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Showing 124 results for Mehdi
Effect of low level laser irradiation with vitamin A on cell viability and apoptosis induction of human skin melanoma
Maral Banihashemi Torshizi , Seyed Mehdi Tabaie, Mina Sadat Naderi, Saeed Hesami Tackallou ,
Volume 79, Issue 10 (January 2022)
Abstract
Background: Skin cancer is the most prevalent type of cancer and melanoma is the deadliest kind of skin cancer in the world. Due to enhanced induction of apoptosis and ROS levels, low-level lasers can be utilized to destroy skin cancer cells. Lasers are used to treat some skin lesions. Vitamin A is beneficial in the prevention and treatment of skin cancer. Vitamin A inhibits the pathway of cancer signals in the skin and suppresses tumor growth. In this study, the combined effect of low-level laser radiation (LLL) and vitamin A on cellular factors of skin melanoma cancer cells was investigated.
Methods: An in-vitro interventional laboratory study was performed in the cell culture laboratory of Medical Laser Research Center, Yara Institute in 2020-2021 (July 2020 to July 2021). First, A375 skin cancer cells were cultured in DMEM with 10% FBS. After preparation and culture of A375 cell lines, different concentrations of vitamin A (1, 5, 50, 100 μM) and LLL energy doses (1, 2, 5, 10 J/cm2) as treatments were done. Combination research of these treatments was performed to eliminate skin melanoma cancer cells. The rate of viability was determined using the MTT test, and the rate of apoptosis was determined using flow cytometry.
Results: The results indicated that a low-level laser with energy dosages of two and 5 J/cm2 and vitamin A treatment with a concentration of 50 μM in the A375 skin cancer cell line had the lowest viability and the highest induction of apoptosis. Furthermore, the results of the combination of Vitamin A and LLL treatments showed a synergistic effect with a greater reduction in the viability of skin melanoma cells and a greater amount of apoptosis.
Conclusion: In general, vitamin A and Low-level laser diminish the viability of cancer cells. Combination therapy of Low-level laser in the effective dose with vitamin A in optimal concentration provides anti-cancer effects. Further reductions in cancer cell viability caused by vitamin A and low-level laser radiation could pave the way for a novel approach in cancer treatment.
 

Development of the “safe sex knowledge and behavior questionnaire”, a tool for use in patients with severe mental illnesses
Firoozeh Raisi , Seyyed Taha Yahyavi, Zahra Shahvari , Ehsan Kazemi Khaledi , Mehdi Soleimani, Agaah Ashrafi,
Volume 79, Issue 10 (January 2022)
Abstract
Background: Patients with severe mental illnesses are more prone to experience sexual health problems. Herein, we developed a "Safe Sex Knowledge and Behavior Questionnaire for Patients with Severe Mental Illnesses"(SSKBQ-SMI).
Methods: The present study was conducted in the form of methodological research in 4 stages. In the first stage, items of the questionnaire were selected and the item pool was formed by using similar studies and experts' opinions. During the next steps, the psychometric properties of the questionnaire were assessed using content validity, face validity, reliability and construct validity. The content validity was tested using the Content Validity Index and Content Validity Ratio. The charts of content validity were given to 13 specialists expert in sexual health including psychiatrists, clinical psychologists, gynecologists, urologists, and infectious disease specialists. The reliability was tested by using the test-retest method in 70 patients with two-week intervals. The construct validity was tested using exploratory factor analysis in 265 patients. The internal consistency was calculated by using Cronbach's alpha index.
Results: After determining the content and face validity, a tool was obtained with 16 True/False items in the knowledge section (with one score for each correct answer and the total score range from 0 to 16) and 16 five-point Likert scale items in the behavior section (with each question score range from 0 to 3 and the total behavior score range from 0 to 48, the lower score defined safer behavior). The correlation coefficient of the scale scores in the test-retest method was calculated to be 0.880 (P<0.001) and 0.951 (P<0.001) in the sections of knowledge and behavior, respectively. The Cronbach's alpha coefficient was 0.809 for the section of knowledge, 0.756 for the section of behavior, and 0.782 for the whole questionnaire. Exploratory factor analysis confirmed the existence of 4 factors in the knowledge section and 3 factors in the behavior section.
Conclusion: The present 32-item questionnaire was designed based on experts' opinions and important statements of patients about sexual health, simple scoring, good reliability and validity, is a suitable tool for assessing the safe sex knowledge and behavior in patients with severe mental illnesses.

Study of knee range of motion after soft tissue repair in both flexion and extension during total knee arthroplasty: a randomized clinical trial
Kiavash Hushmandi, Mohsen Heidari , Seyedeh Omolbanin Seyed Rezaei, Alireza Bahonar, Mehdi Motififard, Hamed Gholizadeh, Mehdi Raei,
Volume 79, Issue 11 (February 2022)
Abstract
Background: The patient's position during the recovery time after arthroplasty surgery can be a factor in reducing complications and improving patients’ condition. Therefore, this study was performed to compare the knee range of motion after soft tissue repair in both flexion and extension positions of total knee arthroplasty.
Methods: This study is a double-blind clinical trial. The study population was all candidates for total knee arthroplasty surgery in Al-Zahra and Kashani hospitals in Isfahan from July 2011 to September 2012. The sample size was selected using the statistical formula of 88 patients and randomly divided into two groups of flexion and extension. In the first group during the knee soft tissue repair, the knee was in flexion and in the second group it was in extension and then it was repaired. Information such as age, sex, body mass index and surgical position were recorded in the checklist. The knee range of motion was measured at the end of the first, second, fourth, eighth and twelfth weeks and recorded in a checklist. In order to compare the pattern of changes in mean knee range of motion over time in the two groups, mixed linear models and conventional marginal models to generalized estimator equations were used by STATA software.
Results: The results showed that there was no significant difference between the flexion and extension groups in knee range of motion. In both groups, the mean knee range of motion increased with time (P<0.001). The mean scores of knee function after the end of the twelfth week in the flexion and extension groups were 141.04±23.19 and 143.09±22.34, respectively, and this difference was not significant.
Conclusion: Soft tissue repair in a particular position is not so effective on the outcome that we want to institutionalize it by spending a considerable amount of budget for training surgeons.

Evaluation role of beta-2 adrenoceptor agonist and antagonist in the expression of gap junction genes (connexin 37/43) in cumulus cells of women with poor ovarian response
Farideh Zafari Zangeneh , Samad Muhammadnejad, Mohammad Mehdi Naghizadeh, Maryam Bagheri, Elnaz Hekmat,
Volume 79, Issue 11 (February 2022)
Abstract
Background: Connexon is a membrane structural protein in the gap junctions. These cellular connections are responsible for transporting ions and messenger molecules to the oocyte. This study aimed to investigate the role of beta-2-adrenoceptors in the process of follicle growth based on the expression of the two connexins 37/43 in the gap junctions that have a primary role in the mitotic resumption and oocyte maturation.
Methods: This case-control study was conducted from April 2019 to November 2020 at the Reproductive Health Research Center of Tehran Imam Khomeini Hospital was performed on women with the poor ovarian response (POR) and control (women donate eggs) groups. Both groups had entry criteria with a body mass index under 28 m2/kg and 20-45 years old. Exit criteria were including no drug use except ovarian stimulants and no illness. The diagnosis was made agreeing to the Bologna model criterion. Ovulation stimulation cycle was performed, and then after the puncture, cumulus cells were isolated by enzyme and were freezing in -80 centigrade until the time of inserting into the cell culture medium. Isoproterenol (agonist) and propranolol (antagonist) at a concentration of 100 nM were added to the culture medium as the beta-2 adrenoceptors selective drugs. After culture, RNA extraction was performed and the concentration was read by Nanodrop, and then cDNA was synthesized. Gene expression was determined by real-time PCR.
Results: The findings of connexin expression in the three study groups: without the drug (P<0.001), propranolol (P<0.001), and isoproterenol (P<0.001) were significant compared to the control group. Isoproterenol decreased expression but propranolol increased it (P<0.001).
Conclusion: These findings confirm the important role of connexins 37 and 43 in cumulus cleft junctions that propranolol was able to increase its expression. Therefore, we suggest firstly these two connexins can be an effective target for oocyte growth and maturation. Secondly, propranolol could be a new treatment for women with POR and be effective in assisted reproductive technology (ART).
 

Comparison of the analgesic effect before and after injection of hyaluronic acid in patients with knee osteoarthritis in Amir A'alam hospital
Nader Ali Nazemian, Arman Taheri , Mehdi Sanatkar,
Volume 79, Issue 11 (February 2022)
Abstract
Background: One of the most important issues for patients with osteoarthritis is reducing pain and returning them to normal life. In addition to losing weight and improving daily activities, pain management treatments may be needed. One of these treatments is the injection of hyaluronic acid gel into the knee joint, which has been studied in this study.
Methods: In this study, 61 patients with knee osteoarthritis were included and the Then, they received the injection of hyaluronic acid gel, and the intensity of pain, range of motion of the knee joint, and inflammation of the knee joint were measured. The numeric rating scale was used to measure pain intensity, and movement angle was used to measure the range of motion
Results: The mean age of patients in this study was 60.52±11.77 years. Pre-injection pain index in patients was 7.90±0.99, which decreased to 5.49±1.91 on the third day, 5.98±1.98 on the seventh day and 3.77±2.91 on the 30th day (P<0.001). The amplitude of painless movement based on the degree before injection in patients was 38.85±19.44 which increased to 60.25±21.65 on the third day to 65.25±22.65 on the seventh day and to 71.07±24.17 on the 30th day (P<0.001). Inflammation rate was reported before injection in 29 patients which decreased to 6 patients on the third day after injection (P=0.009).
Conclusion: Injection of hyaluronic acid into the joint has analgesic effects and significantly improves the function and range of motion of patients. It is recommended that hyaluronic acid could be considered as a suitable drug in the treatment process of these patients. Considering that using this method, which is a useful treatment method in reducing patients' pain and improving their function, we recommend this method, especially in the elderly and without the need for surgery.

Ranking the factors affecting the care and provision of health services to patients in medical centers using the VIKOR dempster-shafer method: a brief report
Mahsa Salehinejad Gilchalan , Mehdi Sadeghzadeh,
Volume 79, Issue 12 (March 2022)
Abstract
Background: Determining the rank of important parameters in ranking health care and providing health services to patients in medical centers.
Methods: The research method is descriptive-analytical and applied in terms of classification. The data is from the database of the Faculty of Health and Medicine of the University of Tehran, which was collected as an archive from April 1998 to May 1999. The statistical population were all experts, specialists and experts of the Faculty of Health 29 of whom completed the questionnaire. The weight of the criteria was evaluated using the AHP method and in the next stage, the medical centers were ranked using the DS-VIKOR method. The analysis method in this study consists of the following steps steps:
• Implementing a simple VIKOR method.
• Implementing the Dempster-Shafer and Vicker method.
• Implementing the AHP method
• Implementation of the Topsis method.
• Comparing the proposed methods to review and compare which ones work best.
Results: The weight of medical centers was assessed by AHP method and then the combined centers were ranked by Dempster-Shafer and VIKOR combined methods  using the information of four medical centers, the DS-Vikor approach was implemented. The purpose of six criteria and three experts was used for evaluation. The results show that the effectiveness of care and treatment process is more important from the experts' point of view. Dempester-Schaefer and Vicor The medical centers in question are ranked. For validation, at the end, the medical centers were ranked by TOPSIS method.
The integrated system includes various subsystems giving caring and providing health services to patients in medical centers that can be built and configured and are ranked.
The model can investigate the effectiveness of giving caring and providing health services to patients in medical centers.
Conclusion: By combining the two methods of Dempster-Shafer and Vicker, the confidence in the whole uncertainty is improved and the results are more reliable. This approach can help reduce the uncertainty caused by people's cognition to increase the level of decision-making, allowing us to overcome the problem of choosing the right level of uncertainty and to deal with uncertainty in a practical and justified way.

The effectiveness of magnetic field therapy on fatigue in patients with multiple sclerosis-a randomized, single-blind clinical trial: a brief report
Arash Bostani, Hadi Gharabaghian Azar, Mehdi Jafari, Mastane Babaei Gramkhani,
Volume 80, Issue 1 (April 2022)
Abstract
Background: Multiple sclerosis (MS), as an inflammatory autoimmune disease and chronic degenerative central nervous system degeneration, often occurs in early adulthood. One of the common and debilitating symptoms of this disease is fatigue, which can affect up to 80% of patients with MS. This study aimed to evaluate the effectiveness of magnetic field therapy on fatigue in patients with MS.
Methods: Present study is a single-blind randomized clinical trial (RCT) that Was conducted on patients with multiple sclerosis from March 2019 to September 2021. In this study, 46 patients who met our inclusion criteria were divided into two groups randomly: magnetotherapy intervention and control group. The intervention was performed in the form of a pulsed magnetic field with a frequency of 15 Hz and an intensity of 4.5 Millie Tesla. In order to blind patients, they were unaware of the intervention or control group, and the technician in charge of the treatment and the statistician knew about it. Data were then collected and recorded using the Fatigue Severity Scale, the Patient Health Questionnaire, and the Epworth Sleepiness Scale Questionnaire.
Results: Of the 46 patients studied, 22 (48%) were male and the rest of them were female [24 cases (52%)]. The mean age of men and women was 34.4±7.3 and 33.5±1.7 years, respectively. Among the intervention and control groups, 8 people took amantadine equally in each group. In the magneto-therapy intervention group, the mean severity of fatigue reduced from 4.91±0.86 to 4.27±1.10, which was significant (p=0.024). In our control group, the mean intensity of fatigue reduced from 4.83±0.83 to 4.37±0.81, which was significant statistically (p=0.028). Although, the difference between the response of the two groups to treatment was not significant (p=0.382).
Conclusion: Due to the lack of significant differences in the reduction of fatigue severity, this treatment is not recommended for the treatment and management of fatigue in patients with MS.

Appendicovesical fistula presenting as a bladder mass in a girl with cystic fibrosis: a case report
Hamid Arshadi, Pooya Hekmati, Hojatollah Raji, Mohammad Vasei , Mehrzad Mehdizadeh,
Volume 80, Issue 1 (April 2022)
Abstract
Background: Appendicovesical fistula in patients suffering from cystic fibrosis is a rare condition. Although this situation is so rare it should be considered in the differential diagnosis, dealing with a patient with cystic fibrosis and chronic abdominal pain with no response to primary management. To the best of our knowledge, this is the third case of appendicovesical fistula in a patient with cystic fibrosis.
Case presentation: In this paper, we are reporting a bladder lesion of a nine-year-old Iranian girl, a known case of cystic fibrosis, who was referred to pediatric urology clinic, Children’s Medical Center, Tehran University of Medical Sciences. The girl is a known case of cystic fibrosis on regular follow-up who had chronic abdominal pain for about one year. While primary management had been failed for her, further workups were done by her pediatric pulmonologist. In her pelvic sonography, the radiologist reported a bladder lesion so she was referred to our clinic. Cystoscopy was done for her, but transurethral biopsy/resection was impossible according to the lesion location. The non-papillary nature of the lesion raised our concern about the possibility of genital rhabdomyosarcoma with bladder invasion. So, an Abdominopelvic CT scan and a pelvic MRI were also done for her. Intact uterus and vagina with an enhancing lesion at the dome of the bladder with some degree of inflammation/attachment around the adjacent GI tract were detected on her images. The urachal inflammatory/tumoral process could not be ruled out. So open surgical exploration was planned. During the attempt for surgical exploration and partial cystectomy, at the Children’s Medical Center in December 2021, we found that the mass, is actually her appendix which has invaded the urinary bladder, and presented as a bladder lesion.
Conclusion: Abdominal pain is a relatively common complaint of patients with cystic fibrosis. Every caregiver or physician should consider rare conditions, dealing with a cystic fibrosis patient whose abdominal pain does not respond to common management.

Evaluation of the effect of using platelet-rich fibrin in healing wounds caused by fistulas with supralevator collection and its effect on fistula recurrence
Mehdi Alemrajabi, Seyed Hamze Musavi , Behrouz Seydi Majd , Tayeb Ramim,
Volume 80, Issue 2 (May 2022)
Abstract
Background: Supralevator abscesses make up to 9% of all cryptoglandular abscesses. Given that platelet-rich fibrin accelerates tissue growth and reduces infection, it seems necessary to investigate its effect on the healing of fistula wounds because it can accelerate the healing of morbid wounds and reduce its effect on recurrence.
Methods: The study was performed as a single-blind clinical trial in patients who were referred to the surgical clinic of Rasoul Akram Hospital (PBUH), with the approval of the supralevator collection. Before surgery, Wexner Score were identified in patients who underwent surgery, and the entire path of fistulas and cavities was identified. Clinical outcomes were monitored one day after surgery for up to two months once a week, then every month until complete recovery, and then six months after surgery. After the operation, the patients were examined for recurrence, until the PRF was absorbed, the dressing of the operation site was performed only with normal saline, and the patients were on a low-residue diet so that they could not excrete as much as possible.
Results: 10 people participated in the final analysis. The mean age of patients was 33.20 years (26-46 years). Three patients had a history of perianal abscess surgery, two patients had a history of fistula surgery and 1 patient had a history of Fisher surgery. The mean closing time of the cavity was 14.2 days (10-22 days). Two patients (20%) had a fever and two patients (20%) had a surgical site infection. Bleeding and recurrence were not observed in any of the patients. The mean preoperative Wexner score was 0.80±0.76 Which decreased to 0.68±0.50 postoperatively (P=0.045).
Conclusion: Finally, the findings of the study showed that the use of PRF to repair a complex fistula is a method that can be easily repeated with minimal side effects and can heal wounds caused by fistulas with supralevator collection. This treatment can play an important role in the treatment of complex fistulas that have moderate or extensive involvement with the sphincter, or the occurrence of fistulas with sphincter dysfunction.

 

Costs of services covered by the global payment system in Tehran University of Medical Sciences
Jalal Saeedpour , Mehdi Rezaei , Shamsi Ekhteyar, Sara Akhavan Rezayat , Soheila Damiri , Faezeh Fartaj, Maryam Radin Manesh ,
Volume 80, Issue 4 (July 2022)
Abstract
Background: In Iran, a combination of three methods of budget payment, fee for service and case-based payment (known as the global payment system) is used to reimburse the cost of hospital services. The aim of this study was to investigate the costs of 90 services of the Global Hospital Reimbursement System at Tehran University of Medical Sciences.
Methods: This descriptive cross-sectional applied study was performed from March  2017 to March 2019 in the hospitals of Tehran University of Medical Sciences. The billing and record data of all patients whose services were reimbursed on a global payment system basis were extracted from hospital information systems. Data were analyzed using descriptive statistics (frequency mean. std deviation, maximum & minimum) in SPSS 21 and Excel 2016.
Results: During two years in TUMS, the costs of services provided to 143,866 patients have been reimbursed based on the global payment system., which had a cost of 2300 billion rials. 80% of the total services and costs were related to 10 services. 78.46% of the cases were related to two specialized groups of ophthalmology and obstetrics and gynecology. 83.17% of the total costs of services reimbursed globally at the TUMS were related to these two specialized groups. The average cost per service was about 16 million Rials, but varied greatly for different services, ranging from about 1.8 million Rials to 67 million Rials. On average, for a global service, the share of each of the cost subgroups of diagnostic services, hoteling and nursing services, medicine and consumables, operating room and surgery, physician's visit and consultation, respectively 3.1%, 11.6%, 21.4%, 49.9% and 13.9%.
Conclusion: Managers need to focus on high-frequency and high-cost services to reduce the cost and financial losses for services that are under the global payment system. Depending on the specific cost pattern of each service, the strategies adopted to control the costs of that service should also be different.

Comparing the diagnostic accuracy of bedside ultrasound with wound exploration in diagnosis of nerve and tendon injuries in upper extremities: a brief report
Marzieh Khademi, Maryam Masaeli, Mehdi Azarmnia, Masoud Shahabian, Maziar Karamnejad, Mohammad Reza Azimi Aval , Azadeh Asghari Birbaneh,
Volume 80, Issue 4 (July 2022)
Abstract
Background: Trauma is one of the most common causes of death in all ages. Considering the prevalence of trauma in the general population, and its costs and complications, it is important to use aiding tools to accelerate the diagnosis in order to act in time. The aim of this study was to evaluate the efficacy of ultrasound in diagnosing nerve and tendon injuries in the upper extremities.
Methods: This study is a cross-sectional study, which was carried out at the emergency department of the Besat Hospital, Tehran from march 2018 to march 2019. The statistical population was all patients who had been referred with deep lacerations in upper extremities and had injuries in the superficial or deep compartments (nerves/ tendons). For all the patients who met the inclusion criteria, bedside sonography with 11 Mhz Linear probe was performed by the researcher and under the supervision of the radiologist. The results were compared with the results from local exploration of the wounds. Local exploration of the wounds was also done under the surgeon's supervision. After completing the sample size and data collection, SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) was used for statistical analysis
Results: In this study, from 144 patients with penetrating trauma in the upper extremities, 56 patients were suspected with nerve injuries and 50 patients were suspected with tendon injuries. After evaluation with an ultrasound probe, 21 out of 23 cases suspected of nerve injuries were confirmed by local exploration. Local exploration confirmed that 27 out of 28 cases were suspected of tendon injuries. The accuracy of ultrasound in the assessment of nerve damage was estimated at 99.64% and in tendon damage at 92%, and the sensitivity of ultrasound in the diagnosis of nerve damage was 91.30% and in the diagnosis of tendon damage was 96.42%.
Conclusion: By the results of this research it can be concluded, that ultrasound leads to a faster diagnosis. It provides a wider field of view, can reduce possible secondary injuries and increases the accuracy of the diagnosis.

Comparison of roux-en-y gastric bypass techniques with and without distal gastric plication in patients with morbid obesity
Mehdi Asgari, Ali Sanaee, Faramarz Pazyar,
Volume 80, Issue 5 (August 2022)
Abstract
Background: The vertical gastric plication technique leads to poor long-term outcomes and is associated with intolerable reflux, dysphagia, or weight gain in a high percentage of patients. Therefore, in this study, the therapeutic results of two methods with and without plication of the distal part of the stomach in gastric bypass surgery in patients with morbid obesity were compared.
Methods: In this clinical trial randomized single-blind study, 40 patients with morbid obesity who were referred to one of the hospitals affiliated with Jundishapur University of Medical Sciences in Ahvaz during March 2020-February 2021, were randomly divided into two groups: with plication of the distal part of the stomach (n=20) and without plication of the distal part of the stomach (n=20) in Roux-en-Y gastric bypass surgery. Weight loss rate, complications related to surgery, outcomes and satisfaction of patient were noted and followed up for one year.
Results: The mean percentage of weight loss at different times did not show a significant difference between the two groups (p>0.05). The length of hospitalization after surgery was significantly less in the distal gastric plication group (p=0.0001). During one year of follow-up, hypertension, diabetes, HLP, and reflux were well in the distal plication method but showed no significant difference (p>0.05). Satisfaction of the patients was more in the distal plication method and showed no significant difference (p>0.05). One year after the operation, the change of diet showed no significant difference in the two groups (p>0.05).
Conclusion: It looks that using the laparoscopic distal gastric plication method is an effective and safe method and is associated with early ideal weight loss, reduction of complications, and increase in satisfaction of patients with BMI>=35 kg/m2. No need to use a foreign body, stapler or bandage and the possibility of re-operation are the advantages of this technique.

Development of clinical guideline for early detection of critical congenital heart diseases at birth by pulse oximetry
Alireza Ahmadi , Mohammad Reza Sabri , Zohreh Sadat Navabi, Mehdi Ghaderian , Bahar Dehghan,
Volume 80, Issue 5 (August 2022)
Abstract
Background: Congenital heart defects (CHD) are the most common type of birth defects. The main screening tests used to identify babies with congenital heart defects include prenatal echocardiography and postnatal clinical assessment. Routine pulse oximetry has been reported as an additional screening test that can potentially improve the early diagnosis of critical congenital heart disease (CCHD).
Methods: This study is a multi-stage evolutionary study that was conducted for 12 months from March 2021 to March 2022 at Pediatric Cardiovascular Research Center in Cardiovascular Institute, Isfahan, Iran. In the first phase, after identifying the topic and aims of the present study, questions were designed through the PICO method including (population, intervention, control, and outcomes). Then conducting systematic searches, the quality of all existing clinical guidelines (CG) of this field were evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument and a committee consisting of pediatric cardiologists and neonatologists in the field. Next, based on the opinions of experts, the quality of 1 out of 6 clinical guidelines for early detection of critical congenital heart disease at birth by pulse oximetry was assessed as optimal. Finally, the clinical guidelines draft was evaluated using the Delphi method and the panel of experts. After expert panel meetings and consensus between members, the final version of the guideline for early detection of critical congenital heart diseases at birth by pulse oximetry was developed.
Results: In the present study, criteria of clinical practice regarding the stages of newborn screening by pulse oximetry at birth were determined based on the evidence and health conditions and were presented in twenty-eight recommendations and six sections. The final recommendations were presented in the results section.
Conclusion: The finding of the present study showed that physicians, nurses, and midwives can apply the recommendations of this clinical guideline for the early detection and referral of neonates with critical congenital heart disease.

The effect of neonatal bloodletting in the treatment of neonatal jaundice: a review article
Reza Saeidi, Ali Saeidi, Azri Izanloo, Mehdi Hosseini,
Volume 80, Issue 9 (December 2022)
Abstract
Neonatal hyperbilirubinemia occurs in 60-80% newborns in the first few days of birth, in most cases, jaundice is physiologic and usually improves without treatment. Bloodletting is the withdrawal of blood from a patient to prevent or cure illness and disease. Recently the Bloodletting is one of the common treatments for neonatal jaundice. In this review study, we have evaluated medical articles and narrative books (hadiths) for the application of this method in neonatal jaundice. In this systematic review we evaluated PubMed databases, Cochrane, Google Scholar, collaboration library, SID, Magiran, and narrative books (hadiths) with the subject of cupping and Bloodletting were included in the study 1983 and September 2019. In this study, all of articles with the title “Bloodletting“, "cupping" and “Wet cupping”, “Dry cupping”, “Air trapping”, “Scarification”, “Hejamat”, “ear cupping” and the abstracts of the articles presented in the conferences were studied. Then, in the evaluation stage of the articles, all the studies unrelated to the issue were excluded from the research. Also, in this study, all Shia and Sunni hadith sources and the Holy Qur'an were evaluated. The evaluation of hadiths was carried out by Jama Al-Ahadith software, which is a collection of Shia and Sunni hadith books. We assessed 1120 articles related to Bloodletting, none of which were related to neonatal jaundice and Bloodletting. Cupping is a therapeutic method that dates back thousands of years. Bloodletting by scarification was an accepted practice in Ancient Egypt. In Greece, bloodletting was in use in the 5th century BC. "Bleeding" a patient to health was modeled on the process of menstruation. During the Roman Empire, the Greek physician Galen, who subscribed to the teachings of Hippocrates, advocated physician-initiated bloodletting. The popularity of bloodletting was reinforced by the ideas of Galen. In our study in Shiite and Sunni narrations, only two narrations recommended infant Bloodletting after four months just for prevention. According to our finding there is no article or narration that recommended Bloodletting for neonatal jaundice.

Prevalence and risk factors of intestinal metaplasia in patients with dyspepsia
Mehdi Ghobakhlou, Hamidreza Ghasemi Basir , Ahmad Jahdari , Elnaz Ataei, Ali Saadatmand,
Volume 80, Issue 9 (December 2022)
Abstract
Background: Intestinal metaplasia in the stomach is one of the precancerous lesions of gastric tissue. If the lesions are diagnosed early before invasive cancer develops, it is possible to prevent the progression to malignant lesions. Therefore, this study was performed to evaluate the prevalence and risk factors of intestinal metaplasia in patients with dyspepsia.
Methods: This descriptive cross-sectional study was performed on patients who were referred to Shahid Beheshti Hospital in Hamadan, Iran from the beginning of 2019 to the end of 2020. A total of 250 patients over 16 years of age who complained of dyspepsia for at least more than three months were included in the study. Examination was performed for patients along with the completion of a pre-designed questionnaire including demographic information and metaplasia risk factors. Also, endoscopy and biopsy specimen of gastric mucosa were performed for histological examination. Finally, the data were analyzed using SPSS software version 16 with related statistical tests.
Results:  There was no significant relationship between job type, level of education, marital status and family history of gastric cancer, smoking, alcohol, high salt, dairy products and high-nitrate diet with the disease. There was a significant relationship between body mass index and the presence of intestinal metaplasia in men (P=0.032). The average age of men with metaplasia was about 13 years older than those without the disease. Also gastric ulcer (84%) and pan gastritis (40.4%) were the most common cases in endoscopic results. The number of female patients with epigastric pain was about 14% higher than male patients. Gastric ulcer was significantly associated with gender, with about 12% more gastric ulcers observed in men than women (P=0.014). Also, no significant relationship was observed between the presence of Helicobacter pylori and the severity of its colonization with intestinal metaplasia. (P=0.230)
Conclusion: In this study, no significant relationship was observed between the presence of Helicobacter pylori and the severity of its colonization simultaneously with intestinal metaplasia. Apart from the two factors of increasing age and type of sex, no serious risk factors for intestinal metaplasia were seen.

Sporadic pulmonary lymphangioliomyomatosis (LAM) in a 24-year-old female: a case report
Shahram Seyfi, Nazli Farnoosh, Kayvan Latifi, Parviz Amri Male , Hamed Mehdinezhad Gorji , Asadollah Shakeri, Khadijeh Ezoji ,
Volume 80, Issue 11 (February 2023)
Abstract
Background: Sporadic lymphangioleiomyomatosis (S-LAM) is a rare disease that generally affects young women and involves the abnormal proliferation of smooth muscle cells (LAM cells) in the lungs (pulmonary LAM). There are two types of LAM, sporadic and LAM with tuberous sclerosis, which is an autosomal dominant genetic disease caused by mutations in the Tsc1 and Tsc2 genes. The most common manifestation of this disease is pneumothorax due to cyst rupture. Median transplant-free survival for pulmonary LAM is 23 years from diagnosis. Factors associated with a poor prognosis are often those associated with a more rapid decline in lung function.
Case Presentation: The patient was a 24-year-old woman who presented with pneumothorax and multiple bullae in both lungs. The patient had no family history of respiratory disease, and the patient herself had no symptoms other than mild shortness of breath following activity from a year ago. A lung CT scan was performed for the patient and multiple bullae were evident in both lungs, which confirmed the diagnosis. There was no evidence of involvement of other organs but the lung. For the patient in the ICU with the diagnosis of left pneumothorax, a chest tube was inserted and she underwent mechanical ventilation. Finally, after 24 days of hospitalization, oxygen therapy of the patient was performed with a normal mask, and she underwent left lung pleurodesis with talcum powder, and a few days later, right lung pleurodesis was performed on the patient. On the 36th day of hospitalization, her general condition improved and she was discharged from the ICU. The patient was discharged in good general condition and had no problem on her four months follow-up.
Conclusion: Fortunately, with the diagnosis of LAM for the patient according to the CT scan of the patient's lung, she was treated with insertion of a chest tube and by performing pleurodesis, the recurrence of pneumothorax was prevented. In a young woman with spontaneous pneumothorax, sporadic LAM is one of the differential diagnoses.

Investigating the effects of swimming exercise training on xidative stress induced by chronic morphine administration
Mehdi Sadegh, Mohammad Hassan Sakhaie ,
Volume 80, Issue 12 (March 2023)
Abstract
Background: Morphine as a strong analgesic compound is widely prescribed in clinic to control medium to severe pain, they are also may cause drug abuse. Recent studies have shown chronic morphine consumption and it could induce oxidative stress and cause cell damage. In this study, the effects of daily swimming exercise investigated on oxidative stress indices in the hippocampus and plasma of morphine dependent rats.
Methods: In this study, 48 adult male wistar rats were randomly divided to four groups. Experiments were done during January to March 2022 at Arak University of Medical Sciences. Morphine was self-administrated for 4 weeks, as dissolved (0.4 mg/ml) in the daily drinking water. Exercise training was included 15 minutes daily continuous swimming in a swimming pool. Swimming occurred during all days of morphine consumption. At the end, 6 rats were randomly selected from each group and withdrawal signs were evaluated by naloxone injection, to confirm morphine dependency. Then, hippocampus and plasma were collected from the 8 remaining rats of each group and were used for GSH, GSSG, MDA, irisin and BDNF assessment.
Results: All rats in morphine consumed groups showed withdrawal signs in naloxone text, which means morphine dependency successfully were induced. However swimming exercise significantly reduced the consumption size of morphine. GSH was significantly decreased, while GSSG and MDA were significantly increased in the plasma and hippocampus of morphine groups in compare with control. Morphine consumption had no effect on plasma levels of irisin, while significantly decreased hippocampus level of BDNF. Daily swimming exercise in the morphine consumed group significantly repaired morphine effects on plasma and hippocampus levels of GSH, GSSG, MDA and hippocampus levels of BDNF.
Conclusion: Daily swimming exercise during the morphine consumption is able to repair at least some parts of the oxidative stress induced by morphine. This effect might help to reduce cellular and molecular damages raised by chronic morphine consumption.

Comparison of magnetic resonance imaging and CT scan in patients with complaints of mediastinal and chest wall mass
Mahdi Yadollahzadeh, Nader Rezaei , Mohsen Farrokhpour , Mehdi Azimi, Maedeh Barahman, Mohammad Bahadoram , Amirhossein Forouzanmehr , Seyed Ali Javad Mousavi ,
Volume 81, Issue 6 (September 2023)
Abstract
Background: The realm of diagnosing intrathoracic lesions involves a spectrum of imaging methodologies, among which computed tomography (CT)-scan and magnetic resonance imaging (MRI) stand prominent. In the context of Iran, where there is no study comparing the efficacy of CT-scan and MRI for evaluating intrathoracic lesions, our study endeavors to bridge this gap. Mindful of the nuanced advantages and drawbacks inherent in each method, we aim to conduct a comprehensive comparative analysis of CT-scan and MRI in diagnosing intrathoracic lesions, focusing on patients seeking care at Firoozgar Hospital's pulmonary clinic.
Methods: Embarking on a cross-sectional exploration at Firoozgar Hospital Pulmonary Clinic in Tehran, Iran, our investigative journey unfolded between April 2020 and March 2021. Thirty patients, spanning ages 21 to 69, presenting with intra-thoracic lesions encompassing mediastinal and chest wall anomalies, underwent simultaneous CT scan and MRI examinations. In pursuit of diagnostic certainty, histopathology was ordained as the gold standard, and the ensuing results underwent meticulous scrutiny and analysis utilizing SPSS 23 statistical software.
Results: Our study cohort comprised 30 patients, averaging 44.83 years (SD=12.71), with males constituting 60% of the population. Delving into the histological reports, CT-scan and MRI accurately diagnosed 25 (83.3%) and 28 (93.3%) cases, respectively, in retrospective analysis. The Kappa matching coefficient for CT-scan stood at 0.783, while for MRI, it soared to 0.912. A notable revelation surfaced as the Kappa matching coefficient for both CT-scan and MRI maintained a robust 0.783 (P<0.001 in all three cases).
Conclusion: MRI might wield a superior diagnostic prowess compared to CT-scan in evaluating intrathoracic lesions. The robust Kappa matching coefficients endorse a substantial concordance between the two imaging modalities. The implications further beckon contemplation that, in select scenarios, the acquisition of biopsy and histopathology may prove redundant when scrutinizing intrathoracic lesions using the tandem approach of CT-scan and MRI. However, to etch these findings into the annals of medical certainty, a multicenter study endowed with a judicious sample size emerges as an imperative next step.

Efficacy of filgrastim and Lenograstim drug treatment in patients with neutropenia: a systematic review
Sogol Shirzad, Zeinab Karimi, Mehdi Mohsen Zadeh , Masoud Mohammadi,
Volume 81, Issue 7 (October 2023)
Abstract
Background: Neutropenia refers to a decrease in the absolute number of neutrophils in the blood circulation, certain drugs are used in connection with the treatment of neutropenia. Therefore, the aim of this study is to investigate and compare the efficacy of filgrastim and lenograstim drug treatment in patients with neutropenia in a systematic review.
Methods: This study is a systematic review study conducted in connection with the comparison of the effectiveness of filgrastim and lenograstim in neutropenic patients based on the search in Google scholar, PubMed, ScienceDirect, Irandoc, SID, Magiran databases in the time range of January 2000 to August 2023. This systematic review was based on the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, including systematic search of databases, organization of documents for review, selection of studies, information extraction and finally presentation of the final report. The keywords used for searching in this study were selected based on published primary studies and MESH, and after a detailed examination of the study questions, they were selected according to the PECO criteria.
Results: 1099 articles were identified in the review of the investigated databases, and after removing duplicate articles, unrelated articles, as well as articles that did not have access to their full text or did not have the required information, eight studies were the final phase, and were checked. Out of the eight selected articles, three articles declared the effectiveness of lenograstim more than filgrastim. Two articles mentioned the greater effect of filgrastim and three articles published in recent years declared the effect of two drugs to be the same. Among these articles, the studies that considered the drug dosage to be the same in the investigated groups and the studies that had a larger statistical population in order to generalize to the society are more important.
Conclusion: According to studies conducted in recent years, both filgrastim and lenograstim recombinant drugs have the same effectiveness in the treatment of neutropenia.

Prevalence of congenital heart disease among term infants with respiratory distress: a case study in Kerman
Mohammad Mehdi Bagheri , Fahimeh Sadeghi Zarandi ,
Volume 81, Issue 8 (November 2023)
Abstract

                                                            
Background: Congenital heart diseases (CHD) as one of the most common disorders in newborns are leading cause of perinatal mortality, also one of respiratory distress syndrome causes in newborns. This study aimed to determine the prevalence of congenital heart diseases in infants with respiratory distress syndrome.
Methods: This cross-sectional study is a retrospective study that surveyed congenital heart diseases in 145 term infants who were hospitalized in neonatal intensive care unit (NICU), Afzalipour hospital, Kerman. These infants were admitted to the neonatal intensive care unit from March 20, 2012 to the end of March 20, 2015 due to respiratory distress syndrome. Information was extracted from the medical records and then were entered in the checklist. Descriptive statistics (frequency, percentage), analytical (chi-square test) and SPSS version 20 software were used to analyze the data.
Results: Out of 145 infants with respiratory distress syndrome, 123 infants had congenital heart diseases. Therefore, the prevalence of congenital heart diseases in patients with respiratory distress syndrome was 84.83%. The most infants with congenital heart diseases were male (66.67%) and weighed between 3-4 kg (47.97%). More than 69% of newborns with congenital heart diseases were born by cesarean section and most of them were receiving medical treatment (85.37%). There was a significant difference between patient outcome and congenital heart diseases (P=0.018). The difference between sex, weight and type of delivery with congenital heart diseases was not significant. In terms of the prevalence of congenital heart diseases, atrial septal defect (ASD) was the most prevalent with 14.48%. After that, patent ductus arteriosus (PDA) was the most prevalent with 11.72%.
Conclusion: Due to the high prevalence of congenital heart diseases in term children with respiratory distress syndrome, all term infants with symptoms of respiratory distress syndrome need cardiac examination, especially echocardiography to diagnose the cause. In addition, due to the high mortality of infants with congenital heart diseases with symptoms of respiratory distress syndrome, the need for more, more accurate and complete care of these infants is suggested.


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