Showing 50 results for Shad
Zohreh Habibi, Seyed Morsal Mosallami Aghili , Seyed Amir Hossein Javadi , Arash Seifi, Kourosh Karimi Yarandi, Seyed Ali Dehghan Manshadi , Fereshteh Naderi Behdani ,
Volume 79, Issue 2 (May 2021)
Abstract
Background: Neurosurgery practice conflicts with many challenges during the COVID-19 pandemic; Including the lack of beds in intensive care units, as well as the use of some methods such as drills and trans-nasal and trans-oral approaches that produce aerosols or are directly in contact with patient discharge. Due to these challenges, developing a clinical guideline to help neurosurgeons and medical staff in decision making and improving patients and medical staff safety during the COVID-19 pandemic is the purpose of this study.
Methods: First, all of the relevant clinical guidelines to neurosurgical practice during the COVID-19 pandemic were extracted from the data centers. Finally, five clinical guidelines were selected. The questions and the items were designed according to these guidelines. The answers to each of the questions were extracted from these guidelines. The complementary evidence was extracted by searching in the data centers again. Finally, the answers were edited and the edited answers were considered as the recommendations. These recommendations were sent to 4 experts in the Neurosurgery field and 2 experts in the infectious diseases field. The appraisers evaluated the recommendations according to the AGREE-REX instrument. This instrument has 9 items and 3 domains including clinical applicability, values and preferences, and implement ability. Recommendations with above 80% agreement were considered as the final recommendations.
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Results: The final recommendations were presented as “Clinical guideline of neurosurgical practice during the COVID-19 pandemic” in the results section.
Conclusion: This clinical guideline was developed by using similar guidelines and available evidence. Proper usage of personal protective equipment, reduction of unnecessary contacts between medical staff and patients, use of Telemedicine for follow-up, proper air conditioning, screening patients for COVID-19, reduction of elective surgery, use of less invasive methods, management of aerosol production and reduction of trans-oral and trans-nasal approaches are the most important recommendations of this clinical guideline.
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Ghasem Janbabai, Amir Hashem Shahidi Bonjar , Abtin Heidarzadeh, Mahdi Shadnoush , Ghasem Sadeghi, Mohsen Dalband, Amir Reza Rokn, Hamid Samadzadeh, Ali Tajernia, Said Sai, Reza Masaeli, Gholamreza Heydari, Ali Yazdani , Behzad Houshmand ,
Volume 79, Issue 2 (May 2021)
Abstract
Background: The advent of Severe Acute Respiratory Syndrome Coronavirus 2 (so-called SARS-CoV-2) causing Coronavirus Disease 2019 (so-called COVID-19) occurred in Dec. 2019 in Wuhan, China. Having an inconceivable worldwide contagion, the outbreak was labeled a pandemic by the WHO. Dental services and related professions (including dentists, dental assistants, dental hygienists and the personnel of cleansing, remedial, triage, dental laboratories, radiographic laboratories and other related paraclinicals), facing galore aerosol and droplets, are in the topmost risk groups exposed to the queer virus. This study was fulfilled to round up evidence-based data to break a link at any part of the virus transmission chain in dental services and related professions.
Methods: Relevant online databases, as PubMed, MEDLINE, Embase, Scopus, Google Scholar and TripDatabase were searched meticulously and evaluated for relevant published original research papers. Subsequently, to fulfill the investigation, ADA, CDC and WHO websites were reviewed to gain relevant guidelines and protocols. Consequently, 476 resources were included considering the canonical inclusion criteria. For the sake of quality assessment of the resources, an authentic checklist was exploited to score the resources from 1 to 15, wherein the admissible score was 10. After deliberation of resources, 366 of them were excluded and finally, 110 resources were selected and overhauled to attain a comprehensive perception on the subject of the investigation.
Results: Transmission of SARS-CoV-2 includes direct transmission (via droplet and aerosol inhalation) and indirect transmission (via surface and instrument contamination), which can amply occur in dental services and related professions. Therefore, an all-inclusive evidence-based miscellany was rallied on several exigent topics, containing genuine esteem in reputable scientific authorities, to present a consummate report for the dental clinicians and related practitioners, working in the course of the running pandemic.
Conclusion: Contemplating the ongoing crisis, undertaking a set of miscellany elected guidelines and protocols, is indispensable in this vital interval of history to bridle the current pandemic, which has been abridged via this systematic perusal. |
Hamidreza Mehryar, Omid Garkaz, Peyman Atabaki, Shadi Gharibi, Nasser Khalili, Sahar Paryab,
Volume 79, Issue 2 (May 2021)
Abstract
Background: Chest pain is the most common reason for patients to be referred to the emergency department of hospitals. This study was performed to compare the GRACE and TIMI scores in predicting important cardiovascular events in patients.
Methods: This descriptive-analytical study was performed on 862 cardiac patients who were referred to the emergency department of Taleghani Hospital in Urmia in the period of April 1, 2016 to the end of September 2016 by census method. A checklist containing demographic information, medical history and risk factors was used to collect data. After scoring patients, we examined and followed up both groups over the next 30 days and recorded any cardiovascular events such as sudden death, AMI or immediate revascularization. The data were tested using SPSS16 and descriptive statistics tests. T-test and ROC curve were analyzed.
Results: The results showed that in general, out of 862 patients who were studied (50.3%), 433 were female and (49.7%) 429 were male. Most of the patients were under 65 years old 627 (72.7%) and the age range was (17-91). The highest initial diagnosis of nonSTEMI patients was UA with 811 (94.9%) cases. On the other hand, the highest risk factors of patients were HTN 449(52%), CAD 314 (36.425) and DM 22 (25.55). The highest blood pressure was between (100-120) with 328 cases and serum creatinine between (0.6 to 1.3) with 770 cases. MACE after 30 days in GRACE system 17 people (32.69%) were in high risk group and in TIMI 3 people (37.5%) were in high risk group. In MACE evaluation, the specificity of GRACE system (cutoff point=30) was 89.27 vs. 52.24, the specificity of TIMI system (cutoff point=7.3) and the sensitivity of GRACE 93 (cutoff point=10) versus TIMI 85.71 (cutoff point=8.3) is.
Conclusion: The results showed that GRACE was more sensitive and characteristic than TIMI. |
Hamid Arshadi, Pooya Hekmati, Hojatollah Raji, Mohammad Vasei , Mehrzad Mehdizadeh,
Volume 80, Issue 1 (April 2022)
Abstract
Background: Appendicovesical fistula in patients suffering from cystic fibrosis is a rare condition. Although this situation is so rare it should be considered in the differential diagnosis, dealing with a patient with cystic fibrosis and chronic abdominal pain with no response to primary management. To the best of our knowledge, this is the third case of appendicovesical fistula in a patient with cystic fibrosis.
Case presentation: In this paper, we are reporting a bladder lesion of a nine-year-old Iranian girl, a known case of cystic fibrosis, who was referred to pediatric urology clinic, Children’s Medical Center, Tehran University of Medical Sciences. The girl is a known case of cystic fibrosis on regular follow-up who had chronic abdominal pain for about one year. While primary management had been failed for her, further workups were done by her pediatric pulmonologist. In her pelvic sonography, the radiologist reported a bladder lesion so she was referred to our clinic. Cystoscopy was done for her, but transurethral biopsy/resection was impossible according to the lesion location. The non-papillary nature of the lesion raised our concern about the possibility of genital rhabdomyosarcoma with bladder invasion. So, an Abdominopelvic CT scan and a pelvic MRI were also done for her. Intact uterus and vagina with an enhancing lesion at the dome of the bladder with some degree of inflammation/attachment around the adjacent GI tract were detected on her images. The urachal inflammatory/tumoral process could not be ruled out. So open surgical exploration was planned. During the attempt for surgical exploration and partial cystectomy, at the Children’s Medical Center in December 2021, we found that the mass, is actually her appendix which has invaded the urinary bladder, and presented as a bladder lesion.
Conclusion: Abdominal pain is a relatively common complaint of patients with cystic fibrosis. Every caregiver or physician should consider rare conditions, dealing with a cystic fibrosis patient whose abdominal pain does not respond to common management.
Nasim Vahidfar, Mahdieh Parvizi, Marzyehsadat Peyman, Hana Safar, Saeed Farzenehfar , Mehrshad Abbasi,
Volume 80, Issue 2 (May 2022)
Abstract
Background: Labeled leucocytes could be used for localization of infection foci after surgeries or in inflammatory diseases including inflammatory bowel diseases. Extraction of leucocytes needs 10% Hetastarch which is not available in Iran. We provide a method employing multiple centrifuges to extract and label leucocytes with Tc-HMPAO.
Methods: The study was conducted from April to June 2018 in the Nuclear Medicine Unit of Valiasr Hospital. Leucocytes were extracted from a 60 ml blood sample anticoagulated with Acid-citrate-dextrose through four-step centrifugation as below: 1-whole blood was centrifuged at 1k cycle per minute (CPM) for eight minutes to precipitate red blood cells (RBC). Supernatant including RBC free plasma, WBC, and platelet was extracted for the next step. 2-WBC was precipitated at 1.8k CPM for five minutes and platelet-rich plasma (PRP) as supernatant. 3- PRP was centrifuged at 3k for five minutes and cell-free plasma (CFP) was extracted as supernatant, and 4- precipitate WBS at step two was washed with saline and centrifuged at 0.5k CPM to achieve washed WBC. Then the leucocytes were labeled with 40 mCi Tc-HMPAO through 15 minute incubation at 37-38 degrees centigrade. The extra free pertechnetate was eliminated using two additional centrifugation steps as follows: 1-0.5k CPM for five minutes to dispense free pertechnetate, and 2-0.5 for five minutes to achieve high radiochemical purity labeled WBC. Finally, the labeled WBC was re-suspended in CFP and reinjected to the patient. Imaging at 2-4 hours was done. The pathology and imaging of labeled WBC distribution are reported
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Results: No RBC was detected in microscopy. The majority of the leucocytes were lymphocytes with rare accompanying platelets. The radiolabeling efficiency of the procedure was higher than 40%. The viability test indicated more than 80% of viable cells. The radiochemical purity of the final product was more than 95%. Two to four hours after injection, low background images were acquired. The liver and spleen were target organs with low-grade urinary, thyroid, and GI activity.
Conclusion: Employing multi-stage centrifugation, Tc-HMPAO labeled leucocyte scan could be efficiently performed.
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Rasoul Samimi, Amir Peymani, Samaneh Rouhi , Shadman Nemati, Sanaz Ahmadi, Afra Hossein Panahi , Somayeh Ahmadi Gorji ,
Volume 80, Issue 3 (June 2022)
Abstract
Background: Helicobacter pylori infection and respiratory tract infection at the same time cause pathogenicity increase and death. The aim of this study was to evaluate the co-occurrence of upper respiratory tract disorders and gastrointestinal infections of H. pylori.
Methods: The present study was conducted as a systematic review and meta-analysis, from August 2019 to Agusut 2020, at Qazvin University of Medical Sciences. Articles in the international databases (April 2001-December 2018) on the coexistence of upper respiratory tract disorders with H. pylori gastrointestinal infections were examined. The random effect model with a 95% confidence level was used to analyze the data.
Results: The highest prevalence of respiratory disorders co-occurrence associated with adenoid tissue (33%), nasal polyps (100%), chronic rhinosinusitis (71%) and gastrointestinal infections of H. pylori was reported in 2006 in Turkey, 2011 in Poland and 2015 in Egypt. Concurrent prevalence of the disease, according to the type of upper respiratory tract disorders in all studies, the estimated effect size according to the random model was 53% in chronic rhinosinusitis, 63% in nasal polyps, 62% in adenoid tissue and 60% in total, which was significant (P=0/000). The prevalence of co-occurrence of upper respiratory tract disorders with gastrointestinal infections of H. pylori in patients was estimated to be 61% at the age of more than 27 years and 60% at the age of fewer than 27 years. Pooled estimation of the concurrent prevalence of infection (in total) was estimated to be 60% and was significant among the studies (P=0/000).
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Conclusion: The concurrent prevalence of upper respiratory tract disorders with gastrointestinal infections of H. pylori was observed to be almost equal and significant in elderly and young patients. Due to the fact that the simultaneous occurrence of two types of infections and diseases in people is very dangerous, screening of patients with each of these infections is necessary to identify the other infection and prescribe appropriate drugs.
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Naser Piri, Salahedin Delshad, Maryam Aghaee,
Volume 80, Issue 10 (January 2023)
Abstract
Background: Among diseases causing acute lower abdominal pain in women, isolated fallopian tube torsion is a rare cause that occurs mainly in women of reproductive ages and if left untreated can lead to fertility problems. Immediate diagnosis and timely surgery are urgent and necessary to preserve the fertility of females. Successful pregnancy with simultaneous involvement of isolated fallopian tube torsion is one of the rare operations in the world.
Case Presentation: The reported case is a 37-year-old pregnant woman (Gravid 2, with 33-week gestational age) with nausea, vomiting and abdominal pain in August 2020 who presented to the Maryam Hospital in Karaj in August 2020. The patient was examined in the operating room under anesthesia, and pain in the right and lower abdomen was observed. There was no anorexia, and on examination, there was severe tenderness in the right lower quadrant (RLQ) area. There was no pain in other parts of the abdomen. Ultrasonography in the patient's tenderness showed an image of a tubular and cystic structure measuring 30×10 mm. In CBC test, leukocytosis with high PMN (Polymorphonuclear), (WBC: 11700 mm3 and Neutrophil: 78%) was observed. During laparotomy, isolated torsion of the right fallopian tube observed, half of which was cyanotic. Due to the confirmation of fimbriae necrosis during surgery, preservation of uterine tube integrity, fallopian tube detorsion, excision of cyanotic fimbriae and hemorrhagic cyst of fimbriae, intra-abdominal fluid suction and fimbriae repair performed. The patient discharged in good condition after two days and gave birth to a healthy baby at 38 weeks of gestation by cesarean section.
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Conclusion: Isolated fallopian tube torsion should be considered as a potential differential diagnosis in patients that have acute lower abdominal pain in women of reproductive ages and even adolescents. Early diagnosis and early surgical intervention are critical to maintaining the fallopian tube and fertility in the future. Laparoscopy is one of the main diagnostic tools for assessing, management and maintenance isolated torsion of the fallopian tube.
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Vahid Malekzadeh, Shadi Sheikhizadeh , Mohadeseh Taklo, Hossein Jamalifar, Younes Ghaseminezhad Koshali , Hassan Khorramian, Hossein Naseri ,
Volume 82, Issue 2 (May 2024)
Abstract
Background: Considering the emergence of new diseases, increased prevalence of nosocomial infections, and microbial resistance in recent years, it is necessary to disinfect the hands with a suitable hand sanitizer, as instructed by the Center for Disease Control (CDC). This is because hand hygiene is the most important way to control infections. Surgical hand antisepsis protocols emphasize the importance of both mechanical cleaning and antimicrobial action to effectively eliminate microbial contamination. Recommendations from organizations such as the Association of Perioperative Registered Nurses (AORN), the World Health Organization (WHO), and the Association for Professionals in Infection Control and Epidemiology (APIC) underscore this principle. While routine handwashing removes visible debris and transient microbes, surgical hand antisepsis requires additional steps and the use of antimicrobial agents. This may involve a surgical scrub with an antimicrobial soap or the application of an alcohol-based hand rub (ABHR). The latter approach has demonstrated greater efficacy in reducing microbial contamination compared to soap and water alone. Since a few compressive studies in Iran have dealt with global standards for disinfectants, this study investigated the effects of surgical scrub based on the European standards with TGSept AL Plus, produced by the research team of Tajhiz Gostar Sharif , on normal flora of hands in a group of the operating room medical staff in Hazrat Fatemeh Plastic Surgery and Repair Hospital of Tehran, in 2023.
Methods: This study evaluated the short-term durability and effectiveness of this solution according to the EN12791 standard on microorganisms and microbial contamination reduction. To this end, 30 members of the surgical team were randomly selected. The bacterial sampling was performed three times: after washing the hands with common detergents, after hand scrubbing with the studied disinfectant (about 90 seconds), and three hours after surgery. The samples were immediately transferred to a laboratory for swap culture and pour plate test.
Results: Then bacterial colonies were counted, contamination reduction was measured, and the shelf life of the solution was determined according to the standards. Results showed that a 60-to-90-second scrub with an alcohol-based disinfectant is the best way to reduce hand contamination and, thereby, nosocomial infections.
Conclusion: Based on the study findings, alcohol-based solutions can be recommended for surgical scrubs, according to WHO guidelines.
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Mahshad Mohtadi, Mohammad Javad Pasand , Ghazaleh Eslamian,
Volume 82, Issue 3 (June 2024)
Abstract
Background: Athletes are seeking ways to enhance sports performance and protect themselves from the long-term effects of exercise. One potentially effective solution is the administration of colostrum supplements. Evidence suggests that it can support immune system function by maintaining the integrity of the intestinal barrier. The aim of this study is to evaluate the impact of colostrum supplementation on athletes' immune system performance.
Methods: This systematic review searched English and Farsi databases including Medline, Scopus, Embase, ScienceDirect, Scientific Information Database, Islamic World Science Citation, Cochrane, and Google Scholar website without a time limit until November 2023. Eighteen randomized clinical trials, following the Cochrane protocol, were analyzed to assess the effects of colostrum supplementation on athletes' immune systems. The studies measured various factors, such as the amount of cytokines, concentration of serum immunoglobulins, salivary immunoglobulin, white blood cell count, neutrophil oxidative reactions, and the rate of respiratory system-related diseases in athletes during the consumption of colostrum supplements or its derivatives. The potential risks of bias in the studies were evaluated using the Cochrane Risk of Bias 2.0 tool for randomized controlled trials.
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Results: The findings of these studies indicate that daily consumption of 3.2 grams of colostrum for 24 weeks can decrease the production of inflammatory cytokines caused by exercise and increase anti-inflammatory cytokines. Additionally, a daily intake of 20 grams of colostrum supplement can protect against the reduction of neutrophil function and immune responses resulting from long-term exercise. The group receiving colostrum experienced fewer upper respiratory tract diseases compared to the placebo group in studies that investigated this indicator. No significant effects on leukocyte count were observed with any dosage of supplementation, and the results of studies on other immune indicators were inconsistent.
Conclusion: Bovine colostrum can improve athletes' immune system performance by regulating immune parameters and mitigating the negative effects of intense exercise. However, the contradictory results of existing studies call for further research that examines different doses of colostrum in various sports.
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Mohadeseh Shad, Ali Samady Khanghah , Reza Shojaeian, Khashayar Atqiaee,
Volume 82, Issue 7 (October 2024)
Abstract
Background: Rectal prolapse, characterized by the extrusion of the rectal mucosa through the anal sphincter, is a relatively rare condition in children. This condition can be attributed to several anatomical and functional factors. This study aimed to investigate defecation habits in children with rectal prolapse.
Methods: This retrospective study was conducted from 2017 to 2021 in Akbar and Sheikh children's hospitals. The study population included 50 children under the age of 14 who were diagnosed with rectal prolapse and visited the hospitals. Data were collected using pre-prepared checklists and analyzed using SPSS version 24. Inclusion criteria were children under 14 years diagnosed with rectal prolapse, while exclusion criteria included incomplete data or other severe unrelated health conditions.
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Results: The results showed that 67.4% of the sample were boys, and the most affected age group was children under 2 years (38.8%). A total of 57.1% of the children had daily bowel movements, and 68.2% reported consistently hard stools. Additionally, 48% of the children experienced pain or burning during defecation.
Conclusion: The findings of this study indicate that children with rectal prolapse often face challenges related to stool consistency and defecation pain, despite having frequent bowel movements. These results emphasize the need for targeted interventions to improve stool consistency and manage pain to effectively prevent and treat rectal prolapse.
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