoing coronary artery bypass graft surgery in Seyed al Shohada Heart Center, Urmia, Iran, from October 2019 to March 2020. Patients undergoing other cardiac surgeries, patients with left main coronary artery involvement, patients with low-threshold chest pain, and life-threatening emergencies were excluded. At the preoperative period and based on the CAF (the Comprehensive Assessment of Frailty) Scoring System and the EuroScore system, the total score was calculated for each patient. Patients were followed up until one month after surgery in terms of morbidity and mortality. Patients' data were analyzed and the correlation between the total score of both systems and the postoperative consequences were statistically analyzed.
| Results: In this study, the mean age of patients was 70.84±5.07 (65-91) years and most of the patients were male, 65(73 9%).The mean ejection fraction of patients was 44.13±5%. Twelve patients (13.6%) had mild frailty (CAF score of 1 to 8), 74 patients (84.1%) had moderate frailty (CAF score of 9 to 18) and 2 patients (2.3%) had severe frailty (CAF score of 19 to 28). In the postoperative period, there were two cases of mortality (2.3%) and four cases of complications (4.55%). The mean serum creatinine level in dead patients was significantly higher than in discharged patients. We did not find any significant relationship between frailty CAF score and EuroSocre with postoperative complications. In a comparison of two methods for predicting surgery outcomes: the mean EuroScore in the two dead patients was significantly higher than discharged patients (8.11 vs 2.89 with p value=0.001). Conclusion: EuroSocre evaluation was a better predictor of postoperative mortality and its measurement is easy. |
Mina Mir Nezami , Hamid Hamidi , Saeed Karimi Motaleb ,
Volume 80, Issue 4 (July 2022)
Volume 80, Issue 4 (July 2022)
Abstract
Background: Vitiligo is a skin autoimmune disease that affects 0.1% to more than 8% of people in the world. About 50% of patients develop the disease before the age of 20. In this disease, melanocytes are destroyed in the skin, mucous membranes and retina. As a result, white spots appear on different parts of the body. Studies have suggested the role of oxidative stress in vitiligo. Coenzyme Q10 is a specific lipophilic antioxidant. The aim of this study was to evaluate the therapeutic effect of coenzyme Q10 in patients with generalized vitiligo.
Methods: This study was a randomized, double-blind, clinical trial of patients with generalized vitiligo who had been referred to the dermatology clinics of Vali-e-Asr Hospital and Imam Reza Clinic in May-August 2016. The sampling method was random. Patients were treated with standard treatment, and the case groups in addition to standard treatment with tablets containing coenzyme Q10. Patients were evaluated for response at the first visit, 1 and 3 months after the start of treatment.
Methods: This study was a randomized, double-blind, clinical trial of patients with generalized vitiligo who had been referred to the dermatology clinics of Vali-e-Asr Hospital and Imam Reza Clinic in May-August 2016. The sampling method was random. Patients were treated with standard treatment, and the case groups in addition to standard treatment with tablets containing coenzyme Q10. Patients were evaluated for response at the first visit, 1 and 3 months after the start of treatment.
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Results: The mean age of 50 patients was 26.2±4.3 years. The diameter of the largest depigmented patch decreased in both intervention (P=0.000) and control (P=0.001) groups during 3 months of treatment. The difference in the frequency of patients in the grade of repigmentation was significant at the end of the third month compared to the end of the first month of treatment in both intervention (P=0.01) and control (P=0.02) groups. At the end of the third month, the frequency of patients in both intervention group with 21 patients (76%) and the control group with 18 patients (72%) were more in grades 1 and 2, while at the end of the first month, the frequency of patients in both intervention groups with 23 patients (92%) and control with 23 patients (92%) was more in grades 0 and 1.
Conclusion: Adjuvant therapy with oral coenzyme Q10 has no effect on improving depigment patch in vitiligo. |
Hassan Boskabadi , Mahdie Mir, Maryam Zakerihamidi,
Volume 80, Issue 6 (September 2022)
Volume 80, Issue 6 (September 2022)
Abstract
Background: The gender of the baby is one of the risk factors for neonatal jaundice, but the difference in the severity of jaundice and its prognosis between the two sexes is not clear. Therefore, in this study, we investigated the severity, duration and prognosis of jaundice in both sexes.
Methods: The present study is a cross-sectional study that was performed on 2847 icteric neonates over 35 weeks admitted to Ghaem Hospital in Mashhad from May 2014 to May 2021. This study is done by available sampling. After confirmation of jaundice in infants, data were recorded using a researcher-made checklist including maternal demographic information (maternal age, mode of delivery), complete infant characteristics (age, birth weight, age at onset of jaundice, jaundice recovery age) and laboratory findings (Bilirubin, Indirect Coombs, direct Coombs, G6PD), and neonatal development up to two years of age was performed based on the Denver 2 test. Then data analysis was performed by SPSS software using Chi-square test and Student’s t-test.
Methods: The present study is a cross-sectional study that was performed on 2847 icteric neonates over 35 weeks admitted to Ghaem Hospital in Mashhad from May 2014 to May 2021. This study is done by available sampling. After confirmation of jaundice in infants, data were recorded using a researcher-made checklist including maternal demographic information (maternal age, mode of delivery), complete infant characteristics (age, birth weight, age at onset of jaundice, jaundice recovery age) and laboratory findings (Bilirubin, Indirect Coombs, direct Coombs, G6PD), and neonatal development up to two years of age was performed based on the Denver 2 test. Then data analysis was performed by SPSS software using Chi-square test and Student’s t-test.
|
Results: 1642 infants (57.7%) were boys and 1205 infants (42.3%) were girls. Mean and standard deviation of bilirubin in values less than 20 mg/dl in boys was 17.20±2.48 mg/dl and in girls was 16.54±2.80 mg/dl (P=0.000), birth weight was 3.16±0.49 (kg) for boys and 3.07±0.45 for girls (P=0.000). In two groups of male and female infants, age (P=0.004), direct bilirubin (P=0.001), direct and indirect Coombs (P=0.000), and G6PD enzyme deficiency (P=0.000) had a significant difference. Acute kernicterus was reported in 25 (2.03%) boys and 4 (0.46%) girls (P<0.001). In the two-year follow-up, 23 boys (1.9%) and 11 girls (1.28%) had developmental delay (P<0.05).
Conclusion: The incidence of jaundice in male infants was higher than female infants, which is probably due to a higher prevalence of G6PD deficiency in boys. The severity of jaundice was higher in boys less than 20 mg/dl. Jaundice has a worse prognosis in male infants. |
Hassan Boskabadi, Maryam Zakerihamidi,
Volume 80, Issue 8 (November 2022)
Volume 80, Issue 8 (November 2022)
Abstract
Background: Neonatal sepsis is a severe systemic bacterial infection that affects on premature neonates prognosis. Therefore, the aim of this study was to evaluate the short-term prognosis of neonate's infection.
Methods: The present study is a cross-sectional study that was performed on 729 neonates suspected of infection, in neonatal ward in Ghaem Hospital of Mashhad since May 2015 to May 2022 by available sampling. The data collection tool was a researcher-made checklist containing neonatal characteristics (gestational age, birth weight, first and fifth minute Apgar score, and neonatal status at discharge) and laboratory information (White Blood Cell, Platelet (PLT), C-reactive Protein, Blood culture, Cerebrospinal fluid culture). Infants with congenital infection, congenital anomaly and positive blood cultures without clinical and laboratory symptoms were excluded from the study. Neonatal prognosis was compared in terms of death or discharge among neonates with and without definitive infection. First, we described the results using statistical tables and graphs, and then, data were analyzed by Kolmogorov-Smirnov, T test and SPSS software, version 26 (IBM SPSS, Armonk, NY, USA). P<0.05 considered as significant.
Methods: The present study is a cross-sectional study that was performed on 729 neonates suspected of infection, in neonatal ward in Ghaem Hospital of Mashhad since May 2015 to May 2022 by available sampling. The data collection tool was a researcher-made checklist containing neonatal characteristics (gestational age, birth weight, first and fifth minute Apgar score, and neonatal status at discharge) and laboratory information (White Blood Cell, Platelet (PLT), C-reactive Protein, Blood culture, Cerebrospinal fluid culture). Infants with congenital infection, congenital anomaly and positive blood cultures without clinical and laboratory symptoms were excluded from the study. Neonatal prognosis was compared in terms of death or discharge among neonates with and without definitive infection. First, we described the results using statistical tables and graphs, and then, data were analyzed by Kolmogorov-Smirnov, T test and SPSS software, version 26 (IBM SPSS, Armonk, NY, USA). P<0.05 considered as significant.
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Results: According to the results of this study, low birth weight and lower gestational age and lower Apgar score increase the risk of neonatal death. About one-fifth of infants died of definitive infection. The cases of death due to infection in the group of deceased infants were about 4 times higher than in the group of discharged infants. About one third of the babies with sepsis and half of the babies with meningitis died. Forty-four percent of infants with early sepsis and 40% of infants with late sepsis died. In cases of neonatal death due to sepsis, the most common gram-negative infectious agent was Acinetobacter and the most common gram-positive infectious agent was Enterococcus.
Conclusion: Neonatal definitive infection worsens their prognosis. So, the risk of neonatal death increases by 5 times. The probability of death in meningitis is more than sepsis and in early sepsis is more than late sepsis and in sepsis due to gram-negative is more than gram-positive. |
Hassan Boskabadi , Nafiseh Pourbadakhshan, Maryam Zakerihamidi,
Volume 80, Issue 10 (January 2023)
Volume 80, Issue 10 (January 2023)
Abstract
Background: Maternal diseases such as diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy in pregnancy are associated with fetal and neonatal complications. The aim of this study was to compare the prognosis of neonates in maternal diseases.
Methods: This study was a cross-sectional study. The present study was performed on 600 preterm infants with mothers with diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy. This study was done in Ghaem Hospital of Mashhad from March 2015 to April 2021 with available sampling. The data collection tool was a researcher-made checklist including infant (gestational age, Apgar score of the first minute, Apgar score of the fifth minute) and maternal (mode of delivery, prenatal care, premature rupture of the membranes) characteristics. Neonatal prognosis was compared at birth. All clinical and diagnostic examinations of newborns were performed by a neonatologist. Neonatal and maternal data in the group of newborns with normal mothers and newborns with maternal diseases were analyzed by Kolmogorov-Smirnov and Chi-square tests. The significance level was considered p≤0.05 in all cases.
Methods: This study was a cross-sectional study. The present study was performed on 600 preterm infants with mothers with diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy. This study was done in Ghaem Hospital of Mashhad from March 2015 to April 2021 with available sampling. The data collection tool was a researcher-made checklist including infant (gestational age, Apgar score of the first minute, Apgar score of the fifth minute) and maternal (mode of delivery, prenatal care, premature rupture of the membranes) characteristics. Neonatal prognosis was compared at birth. All clinical and diagnostic examinations of newborns were performed by a neonatologist. Neonatal and maternal data in the group of newborns with normal mothers and newborns with maternal diseases were analyzed by Kolmogorov-Smirnov and Chi-square tests. The significance level was considered p≤0.05 in all cases.
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Results: The results show that 161 newborns (28.90%) had normal mothers, 89 newborns (15.98%) had diabetic mothers, 117 newborns (21.01%) had hypertensive mothers, and 50 newborns (8.98%) had hypothyroid mothers. One hundred tweny newborns (21.72%) had mothers with preeclampsia, 19 newborns (3.41%) had mothers with epilepsy. Newborns with mothers with epilepsy had the lowest Apgar score of the first minute and the lowest gestational age and newborns with mothers with diabetes had the lowest Apgar score of the fifth minute. Mothers with hypothyroidism had the highest rate of premature rupture of the membranes and mothers with hypertension and preeclampsia had the highest incidence of cesarean section.
Conclusion: Maternal diseases including diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy affect the prognosis of neonates in terms of the severity of prematurity, premature rupture of the membranes, type of delivery, Apgar scores of the first and fifth minutes. Therefore, proper control and treatment of these diseases may improve neonatal prognosis. |
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