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Showing 1117 results for Type of Study: Original Article
Maryam Bahadur, Zahra Momeni,
Volume 83, Issue 3 (6-2025)
Volume 83, Issue 3 (6-2025)
Abstract
Background: Radiotherapy is one modalities for common cancers like cervical and endometrial. Although radiation therapy has side effects such as digestive problems and radiation-induced changes in the sacrum. At the current article, the factors that evaluate the side effects of radiation therapy for two energies of 6 and 15 megavoltage were compared.
Methods: For this study, the data of 50 female patients with an average age of 58.5 years with cervical and endometrial cancers were used. For each patient, the BOX treatment plan was carried out with Eclipse software for two energies, 6 and 15 MV, with total prescribed dose of 50 Gy. Along with factors such as dose homogeneity, sacrum bone dose, and maximum rectal dose were compared.
Results: The comparison reveals that the maximum rectal dose for 6 MV energy was significantly (Pvalue=0.001) more than those planed with 15 MV.
For the volume of the sacrum that receives a dose of 40 Gy (V_40), it was seen that for 6MV (99.86±0.42) energy, were significantly more than the treatment plan with 15 MV energy (99.83±0.48) (Pvalue=0.026). According to the homogeneity index for this study, a statistically significant difference was seen for the value obtained from HI2 and HI3 for 6 MV compared to 15 MV Pvalue<0.001, PValue=0.008 respectively which the treatment plans performed with 15 MV energy were more homogeneous than MV 6 energy.
Conclusion: In this article, it was observed that the use of low energies for the treatment of pelvic cancers, enhances the percentage of the maximum dose reached to healthy organs, which causes patients to suffer complications Therefore, it is recommended to use high energy, such as 15 MV, to reduce the side effects of radiotherapy, and also it has been suggested that patients should be followed up for 3 to 5 years in order to obtain more reliable information about the sacrum dose.
Methods: For this study, the data of 50 female patients with an average age of 58.5 years with cervical and endometrial cancers were used. For each patient, the BOX treatment plan was carried out with Eclipse software for two energies, 6 and 15 MV, with total prescribed dose of 50 Gy. Along with factors such as dose homogeneity, sacrum bone dose, and maximum rectal dose were compared.
Results: The comparison reveals that the maximum rectal dose for 6 MV energy was significantly (Pvalue=0.001) more than those planed with 15 MV.
For the volume of the sacrum that receives a dose of 40 Gy (V_40), it was seen that for 6MV (99.86±0.42) energy, were significantly more than the treatment plan with 15 MV energy (99.83±0.48) (Pvalue=0.026). According to the homogeneity index for this study, a statistically significant difference was seen for the value obtained from HI2 and HI3 for 6 MV compared to 15 MV Pvalue<0.001, PValue=0.008 respectively which the treatment plans performed with 15 MV energy were more homogeneous than MV 6 energy.
Conclusion: In this article, it was observed that the use of low energies for the treatment of pelvic cancers, enhances the percentage of the maximum dose reached to healthy organs, which causes patients to suffer complications Therefore, it is recommended to use high energy, such as 15 MV, to reduce the side effects of radiotherapy, and also it has been suggested that patients should be followed up for 3 to 5 years in order to obtain more reliable information about the sacrum dose.
Saeed Kafrashi, Hamidreza Norouzi, Malihe Safari,
Volume 83, Issue 3 (6-2025)
Volume 83, Issue 3 (6-2025)
Abstract
Background: In this study, Botox method is compared with sleeve gastrectomy as one of the endoscopic methods in the treatment of obesity for patients who are not effective in lifestyle and drug modification methods and do not have the interest or necessary conditions for bariatric surgery.
Methods: This Cross-sectional study was conducted in eligible patients who were outpatients at the gastroenterology clinics of Amir al-Momenin Hospital, Arak, in June 2014 for one year in the gastroenterology clinic after obtaining informed consent, demographic information, and anthropometric measurements. After 12 weeks, patients in both groups were visited again. In patients in group A (Botox group), endoscopy was performed by an experienced gastroenterologist under sedation after a 10-hour fast, and in patients in group B (sleeve gastrectomy) under general anesthesia, a partial and longitudinal gastrectomy was performed. The BAROS questionnaire was used to assess the quality of life of patients.
Results: The mean age of the subjects in the endoscopic botulinum neurotoxin group was 30.88±11.89 years and the sleeve gastrectomy group was 29.88±11.06 years. In this study, 12 subjects (24.0%) were male and 38 subjects (76%) were female. There was a significant difference in the mean body mass index and weight at four measurements in the two study groups (endoscopic botulinum neurotoxin and sleeve gastrectomy). There was no statistically significant difference in the mean blood pressure, laboratory results, and mean quality of life in the study groups.
Conclusion: Endoscopic botulinum injection in the stomach is an effective and safe method for short-term weight loss, but its long-term effect on weight and the occurrence of complications or metabolic effects requires long-term follow-up.
Methods: This Cross-sectional study was conducted in eligible patients who were outpatients at the gastroenterology clinics of Amir al-Momenin Hospital, Arak, in June 2014 for one year in the gastroenterology clinic after obtaining informed consent, demographic information, and anthropometric measurements. After 12 weeks, patients in both groups were visited again. In patients in group A (Botox group), endoscopy was performed by an experienced gastroenterologist under sedation after a 10-hour fast, and in patients in group B (sleeve gastrectomy) under general anesthesia, a partial and longitudinal gastrectomy was performed. The BAROS questionnaire was used to assess the quality of life of patients.
Results: The mean age of the subjects in the endoscopic botulinum neurotoxin group was 30.88±11.89 years and the sleeve gastrectomy group was 29.88±11.06 years. In this study, 12 subjects (24.0%) were male and 38 subjects (76%) were female. There was a significant difference in the mean body mass index and weight at four measurements in the two study groups (endoscopic botulinum neurotoxin and sleeve gastrectomy). There was no statistically significant difference in the mean blood pressure, laboratory results, and mean quality of life in the study groups.
Conclusion: Endoscopic botulinum injection in the stomach is an effective and safe method for short-term weight loss, but its long-term effect on weight and the occurrence of complications or metabolic effects requires long-term follow-up.
Masoome Pourmokhtari , Shahram Shafa, Nasim Nabizadeh, Reza Sahraei, Hasan Zabetian, Mansour Deylami, Navid Kalani,
Volume 83, Issue 3 (6-2025)
Volume 83, Issue 3 (6-2025)
Abstract
Background: Spinal anesthesia is an effective method for providing analgesia in surgery and a safe alternative to general analgesia; But despite its benefits, in many cases it is not free of side effects, including unwanted cardiovascular events such as hypotension and bradycardia. Ondansetron effectively reduces the incidence of nausea, vomiting, and bradycardia associated with spinal anesthesia Thus, the present study aimed to assess intravenous ondansetron's efficacy in preventing post-spinal hypotension among patients scheduled for lower extremity orthopedic surgery at Peymanieh Hospital in Jahrom, Iran.
Methods: This randomized double-blind clinical trial included 60 patients undergoing lower limb orthopedic surgery at Peymanieh Hospital, Jahrom, Iran, from March 2021 to February 2022. Patients were randomly allocated into two groups: the intervention group (receiving 8 mg intravenous ondansetron) and the control group (receiving distilled water). Systolic and diastolic blood pressure (SBP, DBP) and heart rate (HR) were measured before pre-spinal anesthesia, after spinal anesthesia and then every two minutes for the first ten minutes and at 15, 30, 45, 60 and 90 minutes after surgery. After spinal anesthesia, the patient was asked about pruritus every 10 minutes. Nausea and vomiting during surgery in case of incidence, recording and nausea after spinal anesthesia, the patient was asked every 10 minutes.
Results: The chi-square test indicated no significant differences between the study groups regarding age and sex distribution(P>0.05). Time before anesthesia, immediately after anesthesia, 10 minutes, 15 minutes, 30 minutes, 45 minutes, 60 minutes, 75 minutes, and 90 minutes after anesthesia, significant difference between ondansetron and placebo groups from There was no mean SBP and DBP and HR (P <0.05). No significant difference between ondansetron and placebo groups in the incidence of pruritus and nausea and vomiting at different times (p <0.05).
Conclusion: Dose of 8 mg of ondansetron in lower limb orthopedic surgery has no significant effect on hemodynamic symptoms as well as the prevention of postoperative nausea, vomiting and pruritus in these patients. Therefore, to achieve more results regarding the transient effect of this drug, it can be compared with other drugs in the class of HT3-5 receptor antagonists.
Elham Rajaei, Tina Vosoughi, Forough Nokhostin, Hojatollah Yousefimanesh, Mahnaz Parvazi,
Volume 83, Issue 3 (6-2025)
Volume 83, Issue 3 (6-2025)
Abstract
Background: Osteonecrosis of the jaw has recently been reported in patients receiving denosumab for cancer treatment. Accordingly, the present study aimed to determine the frequency of osteonecrosis of the jaw in cancer patients receiving denosumab.
Methods: In the present descriptive-analytical study, 62 cancer patients receiving denosumab who referred to the oncology clinic of Golestan and Shafa Hospitals in Ahvaz in 1403 were studied. The prevalence of osteonecrosis of the jaw among the studied patients was investigated and its relationship with predisposing factors, including gender, type of cancer, comorbidity, and dental caries status, was recorded and analyzed in a checklist.
Results: The prevalence of osteonecrosis of the jaw was 1.6%. There was no significant association between the incidence of osteonecrosis of the jaw and gender and comorbidities (P<0.05), but females showed a 38% higher probability of developing osteonecrosis of the jaw (95% confidence interval; 1.62-1.18, r=1.386). Breast cancer was the most common type of cancer among the study participants (61.3%), but no significant association was found between the incidence of osteonecrosis of the jaw and the incidence of the cancers studied (P-value=0.986). No significant association was found between the incidence of osteonecrosis of the jaw and dental caries (P-value=0.741). The odds of developing osteonecrosis of the jaw in patients with or without dental caries risk were reported to be 1.1 (95% confidence interval; 1.205-1.021, r=1.109).
Conclusion: Despite the lack of a significant association between the incidence of osteonecrosis of the jaw and various factors such as gender, type of cancer, comorbidities, and dental caries, there was evidence of a relative increase in the risk of osteonecrosis of the jaw in women with cancer treated with denosumab, which highlights the need for further investigation.
Methods: In the present descriptive-analytical study, 62 cancer patients receiving denosumab who referred to the oncology clinic of Golestan and Shafa Hospitals in Ahvaz in 1403 were studied. The prevalence of osteonecrosis of the jaw among the studied patients was investigated and its relationship with predisposing factors, including gender, type of cancer, comorbidity, and dental caries status, was recorded and analyzed in a checklist.
Results: The prevalence of osteonecrosis of the jaw was 1.6%. There was no significant association between the incidence of osteonecrosis of the jaw and gender and comorbidities (P<0.05), but females showed a 38% higher probability of developing osteonecrosis of the jaw (95% confidence interval; 1.62-1.18, r=1.386). Breast cancer was the most common type of cancer among the study participants (61.3%), but no significant association was found between the incidence of osteonecrosis of the jaw and the incidence of the cancers studied (P-value=0.986). No significant association was found between the incidence of osteonecrosis of the jaw and dental caries (P-value=0.741). The odds of developing osteonecrosis of the jaw in patients with or without dental caries risk were reported to be 1.1 (95% confidence interval; 1.205-1.021, r=1.109).
Conclusion: Despite the lack of a significant association between the incidence of osteonecrosis of the jaw and various factors such as gender, type of cancer, comorbidities, and dental caries, there was evidence of a relative increase in the risk of osteonecrosis of the jaw in women with cancer treated with denosumab, which highlights the need for further investigation.
Artadokht Khoshooei, Seyedeh Fatemeh Hosseini Nejad , Armin Kia , Nadia Zergani ,
Volume 83, Issue 4 (7-2025)
Volume 83, Issue 4 (7-2025)
Abstract
Background: Nowadays, there is an increased emphasis on using safer and more modern anesthetic drugs. The addition of adjuvants not only enhances the anesthetic effect of the medication but also reduces the required dosage, thereby improving the safety margin. Effective postoperative pain control is a critical component in enhancing recovery and improving outcomes for orthopedic patients. Proper pain management not only facilitates early mobilization but also reduces complications and increases patient satisfaction. This study aimed to evaluate the impact of dexmedetomidine and ketamine as adjuvant drugs in supraclavicular nerve block for reducing postoperative pain following forearm orthopedic surgery.
Methods: This randomized, triple-blind clinical trial was meticulously conducted between April 2024 and March 2025 at Razi Hospital, a major teaching facility affiliated with Jundishapur University of Medical Sciences in Ahvaz, Iran. A total of 102 eligible patients were carefully enrolled and randomly assigned to three distinct groups: dexmedetomidine, ketamine, and control. Each patient received a standardized supraclavicular block using 2% lidocaine combined with the designated adjuvant drug to enhance analgesic efficacy. Vital signs, including heart rate, oxygen saturation, and Mean arterial pressure (MAP), were closely monitored every 15 minutes during surgery. Postoperative pain intensity was assessed using the Visual analog scale (VAS) at 1, 2, 6, 12, and 24 hours after surgery.
Results: Patients in the dexmedetomidine group showed significantly lower heart rate, MAP, and pain intensity compared to both ketamine and control groups at all measured time points (P<0.001). Ketamine also demonstrated better pain control and hemodynamic stability than the control group, although it was less effective than dexmedetomidine. Most differences in mean values between groups were statistically significant, confirming the superior performance of dexmedetomidine.
Conclusion: Dexmedetomidine, when used as an adjuvant in supraclavicular block for forearm orthopedic surgery, resulted in superior pain relief and greater hemodynamic stability compared to ketamine and standard care. These findings support its clinical use as an effective adjunct in regional anesthesia protocols.
Ali Ayatollahi, Maryam Dashti,
Volume 83, Issue 4 (7-2025)
Volume 83, Issue 4 (7-2025)
Abstract
Background: Refractive errors are among the most common and preventable causes of visual impairment in children. Early detection and proper correction are essential to prevent long-term visual complications such as amblyopia and reduced academic performance. The present study aimed to determine the prevalence and distribution patterns of different types of refractive errors among elementary school boys in Hamedan Province, located in western Iran, where limited data are available on this age group.
Methods: This cross-sectional study was conducted between October 2022 and December 2023 on 1053 male students aged 6-12 years, selected through a multistage cluster sampling method covering both urban and rural areas. Examinations included Uncorrected visual acuity (UCVA), Best-corrected visual acuity (BCVA), cycloplegic refraction, cover test, and ophthalmoscopy, all performed by a trained optometrist following a standardized protocol. Based on cycloplegic spherical equivalent refraction, myopia was defined as -0.50 diopter or worse, hyperopia as +2.00 diopter or more, and astigmatism as a cylinder of -0.50 diopter or more. The data were statistically analyzed to explore the association between age and the type of refractive error.
Results: Data from 1027 students were included in the final analysis. The mean age of participants was 9.52±1.63 years. UCVA of 20/40 or worse was found in 16.5% of students, and BCVA of 20/40 or worse in 1.2%. The prevalence rates of myopia, hyperopia, and astigmatism were 6.5%, 5.6%, and 18.9%, respectively. With-the-rule astigmatism was the most frequent type observed. The prevalence of myopia tended to increase with age, while hyperopia showed a decreasing trend.
Conclusion: The findings revealed a relatively high prevalence of refractive errors, particularly astigmatism, among school-aged boys in western Iran. These results emphasize the importance of implementing periodic, school-based vision screening programs and ensuring better access to refractive care services. Promoting awareness among parents, teachers, and health authorities regarding the need for early eye examinations could play a crucial role in preventing avoidable visual impairment and improving children’s visual health and academic success.
Methods: This cross-sectional study was conducted between October 2022 and December 2023 on 1053 male students aged 6-12 years, selected through a multistage cluster sampling method covering both urban and rural areas. Examinations included Uncorrected visual acuity (UCVA), Best-corrected visual acuity (BCVA), cycloplegic refraction, cover test, and ophthalmoscopy, all performed by a trained optometrist following a standardized protocol. Based on cycloplegic spherical equivalent refraction, myopia was defined as -0.50 diopter or worse, hyperopia as +2.00 diopter or more, and astigmatism as a cylinder of -0.50 diopter or more. The data were statistically analyzed to explore the association between age and the type of refractive error.
Results: Data from 1027 students were included in the final analysis. The mean age of participants was 9.52±1.63 years. UCVA of 20/40 or worse was found in 16.5% of students, and BCVA of 20/40 or worse in 1.2%. The prevalence rates of myopia, hyperopia, and astigmatism were 6.5%, 5.6%, and 18.9%, respectively. With-the-rule astigmatism was the most frequent type observed. The prevalence of myopia tended to increase with age, while hyperopia showed a decreasing trend.
Conclusion: The findings revealed a relatively high prevalence of refractive errors, particularly astigmatism, among school-aged boys in western Iran. These results emphasize the importance of implementing periodic, school-based vision screening programs and ensuring better access to refractive care services. Promoting awareness among parents, teachers, and health authorities regarding the need for early eye examinations could play a crucial role in preventing avoidable visual impairment and improving children’s visual health and academic success.
Elham Shirvani Naghani , Leila Moradi, Alireza Jahanshahi, Homeira Rashidi, Alireza Sedaghat,
Volume 83, Issue 4 (7-2025)
Volume 83, Issue 4 (7-2025)
Abstract
Background: Thyroid disorders are common among young women, and hypothyroidism ranges clinically from subclinical to overt disease, potentially causing various maternal and fetal complications. Determining the appropriate levothyroxine (LT4) dose during pregnancy is crucial for maintaining maternal euthyroidism and optimising pregnancy outcomes. This study aimed to evaluate the dose requirements of LT4 in pregnant women with and without a prior history of hypothyroidism, and to investigate the association with Thyroid peroxidase antibody (TPO) levels.
Methods: This hospital- and clinic-based study was conducted from September 2022 to March 2023 among 146 pregnant women attending a private clinic or Golestan Hospital in Ahvaz, Iran. A total of 146 pregnant women diagnosed with subclinical hypothyroidism (SCH, n=62) or overt hypothyroidism (OH, n=84) were randomly selected. Participants were divided into groups based on their history of hypothyroidism and received LT4 treatment. LT4 requirements were determined according to trimester-specific TSH ranges: >10 mIU/L or 2.5-10 mIU/L in the first trimester, and 3-10 mIU/L in the second and third trimesters. Data analysis was performed using SPSS version 22, employing descriptive statistics (mean±SD, frequency, and percentage) and analytical tests, including the independent t-test and Mann-Whitney U test.
Results: Pregnant women with overt hypothyroidism showed a statistically significant difference in mean LT4 dose between those with and without a prior history of hypothyroidism (P<0.05). In contrast, no significant difference was observed in LT4 requirements among women with subclinical hypothyroidism. TPO Ab positivity was associated with higher LT4 requirements, particularly in women with overt disease. Dose adjustments were most frequent during the first trimester, with incremental increases observed in subsequent trimesters. These findings support individualized monitoring, iodine testing, adherence checks, and coordinated antenatal endocrinology care to improve maternal and neonatal outcomes.
Conclusion: Following the diagnosis of hypothyroidism in early pregnancy, LT4 dosing should be tailored according to disease severity, prior history of hypothyroidism, TPO Ab status, and study location to ensure optimal maternal and fetal outcomes.
Methods: This hospital- and clinic-based study was conducted from September 2022 to March 2023 among 146 pregnant women attending a private clinic or Golestan Hospital in Ahvaz, Iran. A total of 146 pregnant women diagnosed with subclinical hypothyroidism (SCH, n=62) or overt hypothyroidism (OH, n=84) were randomly selected. Participants were divided into groups based on their history of hypothyroidism and received LT4 treatment. LT4 requirements were determined according to trimester-specific TSH ranges: >10 mIU/L or 2.5-10 mIU/L in the first trimester, and 3-10 mIU/L in the second and third trimesters. Data analysis was performed using SPSS version 22, employing descriptive statistics (mean±SD, frequency, and percentage) and analytical tests, including the independent t-test and Mann-Whitney U test.
Results: Pregnant women with overt hypothyroidism showed a statistically significant difference in mean LT4 dose between those with and without a prior history of hypothyroidism (P<0.05). In contrast, no significant difference was observed in LT4 requirements among women with subclinical hypothyroidism. TPO Ab positivity was associated with higher LT4 requirements, particularly in women with overt disease. Dose adjustments were most frequent during the first trimester, with incremental increases observed in subsequent trimesters. These findings support individualized monitoring, iodine testing, adherence checks, and coordinated antenatal endocrinology care to improve maternal and neonatal outcomes.
Conclusion: Following the diagnosis of hypothyroidism in early pregnancy, LT4 dosing should be tailored according to disease severity, prior history of hypothyroidism, TPO Ab status, and study location to ensure optimal maternal and fetal outcomes.
Ali-Akbar Shafiei , Saeed Rahmani , Abbas Riazi, Alireza Akbarzadeh Baghan ,
Volume 83, Issue 4 (7-2025)
Volume 83, Issue 4 (7-2025)
Abstract
Background: This study investigates the use of color filters, which represent a scientific and standardized approach to assist individuals with visual impairment. Although there is no fixed protocol for prescribing color filters, these filters, which are often prescribed by ocular care providers in a trial-and-error manner today, help improve visual performance, control glare, and enhance motor skills in affected individuals. Given the absence of formal guidelines and standardized protocols in this area, this study tested common diseases leading to visual impairment against various color filters.
Methods: The study population consisted of patients visiting the Optometry Clinic of Labbafi Nejad Hospital. Participants were voluntarily referred from retinal and corneal departments to this clinic. This quasi-experimental study evaluated acuity at distance and near and contrast sensitivity function with and without color filters, and compared the results. After analysis, filter(s) suitable for each participant were identified and applied clinically, with one-month monitoring and re-evaluation.
Results: A total of 99 participants (54 male, 45 female) with a mean age of 32.19±15.41 years were included. The results showed that after using color filters, distance visual acuity (BCVA) improved significantly in most diseases (P<0.001). However, in albinism and diabetic retinopathy patients, there was no significant improvement in distance vision. At near distance, there was generally a significant improvement in near vision in most diseases after applying the filters (P=0.001). Exceptions included albinism and glaucoma, where no significant difference was observed (P=0.073). For contrast sensitivity (CSF), most patients showed improvement and increased contrast sensitivity (P<0.001), but this increase was not significant in albinism and glaucoma (P=0.483).
Conclusion: The study suggests that the use of certain color filters in visually impaired patients leads to significant improvements in both distance and near acuity and contrast sensitivity function, potentially enhancing quality of life. Based on the quantitative results, selecting the appropriate filter should be disease-specific and done with greater precision. However, the diversity and severity of diseases, the degree of vision loss, and genetic differences among individuals require greater attention to practical experiences and statements from this patient group. Additionally, patients with more than one ocular condition often changed the type and color of the filter.
Methods: The study population consisted of patients visiting the Optometry Clinic of Labbafi Nejad Hospital. Participants were voluntarily referred from retinal and corneal departments to this clinic. This quasi-experimental study evaluated acuity at distance and near and contrast sensitivity function with and without color filters, and compared the results. After analysis, filter(s) suitable for each participant were identified and applied clinically, with one-month monitoring and re-evaluation.
Results: A total of 99 participants (54 male, 45 female) with a mean age of 32.19±15.41 years were included. The results showed that after using color filters, distance visual acuity (BCVA) improved significantly in most diseases (P<0.001). However, in albinism and diabetic retinopathy patients, there was no significant improvement in distance vision. At near distance, there was generally a significant improvement in near vision in most diseases after applying the filters (P=0.001). Exceptions included albinism and glaucoma, where no significant difference was observed (P=0.073). For contrast sensitivity (CSF), most patients showed improvement and increased contrast sensitivity (P<0.001), but this increase was not significant in albinism and glaucoma (P=0.483).
Conclusion: The study suggests that the use of certain color filters in visually impaired patients leads to significant improvements in both distance and near acuity and contrast sensitivity function, potentially enhancing quality of life. Based on the quantitative results, selecting the appropriate filter should be disease-specific and done with greater precision. However, the diversity and severity of diseases, the degree of vision loss, and genetic differences among individuals require greater attention to practical experiences and statements from this patient group. Additionally, patients with more than one ocular condition often changed the type and color of the filter.
Mandana Pouladzadeh, Fatemeh Khazaei, Saeid Bitaraf, Hossein Karimpourian, Mahsa Mombeyni, Mohammad-Reza Mahmoudian-Sani ,
Volume 83, Issue 4 (7-2025)
Volume 83, Issue 4 (7-2025)
Abstract
Background: Breast cancer is the most prevalent malignancy among women and remains a leading cause of cancer-related mortality worldwide. Early detection can markedly improve patient survival, yet existing screening methods often lack sufficient accuracy and sensitivity. lncRNA KCNQ1OT1 has been implicated in the initiation and progression of tumors in several cancers, including breast cancer. This study aimed to evaluate the diagnostic potential of serum lncRNA KCNQ1OT1 expression as a biomarker for early detection of breast cancer.
Methods: This case-control study was conducted at Ahvaz Jundishapur University of Medical Sciences, Shafa Hospital, Ahvaz, Iran, between September 2024 and March 2025. Serum samples were obtained from 30 patients with histologically confirmed breast cancer and 30 healthy women serving as controls. Total RNA was extracted from 500 µL of serum, and cDNA was synthesized using oligo (dT) primers. Real-Time PCR was performed in triplicate, with GAPDH as the internal control. Relative gene expression was calculated using the 2^-ΔΔCt method, and data were analyzed using the Mann-Whitney U test and ROC analysis.
Results: The patient and control groups were homogeneous for most demographic parameters, but showed significant differences in age (P=0.023) and ethnicity (P=0.004). Most patients were in stage I of the disease. The median expression of serum KCNQ1OT1 was significantly lower in patients (0.024, IQR 0.013-0.033) than in controls (0.039, IQR 0.027-0.051), indicating marked downregulation in the patient group (P=0.0003). The ROC analysis yielded an AUC of 0.82 (95% CI: 0.67-0.96, SE=0.07, P=0.0005). At an optimal cutoff value of >0.031, the sensitivity was 70%, the specificity was 95%, and the positive likelihood ratio (LR⁺) ≈ was approximately 14, demonstrating strong discriminative ability.
Conclusion: Serum KCNQ1OT1 exhibits promising diagnostic performance for identifying early-stage breast cancer and may serve as a reliable noninvasive biomarker. Larger multicenter studies incorporating molecular subtyping and tissue correlation are required to validate its clinical applicability and strengthen diagnostic accuracy.
Javad Hashemi, Hoseinali Soltani , Ali Esmaeili , Fatemeh Roshanravan Yazdi , Seyed Hassan Seyed Sharifi ,
Volume 83, Issue 4 (7-2025)
Volume 83, Issue 4 (7-2025)
Abstract
Background: Postoperative pain is a significant concern after cholecystectomy. Given the role of vitamin D in pain management, this study investigated the correlation between preoperative vitamin D levels and postoperative pain severity in patients undergoing laparoscopic cholecystectomy, with the aim of improving pain management and enhancing postoperative care.
Methods: This prospective observational study (January 2024- February 2025) was conducted on 87 patients undergoing laparoscopic cholecystectomy at Imam Ali Hospital of Bojnurd. Inclusion criteria were age 18-45, non-urgent laparoscopic cholecystectomy, and good physical status. Exclusion criteria were chronic pain, regular analgesic use, known psychiatric or neurological disease or treatment, substance abuse, emergency cholecystectomy, or conversion to open surgery. Participants fasted for 12 hours preoperatively. All received 1 g (IV) ceftriaxone one hour before and 12 hours after surgery. Anesthesia was induced with propofol and fentanyl and maintained with isoflurane, nitrous oxide, or oxygen. Anesthesia and surgical technique were standardized, with any deviations recorded. We collected demographic data and extracted perioperative details from records and interviews. Pre-induction venous blood samples were collected, processed, and stored at -20°C. Serum vitamin D concentrations were quantified via ELISA method, and participants were subsequently stratified into two groups based on these measurements. Postoperative pain was assessed on a Visual Analog Scale (0-10) at 6, 12, 18, and 24 hours. Analgesic regimens followed standard protocol under physician supervision and were unaffected by the study.
Results: Lower serum vitamin D levels were associated with higher postoperative pain scores (P<0.01), with this relationship being significant at 6, 12, and 18 hours postoperatively (P<0.01, P<0.01, and P<0.05, respectively). Insufficient vitamin D levels and female gender were also independent risk factors for acute pain after laparoscopic cholecystectomy (P<0.01).
Conclusion: Based on the results of the present study, preoperative vitamin D deficiency is associated with increased postoperative acute pain scores in patients undergoing laparoscopic cholecystectomy, especially in women. These findings may be useful for postoperative pain management in patients with vitamin D deficiency.
Majid Karimifard, Ashkan Sabouri, Khaled Rahmani , Mohammad Azad Majedi, Behzad Ahsan ,
Volume 83, Issue 4 (7-2025)
Volume 83, Issue 4 (7-2025)
Abstract
Background: Patients undergoing mechanical ventilation in the intensive care unit (ICU) are at higher risk for delirium. The present study aimed to compare the frequency of delirium in patients requiring anesthesia receiving the Presedex and fentanyl regimen with the midazolam and fentanyl regimen in the intensive care unit (ICU).
Methods: This historical cohort study was conducted on all patients hospitalized in the intensive care unit of Kowsar Hospital in sanandaj from May 2018 to December 2024 as a census with a sample size of 40 people in each group. Delirium and restlessness were assessed based on RASS criteria and the GCS scale was used to assess the level of consciousness of the patients. The data were entered into SPSS 24 software and a significance level of less than 5% was considered.
Results: The average age of the patients in Perdex, fentanyl, midazolam, and fentanyl regimens was 41.52 and 34.05 years, respectively. 53(66.3%) patients were male and the rest were female. The GCS score in the Presdex and Fentanyl group was 14(35%) and the Midazolam and Fentanyl group was 4(10%) with a level of consciousness above 7. The RASS score (5 patients in the Presdex and fentanyl group (12.5%) and the midazolam and fentanyl group (36 patients in the midazolam and fentanyl group (90%) had an anxiety score of zero or higher) was 0. The frequency of delirium based on CAM-ICU criteria in the Presdex and fentanyl group was 27(67.5%) mild delirium and 13(32.5%) moderate delirium, but in the midazolam and fentanyl group, 6(15%) mild delirium, 24(60%) moderate delirium, and 10(25%) severe delirium were present, and this difference was significant in the results of level of consciousness and restlessness and incidence of delirium (P=0.000).
Conclusion: The results showed that the use of Presedex and fentanyl would be more effective in reducing the incidence of delirium, and the use of this drug could be effective.
Parviz Karimi, Hossein Seidkhani, Zahra Mohebinejad, Shayan Hasanvand,
Volume 83, Issue 4 (7-2025)
Volume 83, Issue 4 (7-2025)
Abstract
Background: Seizures are common neurological disorders in childhood, with a prevalence of 4 to 6 cases per 1,000 children in the community. This study was conducted to evaluate the prognosis of the first non-provoked seizure in terms of recurrence.
Methods: In this descriptive-analytical study, the records of all patients hospitalized with a diagnosis of seizure without a trigger for the first time at Imam Khomeini Hospital in Ilam from April 2016 to March 2019 were reviewed retrospectively. Information was extracted from the patients' records. All records were reviewed in terms of seizure type characteristics.
Results: The results of imaging with seizure recurrence in these patients showed that there was a significant relationship between the result of the first imaging and the report of seizure recurrence (P≥0.001 and Phi-Cramers=0.729). Since EEG of all patients was not recorded, they were excluded from the study. There was also a significant relationship between drug treatment and seizure recurrence at a significance level of 5% (P=0.004 and Phi-Cramers=0.273). This study showed that among the 64 patients who had started drug treatment, 44 reported no seizure recurrence and 20 reported seizure recurrence, and among the 54 patients who had not received drug treatment, 23 reported no seizure recurrence and 31 reported seizure recurrence. In the first year, the highest frequency of seizure recurrence was in the first 6 months. With increasing time after seizure, the rate of seizure recurrence decreased. The highest percentage of seizures without a triggering factor was in the age group of 5-10 years and the lowest percentage was in the age group under 5 years.
Conclusion: Identifying key factors associated with seizure recurrence will enable healthcare professionals to tailor their diagnostic and therapeutic approaches, ultimately enhancing patient care and safety. By understanding the importance of family history, seizure characteristics, and neuroimaging findings, clinicians can make informed decisions that may prevent life-threatening complications and minimize cognitive impairment in affected children.
Methods: In this descriptive-analytical study, the records of all patients hospitalized with a diagnosis of seizure without a trigger for the first time at Imam Khomeini Hospital in Ilam from April 2016 to March 2019 were reviewed retrospectively. Information was extracted from the patients' records. All records were reviewed in terms of seizure type characteristics.
Results: The results of imaging with seizure recurrence in these patients showed that there was a significant relationship between the result of the first imaging and the report of seizure recurrence (P≥0.001 and Phi-Cramers=0.729). Since EEG of all patients was not recorded, they were excluded from the study. There was also a significant relationship between drug treatment and seizure recurrence at a significance level of 5% (P=0.004 and Phi-Cramers=0.273). This study showed that among the 64 patients who had started drug treatment, 44 reported no seizure recurrence and 20 reported seizure recurrence, and among the 54 patients who had not received drug treatment, 23 reported no seizure recurrence and 31 reported seizure recurrence. In the first year, the highest frequency of seizure recurrence was in the first 6 months. With increasing time after seizure, the rate of seizure recurrence decreased. The highest percentage of seizures without a triggering factor was in the age group of 5-10 years and the lowest percentage was in the age group under 5 years.
Conclusion: Identifying key factors associated with seizure recurrence will enable healthcare professionals to tailor their diagnostic and therapeutic approaches, ultimately enhancing patient care and safety. By understanding the importance of family history, seizure characteristics, and neuroimaging findings, clinicians can make informed decisions that may prevent life-threatening complications and minimize cognitive impairment in affected children.
Yaser Sharafi, Mohammad Talebpour, Khosro Najari,
Volume 83, Issue 5 (8-2025)
Volume 83, Issue 5 (8-2025)
Abstract
Background: Dumping syndrome is a common complication after bariatric surgery and can adversely affect patients’ quality of life, particularly in those with diabetes. Although gastric bypass has traditionally been associated with a higher risk of dumping syndrome, evidence comparing its frequency with sleeve gastrectomy remains inconclusive. This study aimed to compare the frequency of dumping syndrome following these two procedures in patients with morbid obesity.
Methods: This prospective cohort study was conducted from April 2021 to July 2022 at Sina Hospital in Tehran. A total of 90 patients with morbid obesity who met the indications for bariatric surgery were not randomly assigned to two treatment groups: gastric bypass (n = 45) and sleeve gastrectomy (n = 45). Baseline assessments included medical history, physical examination, review of medical records, and necessary specialist consultations (including endocrinology and cardiology). All patients’ data were recorded in the Sina Bariatric Surgery Registry Database. Following surgery, patients received standard postoperative care and were evaluated for symptoms of dumping syndrome at one and three months postoperatively using the validated Sigstad questionnaire. Statistical analyses were performed using SPSS software.
Results: The results showed no statistically significant differences between the two groups in terms of age group, gender, excess weight, preoperative BMI, final BMI, and history of diabetes prior to surgery (P-value > 0.05). The final weight was significantly higher in the sleeve gastrectomy group (P-value = 0.033). There were no significant differences in the frequency of early and late dumping syndrome related to the consumption of sweets and other foods between the two groups at the first and third postoperative months (P-value > 0.05). Early dumping syndrome following the consumption of sweets and bread was significantly more frequent among diabetic patients (P-value = 0.037 and P-value = 0.045, respectively).
Conclusion: The prevalence of dumping syndrome was similar in both sleeve and bypass groups. Weight loss over time was significant (P < 0.001) and did not differ between groups (P = 0.211). The syndrome was significantly more common in diabetic patients, highlighting the importance of careful postoperative care and dietary guidance.
Methods: This prospective cohort study was conducted from April 2021 to July 2022 at Sina Hospital in Tehran. A total of 90 patients with morbid obesity who met the indications for bariatric surgery were not randomly assigned to two treatment groups: gastric bypass (n = 45) and sleeve gastrectomy (n = 45). Baseline assessments included medical history, physical examination, review of medical records, and necessary specialist consultations (including endocrinology and cardiology). All patients’ data were recorded in the Sina Bariatric Surgery Registry Database. Following surgery, patients received standard postoperative care and were evaluated for symptoms of dumping syndrome at one and three months postoperatively using the validated Sigstad questionnaire. Statistical analyses were performed using SPSS software.
Results: The results showed no statistically significant differences between the two groups in terms of age group, gender, excess weight, preoperative BMI, final BMI, and history of diabetes prior to surgery (P-value > 0.05). The final weight was significantly higher in the sleeve gastrectomy group (P-value = 0.033). There were no significant differences in the frequency of early and late dumping syndrome related to the consumption of sweets and other foods between the two groups at the first and third postoperative months (P-value > 0.05). Early dumping syndrome following the consumption of sweets and bread was significantly more frequent among diabetic patients (P-value = 0.037 and P-value = 0.045, respectively).
Conclusion: The prevalence of dumping syndrome was similar in both sleeve and bypass groups. Weight loss over time was significant (P < 0.001) and did not differ between groups (P = 0.211). The syndrome was significantly more common in diabetic patients, highlighting the importance of careful postoperative care and dietary guidance.
Ehsan Nasirai, Mehdi Bakhshaee, Bashir Rasoulian, Daryoush Hamidi Alamdari, Kiana Ketabi, Imaneh Roshanzamir,
Volume 83, Issue 5 (8-2025)
Volume 83, Issue 5 (8-2025)
Abstract
Background: To improve hemostasis and optimize the healing process, autologous fibrin sealant (FS) has been introduced in selected cases. However, the clinical benefits of FS in sinonasal surgery remain controversial and require further evaluation. This study aimed to investigate the effects of autologous FS on hemostasis, mucosal healing, postoperative clinical outcomes, and recurrence in patients undergoing bilateral FESS, compared with normal saline as the control.
Methods: This randomized clinical trial included 32 patients who underwent bilateral FESS at Ghaem and Imam Reza University Hospitals in Mashhad, Iran, between 2019 and 2021. For each patient, autologous FS was applied to one nasal cavity, while the contralateral cavity received normal saline. Postoperative outcomes including bleeding, crusting, adhesion formation, and infection were assessed at 1 week, 1 month, and 3 months after surgery. In addition, sinonasal symptom burden and endoscopic findings were evaluated using the Sinonasal Outcome Test (SNOT-22) and the Lund-Kennedy endoscopic score, respectively, both recorded preoperatively and three months postoperatively.
Results: Application of autologous FS significantly reduced immediate postoperative bleeding, and no further bleeding events were noted during follow-up. Pain severity was comparable between the two sides. No statistically significant differences were observed in crust formation, adhesion, infection, recurrence, or changes in Lund-Kennedy scores between the FS and control sides (p=0.08, p=0.8, p=0.17, and p=0.14, respectively).
Conclusion: Autologous fibrin sealant reduced early postoperative bleeding without adversely affecting pain control, mucosal healing, or recurrence after FESS. Larger randomized trials with extended follow-up are recommended to determine its definitive clinical value and potential for routine use in surgical practice.
Methods: This randomized clinical trial included 32 patients who underwent bilateral FESS at Ghaem and Imam Reza University Hospitals in Mashhad, Iran, between 2019 and 2021. For each patient, autologous FS was applied to one nasal cavity, while the contralateral cavity received normal saline. Postoperative outcomes including bleeding, crusting, adhesion formation, and infection were assessed at 1 week, 1 month, and 3 months after surgery. In addition, sinonasal symptom burden and endoscopic findings were evaluated using the Sinonasal Outcome Test (SNOT-22) and the Lund-Kennedy endoscopic score, respectively, both recorded preoperatively and three months postoperatively.
Results: Application of autologous FS significantly reduced immediate postoperative bleeding, and no further bleeding events were noted during follow-up. Pain severity was comparable between the two sides. No statistically significant differences were observed in crust formation, adhesion, infection, recurrence, or changes in Lund-Kennedy scores between the FS and control sides (p=0.08, p=0.8, p=0.17, and p=0.14, respectively).
Conclusion: Autologous fibrin sealant reduced early postoperative bleeding without adversely affecting pain control, mucosal healing, or recurrence after FESS. Larger randomized trials with extended follow-up are recommended to determine its definitive clinical value and potential for routine use in surgical practice.
Fariba Shokri, Mohammad Mehdi Rejati , Mehdi Shokri,
Volume 83, Issue 5 (8-2025)
Volume 83, Issue 5 (8-2025)
Abstract
Background: Asthma attacks are one of the most common reasons for patient referral in adult and paediatric age groups, leading to hospitalization of these patients. In addition to the fact that only a small percentage of asthma attacks are due to bacterial infections, asthma treatment guidelines recommend against the routine use of antibiotics in patients hospitalized for asthma attacks. However, many patients treated for asthma attacks receive antibacterial drugs. Therefore, the aim of the present study is to investigate the prescription of antibacterial drugs in patients with asthma attacks.
Methods: In this study, data related to Imam Khomeini (RA) and Shahid Mustafa Khomeini Teaching Hospitals in Ilam city were examined between April 2017 to March 2022. Cases hospitalized due to asthma attacks in the mentioned hospitals during that time period were included in the study according to the inclusion and exclusion criteria.
Results: A total of 331 patients, including 273 adults (84.4%) and 58 children (17.6%), hospitalized for asthma attacks were included in the study. 84.42% of adults and 70.69% of children received antibacterial drugs. The use of antibacterial drugs in adults (p < 0.001) and children (p = 0.008) was significantly associated with an increase in the average length of hospitalization. Among adults, 12 patients required intubation, which was not significantly associated with the use of antibacterial drugs (p = 0.51). Among children, 1 patient required intubation, which was not statistically significant in terms of association with antibiotic use.
Conclusion: The prescription of antibacterial drugs in the treatment of patients hospitalized due to asthma attacks in teaching hospitals in Ilam city is more than similar domestic and international studies. Also, the prescription of antibacterial drugs in these patients not only has no therapeutic benefit, but is also associated with an increase in the duration of hospitalization. It is necessary to consider the necessary measures to modify the views of specialists on the prescription of antibacterial drugs based on the latest evidence-based guidelines.
Methods: In this study, data related to Imam Khomeini (RA) and Shahid Mustafa Khomeini Teaching Hospitals in Ilam city were examined between April 2017 to March 2022. Cases hospitalized due to asthma attacks in the mentioned hospitals during that time period were included in the study according to the inclusion and exclusion criteria.
Results: A total of 331 patients, including 273 adults (84.4%) and 58 children (17.6%), hospitalized for asthma attacks were included in the study. 84.42% of adults and 70.69% of children received antibacterial drugs. The use of antibacterial drugs in adults (p < 0.001) and children (p = 0.008) was significantly associated with an increase in the average length of hospitalization. Among adults, 12 patients required intubation, which was not significantly associated with the use of antibacterial drugs (p = 0.51). Among children, 1 patient required intubation, which was not statistically significant in terms of association with antibiotic use.
Conclusion: The prescription of antibacterial drugs in the treatment of patients hospitalized due to asthma attacks in teaching hospitals in Ilam city is more than similar domestic and international studies. Also, the prescription of antibacterial drugs in these patients not only has no therapeutic benefit, but is also associated with an increase in the duration of hospitalization. It is necessary to consider the necessary measures to modify the views of specialists on the prescription of antibacterial drugs based on the latest evidence-based guidelines.
Maryam Safari, Abbas Ghaisouri, Shokofeh Mohammadi,
Volume 83, Issue 5 (8-2025)
Volume 83, Issue 5 (8-2025)
Abstract
Background: Shortness of breath is a common disorder and means difficulty in breathing and shortness and shallow breathing that the patient feels unpleasant, difficulty and shallow breathing. The main purpose of this study was to analyze patients undergoing pulmonary angiography with a prognosis of pulmonary embolism in the emergency department.
Methods: This descriptive-analytical study was performed in the adult emergency department of Shahid Mostafa Hospital in Ilam in March2018-March2020 after receiving permission from the ethics committee. This study evaluated patients over 18 years of age who underwent CTPA with a pre-diagnosis of PE.
Results: The highest frequency was reported in CT findings of 31.9% normal, 27.6% PE. In our study based on CT results, 30.2% of patients suffered from PE. The highest frequency was reported in CT findings of 31.9% normal, 27.6% PE. In the present study, 65.5% of patients presented with shortness of breath, of which CT results showed 28.9% (PE), 38.2% (Non PE) and 98% (Normal). Other complaints of patients with shortness of breath were reported with CP (7.8%), lower edema (6%), respiratory distress (8.6%), CP and fever (5.2%) and hemotypy (1.7%).
Conclusion: Based on the above study, we conclude that the criterion for selecting patients for CT angiography to rule out PTE is the most important criterion for clinical examination and the Welsh Criteria score. As we can see, the results showed that patients with a Wales score above 8-12 had 80% PTE and patients with a Wales score of 3-6 had 23.5% PTE and the rest had a negative answer, so the Wells criteria were good criteria which unfortunately Due to some conditions, the diagnosis of a general practitioner or carelessness in examinations are not taken into account and causes a large percentage of patients with complaints of shortness of breath to undergo CT angiography while not having the necessary criteria based on Wells scores and clinical examination. CT angiography is either normal or another condition that does not require CT angiography and radiation.
Methods: This descriptive-analytical study was performed in the adult emergency department of Shahid Mostafa Hospital in Ilam in March2018-March2020 after receiving permission from the ethics committee. This study evaluated patients over 18 years of age who underwent CTPA with a pre-diagnosis of PE.
Results: The highest frequency was reported in CT findings of 31.9% normal, 27.6% PE. In our study based on CT results, 30.2% of patients suffered from PE. The highest frequency was reported in CT findings of 31.9% normal, 27.6% PE. In the present study, 65.5% of patients presented with shortness of breath, of which CT results showed 28.9% (PE), 38.2% (Non PE) and 98% (Normal). Other complaints of patients with shortness of breath were reported with CP (7.8%), lower edema (6%), respiratory distress (8.6%), CP and fever (5.2%) and hemotypy (1.7%).
Conclusion: Based on the above study, we conclude that the criterion for selecting patients for CT angiography to rule out PTE is the most important criterion for clinical examination and the Welsh Criteria score. As we can see, the results showed that patients with a Wales score above 8-12 had 80% PTE and patients with a Wales score of 3-6 had 23.5% PTE and the rest had a negative answer, so the Wells criteria were good criteria which unfortunately Due to some conditions, the diagnosis of a general practitioner or carelessness in examinations are not taken into account and causes a large percentage of patients with complaints of shortness of breath to undergo CT angiography while not having the necessary criteria based on Wells scores and clinical examination. CT angiography is either normal or another condition that does not require CT angiography and radiation.
Fatemeh Mollarahimi-Maleki , Pershang Nazemi, Maryam Yousefi,
Volume 83, Issue 5 (8-2025)
Volume 83, Issue 5 (8-2025)
Abstract
Background: One of the most common cancers in women is cervical cancer, which is the most preventable cancer leading to death among women worldwide. Among the causes related to cervical cancer, the human papillomavirus (HPV) is the main factor responsible for causing cervical intraepithelial neoplasia (CIN) and cervical cancer. The aim of this study was to investigate the prevalence of high-risk HPVs (HPV16 and HPV18) and to determine the immediate absolute risk of CIN2+ in individuals with a positive HPV test.
Methods: This cross-sectional study included women who tested positive for HPV and visited the Gynecologic Oncology Clinic at Tehran University of Medical Sciences from October 2022 to March 2025. Individuals with a positive high-risk HPV result were referred for colposcopy and biopsy. The immediate absolute risk of CIN2+ in HPV-positive patients with HPV16, HPV18, or concurrent HPV16/18 genotypes (Multi. HPV+) was evaluated across different cytologic grades, ranging from NILM (Negative for Intraepithelial Lesion or Malignancy) to SCC (Squamous Cell Carcinoma).
Results: A total of 727 patients participated in the study. The mean age and standard deviation of the participants were 35.99 and 8.48 years, respectively. Among all referrals, the number of women who were positive only for HPV 16 was 170 (23%), and 24 (3.3%) were positive only for HPV 18. The highest number of positive cases for HPV16 and HPV18 were in the age range of 30 to 39 years (45%). In the Multi. HPV+ group, the highest number was observed in individuals under 29 years old (50%). The calculated immediate absolute risk of CIN2+ in HPV16+ individuals was 14% for NILM and 8.6% for ASCUS, while in HPV18+ individuals, it was 8.3% for NILM.
Conclusion: Cytologic triage combined with HPV genotyping testing can be utilized firstly as an approach to identify cellular abnormalities in HPV-infected individuals and subsequently as an appropriate method to reduce referrals for colposcopy.
Methods: This cross-sectional study included women who tested positive for HPV and visited the Gynecologic Oncology Clinic at Tehran University of Medical Sciences from October 2022 to March 2025. Individuals with a positive high-risk HPV result were referred for colposcopy and biopsy. The immediate absolute risk of CIN2+ in HPV-positive patients with HPV16, HPV18, or concurrent HPV16/18 genotypes (Multi. HPV+) was evaluated across different cytologic grades, ranging from NILM (Negative for Intraepithelial Lesion or Malignancy) to SCC (Squamous Cell Carcinoma).
Results: A total of 727 patients participated in the study. The mean age and standard deviation of the participants were 35.99 and 8.48 years, respectively. Among all referrals, the number of women who were positive only for HPV 16 was 170 (23%), and 24 (3.3%) were positive only for HPV 18. The highest number of positive cases for HPV16 and HPV18 were in the age range of 30 to 39 years (45%). In the Multi. HPV+ group, the highest number was observed in individuals under 29 years old (50%). The calculated immediate absolute risk of CIN2+ in HPV16+ individuals was 14% for NILM and 8.6% for ASCUS, while in HPV18+ individuals, it was 8.3% for NILM.
Conclusion: Cytologic triage combined with HPV genotyping testing can be utilized firstly as an approach to identify cellular abnormalities in HPV-infected individuals and subsequently as an appropriate method to reduce referrals for colposcopy.
Mobina Zamanifard, Hamid Reza Norouzi, Fazilat Jokar Darzi , Malihe Safari,
Volume 83, Issue 5 (8-2025)
Volume 83, Issue 5 (8-2025)
Abstract
Background: Helicobacter pylori (H. pylori) is a human gastrointestinal pathogen that infects more than half of the world's population and leads to chronic gastritis and its role in the development of gastric ulcers, gastric cancer and gastric lymphomas is considered. However, eradication of this bacterium with triple therapy fails in more than 30% of cases. Therefore, efforts to find new treatment methods are increasing. As a result, this study was conducted to evaluate the effectiveness and tolerability of several drug regimens compared to the standard regimen.
Methods: This study is a randomized clinical trial in which patients with Helicobacter pylori infection were randomly selected in the endoscopy department of Amiralmomenin Hospital and the Gastroenterology Clinic of Professor Ghavamzadeh Clinic, Arak from October 2024 to March 2025 and were divided into three groups, including a control group and two intervention groups, with three different drug regimens. Four weeks after treatment, the rate of bacterial eradication in all three evaluation groups was assessed using fecal antigen testing and the treatment results were compared using appropriate statistical analyses.
Results: The frequency of negative test results in intervention group 2 was higher than in control and intervention group 1. (P<0.001) and the rate of Helicobacter pylori eradication was in intervention group 2 (94%), in control group (54%), and in intervention group 1 (20%). The chance of H.P eradication in intervention group 1 decreased by 84% compared to the control group and increased by 10.77 times in intervention group 2 compared to the control group. Also, a significant proportion of H.P eradication success was observed in people without diabetes (p-value = 0.022, Phi = -0.188, n = 150) and the rate of drug side effects was higher in intervention group 2 compared to the other two groups.
Conclusion: This study showed that compared to the standard regimen, a 2-week regimen of amoxicillin, omeprazole, and clarithromycin plus bismuth is a good, potent, and more cost-effective regimen for eradicating Helicobacter pylori.
Methods: This study is a randomized clinical trial in which patients with Helicobacter pylori infection were randomly selected in the endoscopy department of Amiralmomenin Hospital and the Gastroenterology Clinic of Professor Ghavamzadeh Clinic, Arak from October 2024 to March 2025 and were divided into three groups, including a control group and two intervention groups, with three different drug regimens. Four weeks after treatment, the rate of bacterial eradication in all three evaluation groups was assessed using fecal antigen testing and the treatment results were compared using appropriate statistical analyses.
Results: The frequency of negative test results in intervention group 2 was higher than in control and intervention group 1. (P<0.001) and the rate of Helicobacter pylori eradication was in intervention group 2 (94%), in control group (54%), and in intervention group 1 (20%). The chance of H.P eradication in intervention group 1 decreased by 84% compared to the control group and increased by 10.77 times in intervention group 2 compared to the control group. Also, a significant proportion of H.P eradication success was observed in people without diabetes (p-value = 0.022, Phi = -0.188, n = 150) and the rate of drug side effects was higher in intervention group 2 compared to the other two groups.
Conclusion: This study showed that compared to the standard regimen, a 2-week regimen of amoxicillin, omeprazole, and clarithromycin plus bismuth is a good, potent, and more cost-effective regimen for eradicating Helicobacter pylori.
Samaneh Arab, Mohammad-Reza Mahmoudian-Sani , Najmeh Fattahi , Zakiye Ekhlasi, Samira Asgharzade,
Volume 83, Issue 5 (8-2025)
Volume 83, Issue 5 (8-2025)
Abstract
Background: Retinal photoreceptor degeneration is a major cause of blindness. Stem cell therapies offer promise, and the miR-183/96/182 cluster, particularly miR-182 and miR-183, plays a crucial role in photoreceptor development and survival. Targeting these miRNAs may enhance human bone marrow–derived mesenchymal stem cells) hBMSCs (differentiation into photoreceptor-like cells, improving their therapeutic potential.
Methods: This in vitro study was conducted from April 2019 to March 2021 at the Clinical Biochemistry Research Center, Shahrekord University of Medical Sciences. hBMSCs were cultured in DMEM with fetal bovine serum and transfected with miR-182 and miR-183 mimics using Lipofectamine, with a scramble miRNA control. Transfection efficiency and miRNA overexpression were evaluated at 24 and 48 hours using real-time PCR. miRNA expression was normalised to Snord, while mRNA levels were normalised to GAPDH using the 2−ΔΔCt method. Photoreceptor-like differentiation was assessed by measuring the expression of retina-specific transcription factors and markers (OTX2, CRX, NRL, SLC1A1, PKCα, Recoverin, and RHO). Statistical analyses included the Shapiro–Wilk test for normality and the Mann-Whitney U test for group comparisons. Data were reported as Mean ± SEM, with 95% confidence intervals, and significance set at α = 0.05.
Results: Transfection of miR-182 and miR-183 significantly increased miRNA levels at 24–48 hours (P < 0.001) compared to the scramble control. This led to a marked upregulation of retinal-related genes, including CRX, OTX2, PKCα, Recoverin, NRL, and RHO, indicating activation of the photoreceptor gene network. Time-resolved analysis revealed stronger effects at 24–48 hours, supporting a transient window for pro-differentiation. RHO and CRX exhibited the most significant increases, while OTX2 and PKCα showed parallel rises, suggesting coordinated activation of early and intermediate photoreceptor programs. Scramble controls did not show comparable changes.
Conclusion: Transient overexpression of miR-182 and miR-183 in hBMSCs activates a photoreceptor-like gene expression program, promoting differentiation toward photoreceptor-like cells. This finding supports the potential use of miR-182/183 in stem cell-based therapies for retinal degeneration. Further studies should confirm protein expression, functional outcomes, and in vivo efficacy.
Alireza Eskandarifar, Zahra Taherkhani, Soleiman Mohammadzadeh , Rama Naghshizadian, Khaled Rahmani,
Volume 83, Issue 5 (8-2025)
Volume 83, Issue 5 (8-2025)
Abstract
Background: Primary nocturnal enuresis (PNE) is a common and distressing childhood disorder characterized by involuntary urination during sleep after the age when bladder control is normally achieved. It affects not only the child’s quality of life but also family dynamics and social relationships. Previous studies have suggested a possible link between PNE and psychological or behavioral problems, yet findings have been inconsistent across populations. The present study aimed to investigate and compare the prevalence and patterns of psychiatric disorders among children with primary nocturnal enuresis and healthy controls in Sanandaj, Iran.
Methods: This case-control study was conducted in Sanandaj from October 2024 to April 2025. The study population included children referred to the Medical, Educational, and Therapeutic Center of Kurdistan University of Medical Sciences. A total of 228 participants were enrolled, comprising 108 children diagnosed with primary nocturnal enuresis and 120 age- and sex-matched healthy controls selected through convenient sampling. Psychiatric assessments were performed using the parent version of the Child Symptom Inventory-4 (CSI-4) questionnaire, which evaluates a wide range of childhood behavioral and emotional disorders based on DSM-IV criteria. Statistical analysis was performed using Stata version 18, and comparisons between groups were made using the chi-square and Fisher’s exact tests. A p-value < 0.05 was considered statistically significant.
Results: Children with primary nocturnal enuresis had significantly higher frequencies of attention deficit disorder (ADD), hyperactivity disorder (HD), attention deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), generalized anxiety disorder (GAD), and tic disorder compared with the control group (p < 0.05). In contrast, the prevalence of phobia and obsessive-compulsive disorder (OCD) was slightly higher in the control group. No statistically significant difference was found regarding post-traumatic stress disorder (PTSD) between the two groups.
Conclusion: The findings suggest that primary nocturnal enuresis may serve as an indicator of increased vulnerability to certain psychiatric disorders in childhood. Early recognition and psychological evaluation of children with enuresis are recommended to improve long-term outcomes and mental well-being.
Methods: This case-control study was conducted in Sanandaj from October 2024 to April 2025. The study population included children referred to the Medical, Educational, and Therapeutic Center of Kurdistan University of Medical Sciences. A total of 228 participants were enrolled, comprising 108 children diagnosed with primary nocturnal enuresis and 120 age- and sex-matched healthy controls selected through convenient sampling. Psychiatric assessments were performed using the parent version of the Child Symptom Inventory-4 (CSI-4) questionnaire, which evaluates a wide range of childhood behavioral and emotional disorders based on DSM-IV criteria. Statistical analysis was performed using Stata version 18, and comparisons between groups were made using the chi-square and Fisher’s exact tests. A p-value < 0.05 was considered statistically significant.
Results: Children with primary nocturnal enuresis had significantly higher frequencies of attention deficit disorder (ADD), hyperactivity disorder (HD), attention deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), generalized anxiety disorder (GAD), and tic disorder compared with the control group (p < 0.05). In contrast, the prevalence of phobia and obsessive-compulsive disorder (OCD) was slightly higher in the control group. No statistically significant difference was found regarding post-traumatic stress disorder (PTSD) between the two groups.
Conclusion: The findings suggest that primary nocturnal enuresis may serve as an indicator of increased vulnerability to certain psychiatric disorders in childhood. Early recognition and psychological evaluation of children with enuresis are recommended to improve long-term outcomes and mental well-being.
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