Search published articles


Showing 229 results for SAR
Evaluation and comparison of statistical models of hemodialysis adequacy in hemodialysis patients in two groups (fistula and permanent catheter) in Arak dialysis center
Kowsar Sadat Ashrafi, Nasser Saeedi, Parvin Soltani, Ali Sadough Abbasian , Mohammad Rafiei, Fereshteh Nejati, Mahdieh Gholamzadeh, Mojtaba Ahmadlou,
Volume 80, Issue 12 (March 2023)
Abstract
Background: Adequacy of dialysis is a very important issue in dialysis patients, so comparing the adequacy of dialysis in different dialysis methods is very important. Therefore, due to the fact that the number of people undergoing dialysis  through fistulas and catheters varies in different centers, and depending on different centers, there is a possibility of decreasing or increasing the adequacy of dialysis, so we decided to do this comparison in Arak support center.
Methods: In this analytical-cross-sectional study, the dialysis patients of Hami Arak Center from April 2019 to September 2019 were divided into two groups (the first group with permanent catheter, the second group with arteriovenous fistula) based on vascular access. The both groups were matched in terms of age, sex, weight, pump speed, filter size and also the duration of dialysis. All patients were dialyzed with the same type of dialysis machine, and the duration of hemodialysis for all samples was 4 hours in each session. To confirm the reliability of the device, it was calibrated before each use and the same setting was used for all samples. The blood samples were taken from the arterial route before dialysis and starting the dilution with heparin or normal saline. Statistical models of dialysis adequacy of patients in two groups were measured using the Kt/V criterion, SPSS and AMOS data analysis was performed.
Results: In the analysis of covariance of BUN before dialysis, there is a statistically significant difference in the studied groups (P<0.05), also in the UF and URR variables, dialysis time and the number of times of dialysis in three consecutive repetitions, there is a statistically significant difference in the studied groups. (dime fistula and catheter) are not present (P<0.05).
Conclusion: In this study, during repeated repetitions, 22% of the dialysis adequacy in the two groups did not have good adequacy, and 78% of the patients in the two groups had appropriate dialysis adequacy.

Evaluation of the relationship between the severity of depression, anxiety and stress with nuclear scan in Urmia
Sara Hassanzadeh, Mahmonir Haghighi, Hojjat Shafipour, Maryam Faramarzpour,
Volume 81, Issue 1 (April 2023)
Abstract
Background: Some negative psychological factors such as depression, anxiety, and stress have been identified as serious risk factors for the final adverse outcome of ischemic heart disease. Given the high prevalence of psychiatric disorders, in this study, we aimed to determine the relationship between the severity of depression, anxiety, and stress, with nuclear scan results in patients referred to Imam Khomeini Hospital in Urmia.
Methods: In this cross-sectional-analytical study, 163 patients with the possibility of ischemic heart disease from various clinics and medical centers referred to Imam Khomeini Hospital in Urmia for nuclear heart scanning from April to July 1400, were assessed by the DASS-21 questionnaire in terms of depression, anxiety, and stress scores. Finally, the data obtained from the DASS-21 questionnaire, nuclear scan, and demographic characteristics were analyzed with SPSS20 software.
Results: According to the results, the mean age of the patients was 54.78±11.54 years, 73% of whom were women. The prevalence of depression, anxiety, and stress was high (72.4, 80.3, and 59.5%, respectively). Although the prevalence of depression, anxiety, and stress in patients with a negative report of ischemia was higher and evaluated as 73.2, 78.7, and 58.3% respectively, there was not a significant difference with the subjects whose heart scan results were positive (P>0.05). Moreover, a weak positive correlation was observed between the severity of depression, anxiety, and stress with the severity of cardiac ischemia in study patients.
Conclusion: The results of this study revealed that the depressive, anxiety, and stress symptoms in patients before a cardiac nuclear scan are often moderate to mild. Likewise, among the different demographic characteristics of patients, only gender played an important role in these disorders. Regardless of the negative nuclear scan results in most patients (77.9%), the prevalence of these psychological symptoms in the studied patients was high. Therefore, considering the possibility of psychological disorders with clinical manifestations mimicking cardiovascular can prevent additional costs for diagnostic and therapeutic procedures in these patients.

Impacts of SARS-CoV-2 on renal function: a review article
Pegah Khales, Sara Minaeian, Ahmad Tavakoli,
Volume 81, Issue 2 (May 2023)
Abstract
COVID-19 is a major worldwide health concern that is linked to severe morbidity and mortality. In contrast to the majority of COVID-19 patients who experience moderate symptoms, about 5% of the patients experience serious manifestations such as acute respiratory distress syndrome, septic shock, and fatal organ failure. Although pneumonia is the main symptom of COVID-19, other organs, such as the kidneys, might also be affected by the condition. Acute kidney injury is one of the most frequent extrapulmonary symptoms of severe COVID-19. Indeed, it has been suggested that COVID-19 affects the kidney as the second most common organ after the lungs. This is due to the fact that the virus attaches to angiotensin-converting enzyme 2 (ACE2) receptors, which have significant expression in the kidney, before entering the host cells. It is important to follow up and monitor patients with COVID-19 for the occurrence of kidney damage, as timely treatment measures will lead to better clinical results and lower patient mortality. Even minor renal function impairment is a distinct risk factor for COVID-19 infection, hospitalization, and death. Furthermore, SARS-CoV-2 infections can raise mortality for those with underlying renal disorders as well as make it more difficult to treat and care for them. It can also produce new kidney damage. Kidney tubular damage is the predominant symptom of SARS-CoV-2 infection's impact on the kidney, with proteinuria as the primary clinical symptom. The pathogenesis of kidney and damage in COVID-19 patients is varied and complicated. In COVID-19 patients, the virus has the ability to infect renal tubular epithelium and podocytes directly, which is linked to Bowman's capsule protein leakage, acute tubular necrosis, mitochondrial dysfunction, and collapsing glomerulopathy. Other causes of acute kidney injury (AKI) in COVID-19 patients, including cytokine storm, lymphopenia, and macrophage activation syndrome, have been caused by SARS-CoV-2-induced immune response dysregulation. Interactions between organs, endothelial dysfunction, hypercoagulability, sepsis, and rhabdomyolysis are considered other major AKI mechanisms. In the present review, we focus on the role of each of these factors involved in AKI in COVID-19 patients.

Prevalence of congenital cytomegalovirus infection in newborns admitted to the intensive care units in Tehran, Iran
Samileh Noorbakhsh, Mohammad Farhadi , Sara Minaeian, Morteza Haghighi Hasanabad ,
Volume 81, Issue 3 (June 2023)
Abstract
Background: Cytomegalovirus (CMV) is the most common cause of congenital infections in newborns which can lead to long-term complications in more than half of the cases with symptomatic infection at birth time. Unfortunately, neonates with congenital CMV infection will mostly remain undiagnosed because the golden time for detection is limited to the first 3 weeks of infants' life. This study aimed to determine the prevalence of congenital CMV infection in newborns admitted to intensive care units of hospitals in Tehran, Iran and assess related risk factors associated with the infection.
Methods: In this cross-sectional study from April to October 2017, newborns within the first three weeks of life who were admitted to the neonatal intensive care units (NICUs) of university-affiliated hospitals in Tehran, Iran, were eligible for enrollment. CMV infection in neonates was diagnosed through testing infants' Guthrie cards and detection of viral DNA via an in-house nested-PCR assay. Congenital CMV infection in neonates with positive results was confirmed by testing urine specimens as a sensitive and gold standard sample. Related data (demographic and maternal factors) were collected by questionnaires and analyzed.
Results: Congenital cytomegalovirus infection was diagnosed in 8 of 63 newborns (12.7%). Hearing loss was seen in 2 infected infants. The mean of head circumferences among infected neonates was significantly lower than that observed in uninfected cases. Infants with CMV related symptoms had statistically more chance to have infection (P=0.02). We also found Guthrie cards as a reliable sample with high sensitivity for CMV detection assays.
Conclusion: The current study showed a high rate of symptomatic congenital CMV infection among neonates attending on NICU sections of hospitals in Tehran, Iran. It is of crucial importance to note that based on evidence, diagnosis of infants with congenital CMV infection at early stages could help to decrease the burden of long-term diseases if associated with prompt interventions and reduce the costs of late-ineffective treatment. Therefore, routine screening of newborns for congenital CMV infection via Guthrie cards is suggested.

Effects of deep brain stimulation in a patient with chronic refractory pain: a case report
Sara Ranji, Mojtaba Shahbazi , Mahdi Shafiee Sabet , Abbas Tafakhori,
Volume 81, Issue 4 (July 2023)
Abstract
Background: Stroke is one of the most important causes of chronic pain. In patients with chronic pain medical therapy with analgesic drugs, anti-epileptic drugs, and serotonin receptor modulators is the first choice. However, for patients who are refractory to the usual medical treatments, different strategies have been proposed to treat these pains. One of these treatments involves the implantation of deep brain electrodes and deep brain stimulation in the thalamus nucleouses. In this article we are reviewing the first case done in Iran.
Case Presentation: A 51-year-old male presented with sudden-onset left side hemiparesis and impaired sensation on the left side of the body, eight years ago. He complained of gradually developing pain on the left side of the body, adding to his symptoms. In his examination, he had dysarthria and his left extremities were spastic and their forces were decreased. Despite numerous medical treatments with gabapentin, pregabalin, duloxetine, carbamazepine and the replacement of an intrathecal baclofen pump during the last few years, he didn't respond very well. This goes so far as to induce severe depression symptoms, which disturbed his daily routine and even induced suicidal ideas. Due to the debilitating symptoms which were resistant to medical treatment, the patient underwent deep brain electrode implantation and deep brain stimulation in the ventral posterior lateral/posterior medial nucleuses in April 2023 at Imam Khomeini Hospital. No remarkable adverse effects were observed after implantation. In the patient’s follow-up, he had a significant improvement in pain and some other symptoms.
Conclusion: Deep brain stimulation of the thalamus nucleus is a known treatment in patients with Parkinson's disease and dystonia. However, for patients with chronic refractory pain, deep brain stimulation is a controversial therapy and has been introduced recently as an effective alternative treatment. In our patient, who suffers from severe unilateral refractory pain after stroke, a deep brain electrode was implanted and after deep brain stimulation significant improvement in pain was seen.

Cost-effectiveness analysis of colonoscopy compared to sigmoidoscopy for colorectal cancer screening in high-risk individuals in Iran
Ahmad Tahmasebi-Ghorrabi , Zahra Heydarifard, Behrouz Nemati, Majid Davari, Alireza Delavari, Hamideh Salimzadeh , Ali Akbari Sari ,
Volume 81, Issue 9 (December 2023)
Abstract
Background: Screening is a cost-effective method for prevention, early detection of the disease and reducing the burden of the third deadliest cancer in the world, i.e. colorectal cancer. This study aimed to analyze the cost-effectiveness of colonoscopy screening compared to sigmoidoscopy for colorectal cancer in high-risk individuals in Iran.
Methods: This economic evaluation study was conducted using the cost-effectiveness method between July 2016 and February 2017. Evaluation of the effectiveness of screening methods was done using a systematic review. Cost evaluation was also done using the costs obtained from the tariff approved by the Iranian Ministry of Health in 2015 for colonoscopy and sigmoidoscopy. Finally, the combined model of decision tree and Markov was used to evaluate the cost effectiveness. Incremental Cost Effectiveness Ratio (ICER) formula was used for cost effectiveness analysis considering the final outcome of 5-year survival of high-risk individuals. Excel and TreeAge software were used for data analysis.
Results: The effectiveness of sigmoidoscopy and colonoscopy in increasing 5-year survival is 11 and 15.7%, respectively, and colonoscopy screening is 4.7% more than sigmoidoscopy. The cost of colonoscopy and sigmoidoscopy screening was calculated as 1000 and 19920 billion Rials, respectively. Based on cost-effectiveness analysis, the cost of treating patients in the case of screening with colonoscopy and sigmoidoscopy is lower than without screening. The ICER ratio of colonoscopy and sigmoidoscopy compared to no screening was -4/441/389/160 and -4/757/954/940 Rials respectively, and colonoscopy compared to sigmoidoscopy was -3/699/785/880 Rials, respectively. Finally, the use of colonoscopy leads to spending 3/699/785/880 Rials less in exchange for obtaining 4722 additional survivals with the prevention of colorectal cancer compared to sigmoidoscopy.
Conclusion: Screening by colonoscopy and sigmoidoscopy methods are effective in reducing the incidence and death of colorectal cancer compared to no screening. Screening by colonoscopy is a dominant option for the high-risk population in Iran. Colonoscopy screening is more cost effective compared to sigmoidoscopy. However, decisions about colorectal cancer screening and screening methods depend on local resources and personal preferences.

Investigating the association between K589E polymorphism of EXO1 gene with the susceptibility lung malignancy as a prognostic marker in the Iranian population
Jamshid Ansari, Milad Pezeshki, Azam Ahmadi, Ali Chehrei,
Volume 81, Issue 9 (December 2023)
Abstract
Background: Lung cancer has the highest incidence and mortality rate of all cancers worldwide. In Iran, it is one of the commonly diagnosed malignancies, and its frequency is increasing rapidly. Genetic variants in DNA repair genes are linked to differences in efficiency of repairing DNA damage, which can influence lung cancer susceptibility. EXO1 is a key gene involved in the mismatch repair pathway. The K589E polymorphism in EXO1 may alter the DNA repair activity of the encoded protein and impact lung cancer risk. The aim of this study was to investigate associations between the K589E polymorphism in EXO1 and lung cancer risk in the Iranian population, and evaluate its potential as a prognostic biomarker.
Methods: This case-control study was conducted to investigate EXO1 K589E variant with susceptibility to lung malignancy in the Iranian population. One hundred patients with lung cancer as a patient group and 100 healthy individuals from Khansari Hospital located in Markazi province were studied, from January 2020 to May 2022. DNA extraction from blood samples of participants was done using a kit.  Genotype determination of both patient and control groups was done using PCR-RFLP technique. Finally, statistical results were analyzed using SPSS software and the logistic regression method.
Results: Genotype and allele frequency  analysis showed the AA genotype (P=0.004, OR=5.391, 95% CI: 1.690-17.200) and A allele (P=0.010, OR=2.851, 95% CI: 1.291-6.300) were correlated with susceptibility to lung cancer. On the other hand, people carrying the G variant allele had a lower risk of lung cancer.
Conclusion:  In summary, this study found the AA genotype and A allele of K589E in EXO1 are correlated with risk of lung cancer in Iranians, while the G allele has protective effects. The K589E polymorphism may serve as a prognostic biomarker for lung cancer susceptibility, but more studies with high population size are required.

Microbiota and probiotics, a new approach in the prevention and treatment of breast cancer: a review article
Saeedeh Keyvani-Ghamsari , Kiana Nouri, Ali Khaleseh Nejad , Shokoufeh Hassani,
Volume 81, Issue 11 (February 2024)
Abstract
Today, despite vast advances in cancer diagnosis and treatment, breast cancer is still the leading cause of cancer-related deaths in women. Various factors such as race, age, family history, mutation in the BRCA1/2 gene, diet, inactivity, alcohol consumption, and estrogen levels have been identified as risk factors for breast cancer. In recent years, microbiota has also been recognized as a new risk factor in breast cancer. In fact, the change in the microbial balance that occurs due to many environmental and internal factors of the body can be effective in the spread of cancer by affecting the intracellular pathways and signals. Studies have shown that intestinal dysbiosis affects the spread of breast cancer by affecting the metabolism and production of estrogen, or mechanisms unrelated to estrogen, such as the production of microbial metabolites that affect the immune system and lead to chronic inflammation. In addition, it has been proven that the breast tissue also has its microbiota, the types of which are different in healthy people, patients, even in different stages of breast cancer, and its subgroups. In such a way that a large amount of Proteobacteria, Firmicutes, Lactobacillus, and Actinobacteria are observed in healthy breasts, while their ratio changes in cancerous tissues. Considering the relationship between microbiota and breast cancer, maintaining a healthy microbiota is a new and significant approach to reducing the risk of developing, spreading, and managing this cancer. In this regard, compounds such as probiotics that can affect the balance of intestinal microbiota are considered as an effective approach to prevent and treat breast cancer. Probiotics can stimulate the growth of beneficial bacteria and inhibit the growth of harmful bacteria by causing physicochemical changes and affecting the metabolism of the intestinal microbiota. Furthermore, the consumption of probiotics can prevent the proliferation of cancer cells and reduce the tumor size by balancing the immune system, reducing inflammation, and inducing apoptosis in the cancer cells. This study describes the importance of microbiota in breast cancer, the difference between microbiota in a healthy person and a sick person, and the role of probiotics in the treatment of breast cancer.

Prevalence of acute kidney injury and its correlation with disease severity and outcomes in COVID-19 patients
Shima Heydari , Mohammad Nasrollahi, Mohammad Khodashenas Roudsari,
Volume 81, Issue 11 (February 2024)
Abstract
Background: Studies of viral pandemics in the past, as well as studies of patients with sepsis, have shown that there is a direct relationship between the occurrence of AKI with disease severity and mortality, prognosis and outcomes. Considering that the COVID-19 disease is a novel pandemic and there is not enough information on the occurrence of AKI with COVID outcomes and its consequences, especially in Iran, it is necessary to conduct research in this field.
Methods: This is a retrospective study on 310 Covid patients hospitalized in the internal medicine, critical care and infectious disease ward of Birjand Valiasr Hospital from 20 March 2020 until 20 March 2021. Data were collected from the hospital's health information unit. The information was collected including demographics, underlying diseases, vital signs, laboratory information, and imaging and type of respiratory support. Finally, data was analyzed by SPSS V.22.
Results: 310 patients with an average age of 51.9 ± 17.4 participated in this study, 58.4% of them were male. The prevalence of acute kidney injury in patients was 7.4%. There was a significant relationship between acute kidney injury and the COVID severity, so that the COVID severity increases with the occurrence of acute kidney injury. There was a significant relationship between COVID outcomes and acute kidney injury, so that a higher mortality rate was observed in patients with acute kidney injury. No significant relationship was found between the occurrence of acute kidney injury and the score of pulmonary involvement. Patients with hypertension were more tent to experience acute kidney injury. Also, patients with acute kidney injury have more leukocytosis compared to patients without acute kidney injury. In this study, no significant relationship was observed between lymphocyte count and acute kidney injury. This study showed that the level of serum CRP and BUN are significantly higher in patients with acute kidney injury.
Conclusion: Acute kidney injury in hospitalized patients with COVID-19 is not common but had a significant effect on disease severity and outcomes.

Page 12 from 12    
First
Previous
1
2
3
...
10
11
12
Next
Last
 

© 2024 , Tehran University of Medical Sciences, CC BY-NC 4.0

Designed & Developed by : Yektaweb