Showing 26 results for Azam
Asra Moradkhani, Mobin Azami, Massomeh Abedini ,
Volume 80, Issue 12 (March 2023)
Abstract
Background: Sever Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in some patients leads to cytokine storm and causes hemophagocytic lymphohistiocytosis (HLH) secondary to this viral agent. HLH is a rare and aggressive disease that increases in children, and is caused by changes in the immune system that associated with high mortality. Consideing the current pandemic, early diagnosis and treatment is important. Herein, we report a case of a 14-month-old infant presented with COVID-19 and prolonged fever who was eventually treated with the diagnosis of HLH. The study has been done in Sanandaj in January 2020.
|
Case Presentation: A 14-month-old female infant with Covid-19, in November 2019 with prolonged fever lasting for 12 days, weakness and lethargy was admitted to Sanandaj Social Security Hospital, in November 2019. The infant did not have any history of illness, drug or allergy and had received vaccination according to the country's protocol. Later she was transferred to Besat Hospital in Sanandaj due to persistent fever and elevated liver enzymes. The patient had severe leukocytosis and hepatosplenomegaly in the second center. During the diagnostic measures for the patient and the rule out of other possible causes through imaging and laboratory investigations and also the evaluation of relevant criteria, HLH was suggested and treated with antibiotics (ceftriaxone, meropenem), IVIg, dexamethasone and pantoprazole. After that the fever decreased, then oral prednisolone was prescribed and a follow-up was recommended. She was discharged in good general condition.
|
Conclusion: The current Covid-19 pandemic causes infection of children and may lead to occurrence of secondary HLH disease. therefore, assessment of children with liver manifestations and resistant fever should be considered by performing a PCR test to avoid complications and consequences as much as possible by timely treatment. more studies should be done in the field of its various dimensions.
Masoume Mirteimouri, Seyyedeh Azam Poorhosseini , Maliheh Rakhshanifar, Seyede Houra Mousavi Vahed , Fedyeh Haghollahi,
Volume 81, Issue 3 (June 2023)
Abstract
Background: The success of labor induction depends on the condition of the cervix at the time of delivery. This study examines the effect of labor induction with an intra-cervical Foley catheter and oxytocin compared to a Foley catheter and misoprostol on cervical preparation and delivery rate in the first 24 hours after induction.
Methods: In a randomized clinical study, pregnant women with a singleton pregnancy and a gestational age of more than 40 weeks, with a Bishop score less than 4 and an intact amniotic sac referred to Umm al-Binin Hospital in Mashhad from 2017 to 2018 were included in the study. They were randomly divided into two groups of Foley catheter and oxytocin (1) or Foley catheter and misoprostol (2). In the first group, immediately after placing the Foley catheter; Oxytocin was started with a dose of 2 milliunits per minute, and every 20 minutes, 2 milliunits were added to reach the maximum dose of 30 milliunits per minute (induction method with a low dose). In the second group, after Foley catheter insertion, sublingual misoprostol was prescribed at a dose of 25 micrograms every 4 hours up to a maximum of 6 doses.
|
Results: 74 pregnant women were randomly evaluated in two groups of 37 people. There is no statistically significant difference in the demographic variables in the two groups. There was a significant difference in the labor rate in the first 24 hours, and it was higher in the oxytocin group (P=0.009). Bishop's score after 24 hours of induction was not significantly different in the two groups. Reaching the active phase was significantly shorter in the oxytocin group. (P=0.01). The time of catheter removal in both groups and the rate of cesarean section and the occurrence of complications were the same in both groups.
Conclusion: The use of oxytocin with a Foley catheter inside the cervix can accelerate the preparation of the cervix and increase the chance of labor in the first 24 hours, but it does not affect labor complications.
|
Mohsen Ebrahimi, Zahra Valipour Moghadam , Seyed Ali Aghapour, Azam Rashidbaghan,
Volume 81, Issue 7 (October 2023)
Abstract
Background: Asthma is a chronic inflammatory disease of the airways. Various tests and questionnaires are designed to monitor the severity of asthma and help the therapist and the health system prescribe the best treatment to control it. This study was designed to compare two methods Asthma Control Questionnaires (ACQ) and Asthma Control test-child (ACT-CHILD) in children with asthma.
Methods: This descriptive cross-sectional study was conducted on 92 children with asthma referred to the Taleghani hospital, Gorgan, in 2022-2023. Patients were in a range of age 4-16 years. Asthma control was evaluated and compared by two methods ACT-CHILD and ACQ. ACT-CHILD included one version for 4-11-year patients completed by their parents and another one for 12-16 –year patients completed by the patients. The clinical symptoms, age, gender and the parents' records related to asthma were completed during the clinical interview. Data was analyzed using Chi-square and Spearman correlation tests. The degree of agreement between two questionnaires was determined using the Kappa coefficient.
|
Results: 84 children aged 4-11 years (91.3%) and 8 children aged 12-16 years (8.7%) were included in the study. According to the ACT-CHILD, 40.2% of children (n=37) had controlled asthma, 44.6% (n=41) had partially controlled asthma, and 15.2% (n=14) had uncontrolled asthma. Based on the ACQ, controlled asthma was observed in 18.5% (n=17), partially controlled asthma in 35.8% (n=33), and uncontrolled asthma in 45.7% (n=42) of children. Asthma control results based on two questionnaires were significantly different from each other (P<0.001). The agreement between the ACT-CHILD and ACQ methods in evaluating children's asthma was at a weak level (P=0.014, κ=0.157), however, a significant negative correlation was observed between the scores of the ACT-CHILD and ACQ questionnaires (r=-0.588, P>0.001) which after categorizing based on age group, this correlation was confirmed only in children aged 4-11 years (r=-0.627, P>0.001).
Conclusion: Our findings showed that there is a poor agreement between ACT-CHILD and ACQ results in the assessment of asthma control. Further studies are recommended.
|
Jamshid Ansari, Milad Pezeshki, Azam Ahmadi, Ali Chehrei,
Volume 81, Issue 9 (December 2023)
Abstract
Background: Lung cancer has the highest incidence and mortality rate of all cancers worldwide. In Iran, it is one of the commonly diagnosed malignancies, and its frequency is increasing rapidly. Genetic variants in DNA repair genes are linked to differences in efficiency of repairing DNA damage, which can influence lung cancer susceptibility. EXO1 is a key gene involved in the mismatch repair pathway. The K589E polymorphism in EXO1 may alter the DNA repair activity of the encoded protein and impact lung cancer risk. The aim of this study was to investigate associations between the K589E polymorphism in EXO1 and lung cancer risk in the Iranian population, and evaluate its potential as a prognostic biomarker.
Methods: This case-control study was conducted to investigate EXO1 K589E variant with susceptibility to lung malignancy in the Iranian population. One hundred patients with lung cancer as a patient group and 100 healthy individuals from Khansari Hospital located in Markazi province were studied, from January 2020 to May 2022. DNA extraction from blood samples of participants was done using a kit. Genotype determination of both patient and control groups was done using PCR-RFLP technique. Finally, statistical results were analyzed using SPSS software and the logistic regression method.
|
Results: Genotype and allele frequency analysis showed the AA genotype (P=0.004, OR=5.391, 95% CI: 1.690-17.200) and A allele (P=0.010, OR=2.851, 95% CI: 1.291-6.300) were correlated with susceptibility to lung cancer. On the other hand, people carrying the G variant allele had a lower risk of lung cancer.
Conclusion: In summary, this study found the AA genotype and A allele of K589E in EXO1 are correlated with risk of lung cancer in Iranians, while the G allele has protective effects. The K589E polymorphism may serve as a prognostic biomarker for lung cancer susceptibility, but more studies with high population size are required.
|
Jamalodin Begjani , Bahareh Yaghmaei, Azam Mahmoudi , Mohammad Mehdi Rajabi ,
Volume 82, Issue 1 (April 2024)
Abstract
Background: Prolonged stay in intensive care unit (ICU) can worsen the patient's prognosis and represents a significant economic burden. Previous studies have reported the effectiveness of early mobilization in reducing length of stay in ICUs for adult patients; However, conflicting results have been reported regarding its effects on pediatric patients. Therefore, this research aimed to investigate the impact of early mobilization on the length of stay in the pediatric intensive care unit (PICU) in ventilated children.
Methods: This pilot quasi-experimental study was conducted on 60 children admitted to the Children's Medical Center hospital from March 2020 to June 2021. For the control group, routine care (standard physiotherapy) was started on the second day of intubation and continued until discharge from the intensive care unit. In this study, we used an early mobilization protocol including active and passive exercises. The intervention was implemented by Pediatric intensive care unit nurses under supervision of a pediatric critical care fellowship physician. In the intervention group, passive exercises were started on the second day of intubation. At each shift, the nurses check the level of sedation and presence of delirium in the patients using the Richmond Agitation-Sedation Scale and the Cornell Assessment of Pediatric Delirium questionnaire. If the results showed that the sedation was not deep and delirium was not present, then active exercises were initiated. If the child did not achieve an adequate score indicating the absence of deep sedation and delirium, the patient remained in the passive exercise phase. The length of stay was recorded based on the patients' records. Descriptive and inferential statistics were used for data analysis using SPSS version 23.
|
Results: The results showed that there was no significant difference in the length of stay in the pediatric intensive care unit (PICU) between the control (23.20±6.34 days) and intervention (22.60±6.18 days) groups (P=0.77).
Conclusion: The implementation of early mobilization did not significantly reduce the length of PICU stay for pediatric. The researchers are advised to identify and evaluate evidence-based guidelines for implementing early mobilization in children with different diagnoses.
|
Azam Zafarbakhsh, Elham Fateminia, Anahita Babak, Somayeh Khanjani, Mamak Shariat, Fedyeh Haghollahi,
Volume 82, Issue 2 (May 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.
|
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.
|
