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Showing 1117 results for Type of Study: Original Article
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.
Hedayat Heydarizadeh, Hossein Seyedkhani, Zahra Mohebinajad, Ali Heydarizadeh,
Volume 83, Issue 5 (8-2025)
Volume 83, Issue 5 (8-2025)
Abstract
Background: Chronic abdominal pain, which is defined as long-term or intermittent abdominal pain, is a common problem in children. Helicobacter pylori infection is acquired in childhood and is one of the important causes of peptic ulcer disease (PUD) and stomach cancer, so this study was conducted with the aim of investigating the prevalence of Helicobacter pylori in children with chronic abdominal pain referred to Imam Hospital in 1402.
Methods: This study is descriptive-cross-sectional and the statistical population of children with chronic abdominal pain referred to Imam Khomeini Hospital in Ilam city in 1402 was tested for Helicobacter bacteria. Helicobacter pylori was checked using stool antigen test.
Results: This study was conducted on 140 children with chronic abdominal pain with an average age of 7.06 years in the age range of 2-16 years, the majority of children living in Ilam city were boys. The type of feeding was reported in all children as regular, and the majority of them were the result of cesarean delivery (67.9%). The prevalence of 40.7% showed HP positivity in children with chronic abdominal pain. The majority of children in the age group of 4-8 years had Helicobacter pylori positive, 20 people (35.7%) and in children older than 12 years, Helicobacter pylori had the lowest frequency. The prevalence of Helicobacter pylori was reported more in girls than in boys, and among the studied cities it was the highest. The outbreak was in the city of Ilam. There was no difference between the prevalence of Helicobacter pylori with age, sex, place of residence and type of delivery.
Conclusion: The general results of our study show that Helicobacter pylori is an important factor for chronic abdominal pain in children, but factors such as sex, place of residence and type of delivery do not affect its prevalence. It is suggested that in future studies, the family history, parents' infection with Helicobacter pylori and its relationship with transmission to the child should be measured.
Methods: This study is descriptive-cross-sectional and the statistical population of children with chronic abdominal pain referred to Imam Khomeini Hospital in Ilam city in 1402 was tested for Helicobacter bacteria. Helicobacter pylori was checked using stool antigen test.
Results: This study was conducted on 140 children with chronic abdominal pain with an average age of 7.06 years in the age range of 2-16 years, the majority of children living in Ilam city were boys. The type of feeding was reported in all children as regular, and the majority of them were the result of cesarean delivery (67.9%). The prevalence of 40.7% showed HP positivity in children with chronic abdominal pain. The majority of children in the age group of 4-8 years had Helicobacter pylori positive, 20 people (35.7%) and in children older than 12 years, Helicobacter pylori had the lowest frequency. The prevalence of Helicobacter pylori was reported more in girls than in boys, and among the studied cities it was the highest. The outbreak was in the city of Ilam. There was no difference between the prevalence of Helicobacter pylori with age, sex, place of residence and type of delivery.
Conclusion: The general results of our study show that Helicobacter pylori is an important factor for chronic abdominal pain in children, but factors such as sex, place of residence and type of delivery do not affect its prevalence. It is suggested that in future studies, the family history, parents' infection with Helicobacter pylori and its relationship with transmission to the child should be measured.
Majid Vatankhah Tarbebar , Saeid Kashani, Milad Mohammadi , Zohreh Nik Eghbali, Mehrdad Malekshoar,
Volume 83, Issue 6 (9-2025)
Volume 83, Issue 6 (9-2025)
Abstract
Background: Laparoscopic cholecystectomy is the gold standard for treating gallbladder diseases; however, it is associated with physiological challenges from pneumoperitoneum and specific patient positioning. Positive end-expiratory pressure (PEEP) may mitigate these effects, but the optimal level remains uncertain. This study compared the impact of three PEEP levels on respiratory performance and hemodynamic stability during laparoscopic cholecystectomy.
Methods: This randomized double-blind clinical trial was conducted at Shahid Mohammadi Hospital, Bandar Abbas, Iran, from August 2023 to February 2024. A total of 75 adult patients aged 18-70 years with ASA class I-II scheduled for elective laparoscopic cholecystectomy were assigned to three groups (n=25 each): PEEP 0 cmH₂O (control), PEEP 5 cmH₂O, and PEEP 7 cmH₂O. Standardized general anesthesia and mechanical ventilation with tidal volumes of 6-8 mL/kg were applied. Hemodynamic variables (mean arterial pressure, heart rate) and respiratory parameters (SpO₂, EtCO₂) were recorded before intubation, during intubation, and at 15, 30, and 60 minutes post-intubation, as well as in the recovery room. Arterial blood gas analysis was performed 30 minutes after intubation. Data were analyzed using ANOVA and chi-square tests with a significance level of 0.05.
Results: The mean age of patients was 41.89±11.39 years, and baseline demographic variables showed no significant differences among groups. Oxygen saturation remained above 94% across all time points without intergroup differences. EtCO₂ values differed significantly at 30 minutes (P=0.04) and 60 minutes (P=0.01), with the highest levels observed in the PEEP 7 group and the lowest in the PEEP 5 group. Although mean arterial pressure and heart rate did not show statistically significant variation among groups, the PEEP 7 group demonstrated the smallest postoperative decline in blood pressure.
Conclusion: A PEEP level of 5 cmH₂O offers the most favorable balance between maintaining oxygenation, supporting effective ventilation, and preserving hemodynamic stability during laparoscopic cholecystectomy. This level can be recommended as a safe and optimal ventilation strategy.
Behzad Nazemroaya, Azim Honarmand, Mitra Timori ,
Volume 83, Issue 6 (9-2025)
Volume 83, Issue 6 (9-2025)
Abstract
Background: The Southern endotracheal tube facilitates surgical access and reduces the risk of tube torsion. Fiberoptic laryngoscopy also improves the accuracy and safety of intubation. Accordingly, the present study aimed to determine the precise placement of the Southern endotracheal tube using fiberoptic laryngoscopy in elective surgeries under general anesthesia.
Methods: This descriptive-analytical prospective study was conducted between April 2025 and July 2025 at Al-Zahra and Ayatollah Kashani Centers of Isfahan University of Medical Sciences. Sampling was performed using a convenience method, and the sample size was estimated at 100 patients (candidates for elective head, face, and nasal surgeries), considering possible dropouts. Data were collected using a checklist and analyzed with SPSS version 27.
Results: In this study, the demographic and clinical characteristics of the patients showed that the mean age was 38.88±15.92 years, and 53% were male, and 47% were female. The results indicated that body mass index, neck circumference, and the distance from the tip of the endotracheal tube to the anterior teeth differed significantly between male and female patients (P<0.05). Specifically, Body Mass Index (BMI) was significantly higher in females, neck circumference was significantly greater in males, and the distance from the tube tip to the anterior teeth was longer in males. Additionally, BMI, the distance from the carina to the anterior teeth, and the distance from the endotracheal tube to the carina showed significant differences among different age groups (P<0.05).
Conclusion: The present study demonstrated that the depth and placement of the endotracheal tube are influenced by factors such as BMI. These findings are consistent with previous studies emphasizing the importance of individual assessment to optimize airway management. Overall, fiberoptic-guided intubation should be considered the gold standard for achieving accurate tube positioning, minimizing the risk of airway complications, and improving intraoperative safety. It is suggested that future studies focus on developing predictive models for optimal tube depth based on demographic and anatomical variables, and on evaluating the impact of these strategies on postoperative outcomes.
Methods: This descriptive-analytical prospective study was conducted between April 2025 and July 2025 at Al-Zahra and Ayatollah Kashani Centers of Isfahan University of Medical Sciences. Sampling was performed using a convenience method, and the sample size was estimated at 100 patients (candidates for elective head, face, and nasal surgeries), considering possible dropouts. Data were collected using a checklist and analyzed with SPSS version 27.
Results: In this study, the demographic and clinical characteristics of the patients showed that the mean age was 38.88±15.92 years, and 53% were male, and 47% were female. The results indicated that body mass index, neck circumference, and the distance from the tip of the endotracheal tube to the anterior teeth differed significantly between male and female patients (P<0.05). Specifically, Body Mass Index (BMI) was significantly higher in females, neck circumference was significantly greater in males, and the distance from the tube tip to the anterior teeth was longer in males. Additionally, BMI, the distance from the carina to the anterior teeth, and the distance from the endotracheal tube to the carina showed significant differences among different age groups (P<0.05).
Conclusion: The present study demonstrated that the depth and placement of the endotracheal tube are influenced by factors such as BMI. These findings are consistent with previous studies emphasizing the importance of individual assessment to optimize airway management. Overall, fiberoptic-guided intubation should be considered the gold standard for achieving accurate tube positioning, minimizing the risk of airway complications, and improving intraoperative safety. It is suggested that future studies focus on developing predictive models for optimal tube depth based on demographic and anatomical variables, and on evaluating the impact of these strategies on postoperative outcomes.
Maryam Hajhashemi , Hedieh Bonakdarchian, Tahereh Khalili Borujeni , Minoo Movahedi , Roya Sahebi, Fedyeh Haghollahi,
Volume 83, Issue 6 (9-2025)
Volume 83, Issue 6 (9-2025)
Abstract
Background: Pelvic organ prolapse (POP) is a condition resulting from weakness or damage to the muscles, ligaments, and other supporting structures of the vagina, and it exposes affected women to reduced quality of life and sexual function. The present study examined the symptoms, sexual function, and quality of life of women one year after repair of pelvic organ prolapse.
Methods: This study was a prospective cohort before-after study that was conducted on 200 married women with pelvic prolapse grade 1-4 (POP-Q) in the age group of 47-75 years who underwent reconstructive surgery (anterior and posterior colporrhaphy) in Shahid Beheshti and Al-Zahra hospitals in Isfahan between October 2022 and March 2024. The data collection tools were three questionnaires: Female Sexual Function Index (FSFI), Pelvic Discomfort (PFDI-20) and Quality of Life (SF-36) which were completed before surgery and one year after surgery. Stata software version 17 was used to analyze the data. To compare the scores before and after, paired t-test or Wilcoxon statistical tests were used, to compare the severity of patients' clinical symptoms based on the levels before and after surgery, the symmetry/Bowker test was used, and to compare the status of the sexual function index (impairment/no impairment) before and after surgery, the McNemar test was used and the significance level was considered to be P<0.05.
Results: The mean age of the study participants was 59.5±12.6 years. The majority of the women (157 individuals; 78.5%) were housewives. The mean number of pregnancies was 4.3±2.1, and the mean number of live births was 3.75±1.89. All women included in the study were postmenopausal. The severity of clinical symptoms, sexual dysfunction index status, and median quality of life score were significant between before and after the intervention. The severity of clinical symptoms, the status of the sexual dysfunction index, and the median quality of life score showed significant differences before and after the intervention.
Conclusion: Pelvic prolapse surgery can significantly improve the quality of life and sexual function of patients one year after surgery, in addition to correcting the anatomical structure.
The comparison of blood loss in cesarean section undergoing
general anesthesia and spinal anesthesia
Mohammad Sadegh Sanie Jahromi , Reza Ashrafzadeh, Ahmad Rastgarian, Navid Kalani , Mohammad Hasan Damshenas,
Volume 83, Issue 6 (9-2025)
Volume 83, Issue 6 (9-2025)
Abstract
Background: In general anesthesia, anesthetic agents are administered by inhalation or intravenously, leading to loss of consciousness, immobility, analgesia, and amnesia. In spinal anesthesia, injection of a local anesthetic into the intrathecal space causes sensory and motor block. The aim of this study was to compare the volume of bleeding during cesarean section under general anesthesia and spinal anesthesia.
Methods: This study is a cross-sectional prospective study. The gauzes used were weighed before the operation and bloody gauzes were weighed after the operation. The difference between the weight of bloody and dry gauzes was recorded as the volume of bleeding. This volume was then added to the volume of blood in the suction chamber and the final bleeding volume was estimated.
Results: 70 patients who were candidates for cesarean section were included in the study. The mean age of the patients included in the study was 24.82±4.98 and their mean weight was 77.11±8.97. The mean hemoglobin in the spinal anesthesia group was 91.12±39. Volume of bleeding during cesarean section by spinal anesthesia was significantly less than general anesthesia (P=0.001). Also, the visual estimation of bleeding in spinal anesthesia was significantly lower than general anesthesia (P<0.001). In this study, there was no significant difference between heart rate, systolic and diastolic pressure before and during surgery, and the first- and fifth-minute Apgar scores between the two groups of general and spinal anesthesia.
Conclusion: We found in this study that the volume of bleeding during cesarean section under spinal anesthesia is less than general anesthesia. It is suggested that in future studies, other methods of estimating bleeding such as postoperative hemoglobin reduction, dilution method, atomic absorption spectroscopy and photometry be used. Also, a comparison should be made between the three groups of general, spinal and epidural anesthesia, and the volume of bleeding in each should be checked and the best anesthesia method should be selected for cesarean section.
Methods: This study is a cross-sectional prospective study. The gauzes used were weighed before the operation and bloody gauzes were weighed after the operation. The difference between the weight of bloody and dry gauzes was recorded as the volume of bleeding. This volume was then added to the volume of blood in the suction chamber and the final bleeding volume was estimated.
Results: 70 patients who were candidates for cesarean section were included in the study. The mean age of the patients included in the study was 24.82±4.98 and their mean weight was 77.11±8.97. The mean hemoglobin in the spinal anesthesia group was 91.12±39. Volume of bleeding during cesarean section by spinal anesthesia was significantly less than general anesthesia (P=0.001). Also, the visual estimation of bleeding in spinal anesthesia was significantly lower than general anesthesia (P<0.001). In this study, there was no significant difference between heart rate, systolic and diastolic pressure before and during surgery, and the first- and fifth-minute Apgar scores between the two groups of general and spinal anesthesia.
Conclusion: We found in this study that the volume of bleeding during cesarean section under spinal anesthesia is less than general anesthesia. It is suggested that in future studies, other methods of estimating bleeding such as postoperative hemoglobin reduction, dilution method, atomic absorption spectroscopy and photometry be used. Also, a comparison should be made between the three groups of general, spinal and epidural anesthesia, and the volume of bleeding in each should be checked and the best anesthesia method should be selected for cesarean section.
Kosar Hajati, Behnaz Deihim ,
Volume 83, Issue 6 (9-2025)
Volume 83, Issue 6 (9-2025)
Abstract
Background: Leishmaniasis is one of the most significant parasitic diseases and is susceptible to secondary bacterial infections, which can result in increased inflammation, delayed tissue repair, and increased drug resistance. Given the importance of this phenomenon, the present study was designed to identify bacterial agents and determine their antibiotic resistance patterns in lesions of patients with cutaneous leishmaniasis.
Methods: The present cross-sectional study was conducted in Dezful, Iran, from May 2022 to December 2022 among 173 patients with suspected cutaneous leishmaniasis. In addition to sampling skin lesions for the diagnosis of leishmaniasis, wound exudates were collected using sterile swabs and cultured on blood agar and MacConkey agar plates. Bacteria were identified by Gram staining and biochemical tests. Antibiotic susceptibility patterns were determined by disk diffusion, according to the CLSI 2024 guidelines. SPSS version 20 software was used for data analysis. In Staphylococcus aureus isolates, methicillin resistance was determined using a cefoxitin disk (30 μg), and vancomycin resistance was determined by broth microdilution. In vancomycin-resistant Enterococcus isolates, a vancomycin disk (30 μg) was used. In Enterobacteriaceae, the extended-spectrum beta-lactamase (ESBL) phenotype was performed using ceftazidime (30 μg) and the ceftazidime/clavulanic acid combination disk (30/10 μg).
Results: Cutaneous leishmaniasis was detected in 65.3% of cases, of which 46 cases (26.6%) had secondary bacterial infection. Staphylococcus aureus (67.4%) and Klebsiella pneumoniae (13%) were the most common isolates. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 13 cases, accounting for 41.9% of the isolates. The frequency of Multidrug-resistant (MDR) Staphylococcus aureus among leishmaniasis patients was 38.7%, but all isolates were susceptible to vancomycin and teicoplanin. Two ESBL-producing Escherichia coli were isolated from leishmaniasis foot ulcers. Leg and back wounds were more frequently involved in bacterial infection (P<0.05).
Conclusion: Inappropriate environmental conditions and lack of treatment facilities play an important role in the occurrence and exacerbation of infectious leishmaniasis lesions. An integrated treatment approach and medical staff training can improve disease control and wound healing.
Methods: The present cross-sectional study was conducted in Dezful, Iran, from May 2022 to December 2022 among 173 patients with suspected cutaneous leishmaniasis. In addition to sampling skin lesions for the diagnosis of leishmaniasis, wound exudates were collected using sterile swabs and cultured on blood agar and MacConkey agar plates. Bacteria were identified by Gram staining and biochemical tests. Antibiotic susceptibility patterns were determined by disk diffusion, according to the CLSI 2024 guidelines. SPSS version 20 software was used for data analysis. In Staphylococcus aureus isolates, methicillin resistance was determined using a cefoxitin disk (30 μg), and vancomycin resistance was determined by broth microdilution. In vancomycin-resistant Enterococcus isolates, a vancomycin disk (30 μg) was used. In Enterobacteriaceae, the extended-spectrum beta-lactamase (ESBL) phenotype was performed using ceftazidime (30 μg) and the ceftazidime/clavulanic acid combination disk (30/10 μg).
Results: Cutaneous leishmaniasis was detected in 65.3% of cases, of which 46 cases (26.6%) had secondary bacterial infection. Staphylococcus aureus (67.4%) and Klebsiella pneumoniae (13%) were the most common isolates. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 13 cases, accounting for 41.9% of the isolates. The frequency of Multidrug-resistant (MDR) Staphylococcus aureus among leishmaniasis patients was 38.7%, but all isolates were susceptible to vancomycin and teicoplanin. Two ESBL-producing Escherichia coli were isolated from leishmaniasis foot ulcers. Leg and back wounds were more frequently involved in bacterial infection (P<0.05).
Conclusion: Inappropriate environmental conditions and lack of treatment facilities play an important role in the occurrence and exacerbation of infectious leishmaniasis lesions. An integrated treatment approach and medical staff training can improve disease control and wound healing.
Aref Teymurinejad, Hossein Seidkhani , Zahra Mohebinejad, Amirreza Eidypou , Hamed Azadi ,
Volume 83, Issue 7 (10-2025)
Volume 83, Issue 7 (10-2025)
Abstract
Background: Kidney stones are the third most common urinary tract disorder after prostate disease and infection. Painful attacks are the most common clinical manifestation, which is known as renal colic. The aim of the present study is to determine the effect of pethidine, pethidine and ketorolac, and ketorolac in patients with primary renal colic.
Methods: Renal colic patients at Imam Khomeini Hospital in Ilam from April 2023 and March 2023. were divided into three groups of 36 people. The first group received pethidine 25 mg, the second group received ketorolac 30 mg, and the third group received a combination of 2 drugs. A questionnaire included demographic information of the patients, heart rate, systolic and diastolic blood pressure, respiratory rate, oxygen saturation, side effects, pain intensity, length of hospitalization, and type of treatment received.
Results: After receiving the drug, the average heart rate increased in all three groups. But in group A, this increase was less than two groups, B and C, and this difference was not statistically significant (P=0.34). The average systolic blood pressure before receiving the drug was significantly higher in the three studied groups (P=0.006), which decreased after receiving the drug, but this decrease in systolic blood pressure in the three groups was not statistically significant (P=0.98). The average pain intensity before receiving the drug was 8.56 ± 1.2 in group A, 9.17 ± 0.878 in group B, and 8.86 ± 0.961 in group C. There was no significant difference between the three groups in terms of initial pain intensity (P=0.45). While the average pain intensity after receiving the medicine was significantly reduced and there was a significant difference (P<0.000).
Conclusion: Overall, the obtained results showed that ketorolac and pethidine have a faster effect and power compared to pethidine and ketorolac alone in controlling the pain of patients with renal colic, and the need for life-saving treatment is also less in this drug, and according to numerous studies, its side effects are also less.
Hossein Majedi , Ebrahim Espahbodi, Seyedeh Fatemeh Hosseini Nejad, Mahshid Vaziri, Fatemeh Javaherforoushzadeh , Mahbubeh Rashidi, Rouzbeh Amiri Motlagh ,
Volume 83, Issue 7 (10-2025)
Volume 83, Issue 7 (10-2025)
Abstract
Background: Postoperative pain remains a major concern following abdominal surgeries, including laparoscopic cholecystectomy. Inadequate pain control may lead to increased opioid consumption, delayed recovery, prolonged hospitalization, and reduced patient satisfaction. Therefore, the use of anesthetic adjuvants with effective analgesic properties and minimal side effects has gained increasing attention. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, and dexmedetomidine, a highly selective α2-adrenergic agonist, are commonly used agents with distinct mechanisms of action. The present study aimed to compare the effects of intraoperative ketamine and dexmedetomidine on postoperative pain following laparoscopic cholecystectomy.
Methods: This randomized, double-blind, controlled clinical trial was conducted on 252 patients undergoing elective laparoscopic cholecystectomy. Patients were randomly assigned into three equal groups: ketamine, dexmedetomidine, and control. The ketamine group received an intravenous infusion of ketamine at a dose of 0.5 mg/kg/h, the dexmedetomidine group received 0.6 µg/kg/min of dexmedetomidine, and the control group received normal saline. Pain intensity was assessed using the Visual Analogue Scale (VAS) at 1, 6, 12, and 24 hours postoperatively. Hemodynamic parameters, including heart rate and mean arterial pressure, were continuously monitored throughout the perioperative period. Data were analyzed using appropriate statistical tests, including ANOVA and nonparametric analyses.
Results: The results demonstrated that postoperative pain scores were significantly lower in the ketamine group compared to both the dexmedetomidine and control groups at all evaluated time points within the first 24 hours after surgery (P < 0.001). Although dexmedetomidine also provided effective analgesia compared with the control group, ketamine showed superior pain reduction. No statistically significant differences were observed among the three groups regarding hemodynamic parameters, indicating comparable cardiovascular stability.
.Conclusion: Intraoperative administration of ketamine was more effective than dexmedetomidine in reducing postoperative pain following laparoscopic cholecystectomy, without compromising hemodynamic stability. Nevertheless, both agents proved to be safe and effective options for postoperative pain management. Ketamine may be considered a preferable.
Methods: This randomized, double-blind, controlled clinical trial was conducted on 252 patients undergoing elective laparoscopic cholecystectomy. Patients were randomly assigned into three equal groups: ketamine, dexmedetomidine, and control. The ketamine group received an intravenous infusion of ketamine at a dose of 0.5 mg/kg/h, the dexmedetomidine group received 0.6 µg/kg/min of dexmedetomidine, and the control group received normal saline. Pain intensity was assessed using the Visual Analogue Scale (VAS) at 1, 6, 12, and 24 hours postoperatively. Hemodynamic parameters, including heart rate and mean arterial pressure, were continuously monitored throughout the perioperative period. Data were analyzed using appropriate statistical tests, including ANOVA and nonparametric analyses.
Results: The results demonstrated that postoperative pain scores were significantly lower in the ketamine group compared to both the dexmedetomidine and control groups at all evaluated time points within the first 24 hours after surgery (P < 0.001). Although dexmedetomidine also provided effective analgesia compared with the control group, ketamine showed superior pain reduction. No statistically significant differences were observed among the three groups regarding hemodynamic parameters, indicating comparable cardiovascular stability.
.Conclusion: Intraoperative administration of ketamine was more effective than dexmedetomidine in reducing postoperative pain following laparoscopic cholecystectomy, without compromising hemodynamic stability. Nevertheless, both agents proved to be safe and effective options for postoperative pain management. Ketamine may be considered a preferable.
Elham Shafighi Shahri , Akram Ehsasatvatan, Sara Rigy Nejad ,
Volume 83, Issue 7 (10-2025)
Volume 83, Issue 7 (10-2025)
Abstract
Background: Phenylketonuria (PKU) is a genetic metabolic disorder that, if left untreated, leads to irreversible cognitive, behavioral, and neurological damage. Sistan and Baluchestan and West Azerbaijan provinces are among the regions that have reported high rates of the disease due to specific ethnic characteristics. This study aims to compare the frequency and pattern of clinical symptoms in the two provinces of Sistan and Baluchestan and West Azerbaijan. Methods: This cross-sectional descriptive-analytical study was conducted on 60 patients with PKU who had been referred to Imam Ali Hospital (Zahedan) and Urmia Hospital during the past ten years. Data were collected from medical records and structured interviews. Results: The mean age of the patients was 5.67 ± 6.98 years. The mean height, weight, and head circumference were 30.28 ± 113.08 cm, 13.22 ± 25.13 kg, and 1.83 ± 43.36 cm, respectively. The mean serum phenylalanine level at the time of diagnosis was 13.58 ± 14.65 mg/dL. Of the 60 patients, 31 (51.7%) were male and 29 (48.3%) were female. The difference between the two sexes in the occurrence of clinical symptoms was not statistically significant (p<0.05). Psychiatric disorders were reported in 20 (33.3%) of the patients. The prevalence of these disorders was significantly higher with increasing age (p = 0.041). Conclusion: This study indicates the existence of significant regional differences in the clinical manifestations of phenylketonuria; such that patients from Sistan and Baluchestan province experienced a higher rate of psychiatric and neurological symptoms than patients from West Azerbaijan. The severity of symptoms increased with increasing age and duration of illness, emphasizing the importance of early diagnosis and continuous therapeutic follow-up. It was also noteworthy that some patients still had severe clinical symptoms despite having lower phenylalanine levels at diagnosis. Overall, the findings of this study emphasize the need for early diagnosis, equitable access to health services, and sustained metabolic control to improve outcomes for PKU patients in the country. |
Mohammad Mehdi Khatib Shahidi, Ali Sadoogh Abbasian , Maliheh Safari ,
Volume 83, Issue 7 (10-2025)
Volume 83, Issue 7 (10-2025)
Abstract
Background: Cisplatin is one of the most effective chemotherapy agents; however, its nephrotoxicity remains the primary dose-limiting factor. This study aimed to determine the prevalence and clinical course of acute kidney injury (AKI) in patients receiving high-dose cisplatin therapy.
Methods: This cross-sectional descriptive study was conducted at Ayatollah Khansari Hospital in Arak, based on clinical records of hospitalized patients from March 2021 to June 2022. Patients who received at least four cycles of cisplatin-based chemotherapy at a dose of 260 mg/m² were included. Data were extracted from the Hospital Information System (HIS) and physical records. Ninety eligible cases were selected via random sampling. Data were summarized using descriptive statistics.
Results: Regarding gender distribution, 54.4% were female (n=49) and 45.6% were male (n=41). The relative frequency of cisplatin-induced AKI was 21.11%. Overall, 26.32% of patients developed chronic kidney disease (CKD), 10.53% reached end-stage renal disease (ESRD), and only 11.42% recovered. An 18 to 24-month follow-up revealed a mortality rate of 21.05%, while 15.79% required treatment modification, and 5.26% needed kidney transplantation. No treatment discontinuation was observed. Logistic regression analysis identified female gender, age 61-70, age >70, poor hydration status, five or more chemotherapy cycles, and diabetes mellitus as significant risk factors for AKI.
Conclusion: High-dose cisplatin is associated with a high risk of permanent renal damage. Given the low recovery rate and the potential for progression to chronic renal failure, careful monitoring of risk factors and rigorous hydration management are vital for these patients.
Methods: This cross-sectional descriptive study was conducted at Ayatollah Khansari Hospital in Arak, based on clinical records of hospitalized patients from March 2021 to June 2022. Patients who received at least four cycles of cisplatin-based chemotherapy at a dose of 260 mg/m² were included. Data were extracted from the Hospital Information System (HIS) and physical records. Ninety eligible cases were selected via random sampling. Data were summarized using descriptive statistics.
Results: Regarding gender distribution, 54.4% were female (n=49) and 45.6% were male (n=41). The relative frequency of cisplatin-induced AKI was 21.11%. Overall, 26.32% of patients developed chronic kidney disease (CKD), 10.53% reached end-stage renal disease (ESRD), and only 11.42% recovered. An 18 to 24-month follow-up revealed a mortality rate of 21.05%, while 15.79% required treatment modification, and 5.26% needed kidney transplantation. No treatment discontinuation was observed. Logistic regression analysis identified female gender, age 61-70, age >70, poor hydration status, five or more chemotherapy cycles, and diabetes mellitus as significant risk factors for AKI.
Conclusion: High-dose cisplatin is associated with a high risk of permanent renal damage. Given the low recovery rate and the potential for progression to chronic renal failure, careful monitoring of risk factors and rigorous hydration management are vital for these patients.
Moghgan Samet Zadeh , Sahar Nikouzad Shahraki , Mohammad Ghasem Hanafi ,
Volume 83, Issue 7 (10-2025)
Volume 83, Issue 7 (10-2025)
Abstract
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Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases worldwide and is closely associated with metabolic syndrome and insulin resistance. Growing evidence suggests a link between NAFLD and cardiovascular diseases, independent of traditional risk factors. Coronary computed tomography angiography (CCTA) is a reliable noninvasive method for evaluating coronary artery disease (CAD) and identifying high-risk coronary plaque characteristics. However, data regarding the association between NAFLD and high-risk coronary plaques remain limited, particularly in Iran. This study aimed to evaluate the prevalence of NAFLD in patients with high-risk coronary plaques detected by CCTA. Methods: In this cross-sectional study, 200 patients who underwent CCTA for the evaluation of coronary plaques in outpatient clinics or the emergency department of Golestan Hospital in ahvaz ,1403 ,were enrolled. Demographic data, including age, sex, weight, and body mass index (BMI), along with clinical characteristics and cardiovascular risk factors such as hypertension, diabetes mellitus, dyslipidemia, smoking status, and medical history were collected. Patients with a history of alcohol consumption or known liver disease were excluded. NAFLD was assessed based on imaging findings. Statistical analyses were performed to compare variables between patients with and without NAFLD. Results: The mean age of patients with NAFLD was 57.89 ± 9.72 years, compared with 55.77 ± 8.97 years in patients without NAFLD, with no statistically significant difference. The prevalence of NAFLD was slightly higher in women than men; however, this difference was not significant. Patients with NAFLD had a significantly higher mean weight than those without NAFLD (85.21 ± 12.12 kg vs. 79.62 ± 11.85 kg; p = 0.001). Additionally, the prevalence of NAFLD increased significantly with higher BMI categories, particularly in obese individuals. Conclusion: Age and gender were not significantly associated with NAFLD prevalence in patients with high-risk coronary plaques. In contrast, increased body weight and higher BMI, especially obesity, were independently associated with a higher risk of NAFLD in this population. |
Sara Memarian, Narges Mostajabi, Behdad Gharib, Parastoo Rostami , Mohammad Taghi Majnoon , Farzaneh Abbasi, Reihaneh Mohsenipour,
Volume 83, Issue 7 (10-2025)
Volume 83, Issue 7 (10-2025)
Abstract
Background: Type 1 diabetes mellitus, with its increasing prevalence in the pediatric population, has a significant impact on the mental health, quality of life, and lifestyle of patients.. The onset of the disease in childhood and its association with the child during school and adolescence, and during the growth and development process, has numerous effects on the growth process and mental experiences of patients.
Methods: This cross-sectional study was conducted in Children, s Medical Center from march 2022 to February 2023 on 183 patients with type 1 diabetes aged 9 to 18 years. The duration of the disease ranged from 1 year to 15 years. 44% of the populations were girls and 56% were boys. 77% were under 13 years of age and the rest were over 13 years of age. Information was completed by parents in the Achenbach electronic questionnaire (112 questions). Then, based on the standard defined for the questionnaire, the scores were classified into clinical, borderline, and normal categories.
Results: No significant differences were observed between the two sexes in terms of the incidence of various disorders. However, significant differences in the incidence of externalizing problems have been reported at different ages and different disease durations. Analysis of the mean T-scores of the studied patients showed that there were significant differences between patients older than 13 years younger than 13 years in terms of externalizing problems, anxiety/depressive disorders, attention deficit/hyperactivity disorders, law-breaking behavior, internalizing problems, and general problems. a significant relationship was observed between the study population and the duration of the illness in terms of aggressive problems, law-breaking problems, and externalizing disorders.
Average scores in externalizing disorders, affective/depressive disorders, law-breaking behavior, internalizing problems, and general problems were significantly related to different ages.
Conclusion: The results of this study show that as patients aging and more than 5 years since the onset of diabetes, the risk of developing psychiatric disorders increases. As a result, routine psychiatric screening is recommended for these children.
Methods: This cross-sectional study was conducted in Children, s Medical Center from march 2022 to February 2023 on 183 patients with type 1 diabetes aged 9 to 18 years. The duration of the disease ranged from 1 year to 15 years. 44% of the populations were girls and 56% were boys. 77% were under 13 years of age and the rest were over 13 years of age. Information was completed by parents in the Achenbach electronic questionnaire (112 questions). Then, based on the standard defined for the questionnaire, the scores were classified into clinical, borderline, and normal categories.
Results: No significant differences were observed between the two sexes in terms of the incidence of various disorders. However, significant differences in the incidence of externalizing problems have been reported at different ages and different disease durations. Analysis of the mean T-scores of the studied patients showed that there were significant differences between patients older than 13 years younger than 13 years in terms of externalizing problems, anxiety/depressive disorders, attention deficit/hyperactivity disorders, law-breaking behavior, internalizing problems, and general problems. a significant relationship was observed between the study population and the duration of the illness in terms of aggressive problems, law-breaking problems, and externalizing disorders.
Average scores in externalizing disorders, affective/depressive disorders, law-breaking behavior, internalizing problems, and general problems were significantly related to different ages.
Conclusion: The results of this study show that as patients aging and more than 5 years since the onset of diabetes, the risk of developing psychiatric disorders increases. As a result, routine psychiatric screening is recommended for these children.
Somayeh Abbaspour , Hassan Karimi, Maryam Farzaneh , Zahra Karimi , Shirin Azizidoost ,
Volume 83, Issue 7 (10-2025)
Volume 83, Issue 7 (10-2025)
Abstract
Background: The duration of hospitalization of patients is considered an important indicator in health resource management and patient evaluation. This study investigated the frequency and causes of readmission in cardiovascular patients
Methods: This was a retrospective study of 105 patients with cardiovascular diseases referred to Imam Khomeini Hospital in Ahvaz who were readmitted from April 2024 until August 2024 within 30 days after discharge due to recurrence of symptoms. Demographic (including age and gender) and clinical information (including duration of hospitalization, regular medication use, regular physician visits, disease diagnosis and dietary adherence) of the patients was extracted from electronic records using a researcher-made checklist.
Results: From 105 patients, 43 (41%) were admitted in the first trimester and 62 (59%) in the second trimester. The mean age of patients in the first trimester was higher than in the second trimester with a statistically significant association with readmission (P=0.038). Most patients were male and their number was higher in the second trimester than in the first trimester and a statistically significant association was observed between the gender of patients with readmission in the first trimester compared to the second trimester (P=0.015). 72 patients with acute coronary syndrome (68.6%) and 33 patients with heart failure (31.4%) were readmitted. The mean length of stay in the first trimester was 1.6 ± 1.15 days and 2.9 ± 2.7 days in the second trimester. A significant association was observed between the duration of hospitalization and readmission (P=0.003). However, no association was observed between regular medication use and regular physician visits in readmitted patients. However, a significant association was observed between dietary adherence in readmitted patients (P=0.045).
Conclusion: Readmission of cardiovascular patients follows a seasonal pattern and is associated with factors such as age, sex, length of stay, and dietary adherence. Routine disease management measures are not sufficient to counteract these effects, and targeted educational programs are necessary at the threshold of high-risk periods.
Methods: This was a retrospective study of 105 patients with cardiovascular diseases referred to Imam Khomeini Hospital in Ahvaz who were readmitted from April 2024 until August 2024 within 30 days after discharge due to recurrence of symptoms. Demographic (including age and gender) and clinical information (including duration of hospitalization, regular medication use, regular physician visits, disease diagnosis and dietary adherence) of the patients was extracted from electronic records using a researcher-made checklist.
Results: From 105 patients, 43 (41%) were admitted in the first trimester and 62 (59%) in the second trimester. The mean age of patients in the first trimester was higher than in the second trimester with a statistically significant association with readmission (P=0.038). Most patients were male and their number was higher in the second trimester than in the first trimester and a statistically significant association was observed between the gender of patients with readmission in the first trimester compared to the second trimester (P=0.015). 72 patients with acute coronary syndrome (68.6%) and 33 patients with heart failure (31.4%) were readmitted. The mean length of stay in the first trimester was 1.6 ± 1.15 days and 2.9 ± 2.7 days in the second trimester. A significant association was observed between the duration of hospitalization and readmission (P=0.003). However, no association was observed between regular medication use and regular physician visits in readmitted patients. However, a significant association was observed between dietary adherence in readmitted patients (P=0.045).
Conclusion: Readmission of cardiovascular patients follows a seasonal pattern and is associated with factors such as age, sex, length of stay, and dietary adherence. Routine disease management measures are not sufficient to counteract these effects, and targeted educational programs are necessary at the threshold of high-risk periods.
Babak Choobi Anzali , Leila Tighi, Hamidreza Mehryar ,
Volume 83, Issue 8 (11-2025)
Volume 83, Issue 8 (11-2025)
Abstract
Background: Subarachnoid hemorrhage is a life-threatening neurological emergency that requires rapid diagnosis to reduce morbidity and mortality. Acute headache is the most common presenting symptom of Subarachnoid hemorrhage; however, it overlaps with many benign conditions, making early differentiation difficult in emergency departments. Although brain computed tomography is the diagnostic gold standard, readily available laboratory markers may assist clinicians in early risk stratification. Complete blood count (CBC) derived inflammatory indices are inexpensive, rapidly obtainable, and routinely measured in emergency settings. This study aimed to evaluate the diagnostic value of CBC derived indices in distinguishing Subarachnoid hemorrhage from other causes of acute headache.
Methods: This study is a retrospective study conducted on patients who presented with acute headache to the emergency department of the educational and therapeutic hospital affiliated with Urmia University of Medical Sciences. Medical records of patients presenting with acute headache between January 2018 and December 2022 were reviewed. A total of 1,025 patients were included. Demographic data and initial laboratory parameters, including white blood cell count (WBC), neutrophil percentage, lymphocyte percentage, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR), were collected. Patients were classified into Subarachnoid Hemorrhage and non-Subarachnoid Hemorrhage groups based on brain CT scan findings and complementary diagnostic evaluations when required. Comparative analyses were performed, and the diagnostic performance of CBC derived indices was assessed using Receiver operating characteristic (ROC) curve analysis.
Results: Among the study population, 22 patients (2.1%) were diagnosed with Subarachnoid Hemorrhage. Patients with Subarachnoid Hemorrhage demonstrated significantly higher mean WBC counts and neutrophil percentages, along with significantly lower lymphocyte percentages, compared with non-Subarachnoid Hemorrhage patients (P<0.001). The mean NLR was higher in the Subarachnoid Hemorrhage group (7.23±4.92) than in the non-Subarachnoid Hemorrhage group (3.67±3.51, P<0.001). ROC curve analysis showed that NLR and neutrophil percentage had the highest diagnostic accuracy, each yielding an Area under the curve (AUC) of 0.76, indicating moderate discriminative ability.
Conclusion: CBC derived inflammatory indices, particularly NLR and neutrophil percentage, may serve as useful adjunctive screening tools for early identification of SAH in patients presenting with acute headache. However, these parameters should complement, rather than replace, definitive neuroimaging methods.
Methods: This study is a retrospective study conducted on patients who presented with acute headache to the emergency department of the educational and therapeutic hospital affiliated with Urmia University of Medical Sciences. Medical records of patients presenting with acute headache between January 2018 and December 2022 were reviewed. A total of 1,025 patients were included. Demographic data and initial laboratory parameters, including white blood cell count (WBC), neutrophil percentage, lymphocyte percentage, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR), were collected. Patients were classified into Subarachnoid Hemorrhage and non-Subarachnoid Hemorrhage groups based on brain CT scan findings and complementary diagnostic evaluations when required. Comparative analyses were performed, and the diagnostic performance of CBC derived indices was assessed using Receiver operating characteristic (ROC) curve analysis.
Results: Among the study population, 22 patients (2.1%) were diagnosed with Subarachnoid Hemorrhage. Patients with Subarachnoid Hemorrhage demonstrated significantly higher mean WBC counts and neutrophil percentages, along with significantly lower lymphocyte percentages, compared with non-Subarachnoid Hemorrhage patients (P<0.001). The mean NLR was higher in the Subarachnoid Hemorrhage group (7.23±4.92) than in the non-Subarachnoid Hemorrhage group (3.67±3.51, P<0.001). ROC curve analysis showed that NLR and neutrophil percentage had the highest diagnostic accuracy, each yielding an Area under the curve (AUC) of 0.76, indicating moderate discriminative ability.
Conclusion: CBC derived inflammatory indices, particularly NLR and neutrophil percentage, may serve as useful adjunctive screening tools for early identification of SAH in patients presenting with acute headache. However, these parameters should complement, rather than replace, definitive neuroimaging methods.
Kourosh Karimi Yarandi , Majid Pourfahraji Fakhrabadi , Siavash Anbaei, Shayan Dabbagh, Mohammad Mahdi ,
Volume 83, Issue 8 (11-2025)
Volume 83, Issue 8 (11-2025)
Abstract
Background: Congenital scoliosis (CSC) and Idiopathic scoliosis (ISC) are complex spinal disorders that may involve neurological components affecting bladder function. Surgery remains the primary treatment for significant deformity, and in selected cases, correction of an associated tethered cord is also required. Given the potential interaction between spinal pathology and lower urinary tract function, this study examined changes in urodynamic findings before and after treatment in patients with CSC and ISC.
Methods: This retrospective cross-sectional study included patients with scoliosis who were presented to the Neurosurgery Clinic at Sina Hospital between September 2016 and September 2018. Preoperative and postoperative urodynamic study (UDS) results were reviewed, and statistical analyses were performed using SPSS version 24.
Results: Thirty-one patients were analyzed, consisting of 10 males (32.2%) and 21 females (67.7%), with a mean age of 14.18 years (median: 13 years). Among the 12 patients with CSC, 10 (83.3%) showed abnormal UDS prior to surgery. In contrast, 13 of 19 patients with ISC (68.4%) demonstrated normal baseline UDS. Following treatment, normalization occurred in 10 CSC patients (83.3%) and in 14 ISC patients (73.7%) (P=0.008). Before surgery, 15 of the 23 patients without a tethered cord (65.2%) had normal UDS, whereas all 8 patients with a tethered cord exhibited abnormal findings. Of the 12 patients with abnormal preoperative UDS, 3 (25%) showed no postoperative change, while 12 patients demonstrated normalization and 4 continued to show abnormal results (McNemar test, P=0.039). Improvement was also observed in 7 of the 8 patients (87.5%) with a tethered cord (P=0.57).
Conclusion: Scoliosis surgery, particularly when combined with tethered cord release, was associated with meaningful improvement in urodynamic function. Urodynamic abnormalities were more common among CSC patients before intervention, and the presence of a tethered cord contributed to greater urinary dysfunction across both scoliosis types. These findings highlight the importance of thorough preoperative urodynamic assessment to guide management and anticipate postoperative outcomes.
Aakar Sofineai , Abbas Ghaisouri, Ali Zeinyvand,
Volume 83, Issue 8 (11-2025)
Volume 83, Issue 8 (11-2025)
Abstract
Background: The COVID-19 epidemic is predicted to cause another NCDs epidemic. The fact that hypertension, as well as other forms of cardiovascular disease, is frequently seen in COVID-19 patients has led to the fact that most patients with SARS-COV-2 are treated with angiotensin converting enzyme inhibitors (ACEIs) and blockers. Angiotensin receptor (ARB) be treated. So far, no study has been conducted on the prevalence of hypertension in patients with coronary heart disease and its relationship with pulmonary involvement. Let's do it.
Methods: This retrospective cross-sectional comparative study is performed on the records of patients admitted to Shahid Mostafa Khomeini Hospital in Ilam with a diagnosis of COVID-19. It was carried out in the summer of 2021 to the summer of 2023. At the time of hospitalization, patients' blood pressure is calculated and recorded according to standard criteria. The degree of hypoxia is also assessed using a pulse oximeter according to the set criteria.
Results: In this study, the mean age of patients aged 54.65 years in the age range of 18-95 years. The correlation coefficient of systolic blood pressure is directly related to pulmonary involvement, but this relationship is not statistically significant. At the age of less than 60 years, the correlation coefficient between systolic blood pressure and pulmonary involvement with age is positive and significant, but at the age of more than 60 years, this relationship is inverse and not significant. The relationship between systolic blood pressure and pulmonary involvement is direct and significant. A linear correlation coefficient was reported between systolic blood pressure and pulmonary involvement with a history of direct hypertension.
Conclusion: In the present study, the prevalence of hypertension was 19.5% and using Pearson linear correlation test, it was shown that there is a direct relationship between blood pressure correlation coefficient with pulmonary involvement, but this relationship was not statistically significant. This relationship was reported to be direct and significant for the age group under 60 years. It was also direct and significant in men.
Methods: This retrospective cross-sectional comparative study is performed on the records of patients admitted to Shahid Mostafa Khomeini Hospital in Ilam with a diagnosis of COVID-19. It was carried out in the summer of 2021 to the summer of 2023. At the time of hospitalization, patients' blood pressure is calculated and recorded according to standard criteria. The degree of hypoxia is also assessed using a pulse oximeter according to the set criteria.
Results: In this study, the mean age of patients aged 54.65 years in the age range of 18-95 years. The correlation coefficient of systolic blood pressure is directly related to pulmonary involvement, but this relationship is not statistically significant. At the age of less than 60 years, the correlation coefficient between systolic blood pressure and pulmonary involvement with age is positive and significant, but at the age of more than 60 years, this relationship is inverse and not significant. The relationship between systolic blood pressure and pulmonary involvement is direct and significant. A linear correlation coefficient was reported between systolic blood pressure and pulmonary involvement with a history of direct hypertension.
Conclusion: In the present study, the prevalence of hypertension was 19.5% and using Pearson linear correlation test, it was shown that there is a direct relationship between blood pressure correlation coefficient with pulmonary involvement, but this relationship was not statistically significant. This relationship was reported to be direct and significant for the age group under 60 years. It was also direct and significant in men.
Kimia Shirbandi, Ramin Azhough, Hosein Shiri ,
Volume 83, Issue 8 (11-2025)
Volume 83, Issue 8 (11-2025)
Abstract
Background: Since multiple factors contribute to the occurrence of postoperative complications and these risk factors are generally more prevalent among elderly individuals compared to younger patients this study was conducted to compare the complications of hemorrhoidectomy between elderly and non-elderly patients.
Methods: For each patient, a data collection form was completed, including demographic characteristics (age, sex, body mass index, ASA class, and comorbidities), as well as laboratory and disease-related information. Postoperative complications assessed were bleeding, anal fissure, rectal stenosis, anal pain, hemorrhoid recurrence, reoperation, postoperative infection, pruritus, and urinary tract infection.
Results: The findings indicated that the lymphocyte-to-monocyte ratio LMR Lymphocite to Monocye Ratio) was associated with a reduced incidence of complications, whereas both the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein CRP (c_reactive protein) levels were associated with an increased incidence of complications. Furthermore, hemorrhoid grade, disease duration, number of hemorrhoidal nodules, preoperative pain severity, and chronic preoperative pain were all significantly associated with a higher likelihood of postoperative complications in elderly patients.
Conclusion: This study demonstrates that several factors including hematologic ratios (LMR, NLR), CRP (c_reactive protein) levels, hemorrhoid grade, disease duration, number of hemorrhoidal nodules, preoperative pain severity, and chronic preoperative pain are significantly associated with the occurrence of postoperative complications following hemorrhoidectomy in elderly patients.
Methods: For each patient, a data collection form was completed, including demographic characteristics (age, sex, body mass index, ASA class, and comorbidities), as well as laboratory and disease-related information. Postoperative complications assessed were bleeding, anal fissure, rectal stenosis, anal pain, hemorrhoid recurrence, reoperation, postoperative infection, pruritus, and urinary tract infection.
Results: The findings indicated that the lymphocyte-to-monocyte ratio LMR Lymphocite to Monocye Ratio) was associated with a reduced incidence of complications, whereas both the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein CRP (c_reactive protein) levels were associated with an increased incidence of complications. Furthermore, hemorrhoid grade, disease duration, number of hemorrhoidal nodules, preoperative pain severity, and chronic preoperative pain were all significantly associated with a higher likelihood of postoperative complications in elderly patients.
Conclusion: This study demonstrates that several factors including hematologic ratios (LMR, NLR), CRP (c_reactive protein) levels, hemorrhoid grade, disease duration, number of hemorrhoidal nodules, preoperative pain severity, and chronic preoperative pain are significantly associated with the occurrence of postoperative complications following hemorrhoidectomy in elderly patients.
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