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Nooshin Shirzad, Fateme Ziamanesh, Seyedahmad Seyedalinaghi , Alireza Esteghamati , Mahboobeh Hemmatabadi ,
Volume 83, Issue 3 (6-2025)
Volume 83, Issue 3 (6-2025)
Abstract
Background: Patients with type 2 diabetes mellitus (T2DM) are diagnosed with a wide range of renal damage, usually presenting with albuminuria and decreased estimated Glomerular Filtration Rate (eGFR). Some patients have only albuminuria and normal eGFR, while others have normoalbuminuria even in advanced stages of chronic kidney disease. This study investigated and followed the course of diabetic nephropathy in patients with T2DM.
Methods: 1107 patients with T2DM were enrolled in the study. This historical cohort was conducted between the years 2017 and 2022. Patients with confirmed type 2 DM, referred to the diabetes clinic of Vali-Asr Hospital, affiliated with the Tehran University of Medical Science. Complete medical history, blood pressure, and laboratory data were obtained in the first and follow-up visits. Follow-up was every 3 to 6 months for 30 months. Every year, 24-hour urinary albumin was measured, and eGFR was estimated based on the Cockcroft-Gault formula.
Results: Male sex, age, disease duration, weight, systolic blood pressure, 2 hours postprandial (2hpp) glucose, serum triglyceride, and uric acid significantly correlated with albuminuria. At the initiation of the study, the highest eGFR values occurred in microalbuminuric patients, followed by a sharp decrease. No significant correlation was found between eGFR and albuminuria in most patients, and more than half of them with eGFR of less than 60 ml/min/m2 still had normal albuminuria
Conclusion: This study showed that patients with microalbuminuria and normoalbuminuria had the highest eGFR values followed by macroalbuminuria, but patients with normoalbuminuria and microalbuminuria had an initial increase and then a decrease, and the macroalbuminuria group showed the sustained and greatest decrease during the follow-up period. Serial surveillance of both albuminuria and GFR is crucial in T2DM.
Methods: 1107 patients with T2DM were enrolled in the study. This historical cohort was conducted between the years 2017 and 2022. Patients with confirmed type 2 DM, referred to the diabetes clinic of Vali-Asr Hospital, affiliated with the Tehran University of Medical Science. Complete medical history, blood pressure, and laboratory data were obtained in the first and follow-up visits. Follow-up was every 3 to 6 months for 30 months. Every year, 24-hour urinary albumin was measured, and eGFR was estimated based on the Cockcroft-Gault formula.
Results: Male sex, age, disease duration, weight, systolic blood pressure, 2 hours postprandial (2hpp) glucose, serum triglyceride, and uric acid significantly correlated with albuminuria. At the initiation of the study, the highest eGFR values occurred in microalbuminuric patients, followed by a sharp decrease. No significant correlation was found between eGFR and albuminuria in most patients, and more than half of them with eGFR of less than 60 ml/min/m2 still had normal albuminuria
Conclusion: This study showed that patients with microalbuminuria and normoalbuminuria had the highest eGFR values followed by macroalbuminuria, but patients with normoalbuminuria and microalbuminuria had an initial increase and then a decrease, and the macroalbuminuria group showed the sustained and greatest decrease during the follow-up period. Serial surveillance of both albuminuria and GFR is crucial in T2DM.
Naseh Yousefi, Katayoun Moradi, Korosh Mansouri , Simin Sajadi , Masoud Torabi ,
Volume 82, Issue 12 (3-2025)
Volume 82, Issue 12 (3-2025)
Abstract
Background: The most common cause of Shoulder pain is inflammation in the subacromial bursa. Intra-bursal corticosteroid injections are one of the most common methods in cases of bursitis. Recently, botulinum toxin A injection has also been used as a safe treatment in these patients. This injection does not have many of corticosteroid disadvantages. The most important disadvantages of this method are its cost. This study was performed to compare corticosteroids with botulinum toxin A in the treatment of subacromial bursitis by single injection.
Methods: This study is a prospective randomized clinical trial performed on patients with rotator cuff tendinopathy who were referred to the physical medicine and rehabilitation clinic of Iran University of Medical Sciences from November 2020 to October 2021. 54 patients with signs and symptoms of rotator cuff tendinopathy, were randomly assigned to one of the two groups of botulinum toxin A or corticosteroid injection. Routine treatment included exercise training for all patients. Patient's symptoms were assessed using VAS, Constant Score and SPADI criteria before treatment, two weeks and two months after injection.
Results: In the VAS study, both groups showed an improvement over baseline (P=0.000), which was significantly greater in the corticosteroid group. VAS between the first and second follow-up showed a decrease in the botulinum toxin A group and an increase in the corticosteroid group. In the Constant Score and SPADI study, both groups showed an improvement over baseline.
Conclusion: This study showed that a single-session injection of botulinum toxin A is less effective than corticosteroid in controlling symptoms of these patients. However, the therapeutic effect of botulinum toxin A, remains 2 months and unlike corticosteroid, has more reliability and durability.
Methods: This study is a prospective randomized clinical trial performed on patients with rotator cuff tendinopathy who were referred to the physical medicine and rehabilitation clinic of Iran University of Medical Sciences from November 2020 to October 2021. 54 patients with signs and symptoms of rotator cuff tendinopathy, were randomly assigned to one of the two groups of botulinum toxin A or corticosteroid injection. Routine treatment included exercise training for all patients. Patient's symptoms were assessed using VAS, Constant Score and SPADI criteria before treatment, two weeks and two months after injection.
Results: In the VAS study, both groups showed an improvement over baseline (P=0.000), which was significantly greater in the corticosteroid group. VAS between the first and second follow-up showed a decrease in the botulinum toxin A group and an increase in the corticosteroid group. In the Constant Score and SPADI study, both groups showed an improvement over baseline.
Conclusion: This study showed that a single-session injection of botulinum toxin A is less effective than corticosteroid in controlling symptoms of these patients. However, the therapeutic effect of botulinum toxin A, remains 2 months and unlike corticosteroid, has more reliability and durability.
Ramyar Rahimi Darehbagh , Sara Moradian , Afshin Hajihasanzadeh, Masood Moradi, Farhang Safar Nejhad ,
Volume 82, Issue 11 (2-2025)
Volume 82, Issue 11 (2-2025)
Abstract
Background: Acute pancreatitis is a common and challenging disease that can develop local and systemic complications. It is divided into biliary and non-biliary pancreatitis, based on ultrasonographic findings. This study aimed to evaluate the clinical and paraclinical findings of patients with acute pancreatitis and related factor.
Methods: This cross-sectional study included all patients hospitalized with a diagnosis of acute pancreatitis in Besat and Towhid hospitals of Sanandaj from March 2016 to March 2018. All patients admitted with a confirmed diagnosis of acute pancreatitis during the mentioned period were enrolled. Inclusion criteria were a definitive diagnosis of acute pancreatitis based on clinical features (characteristic abdominal pain), laboratory findings (serum amylase or lipase elevated more than three times the normal level), and/or imaging evidence. Patients with chronic underlying conditions such as diabetes, chronic renal or hepatic failure, advanced cardiac disease, or neoplasms were excluded to reduce confounding effects.
Results: Of the 150 patients, 89 were female (59.33%), and 61 were male (40.67%). The mean age of the patients was 53.11 years old. 62% of patients had biliary pancreatitis, and 38% had non-biliary. The prevalence of alcoholic pancreatitis in the population was 5.33%. The age of people with biliary pancreatitis was more than non-biliary. According to Ranson's criteria, 6% of patients had severe acute pancreatitis, all of whom were over 60.
Conclusion: Acute pancreatitis was more prevalent among women, particularly in the fifth decade of life, with gallstones being the leading cause. Patients with biliary pancreatitis were significantly older, and advanced age was associated with increased disease severity. Moreover, blood glucose, AST, and LDH were significantly higher in severe cases. These findings highlight the importance of early diagnosis, accurate severity assessment, and special attention to elderly patients and those with biliary pancreatitis to reduce complications and improve clinical outcomes.
Methods: This cross-sectional study included all patients hospitalized with a diagnosis of acute pancreatitis in Besat and Towhid hospitals of Sanandaj from March 2016 to March 2018. All patients admitted with a confirmed diagnosis of acute pancreatitis during the mentioned period were enrolled. Inclusion criteria were a definitive diagnosis of acute pancreatitis based on clinical features (characteristic abdominal pain), laboratory findings (serum amylase or lipase elevated more than three times the normal level), and/or imaging evidence. Patients with chronic underlying conditions such as diabetes, chronic renal or hepatic failure, advanced cardiac disease, or neoplasms were excluded to reduce confounding effects.
Results: Of the 150 patients, 89 were female (59.33%), and 61 were male (40.67%). The mean age of the patients was 53.11 years old. 62% of patients had biliary pancreatitis, and 38% had non-biliary. The prevalence of alcoholic pancreatitis in the population was 5.33%. The age of people with biliary pancreatitis was more than non-biliary. According to Ranson's criteria, 6% of patients had severe acute pancreatitis, all of whom were over 60.
Conclusion: Acute pancreatitis was more prevalent among women, particularly in the fifth decade of life, with gallstones being the leading cause. Patients with biliary pancreatitis were significantly older, and advanced age was associated with increased disease severity. Moreover, blood glucose, AST, and LDH were significantly higher in severe cases. These findings highlight the importance of early diagnosis, accurate severity assessment, and special attention to elderly patients and those with biliary pancreatitis to reduce complications and improve clinical outcomes.
Hamed Zamanian, Ahmad Shalbaf,
Volume 82, Issue 10 (1-2025)
Volume 82, Issue 10 (1-2025)
Abstract
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Background: Nonalcoholic fatty liver disease (NAFLD) represents a growing global health burden, strongly associated with rising rates of obesity, diabetes, and metabolic syndrome. This study introduces a machine learning framework to precisely diagnose NAFLD, classify disease severity, and stratify risk using routine clinical data. Our model improves early detection and risk prediction, supporting evidence-based clinical decisions. Leveraging predictive analytics, this scalable approach identifies high-risk patients and enables personalized interventions. The data-driven strategy optimizes NAFLD management by extracting maximal value from standard healthcare records, delivering both clinical and operational advantages.
Methods: This study examined 181 NAFLD patients across disease stages. The dataset was compiled from February 2010 to January 2019 at Eheim University Hospital, comprising general volunteers who were diagnosed with or without fatty liver based on histopathological evaluation of liver biopsy samples. Forward selection and mutual information identified predictive features, applied in classification models (e.g., random forest) to assess steatosis severity. Explainable AI (XAI) improved model interpretability. Combining robust feature selection, machine learning, and XAI ensured accurate, clinically actionable NAFLD severity evaluation. Results: The XGBoost classifier with forward feature selection attained a classification accuracy of 69.23%±5.5% for steatosis severity. Interpretability analysis highlighted age, Body Mass Index (BMI), High-Density Lipoprotein (HDL), Low-Density Lipoprotein (LDL), A1c Hemoglobin (HbA1c), and glutamate pyruvate transaminase (GPT) as the most impactful variables across three severity classes. Furthermore, GPT, age, BMI, HDL, HbA1c, LDL, triglycerides, and cholesterol were critical to model performance, emphasizing their diagnostic significance in NAFLD progression. These findings suggest their utility in clinical assessments and risk stratification. Conclusion: This study developed a machine learning model for accurate NAFLD diagnosis and severity stratification using routine clinical data. Accessible biomarkers reliably predicted disease progression, enabling gastroenterologists to facilitate early intervention. This cost-effective approach reduces healthcare costs while improving outcomes through precision medicine. Implementing such predictive tools in clinical practice could optimize resource allocation and enhance long-term NAFLD management. The framework supports timely diagnostics and targeted therapies, advancing patient-centered care. |
Fatemeh Rasouli Amiri , Khadijeh Ezoji, Seyed Reza Hosseini, Ali Bijani , Kayvan Latifi ,
Volume 82, Issue 8 (11-2024)
Volume 82, Issue 8 (11-2024)
Abstract
Background: People with chronic pain have a shorter life expectancy than the general population, in part as a result of excess mortality from cardiovascular disease (CVD). The purpose of this study was to investigate the relationship between chronic pain and risk factors of cardiovascular diseases.
Methods: In this study, 400 elderly diabetic patients in phase one of the Amirkola Elderly Cohort Study (AHAP), which was conducted between April 2011 to March 2016, were divided into two groups of 200 people, with chronic pain and without chronic pain. Then, the risk factors for cardiovascular diseases that are available in this plan such as physical activity level, body mass index, blood sugar levels, blood lipid profile status, Hypertension and smoking were examined.
Methods: In this study, 400 elderly diabetic patients in phase one of the Amirkola Elderly Cohort Study (AHAP), which was conducted between April 2011 to March 2016, were divided into two groups of 200 people, with chronic pain and without chronic pain. Then, the risk factors for cardiovascular diseases that are available in this plan such as physical activity level, body mass index, blood sugar levels, blood lipid profile status, Hypertension and smoking were examined.
Results: In the study of baseline variables in the elderly with and without pain with diabetes, it was found that women reported more pain with 54.4% than men with 45.6% that there is a significant difference between the two sexes (P=0.0001). Education level was also associated with having pain so that 67.8% of the elderly with having pain were illiterate and this relationship was significant (P=0.006). 82.5% of the elderly with higher physical activity had less pain than the elderly with less physical activity. This indicates the effect of physical activity in reducing pain and the observed relationship was significant (P=0.001). Triglyceride levels and history of underlying disease were lower in painless elderly (P=0.009 and P=0.002). Physical activity in the elderly without pain was higher than the elderly who had pain and this significant difference was reported (P=0.002).
Conclusion: The results of this study indicate a high prevalence of chronic pain in the elderly in Amirkola. In the elderly without chronic pain, there were lower triglyceride levels, more physical activity and fewer underlying diseases. Attention to chronic pain features among elderly to identify vulnerable groups and providing better care can increase the quality of life in this group.
Conclusion: The results of this study indicate a high prevalence of chronic pain in the elderly in Amirkola. In the elderly without chronic pain, there were lower triglyceride levels, more physical activity and fewer underlying diseases. Attention to chronic pain features among elderly to identify vulnerable groups and providing better care can increase the quality of life in this group.
Mohammad Hossein Rabbani , Parvin Farzanegi, Mohammad Ali Azarbayjani ,
Volume 82, Issue 6 (9-2024)
Volume 82, Issue 6 (9-2024)
Abstract
Background: Aerobic exercise and the consumption of certain supplements, such as ursolic acid, may reduce sarcopenia and osteoporosis by activating or inhibiting specific genes and signaling pathways. This study aimed to investigate the effects of aerobic exercise and ursolic acid supplementation on the expression of genes related to inflammatory and autophagy pathways in type 2 diabetes.
Methods: This experimental study was conducted from May 2023 to October 2023 at Islamic Azad University, Sari Branch. A total of 30 male Wistar rats (12 months old, mean weight 390 g) were randomly assigned to five groups: 1) healthy (normal), 2) diabetic, 3) diabetic+exercise, 4) diabetic+supplement, 5) diabetic+exercise+ supplement. Diabetes was induced via intraperitoneal injection of streptozotocin (50 mg/kg body weight). The aerobic exercise protocol was performed five days a week for eight weeks. The supplement groups received a daily intraperitoneal injection of ursolic acid (250 mg/kg body weight).
Methods: This experimental study was conducted from May 2023 to October 2023 at Islamic Azad University, Sari Branch. A total of 30 male Wistar rats (12 months old, mean weight 390 g) were randomly assigned to five groups: 1) healthy (normal), 2) diabetic, 3) diabetic+exercise, 4) diabetic+supplement, 5) diabetic+exercise+ supplement. Diabetes was induced via intraperitoneal injection of streptozotocin (50 mg/kg body weight). The aerobic exercise protocol was performed five days a week for eight weeks. The supplement groups received a daily intraperitoneal injection of ursolic acid (250 mg/kg body weight).
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Results: Data analysis showed that there was a statistically significant difference between the groups in the expression levels of LC3, Becline-1, TNFα, IL-1β Akt, and FOXO3 genes (P=0.000). The results of the post hoc test also showed that the expression level of LC3, Becline-1, TNFα, IL-1β genes in the model group increased significantly compared to the normal group (P=0.000). A significant difference was observed between intervention groups (P<0.05). The results of the follow-up test also showed that the level of expression of Akt genes in the model group was significantly decreased compared to the normal group (P=0.000). No significant difference was observed between intervention groups (P<0.05).
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Conclusion: The results of the study showed that regular aerobic training and Ursolic acid consumption can affect inflammatory and autophagy pathways. These effects reduce cell atrophy through changes in some biological signals and help improve muscle function in type 2 diabetes. Therefore, aerobic training and Ursolic acid consumption can serve as an effective strategy for improving metabolic status and preventing cellular damage in this patient population.
Fatemeh Hayati, Fariba Talebi, Maryam Khombi Shooshtari , Seyed Bahman Qaderian, Leila Moradi , Asieh Aref,
Volume 82, Issue 5 (8-2024)
Volume 82, Issue 5 (8-2024)
Abstract
Background: Diabetic kidney disease is a common complication of diabetes and the most common cause of end-stage kidney disease worldwide. Empagliflozin is associated with slower progression of kidney disease and a lower incidence of kidney complications. So, the aim of the study is to compare renal outcomes in type 2 diabetic patients with and without empagliflozin.
Methods: This research is a cross-sectional study based on the information contained in the files of patients referred to Imam Khomeini and Golestan hospitals in Ahvaz in 1400-1401. Inclusion criteria included age over 18 years, type 2 diabetes, HGA1c less than or equal to 9, GFR between 30 and 60 ml/min/1.73 m2, use of empagliflozin for more than or equal to three months, and urinary albumin to creatinine ratio greater than 30 mg/dL. Exclusion criteria included patients not attending the clinic for follow-up during the study, proteinuria due to glomerulonephritis, type 1 diabetes, vaginitis, UTI, and liver failure based on history.
Based on this, 136 people with type 2 diabetes were included in the study and were randomly divided into two drug and control groups, one group of patients who took empagliflozin for three months and the other group of patients who did not receive this treatment. Patient data, including serum creatinine, HBA1C, albuminuria, weight, blood pressure, side effects, were extracted and then the patients' data were collected three and six months after receiving empagliflozin. Data analysis was done with descriptive and analytical statistics.
Results: In this study, 56 (41.2%) were male and 80 (58.8%) were female. Changes in eGFR (P=0.044) and (P=0.003), HbA1C (P=0.014), albuminuria (P=0.001) during 3 months and 6 months, and changes in systolic blood pressure (0.020) during 3 months between the empagliflozin group were significantly different compared to the control group. However, there was no significant difference between the two groups in terms of weight changes during 3 months and 6 months (P=0.97) and changes in systolic blood pressure during 6 months (P=0.13).
Conclusion: Using empagliflozin can improve kidney function and reduce albuminuria.
Methods: This research is a cross-sectional study based on the information contained in the files of patients referred to Imam Khomeini and Golestan hospitals in Ahvaz in 1400-1401. Inclusion criteria included age over 18 years, type 2 diabetes, HGA1c less than or equal to 9, GFR between 30 and 60 ml/min/1.73 m2, use of empagliflozin for more than or equal to three months, and urinary albumin to creatinine ratio greater than 30 mg/dL. Exclusion criteria included patients not attending the clinic for follow-up during the study, proteinuria due to glomerulonephritis, type 1 diabetes, vaginitis, UTI, and liver failure based on history.
Based on this, 136 people with type 2 diabetes were included in the study and were randomly divided into two drug and control groups, one group of patients who took empagliflozin for three months and the other group of patients who did not receive this treatment. Patient data, including serum creatinine, HBA1C, albuminuria, weight, blood pressure, side effects, were extracted and then the patients' data were collected three and six months after receiving empagliflozin. Data analysis was done with descriptive and analytical statistics.
Results: In this study, 56 (41.2%) were male and 80 (58.8%) were female. Changes in eGFR (P=0.044) and (P=0.003), HbA1C (P=0.014), albuminuria (P=0.001) during 3 months and 6 months, and changes in systolic blood pressure (0.020) during 3 months between the empagliflozin group were significantly different compared to the control group. However, there was no significant difference between the two groups in terms of weight changes during 3 months and 6 months (P=0.97) and changes in systolic blood pressure during 6 months (P=0.13).
Conclusion: Using empagliflozin can improve kidney function and reduce albuminuria.
Seyyed Ahmad Razavizadegan, Fatemeh Eftekharian , Fatemeh Rahmanian, Navid Kalani,
Volume 82, Issue 5 (8-2024)
Volume 82, Issue 5 (8-2024)
Abstract
Background: Diabetic retinopathy is one of the main causes of blindness in the world and one of the causes of disability in diabetic patients. However, no study has been conducted in Iran to Comparison of Quality of Life between Diabetic Patients With and Without Retinopathy.
Methods: This descriptive-analytical study was conducted on 183 diabetic patients referred to the Jahrom Honari Clinic from October to February 2023. The patients were divided into two groups: diabetic patients without retinopathy complications and diabetic patients with retinopathy complications. The data collection tool included two demographic information questionnaires and a quality of life questionnaire (DQOL-BCI). The data of the two groups and subgroups were compared and analyzed using SPSS version 21 software and descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistical tests (chi-square, t-test, ANOVA, Pearson correlation coefficient) at a significance level of P<0.05.
Results: The majority of diabetic patients participating in the study in the group with retinopathy (70.3%) and the group without retinopathy (75%) were male. The groups of Diabetic Patients With and Without Retinopathy did not differ significantly from each other in terms of demographic variables and were similar. There was a significant difference between Diabetic Patients With and Without Retinopathy in terms of average quality of life (P>0.001). The mean quality of life in the group of diabetic patients with retinopathy (41.19±7.97) was higher than that of the group of diabetic patients without retinopathy (37.22±7.37). There was no significant difference between the mean quality of life and demographic variables in diabetic patients without retinopathy and diabetic patients with retinopathy (P<0.001).
Conclusion: That patients with retinopathy had a higher quality of life than the group without retinopathy. These results were obtained while none of the demographic variables such as age, gender, marital status, and education level had a significant relationship with the quality of life of these patients.
Methods: This descriptive-analytical study was conducted on 183 diabetic patients referred to the Jahrom Honari Clinic from October to February 2023. The patients were divided into two groups: diabetic patients without retinopathy complications and diabetic patients with retinopathy complications. The data collection tool included two demographic information questionnaires and a quality of life questionnaire (DQOL-BCI). The data of the two groups and subgroups were compared and analyzed using SPSS version 21 software and descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistical tests (chi-square, t-test, ANOVA, Pearson correlation coefficient) at a significance level of P<0.05.
Results: The majority of diabetic patients participating in the study in the group with retinopathy (70.3%) and the group without retinopathy (75%) were male. The groups of Diabetic Patients With and Without Retinopathy did not differ significantly from each other in terms of demographic variables and were similar. There was a significant difference between Diabetic Patients With and Without Retinopathy in terms of average quality of life (P>0.001). The mean quality of life in the group of diabetic patients with retinopathy (41.19±7.97) was higher than that of the group of diabetic patients without retinopathy (37.22±7.37). There was no significant difference between the mean quality of life and demographic variables in diabetic patients without retinopathy and diabetic patients with retinopathy (P<0.001).
Conclusion: That patients with retinopathy had a higher quality of life than the group without retinopathy. These results were obtained while none of the demographic variables such as age, gender, marital status, and education level had a significant relationship with the quality of life of these patients.
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Shahla Ahmadi Halili , Zahra Soltani, Saeed Hesam, Maryam Khombi Shooshtari ,
Volume 82, Issue 5 (8-2024)
Volume 82, Issue 5 (8-2024)
Abstract
Background: Diabetic nephropathy is one of the most important complications of diabetes worldwide. In diabetic patients, although renal biopsies performed with less frequency, it is important because these patients may have glomerular disorders other than diabetic nephropathy. Therefore, in this study, we investigated the results of renal biopsies performed on diabetic patients referred to diabetic clinics in Imam Khomeini and Golestan hospitals in Ahvaz, southwest Iran.
Methods: In this descriptive-cross-sectional study, information related to biopsy samples from 67 patients recognize with diabetes who underwent renal biopsy from August 2103 to September 2018, collected and recorded retrospectively. The presence of diabetic nephropathy and other renal diseases was confirmed by pathological evaluation of all renal biopsy specimens. Then, the data were analyzed by using SPSS 20 software.
Results: The results of this study presented that diabetic nephropathy (67.2%), diabetic nephropathy along with acute tubulointerstitial nephritis (7.5%), acute tubulointerstitial nephritis (6%) and membrane glomerulonephritis (6%) were the most frequent diagnosis in diabetic patients with renal disorder. Furthermore, in the described cases, class IV (47.9%), III (35.4%) and II (12.5%) and I (4.2%) were the most common classes of nephropathy, respectively. Interestingly, there was no significant association between age, sex, proteinuria and hematuria with the frequency of nephropathy in the patient who underwent renal biopsy. Also, in this study, the frequency of class I and II nephropathy was 100% in patients older than 50 years, while 64.7% of class III was in patients under 50 years of age, which was also statistically significant (P=0.018). On the other hand, in the studied patients, there were not significant different between the frequency of diabetic nephropathy class and proteinuria, azotemia, and hematuria (P>0.05).
Conclusion: According to the obtained results, to reduce the risk of complications and costs, it seems crucial to be more wary in pick out diabetic patients for renal biopsy and to enhance the threshold of renal biopsy in diabetic patients as much as possible.
Methods: In this descriptive-cross-sectional study, information related to biopsy samples from 67 patients recognize with diabetes who underwent renal biopsy from August 2103 to September 2018, collected and recorded retrospectively. The presence of diabetic nephropathy and other renal diseases was confirmed by pathological evaluation of all renal biopsy specimens. Then, the data were analyzed by using SPSS 20 software.
Results: The results of this study presented that diabetic nephropathy (67.2%), diabetic nephropathy along with acute tubulointerstitial nephritis (7.5%), acute tubulointerstitial nephritis (6%) and membrane glomerulonephritis (6%) were the most frequent diagnosis in diabetic patients with renal disorder. Furthermore, in the described cases, class IV (47.9%), III (35.4%) and II (12.5%) and I (4.2%) were the most common classes of nephropathy, respectively. Interestingly, there was no significant association between age, sex, proteinuria and hematuria with the frequency of nephropathy in the patient who underwent renal biopsy. Also, in this study, the frequency of class I and II nephropathy was 100% in patients older than 50 years, while 64.7% of class III was in patients under 50 years of age, which was also statistically significant (P=0.018). On the other hand, in the studied patients, there were not significant different between the frequency of diabetic nephropathy class and proteinuria, azotemia, and hematuria (P>0.05).
Conclusion: According to the obtained results, to reduce the risk of complications and costs, it seems crucial to be more wary in pick out diabetic patients for renal biopsy and to enhance the threshold of renal biopsy in diabetic patients as much as possible.
Azam Zafarbakhsh, Elham Fateminia, Anahita Babak, Somayeh Khanjani, Mamak Shariat, Fedyeh Haghollahi,
Volume 82, Issue 2 (5-2024)
Volume 82, Issue 2 (5-2024)
Abstract
Background: Preterm premature rupture of membranes (PPROM) significantly impacts perinatal mortality and maternal-fetal outcomes. The purpose of this study is to investigate the frequency of maternal risk factors, maternal and fetal outcomes and the role of care in the occurrence of outcomes.
Methods: This retrospective cross-sectional study involved 317 pregnant women with premature rupture of membranes (PPROM) at Shahid Beheshti Hospital in Isfahan, between April 2020 and April 2022. Data were collected from medical records, including demographic information, risk factors, and maternal and neonatal outcomes. Patients were categorized into two groups: those receiving care (24-34 weeks of gestation) and those undergoing pregnancy termination (less than 24 weeks or more than 34 weeks). The chi-square test was used for qualitative variables, while the T-student test was applied for quantitative variables.
Methods: This retrospective cross-sectional study involved 317 pregnant women with premature rupture of membranes (PPROM) at Shahid Beheshti Hospital in Isfahan, between April 2020 and April 2022. Data were collected from medical records, including demographic information, risk factors, and maternal and neonatal outcomes. Patients were categorized into two groups: those receiving care (24-34 weeks of gestation) and those undergoing pregnancy termination (less than 24 weeks or more than 34 weeks). The chi-square test was used for qualitative variables, while the T-student test was applied for quantitative variables.
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Results: In this study, the average age of patients was 29.42±6.56 years. The most common risk factors for PPROM were 20.2% for abortion records, 20.2% for urinary infections, 18% for cervical insufficiency, and 13.6% for gestational diabetes. Comparing maternal outcomes between the two groups revealed that chorioamnionitis occurred more frequently in the care group (18% vs. 2%, P=0.0001), as did emergency cesarean sections (37% vs. 4.5%, P=0.0001) and NICU hospitalization (71% vs. 17%, P=0.001). In the next stage, a regression test identified the independent effects of variables on maternal and newborn outcomes without intervention or confounding factors. The analysis indicated that mothers in the care group experienced significantly more complications than those in the pregnancy termination group, and their babies also faced significantly more complications.
Conclusion: The study results indicate that a history of abortion, urinary infections, cervical insufficiency, and gestational diabetes are significant risk factors for PPROM. Expectant management of PPROM is associated with more neonatal and maternal complications than pregnancy termination. Thus, timely identification of these risk factors allows healthcare providers to educate mothers and potentially prevent and manage them, significantly reducing the incidence of PPROM and its complications. |
Hamed Alizadeh Pahlavani , Mitra Tajari, Mohadese Hozouri,
Volume 82, Issue 2 (5-2024)
Volume 82, Issue 2 (5-2024)
Abstract
Background: In people with diabetes, metabolic changes can affect the body's response to physical activity. On the other hand, for people with diabetes, exercise can be a powerful tool to manage diabetes and improve overall health through key regulatory proteins such as adenosine monophosphate-activated protein kinase (AMPKα1/2), dynamin-like protein (DLP1), and autophagy-related protein 13 (ATG13). In diabetes, AMPK regulation is often disrupted, contributing to the metabolic imbalances that characterize diabetes. In diabetes, disruption of DLP1 protein as a key regulator of mitochondrial fission leads to the accumulation of damaged mitochondria and metabolic imbalance. ATG13, as an autophagy regulator causes the recycling of damaged cells and damaged components.
Methods: This study was conducted in May to July 2023. In this experimental research, 12 two-month-old male Sprague-Dawley rats with an average weight of 280±30 grams participated. To induce type two diabetes, nicotinamide solution with a dose of 110 mg/kg and streptozotocin (STZ) with a dose of 60 mg/kg were injected, and blood glucose between 126 and 260 mg/dl was determined as the index of diabetes induction. Then the diabetic rats were randomly divided into training (six heads) and control groups (six heads). The moderate-intensity interval training (MIIT) group trained for 4 weeks and four sessions every week. The MIIT program consisted of 4 rounds of 3 minutes with an intensity equal to 55-75% of the maximum speed and active rest periods of two minutes with an intensity of 35-45% of the maximum speed. After 24 hours from the last training, the rats were anesthetized and the soleus muscle tissue was isolated and the proteins were measured by western blot methods.
Methods: This study was conducted in May to July 2023. In this experimental research, 12 two-month-old male Sprague-Dawley rats with an average weight of 280±30 grams participated. To induce type two diabetes, nicotinamide solution with a dose of 110 mg/kg and streptozotocin (STZ) with a dose of 60 mg/kg were injected, and blood glucose between 126 and 260 mg/dl was determined as the index of diabetes induction. Then the diabetic rats were randomly divided into training (six heads) and control groups (six heads). The moderate-intensity interval training (MIIT) group trained for 4 weeks and four sessions every week. The MIIT program consisted of 4 rounds of 3 minutes with an intensity equal to 55-75% of the maximum speed and active rest periods of two minutes with an intensity of 35-45% of the maximum speed. After 24 hours from the last training, the rats were anesthetized and the soleus muscle tissue was isolated and the proteins were measured by western blot methods.
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Results: The results showed that MIIT causes a non-significant increase in AMPK protein (P=0.29) and ATG13 (P=0.079), while it has a significant decrease in DLP1 (P=0.002).
Conclusion: It seems that MIIT, through decreasing DLP1, can have a beneficial effect on energy metabolism and autophagy process in order to optimize cells mitochondria in the soleus muscle of diabetic rats. |
Marziyeh Najafi, Sima Marzban, Roya Rajaee, Behrooz Pouragha,
Volume 81, Issue 12 (3-2024)
Volume 81, Issue 12 (3-2024)
Abstract
Managing overweight and obesity is associated with lower risks of chronic diseases like diabetes. Digital health, particularly smartphones or m-health, effectively manages body weight. Technologies such as telemedicine services, mobile health (mHealth) or the use of mobile phones or portable digital devices in healthcare services and wearable devices can be used in this field. Therefore, this study was conducted to understand the impact of digital health technologies on weight management in diabetic patients.
Methods: The present study is a systematic review study that was initially searched using a systematic review of published studies in the field of digital health for weight management in diabetic patients from October 1401 to October 1402. Our study was conducted in two rigorous steps. Firstly, we performed a systematic review by searching for publications on Digital Health Solutions for Body Weight Management in Diabetic Patients until 12 October 2022. We meticulously combed through two comprehensive databases, PubMed and Web of Science, using a set of specific and relevant keywords. After a thorough screening and full-text assessment, we handpicked eight documents for this study. We cross-referenced with the companies' websites producing the identified applications to enrich our findings further.
Methods: The present study is a systematic review study that was initially searched using a systematic review of published studies in the field of digital health for weight management in diabetic patients from October 1401 to October 1402. Our study was conducted in two rigorous steps. Firstly, we performed a systematic review by searching for publications on Digital Health Solutions for Body Weight Management in Diabetic Patients until 12 October 2022. We meticulously combed through two comprehensive databases, PubMed and Web of Science, using a set of specific and relevant keywords. After a thorough screening and full-text assessment, we handpicked eight documents for this study. We cross-referenced with the companies' websites producing the identified applications to enrich our findings further.
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Results: In the initial search, 223 documents were identified and after screening and qualitative evaluation, eight documents were selected for this study. Our research uncovered a range of mHealth apps that have shown promise in weight management for diabetic patients. These apps have demonstrated potential efficacy, high acceptability, and favorable user experiences. Importantly, they have also improved diabetes management and quality of life for the users.
Conclusion: Our review of digital health solutions has not only illuminated their potential in weight management for diabetic patients but also opened up new avenues for a more personalized, engaging, and practical approach to this issue. As technology continues to advance, these interventions hold the potential to revolutionize diabetes self-management, significantly enhance the quality of life, and contribute to better health outcomes for individuals living with diabetes. |
Lida Saeed, Niusha Bahmanpoor, Robabe Hosseinisadat, Fatemeh Karami Robati ,
Volume 81, Issue 12 (3-2024)
Volume 81, Issue 12 (3-2024)
Abstract
Background: One of the factors affecting the outcome of pregnancy is the primary body mass index (BMI) and the amount of weight gain during pregnancy. This study aimed to check the relationship between mother's initial body mass index and weight gain in pregnancy with pregnancy outcomes.
Methods: This cross-sectional study was conducted on 455 pregnant women referred to Afzalipour Hospital in Kerman, Iran, from August 2021 to August 2022. These pregnant women were included in the study through easy and accessible sampling. The mother's initial weight was recorded through the mother's health card. The height of the mother was measured using a standard meter and the final weight of the mother before delivery was measured using a standard scale available in the department. Other information of the mothers was extracted from their records. Weight gain during pregnancy and initial body mass index were calculated and divided into four categories, less than normal, normal, overweight and obese. Maternal-fetal complications were included in the information registration form. Descriptive and analytical statistical methods and SPSS version 24 software were used to analyze the data.
Results: The average age of women was 27.56±6.82 years. Body mass index of more than 40% of them (44.4%) was normal (19.8-26) and more than 45% of them were overweight 11.5-16 (45.5%). There was a significant relationship between initial body mass index and weight gain during pregnancy (P=0.001), gestational diabetes (P=0.001) and newborn weight (P=0.019). There was also a significant relationship between weight gain during pregnancy with premature birth (P=0.001), vaginal delivery (P=0.001), gestational diabetes (P=0.001) and newborn Apgar (P=0.001).
Methods: This cross-sectional study was conducted on 455 pregnant women referred to Afzalipour Hospital in Kerman, Iran, from August 2021 to August 2022. These pregnant women were included in the study through easy and accessible sampling. The mother's initial weight was recorded through the mother's health card. The height of the mother was measured using a standard meter and the final weight of the mother before delivery was measured using a standard scale available in the department. Other information of the mothers was extracted from their records. Weight gain during pregnancy and initial body mass index were calculated and divided into four categories, less than normal, normal, overweight and obese. Maternal-fetal complications were included in the information registration form. Descriptive and analytical statistical methods and SPSS version 24 software were used to analyze the data.
Results: The average age of women was 27.56±6.82 years. Body mass index of more than 40% of them (44.4%) was normal (19.8-26) and more than 45% of them were overweight 11.5-16 (45.5%). There was a significant relationship between initial body mass index and weight gain during pregnancy (P=0.001), gestational diabetes (P=0.001) and newborn weight (P=0.019). There was also a significant relationship between weight gain during pregnancy with premature birth (P=0.001), vaginal delivery (P=0.001), gestational diabetes (P=0.001) and newborn Apgar (P=0.001).
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Conclusion: High body mass index of the mother and weight gain during pregnancy can cause complications in the mother and the fetus. Therefore, prenatal care should be done more carefully and health care providers should place mothers who have abnormal body mass index and inappropriate weight gain in pregnancy in the high-risk group and under special care to minimize maternal and fetal complications.
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Negar Heidari , Fatemeh Rajati , Mojgan Rajati, Paria Heidari,
Volume 81, Issue 11 (2-2024)
Volume 81, Issue 11 (2-2024)
Abstract
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Elena Lak , Eskandar Hajiani, Jalal Sayyah , Zeynab Hosseinpour , Alireza Sedaghat,
Volume 81, Issue 11 (2-2024)
Volume 81, Issue 11 (2-2024)
Abstract
Background: Diabetes is known to be linked with a high risk of liver stiffness in non-alcoholic fatty liver patients. Previous studies have faced challenges in examining the association between prediabetes and liver stiffness. This study aimed to compare liver fibrosis in diabetes and prediabetes patients.
Methods: This cross-sectional descriptive study was conducted on patients with diabetes and prediabetes who were referred to Imam Khomeini Hospital in Ahvaz from March 2022 to March 2023. The study aimed to clear the relationship between liver stiffness and age, gender, BMI, AST, ALT, ALKP, Bilirubin, and the type of treatment. The normality of quantitative variables was checked using the Kolmogorov-Smirnov test. The chi-square test examined two qualitative variables with more than two levels.
Methods: This cross-sectional descriptive study was conducted on patients with diabetes and prediabetes who were referred to Imam Khomeini Hospital in Ahvaz from March 2022 to March 2023. The study aimed to clear the relationship between liver stiffness and age, gender, BMI, AST, ALT, ALKP, Bilirubin, and the type of treatment. The normality of quantitative variables was checked using the Kolmogorov-Smirnov test. The chi-square test examined two qualitative variables with more than two levels.
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Results: Out of the total participants, 53 people (63.9%) had diabetes, while 30 people (36.1%) had prediabetes. There was a significant difference between the mean severity of liver fibrosis in diabetic and pre-diabetic patients (P=0.014). The frequency of liver stiffness in all levels except in the group with mild or no fibrosis (F0-F1) was higher in diabetic than pre-diabetic patients. In both diabetes and prediabetes groups, there was no significant relationship between gender, age, BMI, ALT, and ALKP with liver fibrosis. However, there was a significant direct relationship between HbA1C% and liver fibrosis (P≥0.003) in both groups. In diabetic patients, a significant relationship between FBS and liver fibrosis was observed (P=0.001). In pre-diabetic patients, significant direct relationship was seen between the severity of liver fibrosis and AST levels (P=0.026).
Conclusion: Diabetic patients showed a higher severity of liver fibrosis compared to pre-diabetic patients. No statistically significant relationship was seen between liver fibrosis and age, sex, body mass index, ALT, and ALKP in both groups. Additionally, both diabetes and prediabetes groups showed significant relationship between liver fibrosis and HbA1C (P≥0.003). Prediabetes was also found to be associated with an elevated risk of liver fibrosis. |
Mohammad Rajabpour, Abbas Heidary , Kavian Ghandehari , Amir Mirhaghi,
Volume 81, Issue 10 (1-2024)
Volume 81, Issue 10 (1-2024)
Abstract
Background: Despite advances in medical treatments, readmission of stroke patients remains high and has been reported between 31% and 56.1% during the first year after discharge. The difference between the risk factors of readmission and the risk factors of stroke is not clear. The purpose of this study is: 1) to determine the preventable risk factors associated with stroke readmission and 2) to provide a conceptual model for preventable factors that effective in the readmission of stroke patients.
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Methods: This integrated review was performed according to Whittemore and Knafl (2005) method in five stages including problem identification, literature search, data evaluation, data analysis, and presentation. In order to find relevant articles, PubMed, Web of Science, CINAHL, Scopus databases and Google Scholar search engine were searched. The search was conducted using the keywords "stroke," "readmission," "recurrence," "re-hospitalization," "review," and "systematic review," for the period between January 2023 and September 2023, following the PRISMA guidelines. In addition to providing a qualitative synthesis of readmission factors categorized into categories, a conceptual model of these factors was also presented.
Results: Out of a total of 3785 article titles, 38 articles were included in the study for the final analysis after screening and removing duplicates. The most important risk factors for readmission in four categories: (1) knowledge deficit about the comorbidities (such as hypertension, atrial fibrillation, diabetes), (2) unhealthy diet and medicine, (3) high-risk behaviors (smoking, alcohol consumption, and tobacco use disorder), and (4) psychological distress (depression and worry about the future). In addition, the conceptual model showed that the most important preventable factor in readmission of stroke patients is of knowledge deficit about comorbidities (especially hypertension). Conclusion: The most important preventable risk factors that are effective in the readmission of stroke patients are knowledge deficit regarding clinical risk factors, especially high blood pressure, high-risk behaviors and unhealthy diet and medicine. Therefore, more detailed care and follow-up programs should be designed for stroke patients after discharge. |
Shayda Barat, Khosro Iranfar, Mahsa Ghanbari,
Volume 81, Issue 10 (1-2024)
Volume 81, Issue 10 (1-2024)
Abstract
Background: Mucormycosis is a rare and aggressive opportunistic fungal infection that has grown significantly in recent years. This infection is rarely seen in healthy people. Mucormycosis usually appears as an acute infection with manifestations in the rhino-cerebral, pulmonary and skin areas, and sometimes its manifestations can be seen as a widespread infection. The special importance of mucormycosis is due to its high mortality rate, which leads to death in 75 to 80 percent of cases. The specific susceptibility of some patients to mucormycosis points to the importance of iron absorption in the pathogenesis of mucormycosis, therefore, we decided to investigate the relationship between serum iron and ferritin levels and mucormycosis disease in patients with underlying factors predisposing to COVID-19.
Methods: This study is a case-control type, in which patients with mucormycosis after contracting COVID-19 and also with a history of diabetes mellitus as the case group and patients with COVID-19 and a history of diabetes mellitus are considered as the control group and the serum level of iron and ferritin will be measured and compared in both groups and the outcome of the study will be determined based on the obtained results.The study took place in hospitals of the Kermanshah university of medical sciences in the Kermanshah city from March 2021 to March 2022.
Methods: This study is a case-control type, in which patients with mucormycosis after contracting COVID-19 and also with a history of diabetes mellitus as the case group and patients with COVID-19 and a history of diabetes mellitus are considered as the control group and the serum level of iron and ferritin will be measured and compared in both groups and the outcome of the study will be determined based on the obtained results.The study took place in hospitals of the Kermanshah university of medical sciences in the Kermanshah city from March 2021 to March 2022.
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Results: In this study, 38 patients were examined in two groups of patients with mucormycosis along with COVID-19 and diabetes in the case group and patients with COVID-19 and diabetes in the control group with an average age of 63 years. In this study, there was no significant difference between the average age in the two studied groups. However, a significant difference was observed between serum iron and ferritin levels in two groups.
Conclusion: Hyperferritinemia is considered not only as an indicator of the systemic inflammatory process in the infection of COVID-19, but also indicates an increase in free iron level, which, as a result, contributes to the growth and spread of the fungus (mucormycosis). |
Mehdi Nikseresht, Valiollah Dabidi Roshan , Khadijeh Nasiri,
Volume 81, Issue 10 (1-2024)
Volume 81, Issue 10 (1-2024)
Abstract
Background: Exercise programs can lead to different physiological adaptations, but the effects of low-volume, low-frequency HIIT protocols with varying interval structures have not been thoroughly investigated. This study aimed to explore the impact of HIIT with high compression (HC) and low compression (LC), with or without berberine (BBR) supplementation, on hematological parameters in pre-diabetic men.
Methods: This semi-experimental study was conducted between October and December 2021 at Mazandaran University. Fifty-four overweight/obese men with a mean age of 48.6±6.6 years, a body mass index of 30.7±7.3 kg/m², and a body fat percentage of 34.4±4.3% were randomly and equally divided into one of six groups: HC, LC, HC+BBR, LC+BBR, BBR, and control. The HC group (2:1 work-to-rest ratio) and LC group (1:1 work-to-rest ratio) underwent training programs comprising 2-4 sets of 8 exercises at an intensity of 80-95% of their maximum heart rate twice a week for 8 weeks. Hematological responses to Bruce's incremental exercise test were measured before and after the intervention. Data were analyzed using a two-way ANOVA with Bonferroni's post hoc test, with a significance level set at P<0.05.
Methods: This semi-experimental study was conducted between October and December 2021 at Mazandaran University. Fifty-four overweight/obese men with a mean age of 48.6±6.6 years, a body mass index of 30.7±7.3 kg/m², and a body fat percentage of 34.4±4.3% were randomly and equally divided into one of six groups: HC, LC, HC+BBR, LC+BBR, BBR, and control. The HC group (2:1 work-to-rest ratio) and LC group (1:1 work-to-rest ratio) underwent training programs comprising 2-4 sets of 8 exercises at an intensity of 80-95% of their maximum heart rate twice a week for 8 weeks. Hematological responses to Bruce's incremental exercise test were measured before and after the intervention. Data were analyzed using a two-way ANOVA with Bonferroni's post hoc test, with a significance level set at P<0.05.
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Results: Baseline hematological indices showed no significant differences between pre-diabetic and non-diabetic groups (all, P>0.05). Following the 8-week intervention, there were significant decreases in white blood cells (WBCs) in the LC and LC+BBR groups, and in lymphocytes across all intervention groups except BBR (all, P<0.05). Additionally, hemoglobin and hematocrit levels showed significant reductions in the HC and HC+BBR groups (both, P<0.05). However, in response to Bruce's incremental exercise test, a significant decrease in WBCs was observed in the LC and LC+BBR groups, with reductions of 18% and 25%, respectively (both, P<0.05).
Conclusion: The LC protocol, even without berberine supplementation, seems to provide better immunological benefits and result in less hemolysis compared to the HC protocol, as evidenced by reductions in white blood cell counts. |
Maryam Fakehi, Marjan Ghaemi, Nasim Eshraghi, Melina Poorkazemi, Maryam Mazloomi, Fedyeh Haghollahi,
Volume 81, Issue 8 (11-2023)
Volume 81, Issue 8 (11-2023)
Abstract
Background: The aim of this study was to identify the associated risk factors of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM).
Methods: This retrospective case-control study was conducted at Firooz-abadi Hospital between 2019 and 2021. The study included 90 pregnant women diagnosed with PROM or PPROM (case group), compared with 90 women without this complication (control group) who presented to the hospital during the specified period. Demographic and clinical information of the case group was collected and compared with data from 90 pregnant women in the control group, matched for gestational age and other relevant factors. Statistical analysis was performed to assess the differences between the groups.
Methods: This retrospective case-control study was conducted at Firooz-abadi Hospital between 2019 and 2021. The study included 90 pregnant women diagnosed with PROM or PPROM (case group), compared with 90 women without this complication (control group) who presented to the hospital during the specified period. Demographic and clinical information of the case group was collected and compared with data from 90 pregnant women in the control group, matched for gestational age and other relevant factors. Statistical analysis was performed to assess the differences between the groups.
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Results: Maternal age and weight were found to be significantly lower in the case group compared to the control group (P=0.02, P<0.001, respectively). This suggests that younger age and lower maternal weight may be risk factors for PROM and PPROM. Furthermore, the number of women with a history of PROM or PPROM was significantly higher in the Case group (P<0.001), indicating that a previous occurrence of membrane rupture increases the risk of subsequent incident. In addition, the study findings showed a significantly higher rate of smoking among pregnant women in the case group compared to the control group (P=0.04). Moreover, the occurrence of urinary tract infections during pregnancy and chorioamnionitis was significantly higher in the case group (P<0.001), suggesting that these infections may contribute to membrane rupture.
Conclusion: In conclusion, our study provides valuable insights into the risk factors associated with PROM and PPROM. It highlights that lower maternal age and weight, a history of PROM or PPROM, lower gestational age, a history of gestational diabetes mellitus and first-trimester bleeding, smoking, and urinary tract infections during pregnancy are significantly associated with an increased risk of PROM and PPROM. These findings emphasize the importance of early identification and management of these risk factors in order to prevent or mitigate the occurrence of PROM and PPROM, ultimately improving maternal and neonatal outcomes. Further research and public health initiatives are warranted to raise awareness and promote preventive measures targeting these identified risk factors. |
Abdolreza Malek, Mahdieh Vahedi, Nafiseh Pourbadakhshan,
Volume 81, Issue 4 (7-2023)
Volume 81, Issue 4 (7-2023)
Abstract
Background: Vasculitis is a heterogeneous group of diseases that means an inflammatory process in blood vessels. Diagnosing vasculitis in children is challenging due to the variety of symptoms. Classification of childhood vasculitis is usually based on clinical phenotypes, size of affected vessels (small, medium, or large), and pathology of inflammatory infiltrates. The aim of this study is to investigate the epidemiological information on types of vasculitis and their clinical symptoms in children in eastern Iran.
Methods: This 3-year descriptive cross-sectional study was performed on all male and female patients with any vasculitis referred to the outpatient clinic and rheumatology department of Akbar Children's Hospital from the beginning of September 2017 to the end of September 2020. Has been. This study was based on information obtained from the checklist (information from the inpatient and outpatient records and information in the HIS). Checklist information included age, gender, drug history, history of surgery, clinical symptoms in different systems, season of disease onset, etc.
Results: Out of 263 children, 135 (51.33%) had Henoch-Schonlein and 100 (38/02%) of them had Kawasaki. The numbers of Behcet, Takayasu and Churg-Strauss patients were 20, three and two, respectively. In most subgroups, female patients were more common than male patients. Kawasaki and Takayasu had the lowest and highest age of onset, respectively. The most common seasons of appearance for Henoch-Schonlein and Kawasaki were autumn and summer respectively. In most subgroups, skin rashes are the most common clinical symptom, with, the most common types being petechiae and purpura.
Methods: This 3-year descriptive cross-sectional study was performed on all male and female patients with any vasculitis referred to the outpatient clinic and rheumatology department of Akbar Children's Hospital from the beginning of September 2017 to the end of September 2020. Has been. This study was based on information obtained from the checklist (information from the inpatient and outpatient records and information in the HIS). Checklist information included age, gender, drug history, history of surgery, clinical symptoms in different systems, season of disease onset, etc.
Results: Out of 263 children, 135 (51.33%) had Henoch-Schonlein and 100 (38/02%) of them had Kawasaki. The numbers of Behcet, Takayasu and Churg-Strauss patients were 20, three and two, respectively. In most subgroups, female patients were more common than male patients. Kawasaki and Takayasu had the lowest and highest age of onset, respectively. The most common seasons of appearance for Henoch-Schonlein and Kawasaki were autumn and summer respectively. In most subgroups, skin rashes are the most common clinical symptom, with, the most common types being petechiae and purpura.
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Conclusion: In the present study, the most common type of vasculitis diagnosed in children in eastern Iran was reported by Henoch-Schonlein and Kawasaki respectively, which was completely different from the most common types of vasculitis in adulthood and indicated the importance of age in diagnosing the type of vasculitis. The necessity of clinical suspicion of these two diseases in children with skin rashes, along with matching with other clinical findings, is undeniable.
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