Showing 518 results for Reza
Hamidreza Mehryar , Sahil Farakh,
Volume 82, Issue 2 (May 2024)
Abstract
Background: Medicines that are used to prevent and cure disease may affect patients if used incorrectly, and this study was conducted with the aim of evaluating the frequency of drug interactions in patients admitted to the emergency department of Imam Khomeini Hospital in Urmia.
Methods: This study is descriptive-analytical in a cross-sectional way, From March 20, 2020 to September 21, 2020, a census was conducted on patients admitted to the emergency department of Imam Khomeini Hospital in Urmia, who were 1901 people. The data was collected using a checklist that included information (age, sex, type of drug and severity of interference and type of interference). After collecting the data, it was entered into SPSS software, version 18 (IBM SPSS, Armonk, NY, USA) and analyzed with the help of descriptive and analytical statistics.
|
Results: In this study, the results showed that out of 1901 studied patients, 1101(57.9) were male and the rest were female 801(42.1), And the average age of the patients was 61.67±17.13 years, and 1160(60.9) patients did not have drug interactions and 724(39.01) had drug interactions, and the most common type of drug interaction was the moderate type, which was present in 75.1% of cases; And the final clinical outcome of the patients was 1088(57.2) discharge, 296(15.5) personal consent discharge and 506(26.6) death. Also, the most common drug interactions were serotide/salbutamol, azithromycin/ondansetron, and aspirin/nitroglycerin, respectively. And there was no significant relationship between the occurrence of drug interactions and the gender of patients (P=0.27) and finally, the average age of patients with drug interactions was 17.7±61.2 years and in patients without drug interactions was 16.7±61.9 years. Conclusion: The overall incidence of drug interactions in the studied patients was equal to 39.01, and the most common drug interactions in patients were of moderate and mild type; and there was no statistically significant relationship between the age of the patients and the gender of the patients and the incidence of drug interactions.
|
Seyedeh Fatemeh Hosseini Nejad , Mahshid Vaziri, Ahmad Reza Mohtadi, Elham Kargar Zadeh , Mohammad Pakzadi,
Volume 82, Issue 3 (June 2024)
Abstract
Background: Postoperative nausea and vomiting (PONV) is a common challenge in cesarean surgeries, on the other hand, the use of dexamethasone has been proposed as an effective prophylaxis in the management of these complications. This study evaluated the effect of dexamethasone in reducing PONV.
Methods: This study was conducted as a randomized and double-blind clinical trial from April 2022 to September 2023 at Razi Hospital of Jundishapur University of Medical Sciences, Ahvaz. Elective cesarean section patients under spinal anesthesia were divided into two groups of 30 people. In this research, there were two groups: a group that received 0.1 mg/kg dexamethasone (Iran company) and a placebo group that received normal saline. The injections were done before the start of anesthesia, and both groups had received 500 cc of normal saline serum before drug injection. During the surgery and after that at specific time intervals, parameters such as blood pressure, heart rate, and the occurrence of nausea and vomiting were recorded through the V&N scoring table and shivering through the shivering scoring table. Recorded 1/2/4/6/12 after surgery.
|
Results: In this study the investigated variable is postoperative nausea and vomiting (PONV), since the investigated variable is a qualitative/nominal variable, to calculate the sample size from the formula P1- P2 ∕√P(1-P) used. The significance level of the tests is considered to be less than 0.05 and data analysis was done with SPSS type 23 software. Although no significant difference was observed between dexamethasone and placebo in the first hour after the operation, in the following hours, dexamethasone significantly reduced nausea and vomiting, on the other hand, heart rate and blood pressure decreased faster in the groups receiving dexamethasone.
Conclusion: Dexamethasone is significantly effective in reducing nausea and vomiting after cesarean surgery. It also has a positive role in reducing the heart rate and blood pressure and This drug is particularly effective in controlling complications after spinal anesthesia after the operation.
|
Reza Sahraei, Ahmad Bostani , Mousa Zare, Navid Kalani, Fatemeh Eftekharian,
Volume 82, Issue 3 (June 2024)
Abstract
Background: Cataract surgery is the most common surgery in the world. The prevalence of age-related cataract increases with age, and its prevalence increases with each decade of age after forty years. Various drugs are used to control analgesia and hemodynamics in patients undergoing cataract surgery. The purpose of this study is to compare dexmedetomidine and 2% lidocaine in the control of analgesia and hemodynamic changes in cataract surgery with local anesthesia.
Methods: In this double-blind clinical trial study, 52 patients with anesthesia class I and II underwent cataract surgery. Patients were randomly assigned to two groups: lidocaine (three cc) and dexmedomedin (five μg/kg + lidocaine). The information collection checklist in this study included: age, gender, history of aspirin use, systolic and diastolic blood pressure, heart rate, intraocular pressure, postoperative complications, and postoperative pain.
|
Results: The Mann-Whitney U test showed that the Dex-Metomedin group had less pain than the Lidocaine group in the first hour after the intervention (P=0.012). Two hours after the intervention, the dexmedemodin group had less pain than the lidocaine group (P=0.001). In the investigation of IOP after retrobulbar block in the dexmedetomidine group, we saw a significant increase in IOP from 16.56±3.12 to 17.96±2.68 mmHg compared to before the block (P=0.001). In the lidocaine group, we also saw a significant increase in IOP from 16.18±3.66 to 19.66±4.67 mm Hg compared to before the block (P=0.001). Before and after retrobulbar block, there was no significant difference between the two groups (P=0.694 and P=0.108, respectively). To investigate the effect of these interventions more precisely, the amount of IOP pressure change was also compared between the two groups, and we saw a greater increase in the lidocaine group than in the dexmedetomidine group (P=0.002).
Conclusion: The results of the present study showed that dexmedetomidine + lidocaine in retrobulbar form compared to lidocaine was able to control the pain level of patients after surgery and systolic and diastolic blood pressure during surgery. It is suggested to use this drug as local anesthesia in cataract surgery.
|
Seyed Hasan Emami Razavi , Mohammadreza Salehi, Hooshang Saberi , Mohammad Zarei, Babak Mirzashahi, Pegah Afarinesh, Sepideh Khodaparast,
Volume 82, Issue 3 (June 2024)
Abstract
Primary pyogenic spinal infection, also known as spondylodiscitis or vertebral osteomyelitis, is a serious and potentially debilitating condition involving a bacterial or fungal infection of the intervertebral disc space and adjacent vertebral bodies. While relatively uncommon, with an estimated incidence of 2.4 per 100,000 population per year, it is a medical emergency that requires prompt diagnosis and treatment to prevent permanent spinal damage and neurological complications. The most common causative organisms are Staphylococcus aureus, which accounts for up to 50% of cases, followed by Gram-negative bacteria such as Escherichia coli, and mycobacterial infections like Mycobacterium tuberculosis. Risk factors for developing primary pyogenic spinal infection include intravenous drug use, a weakened immune system, recent spinal surgery or instrumentation, and contiguous spread from an infection elsewhere in the body, such as a urinary tract infection or endocarditis. Patients typically present with severe, localized back pain, fever, and general malaise, which can easily be mistaken for more common spinal conditions. Prompt diagnosis is critical and involves a thorough medical history, physical examination, laboratory testing, and advanced imaging studies such as magnetic resonance imaging (MRI). Blood cultures and, in some cases, image-guided biopsy may be necessary to identify the causative organism and guide appropriate antimicrobial therapy. The mainstay of treatment is the prompt initiation of targeted antibiotic or antifungal therapy, often requiring intravenous administration for several weeks. Surgical intervention may be necessary in some cases, such as to drain an abscess or provide spinal stabilization. A multidisciplinary approach involving infectious disease specialists, spine surgeons, and rehabilitation providers is essential for optimal management and outcomes. Despite advances in diagnosis and treatment, primary pyogenic spinal infection remains a challenging condition. Delays in diagnosis and treatment can lead to devastating complications, including permanent spinal deformity, paralysis, and even death. With timely and appropriate management, however, most patients are able to achieve a good clinical outcome, though some may experience residual pain or neurological deficits.
Masoomeh Asgar Shirazi , Zahra Omidi, Hossein Dalili , Mamak Shariat, Seyed Reza Raeeskarami, Zeynab Kaviani, Mojtaba Fazel,
Volume 82, Issue 3 (June 2024)
Abstract
Background: Vitamin D deficiency is common among pregnant women and can lead to maternal and fetal complications during pregnancy. This study was conducted with the aim of investigating the relationship between the mother's vitamin D serum level and the infant's anthropometric indices and neurodevelopment.
Methods: This prospective cohort study was conducted on a group of pregnant women who visited Imam Khomeini Hospital in Tehran from September to March 2020. Demographic information and anthropometric characteristics of the newborn were collected using the medical record. Blood samples were collected at the time of delivery to evaluate the mother's vitamin D status, and serum vitamin D levels were measured using standard laboratory procedures. The neurodevelopment of infants was assessed at the age of 6 months through the Ages and Stages Questionnaires (ASQ). Data analysis included using descriptive statistics to summarize maternal and neonatal characteristics. The relationships between maternal serum vitamin D levels, neonatal anthropometric indicators, and neurodevelopmental outcomes were examined through Spearman's rank correlation and Mann-Whitney U tests.
|
Results: In total, 123 pregnant women participated in this study, with a mean age of 31.41 years (±5.75). The mean birth weight, height, and head circumference of the neonates were 3208.33 grams (±706.05), 34.32 cm (±3.91), and 50.33 cm (±2.30), respectively. Statistical analysis showed no significant correlations between maternal serum vitamin D levels and the infants' weight (P=0.318), height (P=0.531), or head circumference (P=0.241). Furthermore, there was no significant association between maternal vitamin D levels and any of the assessed neurodevelopmental domains at six months (P > 0.05).
Conclusion: While this study did not find a positive correlation between the mother's vitamin D serum level and the anthropometric indices and neurodevelopmental domains of infants at six months, it is important to interpret these results cautiously due to the study's limitations. Thus, it is advisable to conduct prospective cohort studies with large sample sizes in diverse demographics nationwide.
|
Khadije Sohrabi, Abbas Ali Gaeini , Elham Shirzad , Shahram Khorshidi , Shahriar Nafissi, Hamid Reza Fateh,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Spinal Muscular Atrophy (SMA) is a neurodegenerative disorder caused by a mutation in the survival motor neuron 1 (SMN1) gene. It is classified into five types (from type 0 to 4) based on the age of onset of symptoms and maximum motor function. This autosomal recessive mutation results in progressive weakness and atrophy of the proximal muscles. Due to the high cost of treatment, the critical timing of intervention, and the varied responses of patients, many individuals do not sufficiently benefit from current therapeutic methods. This study evaluates the impact of resistance training on the quality of life and fatigue in patients with SMA type III, considering the potential benefits of such training.
Methods: The present study was developmental and semi-experimental. Fourteen ambulatory patients with SMA type III were randomly assigned to exercise and control groups. The exercise group engaged in lower limb resistance training at an intensity of 6 to 8 on an adult resistance exercise scale for 10 weeks (25 sessions). During this period, the control group maintained their usual daily activities. Patients in the exercise group did not engage in any exercise activity other than the protocol of the present study. Patients' quality of life was measured with the Short Form 36 (SF-36) questionnaire, and fatigue severity was measured with the Fatigue Severity Scale (FSS), both evaluated pre- and post-intervention. The assessments and exercises were conducted in the occupational therapy department of Shariati Hospital, Tehran, from July 2023 to September 2023.
Results: Analysis of the results showed significant improvements (P<0.05) in the exercise group compared to the control group in the subscales of physical functioning and fatigue within the quality of life assessment. Additionally, notable differences were found between the groups on the fatigue intensity scale. However, No significant difference was observed in the patients' Body Mass Index (BMI) measurements.
Conclusion: Progressive resistance training of the lower limbs enhances the quality of life and reduces fatigue in patients with SMA type III. |
Fatemeh Shakki Katouli , Jayran Zebardast, Zahra Tavoli, Leila Bayani, Fahimeh Zeinalkhani, Reza Mardani , Fahimeh Azizinik,
Volume 82, Issue 4 (July 2024)
Abstract
Background: The prevalence of cesarean section (CS) has recently increased dramatically. Cesarean scar defect (CSD) is one of the most common complications of CS. This study aims to investigate and compare the depth and volume of the CSD in symptomatic patients with and without uterine adenomyosis.
Methods: This retrospective case-control study was done from November 2020 to November 2022 at our referral women's hospital. The patients who underwent sonohysterography with a previous history of one or two CS for at least one year ago and chief complaints of abnormal uterine bleeding were included in our study. The patients with myometrial or endometrial pathology were excluded from the study. The symptomatic patients who met the inclusion criteria were divided into two groups: with adenomyosis (case) and without adenomyosis (control). The demographic data, medical history, and sonohysterography findings were obtained from the patient’s documents and archived images. In sonohysterography, CSD features, including the length, depth, width, volume, RMT (Remained Myometrial Thickness), AMT (Adjacent Myometrial Thickness), and RMT/AMT were measured. To analyze the variables, t-tests, and chi-square were used.
|
Results: Among 310 symptomatic women with a history of previous cesarean section underwent sonohysterography, 160 patients met the inclusion criteria (case group with adenomyosis: 82 patients and control group without adenomyosis: 78 patients). The chief complaints were post-menstrual bleeding (43.8%), prolonged bleeding (34.3%), and intermenstrual bleeding (21.9%). In the case group, 25.6% had CSD with RMT<2mm, but in the control group (without adenomyosis), only 6.4% had RMT<2mm. CSD depth and volume were significantly larger in patients with underlying adenomyosis (P-value of 0.002 and 0.038, respectively). Also, the mean RMT and RMT/AMT ratio were significantly lower in the case group (P-values of 0.004 and 0.00, respectively).
|
Conclusion: Our study demonstrated a strong association between the presence of adenomyosis and larger CSDs. To establish a causative relationship, we suggest a prospective cohort study to follow up the patients and compare the evolution of CSD in patients with and without adenomyosis.
Navid Kalani , Hasan Zabetian, Shahram Shafa, Erfaneh Alirezai, Fatemeh Eftekharian, Reza Sahraei ,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Recently, epinephrine is used to increase the depth and duration of local anesthetic pain, and it is widely used topically to reduce local anesthetic release and reduce bleeding caused by surgery.
Methods: This study was a randomized, double-blind clinical trial on 30 patients aged 18 to 85 years undergoing lower limb orthopedic surgery referred to Peymaniyeh Hospital in Jahrom from September to December 2022. Patients were randomly assigned to two groups, A (epinephrine+fentanyl+bupivacaine) and B (bupivacaine+fentanyl). Systolic blood pressure, diastolic pressure, mean arterial pressure, arterial blood oxygen saturation percentage, and pulse rate were measured and recorded before drug administration, before spinal anesthesia, after anesthesia, and then every half hour until the end of surgery (15, 45, 30, 60, 75, 90, 120) and during recovery. Data analysis was performed using SPSS version 21 software and descriptive (mean, standard deviation) and inferential statistics (t-test, chi-square, Mann-Whitney, Friedman) at a significance level of P<0.05.
|
Results: Thirty patients aged 18 to 85 years (in two groups of 15) with anesthesia class I and II undergoing lower limb orthopedic surgery were evaluated. The study groups are matched in terms of age and gender variables. There was no significant difference in mean systolic, diastolic, mean arterial blood pressure, and heart rate before and after anesthesia, 15, 45, 30, 60, 75, 90, and 120 minutes after drug injection, and at entry and exit from recovery between the Epinephrine+Fentanyl+Bupivacaine and Fentanyl+Bupivacaine groups. There was a significant difference in mean O2SAT before anesthesia, 15, 30, and 75 minutes after drug injection between the epinephrine+fentanyl+bupivacaine and fentanyl+ bupivacaine groups (P<0.05).
Conclusion: The use of the combination of epinephrine+fentanyl+intrathecal bupivacaine compared to the combination of fentanyl+bupivacaine did not have a significant difference in the studied variables of patients' vital signs.
|
Mojtaba Ghaedi, Mojtaba Sohrabpour, Gholamreza Motazedian, Navid Kalani , Reza Sahraei , Mohammad Sadegh Sanie Jahromi,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Rhinoplasty is a challenging and complex surgery because it is designed to meet the unique needs of the patient. In rhinoplasty surgery, many factors contribute to achieving the desired result. These factors include the surgeon's care and observation, analysis of the existing anatomy, choice of surgical technique, degree of soft tissue and cartilage trauma, amount of bleeding, quality of surgical instruments and anesthesia, and anything that helps reduce bleeding.
Methods: This double-blind study was conducted on 50 patients aged 18 to 45 years undergoing septorhinoplasty surgery referred to Motahari Hospital in Jahrom city in 2022. Patients were randomly divided into dexmedetomidine and control groups. The degree of sedation, bleeding and surgeon satisfaction were evaluated and recorded. Data analysis was performed using SPSS software, version 21 (IBM SPSS, Armonk, NY, USA) and descriptive statistics (mean, standard deviation, percentage, number, frequency) and inferential statistical tests (Mann-Whitney U test, Kruskal-Wallis, t-test, chi-square test). The significance level in all tests was considered P<0.05.
|
Results: The majority of patients in the study groups were female and the mean age of patients in the dexmedetomidine group was 34.36±7.33 years and in the control group was 36.60±9.59 years. The study groups were similar in terms of age and body mass index (P<0.05). The frequency of patient sedation in the dexmedetomidine group was lower than the control group, but it was not statistically significant (P<0.05). The results showed that at the beginning of the operation and 90 minutes later, the satisfaction level of the patient surgeon in the dexmedetomidine group was significantly better than the control group (P<0.001). In the dexmedetomidine group, the field of view of the surgeon was relatively clear and completely clear. The amount of bleeding in the dexmedetomidine group was lower than the control group, but it was not statistically significant (P<0.05).
Conclusion: Dexmedetomidine increased the surgeon's satisfaction by reducing bleeding and improving the surgeon's visual field. Therefore, this drug can be used as an anesthetic aid in surgery.
|
Hamid Reza Mehryar, Mohammad Reza Hosseini Azar , Afshin Ebrahimi , Omid Garkaz,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Although the respiratory system is the main element involved in the disease of COVID-19, nevertheless, there are reports of the involvement of other organs and their lesser symptoms. This study was conducted with the aim of investigating the frequency of gastrointestinal symptoms in patients with COVID-19.
Methods: This cross-sectional descriptive study was conducted on all patients diagnosed with COVID-19 hospitalized in Imam Khomeini Hospital from April to September 2021 by census method. The data was collected using a checklist that included demographic information. After the data was collected, it was entered into SPSS software, version 18 (IBM SPSS, Armonk, NY, USA) and analyzed with the help of descriptive statistics.
|
Results: In this study, the results showed that out of 2580 hospitalized patients, 54% were women and 46% were men. And the average age of the patients was 58.67±17.68. The highest frequency of people was in the age range of 40-59 years (925 people). 64% of patients had at least one gastrointestinal symptom, Each of the symptoms had a different prevalence, Anorexia 40% with a preference for men (57%) and the highest frequency in the age range of 40-59 years (430 people), gastrointestinal bleeding 10% with a preference for men (80%), And the highest frequency in the age range of 60-79 years (112 people), abdominal pain 8% with preference for women (65%) with preference for frequency in the age range of 40-59 years (65 people), vomiting 3% with preference for women (51%) with abundance in the age range of 80-99 years (58 people), diarrhea 1.5% with preference in men (51%) with abundance in the age range of 60-79 years (18 people) and constipation in 0.2% with preference Women (67%), all of whom were over 60 years old.
Conclusion: The findings of this study showed that the COVID-19 disease can not only involve the respiratory system but also the digestive system in the course or beginning of the disease.
|
Najibeh Mohseni Moalem Kolae , Abdolreza Jafarirad, Mohammadhossein Hesamirostami , Khadije Moeiltabaghdehi , Mojtaba Ghorbani , Abolfazl Hosseinnattaj,
Volume 82, Issue 4 (July 2024)
Abstract
Background: Death is one of the serious consequences of burns, which usually occurs as a result of hospital infections. This study was conducted with the aim of investigating the existing disagreement regarding the admission of more than 90% patients in the burn intensive care unit with the isolation room of the burn unit.
Methods: This retrospective descriptive-analytical study was conducted based on case review. The statistical population included the files of patients hospitalized in the burn wards and burn intensive care unit of Zare'e Sari Burn and Psychiatric Center from 2011 to 2023 who died. All these patients were included in the study as a census. The data was extracted through a checklist prepared by the researcher. Descriptive and inferential analysis of the data was performed using SPSS version 21 software. The variables studied included gender, age, burn percentage, burn factor, and duration of hospitalization, and determining the relationship between burn percentage and survival time in the two burn intensive care units and the isolation room of the burn unit was the main variable. The mean and standard deviation were used to describe quantitative data, and the frequency and percentage were used to describe qualitative data.
|
Results: Among 882 cases, 226 patients had burns above 90%. 143 cases were related to men (63.3%). Most patients were in the age group of 19 to 40 years (61.9%). The cause of the burn (54.9%) was flame. Among the patients (83.2%) were hospitalized in the isolation room of the burn ward. Although the average days of hospitalization of patients above 90% in the burn intensive care unit was 13.71±11.82 days and the burn isolation room was 8.66±9.11 days, the Mann-Whitney test showed that the average survival time of these patients in the burn isolation room of the burn ward was significantly different from the intensive care unit. (sig.=0.001).
Conclusion: Although the average survival time in the two groups showed a significant difference, ultimately all patients in the two groups died within a few days of each other.
|
Mohammad Masud Khubiari , Simin Najafgholian, Bahareh Abbasi, Ramin Parvizrad, Reza Aghbozorgi,
Volume 82, Issue 5 (August 2024)
Abstract
Background: Emergency Departments (EDs) visits reflect medical needs and demands or the only care available to patients. Many ED visits are potentially preventable with access to high-quality, community-based health care. Given the higher incidence of emergency conditions in patients with cancer the global increase in cancer will pose a challenge for emergency services. Therefore, this study was conducted with the aim of epidemiological investigation of emergency department visits by cancer patients in several centers.
Methods: In this cross-sectional study, the triage form and hospital file of known patients with various cancers, who visited in Eds of valiasr and Amir al Momenin hospitals in Arak, Hazrat Rasool Akram and Lolagar hospitals in Tehran, and Shahid Sadouqi and Shah vali hospitals in Yazd, From April to September 2017. To measure the urgency of ED visits, the emergency severity index and triage form were used, and the outcome of the emergency visit was extracted from the patient's file and recorded in the data collection checklist. Multivariate logistic regression analysis was used to examine the association of patient, hospital and potentially preventable factors.
Results: In this study, 1107 patients, 550 men (%49.7) and 577 women (%50.3) with cancer were were studied. Age 65 and older had the most emergency visits. The most common reason for patients to visit was: pain in different organs (18.2%), fever (8.7%), weakness and malaise (7.5%). A total of 617 (55.7%) visits were potentially preventable. Age 17 years and younger (OR, 3.172; 95% (CI), 2.409-4.021) and presence of more than 1 comorbidity (OR, 3.610; 95% (CI), 3.611-4.521) were positively associated with potentially preventable visits.
Conclusion: In this study, 50.7% of ED visits among patients with cancer were identified as potentially preventable, and the most common reason for patient visits was general and non-specific symptoms such as pain, weakness, and malaise. These findings highlight the need for palliative care and evidence-based interventions in outpatient settings.
Saeed Rahmani, Aliakbar Shafiee, Abbas Riazi , Alireza Akbarzadeh Baghban , Alireza Jafari , Maryam Dashti,
Volume 82, Issue 6 (September 2024)
Abstract
Background: Problems related to blue light exposure are among the various issues experienced by individuals who have undergone Photorefractive Keratectomy (PRK).Given the growing concerns regarding blue light’s effects on visual health, this study aimed to thoroughly investigate the impacts of blue blocker filters on the improvement of vision in patients post-refractive surgery of the PRK type. The primary objective was to evaluate the overall effectiveness of these filters in enhancing visual quality and in reducing complications associated with the surgery, which can significantly affect a patient’s quality of life.
Methods: In a quasi-experimental study conducted from September 1, 2024, to the end of October 2024, individuals who had undergone PRK surgery were examined at the optometry clinic of Dr. Labbafi Nejad Hospital in Tehran. Participants were subjected to assessments both with and without the application of blue blocker filters. Key parameters, including visual acuity and contrast sensitivity among attendees, were meticulously measured under both conditions. The results were then systematically compared and analyzed to draw meaningful conclusions about the impact of blue blocker filters in this context.
|
Results: A total of thirty-four participants, comprising 73.5% females and 26.5% males, with an average age of 32.6 years, were incorporated into the study. Post-surgery, the average refraction measured in the right and left eyes was documented as -0.42±0.16 D and -0.30±0.16 D, respectively. Notably, visual acuity in both eyes significantly improved with the use of the blue light blocking filter (P<0.005) Moreover, contrast sensitivity at varying spatial frequencies of 1.5, 6, and 18 cycles per degree (c/d) also exhibited significant enhancement (P<0.005).
Conclusion: The incorporation of blue blocker filters for individuals with a history of PRK surgery has led to noteworthy improvements in visual acuity and enhanced contrast sensitivity. These findings underscore the critical importance of integrating blue light protection in the post-operative care of patients, as it significantly elevates the overall visual experience and may contribute to better long-term outcomes following refractive surgery.
|
Ehsan Roshan Nasab , Farzaneh Hematian, Ahmad Shamsizadeh Hayatdavodi, Mohammadreza Mirkarimi , Mohsen Ali Samir , Mandana Izadpanah,
Volume 82, Issue 6 (September 2024)
Abstract
Background: Vancomycin resistance in intensive care units has significant complications and additional costs. Given the need for rational use of this antibiotic to prevent the occurrence of antibiotic resistance, the present study was designed to evaluate how to prescribe the antibiotic vancomycin consumption pattern in a pediatric subspecialty hospital.
Methods: This cross-sectional descriptive-analytical study was conducted over a 3-month period (February, May, and June) in 2021 at the Pediatric Hospital of Jundishapur University of Medical Sciences, Ahvaz. All patients hospitalized in the intensive care unit and infectious disease ward with vancomycin prescription were included in the study. Patients who were hospitalized for less than three days or had no desire to enter the study were excluded from the study. Vancomycin prescription by clinical pharmacist was reviewed based on the latest version of Lexicomp from Wolters Kluwer and the National Health Service (NHS) guidelines.
|
Results: Of the 91 hospitalized patients, 70.3% (64 cases) were prescribed vancomycin without performing an antibiogram culture based on experience and 29.7% (27 cases) were based on an antibiogram culture. In 96.7% (88 cases) , the duration of intravenous vancomycin infusion did not comply with the protocol. Red Man Syndrome was observed in 8.8% (8 cases). In 91.2 % (83 cases), no adverse effects were reported. In 65.9% (60 cases), the drug dose was determined based on the correct renal function Glomerular filtration rate (GFR) and in 34.1%, the drug dose was determined regardless of the renal function of the patients. Vancomycin doses were lower and higher than the guidelines in 6 and 25 patients, respectively. Out of all patients, eighty four cases recovered and seven cases died.
Conclusion: In almost half of the patients, Vancomycin were prescribed based on experience and without performing an antibiogram test. Use of guidelines, Serum level monitoring programs and continuous medical education for doctors can be effective in rational use of antibiotics.
|
Pourya Mashategan, Mohammad Reza Ghane , Ali Bahramifar, Mahdi Raei ,
Volume 82, Issue 6 (September 2024)
Abstract
Background: Intubation is normally conducted in an emergency or prior to surgery. A cuffed tracheal tube is fitted, whose inflated cuff exerts pressure on the tracheal wall. Such pressure should, therefore, be monitored every day by use of pressure gauge devices. The general guideline in this regard is that the pressure of the cuff must lie between 20 and 30 cm of water. The exaggerated pressure may cause tissue ischemia, wound, and necrosis of the tracheal wall; if it is too low, this could result in air leakage and oropharyngeal secretions, increasing the risk of insufficient ventilation and aspiration pneumonia. This study aimed at comparing the cuff pressure of an endotracheal tube inflated with alkaline lidocaine versus air for any post-extubation complications and cuff pressure changes.
Methods: This prospective cohort study was conducted on patients who were admitted to the intensive care unit of Baqiyatullah Al-Azam Hospital in Tehran between May 2023 and February 2024, underwent intubation in this unit and met the inclusion criteria for the study. This prospective study included 62 patients, and tracheal tube cuff pressure was recorded at 30 minutes, 60 minutes, 120 minutes, 6 hours, and 24 hours after intubation with a pressure gauge. Patients were randomly divided into two groups-an 'air group', whose cuff was inflated to the pressure of 20 cmH2O by air, and a 'lidocaine group,' whose cuff was filled with 2% lidocaine to the same pressure. In this study, the post-extubation complications, such as sore throat, hoarseness, and cough, were assessed immediately and 24 hours after extubation. Similarly, the tracheal tube displacement during the intubation process was monitored in both groups.
Results: The results showed that the pressure of an endotracheal tube cuff inflated with lidocaine was drastically lower than the one inflated with air, with a p-value of 0.001. On the other hand, the sore throat, cough, and hoarseness after extubation and 24 hours later were significantly fewer in the lidocaine group compared with the air group at a p-value of 0.001.
Conclusion: Cuffs inflated with alkalinized lidocaine clearly avoided high cuff pressure at induction and reduced postextubation sore throat. Hence, alkalinized lidocine-filled endotracheal tube cuffs are comparatively safer and more beneficial than conventional air-filled cuffs.
Majid Jahanshahi , Morteza Taheri , Seyyed Abdollahadi Daneshi , Mostafa Haji Rezaei ,
Volume 82, Issue 6 (September 2024)
Abstract
Background: Decompressive craniectomy (DC) is a therapeutic approach for patients with raised intracranial pressure and cerebral edema. Although DC is not a complicated procedure, it is associated with significant complications and morbidities that significantly affect clinical outcomes. This study investigates the frequency of cerebrospinal fluid (CSF) circulation disorders after DC and evaluates related factors.
Methods: This cross-sectional analytical study was conducted on 79 patients who underwent DC at Shohadaye Haftome Tir Hospital, one of the main trauma centers in Tehran. The patients' files and the Picture Archiving and Communication System (PACS) were reviewed to collect demographic, clinical, and radiologic data. After identifying patients with post-operative (after DC) CSF circulation disorders, the relevant factors were determined using multivariate logistic regression.
|
Results: Overall, seventy-nine patients were studied. The mean age of patients was 40.56±12.64 years and 82.3% were male. Forty-seven patients (59.5%) underwent DC due to traumatic causes and thirty-two patients (40.5%) due to vascular pathologies. In total, 36.7% (nineteen) of patients were affected by some degree of subdural hygromas of which 13 patients (44.8%) progressed to clinical and radiologic hydrocephalus. 19% (fifteen patients) developed hydrocephalus within the first six months after surgery. Considering the clinical variables, the GCS of patients was the only one that showed a significant relationship with CSF circulation disorders. Regarding radiological variables, the presence of intraventricular hemorrhage (IVH) was the only relevant factor. In addition, from the surgical perspective, performing duraplasty (autograft or allograft) and reoperation demonstrated significant relationships with CSF circulation disorders. The results of multivariate logistic regression showed that having intraventricular hemorrhage (OR, 6.15-6.9414: CI95%, P=0.003) and reoperation (75.91: OR, 3.88-3.6, 1485/43: CI95%, P=0.004) were two independent factors associated with hydrocephalus in DC patients.
|
Conclusion: In patients who have undergone decompressive craniectomy, intraventricular hemorrhage (IVH) and reoperation can be independent risk factors for CSF circulation disorders. Although the incidence and presence of IVH cannot be controlled, careful and meticulous surgical technique and skill can significantly improve the outcome of decompressive craniectomy by reducing the need for reoperation
Mohammad Gholami , Alireza Mahmoudabadi, Maryam Moradi , Hossein Nezami, Hamideh Mohammadzadeh ,
Volume 82, Issue 7 (October 2024)
Abstract
Background: Androgenetic alopecia is the most common cause of hair loss, and its prevalence increases with age. Different studies have reported different results regarding the association of cardiovascular diseases with androgenetic alopecia. The present study aimed to The present study aimed to Investigating the relationship between androgenetic alopecia and the thickness of the intima media of the carotid artery in the referrals to the specialized skin and hair clinic of Allameh Bohlool Gonabadi Hospital.
|
Methods: This case-control study was conducted from October 2021 to June 2022 on 100 patients referred to the Skin and Hair Clinic of Allameh Bahloul Hospital in two groups of 50 cases and controls, aged less than 40 years. The subjects were matched in terms of age and gender. Patients with alopecia were classified into three categories: mild, moderate, and severe based on the diagnosis of the treating physician. The thickness of the intima-media layer of the carotid artery was measured using ultrasound.
Results: There were 37 males and 13 females in both the case and control groups. The mean age in the case group was 29.50 and 30.28 years, respectively. In addition, the duration of alopecia in the case group was 6.9 years. Although the results indicated that the carotid artery intima-media thickness was higher in patients with androgenetic alopecia, no statistically significant relationship was found between androgenetic alopecia and carotid artery intima-media thickness (P=0.66). There was also a statistical relationship between the carotid artery intima-media thickness and the duration of alopecia (P=0.03).
Conclusion: Considering the relationship between the thickness of the intima media of the carotid artery and the duration of alopecia, it can be said that there is a possible relationship between alopecia and atherosclerosis, but to prove it, studies with a larger sample size are needed.
|
Mohadeseh Shad, Ali Samady Khanghah , Reza Shojaeian, Khashayar Atqiaee,
Volume 82, Issue 7 (October 2024)
Abstract
Background: Rectal prolapse, characterized by the extrusion of the rectal mucosa through the anal sphincter, is a relatively rare condition in children. This condition can be attributed to several anatomical and functional factors. This study aimed to investigate defecation habits in children with rectal prolapse.
Methods: This retrospective study was conducted from 2017 to 2021 in Akbar and Sheikh children's hospitals. The study population included 50 children under the age of 14 who were diagnosed with rectal prolapse and visited the hospitals. Data were collected using pre-prepared checklists and analyzed using SPSS version 24. Inclusion criteria were children under 14 years diagnosed with rectal prolapse, while exclusion criteria included incomplete data or other severe unrelated health conditions.
|
Results: The results showed that 67.4% of the sample were boys, and the most affected age group was children under 2 years (38.8%). A total of 57.1% of the children had daily bowel movements, and 68.2% reported consistently hard stools. Additionally, 48% of the children experienced pain or burning during defecation.
Conclusion: The findings of this study indicate that children with rectal prolapse often face challenges related to stool consistency and defecation pain, despite having frequent bowel movements. These results emphasize the need for targeted interventions to improve stool consistency and manage pain to effectively prevent and treat rectal prolapse.
|
Khadijeh Rezaei Kahkhaei , Soha Shokri, Tayebeh Azarmehr, Mehdi Afshari , Maryam Nakhaee Moghadam , Kolsoum Rezaie Kahkhaie , Leili Rezaei Kahkhaei ,
Volume 82, Issue 7 (October 2024)
Abstract
Background: Abortion is the termination of pregnancy before the 20th week of pregnancy, which may be spontaneous or induced. In general, therapeutic abortion is defined as the termination of pregnancy before the 20th week of pregnancy in order to save the mother's life and prevent birth defects. The purpose of this study is to investigate the causes of legal abortion in women referring to Amir al-Mominin Ali hospital in Zabol city.
Methods: This study is a descriptive-cross-sectional study. The studied population included women who had a legal abortion on March 1, 2022 to September 1, 2022 at Amir al-Mominin Ali Zabol Hospital (Zabol-Iran). The tool used was a checklist made by the researcher and approved by the faculty members of Zabol University of Medical Sciences. The researchers collected the necessary information, including demographic information, obstetrics and mother's illness, fetal disorders, test results, ultrasound screenings, pathology results of patients and other conditions that led to the issuance of an abortion license.
|
Results: In the specified period of time, there were 100 abortion cases that were investigated, and 78 (78%) of these abortions had maternal causes and 22% had fetal causes. The most common maternal causes of abortion were cardiovascular problems (7%) and mothers' age. Also, the most fetal causes were cerebrospinal causes (23%). Mothers who had abortions of maternal origin were significantly older than mothers with abortions of fetal origin (p=0.009).
Conclusion: The present study showed that in Sistan region, most cases of legal abortion depended on fetal reasons and mothers' age.
|
Sara Rezapour , Mehrab Deylami, Marjan Kazeminia,
Volume 82, Issue 7 (October 2024)
Abstract
Background: The mandibular first molar teeth are the most common teeth that undergo endodontic treatment and are anatomically very challenging. Adequate knowledge of the danger zone in the mesial root of the first mandibular molars helps reduce the risk of misdiagnosis of perforation during treatment. The aim of this study was to compare the dentin thickness of the danger zone in the mesial canals of the mandibular first molar in CBCT(Cone Beam Coomputed Tomography) images at intervals of 3, 4, 5 mm below the orifice canal.
Methods: In this study, CBCT images of 144 mandibular first molars from 74 patients aged 18 to 66 years were examined. Mean orifice to Furcation was calculated and mean distal dentin thickness of mesiobuccal and mesiolingual canals was measured at 3, 4 and 5 mm below the orifice. The mean thickness of the distal dentin was examined in terms of age, sex and maxillary side.
Results: The lowest mean distal wall thickness of mesiobuccal and mesiolingual canals was 5 mm below the orifice of the canal. The mean distal wall thickness of mesiobuccal and mesiolingual canals were higher in men than women (P <0.05). The mean distal wall thickness did not show a significant relationship with age. (P=0.745) except in the area of 3 and 5 mm below the orifice in the mesiobuccal canal which was significantly associated with age (P=0.01). No statistically significant difference was observed between the two mandibular sides (P=0.543) except in the 4 mm area below the orifice in the mesiolingual canal (P <0.05).
|
Conclusion: The present study showed that the danger zone is observed in the distal dentin of the mesiobuccal and mesiolingual canals of the mandibular first molar teeth in men and women 5 mm below the orifice of the canal. The mean dentin thickness of the distal wall was lower in women than in men.
|
