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Showing 1117 results for Type of Study: Original Article
Seyede Hakimeh Sajadi, Mohadeseh Karimi ,
Volume 82, Issue 12 (3-2025)
Volume 82, Issue 12 (3-2025)
Abstract
Background: Approximately 16% of all female cancers. Due to its high prevalence and considerable impact on patient survival, comprehensive evaluation of histopathological and molecular features is crucial for improving disease management. This study aimed to analyze the histopathological spectrum and immunohistochemical (IHC) molecular subtypes of invasive breast tumors in an Iranian population, with the ultimate goal of guiding tailored therapeutic strategies.
Methods: This retrospective cross-sectional study was conducted between 2021 and 2023 at Shahid Mohammadi Hospital, Bandar Abbas, Iran. Initially, 110 female patients diagnosed with invasive breast carcinoma were evaluated. After applying exclusion criteria (bilateral breast cancer, in-situ carcinoma, prior neoadjuvant chemotherapy, or inadequate pathological specimens), 10 patients were excluded, leaving 100 cases for final analysis. Demographic and clinical data were collected from medical records, while histopathological assessment was performed using hematoxylin-eosin (H&E) staining. Immunohistochemistry was applied to evaluate estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki-67 expression, enabling classification into molecular subtypes: Luminal A, Luminal B, HER2-enriched, and Basal-like. Tumor grade and stage were determined according to AJCC/UICC criteria. Statistical analysis was performed using SPSS v21, with significance set at P<0.05.
Results: The patients’ ages ranged from 26 to 73 years, with a mean age of 49.5 years. Histopathologically, invasive ductal carcinoma accounted for 89% of cases, followed by lobular (5%), medullary (3%), and other rare subtypes (3%). Molecular classification revealed 9% Luminal A, 65% Luminal B, 11% HER2-enriched, and 15% Basal-like. A significant association was found between tumor grade and molecular subtype (P=0.001). Luminal B tumors showed the highest frequency of grade III lesions, axillary lymph node metastasis, and advanced tumor stage (II-III), indicating more aggressive biological behavior compared to Luminal A.
Conclusion: This study confirmed that invasive ductal carcinoma is the predominant histological type of breast cancer, with Luminal B being the most prevalent molecular subtype in the studied population. The findings highlight the importance of molecular profiling for accurate prognostication and treatment planning. In particular, the aggressive features of Luminal B tumors emphasize the need for more intensive therapeutic approaches. Incorporating routine IHC-based subtyping into breast cancer management protocols could significantly enhance patient outcomes and support the implementation of precision oncology in Iran.
Methods: This retrospective cross-sectional study was conducted between 2021 and 2023 at Shahid Mohammadi Hospital, Bandar Abbas, Iran. Initially, 110 female patients diagnosed with invasive breast carcinoma were evaluated. After applying exclusion criteria (bilateral breast cancer, in-situ carcinoma, prior neoadjuvant chemotherapy, or inadequate pathological specimens), 10 patients were excluded, leaving 100 cases for final analysis. Demographic and clinical data were collected from medical records, while histopathological assessment was performed using hematoxylin-eosin (H&E) staining. Immunohistochemistry was applied to evaluate estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki-67 expression, enabling classification into molecular subtypes: Luminal A, Luminal B, HER2-enriched, and Basal-like. Tumor grade and stage were determined according to AJCC/UICC criteria. Statistical analysis was performed using SPSS v21, with significance set at P<0.05.
Results: The patients’ ages ranged from 26 to 73 years, with a mean age of 49.5 years. Histopathologically, invasive ductal carcinoma accounted for 89% of cases, followed by lobular (5%), medullary (3%), and other rare subtypes (3%). Molecular classification revealed 9% Luminal A, 65% Luminal B, 11% HER2-enriched, and 15% Basal-like. A significant association was found between tumor grade and molecular subtype (P=0.001). Luminal B tumors showed the highest frequency of grade III lesions, axillary lymph node metastasis, and advanced tumor stage (II-III), indicating more aggressive biological behavior compared to Luminal A.
Conclusion: This study confirmed that invasive ductal carcinoma is the predominant histological type of breast cancer, with Luminal B being the most prevalent molecular subtype in the studied population. The findings highlight the importance of molecular profiling for accurate prognostication and treatment planning. In particular, the aggressive features of Luminal B tumors emphasize the need for more intensive therapeutic approaches. Incorporating routine IHC-based subtyping into breast cancer management protocols could significantly enhance patient outcomes and support the implementation of precision oncology in Iran.
Saeideh Baghaei Barjini , Mozhgan Masoudi , Soheila Pirdadeh Beiranvand , Ashraf Moieni , Soodabeh Zare,
Volume 82, Issue 12 (3-2025)
Volume 82, Issue 12 (3-2025)
Abstract
Background: Intracytoplasmic sperm injection (ICSI) is one of the infertility treatments that may lead to various levels of stress and anxiety in women at different stages. Multiple factors may contribute to these psychological disorders. This study aimed to assess the levels of stress, anxiety, and depression before embryo transfer in women undergoing ICSI.
Methods: This cross-sectional analytical study was conducted from July to October 2024 on 70 women candidates for ICSI at Arash Women's Hospital in Tehran, prior to embryo transfer. Participants were selected through convenience sampling. Inclusion criteria included at least three years of infertility, no background in psychology or attendance in counseling sessions, no major physical or mental illnesses, and no severe stressful events in the past six months (such as the death of first-degree relatives or major accidents). Participants could withdraw from the study at any time. The DASS-21 (Depression, Anxiety, Stress Scale) was used to assess stress and anxiety levels. Based on the DASS-21, stress scores of 0-14 were considered normal or mild, 15-18 mild, 19-25 moderate, 26-32 severe, and ≥33 very severe. For anxiety, scores of 0-7 were considered normal or mild, 8-9 mild, 10-14 moderate, 15-19 severe, and ≥20 very severe. The validity of the tool was confirmed by Antony and validated in Iran by Sahebi.
Results: Among the 70 participants, 92.8% experienced stress and anxiety. The mean stress score was 20.77±4.87, and the mean anxiety score was 11.70±4.23, indicating moderate levels. Women over 42 years old had significantly lower stress scores compared to others (P<0.001). Conversely, women under 30 showed significantly higher anxiety scores (P<0.01). No significant associations were found between stress/anxiety and other demographic or infertility-related factors (P>0.05).
Conclusion: The findings indicate that women undergoing embryo transfer in ICSI procedures commonly experience stress and anxiety. Therefore, appropriate psychological interventions are recommended to support this group during treatment.
Methods: This cross-sectional analytical study was conducted from July to October 2024 on 70 women candidates for ICSI at Arash Women's Hospital in Tehran, prior to embryo transfer. Participants were selected through convenience sampling. Inclusion criteria included at least three years of infertility, no background in psychology or attendance in counseling sessions, no major physical or mental illnesses, and no severe stressful events in the past six months (such as the death of first-degree relatives or major accidents). Participants could withdraw from the study at any time. The DASS-21 (Depression, Anxiety, Stress Scale) was used to assess stress and anxiety levels. Based on the DASS-21, stress scores of 0-14 were considered normal or mild, 15-18 mild, 19-25 moderate, 26-32 severe, and ≥33 very severe. For anxiety, scores of 0-7 were considered normal or mild, 8-9 mild, 10-14 moderate, 15-19 severe, and ≥20 very severe. The validity of the tool was confirmed by Antony and validated in Iran by Sahebi.
Results: Among the 70 participants, 92.8% experienced stress and anxiety. The mean stress score was 20.77±4.87, and the mean anxiety score was 11.70±4.23, indicating moderate levels. Women over 42 years old had significantly lower stress scores compared to others (P<0.001). Conversely, women under 30 showed significantly higher anxiety scores (P<0.01). No significant associations were found between stress/anxiety and other demographic or infertility-related factors (P>0.05).
Conclusion: The findings indicate that women undergoing embryo transfer in ICSI procedures commonly experience stress and anxiety. Therefore, appropriate psychological interventions are recommended to support this group during treatment.
Babak Hooshmand-Moghadam , Abbas Ali Gaeini,
Volume 82, Issue 12 (3-2025)
Volume 82, Issue 12 (3-2025)
Abstract
Background: As survival rates among breast cancer patients improve, cardiovascular disease (CVD) has emerged as a leading cause of long-term morbidity and mortality in postmenopausal survivors. This epidemiological transition from oncologic risk to cardiometabolic vulnerability reveals a critical yet underexplored dimension of survivorship care. Structured exercise training represents a promising intervention, and this narrative review-grounded in a systematic literature search investigates the effects of aerobic, resistance, and combined training modalities on cardiovascular health in postmenopausal women with breast cancer. The review synthesizes evidence across physiological mechanisms, clinical outcomes, and implementation challenges to provide a comprehensive perspective on exercise oncology in this underserved population.
Methods: A systematic search of reputable international databases including PubMed, Scopus, Web of Science, Embase, and Google Scholar as well as Persian databases SID and Magiran was conducted to identify relevant human studies, clinical trials, and randomized controlled trials published between January 2000 and April 2025. Screening, selection, and synthesis of the studies were performed in Iran between October 2024 and January 2025.
Results: Accumulating evidence supports that structured exercise especially combined aerobic and resistance training exerts substantial cardioprotective effects through multiple mechanisms, including reductions in systemic inflammation, improvements in body composition, regulation of blood pressure, enhancement of cardiorespiratory fitness, and improved left ventricular function. Combined interventions consistently outperformed single-modality programs, underscoring the importance of integrative approaches in oncologic rehabilitation. Despite this promise, persistent barriers such as limited access to trained personnel, lack of individualized protocols, and weak institutional support impede translation into routine practice. Notably, few existing reviews have bridged mechanistic, clinical, and operational domains in this population, highlighting a significant gap in the literature.
Conclusion: Exercise training is not merely an adjunct to care it is a clinically potent, physiologically grounded, and policy-relevant strategy for mitigating cardiovascular risk in postmenopausal breast cancer survivors. Given the increasing burden of CVD in this group, integrating personalized, evidence-based exercise into oncologic care pathways is both urgent and essential for advancing survivorship standards and informing future clinical guidelines.
Reza Baghbanian, Shirin Azizidoost , Kamran Mahmoodi , Mahbobeh Rashidi , Golshan Mirmomeni, Sina Ganji Nataj ,
Volume 82, Issue 12 (3-2025)
Volume 82, Issue 12 (3-2025)
Abstract
Background: Coagulopathy is one of the most common causes of mortality in the intensive care unit. This study was designed and implemented to investigate the relationship between acidosis and coagulation disorders in patients undergoing laparotomy in the intensive care unit.
Methods: This retrospective study reviewed the files of 121 patients undergoing laparotomy in the intensive care unit of Imam Khomeini Hospital of Ahvaz during 2024. Demographic and clinical records and blood test results were extracted to measure parameters related to acidosis and coagulation tests. Then, the rates of coagulopathy, thrombocytopenia, acidosis, and patient outcome were calculated. The data obtained were analyzed using SPSS version 27 software.
Results: Most patients studied were male (72 (59.5%)) with a mean age of 54.18±21.1 years and a mean length of stay of 6.78±5.87 days. Hypertension (34 (28.1%)) was the most important comorbidity and peritonitis (54 (44.6%)) was the most important cause of hospitalization. The incidence rates of coagulopathy, thrombocytopenia, and acidosis were reported to be 29 (24%), 27 (22.3%) and 115 (95%), respectively. A total of 44 (36.5%) patients died during the study period. Although the rates of coagulopathy and thrombocytopenia were higher in patients with acidosis, these differences were not significant (P<0.05). The mortality rates among those without thrombocytopenia, mild, moderate, and severe thrombocytopenia were reported as 27 (28.7%), 4 (33.3%), 9 (81.1%), and 4 (100%), respectively, showing a significant difference (P=0.001). The mean pH in deceased patients was significantly lower than in others (0.13±7.19 vs. 0.88±7.25; P=0.005). The mortality rate in patients with coagulopathy was also significantly higher than in others (20 (69%) vs.24 (26.4%); P=0.000).
Conclusion: The incidence of acidosis and coagulation disorders in patients undergoing laparotomy and admitted to the intensive care unit is significant and is linked to poorer outcomes for these patients. However, acidosis was not found to be an independent risk factor for coagulation disorders in this population. Further research is necessary to confirm or refute these findings.
Methods: This retrospective study reviewed the files of 121 patients undergoing laparotomy in the intensive care unit of Imam Khomeini Hospital of Ahvaz during 2024. Demographic and clinical records and blood test results were extracted to measure parameters related to acidosis and coagulation tests. Then, the rates of coagulopathy, thrombocytopenia, acidosis, and patient outcome were calculated. The data obtained were analyzed using SPSS version 27 software.
Results: Most patients studied were male (72 (59.5%)) with a mean age of 54.18±21.1 years and a mean length of stay of 6.78±5.87 days. Hypertension (34 (28.1%)) was the most important comorbidity and peritonitis (54 (44.6%)) was the most important cause of hospitalization. The incidence rates of coagulopathy, thrombocytopenia, and acidosis were reported to be 29 (24%), 27 (22.3%) and 115 (95%), respectively. A total of 44 (36.5%) patients died during the study period. Although the rates of coagulopathy and thrombocytopenia were higher in patients with acidosis, these differences were not significant (P<0.05). The mortality rates among those without thrombocytopenia, mild, moderate, and severe thrombocytopenia were reported as 27 (28.7%), 4 (33.3%), 9 (81.1%), and 4 (100%), respectively, showing a significant difference (P=0.001). The mean pH in deceased patients was significantly lower than in others (0.13±7.19 vs. 0.88±7.25; P=0.005). The mortality rate in patients with coagulopathy was also significantly higher than in others (20 (69%) vs.24 (26.4%); P=0.000).
Conclusion: The incidence of acidosis and coagulation disorders in patients undergoing laparotomy and admitted to the intensive care unit is significant and is linked to poorer outcomes for these patients. However, acidosis was not found to be an independent risk factor for coagulation disorders in this population. Further research is necessary to confirm or refute these findings.
Ramyar Rahimi Darehbagh , Ebrahim Khajeh, Daem Roshani , Farhang Safarnejhad,
Volume 82, Issue 12 (3-2025)
Volume 82, Issue 12 (3-2025)
Abstract
Background: Surgical site infections (SSIs) represent one of the most common and significant complications following surgical interventions. These infections not only prolong hospital stay and recovery but also impose a considerable economic burden on healthcare systems and patients. Reducing the risk of SSIs is therefore a major focus of perioperative care, and several strategies have been proposed to minimize their occurrence. One of the most widely practiced preventive measures is preoperative skin antisepsis, aimed at lowering the microbial load at the surgical site. Among available antiseptics, chlorhexidine has been shown to have broad-spectrum antimicrobial activity and sustained effectiveness. This study was designed to evaluate the effect of preoperative chlorhexidine showers on the incidence of SSIs in patients undergoing elective inguinal hernia surgery.
Methods: A randomized clinical trial was carried out in 2019 at Kowsar Hospital, Sanandaj. A total of 300 patients scheduled for elective inguinal hernia repair were enrolled and randomly assigned into three groups of 100 participants each. The intervention group was instructed to take a shower with 4% chlorhexidine solution on the night before surgery. Control group 1 took a routine bath using regular detergents, while control group 2 did not bathe prior to the operation. All patients were monitored for the occurrence of superficial SSIs for up to 30 days postoperatively.
Results: Among the 300 patients included in the study, 12 cases (4%) of superficial SSIs were documented. The distribution of infections varied significantly across the groups: one case in the chlorhexidine group, three cases in the regular detergent group, and eight cases in the group that did not shower. Statistical analysis confirmed that the difference in infection rates among the groups was significant (P=0.034).
Conclusion: The findings of this clinical trial demonstrate that preoperative showers with 4% chlorhexidine solution are effective in reducing the incidence of SSIs in patients undergoing elective inguinal hernia surgery. Implementing this simple, low-cost intervention may therefore be a valuable strategy in routine surgical practice to enhance patient outcomes and reduce postoperative complications.
Tahereh Parsajam , Behnam Reza Makhsoosi, Ali Najafpour, Kimia Fathi,
Volume 83, Issue 1 (4-2025)
Volume 83, Issue 1 (4-2025)
Abstract
Background: Thyroid hormones play a key role in the development of various organs of the body. The breast and thyroid are hormone-responsive organs that are closely related to changes in endocrine activity and glandular diseases. Breast cancer is the most common cancer in women and the second leading cause of cancer-related death. Due to the inconsistencies in the relationship between breast cancer and thyroid diseases and the lack of regional data, the present study was designed and conducted with the aim of investigating the prevalence of various thyroid disorders in patients with breast cancer and its relationship with the type of breast cancer and age.
Methods: In this prospective study, we examined 50 women with breast cancer who had undergone surgery after surgery. The location of this study was Imam Reza Hospital in Kermanshah and the duration of this study was 12 months from the beginning of March 2023 to the end of March 2024. Patient information included: age, histopathological type of cancer, and thyroid test results including serum TSH, FT4, and ATPO levels, were recorded and reviewed.
Results: Based on the results obtained, it was shown that the average age of people with thyroid disorders in patients with breast cancer was 42.88 and the standard deviation was 11.313. Also, there was no significant difference between the age of people and thyroid disorders in patients with breast cancer (P-value < 0.89). In the study of thyroid disorders in patients with breast cancer, it was shown that there was a significant relationship between patients with breast cancer and the amount of TSH and the amount of FT4. This means that people with breast cancer had an increase in the amount of TSH and the amount of FT4. However, there was no significant relationship between patients with breast cancer and the amount of ATPO (P-value < 0.319).
Conclusion: Thyroid disorders are more prevalent in patients with breast cancer than in the normal population, and given the relationship between the types of thyroid disorders and the type of breast cancer histopathology, these results can be used and screening methods can be used more effectively in those who have risk factors for breast cancer for early diagnosis and treatment of the disease.
Methods: In this prospective study, we examined 50 women with breast cancer who had undergone surgery after surgery. The location of this study was Imam Reza Hospital in Kermanshah and the duration of this study was 12 months from the beginning of March 2023 to the end of March 2024. Patient information included: age, histopathological type of cancer, and thyroid test results including serum TSH, FT4, and ATPO levels, were recorded and reviewed.
Results: Based on the results obtained, it was shown that the average age of people with thyroid disorders in patients with breast cancer was 42.88 and the standard deviation was 11.313. Also, there was no significant difference between the age of people and thyroid disorders in patients with breast cancer (P-value < 0.89). In the study of thyroid disorders in patients with breast cancer, it was shown that there was a significant relationship between patients with breast cancer and the amount of TSH and the amount of FT4. This means that people with breast cancer had an increase in the amount of TSH and the amount of FT4. However, there was no significant relationship between patients with breast cancer and the amount of ATPO (P-value < 0.319).
Conclusion: Thyroid disorders are more prevalent in patients with breast cancer than in the normal population, and given the relationship between the types of thyroid disorders and the type of breast cancer histopathology, these results can be used and screening methods can be used more effectively in those who have risk factors for breast cancer for early diagnosis and treatment of the disease.
Omolbanin Taziki, Nadia Jamal,
Volume 83, Issue 1 (4-2025)
Volume 83, Issue 1 (4-2025)
Abstract
Background: Asymptomatic hypotension is a common complication in patients undergoing hemodialysis, which can lead to serious consequences. Troponin I, as a biochemical marker for myocardial injury, may play a role in the diagnosis and management of this complication. This study aimed to investigate the relationship between serum troponin I level changes and asymptomatic hypotension in patients with advanced kidney failure undergoing hemodialysis.
Methods: In this cross-sectional study, 120 adult ESRD patients (aged 30–80 years) with an ejection fraction (EF) >50% who attended the hemodialysis unit of Shohada Tajrish Hospital over a 6-month period starting 15 January 2024 were enrolled. Demographic and clinical data were collected using a checklist. Serum troponin I levels were measured before and after dialysis, and patients' blood pressure was recorded throughout dialysis sessions. For quantitative variables, mean and standard deviation were reported; for qualitative variables, absolute and relative frequencies were presented. Statistical analysis was performed using the Paired t-test, Independent t-test, Pearson correlation coefficient, and their non-parametric equivalents as appropriate. A significance level of p < 0.05 was considered statistically significant.
.Results: A total of 120 patients were examined, with a mean age of 57.6 ± 7.1 years. The gender distribution was 67 males (55.8%) and 53 females (44.2%). The mean body mass index was 20.73 ± 0.98. Significant differences were found in mean blood pressure, heart rate, body weight, and changes before and after dialysis (P<0.05). These differences included a decrease in blood pressure, and body weight, an increase in heart rate, and an increase in troponin levels. No significant relationship was found between troponin changes before and after dialysis with age, gender, height, weight, body mass index, heart rate, average duration of dialysis, and other laboratory variables (P>0.05). However, a significant correlation was found between troponin changes and blood pressure changes, indicating that as troponin levels increased, the mean blood pressure of patients decreased.
Conclusion: The findings of this study indicate a significant relationship between increased serum troponin I levels and asymptomatic hypotension in patients with advanced kidney failure undergoing hemodialysis. These results may be useful in identifying at-risk patients and improving therapeutic management. Further research is needed to confirm this relationship and explore its underlying mechanisms.
Methods: In this cross-sectional study, 120 adult ESRD patients (aged 30–80 years) with an ejection fraction (EF) >50% who attended the hemodialysis unit of Shohada Tajrish Hospital over a 6-month period starting 15 January 2024 were enrolled. Demographic and clinical data were collected using a checklist. Serum troponin I levels were measured before and after dialysis, and patients' blood pressure was recorded throughout dialysis sessions. For quantitative variables, mean and standard deviation were reported; for qualitative variables, absolute and relative frequencies were presented. Statistical analysis was performed using the Paired t-test, Independent t-test, Pearson correlation coefficient, and their non-parametric equivalents as appropriate. A significance level of p < 0.05 was considered statistically significant.
.Results: A total of 120 patients were examined, with a mean age of 57.6 ± 7.1 years. The gender distribution was 67 males (55.8%) and 53 females (44.2%). The mean body mass index was 20.73 ± 0.98. Significant differences were found in mean blood pressure, heart rate, body weight, and changes before and after dialysis (P<0.05). These differences included a decrease in blood pressure, and body weight, an increase in heart rate, and an increase in troponin levels. No significant relationship was found between troponin changes before and after dialysis with age, gender, height, weight, body mass index, heart rate, average duration of dialysis, and other laboratory variables (P>0.05). However, a significant correlation was found between troponin changes and blood pressure changes, indicating that as troponin levels increased, the mean blood pressure of patients decreased.
Conclusion: The findings of this study indicate a significant relationship between increased serum troponin I levels and asymptomatic hypotension in patients with advanced kidney failure undergoing hemodialysis. These results may be useful in identifying at-risk patients and improving therapeutic management. Further research is needed to confirm this relationship and explore its underlying mechanisms.
Morteza Talebi Doluee , Mohsen Ramzanzadeh, Majid Shahbazi, Mahdi Foroughian,
Volume 83, Issue 1 (4-2025)
Volume 83, Issue 1 (4-2025)
Abstract
Background: Ankle sprain is one of the most common sports injuries and accounts for 10 to 30 percent of sports injuries, especially in athletes. This injury can lead to pain, imbalance, and movement restriction, and therefore has a significant impact on athletes' performance. Therefore, the aim of this study was to investigate the effect of dry needling on tissue repair of ligamentous injury in the acute phase of ankle sprain.
Methods: This double-blind clinical trial study was conducted on 52 patients with ankle sprains at Imam Reza Hospital in 2023. Patients were divided into two groups: control and intervention. The control group received conventional treatment including medication and splints, while the intervention group received dry needling in addition to conventional treatments. Data analysis was performed using SPSS version 21 software and descriptive statistics and inferential statistical tests at a significance level of P<0.05.
Results: The results showed that the intervention group showed significant improvement in pain (P=0.002), activities of daily living (P<0.001), sports activities (P<0.001), plantar flexion (P=0.027), dorsiflexion (P=0.003), inversion (P=0.012), and edema (P=0.005) compared to the control group. However, there was no significant difference in symptom severity (P=0.752) and quality of life (P=0.348) between the two groups. Overall patient change analysis showed that most patients in the intervention group improved, while only 7.7% in the control group improved.
Conclusion: A combination of splinting, medication, and dry needling can be effective in improving pain, daily activities, exercise and recreation, range of motion, and edema in patients with ankle sprains. These findings can provide a basis for implementing new treatment protocols for the management of ankle sprains in athletes and other injured patients. It is recommended that further studies be conducted on the long-term effects of dry needling and other therapeutic interventions to further identify their potential to accelerate the recovery process in patients.
Methods: This double-blind clinical trial study was conducted on 52 patients with ankle sprains at Imam Reza Hospital in 2023. Patients were divided into two groups: control and intervention. The control group received conventional treatment including medication and splints, while the intervention group received dry needling in addition to conventional treatments. Data analysis was performed using SPSS version 21 software and descriptive statistics and inferential statistical tests at a significance level of P<0.05.
Results: The results showed that the intervention group showed significant improvement in pain (P=0.002), activities of daily living (P<0.001), sports activities (P<0.001), plantar flexion (P=0.027), dorsiflexion (P=0.003), inversion (P=0.012), and edema (P=0.005) compared to the control group. However, there was no significant difference in symptom severity (P=0.752) and quality of life (P=0.348) between the two groups. Overall patient change analysis showed that most patients in the intervention group improved, while only 7.7% in the control group improved.
Conclusion: A combination of splinting, medication, and dry needling can be effective in improving pain, daily activities, exercise and recreation, range of motion, and edema in patients with ankle sprains. These findings can provide a basis for implementing new treatment protocols for the management of ankle sprains in athletes and other injured patients. It is recommended that further studies be conducted on the long-term effects of dry needling and other therapeutic interventions to further identify their potential to accelerate the recovery process in patients.
Anahita Zoghi , Mahbobe Taheri, Shima Alizadeh ,
Volume 83, Issue 1 (4-2025)
Volume 83, Issue 1 (4-2025)
Abstract
Background: Migraine is a complex neurological disease that has affected hundreds of people of different ages and races. Migraine causes changes in the white matter and may cause cognitive changes in affected patients, but studies in this field are still limited and sometimes have contradictory results. The purpose of this study is investigate and compare cognitive function in patients with migraine.
Methods: In this case-control study, which was conducted with the aim of investigating and comparing cognitive function in migraine patients with the control group, cognitive function in migraine patients (with and without aura) referred to the Luqman Hospital clinic in the year 2023 were evaluated and compared with the healthy control group. Patient information was recorded in SPSSv.25 and analyzed.
Results: A gender difference was observed between the two groups, and women were significantly more in the migraine group (P-value: 0.003). This issue was also seen regarding age, and people with migraine were significantly older than normal people (33.91 ± 10.86 vs. 30.43 ± 7.89, P-value: 0.013). The visual score had a significant difference between the two groups (P-value: 0.001). In general, it was seen that the cognitive status score had a statistically significant difference between the two groups and it was lower in the migraine group (P-value<0.001).
Conclusion: It is concluded that migraine patients have some degree of cognitive impairment and this is not associated with migraine. Based on our findings, there is a significant difference in gender and level of education between normal individuals and migraineurs, and migraineurs are usually women and have lower education than normal individuals, which could be due to impaired quality of life due to migraine and cognitive impairment. The current study did not examine chronic migraine, but it was found that there was no difference in cognitive impairment between migraine with and without aura. Whether chronic migraine differs from other migraines in the incidence of cognitive impairment needs to be investigated in future studies.
Methods: In this case-control study, which was conducted with the aim of investigating and comparing cognitive function in migraine patients with the control group, cognitive function in migraine patients (with and without aura) referred to the Luqman Hospital clinic in the year 2023 were evaluated and compared with the healthy control group. Patient information was recorded in SPSSv.25 and analyzed.
Results: A gender difference was observed between the two groups, and women were significantly more in the migraine group (P-value: 0.003). This issue was also seen regarding age, and people with migraine were significantly older than normal people (33.91 ± 10.86 vs. 30.43 ± 7.89, P-value: 0.013). The visual score had a significant difference between the two groups (P-value: 0.001). In general, it was seen that the cognitive status score had a statistically significant difference between the two groups and it was lower in the migraine group (P-value<0.001).
Conclusion: It is concluded that migraine patients have some degree of cognitive impairment and this is not associated with migraine. Based on our findings, there is a significant difference in gender and level of education between normal individuals and migraineurs, and migraineurs are usually women and have lower education than normal individuals, which could be due to impaired quality of life due to migraine and cognitive impairment. The current study did not examine chronic migraine, but it was found that there was no difference in cognitive impairment between migraine with and without aura. Whether chronic migraine differs from other migraines in the incidence of cognitive impairment needs to be investigated in future studies.
Reza Sahraei, Anahita Haghjoo , Hasan Zabetian, Mansour Deylami, Rahil Haghjoo, Fatemeh Khadempir, Navid Kalani ,
Volume 83, Issue 1 (4-2025)
Volume 83, Issue 1 (4-2025)
Abstract
Background: Spinal anesthesia is a common method for elective cesarean sections; however, complications such as shivering and nausea may affect postoperative recovery quality. Bupivacaine is a standard drug used in this procedure, but its combination with opioids like sufentanil may have beneficial effects in reducing these complications. This study aimed to compare the incidence of shivering and nausea in women undergoing elective cesarean section who received either bupivacaine alone or a bupivacaine-sufentanil combination.
Methods: The present study was a double-blind randomized clinical trial conducted over a 6-month period from April 2021 to October 2021 on 30 patients undergoing elective cesarean section with spinal anesthesia at Motahari Hospital in Jahrom city. Patients were randomly assigned using a random number table into two groups: bupivacaine alone and bupivacaine-sufentanil combination. The frequency of nausea, vomiting, and shivering was recorded at different time points: before spinal anesthesia, after spinal anesthesia, 3 minutes before delivery, immediately after delivery, at 15, 30, and 45 minutes, upon recovery room admission, and upon discharge from recovery. The data analysis was performed using descriptive statistics indicators (frequency, percentage, mean, and standard deviation) and inferential statistical tests (t-test, Mann-Whitney, chi-square and Friedman) using SPSS software version 21. A significance level of p < 0.05 was considered.
Results: In the bupivacaine-sufentanil group, the highest frequency of shivering occurred at 30 minutes post-spinal anesthesia (20%) and upon recovery room admission (26.7%). In the bupivacaine-alone group, the highest frequency was observed upon recovery room admission (33.3%) and at discharge from recovery (26.7%). The highest nausea frequency was 33.3% in the bupivacaine-sufentanil group and 40% in the bupivacaine group at 3 minutes before delivery. However, no statistically significant difference was found between the two groups at different time points.
Conclusion: The present study showed that adding low-dose sufentanil to bupivacaine in spinal anesthesia protocols, while potentially having minor clinical effects on certain complications, did not lead to a significant difference in the incidence of shivering and nausea. Therefore, for more precise clinical decision-making regarding drug combinations in regional anesthesia, further studies with larger sample sizes and different drug dosages are recommended.
Methods: The present study was a double-blind randomized clinical trial conducted over a 6-month period from April 2021 to October 2021 on 30 patients undergoing elective cesarean section with spinal anesthesia at Motahari Hospital in Jahrom city. Patients were randomly assigned using a random number table into two groups: bupivacaine alone and bupivacaine-sufentanil combination. The frequency of nausea, vomiting, and shivering was recorded at different time points: before spinal anesthesia, after spinal anesthesia, 3 minutes before delivery, immediately after delivery, at 15, 30, and 45 minutes, upon recovery room admission, and upon discharge from recovery. The data analysis was performed using descriptive statistics indicators (frequency, percentage, mean, and standard deviation) and inferential statistical tests (t-test, Mann-Whitney, chi-square and Friedman) using SPSS software version 21. A significance level of p < 0.05 was considered.
Results: In the bupivacaine-sufentanil group, the highest frequency of shivering occurred at 30 minutes post-spinal anesthesia (20%) and upon recovery room admission (26.7%). In the bupivacaine-alone group, the highest frequency was observed upon recovery room admission (33.3%) and at discharge from recovery (26.7%). The highest nausea frequency was 33.3% in the bupivacaine-sufentanil group and 40% in the bupivacaine group at 3 minutes before delivery. However, no statistically significant difference was found between the two groups at different time points.
Conclusion: The present study showed that adding low-dose sufentanil to bupivacaine in spinal anesthesia protocols, while potentially having minor clinical effects on certain complications, did not lead to a significant difference in the incidence of shivering and nausea. Therefore, for more precise clinical decision-making regarding drug combinations in regional anesthesia, further studies with larger sample sizes and different drug dosages are recommended.
Mastaneh Moghtaderi, Hossein Amirzargar, Behnaz Bazargani , Arash Abbasi, Daryoush Fahimi, Fahime Asgarian,
Volume 83, Issue 1 (4-2025)
Volume 83, Issue 1 (4-2025)
Abstract
Background: Posterior urethral valve (PUV) is recognized as one of the most frequent causes of obstructive uropathy in the pediatric population, particularly in male infants. This congenital anomaly leads to variable degrees of urinary outflow obstruction, which may result in progressive renal damage and deterioration of kidney function over time. Despite advances in diagnostic modalities and surgical interventions, infants and children affected by PUV continue to demonstrate suboptimal long term renal outcomes, with a considerable proportion developing chronic kidney disease (CKD). Understanding early predictors of adverse renal prognosis is essential to guide timely interventions and optimize follow up strategies. The present study aimed to assess the long term renal outcomes, over a minimum of five years, of patients with PUV treated at the Children’s Medical Center, and to investigate the role of preoperative serum creatinine levels as a predictor of future CKD in this patient group.
Methods: A cross sectional and retrospective study design was employed. The medical records of patients diagnosed with PUV between March 2011 and March 2016 who had at least five years of documented follow up were reviewed at the Children’s Medical Center in 2021. Data extracted included demographic characteristics, laboratory tests—particularly pre and post operative serum creatinine—ultrasound imaging results, surgical details, and follow up findings throughout the study period.
Results: Eighty one patients met the inclusion criteria, with a mean age at diagnosis of 105 days. At the five year follow up, the overall prevalence of CKD among these patients was estimated at approximately 9.9%. During the follow up period, one patient died due to kidney disease, one underwent kidney transplantation, and three required maintenance dialysis. Statistical analysis demonstrated that a preoperative creatinine level exceeding 1.15 mg/dL was strongly associated with the future development of CKD, showing 100% sensitivity and 75% specificity in predicting adverse long term renal outcomes.
Conclusion: This study underscores the persistent risk of CKD in children with PUV, even after surgical intervention. Regular and comprehensive monitoring of renal function remains vital in this high risk group. Preoperative serum creatinine may serve as a reliable, accessible, and clinically useful prognostic marker to identify patients who may benefit from closer follow up and proactive management strategies.
Methods: A cross sectional and retrospective study design was employed. The medical records of patients diagnosed with PUV between March 2011 and March 2016 who had at least five years of documented follow up were reviewed at the Children’s Medical Center in 2021. Data extracted included demographic characteristics, laboratory tests—particularly pre and post operative serum creatinine—ultrasound imaging results, surgical details, and follow up findings throughout the study period.
Results: Eighty one patients met the inclusion criteria, with a mean age at diagnosis of 105 days. At the five year follow up, the overall prevalence of CKD among these patients was estimated at approximately 9.9%. During the follow up period, one patient died due to kidney disease, one underwent kidney transplantation, and three required maintenance dialysis. Statistical analysis demonstrated that a preoperative creatinine level exceeding 1.15 mg/dL was strongly associated with the future development of CKD, showing 100% sensitivity and 75% specificity in predicting adverse long term renal outcomes.
Conclusion: This study underscores the persistent risk of CKD in children with PUV, even after surgical intervention. Regular and comprehensive monitoring of renal function remains vital in this high risk group. Preoperative serum creatinine may serve as a reliable, accessible, and clinically useful prognostic marker to identify patients who may benefit from closer follow up and proactive management strategies.
Mohsen Ghoryani, Mohsen Ahmadi, Mahdi Atabaki, Jalil Tavakkol-Afshari , Mojgan Mohammadi,
Volume 83, Issue 2 (5-2025)
Volume 83, Issue 2 (5-2025)
Abstract
Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder marked by persistent inflammation, progressive joint destruction, functional disability, and systemic complications. Key inflammatory mediators, such as tumor necrosis factor-alpha (TNF-α) and interleukin-17 (IL-17), play critical roles in disease progression and tissue damage. Mesenchymal stem cells (MSCs) have recently gained attention as a therapeutic approach for autoimmune diseases because of their abilities in self-renewal, immune modulation, and tissue repair. Considering the role of pro-inflammatory cytokines in the pathogenesis of RA, this study investigated the effect of autologous bone marrow-derived MSCs (ABMSCs) on the gene expression of TNF-α and IL-17A in patients with refractory RA.
Methods: The study utilized archived RNA from the research team's previous clinical trial. In this study, 13 patients with refractory RA who underwent MSC transplantation (MSCT) at an intravenous dose of 1×10⁶ ABMSCs per kilogram of body weight were evaluated at baseline and at 1, 6, and 12 months post-injection. Between November 2023 and March 2024, archived RNA samples were converted into cDNA at the Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Then, the expression levels of TNF and IL-17A were analyzed using SYBR Green-based real-time PCR.
Results: TNF-α gene expression declined significantly 1 month after MSCT (mean±SEM: 1.00±0.00 at baseline vs. 0.38±0.11 at 1 month, P=0.045). However, no significant differences were observed at 6 months (1.21±0.38) or 12 months (0.61±0.18) compared to baseline (P>0.05). IL-17A gene expression remained statistically unchanged across all time points (baseline: 1.00±0.00; 1 month: 0.87±0.31; 6 months: 1.19±0.42; 12 months: 1.79±0.92; P>0.05).
Conclusion: The results of this study suggest that ABMSCs may exert an anti-inflammatory effect by modulating TNF-α in patients with refractory RA. However, the findings related to IL-17A do not support the hypothesis that ABMSC injection exerts anti-inflammatory effects through modulation of IL-17A gene expression in these patients.
Methods: The study utilized archived RNA from the research team's previous clinical trial. In this study, 13 patients with refractory RA who underwent MSC transplantation (MSCT) at an intravenous dose of 1×10⁶ ABMSCs per kilogram of body weight were evaluated at baseline and at 1, 6, and 12 months post-injection. Between November 2023 and March 2024, archived RNA samples were converted into cDNA at the Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Then, the expression levels of TNF and IL-17A were analyzed using SYBR Green-based real-time PCR.
Results: TNF-α gene expression declined significantly 1 month after MSCT (mean±SEM: 1.00±0.00 at baseline vs. 0.38±0.11 at 1 month, P=0.045). However, no significant differences were observed at 6 months (1.21±0.38) or 12 months (0.61±0.18) compared to baseline (P>0.05). IL-17A gene expression remained statistically unchanged across all time points (baseline: 1.00±0.00; 1 month: 0.87±0.31; 6 months: 1.19±0.42; 12 months: 1.79±0.92; P>0.05).
Conclusion: The results of this study suggest that ABMSCs may exert an anti-inflammatory effect by modulating TNF-α in patients with refractory RA. However, the findings related to IL-17A do not support the hypothesis that ABMSC injection exerts anti-inflammatory effects through modulation of IL-17A gene expression in these patients.
Majid Vatankhah, Saeed Kashani, Mohsen Sarafikhah, Bibi Mona Razavi, Mehrdad Sayadinia, Mehrdad Malekshoar,
Volume 83, Issue 2 (5-2025)
Volume 83, Issue 2 (5-2025)
Abstract
Background: Aspiration pneumonia is a significant and potentially preventable cause of morbidity and mortality in critically ill ICU patients. Prophylactic pharmacological interventions, particularly antiemetics like metoclopramide (a prokinetic agent) and ondansetron (a 5-HT3 receptor antagonist), are commonly employed to reduce gastric aspiration and subsequent pneumonia. Despite their widespread use, comparative efficacy data remains limited. This randomized controlled trial was specifically designed to rigorously compare the effectiveness of these two distinct antiemetic strategies in preventing aspiration pneumonia among high-risk, mechanically ventilated patients, aiming to provide evidence-based guidance for clinical practice.
Methods: This double-blind randomized clinical trial involved 116 individuals admitted to the ICU at Shahid Mohammadi Hospital, Bandar Abbas from March 2024 to March 2025. Subjects were randomly assigned to metoclopramide or ondansetron groups. Enrollment criteria consisted of patients between 17 and 70 years old in the ICU requiring intubation and mechanical ventilation. Monitoring continued for 72 hours, with evaluation utilizing the Clinical Pulmonary Infection Score (CPIS), chest X-ray (CXR) results, and physical assessments. Data were analyzed with SPSS version 21 employing descriptive statistics (mean, standard deviation, percentage, frequency) and inferential tests with significance set at P<0.05.
Results: Chi-square analysis indicated no statistically significant gender difference between groups (P=0.947). Mean age was 30.6±10.5 years for metoclopramide recipients and 32.9±6.12 years for ondansetron recipients. Further analysis revealed no significant differences in age or BMI between cohorts. No significant difference emerged between metoclopramide and ondansetron groups regarding aspiration pneumonia occurrence, with similar incidence rates in both arms. Multiple logistic regression demonstrated that statistically, no variables influenced aspiration pneumonia development.
Conclusion: The results of this randomized trial clearly demonstrate no statistically significant difference in efficacy between metoclopramide and ondansetron for preventing aspiration pneumonia in intubated ICU patients. Both agents showed comparable effectiveness in our study population, suggesting that either drug represents a clinically acceptable prophylactic option. This finding provides clinicians with valuable therapeutic flexibility based on individual patient characteristics, drug availability, and cost considerations. However, further multicenter studies with larger sample sizes are recommended to confirm these findings across diverse patient populations and settings.
Mahasti Emami Hamzehkolaee , Amirhesam Alirezaei, Marjan Moudi, Sepide Veysi , Masoumeh Asgharpour,
Volume 83, Issue 2 (5-2025)
Volume 83, Issue 2 (5-2025)
Abstract
Background: Hydrochlorothiazide (HCTZ) is widely used for hypertension, but electrolyte disorders-especially hyponatremia remain major safety concerns. Limited regional data on its prevalence, timing, and determinants may undermine patient safety. This retrospective study evaluated risk factors for HCTZ-associated hyponatremia in hospitalized adults with hypertension and identified predictors of its severity.
Methods: A retrospective analysis was conducted on 217 patients hospitalized at Ayatollah Rouhani Hospital in Babol (2019-2021). Eligible participants were aged ≥18 years and had received HCTZ for at least seven consecutive days. Patients with baseline hyponatremia, concurrent use of drugs independently causing hyponatremia, or incomplete laboratory data were excluded. Demographic, clinical, medication, and biochemical variables were abstracted from medical records. Hyponatremia was defined as serum sodium <135 mmol/L and categorized as mild (130-134), moderate (125-129), or severe (<125). Predictors of occurrence were estimated with multivariable logistic regression; onset timing was assessed using a Cox proportional hazards model; and severity determinants were examined through multinomial logistic regression. Statistical significance was set at P<0.05.
Results: Hyponatremia occurred in 32.7% (71.217) of patients, most frequently within the early weeks of HCTZ treatment. Among affected individuals, 49.3% had mild, 31.0% moderate, and 19.7% severe hyponatremia. Adjusted analyses showed that older age, concurrent nonsteroidal anti-inflammatory drug (NSAID) use, shorter HCTZ duration, and lower serum potassium and uric acid independently increased hyponatremia risk, while HCTZ dose and sex were nonsignificant. In the Cox model, older age and lower potassium and uric acid predicted earlier onset. Patients with hyponatremia more often presented with weakness, headache, altered consciousness, and seizures. Baseline glucose, creatinine, and most comorbidities were not independently associated with risk or timing.
Conclusion: HCTZ-related hyponatremia was common and typically emerged soon after initiation. Advanced age, NSAID co-administration, brief exposure, and reduced potassium and uric acid were practical, readily measurable markers associated with both occurrence and earlier onset. Routine early and repeated electrolyte monitoring particularly in older adults and patients receiving NSAIDs- together with patient education on warning symptoms is recommended. These findings highlight key predictors for targeted surveillance and prevention in similar clinical contexts.
Methods: A retrospective analysis was conducted on 217 patients hospitalized at Ayatollah Rouhani Hospital in Babol (2019-2021). Eligible participants were aged ≥18 years and had received HCTZ for at least seven consecutive days. Patients with baseline hyponatremia, concurrent use of drugs independently causing hyponatremia, or incomplete laboratory data were excluded. Demographic, clinical, medication, and biochemical variables were abstracted from medical records. Hyponatremia was defined as serum sodium <135 mmol/L and categorized as mild (130-134), moderate (125-129), or severe (<125). Predictors of occurrence were estimated with multivariable logistic regression; onset timing was assessed using a Cox proportional hazards model; and severity determinants were examined through multinomial logistic regression. Statistical significance was set at P<0.05.
Results: Hyponatremia occurred in 32.7% (71.217) of patients, most frequently within the early weeks of HCTZ treatment. Among affected individuals, 49.3% had mild, 31.0% moderate, and 19.7% severe hyponatremia. Adjusted analyses showed that older age, concurrent nonsteroidal anti-inflammatory drug (NSAID) use, shorter HCTZ duration, and lower serum potassium and uric acid independently increased hyponatremia risk, while HCTZ dose and sex were nonsignificant. In the Cox model, older age and lower potassium and uric acid predicted earlier onset. Patients with hyponatremia more often presented with weakness, headache, altered consciousness, and seizures. Baseline glucose, creatinine, and most comorbidities were not independently associated with risk or timing.
Conclusion: HCTZ-related hyponatremia was common and typically emerged soon after initiation. Advanced age, NSAID co-administration, brief exposure, and reduced potassium and uric acid were practical, readily measurable markers associated with both occurrence and earlier onset. Routine early and repeated electrolyte monitoring particularly in older adults and patients receiving NSAIDs- together with patient education on warning symptoms is recommended. These findings highlight key predictors for targeted surveillance and prevention in similar clinical contexts.
Mohammad Darayesh,
Volume 83, Issue 2 (5-2025)
Volume 83, Issue 2 (5-2025)
Abstract
Background: Acne is a common adolescent skin disorder presenting with papules, pustules, and cysts on the face, chest, and back, which may persist into adulthood with varying severity. Dexpanthanol (bepacto) is an effective treatment for acne, administered both topically and intramuscularly. This study aimed to compare the efficacy of topical bepacto ointment versus intramuscular bepacto injections for mild to moderate acne.
Methods: This study was a randomized, controlled, split-face clinical trial. Patients were randomly divided into two groups: one receiving weekly intramuscular bepacto ampoule injections and the other applying topical bepacto ointment twice daily. The treatment protocol consisted of an initial one-month phase followed by a two-month continuation phase. Following acne diagnosis, patients were classified into three severity categories (mild, moderate and severe) according to Lehman's criteria. Data collection instruments for this study included a demographic information questionnaire and the Acne-QOL (Acne Quality of Life) questionnaire.
Results: The Mann-Whitney U test results indicated no statistically significant differences in quality-of-life outcomes between the topical and intramuscular treatment groups (P>0.05). Subsequent Friedman test analysis revealed distinct treatment response patterns: among 18-24-year-old patients with mild baseline acne severity, both treatment groups maintained mild severity at 2-week and 4-week follow-ups, with significant improvement achieved by week six. However, in moderate acne cases within the same age group, the topical treatment group showed progressive improvement - maintaining moderate severity at two weeks, progressing to mild by four weeks, and achieving complete resolution by week six. In contrast, the intramuscular group with moderate acne demonstrated persistent moderate severity at both 2-week and 4-week follow-ups, with only partial improvement to mild severity by week 6 and no complete resolution observed during the study period. These findings suggest that while both administration routes similarly affected quality of life measures, topical dexpanthanol demonstrated superior efficacy and faster response times, particularly in cases of moderate acne severity among young adult patients.
Conclusion: Intramuscular dexpanthanol may optimize treatment initiation timing and reduce costs in mild-to-moderate acne management.
Methods: This study was a randomized, controlled, split-face clinical trial. Patients were randomly divided into two groups: one receiving weekly intramuscular bepacto ampoule injections and the other applying topical bepacto ointment twice daily. The treatment protocol consisted of an initial one-month phase followed by a two-month continuation phase. Following acne diagnosis, patients were classified into three severity categories (mild, moderate and severe) according to Lehman's criteria. Data collection instruments for this study included a demographic information questionnaire and the Acne-QOL (Acne Quality of Life) questionnaire.
Results: The Mann-Whitney U test results indicated no statistically significant differences in quality-of-life outcomes between the topical and intramuscular treatment groups (P>0.05). Subsequent Friedman test analysis revealed distinct treatment response patterns: among 18-24-year-old patients with mild baseline acne severity, both treatment groups maintained mild severity at 2-week and 4-week follow-ups, with significant improvement achieved by week six. However, in moderate acne cases within the same age group, the topical treatment group showed progressive improvement - maintaining moderate severity at two weeks, progressing to mild by four weeks, and achieving complete resolution by week six. In contrast, the intramuscular group with moderate acne demonstrated persistent moderate severity at both 2-week and 4-week follow-ups, with only partial improvement to mild severity by week 6 and no complete resolution observed during the study period. These findings suggest that while both administration routes similarly affected quality of life measures, topical dexpanthanol demonstrated superior efficacy and faster response times, particularly in cases of moderate acne severity among young adult patients.
Conclusion: Intramuscular dexpanthanol may optimize treatment initiation timing and reduce costs in mild-to-moderate acne management.
Behzad Iranmanesh, Ali Morsali, Nazanin Zeinali Nezhad ,
Volume 83, Issue 2 (5-2025)
Volume 83, Issue 2 (5-2025)
Abstract
Background: Non-melanoma skin cancers (NMSCs) are among the most prevalent malignancies globally. Investigating their characteristics and treatment-related outcomes can significantly contribute to optimizing management strategies including surgery, chemotherapy and radiotherapy. This study aimed to examine the characteristics of NMSCs and the complications following surgical treatment (such as necrosis and bleeding).
Methods: This is a retrospective descriptive cross-sectional study which was conducted to investigate the features of patients initially diagnosed with NMSC (confirmed by histopathological examination of the lesion) at dermatology ward of Afzalipour Hospital, Kerman University of Medical Sciences, between 2018 and 2021. Inclusion criteria were definitive diagnosis (based on the result of pathology) of an NMSC and undergoing surgical management. Exclusion criteria included incomplete patient records. Relevant data were extracted and recorded using a data collection form. Finally, all collected information was statistically analyzed according to the study objectives, and the overall frequency of NMSC surgeries, as well as their frequency based on study variables, was reported descriptively.
Results: A total of 37 NMSC surgeries were performed. The majority were basal cell carcinomas located on the face. Over half of the patients were male, and most had underlying medical conditions despite lacking common risk factors such as smoking and sun exposure. The most common flap techniques used were rotational flap, island pedicle flap, and H-plasty flap. Two complications were observed: one case of bleeding at the surgical site and one case of wound edge necrosis, both occurring one week post-operation.
Conclusion: In the southeastern region of Iran, NMSCs requiring surgical treatment showed a lower prevalence than anticipated. However, their pathological and demographic characteristics were consistent with global observations. The incidence of post-surgical complications was also low. Nevertheless, future studies with larger sample sizes in this region and across the country are recommended to enhance the reliability of these findings.
Methods: This is a retrospective descriptive cross-sectional study which was conducted to investigate the features of patients initially diagnosed with NMSC (confirmed by histopathological examination of the lesion) at dermatology ward of Afzalipour Hospital, Kerman University of Medical Sciences, between 2018 and 2021. Inclusion criteria were definitive diagnosis (based on the result of pathology) of an NMSC and undergoing surgical management. Exclusion criteria included incomplete patient records. Relevant data were extracted and recorded using a data collection form. Finally, all collected information was statistically analyzed according to the study objectives, and the overall frequency of NMSC surgeries, as well as their frequency based on study variables, was reported descriptively.
Results: A total of 37 NMSC surgeries were performed. The majority were basal cell carcinomas located on the face. Over half of the patients were male, and most had underlying medical conditions despite lacking common risk factors such as smoking and sun exposure. The most common flap techniques used were rotational flap, island pedicle flap, and H-plasty flap. Two complications were observed: one case of bleeding at the surgical site and one case of wound edge necrosis, both occurring one week post-operation.
Conclusion: In the southeastern region of Iran, NMSCs requiring surgical treatment showed a lower prevalence than anticipated. However, their pathological and demographic characteristics were consistent with global observations. The incidence of post-surgical complications was also low. Nevertheless, future studies with larger sample sizes in this region and across the country are recommended to enhance the reliability of these findings.
Sepideh Mahdavi, Mohammad Hassan Emamian , Zahra Kordi, Mansooreh Fateh, Mostafa Enayatrad,
Volume 83, Issue 2 (5-2025)
Volume 83, Issue 2 (5-2025)
Abstract
Background: Stomach cancer is the fifth most common cancer worldwide. This study aimed to investigate the trend in the incidence of stomach cancer in Shahroud and Meyami districts over a thirteen-year period.
Methods: This study is a cross-sectional study that examines the incidence of stomach cancer using data from the population-based cancer registry system in Shahroud and Meyami Districts in Semnan province over a thirteen-year period from the beginning of April 2010 to the end of March 2022. Age-standardized incidence rates were calculated using both the new and old-World Health Organization standard populations. Trend in cancer incidence were analyzed using Joinpoint regression.
Results: Between 2010 and 2022, a total of 474 new cases of stomach cancer were reported. The mean age at diagnosis was 69.3±12.8 years, with 70.3±12.7 years in men and 67.8±12.8 years in women. The age-standardized incidence rate based on the new WHO population was 15.1 per 100,000 people for the entire period, and 20.9 and 9.5 per 100,000 for men and women, respectively. The annual percentage change indicated a (APC: -4.60 % (95% CI: -0.08 to -9.36)) decrease per year, which was statistically significant (P=0.047), particularly in men (APC= -4.42%, (95% CI: -8.39 to -0.63, P=0.024)), whereas the decline in women was not statistically significant (APC= -4.28%, (95% CI: -10.45 to 1.79, P=0.150)). The incidence of stomach cancer increases with age, with the highest number of cases observed in the 75-79 years age group. The incidence trend in the age group 70-74 years (AAPC: -8.98% (95% CI: -2.75, -14.72 was significantly (P=0.005) decreasing.
Conclusion: The findings of this study showed that the age-standardized incidence rate of stomach cancer had a decreasing trend and that incidence increased with advancing age. Moreover, the incidence rate in men was approximately twice that in women. In men, the incidence trend showed a significant decline, whereas in women no significant change was observed.
Methods: This study is a cross-sectional study that examines the incidence of stomach cancer using data from the population-based cancer registry system in Shahroud and Meyami Districts in Semnan province over a thirteen-year period from the beginning of April 2010 to the end of March 2022. Age-standardized incidence rates were calculated using both the new and old-World Health Organization standard populations. Trend in cancer incidence were analyzed using Joinpoint regression.
Results: Between 2010 and 2022, a total of 474 new cases of stomach cancer were reported. The mean age at diagnosis was 69.3±12.8 years, with 70.3±12.7 years in men and 67.8±12.8 years in women. The age-standardized incidence rate based on the new WHO population was 15.1 per 100,000 people for the entire period, and 20.9 and 9.5 per 100,000 for men and women, respectively. The annual percentage change indicated a (APC: -4.60 % (95% CI: -0.08 to -9.36)) decrease per year, which was statistically significant (P=0.047), particularly in men (APC= -4.42%, (95% CI: -8.39 to -0.63, P=0.024)), whereas the decline in women was not statistically significant (APC= -4.28%, (95% CI: -10.45 to 1.79, P=0.150)). The incidence of stomach cancer increases with age, with the highest number of cases observed in the 75-79 years age group. The incidence trend in the age group 70-74 years (AAPC: -8.98% (95% CI: -2.75, -14.72 was significantly (P=0.005) decreasing.
Conclusion: The findings of this study showed that the age-standardized incidence rate of stomach cancer had a decreasing trend and that incidence increased with advancing age. Moreover, the incidence rate in men was approximately twice that in women. In men, the incidence trend showed a significant decline, whereas in women no significant change was observed.
Hossein Akhavan, Fatemeh Rezaei,
Volume 83, Issue 3 (6-2025)
Volume 83, Issue 3 (6-2025)
Abstract
Background: An Electrocardiogram is a non-invasive method for receiving heart signals. Despite advances in imaging methods, the electrocardiogram still plays an important role remains a vital tool in the diagnosis of heart diseases. Analysis of electrocardiogram signals plays an important role in the early detection of heart diseases such as arrhythmias and heart attacks. Today, with the advancement of science and technology, computer methods have received more and more attention from doctors. In this study, machine learning methods were used to classify normal and abnormal heartbeats.
Methods: The data under study were extracted from a dataset called Heartbeat published on the Kaggle website. This dataset includes samples of audio ECG signals that are divided into healthy and unhealthy categories. First, the data were preprocessed and normalized to prepare them for input into the model. Then, temporal and frequency features were extracted from the signals. Next, a hybrid model consisting of one-dimensional convolutional layers was designed and trained. Also, by using the early stopping method, overfitting was prevented and the stability of the model was improved.
Results: In this study, it was shown that by using deep learning, especially using CNN and 1D Conv, an accuracy of 0.99% and a loss of 0.0350 for test data in detecting normal and abnormal heartbeats can be achieved. This model has the ability to analyze complex structures and temporal dynamics of ECG signals and is able to detect patterns related to cardiac disorders.
Conclusion: Today, the electrocardiogram has received more attention than ever before. Appropriate selection of the model, data standardization, and a qualitative range of data are among the factors of high accuracy in this study. This study can be an effective step in the development of intelligent systems for diagnosing cardiac disorders and can be used in medical applications, especially in the field of continuous patient monitoring.
Bibi Mona Razavi, Tayyebeh Zarei, Seyed Mohammad Sadegh Ahmadi Rashti , Mehrdad Sayadinia,
Volume 83, Issue 3 (6-2025)
Volume 83, Issue 3 (6-2025)
Abstract
Background: The use of mesh is considered one of the most effective methods and is considered the method of choice in hernia repair. However, the debate about the choice of mesh type still persists. Therefore, in the present study, the results of using ultra-light Prolene mesh with standard Prolene mesh in hernia repair surgery were compared.
Methods: The present study is a double-blind, randomized, controlled clinical trial that was conducted at Shahid Mohammadi Hospital in Bandar Abbas. Demographic information including age, sex, height, and weight were recorded in a checklist. Patients were randomly assigned to two groups. Each group used Prolene mesh in the first group and ultra-light Prolene mesh in the second group for repair. Hernia repair was performed by the surgeon using the Lebakhstein method.
Results: 119 patients were included in the study. 70 patients (57.4%) had direct hernia and 52 patients (42.6%) had indirect hernia. The mean age of the Prolene group was 43.8±7.49 and the ultra-light Prolene group was 44.32±8.91 years (P=.713). The mean BMI in the Prolene group was 29.94±3.43 and in the ultra-light Parwan group was 29.66±3.76 (P=.673). Wound infection was not observed in either group. Chronic pain was 14.5 in the Prolene group and 10.3 in the ultra-light Prolene group (P=.490). Administrative retention was 6.3 in the Prolene group and 8.5 in the ultra-light Prolene group (P=.738). The recurrence rate 3 months after surgery was 0 in the Prolene group and 1 case (1.7%) in the ultra-light Prolene group (P=.487). The recurrence rate 12 months after surgery was 2 cases (3.2%) in the Prolene group and 3 cases (5.2%) in the ultralight Prolene group (P=. 672). The time to complete recovery was 6.94±1.63 days in the Prolene group and 6.68±1.64 days in the ultralight Prolene group (P=. 368). There was no significant difference in pain intensity at 2, 6, and 24 hours after surgery between the two study groups.
Conclusion: Both Prolene and ultralight Prolene mesh have relatively similar efficacy in inguinal hernia repair. Although the advantages of ultralight Prolene mesh, such as pain intensity, chronic pain, and faster onset of motion, were slightly different in the ultralight Prolene group, the recurrence rate was slightly higher in the ultralight Prolene group.
Methods: The present study is a double-blind, randomized, controlled clinical trial that was conducted at Shahid Mohammadi Hospital in Bandar Abbas. Demographic information including age, sex, height, and weight were recorded in a checklist. Patients were randomly assigned to two groups. Each group used Prolene mesh in the first group and ultra-light Prolene mesh in the second group for repair. Hernia repair was performed by the surgeon using the Lebakhstein method.
Results: 119 patients were included in the study. 70 patients (57.4%) had direct hernia and 52 patients (42.6%) had indirect hernia. The mean age of the Prolene group was 43.8±7.49 and the ultra-light Prolene group was 44.32±8.91 years (P=.713). The mean BMI in the Prolene group was 29.94±3.43 and in the ultra-light Parwan group was 29.66±3.76 (P=.673). Wound infection was not observed in either group. Chronic pain was 14.5 in the Prolene group and 10.3 in the ultra-light Prolene group (P=.490). Administrative retention was 6.3 in the Prolene group and 8.5 in the ultra-light Prolene group (P=.738). The recurrence rate 3 months after surgery was 0 in the Prolene group and 1 case (1.7%) in the ultra-light Prolene group (P=.487). The recurrence rate 12 months after surgery was 2 cases (3.2%) in the Prolene group and 3 cases (5.2%) in the ultralight Prolene group (P=. 672). The time to complete recovery was 6.94±1.63 days in the Prolene group and 6.68±1.64 days in the ultralight Prolene group (P=. 368). There was no significant difference in pain intensity at 2, 6, and 24 hours after surgery between the two study groups.
Conclusion: Both Prolene and ultralight Prolene mesh have relatively similar efficacy in inguinal hernia repair. Although the advantages of ultralight Prolene mesh, such as pain intensity, chronic pain, and faster onset of motion, were slightly different in the ultralight Prolene group, the recurrence rate was slightly higher in the ultralight Prolene group.
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.
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