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Effect of strabismus surgery on emotional quotient in patients referring to Imam Khomeini Hospital, Ahvaz
Gholamreza Khataminia , Reza Papahn, Atefeh Mahdianrad , Soroush Karamirad, Samaneh Mohamadpour,
Volume 81, Issue 12 (March 2024)
Abstract
Background: Psychosocial improvements of successful strabismus surgery have been reported in previous studies. But the effect of strabismus surgery on the emotional intelligence of patients is unclear. The aim of this study was to evaluate the effect of strabismus surgery on emotional quotient in patients referring to Imam Khomeini Hospital, Ahvaz.
Methods: This prospective interventional study conducted on patients underwent strabismus surgery in Imam Khomeini Hospital, Ahvaz during May 2021 to March 2022. A total of 38 patients between 8-37 years were included. Patients with previous surgery were excluded. All subjects were evaluated before and three months after successful strabismus surgery. Three months post-surgery the improvement of emotional quotient, self-esteem, body image, social anxiety and social avoidance were evaluated and compared with previous surgery. All data were analyzed by SPSS (V25). P-Value less than 0.05 was considered as significant level.
Results: 38 subjects including 18 males (47.4%) and 20 females (52.6%) were included. The mean age of patients was 18.11±9.33 years old. Our results showed that compared with before surgery, significant improvements were noted after surgery, within the emotional quotient subscales including self-awareness (P=0.016), self-regulation (P<0.0001), self-motivation (P<0.0001), empathy (P<0.0001), social skills (P<0.0001) and emotional quotient total score (P<0.0001). Further analysis revealed statistically significant improvements in body image (P<0.0001), social anxiety (P=0.004) and social avoidance (P=0.002). The result showed that the improvement of emotional quotient after strabismus surgery was significantly higher in the age group of less than 12 years (P<0.0001). No significant difference was fund between two  genders for emotional quotient subscales (P>0.05).
Conclusion: The results of this study showed a significant improvement in the psychosocial factors including emotional quotient, body image, social anxiety and social avoidance after strabismus surgery. This result suggests that beyond functional and cosmetic improvements, successful strabismus surgery can result in improved emotional quotient and social anxiety, with the greatest effect noted in younger patients.

Determining the diagnostic reference levels (DRL) of CT scan imaging in Saveh Hospitals: a brief report
Mohamad Sarkheil, Mehran Mohseni, Akbar Ali Asgharzadeh , Ali Rasouli Bozcheloie ,
Volume 82, Issue 5 (August 2024)
Abstract
Background: Based on the recommendation of the European Committee and ICRP, DRL values should be determined at the local, national and regional levels for CTDIvol (Computed Tomography Dose Index volume) and DLP (Dose Length Product) dose indicators. According to the radiation protection guidelines, it is essential study has determined DRL in Saveh hospitals
Methods: This study was conducted with two methods based on the results and calculations obtained from the annual Quality Control (QC) reports and the Data Collection (DC) method related to patient scans. In this study, by referring to the annual reports of each device and using radiation components during dosimetry and determining CTDIair or CTDIw, the correction factor was obtained. Using this factor and existing equations, DLP and CTDIvol were calculated based on quality control standards. The second quartile or the median was determined as DRL for head, sinus, chest and abdomen/pelvis imaging protocols and its values were compared with each other and other studies. This study was conducted in February and March 2023 in three hospitals in Saveh city.
Results: The diagnostic reference levels of CTDIvol index were obtained in both QC and DC methods for head (32.76 and 32.36), sinus (11.73 and 9.89), chest (6.06 and 5.11) and abdomen/pelvis (11.86 and 10.56) imaging. The highest DRL values of DLP index in both QC and DC methods are for head, abdomen/pelvis, chest and sinus CT scans, respectively. In the QC method, these values were (603.99), (478.15), (187.15), and (132.65) respectively, and in the DC method, the values were (601.84), (427.76), (219.01), and (114.81) mG.cm.
Conclusion: According to the results of this study and the lack of significant difference between the DRL values of CTDIvol and DLP indicators in both QC and DC methods, it is recommended that the centers, if they have the acceptance criteria for annual quality control, can determine the DRL by referring to the device console information from the DC method.

Investigating the frequency of anterograde amnesia after endoscopy with midazolam as a premedication
Mehrdad Sayadinia, Seyed Mohamad Seyed Mirzayi , Majid Vatankhah, Mehrdad Malekshoar, Tayyebeh Zarei, Bibi Mona Razavi,
Volume 82, Issue 11 (February 2025)
Abstract
Background: Endoscopy is a common medical procedure that often involves the administration of sedative agents to ensure patient comfort and cooperation. Midazolam, a short-acting benzodiazepine, is commonly used as a premedication for its anxiolytic and amnestic properties. Despite its widespread use, there is limited research specifically assessing the occurrence of anterograde amnesia, a potential side effect associated with midazolam administration during endoscopic procedures. Understanding the frequency of this adverse effect is crucial for optimizing patient safety and procedural outcomes.
Methods: In this prospective cohort study After obtaining approval and ethical clearance, patients eligible for endoscopy at Bandar Abbas Shahid Mohammadi Hospital were included in the study. They received 2mg midazolam intravenously before the procedure, followed by propofol for anesthesia maintenance. A memory test involving personal details was conducted before and after the procedure to assess progressive amnesia. Additionally, patients were asked about the procedure 5 minutes before discharge.
Results: 342 endoscopy candidates participated, with an average age of 46.77 years, over half being men. Less than a quarter had a diploma. Average endoscopy time was 2.96 minutes, mostly ASA class 2. Recall scores after midazolam injection and endoscopy were 5.22 and 2.87, respectively. Post-graduate education showed a significant difference in midazolam amnesia. No significant gender difference was observed. Longer endoscopy duration correlated with decreased recall scores. ASA class 2 patients had lower post-endoscopy recall scores than ASA class 1. Recall scores decreased with age, with the highest in the 19-29 age range, a statistically significant finding.
Conclusion: This study In conclusion, this study provided valuable insights into the factors influencing midazolam anterograde amnesia. Key findings include a significant association between higher education levels, particularly post-graduate education, and increased recall scores after midazolam injection. Gender did not show a significant impact on midazolam amnesia, but the duration of endoscopy played a crucial role. Additionally, patients in ASA class 2 exhibited lower recall scores than those in class 1, highlighting the influence of overall health status. Age also emerged as a factor, with the youngest age group showing the highest recall scores after endoscopy. These findings contribute to our understanding of factors affecting midazolam-induced amnesia during endoscopy procedures.

The challenging management of hyperparathyroidism in a 9-year-old boy: a case report
Reza Tavakolizadeh , Abbas Alibakhshi, Sevil Abdolmohamadian ,
Volume 82, Issue 12 (March 2025)
Abstract
Background: Primary hyperparathyroidism is a rare but significant endocrine disorder in pediatric patients; although uncommon, parathyroid adenomas are the most frequently identified cause of primary hyperparathyroidism in this population. Diagnosis and treatment of primary hyperparathyroidism in children, especially in cases caused by parathyroid adenoma, demand careful assessment and require a coordinated and multidisciplinary approach involving endocrinologists, pediatric surgeons, radiologists, and other specialists. Early diagnosis is often delayed due to the rarity of the disease and the nonspecific nature of presenting symptoms.
Case Presentation: This case report describes the complex clinical management of a 9-year-old boy who presented with gradual onset of bone pain and visible deformities of the upper and lower extremities, which prompted further evaluation and later led to a diagnosis of hyperparathyroidism secondary to a parathyroid adenoma. The diagnosis was confirmed by elevated parathyroid hormone levels, hypercalcemia, and imaging studies revealing a parathyroid adenoma. Despite a comprehensive preoperative planning and surgical intervention, adenoma resection was not successful during the first two surgeries, leading to persistent hyperparathyroidism and subsequent surgical complications such as postoperative thyroid tissue damage and resultant iatrogenic hypothyroidism. Ultimately, the third surgical attempt successfully removed the adenoma, leading to a marked resolution of hyperparathyroidism and gradual return to normal calcium and parathyroid hormone levels. The patient’s bone pain and deformities showed improvement during follow-up.
Conclusion: This case highlights the numerous challenges in managing hyperparathyroidism in pediatric patients. In particular, it illustrates the potential complications that can arise when the disease is resistant to initial treatment efforts. This report underscores the importance of having a multidisciplinary approach, carefully planned and executed surgical intervention and vigilant postoperative care in pediatric patients with hyperparathyroidism. Early recognition, accurate localization of the adenoma, and coordination among specialists are essential for favorable outcomes in complex pediatric cases such as this. Continued follow-up is essential to monitor for recurrence and to manage any long-term complications.

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