Showing 96 results for Mahdi
Fatemeh Saeedi, Mahdieh Zaki Zade , Mohammadbagher Sohrabi , Mostafa Enayat Rad , Sina Habib Zade , Mansooreh Fateh,
Volume 81, Issue 7 (October 2023)
Abstract
Background: With a national vaccination program, we have achieved success in the prevention of infectious diseases in the community especially in children. Despite this great success, the side effects of vaccination may not encourage some people in the community to get vaccinated. In this study, we investigate the prevalence of common side effects of vaccination in Shahrood city.
Methods: This study investigated the incidence of complications caused by vaccination in infants and children under seven years old in Shahrood city in a 5-year period from April 2016 to March 2020. We collected demographic and clinical information, by referring to the health centers and complications recorded after routine vaccinations such as fever, rash, diarrhea, swelling and other complications of vaccination were collected.
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Results: Findings Among the 429 registered complications between 2016 and 2020, most complications were related to pentavalent and trivalent vaccines. Among the registered complications, high fever is the most common complication in both term and pre-term groups. (202 cases, 47.1%) other complications included maculopapular rash (59 cases), mild local complications (55 cases), vomiting (41 cases), and continuous screaming (36 cases), respectively. Among these, 123 cases were resolved without treatment, 297 cases were resolved with drug treatment on an outpatient basis, and only eight cases required hospitalization.
Conclusion: In general, the vaccination program is highly effective despite having limited side effects. Knowing this information, can increase vaccination in the country.
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Mohammad Mahdi Gholamian , Mehrnoush Dianatkhah, Mohammad Kermani-Alghoraishi, Ehsan Shirvani,
Volume 81, Issue 8 (November 2023)
Abstract
Background: The purpose of this study was to evaluate the adherence to the ESC 2020 guideline for the management of NSTE-ACS patients admitted to Shahid Chamran Cardiology Hospital affiliated to Isfahan University of Medical Sciences in 2021.
Methods: In this retrospective study which was done during April 2021 to September 2021 we reviewed the hospital documents of 239 NSTE-ACS patients, in regard to prescribed medication during the admission period in Shahid Chamran Heart Center. Guideline-adherence was evaluated according to ESC2020 guideline. Totally 18 items were evaluated including Antiplatelet (Clopidogrel, Ticagrelor, and Prasugrel) Anticoagulant (Heparin or Enoxaparin), PPI, Statin, Beta blocker, and RAAS blockers (including ACEI/ARB or MRA). In each section the selected drug and the administered dose were compared with the guideline and the guideline adherence for each part was expressed as percent.
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Results: Almost complete guideline adherence was described for 12 out of 18 reviewed items (77%). However, guideline adherence in relation to the type of medicine chosen as an antiplatelet was reported to be very low, and only 1.2% of the cases received ticagrelor or prasugrel which are the guideline recommended antiplatelet agent. Additionally, most of the administered GP2b3a antagonist agents such as eptifibatide were not in accordance with the guideline (Guideline adherence 39.74%). Also, the choice of the anticoagulant agent was among the items with low guideline adherence (29.76%) and the cross-over between anticoagulants (changing heparin to enoxaparin or vice versa) which has been inhibited by the guideline was seen with high incidence in this center (78 cases).
Conclusion: The present study showed relatively high guideline adherence in the most aspects of medical management. However, compliance was reported to be low in relation to the antiplatelet selection, the choice of the anticoagulant agent, and the indication for GP2b3a antagonist use, which maybe due to the higher cost of recommended agents, and shortage of some medications and dosage forms in Iran.
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Alireza Dehghan, Mahbube Abshirini, Hamid Nemati, Mahdi Saeedi-Moghadam ,
Volume 81, Issue 11 (February 2024)
Abstract
Background: Developmental disorders in children include a group of problems and limitations in learning and acquiring specific skills of each age group. The term global developmental delay is used to describe developmental disability in children under five years of age, which is in at least two areas of major development. Neuroradiological imaging such as brain MRI provides important information for physicians. The purpose of this study is to determine the role of brain MRI in predicting the clinical outcome of global developmental delay in children.
Methods: In this cross-sectional study, from 79 - from September 2013 to September 2018 at Motahari Clinic of Shiraz University of Medical Sciences, Shiraz Iran - eligible children with developmental disabilities, 37 patient who had brain MRI were selected as a sample and children scores in five ASQ clinical areas and MRI findings were reviewed and compared. Patients suffering from metabolic, genetic, trauma, infection and neoplasms problems and diseases were excluded from the study.
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Results: Out of 37 patients studied, 23 were female and 14 were male with a dispersion of three 3 to 60 months of age. 31 of these children had at least one abnormal finding in brain MRI images and the other six were completely normal. In relation to the imaging findings, the highest frequency is related to abnormal head circumference with a prevalence of 54% and the lowest frequency is related to abnormal myelinization with a prevalence of 10.8%. Results of MRI findings correlation with developmental domains demonstrated that Children with white matter disorder on MRI show severe gross motor abnormality (P<0.049) and who had MRI finding of cortical problems suffer from developmental delay in fine motor area. (P<0.001).
Conclusion: Considering the mentioned findings; brain MRI can be a useful diagnostic tool in children with developmental delay and also focusing on the developmental area that is more likely to be affected, MRI can help with treatment and rehabilitation process of these children in the future.
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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.
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Morad Ali Zareipour, Shahla Mohammad Khani , Behjat Khorsandi , Faezeh Afkhami Aghda , Fateme Moshirenia, Mahdieh Hardani Naeemzadeh ,
Volume 82, Issue 1 (April 2024)
Abstract
Background: The type of delivery significantly affects a woman's life and her newborn's health. Various factors, including medical conditions, personal preferences, and cultural influences, shape this decision. Increasing cesarean delivery rates have raised concerns about associated risks. This study examines the health impacts of different delivery types on mothers and newborns in Yazd hospitals, with a focus on maternal and neonatal outcomes.
Methods: This cross-sectional analytical study involved a substantial cohort of 69,321 mothers who delivered in Yazd between March 21, 2018 to March 20, 2022. Comprehensive data were collected from Iman Hospital and relevant online patient records. To analyze the relationship between delivery type and health outcomes, independent samples t test and chi-square test were utilized. Additionally, odds ratios were calculated to assess relative risks concerning various maternal and neonatal outcomes. SPSS 26 software was employed for all analyses, with a significance level set at 5% to ensure robustness in the findings.
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Results: The average age of participants in the study was 34.45±6.44 years, highlighting a mature population of mothers. Neonatal outcomes indicated that babies delivered naturally were more likely to have unfavorable Apgar scores (ranging from four to six) when compared to infants delivered via cesarean section (CI=0.99-1.55, P=0.05, OR=1.24). Furthermore, naturally delivered infants showed a significantly higher likelihood of having Apgar scores below six (CI=0.90-1.03, P=0.001). Alarmingly, the odds of neonatal death were found to be 1.22 times higher for cesarean births (CI=1.19-1.25, P<0.001). Additionally, mothers who underwent cesarean deliveries exhibited nearly a 4.9 times higher likelihood of requiring intensive care after delivery (CI=4.71-5.12, P<0.001, OR=4.9) and were 14.3 times more likely to be hospitalized postoperatively compared to those who had natural deliveries (CI=3.53-1.31, P<0.001, OR=14.33).
Conclusion: This study indicates that cesarean delivery is associated with higher complications for both mothers and newborns, highlighting the need to promote natural childbirth for better health outcomes.
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Fatemeh Parsa , Fariborz Bagheri, Hossein Mahdian,
Volume 82, Issue 3 (June 2024)
Abstract
Background: Considering the significant increase in suicidal tendencies and attempts during puberty, this study aims to investigate the effectiveness of compassion-focused therapy compared to emotion-focused therapy in increasing the resilience of female students who attempted suicide in the past has been was evaluated.
Methods: semi-experimental research was used with a pre-test and post-test design. The target population was female students of the first and second grade of high school who attempted suicide and referred to the counseling center of the General Directorate of Education, and the research was conducted from the time of data collection to the time of implementation from May 2022 to June 2023 was conducted in the counseling center under the supervision of the science and research department of Islamic Azad University, Tehran branch, was conducted and the available sampling method was selected and randomly and a total of 30 people were divided into two experimental groups (15 people) and control groups (15 people). First, Connor and Davidson's resilience questionnaire (2003) was taken from all three groups. The experimental group underwent eight 90-minute sessions of emotion-focused compassion therapy, while the control group received no intervention. After the end of the treatment sessions, the resilience questionnaire of Connor and Davidson (2003) was administered again and repeated after one month of follow-up. The collected data were analyzed using statistical tests (multivariate analysis of covariance and analysis of variance).
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Results: The results obtained from the data analysis showed a significant difference in the pre-test, post-test and follow-up resilience averages in the three groups. Resilience scores for the experimental groups were significant at P < 0.05, which indicates a significant difference. Additionally, the compassion-focused therapy group showed greater improvements in resilience compared to the emotion-focused group.
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Conclusion: These findings confirm the positive effect of both types of treatment on the resilience of female students who have previously attempted suicide, and compassion-focused therapy was more effective than emotion-focused therapy
Nima Bagheri, Mahdieh Ghiasi, Khalil Pestehei,
Volume 82, Issue 4 (July 2024)
Abstract
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Tendon ruptures may occur as a result of acute injuries or degenerative changes in the tendons caused by aging, excessive and long-term use of the shoulders, and sudden wear and tear. This tear may be partial or completely separate the tendon from its attachment to the bone. Rotator cuff tendinopathy of the shoulder is one of the common causes in patients that affect the daily performance and quality of life. Tendinopathy problems are one of the most common problems of people who refer to medical centers, and in some people, improvement is very important because of their job position. Platelet-rich plasma has received attention due to having growth factors involved in tissue repair in tendinopathy patients. This review study examined the clinical effect of platelet-rich plasma injection in rotator cuff tendinopathy, as well as other studies comparing it with corticosteroids. A literature search was conducted in various scientific databases to obtain articles up to 2022 examining the clinical effects of PRP injection on tendinopathy. Platelet-rich plasma (PRP) is one of the products derived from blood that contains a greater number of physiological platelets. PRP contains a large amount of growth factors such as TGF-β, platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF), which play an important role in cell proliferation, cell differentiation, chemotaxis and angiogenesis. These growth factors are significantly upregulated following tendon injury and are active at different stages of the healing process. Platelet-rich plasma is an autologous source of growth factors and has been shown to be beneficial in the treatment of tendinopathy and osteoarthritis. PRP injection can be recommended as a suitable and desirable method in tendinopathy and rotator cuff tear patients, especially in adults, and can be substituted for corticosteroids. PRP is a minimally invasive treatment method that is used to treat muscle diseases and tendon injuries. In this method, blood is taken from the person, and after that, the components of the blood are separated during a process, and the platelet-enriched plasma is re-injected into the muscles and tendons of the shoulder.
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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.
Fateme Sadat Zendehdel, Seyyed Abdolhamid Angaji , Behnaz Beikzadeh, Behzad Narouie , Mahdi Mohammadi,
Volume 82, Issue 6 (September 2024)
Abstract
Background: Clear renal cell carcinoma (ccRCC) is the most common malignant kidney tumor and has a high mortality rate. The pathogenesis of this cancer is complex and efficient biomarkers for its diagnosis and prediction are limited. This study aimed to identify predictive genes in ccRCC through analysis and laboratory validation ccRCC is the most common malignant kidney tumor and has a high mortality rate.
Methods: The present study was a case-control study in which samples were taken from patients and healthy individuals from Labafi Nejad Hospital in Tehran between October 2012 and April 2014, and laboratory tests were performed on the samples.
First, genes with differential expression in ccRCC patients were identified by bioinformatics using gene expression profile data from the Gene Expression Omnibus (GEO) database with accession number GSE213324. Data analysis was performed using Galaxy web server, protein-protein interactions were checked using Cytoscape and STRING app software, and finally two genes were selected for real-time PCR testing.
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Results: Analysis identified 4,065 genes with differential expression in RCC tissues compared to healthy tissues. These genes are involved in immune responses and renal disease pathways, suggesting their potential role in disease development. After constructing the protein-protein interaction network and identifying differentially expressed genes in kidney tissue and blood, two genes, MTTP and CALCA, were selected for further investigation. In the Mann-Whitney U test, the expression of the CALCA gene decreased significantly in the patient group (P<0.05). On the other hand, the MTTP gene showed a decrease in expression, but not significantly. The AUC calculated to evaluate the diagnostic accuracy for the CALCA gene was 0.64 and significant (P<0.05), demonstrating its potential as a useful biomarker for ccRCC diagnosis. However, the AUC for the MTTP gene was not significant.
Conclusion: The reduction in CALCA expression could serve as a useful biomarker for diagnosing ccRCC.
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Mahdieh Soltani , Seyyede Zohreh Seyyedsalehi, Reyhane Mahdavi,
Volume 82, Issue 9 (December 2024)
Abstract
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With the rapid expansion of artificial intelligence across clinical disciplines, a variety of artificial neural networks (ANNs) have become indispensable tools for endowing computer systems with advanced analytical power. Dentistry, as an information‑rich branch of medicine, routinely generates and must interpret large, complex datasets from imaging and diagnostic records. Consequently, researchers have increasingly directed their attention toward intelligent, automated techniques for analyzing dental data. This study therefore surveys and synthesizes the methods that have been applied to the intelligent and automated analysis of such data, highlighting the prevailing trends in current literature.The majority of the examined investigations relied on panoramic radiographic images of the teeth orthopantomograms (OPG) as their primary source material. Three overarching technical objectives repeatedly emerged: first, tooth diagnosis, meaning the reliable separation and identification of each individual tooth from its neighbors; second, sample segmentation, that is, the piece‑by‑piece analysis of visual information within the image; and third, semantic segmentation, namely, the contextual interpretation of information extracted from the radiograph. Depending upon which of these objectives was pursued, researchers selected different neural‑network architectures and configurations. Across the reviewed corpus, input images were typically subjected to preprocessing steps such as normalization, noise reduction, and contrast enhancement before being supplied to a neural network for training, thereby preparing the data for subsequent machine interpretation. In several instances, the raw output produced by the neural network underwent additional post‑processing, a stage designed to refine the preliminary results and enhance overall accuracy. The comparative analysis presented here concentrates on how effectively the various neural‑network models fulfilled the three technical objectives described above. The surveyed articles reveal two dominant analytical approaches. In the intelligent problem‑solving paradigm, convolutional neural networks (CNNs) overwhelmingly predominate. Conversely, in the automated paradigm, investigators favor classical, non‑learning algorithmic techniques. Work employing ANNs consistently emphasizes image comprehension, segmentation, feature extraction, feature classification, network modeling, and careful variable tuning to promote effective learning that aligns with each study’s stated objectives.
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Reza Ghalehtaki, Mahdieh Razmkhah, Ali Kazemian, Mostafa Farzin, Samaneh Salarvand, Kasra Kolahdouzan, Ehsan Saraee,
Volume 82, Issue 10 (January 2025)
Abstract
Background: Gliomas are the most common primary brain tumors in adults, with low-grade gliomas making up 15% of cases. These slow-growing tumors often occur in young adults. Radiotherapy is one of the treatment options. New radiotherapy techniques like IMRT may reduce complications by sparing normal tissue. The study aims to determine which tumors benefit most from IMRT based on tumor location and size.
Methods: Patients diagnosed with low-grade glioma who were referred for treatment at the Cancer Institute of Imam Khomeini Hospital between September 2017 and September 2020 were included in this study. All patients underwent CT simulation with a thermoplastic mask for immobilization. A diagnostic MRI (performed within two weeks prior) was fused with the planning CT to define the target volume (GTV/CTV), with contours verified by a neuroradiologist. A doctor outlines the treatment volume and critical organs for both 3D and IMRT techniques. Radiotherapy physics experts design treatment plans using both techniques, which are then approved by a radiation oncologist. The treatment volume coverage and doses to critical organs are compared between the two techniques.
Results: Among 25 patients, 14 patients (56%) with single-lobe involvement, 7 (28%) with two lobes, and 4 (16%) with multifocal disease. Right-side brain involvement was seen in 32%, with the frontal lobe most affected. IMRT significantly reduced the mean and maximum cochlear dose on the treatment side in all patients. It also lowered the mean chiasma dose in those with both lobes involved and reduced cochlear dose on the opposite side in frontal lobe cases. No significant difference was found between the techniques for patients with multiple lobe involvement.
Conclusion: According to our study on 25 patients with low-grade glioma, it was shown that there is no clear difference between the two techniques. Given the young age and long survival of LGG patients, IMRT may be preferred when hearing preservation is a priority. Further studies with larger cohorts are needed to confirm these findings.
Farahnaz Bidari Zerehpoosh , Mahdieh Saffari, Shahram Sabeti , Kaveh Ebrahimzadeh, Mahbobeh Taheri,
Volume 82, Issue 11 (February 2025)
Abstract
Background: This study aimed to investigate the markers ACTH, KI67, CAM5.2, GH, PRL, FSH, LH, TSH in pathological samples of patients with pituitary neuroendocrine tumors by IHC staining.
Methods: In this retrospective study, all patients with PitNETs who had undergone surgery at Loghman Hospital from 2020 to 2022 were included in the study. The slides were prepared by IHC staining and with the markers ACTH, KI67, CAM5.2, GH, PRL, FSH, LH, TSH were evaluated. IHC staining for SF1-PIT1-TPit transcription factors was performed for 16 patients with negative initial markers.
Results: 424 patients participated in this study. The mean and standard deviation of the age of the patients studied were 43.7 and 13.7 years, respectively. LH and FSH markers had the highest and TSH marker had the lowest proportion of positive cases. The possibility of LH and FSH markers being positive in men was significantly higher than in women, and conversely, the possibility of GH and ACTH markers being positive in women was significantly higher than in men. The possibility of LH and FSH markers being positive in patients over 40 years of age was significantly higher than in patients 40 years of age and younger, and conversely, the possibility of GH and PRL markers being positive in patients 40 years of age and younger was significantly higher than in patients over 40 years of age. Most cases (66.3%) were treated during the follow-up period.
Conclusion: The findings indicate that accurate pathological identification of tumors plays an important role in the selection of treatment methods, especially drug and surgical treatment, and can lead to improved patient management.
Morteza Talebi Doluee , Mohsen Ramzanzadeh, Majid Shahbazi, Mahdi Foroughian,
Volume 83, Issue 1 (April 2025)
Abstract
Background: Ankle sprain is one of the most common sports injuries and accounts for 10 to 30 percent of sports injuries, especially in athletes. This injury can lead to pain, imbalance, and movement restriction, and therefore has a significant impact on athletes' performance. Therefore, the aim of this study was to investigate the effect of dry needling on tissue repair of ligamentous injury in the acute phase of ankle sprain.
Methods: This double-blind clinical trial study was conducted on 52 patients with ankle sprains at Imam Reza Hospital in 2023. Patients were divided into two groups: control and intervention. The control group received conventional treatment including medication and splints, while the intervention group received dry needling in addition to conventional treatments. Data analysis was performed using SPSS version 21 software and descriptive statistics and inferential statistical tests at a significance level of P<0.05.
Results: The results showed that the intervention group showed significant improvement in pain (P=0.002), activities of daily living (P<0.001), sports activities (P<0.001), plantar flexion (P=0.027), dorsiflexion (P=0.003), inversion (P=0.012), and edema (P=0.005) compared to the control group. However, there was no significant difference in symptom severity (P=0.752) and quality of life (P=0.348) between the two groups. Overall patient change analysis showed that most patients in the intervention group improved, while only 7.7% in the control group improved.
Conclusion: A combination of splinting, medication, and dry needling can be effective in improving pain, daily activities, exercise and recreation, range of motion, and edema in patients with ankle sprains. These findings can provide a basis for implementing new treatment protocols for the management of ankle sprains in athletes and other injured patients. It is recommended that further studies be conducted on the long-term effects of dry needling and other therapeutic interventions to further identify their potential to accelerate the recovery process in patients.
Mohsen Ghoryani, Mohsen Ahmadi, Mahdi Atabaki, Jalil Tavakkol-Afshari , Mojgan Mohammadi,
Volume 83, Issue 2 (May 2025)
Abstract
Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder marked by persistent inflammation, progressive joint destruction, functional disability, and systemic complications. Key inflammatory mediators, such as tumor necrosis factor-alpha (TNF-α) and interleukin-17 (IL-17), play critical roles in disease progression and tissue damage. Mesenchymal stem cells (MSCs) have recently gained attention as a therapeutic approach for autoimmune diseases because of their abilities in self-renewal, immune modulation, and tissue repair. Considering the role of pro-inflammatory cytokines in the pathogenesis of RA, this study investigated the effect of autologous bone marrow-derived MSCs (ABMSCs) on the gene expression of TNF-α and IL-17A in patients with refractory RA.
Methods: The study utilized archived RNA from the research team's previous clinical trial. In this study, 13 patients with refractory RA who underwent MSC transplantation (MSCT) at an intravenous dose of 1×10⁶ ABMSCs per kilogram of body weight were evaluated at baseline and at 1, 6, and 12 months post-injection. Between November 2023 and March 2024, archived RNA samples were converted into cDNA at the Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Then, the expression levels of TNF and IL-17A were analyzed using SYBR Green-based real-time PCR.
Results: TNF-α gene expression declined significantly 1 month after MSCT (mean±SEM: 1.00±0.00 at baseline vs. 0.38±0.11 at 1 month, P=0.045). However, no significant differences were observed at 6 months (1.21±0.38) or 12 months (0.61±0.18) compared to baseline (P>0.05). IL-17A gene expression remained statistically unchanged across all time points (baseline: 1.00±0.00; 1 month: 0.87±0.31; 6 months: 1.19±0.42; 12 months: 1.79±0.92; P>0.05).
Conclusion: The results of this study suggest that ABMSCs may exert an anti-inflammatory effect by modulating TNF-α in patients with refractory RA. However, the findings related to IL-17A do not support the hypothesis that ABMSC injection exerts anti-inflammatory effects through modulation of IL-17A gene expression in these patients.
Ayoub Tavakolian, Shapour Badiee, Mahdi Mohammadi, Elahe Pourahmadi, Samaneh Sabouri, Navid Kalani , Mahdi Foroughian ,
Volume 83, Issue 7 (October 2025)
Abstract
Background: The present study is a systematic and comparative review of the studies conducted in the field of hospice centers for patients with acute incurable diseases with a life expectancy of less than six months in the world with the aim of examining the need in Iran and the experiences of other countries, identifying candidates to receive these services, type of services provided, costs and resources in these centers.
Methods: The present study was conducted as a systematic review by searching the databases: Scopus, PubMed, Elsevier, and Google Scholar search engine between 2010 and 2023. To search these databases, keywords such as hospice care centers, centers providing health services for patients with life expectancy less than six months, allocation of resources, allocation were used. After selecting the articles, the following topics were extracted from each article and compared: costs, sources of funding, candidates for receiving services, families' views, quality of near-death care, quality of life, quality of death, services provided, therapeutic interventions performed, place of death, length of stay.
Results: 6 articles referred to the discussion of cost, and in all articles except one case, the use of hospice was associated with reducing the cost of patients. In one study, the source of funding was philanthropic contributions and in another study, the national budget. In all the reviewed articles, the use of hospice was associated with an increase in the quality of care, quality of end of life and quality of death, and a decrease in therapeutic interventions. The care provided by hospice was also introduced in the form of symptom assessment and management, pain relief, psychosocial support and respite care.
Conclusion: Based on the findings of the present study, hospices can play an effective role in reducing treatment costs and, on the other hand, improve the quality of care, life and death in eligible people. In addition, hospices improved the end-of-life quality from the perspective of the deceased's family by reducing invasive interventions and providing physical and spiritual care.
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Kourosh Karimi Yarandi , Majid Pourfahraji Fakhrabadi , Siavash Anbaei, Shayan Dabbagh, Mohammad Mahdi ,
Volume 83, Issue 8 (November 2025)
Abstract
Background: Congenital scoliosis (CSC) and Idiopathic scoliosis (ISC) are complex spinal disorders that may involve neurological components affecting bladder function. Surgery remains the primary treatment for significant deformity, and in selected cases, correction of an associated tethered cord is also required. Given the potential interaction between spinal pathology and lower urinary tract function, this study examined changes in urodynamic findings before and after treatment in patients with CSC and ISC.
Methods: This retrospective cross-sectional study included patients with scoliosis who were presented to the Neurosurgery Clinic at Sina Hospital between September 2016 and September 2018. Preoperative and postoperative urodynamic study (UDS) results were reviewed, and statistical analyses were performed using SPSS version 24.
Results: Thirty-one patients were analyzed, consisting of 10 males (32.2%) and 21 females (67.7%), with a mean age of 14.18 years (median: 13 years). Among the 12 patients with CSC, 10 (83.3%) showed abnormal UDS prior to surgery. In contrast, 13 of 19 patients with ISC (68.4%) demonstrated normal baseline UDS. Following treatment, normalization occurred in 10 CSC patients (83.3%) and in 14 ISC patients (73.7%) (P=0.008). Before surgery, 15 of the 23 patients without a tethered cord (65.2%) had normal UDS, whereas all 8 patients with a tethered cord exhibited abnormal findings. Of the 12 patients with abnormal preoperative UDS, 3 (25%) showed no postoperative change, while 12 patients demonstrated normalization and 4 continued to show abnormal results (McNemar test, P=0.039). Improvement was also observed in 7 of the 8 patients (87.5%) with a tethered cord (P=0.57).
Conclusion: Scoliosis surgery, particularly when combined with tethered cord release, was associated with meaningful improvement in urodynamic function. Urodynamic abnormalities were more common among CSC patients before intervention, and the presence of a tethered cord contributed to greater urinary dysfunction across both scoliosis types. These findings highlight the importance of thorough preoperative urodynamic assessment to guide management and anticipate postoperative outcomes.
