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Showing 21 results for Prognosis
Coma Etiologies And Its One-Month Outcome Sina Hospital (Year 2000)
Togha M, Mahdy Zadeh E, Tahmasbi S,
Volume 60, Issue 5 (8-2002)
Abstract
Defining the patient outcome and decision making about allocation of our limited fund and technology for comatose patients depends on our knowledge about frequency and outcome of various coma etiologies. We determined the various coma causes frequency and one-month outcome of non traumatic coma. . In addition the co existence of the primary neurologic signs with the one-month outcome of non traumatic coma was defined.
Methods and Materials: Our study is based on 130 comatose patients in a one-year study in Sina Hospital that consisted of 80 non traumatic and 50 traumatic patients.
Results: 74% of the cases were men and 26% were women. The most common etiology of coma was trauma (38.5%). The other common etiologies were cerebro‌vascular diseases (25.4%), cancer (10%) and hypoxia-ischemia (8.5%). The most common cause of coma in men was trauma (46.9%) while the vascular diseases were the most common etiology of coma in women (41.2%).In under 40 year patients trauma was the cause of coma in 57.5% of cases in respect to 28% in above 40 cases. On the other hand, vascular diseases and malignancies were the etiology of coma in 15% of under 40 year patients and 46.5% of above 40 year patients. Among traumatic etiologies of coma, subdural hematoma was the most frequent (40%). In our research none of patients who did not have one of pupillary, oculocephalic or motor reflexes in the 3rd and 7th day of the onset of coma had acceptable outcome after one month. With consideration of pupillary, corneal, oculocephalic and motor reflexes in combination, loss of at least two of them in the 3rd and 7th day accompanied with no acceptable outcome. On the other hand the presence of three or more reflexes in the 3rd and 7th day of coma was a good prognostic factor, with 80% and 88.9% chance of acceptable recovery respectively.
Conclusion: According of the study, the best time for prediction of outcome in a comatose patient, is the third or seventh the day after the onset of coma. Also relay on combination of brain stem reflexes, gives us more acceptable result.
Clinical Course and prognosis of 203 patients with MS in shahid Mostafa Khomeini Hospital, Tehran 2002
Nabavi Sm, Poorfarzam Sh, Ghassemi H,
Volume 64, Issue 7 (8-2006)
Abstract
Background: Multiples sclerosis is a common demyelinating disease of CNS and the main cause of disability in young adults all over the world so any research in different aspects of the disease has great value. researches in Iran are few in quantity and low in sample size. To determine clinical course and prognosis of the disease in Iranian MS patients we have studied these items in a considerable sample size.
Methods: Two hundred and three definite MS patients (according to MC’donalds 2001 criteria) included in this study and a planned questionnaire completed by visiting the patients or by degree of disability estimated according to EDSS (Expanded Disability Status Scale) score system. The results analyzed with SPSS software.
Results: Mean age of the patients was 35. All required examinations have been done by a neurologist and 60.6 percent were female. Mean duration of disease was 8.3 years. the main form of onset of symptoms was sensorimotor (mixed). Mean Attack rate was 5.5 times during the disease duration. Clinical course in 72.4 percent was relapsing-remitting type. Mean disability scale number according to EDSS was 5.2. Death rate was two percent. 69.3 percent of patients were able to work in the society. The degree of disability increased with increasing age, in lower educational state, in longer duration of the disease and in male gender.
Conclusion: The results of clinical course and type of MS, mean of disease duration from the onset and mean EDSS are compatible and comparable with similar studies in other countries though some results are different. For future large sample, multicenter studies recommended
Centralization of ovarian cancer surgery: Do patients benefit?
Ghaemmaghami F, Hasanzadeh M, Modarresgilanimadani M, Behtash N, Mousavi As, Ramezanzadeh F,
Volume 65, Issue 4 (7-2007)
Abstract

Background: The aim of this study was to compare the outcome of treatment for ovarian cancer patients who have been treated by gynecologist oncologists and patients who have been treated by general gynecologists or general surgeons.

Methods: We enrolled in this cohort retrospective study all patients diagnosed with primary ovarian cancer in Vali-e-Asr Hospital, Tehran, Iran, between April 1999 and January 2005. A total 157 consecutive patients with ovarian cancer were available for analysis. Of these, 60 patients were treated by gynecologist oncologists and 95 by general gynecologists, and two patients were treated by general surgeons.

Results: The number of patients who underwent optimal cytoreductive surgery (residual tumor <1 cm) was higher in the gynecologist oncologist group, than in the general gynecologist group (P<0.001). Repeated surgeries were required for a majority of patients in the general gynecologist group, while only a few patients in the gynecologist oncologist group needed a second operation (P<0.0001). The interval between the initial surgery and the beginning of chemotherapy was significantly longer in the gynecologist oncologist group compared to that of the general oncologist group (P=0.001). Overall survival and disease-free survival was considerably greater in the gynecologist oncologist group. Optimal cytoreductive surgery and stage of disease are prognostic factors in patients with ovarian cancer. We can therefore conclude that patients with ovarian cancer who are treated by gynecologist oncologists have a better outcome.

Conclusions: We suggest that patients requiring cytoreductive surgery for ovarian cancer be referred to a gynecologist oncologist rather than having a less specialized physician care for such cases.


The effect of stress on prognosis and treatment response in 100 Rheumatoid Arthritis patients
Hussain Khan Z, Mirazimi F, Najafizade S R, Pasha Meisami A,
Volume 65, Issue 5 (8-2007)
Abstract
Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease with several factors that contribute to its manifestation and continuation. One of the factors that initiate RA is emotional stress, which is in direct relationship with the sufficiency or insufficiency of the neuro-endocrine axis. Therefore, any stress that is not resolved in the neuro-endocrine axis might lead to RA and, as the stress continues, it causes the continuation of the disease. The aim of this study is to determine the effect of stress on continuation of RA and to find curative methods and, ultimately, the best method for treatment.

Methods: One hundred rheumatoid arthritic patients (80 females and 20 males), having a final diagnosis of RA based on the guidelines of the American College of Rheumatology and onset of disease within the last 12-36 months, were studied as case and control subjects. Data was collected using interviews and questionnaires that reflected their life events with stress as a serious factor in their disease. The patients were divided into two groups: group A with stable stress and group B with unstable stress. The same treatment method was given to both groups. The results of the treatment were evaluated and compared after two years of follow up.

Results: There was significant improvement in the patients in group B with unstable stress over that of the patients in group A with stable stress (P<0.0001).

Conclusion: The present study shows that a considerable number of RA patients suffer from serious stress that affects their clinical path and improvement, and is quite visible in the health indexes and continuity of the disease. The results further showed that stress can play an important role in the initiation and continuation of RA. Therefore, by identifying and making efforts to remove the stress factors using anti-anxiety drugs, the disease can be better controlled.


Prognostic factors in children with acute lymphoblastic leukemia: a ten year study
Oloomi Yazdi Z,
Volume 65, Issue 12 (3-2008)
Abstract

Background: Acute lymphoblastic leukemia (ALL) is the most common cancer in the pediatric population. With modern treatments, the chance of the complete recovery is nearly 100%. The most important prognostic factors are appropriate treatment protocol and determination of patient risk factors based on clinical, morphological, immunological and cytological characteristics. In this study we reviewed frequency of these factors, like as age, gender, the primary white blood cell number, sub- group on the base of FAB classification, immunophenotype and the clinical progress.

Methods: In this retrospective study, we reviewed 877 pediatric patients with the diagnosis of ALL between the years of 1994 and 2004. In these patients the age, gender, primary WBC count, sub-group based on the FAB classification, immunophenotype and the clinical progress in 177 patient with acute lymphoblastic leukemia at Imam Khomeini Hospital between the years of 1994 to 2004 were determined.

Results: Of these patients, 1.6% was younger than one year, 24.8% more than ten years old and 73.6% were between the ages of one and ten years 63.8% were male. WBC counts were above 50,000/ul in 28.8% of the patients. FAB classifications included L1 in 80.2%, L2 in 17.5% and L3 in 2.3% of the patients. Immunophenotypes included pre-B cell in 63.8%, early pre-B cell in 23.1%, T cell in 12.3% and mature B cell in 0.8% of the patients. Marker CD10+ was detected in 88.1% of the B cell cases. In this study group, 74% of the patients recovered, 16.3% died and 16.5% relapsed.

Conclusions: The prevalence of FAB-L1 and pre-B cell cases in this study is greater than a previous study, while the prevalence of FAB-L2 and early pre-B cell cases is less than that of the previous study.


Prognostic factors of pemphigus vulgaris disease: a study on 119 patients
Halaji Z, Esmaili N, Moeineddin F, Zeinali F, Aalami L, Shams Davatchi Sh,
Volume 66, Issue 12 (3-2009)
Abstract

Background: Since the systemic steroids are introduced in Pemphigus Vulgaris treatment, the prognosis of disease improved significantly. This study was designed to evaluate determining factors in the prognosis of pemphigus vulgaris in Iranian patients.

Methods: In this study, 119 patients with documented pemphigus vulgaris who had presented to Razi Hospital from 2001 until 2003 were included. These patients had presented for the first time and treated with prednisolone and Azathioprine. Morality rate, minor and major relapses and duration of first remission had been defined as prognostic criteria and correlation between them and other demographic variables and disease characteristics were investigated.

Results: The majority of patients (84.1%) were followed for more than one year. The major recurrence and minor recurrence occurred in 28(23.5%) and 65(54.6%) of patients respectively, no case of mortality was observed. In patients who received treatment six months or less after onset of disease the frequency of major recurrence was less than the others. 18(17.8%) vs. 12(41.4%), (p=0.009). Duration of primary remission more than one year was detected in most of the patients (64.7%). In patients with less than 10 initial cutaneous lesions, period of primary remission was longer than the other patients. (p=0.009). Shorter duration of primary remission were noted in older patients (age>50) in comparison with younger patients (age≤50, p=0.04).

Conclusions: Male gender, old age, interval more than 6 months between onsets of symptoms to initial treatment and more than 10 skin lesions on admission, are associated with poor prognosis of pemphigus vulgaris.


Plasma procalcitonin level as a predictor of treatment response in ICU patients with bacterial sepsis
Mobaien Ar, Shams S,
Volume 68, Issue 2 (5-2010)
Abstract

Background: Sepsis is one of the most important causes of mortality in severely ill ICU patients. At least, a part of high mortality rate in sepsis patients is due to less specific clinical symptoms for prompt diagnosis. Recently some studies report that serum levels of procalcitonin will increase in these patients but changes of serum levels following treatments is not known. This study was designed to determin procalcitonin levels in patients with bacterial infectious disease in ICU, initially and during therapy and compare the levels during response to treatment.

Methods: This prospective cross-sectional study was conducted on ICU patients with infectious diseases, blood specimen collected on day 1 and then in days 3 and 7 of ICU admission. The semi-quantitative PCT-Q test was performed.

Results: Thirty five patients, 22(62.9 %) men and 13(37.1%) women, were enrolled in this study. 18(51.4%) patients died. Procalcitonin level in most patients in admission day was more than 10 ng/ml [16 (45.7%)] but in patients that react to treatment, decline to lower than 0.5 ng/ml [14(77.8%)]. Mean rank of procalcitonin level from 1.14 ng/ml in first day reached to 2.72 ng/ml in seventh day (p<0.0001).

Conclusions: This study showed that serum procalcitonin levels in ICU patients with bacterial sepsis significantly decrease following response to treatment. The measurement of serum procalcitonin in ICU patients with bacterial infectious diseases at first arrival day and following treatment is recommended.
Serum triglyceride level and prognosis of acute cerebral ischemic stroke
Toghae M, Namakian F, Gheini Mr, Aloosh M,
Volume 68, Issue 7 (10-2010)
Abstract

Background: Cerebrovascular ischemic accident is the third most common cause of death in community. Management of high-risk patients reduces complications and mortality. Serum lipid profile is one of the most important factors influencing the prognosis.

Methods: In this cross sectional study, 123 (58 female and 65 male) patients with acute ischemic stroke, mean aged 65.1± 11.16 years, were admitted to Sina Hospital between September 2008 and September 2009. The inclusion criteria were age between 40-90 years and ischemic stroke within the anterior or posterior brain blood system. The exclusion criteria were brain tumor or abscess, venous sinus thrombosis, liver disease, renal failure, hypothyroidism or metabolic problems. Serum lipid profile was evaluated during the first 24 hours after stroke and after 12 hours of fasting. Furthermore, the patients' inability was evaluated on the first and fifth day of hospitalization by NIH Stroke Scale (NIHSS).

Results: Patients' total serum cholesterol was 189.93± 51.46 mg/dl and mean total serum triglycerides was 157.72± 72.67 mg/dl. The mean HDL and LDL was 47.70± 14.43 and 105.98± 37 mg/dl, respectively. In the analysis, a significant inverse relationship was found between serum triglyceride levels and fifth day's NIHSS. In addition, age and a history of heart disease had a significant direct relationship with the first day's NIHSS. (p< 0.05)

Conclusion: The study showed a better prognosis in cases with increased plasma triglyceride levels, after cerebral ischemic stroke. Besides, older age and a history of ischemic heart disease were associated with a worse prognosis.


The clinical outcome of patients with acute coronary syndrome without critical stenosis in angiography: a prospective cohort study
Nadia Hatmi Z, Kazemi Said A, Khoshkar Najar Sh,
Volume 69, Issue 8 (11-2011)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Previous studies were suggestive of a good prognosis in patients with acute coronary syndrome (ACS) and absence of any critical stenosis in coronary angiography but recent limited reports have revealed that patients with non-obstructive acute coronary syndrome are at a higher risk of future clinical coronary events.

Methods : A concurrent prospective cohort study was designed and 146 male patients with ACS and non-obstructive coronary artery disease were regarded as the unexposed group, while 191 female patients with non-obstructive coronary artery disease were regarded as the exposed group. Coronary events were recorded within one year of follow-up. Prognostic factors were evaluated at baseline by using a standardized protocol.
Results : Of the 337 patients with ACS, 191 (56.6%) were female. Coronary events in female patients after one year of follow-up were: ST EMI 3 (1.6%), unstable angina pectoris 22 (11.5%), Q-wave MI 1 (0.5%) and no syncope. In male patients the outcomes were: ST EMI 4 (2.7%), unstable angina pectoris 29 (19.9%), Q-wave MI 1 (0.7%), and syncope 1 (0.7%). Multivariate adjusted relationships revealed that physical inactivity (P=0.035), dyslipidemia (P=0.001), low ankle brachial index (P=0.024) and age between 40-50 years (P=0.004) were significantly associated with coronary events in women. In male patients, body mass index of 30-39.99 (P=0.011) was associated with a higher rate of ST-segment elevated MI.
Conclusion: Prognostically, coronary events and clinical endpoints were significantly different between men and women with acute coronary syndrome. Persistence of symptoms over one year seems to relate to the development and progression of coronary atherosclerosis.


Clinicopathologic aspects and treatment results in malignant sex cord-stromal tumor of ovary
Fatemeh Homaee , Malihe Hasanzadeh Mofrad, Masoumeh Mirtaymoore , Monavar Afzal Aghaee, Babak Eslame ,
Volume 73, Issue 7 (10-2015)
Abstract

Background: Ovarian sex cord-stromal tumors (SCST) account for rare ovarian malignancy. These tumors are 5-8% of all ovarian neoplasms. The most common type of sex cord ovarian tumors is granulosa cell tumor (GCT). In this study our purpose was to have a look at some of clinicopathologic aspects and treatment results of these tumors. Methods: In a retrospective study, all documents of patients with SCST was referred to tumor clinics of Ghaem and Omid Hospitals, from 1998 to 2008. The data of patients were collected and analyzed. Results: In 39 (5.9) of the 398 cases, ovarian malignancies was present in SCST. Eight Patients omitted from the study because there were not enough data for them. The commonest pathology was adult granulosa cell tumor in 25 patients (80.6%). Two patients (8.33%) had juvenile granulosa cell tumor, they were 25 and 38 years old. At time of diagnosis, 27 cases (87.1%) were in early stages (stage I). Mean age of patients was 41 years (range 16-76 years) at time of diagnosis of disease. Surgical staging of cancer was performed in 14 patients (46.7%). We did fertility sparing surgery in 12 patients (40%). Two patients were pregnant after surgery. 17 patients (54.80%) did not receive chemotherapy. Three patients (9.7%) received radiotherapy. Overall survival rates were 95% at both 2 years and 5 years. Longer survival had correlation with early stages of disease (P= 0.002). Age, conservative surgery and chemotherapy had no correlations with survival. Conclusion: The prognosis of SCST is almost good. Most of the patients were diagnosed in early stage of disease. In sex cord ovarian tumor, the only factor that have a full effect on survival, is stage of the disease. If the patients desire to preserve fertility, we can do fertility sparing surgery with minimal effect on survival.


Androgen receptor expression on breast cancer cells: a clinicopathologic and survival study
Sanambar Sadighi, Hosein Kamranzadeh, Easa Jahanzad , Saghi Vaziri ,
Volume 73, Issue 8 (11-2015)
Abstract

Background: Breast cancer is the most common cancer in women around the world. It has been known for over a century that androgens and androgen receptor (AR) play a role in normal and neoplastic breast cells. The aim of this study was to determined the AR expression on tumor cells and its correlation with other prognostic and predictive factors as well as contribution of AR in patients overall survival (OS) and disease- free survival (DFS). Methods: This retrospective cross-sectional study performed on 189 patients who referred to Medical Oncology Ward of Cancer Institute, Tehran University of Medical Sciences, from April 2007 to February 2010. We performed an immunohistochemistry study for AR (AR441 clone, Dako, Germany) (10% cut-off point) and Ki-67 MIB-1 clone, Dako, Germany) on paraffin embedded blocks. Other data were extracted from patients’ documents. Results: Overall, AR expression was 49.1%. Mean age of the patients with and without AR was 47.86 and 48.49 years, respectively. AR positive tumors presented more in stage I/II than III/IV (P=0.02) and AR were more positive for estrogen receptor positive, lower grade of tumor (grade I/II versus III) and lower Ki-67 (P=0.01). AR positivity had neither correlation with progesterone receptor, HER2/neu, P53 expression or menopausal status. OS and DFS were higher in AR positive patients but did not reach statistical significance. In triple-negative breast cancer (TNBC) group, 25% of tumors showed AR expression. AR had non-significant positive correlation with OS in TNBC cancer patients. OS and DFS had significant statistic positive correlation with ER, PR and stage regardless of AR status. Conclusion: Based on this study, although androgen receptor expression showed correlation with other prognostic factors for survival in patients, we didn’t find statistically significant independent relationship between AR and overall survival in patients. As far as there isn’t any targeted therapy for triple-negative breast cancer (TNBC), prospective basic and clinical studies regarding AR inhibitors in the treatment of TNBC seems to be logical and valuable.


The serum level of CRP at the first 24h of admission and acute stroke early detection
Reza Ebrahimi Rad, Mohammad Reza Zarbakhsh Bahri , Samira Sarabi ,
Volume 75, Issue 1 (4-2017)
Abstract

Background: Nowadays, stroke can be considered as the one of the major causes of disability and mortality worldwide. However, relationship between serum C-reactive protein (CRP) level with stroke early prognosis has not been well studied, especially in Iran. Therefore, the present study aimed to study the relationship between CRP level of serum in patients with acute stroke at first 24h of admission and stroke early prognosis.

Methods: This prospective cross-sectional study was performed on 50 patients with acute stroke who were admitted at Emergency Ward of Shahid Rajaie Hospital, in Tonekabon City, Iran, between May 2013 to July 2014. In first step, valid clinical diagnosis was made based on CT scan and magnetic resonance imaging (MRI) of the patients. The ethical observations were considered for all patients. The serum level of CRP was measured by standard method, at first 24h of the admission. Clinical information and risk factors (age, gender, type of stroke, high blood pressure, diabetes mellitus) was detected for each patient. On discharge, early prognosis by modified Rankin Scale (mRS) (mRS< 3= good and mRS≥ 3= bad) was also recognized. In this study, statistical analysis was performed using SPSS software, and logistic regression method was used (P< 0.05).

Results: The results of this study showed that 38% of the patients were 70-80 years old. Also, 52% of the patients were male and 48% were female. The serum CRP level of patients at the first 24h of admission increased in all studied patients. The mean of the serum CRP level was 12.82 that were higher than the normal range. The statistical analysis showed that there was no significant relationship between the serum CRP level and the stroke early prognosis.

Conclusion: Although the serum CRP level was not recognized as an anticipator factor for stroke prognosis at this study, it is recommended to performance of more studies by case-study method on this setting.

The incidence of major cardiovascular events relied coronary vessels after angioplasty and stent types complications
Siros Norozi , Alireza Rai , Ebrahim Salimi , Hamed Tavan ,
Volume 75, Issue 10 (1-2018)
Abstract
Background: Cardiovascular diseases alone have become the leading cause of death worldwide. One of the treatment methods cardiovascular disease is angioplasty. This study aimed to investigate the clinical results after coronary artery angioplasty, based on the incidence of major cardiovascular events with emphasis on stent types.
Methods: In this retrospective cross-sectional study, the prevalence of risk factors (age, history of previous illness and previous surgery) was assessed by using a case file for patients undergoing coronary angioplasty and stent placement during the years 2006 to 2016 and found during the follow-up. The place of the study was the Imam Ali Hospital's educational center affiliated to Kermanshah University of Medical Sciences, Iran, from July to September 2017.
Results: In this study, 1188 patients undergone to stent containing 909 non-drug stents, 504 sirolimus-eluting stents and 316 paclitaxel-eluting stents. Patients were followed-up one to five years. During follow-up, 98 patients involved major cardiovascular events, 6 cases involved with death and 91 patients involved with myocardial infarction. 1729 of patients undergone angioplasty and during follow-up, 91 patients had stent restenosis. In this study stent restenosis showed the highest correlation with the incidence of major cardiovascular events. With a view to stent type in lesions with stent restenosis, 61.7% was in non-drug stent, 23.5% was in paclitaxel-eluting stent and 14.8% was in sirolimus-eluting stent. This study also showed that despite the superiority of sirolimus-stained stents, there was no difference between paclitaxel-stained stents and non-drug stents in clinical outcomes and restenosis.
Conclusion: The results showed that the syringes impregnated with sirolimus have better quality. Also, stents that have a smaller diameter or need dilatation in the procedure have a worse prognosis and cause more complications in the patient.

Providing a model for predicting blood pressure fluctuations after induction of general anesthesia with data mining: a brief report
Monireh Hosseini, Zahra Manouchehri ,
Volume 79, Issue 12 (3-2022)
Abstract
Background: Fluctuations in blood pressure after induction of general anesthesia have played a significant role in complications of surgery. Therefore, the present study was performed by identifying the causes of blood pressure fluctuations after induction of anesthesia, predicting and preventing them.
Methods: For this study which is a retrospective cohort, data mining methods in the data set including the information related to 3150 patients who underwent anesthesia and surgery from April 2018 to September 2019 in Imam Khomeini Hospital in Kermanshah were used. The data set included patients aged 18 years and older (age range of 18 to 96) who underwent a general anesthesia induction test using Propofol and subsequently endotracheal intubation for non-cardiac surgery. If patients did not have intubation, data were missing, or patients underwent intubation after repeated trials, they got excluded. In total, 2640 patients were included in this analysis. Preoperative patient clinical information was collected from pre-anesthesia evaluation records. Intraoperative data were obtained from computer anesthesia records. This data from the patient monitoring system and the anesthesia machine was automatically stored in the anesthesia files, while drug doses and anesthesia techniques were recorded manually. The data were then pre-processed using SPSS software, version 26 (IBM SPSS, Armonk, NY, USA).
Results: In this study, 53 features of patients' records were used (The maximum number of features used in previous studies were 48 features, which compared to them, 5 new features were included in the study) for which a P-value was calculated. Finally, features with a P<0.05 (Indicates the level of significance of the variable) were selected. Then, three data mining algorithms, logistic regression, neural networks and decision tree (the most repetitive data mining algorithms based on previous studies) were used to predict blood pressure. Also, using the criteria of accuracy, precision, sensitivity and F function, the performance of three prediction algorithms in data mining was evaluated.
Conclusion: Six features with P<0.05 were selected that the logistic regression model was more accurate, which was presented as the final model for predicting increased blood pressure fluctuations with path coefficients.
 

Lean individual’s non-alcoholic fatty liver disease: a review article
Naser Ebrahimi Daryani , Mohammad Reza Pashaei ,
Volume 80, Issue 6 (9-2022)
Abstract
Nonalcoholic fatty liver disease (NAFLD) is defined by steatosis in more than 5% of liver cells, in the absence of a secondary cause such as drugs, alcohol, or other causes. The incidence of NAFLD is increasing every day; almost a quarter of the world's adult population is affected by this disease. The burden of NAFLD is affected by the epidemics of obesity and type 2 diabetes (T2DM), and therefore, we do not expect the prevalence of this disease to decrease in the future. The world is now in the process of passing on health to non-chronic diseases, like NAFLD. The most common cause of chronic liver disease worldwide is non-alcoholic fatty liver disease. About 25 percent of the world's population is affected by the disease, and it ranges from simple steatosis to cirrhosis. 1 in 4 individuals with NAFLD is a person with non-alcoholic steatohepatitis, which is associated with complications and significant mortality and morbidity due to complications such as liver cirrhosis and hepatocellular carcinoma. Non-alcoholic fatty liver disease is closely related to metabolic syndrome, and it can be said that the liver is an integral part of obesity. Diagnostic methods for this disease include laboratory tests, imaging studies and liver biopsy. Although NAFLD is observed predominantly in obese persons or type 2 diabetes, an estimated 7% to 20% of people with NAFLD have lean body habitus. Recent studies have shown that fatty liver can occur in lean individuals, even without abdominal and visceral fat. Fatty liver in lean people (Lean NAFLD) is a relatively new concept that has attracted many people to find the differences between lean and obese people. The pathophysiological mechanisms of lean NAFLD are still poorly understood. Studies have shown that NAFLD without obesity is more closely related to factors such as environmental, genetic susceptibility, and epigenetic regulation. In addition to lifestyle modifications such as weight loss, diet and physical activity, only a few NAFLD-specific drug treatment options such as vitamin E and pioglitazone are considered. This article discusses the pathogenesis of fatty liver in lean individuals, its treatment, prognosis, and its relationship with metabolic syndrome.

Evaluation of severity, duration and complications of jaundice in infants of both sexes at Ghaem Hospital in Mashhad from 2014 to 2021
Hassan Boskabadi , Mahdie Mir, Maryam Zakerihamidi,
Volume 80, Issue 6 (9-2022)
Abstract
Background: The gender of the baby is one of the risk factors for neonatal jaundice, but the difference in the severity of jaundice and its prognosis between the two sexes is not clear. Therefore, in this study, we investigated the severity, duration and prognosis of jaundice in both sexes.
Methods: The present study is a cross-sectional study that was performed on 2847 icteric neonates over 35 weeks admitted to Ghaem Hospital in Mashhad from May 2014 to May 2021. This study is done by available sampling. After confirmation of jaundice in infants, data were recorded using a researcher-made checklist including maternal demographic information (maternal age, mode of delivery), complete infant characteristics (age, birth weight, age at onset of jaundice, jaundice recovery age) and laboratory findings (Bilirubin, Indirect Coombs, direct Coombs, G6PD), and neonatal development up to two years of age was performed based on the Denver 2 test. Then data analysis was performed by SPSS software using Chi-square test and Student’s t-test.
Results: 1642 infants (57.7%) were boys and 1205 infants (42.3%) were girls. Mean and standard deviation of bilirubin in values less than 20 mg/dl in boys was 17.20±2.48 mg/dl and in girls was 16.54±2.80 mg/dl (P=0.000), birth weight was 3.16±0.49 (kg) for boys and 3.07±0.45 for girls (P=0.000). In two groups of male and female infants, age (P=0.004), direct bilirubin (P=0.001), direct and indirect Coombs (P=0.000), and G6PD enzyme deficiency (P=0.000) had a significant difference. Acute kernicterus was reported in 25 (2.03%) boys and 4 (0.46%) girls (P<0.001). In the two-year follow-up, 23 boys (1.9%) and 11 girls (1.28%) had developmental delay (P<0.05).
Conclusion: The incidence of jaundice in male infants was higher than female infants, which is probably due to a higher prevalence of G6PD deficiency in boys. The severity of jaundice was higher in boys less than 20 mg/dl. Jaundice has a worse prognosis in male infants.

Short-term prognosis of definitive neonatal infection
Hassan Boskabadi, Maryam Zakerihamidi,
Volume 80, Issue 8 (11-2022)
Abstract
Background: Neonatal sepsis is a severe systemic bacterial infection that affects on premature neonates prognosis. Therefore, the aim of this study was to evaluate the short-term prognosis of neonate's infection.
Methods: The present study is a cross-sectional study that was performed on 729 neonates suspected of infection, in neonatal ward in Ghaem Hospital of Mashhad since May 2015 to May 2022 by available sampling. The data collection tool was a researcher-made checklist containing neonatal characteristics (gestational age, birth weight, first and fifth minute Apgar score, and neonatal status at discharge) and laboratory information (White Blood Cell, Platelet (PLT), C-reactive Protein, Blood culture, Cerebrospinal fluid culture). Infants with congenital infection, congenital anomaly and positive blood cultures without clinical and laboratory symptoms were excluded from the study. Neonatal prognosis was compared in terms of death or discharge among neonates with and without definitive infection. First, we described the results using statistical tables and graphs, and then, data were analyzed by Kolmogorov-Smirnov, T test and SPSS software, version 26 (IBM SPSS, Armonk, NY, USA). P<0.05 considered as significant.
Results: According to the results of this study, low birth weight and lower gestational age and lower Apgar score increase the risk of neonatal death. About one-fifth of infants died of definitive infection. The cases of death due to infection in the group of deceased infants were about 4 times higher than in the group of discharged infants. About one third of the babies with sepsis and half of the babies with meningitis died. Forty-four percent of infants with early sepsis and 40% of infants with late sepsis died. In cases of neonatal death due to sepsis, the most common gram-negative infectious agent was Acinetobacter and the most common gram-positive infectious agent was Enterococcus.
Conclusion: Neonatal definitive infection worsens their prognosis. So, the risk of neonatal death increases by 5 times. The probability of death in meningitis is more than sepsis and in early sepsis is more than late sepsis and in sepsis due to gram-negative is more than gram-positive.

Prognosis of neonates in maternal diseases
Hassan Boskabadi , Nafiseh Pourbadakhshan, Maryam Zakerihamidi,
Volume 80, Issue 10 (1-2023)
Abstract
Background: Maternal diseases such as diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy in pregnancy are associated with fetal and neonatal complications. The aim of this study was to compare the prognosis of neonates in maternal diseases.
Methods: This study was a cross-sectional study. The present study was performed on 600 preterm infants with mothers with diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy. This study was done in Ghaem Hospital of Mashhad from March 2015 to April 2021 with available sampling. The data collection tool was a researcher-made checklist including infant (gestational age, Apgar score of the first minute, Apgar score of the fifth minute) and maternal (mode of delivery, prenatal care, premature rupture of the membranes) characteristics. Neonatal prognosis was compared at birth. All clinical and diagnostic examinations of newborns were performed by a neonatologist. Neonatal and maternal data in the group of newborns with normal mothers and newborns with maternal diseases were analyzed by Kolmogorov-Smirnov and Chi-square tests. The significance level was considered p≤0.05 in all cases.
Results: The results show that 161 newborns (28.90%) had normal mothers, 89 newborns (15.98%) had diabetic mothers, 117 newborns (21.01%) had hypertensive mothers, and 50 newborns (8.98%) had hypothyroid mothers. One hundred tweny newborns (21.72%) had mothers with preeclampsia, 19 newborns (3.41%) had mothers with epilepsy. Newborns with mothers with epilepsy had the lowest Apgar score of the first minute and the lowest gestational age and newborns with mothers with diabetes had the lowest Apgar score of the fifth minute. Mothers with hypothyroidism had the highest rate of premature rupture of the membranes and mothers with hypertension and preeclampsia had the highest incidence of cesarean section.
Conclusion: Maternal diseases including diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy affect the prognosis of neonates in terms of the severity of prematurity, premature rupture of the membranes, type of delivery, Apgar scores of the first and fifth minutes. Therefore, proper control and treatment of these diseases may improve neonatal prognosis.

Evaluation of serum albumin as a risk factor for mortality in patients with sepsis admitted to ICU
Farhad Soltani, Foroogh Doraghi, Saeed Hesam, Fereshteh Amiri ,
Volume 80, Issue 11 (2-2023)
Abstract
Background: One of the major challenges in intensive care unit (ICU) patients is sepsis. The incidence of sepsis in patients admitted to the ICU has been reported from 13.6-39.3%. Many factors affect patient mortality, including acute phase proteins such as albumin.
Methods: The present study was a retrospective study in which patients with a diagnosis of sepsis referred to Golestan Hospital in Ahvaz from March to August were collected. In the present study, patients with sepsis admitted to the ICU who did not show improvement for more than 7 days were evaluated for length of hospital stay, survival and the relationship with albumin levels. During the study, albumin was checked every 72 hours and its validation was done. Based on albumin levels less than 2.6, they were treated with albumin. The patients who did not have an increase in the level of albumin remained in the study.
Results: 124 patients including 64 women (51.6) and 60 men (48.4) with a mean age of 66.4±15.4 were included in the study. The mean duration of hospitalization was 31.4±18.9 days, in which 24 patients (19.4%) died and 100 patients (80.6%) were discharged. Age, albumin and protein levels were associated with disease prognosis (P<0.001). Also, the duration of hospitalization in the deceased patients was longer than the recovered patients (27.7±25 vs. 32±17.1) (P=0.04). After further investigations, it was found that there is no difference between the deceased people (66±15.7) and the recovered people (67.7±14.1) (P=0.7).
Conclusion: The results of the present study showed that albumin has a direct effect on the severity of sepsis and this issue affects older patients more. Therefore, it is recommended that albumin be considered as a risk factor and one of the influential factors in choosing the best treatment strategy, which is associated with a reduction in mortality, hospitalization and treatment costs.

Examining the results of cardiopulmonary resuscitation and its influencing factors with emphasis on the cause of cardiac arrest and 1-year prognosis of rescued patients
Siros Norozi , Paniz Poursiabidi ,
Volume 80, Issue 12 (3-2023)
Abstract
Background: Cardiopulmonary resuscitation is a quick and immediate intervention to prevent death in a person who has suddenly suffered cardiorespiratory arrest. This study aims to investigate the results of cardiopulmonary resuscitation and the factors affecting it with emphasis on the cause of cardiac arrest and 1-year prognosis of the saved patients.
Methods: Materials and methods: This research is a retrospective descriptive-analytical study that was conducted for 24 months, from April 1, 2017 to the end of March 2018, in Shahid Mostafa Khomeini Hospital in Ilam, from July 2022 to September 2022. The necessary information was collected based on the data available in the patients' files. Data analysis was done using SPSS24 software.
Results: Out of 152 patients, 64(42.1%) were men and 88(57.9%) were women. The average in the group that had a successful CPR was 60.75 years and in the group that had an unsuccessful CPR was 68.27 years. 13.7% of all CPRs occurred during shift change. The number of CPR was 11 cases (7.2%) in changing night shift to morning, six cases (3.9%) in changing evening shift to night, and four cases (2.6%) in changing evening to night shift. Most of the patients who underwent CPR were patients with internal diseases.
Conclusion: In this study, the final success rate of CPR was close to other studies. These results indicate that performing CPR is considered at any time. However, the reasons for the failure of the rehabilitation operation should be looked for in other factors. These factors can include updating nursing and medical team’s knowledge in the field of resuscitation, experience and skills of the resuscitation team, and periodic training of the resuscitation team, which should be considered regularly in order to reduce unsuccessful cases.

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