Showing 195 results for Ch
Tannaz Ahadi , Nima Khaje , Bijan Forogh , Labaneh Janbazi, Masumeh Bagherzadehcham.m@iums.ac.ir,
Volume 80, Issue 4 (July 2022)
Abstract
Background: There are many conservative interventions to reduce the symptoms of coccydynia, but it is not clear which treatment can be more effective. The aim of this review study was to evaluate the types of conservative interventions and the effectiveness of each of them in reducing coccydynia symptoms.
Methods: This systematic review was carried out based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) instruction. A search for research studies published up to October 2021 was conducted in Neuromusculoskeletal Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran, using Scopus, Science Direct, Web of Knowledge and Cochrane without data constraints. The search was carried out in October 2021 and continued for seven months. The quality of the articles was evaluated using the Physiotherapy Evidence Database scale (PEDro). All prospective randomized clinical trial studies in which participants suffered from coccydynia and were treated with nonsurgical treatments were included.
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Results: 945 articles were found in the primary search of the databases. After eliminating 493 repetitive papers, 452 studies remained which were screened by the two researchers of this study in terms of the title and abstract. 40 studies were selected for full-text evaluation. Finally, 12 articles were included in the review study. Two papers used extracorporeal shockwave, two papers used impar ganglion block, three papers manual therapy, and four studies injection. The remaining four studies used iontophoresis with ketoprofen, biofeedback therapy, acupuncture, and physiotherapy with Kinesio taping.
Conclusion: Treatment with extracorporeal shock wave and impar ganglion block significantly improve tailbone pain and show more permanent effects on patients' symptoms. Manual therapies are mostly used in cases where the tailbone is stable. It seems that achieving the desired response requires more than six sessions, which is not pleasant for patients. Injections, especially those performed under fluoroscopic guidance, require high skill in addition to being unpleasant and painful. However, this procedure is done in one session, so there is no need for the next visit.
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Salma Aryanejad , Fatemeh Taheri Bojd , Atiye Riasi, Tayyebeh Chahkandi, Forod Salehi,
Volume 80, Issue 5 (August 2022)
Abstract
Background: Obesity and overweight are one of the components of metabolic syndrome and the cause of cardiovascular disease and sudden cardiac death. Obesity is associated with a wide range of electrocardiogram (ECG) abnormalities.
Methods: This case-control study was performed on 50 children and adolescents aged 9 to 18 years in Birjand from May to October 2020. In the control group, 25 people with normal weight and in the case group, 25 people with obesity or overweight were included in the study. Individuals with a body mass index of 85-95 percent were defined as overweight, ones with a body mass index above the 95th percentile were defined as obese, and individuals with a body mass index below the 85th percentile were defined as normal. After clinical examination, height, weight and electrocardiogram indices were measured and compared by using statistical tests by SPSS (Version 19) software.
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Results: There were 15 boys in the control group and 17 boys in the case group. The mean age of the control and case groups was 11.28±2.13 and 10.96±1.97 years, respectively. The mean distance between the peak to the end of the T wave in the case group was 323.72±120.15 and in the control group was 79.20±13.06. The mean difference between the shortest and longest distance of TP-e in case group was 48±23.04 and in control group was 18.44±5.58, respectively. There was a statistically significant difference between the two indices (P<0.001). But in other variables, no statistically significant difference was observed between the two groups.
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Conclusion: The results of the present study showed that obesity can have adverse effects on the ECG of children compared to normal-weight individuals. These changes are associated with an increased risk of arrhythmias. Given that these changes can be corrected with weight control, it is recommended to warn families and educate them to prevent and control overweight and obesity.
Seyed Hamed Jafari, Mahshid Manuchehrinasab, Mahdi Saeedi Moghadam , Banafsheh Zeinali Rafsanjani ,
Volume 80, Issue 5 (August 2022)
Abstract
Background: CT is the gold standard method for diagnosing kidney and urinary tract stones. This imaging technique delivers radiation dose to patients, which increases the risk of cancer, especially in patients who need frequent assessment. The aim of this study was to compare the diagnostic ability of ultrasound in Iran compared to CT for diagnosing kidney stones in patients with colic pain.
Methods: The data of this cross-sectional retrospective study was gathered from the patients who were admitted to a University-affiliated hospital, Shiraz University of Medical Sciences from March 2019 to September 2019 suspected of nephrolithiasis and performed CT were collected along with their ultrasound reports. To compare sonography and CT, sensitivity, specificity, and positive and negative predictive values were calculated and the diagnostic percentage difference between the two modalities was evaluated. The diagnostic efficiency of ultrasound in stones of different sizes and locations was also evaluated.
Results: The sensitivity, specificity, and positive and negative predictive values of ultrasound in the initial diagnosis of stones were 83.47%, 62.15%, 85.94% and 57.58%, respectively. Ultrasound diagnosis was not significantly different from CT p=23 actually ultrasound diagnoses were different from CT in only 2.11% of cases. Ultrasound was the most successful in detecting bladder and urethra stones larger than 10 mm.
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Conclusion: The results of this study showed that although ultrasound is less sensitive than CT in the diagnosis of nephrolithiasis, the use of ultrasound could be useful as a primary diagnostic test in patients with suspected nephrolithiasis. The important point is that the strategy of starting the evaluation with ultrasound, and performing additional imaging if necessary, leads to a reduction in the radiation dose of patients with nephrolithiasis. These patients have to do this procedure many times to diagnose and follow up the disease and clearly the offered method leads to reduction of the radiation absorbed dose and the possible effects of radiation, which is in line with the principle of ALARA, the basic principle of radiation protection.
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Ebrahim Jaafaripooyan, Haniye Sadat Sajadi , Maryam Tajvar, Elham Ehsani Chimeh , Iman Falah, Farhad Habibi,
Volume 80, Issue 6 (September 2022)
Abstract
Background: The prevalence of emerging and re-emerging diseases has made the need for basic preparations for all health care organizations more crucial. Strengthening preparedness and formulating crisis strategies will have a great impact on reducing casualties. Given the importance of preparing hospitals to deal with such an outbreak and reduce the resulting mortality, the present study was conducted to assess their readiness against Covid-19.
Methods: The present study is a quantitative and descriptive cross-sectional research conducted from October to March 2019. Data collection used the standard checklists prepared by the European Center for the Prevention and Control of Coronavirus and the Centers for Disease Control and Prevention, consisting of eight domains and 21 components. The minimum score that each hospital could get in this checklist was 143 and the maximum was 429. The sampling method in the present study was a census, and nine reference hospitals for Corona were included in the study. All hospitals’ directors, managers, quality officers and crisis secretaries and others related to hospital readiness during Covid-19 were recruited by the census.
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Results: On average, the hospitals scored 391 out of 429, indicating a fairly "high readiness" in dealing with Covid-19. The highest score obtained by the hospitals was 425 and the lowest score was 349. In terms of preparation areas, the hospitals’ readiness was higher than 80% in all areas. The highest readiness of hospitals was in the fifth domain, i.e. Hand hygiene, personal protective equipment and hospital waste management. The 7th domain namely, patient placement and relocation, and patient visitor access was of the lowest preparation.
Conclusion: The hospitals were of fairly appropriate readiness to deal with Covid-19. This level of preparedness, despite being desirable, might not reflect the real capacity of hospitals to deal with this disease. Regular evaluation of the Covid referral hospitals could help make these hospitals more prepared. Also, the experiences of hospitals that were more prepared should be used to improve the condition of other hospitals.
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Mehran Kouchek, Niloufar Taherpour, Mirmohammad Miri, Roja Asadpour , Fatemeh Ilbeygi, Seyed Pouzhia Shojaei, Mohammad Sistanizad,
Volume 80, Issue 9 (December 2022)
Abstract
Background: Hypertension is an important and controllable risk factor for heart diseases, stroke, renal failure and peripheral vascular disease. The aim of this study was to determine the level of awareness of patients with hemorrhagic stroke to control blood pressure and to provide solutions to improve patients’ awareness.
Methods: This study is a descriptive cross-sectional study that was conducted to evaluate the knowledge of patients with hemorrhagic stroke about the use of antihypertensives. The study population consists of all patients with hemorrhagic stroke, who were admitted to the intensive care unit of Imam Hossein Hospital in Tehran from September 2020 to March 2021. Data related to blood pressure awareness and drug history was completed by the researcher through the method of direct contact with the patients or their relatives. In this study, 17 patients diagnosed with hemorrhagic stroke due to hypertension who were admitted to the intensive care unit of Imam Hossein Hospital in Tehran, were included. The extent of the exact treatment adherence was assessed using the Morisky questionnaire.
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Results: In this study, the median of patients age was 67 and 10 (58.82%) of them were women. The median systolic and diastolic blood pressures were 170 and 95 mmHg on admission. 4(23.53%) subjects were not aware of the disease. Out of 13 people who were aware of their hypertension, 11(64.71%) were under the supervision of a physician. However, 7(63.64%) of the subjects, despite being under the supervision of a physician and acceptable drug adherence, did not have controlled blood pressure and expired.
Conclusion: This study is a warning for patients and health care providers to pay more attention to blood pressure control. Furthermore, educating the community as well as medical staff about the importance of timely diagnosis and accurate treatment of hypertension is highly recommended.
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Aghdas Souresrafil, Mohammadreza Sheikhy-Chaman,
Volume 81, Issue 1 (April 2023)
Abstract
Ali Taghizadeh, Leila Pourali, Mona Joudi, Bahareh Makvandi , Elahe Hasanzadeh, Saeideh Ahmadi Simab , Golshid Nouri Hosseini , Mehrdad Gazanchian,
Volume 81, Issue 3 (June 2023)
Abstract
Background: Breast cancer is the most common type of cancer in many countries, accounting for over 18% of all cancers in females. There are more than one million new cases of breast cancer each year. Most women diagnosed with breast cancer are over the age of 50, but younger women can also get breast cancer. About one in seven women are diagnosed with breast cancer during their lifetime. There's a good chance of recovery if it's detected at an early stage. In Iran, breast cancer is the most common cancer among women, making up 21.4% of all female cancers. The mortality rate of this cancer is 4.33 for every 100,000 people. The purpose of this research is to see how often different kinds of early breast cancer come back and how long people live after being diagnosed.
Methods: This retrospective study evaluated the medical records of 500 breast cancer patients at two hospitals in Mashhad, Iran during April 2006 to March 2016. We used SPSS software, version 16 (SPSS Inc., Chicago, IL, USA) to analyze data. A P value less than 0.05 means that the results are considered statistically significant.
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Results: We included 230 women with breast cancer. The average overall survival was 130.7 months, with 83.2% of people surviving for five years and 78.8% surviving for 10 years. The stage of the disease is strongly linked to the recurrence (P=0.000). Additionally, the specific type of disease is also strongly related to disease recurrence (P=0.01) or metastasis (P=0.01). Patients who have the triple-negative subtype had the highest chance of the cancer spreading and recurrence compared to patients with other subtypes.
Conclusion: The different types of breast cancer are strongly linked to the disease recurrence or metastasis. Patients with triple-negative subtypes had the most cases of cancer spreading to other parts of the body and coming back again, compared to other subtypes. Our findings also showed that patients with the triple-negative disease had the worst overall and disease-free survivals.
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Hadi Lotfi, Morteza Izadi, Ehsan Lutfi , Hadi Esmaeili Gouvarchin Ghaleh,
Volume 81, Issue 7 (October 2023)
Abstract
Deliberate or threatening use of viruses, bacteria, toxins, or poisonous substances prepared from living organisms to cause death or disease in humans, animals, and plants is called bioterrorism. These agents can be spread by spraying them in the air, causing infection in animals, transferring this infection to humans, or contaminating water and food sources. Defense measures, such as emergency responses to this type of terrorism, are unfamiliar and unknown. The general state of helplessness caused by the lack of complete preparation and the lack of anti-pollution strategies complicates the issue. The ability and widespread interest of civilian personnel to participate in the development of chemical and biological weapons is directly related to easy access to academic excellence around the world. Another factor is the tempting misuse of freely available electronic data and knowledge about the production of antibiotics, vaccines, and conventional weapons with their various complex details. The use of animals in laboratory research to better understand the mechanisms of disease and treatment and to overcome the limitations of clinical trials has a long history. For many viruses, laboratory diagnostic methods and reagents must be continuously modified to account for genetic variations and variants. Unlike bacterial diseases, many of which can be treated with antimicrobial drugs, there are fewer medical countermeasures to combat viral infections. Many of these pathogens are lethal or cause debilitating diseases in humans, making it ethically inappropriate to test the effectiveness of these countermeasures on human volunteers. Researchers must have a correct understanding of various animal models so that they can make the correct choice, gain a better understanding of the clinical symptoms of viral diseases, and provide possible options for treatment and vaccine development. It should be noted that decision-making when faced with a biological attack should be done away from too much fear, and this requires researchers to have prior knowledge of facing these threats. Despite all these checks and measures taken in advance, the international preparedness against these attacks is weak, which can be attributed to the lack of global plans to deal with the epidemic.
Ahmad Kachoei, Monireh Mirzaei , Amrolah Salimi, Mostafa Vahidian, Shima Rahimi, Ali Ghalehnoie,
Volume 81, Issue 7 (October 2023)
Abstract
Background: Considering the high prevalence of breast masses and the importance of screening and follow-up for malignancies in women, and since age and hormonal changes during menopause play a role in determining the type of pathology and prognosis of the masses, the purpose of this study is to determine the relationship between menopause and mass pathology.
Methods: This was a cross-sectional-analytical study that was conducted in order to investigate the types of pathology of breast masses and their relationship with the age of menopause in women referred to Shahid Beheshti Hospital in Qom between April 2013 and April 2019. The inclusion criteria include: having sufficient file information and having a contact number to complete personal information, no history of cancer in other parts of the body and simultaneous malignancies, and the exclusion criteria also include: samples that were taken by cellular aspiration sampling, There were women who had a history of first-degree breast malignancy and were previously diagnosed with breast cancer and there was a possibility that the new mass under study was metastatic. Finally, the patients' information was extracted from the files and recorded in pre-prepared checklists. And the supplementary information of the incomplete files was asked and completed using the contact information of the patients. After collecting the information, using SPSS software version 26 and with chi-square and t-test statistical tests and considering the significance level of 0.05 the data was analyzed.
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Results: He prevalence of malignancy in postmenopausal women was higher than in premenopausal women. Also, a significant difference was found between tumor size, the presence or absence of metastasis, and menopause (P<0.05), but no significant difference was found between tumor location and menopause (P>0.05).
Conclusion: Breast malignancies (invasive ductal carcinoma, invasive mixed carcinoma, mucinous, medullary, and papillary carcinoma) were more common in postmenopausal women than non-menopausal women. In both groups, ductal dilatation and chronic inflammation were the most benign findings, and fibroadenoma was found at a much lower rate in menopausal women than in non-menopausal.
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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.
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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.
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Hamid Reza Choobdari , Mohammad Ali Gharaat ,
Volume 81, Issue 10 (January 2024)
Abstract
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Stroke is a medical condition in which occluded blood flow to the brain causes cell necrosis. The main types of stroke are ischemic (due to lack of blood flow with much higher prevalence) and hemorrhagic (due to bleeding with low prevalence). Ischemic stroke is caused by the reduction of blood to the brain tissue or complete occlusion of brain vessels by a blood clot following arterial plaques rapture of cerebral arteries due to atherosclerosis, cerebral myocardial infarction and small vascular lesion infarction. Inflammatory reactions, increased oxidative stress, cell death and autophagy are the most aggravating factors in this condition. Instead, hemorrhagic stroke is caused by spontaneous intracranial hemorrhage and subarachnoid hemorrhage, highly common in men. To prevent the possible causes of stroke, investigators attempted to study about the ways that may decrease the risk factors such as trauma, high arterial hypertension, alcohol, low-density lipoprotein and glycerides, tobacco and drugs. Physical activity is a potent inhibitory factor which reported to be effective in prevention of stroke and post-stroke rehabilitation. Aerobic, combined or strenuous activities protect brain tissue by balancing apoptotic and anti-apoptotic pathways, stimulating angiogenesis, reducing oxidative stress, increasing antioxidant activity, optimizing Integrity and preservation of the blood-brain barrier, improving nerve functions and preventing neuronal death. The mechanisms involved in rehabilitation after ischemic stroke with physical activity mostly refer to improved dendrites and synapses, synaptic flexibility, regulation of inotropic receptors with glutamate, increased BDNF, GAP43 and insulin-like growth factor. In patients with cognitive impairments following acute ischemic stroke, high intensity exercise improves processing timing and attention allocation, self-independence, walking ability, aerobic power and reduces memory degradation. Moreover, early start of physical activity after ischemic stroke inhibits the initial physiological response to stroke and prevents optimal recovery. In contrary, reports show positive effects of onset of physical exercise a day after stroke. In hemorrhagic stroke, exercise reduces systolic blood pressure, moderates resting blood pressure via parasympathetic regulations and triggers angiogenesis in the nervous system. Light to moderate or long-term physical training is recommended in comparison to short-term high-intensity training. In addition, early onset of physical activity during recovery after stroke may be beneficial.
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Mohammadreza Sheikhy-Chaman , Neda Hoseini Abforosh, Aghdas Souresrafil, Vahid Makhtoumi,
Volume 81, Issue 10 (January 2024)
Abstract
Javad Alipour, Reihaneh Askary Kachoosangy , Zahra Ebrahimabadi , Yaghoub Shavehei, Mohammad Sadegh Malek ,
Volume 81, Issue 11 (February 2024)
Abstract
Background: Most hemiplegic children experience disorders related to lower limbs such as balance. Considering the importance of balance, in order to participate in activities of daily living, it is very important to use modern neuro-rehabilitation methods such as mirror therapy to improve balance. The purpose of the present study was to determine the effectiveness of mirror therapy on the static and dynamic balance of children with hemiplegic CP aged 5 to 12 years.
Methods: This study was conducted as a double-blind, randomized clinical trial on 20 children with spastic hemiplegia aged between 5-12 years old, from June 2021 to August 2022 in Tehran, Iran. Participating children were randomly allocated into test (n=10) and control (n=10) groups. The children in the treatment group underwent 20 treatment sessions during four weeks. Each session consisted of 30 minutes of routine treatment and 15 minutes of mirror therapy for lower limbs. In the control group, sham therapy was performed instead of mirror therapy. The exercises performed in a seated position were: (1) active flexion of hip, knee, and ankle joints, (2) active knee extension plus ankle dorsiflexion, and (3) knee flexion (> 90°). Both groups were measured by the Pediatric Balance Scale to assess static balance and the Timed Up and Go test to assess dynamic balance at entry and the end of the study. SPSS version 26 software was used for statistical analysis.
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Results: Examining the results of the evaluations showed that before the treatment, the static and dynamic balance of the two groups did not differ significantly (p> 0/05), but the static and dynamic balance scores of the children in the treatment group after the four weeks mirror therapy period (five days per week) were statistically significant different from the control group (p<0/05).
Conclusion: According to the present study, it seems that mirror therapy as a complementary treatment can have a positive effect on improving balance (static and dynamic) in children with hemiplegic CP.
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Maryam Ameri, Atieh Ansari, Abbas Aghabiklooei, Farrokh Taftachi , Leyla Abdolkarimi,
Volume 82, Issue 1 (April 2024)
Abstract
Background: Medical errors are one of the biggest problems of the health system in countries. Identifying the factors responsible for these errors is crucial to designing optimal strategies to reduce such occurrences. The aim of this study was to investigate the type and nature of medical errors.
Methods: In this cross-sectional descriptive study, all documented medical errors that occurred between March 2021 and February 2022 at Firoozgar Educational and Medical Center were thoroughly examined. The data collection involved reviewing records from various departments within the center to ensure a comprehensive analysis of error types. The extracted data were processed and analyzed using SPSS v.22 software, allowing for statistical evaluation and identification of potential patterns or trends in medical errors over the specified period.
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Results: A total of 214 cases were reviewed. 45.3% of the recorded medical errors occurred in the morning shift, 20.6% in the evening shift and 34.1% in the night shift. The highest number of medical errors was reported by nurses (40.7%), followed by physicians (16.8%) and paramedics (11.7%). The etiology of most medical errors was systemic errors (63.6%) followed by pharmacological errors (15.4%) and technical errors (13.1%) and the most reported systemic errors were of insufficient supervision. Most of the patients who had medical errors were admitted to the inpatient wards (40.7%) and later to the surgical wards (17.3%) and ICU (12.6%). 62.1% of medical errors did not cause any specific complication and in 33.2% of cases, mild complication, 10.7% moderate complication and 3.3% severe complication occurred for patients. 62.1% of medical errors had no consequences for anyone, and in 36.9% of cases, the consequences of errors were to the patient and 1% of the consequences of errors were to the organization and employees.
Conclusion: Most of the reported medical errors were performed by nurses and were uncomplicated errors. Establishing transparent and accurate self-reporting systems is essential to identify medical errors of all employees.
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Nasrin Changizi, Arash Shirdel, Amin Daemi ,
Volume 82, Issue 1 (April 2024)
Abstract
Mohamad Sarkheil, Mehran Mohseni, Akbar Ali Asgharzadeh , Ali Rasouli Bozcheloie ,
Volume 82, Issue 5 (August 2024)
Abstract
Background: Based on the recommendation of the European Committee and ICRP, DRL values should be determined at the local, national and regional levels for CTDIvol (Computed Tomography Dose Index volume) and DLP (Dose Length Product) dose indicators. According to the radiation protection guidelines, it is essential study has determined DRL in Saveh hospitals
Methods: This study was conducted with two methods based on the results and calculations obtained from the annual Quality Control (QC) reports and the Data Collection (DC) method related to patient scans. In this study, by referring to the annual reports of each device and using radiation components during dosimetry and determining CTDIair or CTDIw, the correction factor was obtained. Using this factor and existing equations, DLP and CTDIvol were calculated based on quality control standards. The second quartile or the median was determined as DRL for head, sinus, chest and abdomen/pelvis imaging protocols and its values were compared with each other and other studies. This study was conducted in February and March 2023 in three hospitals in Saveh city.
Results: The diagnostic reference levels of CTDIvol index were obtained in both QC and DC methods for head (32.76 and 32.36), sinus (11.73 and 9.89), chest (6.06 and 5.11) and abdomen/pelvis (11.86 and 10.56) imaging. The highest DRL values of DLP index in both QC and DC methods are for head, abdomen/pelvis, chest and sinus CT scans, respectively. In the QC method, these values were (603.99), (478.15), (187.15), and (132.65) respectively, and in the DC method, the values were (601.84), (427.76), (219.01), and (114.81) mG.cm.
Conclusion: According to the results of this study and the lack of significant difference between the DRL values of CTDIvol and DLP indicators in both QC and DC methods, it is recommended that the centers, if they have the acceptance criteria for annual quality control, can determine the DRL by referring to the device console information from the DC method.
Reihane Chegini , Seyed Hasan Seyed Sharifi , Rasul Nikdel ,
Volume 82, Issue 5 (August 2024)
Abstract
Background: Benign tumors of the gastrointestinal tract with a muscular origin are typically found in the esophagus, stomach, or small intestine, and rarely in the large intestine. Approximately 3% of all gastrointestinal leiomyomas occur in the large intestine, primarily in the descending colon and sigmoid colon. These lesions are usually asymptomatic and are often discovered during endoscopic procedures.
Case Presentation: A 38-year-old female patient admitted to the emergency department of Imam Ali Hospital in Bojnurd city in January 2024, reporting vague and nonspecific lower abdominal pain, abdominal distension, nausea, vomiting, low appetite and signs of partial gastrointestinal obstruction over the past week that don’t have any history of weight loss, gastrointestinal bleeding, constipation or family history of cancer. Her symptoms had not responded to Over-the-counter (OTC) medicines and outpatient treatment. Given the nonspecific manifestations, a CT scan of the abdomen and pelvis with iv contrast was requested for further evaluation of inta abdominal disease. The CT findings indicated a 5.5 cm lesion at the beginning of the large intestine, which exerted pressure on the distal part of small intestine, leading to evidence of partial obstruction of the distal part of small intestin. The patient was diagnosed with small bowel obstruction due to an ascending colon tumor and was scheduled for surgical intervention. She underwent resection of right colon, 10-15 cm of terminal ileum along with drainage of the regional lymph nodes. The excised tissue sample was sent for histopathological examination, which suggested a benign colon tumor likely to be a leiomyoma. To facilitate a more accurate diagnosis, immunohistochemical analysis was recommended, which confirmed the diagnosis of leiomyoma.
Conclusion: Colonic leiomyomas can present with various symptoms depending on their size and location. Due to the difficulty in differentiating leiomyomas from malignant colonic tumors, particularly when they are larger, surgical intervention is often recommended. This case highlights the importance of early diagnosis and appropriate management strategies for these tumors to prevent potential complications.
Mohammad Parsa Mahjoub , Naser Kechuian, Mohammad Haji Aghajani , Hossein Aghamiri , Ainaz Samadi, Fateme Omidi ,
Volume 82, Issue 7 (October 2024)
Abstract
Background: Cardiovascular surgery is sometimes associated with brain consequences such as cognitive disorders. Diagnosis of cognitive disorders risk factors in cardiovascular patients is important for increasing patient satisfaction and success after (CABG). In the present study, the frequency of cognitive disorders in cardiovascular patients and its effective factors were investigated.
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Methods: In the current cross-sectional study that was conducted from September 2019 to the February 2022, 60 cardiovascular patients undergoing CABG surgery were selected by convenience sampling method. Demographic, clinical, and intraoperative information was recorded for participants in the data collection form. Mini–Mental State Examination quesionary.
Results: The results showed that 15% of participants had cognitive impairment. Gender and age were the actual variables on the incidence of cognitive disorders after CABG surgery. The frequency of cognitive disorders in women was 14 times higher than men and 6.5 times higher in the elderly. Elderely population was considered as 65 years old or above. The clinical variables such as blood transfusion under surgery and ejection fraction<40% were effective factor for incidence of cognitive disorders in cardiovascular patients.
Conclusion: The CABG surgery may be associated with cognitive disorders in cardiovascular patients, which is more common in women and the elderly. Further studies are recommended to confirm the results of the present study and identify the related risk factors.
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Afsaneh Amirabi, Samira Mashhadi Alipouri , Elghar Khanchi,
Volume 82, Issue 10 (January 2025)
Abstract
Background: Ectopic pregnancy (EP) is a leading cause of maternal mortality globally. Early diagnosis and treatment has been associated with reduction in maternal mortality and has shifted treatment to conservative methods. The most widely used drug for Medical treatment is methotrexate (MTX). This study aimed to investigate the predictive value of early changes (day 1/4) in serum β-HCG levels in managing tubal pregnancy with single-dose MTX.
Methods: In this cross-sectional analytical study, 135 eligible women with tubal pregnancy who received a single dose of methotrexate, were included. Methotrexate was administered intramuscularly (50 mg/m²), and serum β-HCG levels were measured on days 1, 4, and 7 following the injection. The percentage change in serum β-HCG levels compared to the initial values was calculated. Treatment failure was defined as the need for surgery and/or additional dose of methotrexate.
Results: The treatment success rate was 67% while the treatment failure rate was 33%. Among patients whose β-HCG levels increased on day 4 compared to day 1, the treatment failure rate was 86%. In contrast, for patients with decreased β-HCG levels, the failure rate was only 19%. The changes in β-HCG levels from day 1 to day 4 indicated that a decrease of less than 20% in β-h-CG levels on day 4 compared to day 1 was associated with a sensitivity of 72.2% ( CI95%: 62.2% to 82.4%) and a specificity of 80% (CI95%: 66.18% to 89.1%). This change in β-HCG levels also exhibited a positive predictive value of 60% and a negative predictive value of 88% for predicting treatment failure.
Conclusion: Based on the findings of this study, changes in β-HCG levels on days four and seven may serve as predictive factors for the failure of single-dose methotrexate treatment in patients with tubal pregnancy.
Maryam Hajhashemi , Hedieh Bonakdarchian, Tahereh Khalili Borujeni , Minoo Movahedi , Roya Sahebi, Fedyeh Haghollahi,
Volume 83, Issue 6 (September 2025)
Abstract
Background: Pelvic organ prolapse (POP) is a condition resulting from weakness or damage to the muscles, ligaments, and other supporting structures of the vagina, and it exposes affected women to reduced quality of life and sexual function. The present study examined the symptoms, sexual function, and quality of life of women one year after repair of pelvic organ prolapse.
Methods: This study was a prospective cohort before-after study that was conducted on 200 married women with pelvic prolapse grade 1-4 (POP-Q) in the age group of 47-75 years who underwent reconstructive surgery (anterior and posterior colporrhaphy) in Shahid Beheshti and Al-Zahra hospitals in Isfahan between October 2022 and March 2024. The data collection tools were three questionnaires: Female Sexual Function Index (FSFI), Pelvic Discomfort (PFDI-20) and Quality of Life (SF-36) which were completed before surgery and one year after surgery. Stata software version 17 was used to analyze the data. To compare the scores before and after, paired t-test or Wilcoxon statistical tests were used, to compare the severity of patients' clinical symptoms based on the levels before and after surgery, the symmetry/Bowker test was used, and to compare the status of the sexual function index (impairment/no impairment) before and after surgery, the McNemar test was used and the significance level was considered to be P<0.05.
Results: The mean age of the study participants was 59.5±12.6 years. The majority of the women (157 individuals; 78.5%) were housewives. The mean number of pregnancies was 4.3±2.1, and the mean number of live births was 3.75±1.89. All women included in the study were postmenopausal. The severity of clinical symptoms, sexual dysfunction index status, and median quality of life score were significant between before and after the intervention. The severity of clinical symptoms, the status of the sexual dysfunction index, and the median quality of life score showed significant differences before and after the intervention.
Conclusion: Pelvic prolapse surgery can significantly improve the quality of life and sexual function of patients one year after surgery, in addition to correcting the anatomical structure.
