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Davoud Farajzadeh , Sedigheh Karimi-Gharigh, Siavoush Dastmalchi ,
Volume 75, Issue 3 (June 2017)
Volume 75, Issue 3 (June 2017)
Abstract
Tumor necrosis factor-alpha (TNF-α) is a pro-inflammatory cytokine produced by a variety of cells, including hematopoietic and non-hematopoietic cells, malignant cells, macrophages, B lymphocytes, T lymphocytes, natural killer cells, neutrophils, astrocytes, endothelial cells, and smooth muscle cells. TNF-α is a homo-trimeric molecular whose individual subunits are composed of antiparallel beta-sheets, forming a regular triangular prism shape. TNF-α binds to three receptor molecules through its receptor-binding sites, which are at the base of its pyramid structure. Biological responses to TNF-α are mediated through two different receptors: TNFR1 and TNFR2. These receptors are transmembrane glycoproteins with extracellular domains containing multiple cysteine-rich repeats that are structurally and functionally homologous, and the intracellular domains that are discrete and transduce their signals through both overlapping and distinct pathways. However, though TNF-α was initially discovered as an anti-tumor agent, it has been revealed that TNF-α and other ligands of this family are involved in some diseases like cancer, neurological, pulmonary, cardiovascular and autoimmune diseases and metabolic disorders. In general, TNF-α activates the control systems involved in cell proliferation, differentiation, inflammation and cell death, and the regulation of immune system. Although a normal level of TNF-α is very important for the regulation of immune responses, the persistence of the immune response as a result of inappropriate and excessive production of TNF-α can cause some inflammatory or autoimmune diseases. Accordingly, either neutralization TNF-α or blockade of its receptors using TNF-α inhibitors can be an effective therapeutic strategy to prevent or treat such inflammatory diseases. Several methods have been used to inhibit TNF-α, including the production of chimeric or fully human antibodies, soluble TNF-α receptors, or anti-TNF-α small molecules. The two previous agents are mostly capable of inhibiting the binding of TNF-α to its associated receptors, while anti-TNF-α small molecules, in addition to the above, inhibit the biosynthesis of TNF-α by blocking TNF-α mRNA biosynthesis, through the inhibition of its post-translational processing, or by blocking TNF-α receptors. Therefore, in this review article, we discuss the structure and characteristics of TNF-α and its related receptors: TNF-α signaling, TNF-α-mediated inflammatory diseases as well as TNF-α inhibition strategies.
Fatemeh Haidari , Mohammad-Hossein Haghighi-Zade, Gholam-Abas Kayedani , Negar Karimi Birgani ,
Volume 76, Issue 2 (May 2018)
Volume 76, Issue 2 (May 2018)
Abstract
Background: Anemia is the most common nutritional disorder in the world in which iron deficiency is one of its main causes. The prevalence of obesity and risk of iron deficiency anemia in these individuals is increasing. The present study examined the association between iron deficiency, dietary intake and obesity and obesity-induced inflammation in female students.
Methods: This descriptive cross-sectional study was conducted in Ahvaz University of Medical Sciences, Ahvaz, Iran, from May to March of 2016. A total of 170 female students were selected by stratified random sampling. Being in the age of 18-35 years, having a regular menstrual cycle, not following a specific diet and not taking any medication or dietary supplements that could affect iron status were indicators of inclusion in the study. General information and physical activity questionnaire were completed and a semi-quantitative feed frequency questionnaire was used to obtain food intake information. Anthropometric indicators including weight, height, body mass index (BMI), waist circumference and body fat were measured. Obesity was evaluated with 3 different definitions. Biochemical indices such as iron, hemoglobin, hematocrit, transferrin, total iron binding capacity (TIBC), ferritin, and hs-CRP were also measured.
Results: The dietary intake of iron and some nutrients related to iron (including energy, protein, vitamin C and calcium) showed no significant difference in dietary intake between different groups of obesity definitions. Serum iron levels and hemoglobin concentration had a significant negative correlation with BMI and hs-CRP concentrations (P=0.026 and P=0.01 respectively). The relationship between transferrin levels and total iron binding capacity with the index of waist circumference was positive and significant (P=0.040, P=0.034, respectively). Also, there was a significant positive correlation between obesity and hs-CRP levels (P=0.014). There was no significant relationship between other evaluated factors with different degrees of obesity.
Conclusion: Chronic obesity and inflammation which could be caused by obesity, can contribute to iron deficiency, regardless of dietary iron intake.
Methods: This descriptive cross-sectional study was conducted in Ahvaz University of Medical Sciences, Ahvaz, Iran, from May to March of 2016. A total of 170 female students were selected by stratified random sampling. Being in the age of 18-35 years, having a regular menstrual cycle, not following a specific diet and not taking any medication or dietary supplements that could affect iron status were indicators of inclusion in the study. General information and physical activity questionnaire were completed and a semi-quantitative feed frequency questionnaire was used to obtain food intake information. Anthropometric indicators including weight, height, body mass index (BMI), waist circumference and body fat were measured. Obesity was evaluated with 3 different definitions. Biochemical indices such as iron, hemoglobin, hematocrit, transferrin, total iron binding capacity (TIBC), ferritin, and hs-CRP were also measured.
Results: The dietary intake of iron and some nutrients related to iron (including energy, protein, vitamin C and calcium) showed no significant difference in dietary intake between different groups of obesity definitions. Serum iron levels and hemoglobin concentration had a significant negative correlation with BMI and hs-CRP concentrations (P=0.026 and P=0.01 respectively). The relationship between transferrin levels and total iron binding capacity with the index of waist circumference was positive and significant (P=0.040, P=0.034, respectively). Also, there was a significant positive correlation between obesity and hs-CRP levels (P=0.014). There was no significant relationship between other evaluated factors with different degrees of obesity.
Conclusion: Chronic obesity and inflammation which could be caused by obesity, can contribute to iron deficiency, regardless of dietary iron intake.
Leyla Abdolkarimi, Farrokh Taftachi , Faranak Hayati, Shahrokh Mehrpisheh, Negar Seify Moghadam ,
Volume 76, Issue 4 (July 2018)
Volume 76, Issue 4 (July 2018)
Abstract
Background: Burns are one of the most devastating forms of trauma worldwide. In the elderly, flame and scald burns, or scalds alone, are the major causes of burns, occur at home, particularly in the kitchen and bathroom. Because elderly burned patients suffer from greater morbidity and mortality than younger patients with similar burn extents, preventing burns is paramount to continuing functionality and quality of life. Burns are largely explainable by characteristics of both the individual and the physical environment. Our study aims to analyses the epidemiologic characteristics of burn in the elderly (above 60 years old) in Iran.
Methods: Records of elderly patients (aged 60 and older) admitted with acute burns to the Burn Center of the Shahid Motahari Hospital, Tehran, Iran, between March 2007 and March 2014 was carried out. Patient demographics, etiology of burn, mechanism of injury, burn extent, mortality, severity of burn, length of stay in hospital, and outcomes were reviewed. The information was analyzed by SPSS software, version 18 (SPSS Inc., Chicago, IL, USA). T-test, oneway anova and K square were used.
Results: A total of 374 elderly patients were admitted. Majority of the patients were men 231 (61.8%) and the number of women were 143(38.2%). The most common etiologies were scalds (20.3%) and (oil-benzine-gasoline) (19.8%). The mean age of the patient was 71.5 years, which was average in women (72) and men (70.5 years). There was a statistically significant difference between the mean age in both male and female groups, so that the mean age of women was significantly higher than men (P=0.004). There was a significant correlation between gender and (etiology, hospital stay-mortality) and between treatment outcome and (etiology and motivation) and between motivation and etiology (P<0.001).
Conclusion: Boiling water was the main cause of burning in older women. Diminished senses, concentration disorders, slower reaction time, reduced mobility, and bedridden states may decrease elder's ability to identify fire and also to escape harm.
Methods: Records of elderly patients (aged 60 and older) admitted with acute burns to the Burn Center of the Shahid Motahari Hospital, Tehran, Iran, between March 2007 and March 2014 was carried out. Patient demographics, etiology of burn, mechanism of injury, burn extent, mortality, severity of burn, length of stay in hospital, and outcomes were reviewed. The information was analyzed by SPSS software, version 18 (SPSS Inc., Chicago, IL, USA). T-test, oneway anova and K square were used.
Results: A total of 374 elderly patients were admitted. Majority of the patients were men 231 (61.8%) and the number of women were 143(38.2%). The most common etiologies were scalds (20.3%) and (oil-benzine-gasoline) (19.8%). The mean age of the patient was 71.5 years, which was average in women (72) and men (70.5 years). There was a statistically significant difference between the mean age in both male and female groups, so that the mean age of women was significantly higher than men (P=0.004). There was a significant correlation between gender and (etiology, hospital stay-mortality) and between treatment outcome and (etiology and motivation) and between motivation and etiology (P<0.001).
Conclusion: Boiling water was the main cause of burning in older women. Diminished senses, concentration disorders, slower reaction time, reduced mobility, and bedridden states may decrease elder's ability to identify fire and also to escape harm.
Roghaye Ghasemi, Azadeh Shojaei, Behnaz Karimi,
Volume 77, Issue 2 (May 2019)
Volume 77, Issue 2 (May 2019)
Abstract
Background: Prostate cancer is currently the third malignant disease in Iran and fifth common cancer worldwide. The aim of this study was to determine the expression of GPRC6A, E.cadherin, and ZEB1 genes in prostate cancer in comparison with benign tumor. Since early detection of cancer plays an important role in treatment, this study aims to identify the role of GPRC6A, E.cadherin and ZEB1 genes in screening of prostate cancer.
Methods: In this case-control study, 30 samples including 15 samples of malignant prostate cancer and 15 samples of benign tumor were collected from the patients. RNA was extracted from the tissues, followed by cDNA preparation. In the last step, expression of GPRC6A, E.cadherin and ZEB1 genes was measured using the Real-time polymerase chain reaction (PCR) technique and the Relative expression software tool (REST), Version 2009 (http://rest.gene-quantification.info/).
Results: In this study, the expression of GPRC6A genes compared to its benign tumor increased 3-fold, ZEB1 expression in prostate cancer, compared to its benign tumor, increased 2-fold, and expression of E.cadherin gene in cancerous samples compared to benign tumor declines 10 was equal. In this study, there was no significant relationship between the expression of genes in benign and malignant samples with common diagnostic factors in this type of disease such as age, Prostate-specific antigen (PSA), pathologic stage and Gleason score.
Conclusion: According to this study and similar studies, increased expression of GPRC6A in prostate cancer cells can stimulate the progression of cancer cells by regulating cell proliferation and invasive response to various ligands. Increasing the expression of ZEB1 and decreasing the expression of E.cadherin is also due to the lack of binding of cells and spread of metastasis. As a result, tumors express ZEB1 with absence of E.cadherin is associated with advanced disease or metastases, which indicates that ZEB1 induces EMT and tumor progression in clinical cancers. Therefore examined genes have potential for screening prostate cancer and they can be used as a diagnostic marker for prostate cancer with further investigation.
Methods: In this case-control study, 30 samples including 15 samples of malignant prostate cancer and 15 samples of benign tumor were collected from the patients. RNA was extracted from the tissues, followed by cDNA preparation. In the last step, expression of GPRC6A, E.cadherin and ZEB1 genes was measured using the Real-time polymerase chain reaction (PCR) technique and the Relative expression software tool (REST), Version 2009 (http://rest.gene-quantification.info/).
Results: In this study, the expression of GPRC6A genes compared to its benign tumor increased 3-fold, ZEB1 expression in prostate cancer, compared to its benign tumor, increased 2-fold, and expression of E.cadherin gene in cancerous samples compared to benign tumor declines 10 was equal. In this study, there was no significant relationship between the expression of genes in benign and malignant samples with common diagnostic factors in this type of disease such as age, Prostate-specific antigen (PSA), pathologic stage and Gleason score.
Conclusion: According to this study and similar studies, increased expression of GPRC6A in prostate cancer cells can stimulate the progression of cancer cells by regulating cell proliferation and invasive response to various ligands. Increasing the expression of ZEB1 and decreasing the expression of E.cadherin is also due to the lack of binding of cells and spread of metastasis. As a result, tumors express ZEB1 with absence of E.cadherin is associated with advanced disease or metastases, which indicates that ZEB1 induces EMT and tumor progression in clinical cancers. Therefore examined genes have potential for screening prostate cancer and they can be used as a diagnostic marker for prostate cancer with further investigation.
Mahmoud Ebrahimi , Mohammad Karimi , Faranak Dehghani , Amir Biriaei , Nafiseh Farhadian, Shiva Golmohammadzadeh ,
Volume 77, Issue 3 (June 2019)
Volume 77, Issue 3 (June 2019)
Abstract
Background: Sesame oil can be used to treat cardiovascular diseases, such as atherosclerosis, by reducing the levels of fibrinogen and factor VII. The aim of this study is to prepare a microemulsion containing sesame oil as a drug nanocarrier for improving the aqueous solubility and therapeutic effects of this vegetable oil on the reduction of the fibrinogen and factor VII levels in animal model.
Methods: This experimental study was performed for microemulsion preparation and animal test at Ferdowsi University of Mashhad and Cardiovascular Research Center of Mashhad University of Medical Sciences, Mashhad, Iran, respectively, from April 2015 to January 2017. To prepare the microemulsion samples, Tween 80 and span 80 were selected as surfactant couple and surfactant ratios of 8:1, 9:1 and 10:1 were determined for construction of pseudo-ternary phase diagrams. The Zealand white rabbits were categorized in three groups: receiver of base diet group, high cholesterol diet and high cholesterol diet plus microemulsion.
Results: The average particle size of the samples was in the range of 16.64±0.1 to 21.16±0.2 nm with a uniform particle size distribution. Zeta potential was in the range of -10.7 to 18.4 mV, refraction index was approximately 1.39. Electrical conductivity coefficient was in the range of 297 to 311 μz and pH of all the samples were approximately 6.42 for all samples. All of the microemulsion samples were physically stable and the prepared sample with 9:1 surfactant ratio was selected to investigate the animal test due to the higher oil percentage in comparison with the other samples that be stable over 6 months. Significant decrease in the levels of fibrinogen and factor VII in the third group of rabbits was observed compared to the other groups.
Conclusion: The results of this study showed the effective performance of nanostructured drug delivery systems in the form of microemulsion to improve the aqueous solubility and therapeutic effects of hydrophobic compounds such as vegetable oils.
Methods: This experimental study was performed for microemulsion preparation and animal test at Ferdowsi University of Mashhad and Cardiovascular Research Center of Mashhad University of Medical Sciences, Mashhad, Iran, respectively, from April 2015 to January 2017. To prepare the microemulsion samples, Tween 80 and span 80 were selected as surfactant couple and surfactant ratios of 8:1, 9:1 and 10:1 were determined for construction of pseudo-ternary phase diagrams. The Zealand white rabbits were categorized in three groups: receiver of base diet group, high cholesterol diet and high cholesterol diet plus microemulsion.
Results: The average particle size of the samples was in the range of 16.64±0.1 to 21.16±0.2 nm with a uniform particle size distribution. Zeta potential was in the range of -10.7 to 18.4 mV, refraction index was approximately 1.39. Electrical conductivity coefficient was in the range of 297 to 311 μz and pH of all the samples were approximately 6.42 for all samples. All of the microemulsion samples were physically stable and the prepared sample with 9:1 surfactant ratio was selected to investigate the animal test due to the higher oil percentage in comparison with the other samples that be stable over 6 months. Significant decrease in the levels of fibrinogen and factor VII in the third group of rabbits was observed compared to the other groups.
Conclusion: The results of this study showed the effective performance of nanostructured drug delivery systems in the form of microemulsion to improve the aqueous solubility and therapeutic effects of hydrophobic compounds such as vegetable oils.
Masoud Ghiasian, Sajjad Daneshyar , Khaled Karimi Nejad , Abbas Moradi,
Volume 77, Issue 8 (November 2019)
Volume 77, Issue 8 (November 2019)
Abstract
Background: Venous anomalies are the most common vascular malformation of the central nervous system in adult, it can form anywhere in the body, but are most likely to cause symptoms when they grow in the brain or spinal cord. Common symptoms include headaches or seizures. Experiencing symptoms depend on where the lesions grow and how many of the lesions are present. Most of the time, these formations cause no problems. In some people, knowing the clinical signs and possible future complications in the disease can help to treat the disease and diagnose it.
Methods: In this Prospective cohort study, 41 patients with cavernous malformation who were diagnosed by neurologist referred to Sina Hospital in Hamedan City, Iran, from 2016 to 2017 were studied. Patients' information about their referrals during the follow-up period were collected and the results were reported.
Results: This study was conducted on 20 (48.79%) females and 21 (51.21%) males with the mean ages of 50±2 years. The most common manifestation of disease was seizure in 20 patients (48.78%). Most of these lesions were found in parietal lobe in 11 cases (26.82%) and then in the frontal lobe with 8 cases (19.51%). In terms of complications during follow-ups, 16 patients (39.2%) were uncomplicated, 16 patients had 48 episodes of seizure, seven patients had nine episodes of hemorrhage, two patients with hemiparesis, one patient with headache and one patient with sixth cranial nerve paralysis. According to the associated disease and risk factors, nine patients (26.82%) had high blood pressure, five patients (12.19%) had meningioma and three patients (7.31%) had diabetes. Seven patients (17.07%) had a positive family history that symptoms and complications in this patients are higher than the rest of patients.
Conclusion: In this study, most of the cases are sporadic and the most common symptom was seizure. The most common symptom in supratentorial lesions were seizure whereas in multiple and infratentorial lesions were bleeding. Five patients were involved with meningioma which could be considered in more studies with more patients in future.
Methods: In this Prospective cohort study, 41 patients with cavernous malformation who were diagnosed by neurologist referred to Sina Hospital in Hamedan City, Iran, from 2016 to 2017 were studied. Patients' information about their referrals during the follow-up period were collected and the results were reported.
Results: This study was conducted on 20 (48.79%) females and 21 (51.21%) males with the mean ages of 50±2 years. The most common manifestation of disease was seizure in 20 patients (48.78%). Most of these lesions were found in parietal lobe in 11 cases (26.82%) and then in the frontal lobe with 8 cases (19.51%). In terms of complications during follow-ups, 16 patients (39.2%) were uncomplicated, 16 patients had 48 episodes of seizure, seven patients had nine episodes of hemorrhage, two patients with hemiparesis, one patient with headache and one patient with sixth cranial nerve paralysis. According to the associated disease and risk factors, nine patients (26.82%) had high blood pressure, five patients (12.19%) had meningioma and three patients (7.31%) had diabetes. Seven patients (17.07%) had a positive family history that symptoms and complications in this patients are higher than the rest of patients.
Conclusion: In this study, most of the cases are sporadic and the most common symptom was seizure. The most common symptom in supratentorial lesions were seizure whereas in multiple and infratentorial lesions were bleeding. Five patients were involved with meningioma which could be considered in more studies with more patients in future.
Reza Abdollahi , Bahman Vahidi , Mohammad Karimi ,
Volume 77, Issue 9 (December 2019)
Volume 77, Issue 9 (December 2019)
Abstract
Background: Cerebral aneurysm disease causes intracranial hemorrhage by rupturing, which can eventually, lead to organ failure or death. For this reason, it is important to anticipate the reasons for rupturing of a cerebral aneurysm from biomechanical point of view. Investigating this disease may even help the physicians to find treatments and predict the patient’s situation. This research was conducted to understand risks of development and rupture of a patient-specific cerebral aneurysm.
Methods: In a computational simulation, fluid-structure interaction method has been used for a patient-specific case. Also, considering the speed of the systole as the initial condition of the problem, the blood fluid domain has been solved in three types of fluid mathematical models (Newtonian, non-Newtonian Carreau, and non-Newtonian power-law). Then, the pressure results on the wall have been transmitted to ANSYS software, version 15.0 (ANSYS Inc., Canonsburg, PA, USA) and the structure has been solved based on three material models (linear elastic, hyperplastic Neo-Hookean and hyperplastic Mooney-Rivlin, with 5 parameters). The study was done in University of Tehran, Iran, from October 2016 to September 2018.
Results: Shear stress, pressure, flow velocity, wall displacement and von-Mises stress have been extracted from the simulations. The average wall displacement of the aneurysm was 1.8 mm. Also, no significant difference was found in the amount of arterial wall displacement, with constant wall material model and different blood models. However, a significant difference has been observed in the case of considering constant blood model and different wall material models in the value of displacement.
Conclusion: With regard to the amount of displacement of the aneurysm wall in this particular patient, with the geometry and location of the specific aneurysm, the brain nerves 3 and 6 were under stress and exposed to damage. The minimum shear stress was in the aneurysm neck, which stimulates the endothelial cells in the area of aneurysm. In addition, the blood model didn’t had a significant effect on the displacement calculations, while the wall material model played a more decisive role.
Methods: In a computational simulation, fluid-structure interaction method has been used for a patient-specific case. Also, considering the speed of the systole as the initial condition of the problem, the blood fluid domain has been solved in three types of fluid mathematical models (Newtonian, non-Newtonian Carreau, and non-Newtonian power-law). Then, the pressure results on the wall have been transmitted to ANSYS software, version 15.0 (ANSYS Inc., Canonsburg, PA, USA) and the structure has been solved based on three material models (linear elastic, hyperplastic Neo-Hookean and hyperplastic Mooney-Rivlin, with 5 parameters). The study was done in University of Tehran, Iran, from October 2016 to September 2018.
Results: Shear stress, pressure, flow velocity, wall displacement and von-Mises stress have been extracted from the simulations. The average wall displacement of the aneurysm was 1.8 mm. Also, no significant difference was found in the amount of arterial wall displacement, with constant wall material model and different blood models. However, a significant difference has been observed in the case of considering constant blood model and different wall material models in the value of displacement.
Conclusion: With regard to the amount of displacement of the aneurysm wall in this particular patient, with the geometry and location of the specific aneurysm, the brain nerves 3 and 6 were under stress and exposed to damage. The minimum shear stress was in the aneurysm neck, which stimulates the endothelial cells in the area of aneurysm. In addition, the blood model didn’t had a significant effect on the displacement calculations, while the wall material model played a more decisive role.
Alireza Mahoori, Nazli Karami , Seyedeh Zahra Karimi Sarabi ,
Volume 77, Issue 9 (December 2019)
Volume 77, Issue 9 (December 2019)
Abstract
Background: Emergence from general anesthesia and removing of tracheal tube can be associated with coughing, agitation, and hemodynamic disturbances. Dexmedetomidine is an alpha two adrenoceptor agonist that has effective sedation with less cardiovascular unstability and respiratory depression and may be useful for extubation and prevention of hemodynamic response during tracheal tube removing. The aim of this study was to evaluate the effect of dexmedetomidine on hemodynamic responses during endotracheal extubation and sedation level in recovery room.
Methods: In an analytical study, fifty women aged 20-50 years old candidate to cholecystectomy under general anesthesia and tracheal intubation were entered randomly to this study in two groups (no. 25) at Imam Khomeini Hospital, Urmia, Iran, and under support of Urmia University of Medical Sciences Urmia, Iran, from May 2017 to May 2018. Ten minutes before end of surgery, 0.8 µg/kg dexmedetomidine in the study group and for the other patients in control group normal saline as placebo were infused over ten minutes. During the emergence phase, blood pressure, heart rate and oxygen saturation were recorded at 0,1,2,3 and 5 minutes after extubation. Also, sedation index was evaluated via the Ramsay sedation score and recorded at recovery room.
Results: Heart rate, systolic blood pressure and diastolic blood pressure in patient with infusion of dexmedetomidine were lower significantly at 1,2,3 and 5 minutes after extubation than control group. Data for heart rate, systolic and diastolic pressure, at min 1 after extubation were 81±6 vs. 88±9, 120.64±13.21 vs. 137.52±11.06, 72.84±8.32 vs. 81.36±9.26 in dexmedetomidine and control groups respectively. Data for heart rate, systolic and diastolic pressure, at min 5 after extubation were 73±6 vs. 80±8, 110.64±10.68 vs. 119.88±10.01, 69.84±8.32 vs. 73.48±5.13 in study and control groups, respectively. As well as 80% of the patients in dexmedetomidine group had satisfactory sedation and cooperation in compare to the 28% in control group (P=0.001).
Conclusion: Intravenous infusion of 0.8 µg/kg dexmedetomidine 10 minutes before extubation of endotracheal tube and during emergence, facilitate extubation and lead to hemodynamic stability and satisfactory sedation.
Methods: In an analytical study, fifty women aged 20-50 years old candidate to cholecystectomy under general anesthesia and tracheal intubation were entered randomly to this study in two groups (no. 25) at Imam Khomeini Hospital, Urmia, Iran, and under support of Urmia University of Medical Sciences Urmia, Iran, from May 2017 to May 2018. Ten minutes before end of surgery, 0.8 µg/kg dexmedetomidine in the study group and for the other patients in control group normal saline as placebo were infused over ten minutes. During the emergence phase, blood pressure, heart rate and oxygen saturation were recorded at 0,1,2,3 and 5 minutes after extubation. Also, sedation index was evaluated via the Ramsay sedation score and recorded at recovery room.
Results: Heart rate, systolic blood pressure and diastolic blood pressure in patient with infusion of dexmedetomidine were lower significantly at 1,2,3 and 5 minutes after extubation than control group. Data for heart rate, systolic and diastolic pressure, at min 1 after extubation were 81±6 vs. 88±9, 120.64±13.21 vs. 137.52±11.06, 72.84±8.32 vs. 81.36±9.26 in dexmedetomidine and control groups respectively. Data for heart rate, systolic and diastolic pressure, at min 5 after extubation were 73±6 vs. 80±8, 110.64±10.68 vs. 119.88±10.01, 69.84±8.32 vs. 73.48±5.13 in study and control groups, respectively. As well as 80% of the patients in dexmedetomidine group had satisfactory sedation and cooperation in compare to the 28% in control group (P=0.001).
Conclusion: Intravenous infusion of 0.8 µg/kg dexmedetomidine 10 minutes before extubation of endotracheal tube and during emergence, facilitate extubation and lead to hemodynamic stability and satisfactory sedation.
Mohsen Soleimani , Rahimeh Nabavi , Nadia Karimi , Abbasali Ebrahimian ,
Volume 78, Issue 3 (June 2020)
Volume 78, Issue 3 (June 2020)
Abstract
Background: Uremic pruritus is one of the important problems in patients undergoing hemodialysis. Causing the mechanism of uremic pruritus in hemodialysis patients is complex and multifactorial. Almost 60 percent of hemodialysis patients suffer from uremic pruritus. Oral hydroxyzine is a common treatment for uremic pruritus of this patients. This study aimed to survey effect of hydroxyzine on uremic pruritus of hemodialysis patients.
Methods: This quasi-experimental study (pre and post design) performed on 40 patients with eligible criteria. All of the hemodialysis patients who suffer from pruritus received a tablet of hydroxyzine 25 mg daily for 6 weeks. In this time, drugs and the plan of hemodialysis were constant. Pruritus score of patients, evaluated with 5-D pruritus scale that had 8 items with 5-score Likert scale and evaluate duration, direction, disability, and distribution of pruritus. Severity scores of pruritus before and after treatment with tablet of hydroxyzine were compared. This study was conducted on hemodialysis patients in the Soodeh Center of Hemodialysis in the south of Tehran, Iran, from September 2016 to February 2017.
Results: The findings of this study showed that most of the patients in this study were male (55%) with mean age of 55.97±11.59 years. The most cause of chronic renal failure in these patients was diabetes (37.5%). This study showed that 32.5% of the hemodialysis patients had moderate to severe uremic pruritus. The mean score of pruritus before the treatment with hydroxyzine was 16.73±3.4 and the most effect of this drug was in the social activity item (2.47±0.6). After treatment with hydroxyzine, the mean score of pruritus in the patients was 9.65±2.15 that was decreased significantly (P<0.001). The findings showed that there was no significant relationship between decrease of pruritus and characteristics of patients.
Conclusion: This study showed that uremic pruritus is still a challenge in hemodialysis patients. According to this study use of hydroxyzine, regardless of uremic pruritus mechanism, could be decreased uremic pruritus of hemodialysis patients.
Methods: This quasi-experimental study (pre and post design) performed on 40 patients with eligible criteria. All of the hemodialysis patients who suffer from pruritus received a tablet of hydroxyzine 25 mg daily for 6 weeks. In this time, drugs and the plan of hemodialysis were constant. Pruritus score of patients, evaluated with 5-D pruritus scale that had 8 items with 5-score Likert scale and evaluate duration, direction, disability, and distribution of pruritus. Severity scores of pruritus before and after treatment with tablet of hydroxyzine were compared. This study was conducted on hemodialysis patients in the Soodeh Center of Hemodialysis in the south of Tehran, Iran, from September 2016 to February 2017.
Results: The findings of this study showed that most of the patients in this study were male (55%) with mean age of 55.97±11.59 years. The most cause of chronic renal failure in these patients was diabetes (37.5%). This study showed that 32.5% of the hemodialysis patients had moderate to severe uremic pruritus. The mean score of pruritus before the treatment with hydroxyzine was 16.73±3.4 and the most effect of this drug was in the social activity item (2.47±0.6). After treatment with hydroxyzine, the mean score of pruritus in the patients was 9.65±2.15 that was decreased significantly (P<0.001). The findings showed that there was no significant relationship between decrease of pruritus and characteristics of patients.
Conclusion: This study showed that uremic pruritus is still a challenge in hemodialysis patients. According to this study use of hydroxyzine, regardless of uremic pruritus mechanism, could be decreased uremic pruritus of hemodialysis patients.
Isa Khaheshi, Taraneh Faghihi Langroudi , Sima Salimi, Marjaneh Karimi, Abbas Arjmand Shabestari , Maral Edalati, Shahabeddin Gorji, Elham Mahmoudi ,
Volume 78, Issue 4 (July 2020)
Volume 78, Issue 4 (July 2020)
Abstract
Background: Systemic sclerosis is an autoimmune disease affecting connective tissues, (including epidermal, subepidermal, microvasculature, etc.), leading to various extent of end-organ damage. The leading cause of mortality among these patients is lung involvement. The cardiovascular events happen more frequently in patients suffering systemic scleroderma, comparing to healthy population. This study was designed to clear the correlation between development of coronary calcification (as an indicator of atherosclerosis) and lung disease in these patients.
Methods: All patients with definite diagnosis of systemic sclerosis, who referred to Shahid Modarres Hospital between March 2011and March 2014, entered to the study. Patients suffering hypertension, hyperlipidemia and who had a past or current history of smoking were excluded from the study. Atherosclerosis was determined by coronary calcium score (based on Agatston score) and the severity and extent of lung disease was assessed by wells scoring system and Warrick scoring system (based on lung CT scan without contrast). The spearman correlation analysis was done on the data by SPSS software, version 20 (IBM SPSS, Armonk, NY, USA). All the patients had informed consent and no additive charge was delivered.
| Results: The study population consisted of 25 patients with systemic sclerosis. 21 patients were female and the 4 other ones were male. The mean age was 67±4 years old. The mean Wells score in patients was 13±2.59, the mean Warrick severity score was 6.54±6.16 and the mean Warrick extent score was 14.42±14.59. No correlation was observed between presence of calcification in coronary arteries (Wells score r2=0.63 P=0.77, severity score r2=0.27, P=0.2, extent score r2=0.11, P=0.6), aorta annulus (Wells score r2=0.04, P=0.83, severity score r2=0.06, P=0.77, extent score r2=0.06, P=0.76) and thoracic aorta (Wells score r2=0.05, P=0.83, severity score r2=0.03, P=0.9, extent score r2=0.03, P=0.9) with the severity and extent of lung involvement. Conclusion: It seems that the presence of coronary atherosclerosis or calcifications in aorta annulus and thoracic aorta (assessed by Agatston calcium score) has no significant correlation with the severity and extent of lung disease (assessed by Wells and Warrick score) in patients with systemic sclerosis. |
Mitra Radfar, Narjes Jafari, Mona Karimi Khaledi , Naeeme Taslimi Taleghani , Reihaneh Askary Kachoosangy , Leila Yazdi,
Volume 78, Issue 12 (March 2021)
Volume 78, Issue 12 (March 2021)
Abstract
Background: Developmental delay in preterm infants was estimated to be more common than term infants. Identifying the factors predisposing to developmental delay can help experts and health professionals in this field to prevent developmental delay of the infants, and leads to better management of the condition of them. This study aimed to evaluate and investigate the predisposing factors of developmental delay in preterm infants in the first year of their lives.
Methods: In this analytical cross-sectional study, 87 preterm infants were enrolled in the study by convenience sampling during the period of April 2016 to the end of March 2017 from two educational hospitals of Shahid Beheshti University of Medical Sciences (Imam Hussein hospital and Mahdiyeh hospital). Demographic and other initial data such as age, sex, gestational age, and the data about clinical problems observed at birth were collected through infants' medical records and were recorded in a special form for each infant. Also, the ASQ test was used to assess infants' developmental status at one year of age.
Methods: In this analytical cross-sectional study, 87 preterm infants were enrolled in the study by convenience sampling during the period of April 2016 to the end of March 2017 from two educational hospitals of Shahid Beheshti University of Medical Sciences (Imam Hussein hospital and Mahdiyeh hospital). Demographic and other initial data such as age, sex, gestational age, and the data about clinical problems observed at birth were collected through infants' medical records and were recorded in a special form for each infant. Also, the ASQ test was used to assess infants' developmental status at one year of age.
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Results: Based on the findings, 23 infants (26.4%) had the abnormal developmental condition at the end of one year. There was a significant relationship between infants' developmental status and their age, birth height, one-year-old weight, one-year-old height, duration of ventilator use, Apgar scores at first and twentieth minutes, seizures, reflex reduction, pneumonia, breastfeeding status in the first year of life, Retinopathy of prematurity (ROP), receiving occupational therapy services, and electrocardiogram (ECG) findings at one year of age. Among these variables, only breastfeeding status in the first year of life was able to predict infants' developmental status at the end of one year (OR=0.18).
Conclusion: This study showed that the risk of developmental delay in preterm infants who are breastfed in the first year of life or fed the combination of breast milk and supplemental feeding is one-fifth lower than other preterm infants who were not breastfed. |
Zohreh Habibi, Seyed Morsal Mosallami Aghili , Seyed Amir Hossein Javadi , Arash Seifi, Kourosh Karimi Yarandi, Seyed Ali Dehghan Manshadi , Fereshteh Naderi Behdani ,
Volume 79, Issue 2 (May 2021)
Volume 79, Issue 2 (May 2021)
Abstract
Background: Neurosurgery practice conflicts with many challenges during the COVID-19 pandemic; Including the lack of beds in intensive care units, as well as the use of some methods such as drills and trans-nasal and trans-oral approaches that produce aerosols or are directly in contact with patient discharge. Due to these challenges, developing a clinical guideline to help neurosurgeons and medical staff in decision making and improving patients and medical staff safety during the COVID-19 pandemic is the purpose of this study.
Methods: First, all of the relevant clinical guidelines to neurosurgical practice during the COVID-19 pandemic were extracted from the data centers. Finally, five clinical guidelines were selected. The questions and the items were designed according to these guidelines. The answers to each of the questions were extracted from these guidelines. The complementary evidence was extracted by searching in the data centers again. Finally, the answers were edited and the edited answers were considered as the recommendations. These recommendations were sent to 4 experts in the Neurosurgery field and 2 experts in the infectious diseases field. The appraisers evaluated the recommendations according to the AGREE-REX instrument. This instrument has 9 items and 3 domains including clinical applicability, values and preferences, and implement ability. Recommendations with above 80% agreement were considered as the final recommendations.
Methods: First, all of the relevant clinical guidelines to neurosurgical practice during the COVID-19 pandemic were extracted from the data centers. Finally, five clinical guidelines were selected. The questions and the items were designed according to these guidelines. The answers to each of the questions were extracted from these guidelines. The complementary evidence was extracted by searching in the data centers again. Finally, the answers were edited and the edited answers were considered as the recommendations. These recommendations were sent to 4 experts in the Neurosurgery field and 2 experts in the infectious diseases field. The appraisers evaluated the recommendations according to the AGREE-REX instrument. This instrument has 9 items and 3 domains including clinical applicability, values and preferences, and implement ability. Recommendations with above 80% agreement were considered as the final recommendations.
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Results: The final recommendations were presented as “Clinical guideline of neurosurgical practice during the COVID-19 pandemic” in the results section.
Conclusion: This clinical guideline was developed by using similar guidelines and available evidence. Proper usage of personal protective equipment, reduction of unnecessary contacts between medical staff and patients, use of Telemedicine for follow-up, proper air conditioning, screening patients for COVID-19, reduction of elective surgery, use of less invasive methods, management of aerosol production and reduction of trans-oral and trans-nasal approaches are the most important recommendations of this clinical guideline. |
Ali Mohammad Mosadeghrad, Mahnaz Afshari, Fereshteh Karimi ,
Volume 80, Issue 1 (April 2022)
Volume 80, Issue 1 (April 2022)
Abstract
Background: Conceptual review is a creative research method for generating new knowledge in the context of a vague and complex concept that helps to explain and clarify the concept, its components and its relation to related concepts. This study aimed to explain the methodology of conceptual review in the health system.
Methods: Articles related to the conceptual research method were searched and collected in four databases (i.e., PubMed, Scopus, Embase, Science Direct) and two search engines (e.g., Google and Google Scholar) between January 1950 and September 2021. Finally, 83 articles were selected for final review and analyzed through narrative analysis.
Results: This study was conducted using scoping review between October and December 2021. The conceptual review study is a systematic, scientific and objective inquiry that helps to identify and explain the dimensions, components, features and applications of a particular concept by defining, synthesizing and interpreting the findings of studies. It results in clarification of the meaning of concepts. An eight- steps protocol was introduced for conceptual review including concept selection, entry and exit criteria definition; selection of databases and search strategies; selection and reporting of studies using flowcharts; evaluating the validity of selected studies; extracting information about the definition, components, antecedents, consequences and evaluation criteria of the concept from selected studies, synthesizing data and developing a conceptual model and drawing conclusions from the synthesized findings. In addition, the structure of a conceptual review article was described and a checklist for evaluation of a conceptual review study was introduced.
Conclusion: A conceptual review study is a method that defines the concept by searching for scientific sources about a concept and their comprehensive review, explaining their characteristics, antecedents, consequences and applications to determine the position of the concept beyond their vocabulary definition. The conceptual review helps to develop existing theories by identifying the components of a complex concept and its antecedents and consequences and establishing a logical connection between them.
Methods: Articles related to the conceptual research method were searched and collected in four databases (i.e., PubMed, Scopus, Embase, Science Direct) and two search engines (e.g., Google and Google Scholar) between January 1950 and September 2021. Finally, 83 articles were selected for final review and analyzed through narrative analysis.
Results: This study was conducted using scoping review between October and December 2021. The conceptual review study is a systematic, scientific and objective inquiry that helps to identify and explain the dimensions, components, features and applications of a particular concept by defining, synthesizing and interpreting the findings of studies. It results in clarification of the meaning of concepts. An eight- steps protocol was introduced for conceptual review including concept selection, entry and exit criteria definition; selection of databases and search strategies; selection and reporting of studies using flowcharts; evaluating the validity of selected studies; extracting information about the definition, components, antecedents, consequences and evaluation criteria of the concept from selected studies, synthesizing data and developing a conceptual model and drawing conclusions from the synthesized findings. In addition, the structure of a conceptual review article was described and a checklist for evaluation of a conceptual review study was introduced.
Conclusion: A conceptual review study is a method that defines the concept by searching for scientific sources about a concept and their comprehensive review, explaining their characteristics, antecedents, consequences and applications to determine the position of the concept beyond their vocabulary definition. The conceptual review helps to develop existing theories by identifying the components of a complex concept and its antecedents and consequences and establishing a logical connection between them.
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. |
Mahmoud Parham, Davoud Oulad Dameshghi , Hossein Saghafi, Azam Sarbandy Farahani, Saeed Karimi Matloub, Rasool Karimi Matloub,
Volume 80, Issue 8 (November 2022)
Volume 80, Issue 8 (November 2022)
Abstract
Background: Vitamin B12 deficiency is one of the most well-known disorders due to long-term use of metformin due to interference with its absorption.
Methods: This double-blind randomized trial was conducted from June to October 2016 at Shahid Beheshti Hospital in Qom on 60 patients in the age group of 30 to 60 years with a history of type 2 diabetes for one to two years and taking metformin in the amount of one to two grams. Patients were divided into two groups of 30 people. The intervention group received metformin with 1 gram of calcium carbonate daily, and the control group received metformin without calcium. Each of the patients in the intervention group was given 200 calcium carbonate tablets. Vitamin B12 levels of the patients in both groups were measured before the start of the intervention, and they were evaluated in terms of neuropathy according to the Michigan questionnaire. Vitamin B12 of patients and neuropathy in two groups were measured before the intervention and after three months.
Results: There was a difference between the two groups in terms of gender, and no significant difference was observed between the mean ages in the two groups. The mean level of vitamin B12 before receiving calcium in group A (intervention) was lower than group B (control) (P=0.036) and after receiving calcium, the level of vitamin B12 in the intervention group increased (P=0.002). In the control group, the level of vitamin B12 decreased (P=0.030). (P=0.006), and in the control group there was no significant difference in the examination of neuropathy (P=0.2).
Methods: This double-blind randomized trial was conducted from June to October 2016 at Shahid Beheshti Hospital in Qom on 60 patients in the age group of 30 to 60 years with a history of type 2 diabetes for one to two years and taking metformin in the amount of one to two grams. Patients were divided into two groups of 30 people. The intervention group received metformin with 1 gram of calcium carbonate daily, and the control group received metformin without calcium. Each of the patients in the intervention group was given 200 calcium carbonate tablets. Vitamin B12 levels of the patients in both groups were measured before the start of the intervention, and they were evaluated in terms of neuropathy according to the Michigan questionnaire. Vitamin B12 of patients and neuropathy in two groups were measured before the intervention and after three months.
Results: There was a difference between the two groups in terms of gender, and no significant difference was observed between the mean ages in the two groups. The mean level of vitamin B12 before receiving calcium in group A (intervention) was lower than group B (control) (P=0.036) and after receiving calcium, the level of vitamin B12 in the intervention group increased (P=0.002). In the control group, the level of vitamin B12 decreased (P=0.030). (P=0.006), and in the control group there was no significant difference in the examination of neuropathy (P=0.2).
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Conclusion: Oral calcium daily intake increases vitamin B12 levels in patients with type 2 diabetes and calcium may be able to moderate the decrease in serum vitamin B12 levels induced by metformin in patients with type 2 diabetes.
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Seyed Kamal Eshagh Hossaini , Javad Hakimelahi, Mohammad Aghaali, Zahra Mehrabi, Rasool Karimi Matlob , Saeed Karimi Matlob,
Volume 80, Issue 10 (January 2023)
Volume 80, Issue 10 (January 2023)
Abstract
Background: Idiopathic thrombocytopenic purpura (autoimmune), the most common cause of acute onset of thrombocytopenia in children who are otherwise healthy. This study was conducted with the aim of investigating the factors affecting the response to treatment in hospitalized children.
Methods: This retrospective study was conducted by examining the files of patients hospitalized due to ITP in Hazrat Masoumeh (S) Hospital from April 2009 to March 2019. The criteria for inclusion in the study included confirming the diagnosis of ITP and the age of 1 month to 14 years, and the exclusion criteria included cases of discharge with personal consent and not completing the patient's treatment course, the presence of pancytopenia or bicytopenia, the presence of moderate or severe splenomegaly or severe in clinical examinations, BMA based on the presence of a diagnosis other than ITP, not receiving any of the ITP treatment protocols, and patients whose first visit with the diagnosis of ITP was in another center or city. The information about age, sex, clinical symptoms on arrival, initial platelets and the platelets of days 3, 5, 14 and 180 were extracted from the patients' files. The type of treatment protocol, the need to repeat the treatment, the recurrence of the disease and the major complications of the treatment were extracted from the patients' files and finally the data were analyzed with SPSS software.
Results: The response to the treatment on different days was unrelated to the age, gender, and initial platelets (except for one exception) (P>0.05). In relation to clinical symptoms, the response to treatment on days three and five was related to the clinical symptoms at the time of presentation and on days 14 and 180 it was unrelated. Response to treatment on days 3 and 5 in different treatment protocols had a significant relationship (P<0.05), but there was no significant difference on days 14 and 180.
Methods: This retrospective study was conducted by examining the files of patients hospitalized due to ITP in Hazrat Masoumeh (S) Hospital from April 2009 to March 2019. The criteria for inclusion in the study included confirming the diagnosis of ITP and the age of 1 month to 14 years, and the exclusion criteria included cases of discharge with personal consent and not completing the patient's treatment course, the presence of pancytopenia or bicytopenia, the presence of moderate or severe splenomegaly or severe in clinical examinations, BMA based on the presence of a diagnosis other than ITP, not receiving any of the ITP treatment protocols, and patients whose first visit with the diagnosis of ITP was in another center or city. The information about age, sex, clinical symptoms on arrival, initial platelets and the platelets of days 3, 5, 14 and 180 were extracted from the patients' files. The type of treatment protocol, the need to repeat the treatment, the recurrence of the disease and the major complications of the treatment were extracted from the patients' files and finally the data were analyzed with SPSS software.
Results: The response to the treatment on different days was unrelated to the age, gender, and initial platelets (except for one exception) (P>0.05). In relation to clinical symptoms, the response to treatment on days three and five was related to the clinical symptoms at the time of presentation and on days 14 and 180 it was unrelated. Response to treatment on days 3 and 5 in different treatment protocols had a significant relationship (P<0.05), but there was no significant difference on days 14 and 180.
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Conclusion: The best response was in the combined treatment group with methylprednisolone and IVIg, and the lowest response to treatment was observed in those receiving methylprednisolone alone.
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Seyed Hossein Hosseini, Hossein Karimi Moonaghi , Seyed Masoud Hosseini, Hassan Gholami, Vahid Ghavami,
Volume 80, Issue 12 (March 2023)
Volume 80, Issue 12 (March 2023)
Abstract
Background: According to numerous research related to learning styles and also the difference of these styles in students, this study was designed in order to determine the status of learning styles in medical students in Iran.
Methods: This study was conducted as a systematic review and meta-analysis. Searching for articles in this study was done from September 24 to October 15, 2022 in databases: Proquest, PubMed, Iran medex, Scopus, Sid, Magiran, Google Scholar, Eric and medical education journals. The research environment of Iran has been Mashhad. Using the PICOTS model, the keywords: learning styles, clubs, medical students were used to search the mentioned databases. OR, AND operators and possible combinations of keywords were used when searching for articles in databases. The extracted articles were first evaluated in terms of the research title, then the abstract of the article, and finally the text of the article using the "PRISMA Checklist". In each stage, repetitive articles and articles that did not mention the percentage of learning styles were excluded from the study, and the articles that met the inclusion criteria were stored in the (EndNote software, version 20, Clarivate, USA), and at the end, 53 articles were analyzed.
Methods: This study was conducted as a systematic review and meta-analysis. Searching for articles in this study was done from September 24 to October 15, 2022 in databases: Proquest, PubMed, Iran medex, Scopus, Sid, Magiran, Google Scholar, Eric and medical education journals. The research environment of Iran has been Mashhad. Using the PICOTS model, the keywords: learning styles, clubs, medical students were used to search the mentioned databases. OR, AND operators and possible combinations of keywords were used when searching for articles in databases. The extracted articles were first evaluated in terms of the research title, then the abstract of the article, and finally the text of the article using the "PRISMA Checklist". In each stage, repetitive articles and articles that did not mention the percentage of learning styles were excluded from the study, and the articles that met the inclusion criteria were stored in the (EndNote software, version 20, Clarivate, USA), and at the end, 53 articles were analyzed.
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Results: The results of the study showed that the most used learning styles among students of medical sciences in Iran was convergent learning style (32% with 95% confidence interval). In the investigation of the adaptive learning style in the fields of basic sciences during the years 2006 to 2021, the percentage of using this style increased and this trend was statistically significant (P=0.0078).
Conclusion: According to the findings of the study, the most used learning style in medical sciences in Iran is convergent learning style, and considering the characteristics of convergent people, it is necessary to provide effective and efficient training in medical sciences to Students' learning styles should be given special attention so that training can be guided based on their learning styles. |
Neda Negahban Jouzan , Hossein Karimi Moonaghi , Hoorak Poorzand, Mohammad Khajedaluee,
Volume 81, Issue 1 (April 2023)
Volume 81, Issue 1 (April 2023)
Abstract
Background: By examining the comprehensive system for evaluating the academic progress of general medical students, often the objectives of the cognitive domain and the form of cumulative evaluation were used, and the tests were not used much for feedback to the students. The aim of the study is to develop a model that fits the levels of Miller's evaluation pyramid in formative-cumulative forms.
Methods: The search was started in Iranian and international databases, magazines, curriculum of prestigious universities in the world. To find out about the latest events in the field of assessment, AMEE international virtual conferences in August 2021 and the summary booklet of medical education articles of Shahid Motahari 1400 (the 22nd national conference of medical education) were reviewed. Data analysis was done by Beredy's adaptive model. The search and analysis lasted for 11 months. Finally, a model was developed according to Miller's evaluation pyramid. Its validation was done in the focus group meeting in two ways, in person at Mashhad Medical School and virtual.
Methods: The search was started in Iranian and international databases, magazines, curriculum of prestigious universities in the world. To find out about the latest events in the field of assessment, AMEE international virtual conferences in August 2021 and the summary booklet of medical education articles of Shahid Motahari 1400 (the 22nd national conference of medical education) were reviewed. Data analysis was done by Beredy's adaptive model. The search and analysis lasted for 11 months. Finally, a model was developed according to Miller's evaluation pyramid. Its validation was done in the focus group meeting in two ways, in person at Mashhad Medical School and virtual.
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Results: According to the extracted data, the approach of assessment is towards formative assessment format and improvement of traditional methods along with modern methods, which was clearly observed in the study of the curriculum of Harvard-Stanford University in America and Oxford University in England. Integrating the results with Miller's evaluation levels, and the formative and cumulative evaluation format, led to the formulation of a model with the most favorable opinions of experts. In addition, the majority of opinions and suggestions of experts were related to the change in the way of executive policies of universities and providing a context for the emergence of new idea.
Conclusion: A model including measurement methods according to the levels of Miller's evaluation pyramid was developed in formative-cumulative. It is suggested that the model be reviewed by the relevant experts and notified by taking into account the implementation conditions for the correct evaluation process. |
Sogol Shirzad, Zeinab Karimi, Mehdi Mohsen Zadeh , Masoud Mohammadi,
Volume 81, Issue 7 (October 2023)
Volume 81, Issue 7 (October 2023)
Abstract
Background: Neutropenia refers to a decrease in the absolute number of neutrophils in the blood circulation, certain drugs are used in connection with the treatment of neutropenia. Therefore, the aim of this study is to investigate and compare the efficacy of filgrastim and lenograstim drug treatment in patients with neutropenia in a systematic review.
Methods: This study is a systematic review study conducted in connection with the comparison of the effectiveness of filgrastim and lenograstim in neutropenic patients based on the search in Google scholar, PubMed, ScienceDirect, Irandoc, SID, Magiran databases in the time range of January 2000 to August 2023. This systematic review was based on the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, including systematic search of databases, organization of documents for review, selection of studies, information extraction and finally presentation of the final report. The keywords used for searching in this study were selected based on published primary studies and MESH, and after a detailed examination of the study questions, they were selected according to the PECO criteria.
Methods: This study is a systematic review study conducted in connection with the comparison of the effectiveness of filgrastim and lenograstim in neutropenic patients based on the search in Google scholar, PubMed, ScienceDirect, Irandoc, SID, Magiran databases in the time range of January 2000 to August 2023. This systematic review was based on the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, including systematic search of databases, organization of documents for review, selection of studies, information extraction and finally presentation of the final report. The keywords used for searching in this study were selected based on published primary studies and MESH, and after a detailed examination of the study questions, they were selected according to the PECO criteria.
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Results: 1099 articles were identified in the review of the investigated databases, and after removing duplicate articles, unrelated articles, as well as articles that did not have access to their full text or did not have the required information, eight studies were the final phase, and were checked. Out of the eight selected articles, three articles declared the effectiveness of lenograstim more than filgrastim. Two articles mentioned the greater effect of filgrastim and three articles published in recent years declared the effect of two drugs to be the same. Among these articles, the studies that considered the drug dosage to be the same in the investigated groups and the studies that had a larger statistical population in order to generalize to the society are more important.
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Conclusion: According to studies conducted in recent years, both filgrastim and lenograstim recombinant drugs have the same effectiveness in the treatment of neutropenia.
Elmira Hajizade, Hossein Karimi Moonaghi , Jamshid Jamali, Haniye Mastour ,
Volume 81, Issue 10 (January 2024)
Volume 81, Issue 10 (January 2024)
Abstract
Background: In health care, the well-being and flexibility of the operating room staff are of great importance due to the hard and stressful nature of their work. Therefore, this study was conducted to determine the effect of Stoic resilience training on the resilience of operating room staff.
| Methods: The present study was a semi-experimental pre-test-post-test intervention study with a control group. A study was conducted among 67 people operating room staff working in Imam Ali and Imam Hassan hospitals in Bojnord city in September 2023 In this research, the demographic check list and the Connor and Davidson standard resilience questionnaire were used to collect information. The educational intervention was also implemented using the “SeRenE” Stoic education package. This training package includes 4 exercises, which were used only 3 exercises per day and for 6 consecutive days (45 minutes per day) due to the resilience variable. Statistical analysis was done using SPSS version 24 and at a significance level of 0.05. Results: Based on the results, the total resilience score increased after the Stoic training (72.03±8.31) and showed a statistically significant difference with the control group (65.03±11.16) (P>0.05). The results showed that after Stoic training, mean of subscales of competence, trust in one’s instincts, tolerance of negative affect, positive acceptance of change and secure relationships, control as well as the total score of resilience increased in the training group. Although the mean score of spiritual influences dimension increased after the training, this increase was not statistically significant (P=0.097). Conclusion: The findings show that Stoic training had a positive effect on various aspects of resilience among operating room staff, whose effects are more obvious in some subscales such as trusting individual instincts, tolerance of negative emotions, and positive acceptance of change. In general, the results showed that people's resilience increased after Stoic training. It is recommended to include Stoic training programs in the training of health personnel and caregivers. |
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