Showing 574 results for Mohammad
Zahra Mohammadi Taghiabad , Maryam Ahmadi, Alireza Atashi,
Volume 79, Issue 7 (October 2021)
Abstract
Background: Early outcome prediction of hospitalized patients is critical because the intensivists are constantly striving to improve patients' survival by taking effective medical decisions about ill patients in Intensive Care Units (ICUs). Despite rapid progress in medical treatments and intensive care technology, the analysis of outcomes, including mortality prediction, has been a challenge in ICUs. Hence, this study aims to predict the mortality of patients admitted to ICUs using data mining techniques.
Methods: In this study, among the cases of patients who were admitted to ICUs of the Rasoul Akram and Firoozgar hospitals of Tehran City, Iran, from December 2017 to March 2018, the first 24 hours of the ICUs admission data of 874 cases were gathered. A new model based on the standard methodology CRISP was developed. In the modeling section, two well-known data mining techniques called artificial neural network (ANN), K nearest neighbor (KNN) and decision tree (DT) were used. WEKA 3.9.2 open-source software was implemented for data analysis. Finally, according to the accuracy, sensitivity, specificity criteria and AUC-ROC Curve, the superior model was introduced.
Results: Based on the WEKA results, 19 variables had the most impact on the mortality prediction of patients admitted to ICUs including Glasgow Coma Scale (GCS), mechanical ventilation, surgical service at ICUs admission, gender, temperature, serum creatinine, diabetes, Blood urea nitrogen (BUN), age, addiction, International Normalized Ratio (INR), PH, Partial Thromboplastin Time (PTT), albumin, hemoglobin, glucose, pulse rate, hematocrit (HCT), PO2. Based on the created models, some rules have been extracted which can be used as a pattern to predict the probability of mortality. Although the AUC of the three models was acceptable (KNN 81.5%, ANN 77.5% and DT 74.3%), but the accuracy of decision tree J48 (74.2%) was higher.
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Conclusion: The study indicated that in the KNN model, the rules derived from it can be effective in mortality prediction in patients admitted to ICUs.
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Atlasi Safaei, Mohammad Sheibani , Yaser Azizi,
Volume 79, Issue 8 (November 2021)
Abstract
Cancer is the second leading cause of death in the United States and has become a health problem worldwide. The reported incidence of new cancer cases is estimated at 19.3 million, with a mortality rate of 10 million in the world in 2020. There are several therapeutic approaches for cancer, including chemotherapy. Chemotherapy is consuming anti-neoplastic drugs, alone or in combination. However, it causes damages to the normal cells and has many side effects. Cardiac complications are common side effects of some chemotherapy agents. Cardiac myocytes are potentially more susceptible to the long-term adverse effects of chemotherapy agents due to the less regeneration ability in cardiac cells. Moreover, heart muscle dysfunction (cardiomyopathy) and cardiovascular complications may occur in cancer survivors even a year after chemotherapy or radiation therapy and influence their quality of life. Anthracyclines are commonly used in chemotherapy; especially doxorubicin is the most widely used drug of this family. Doxorubicin is an effective anti-malignant agent prescribed for the treatment of some solid tumors (e.g. ovary, breast, and gastrointestinal cancers). Doxorubicin can cause several side effects, ranging from cancer treatment’s common side effects such as fever, nausea, and vomiting to lethal cardiac side effects. Assumed that doxorubicin has many therapeutic and cytotoxic mechanisms, cardiotoxicity induced by doxorubicin is very common and there is no reliable treatment for this problem. The cardiac side effects of doxorubicin during a chemotherapy regimen can be acute, chronic, or even gradually progressive and persistent after the termination of doxorubicin therapy. In patients undergoing doxorubicin therapy, reported symptoms are cardiac rhythm and blood pressure changes, pericarditis, myocarditis, cardiomyopathy, and congestive heart failure. The pathophysiology of doxorubicin-induced cardiotoxicity is very wide. Disruption of normal mitochondrial function, decreased amount of antioxidant factors, production of reactive oxygen species (ROS), an imbalance in calcium hemostasis, activation of inflammatory cytokines, targeting topoisomerase-IIβ (Top2b), and induced DNA damage are associated with doxorubicin-induced cardiotoxicity. Increased doxorubicin in mitochondria activates the redox cycle that ultimately leads to the production of reactive oxygen species in both normal and tumor cells. The present review aims to investigate the cardiotoxic mechanisms of doxorubicin and explain different types of doxorubicin-induced cardiotoxicity.
Farzaneh Kianian, Mehri Kadkhodaee, Behjat Seifi, Fariba Akhondzadeh, Kamal Abdolmohammadi , Arash Abdi, Mina Ranjbaran,
Volume 79, Issue 8 (November 2021)
Abstract
Background: In the present study, we hypothesized that conditioned medium (CM) derived from mesenchymal stem cells attenuates the brain oxidative stress in sepsis induced by the cecal ligation and puncture (CLP) model.
Methods: This study was performed in the Department of Physiology at Tehran University of Medical Sciences from August 2018 to April 2019. Conditioned medium was collected from mesenchymal stem cells isolated from rat's adipose tissues at the second culture passage. Male Wistar rats weighting (220-250 g) were randomly divided into three experimental groups (n=8 each): Sham, Sepsis and CM. Sepsis was induced by cecal ligation and puncture model in the Sepsis and CM groups. Animals in the CM group received the conditioned medium from 5×10
5 mesenchymal stem cells (2 h after sepsis induction, i. p., 3-5 mL). The systolic blood pressure and O2 saturation were measured 24 h after the treatment. The plasma and brain tissue samples were taken for inflammatory and oxidative stress assessment, respectively.
Results: Septic rats showed a significantly lower systolic blood pressure and O2 saturation level. They also had a significant increase in the plasma inflammatory indices (tumor necrosis factor-alpha [TNF-α], interleukin-6 [IL-6]) and brain malondialdehyde (MDA) content as well as a significant reduction in the brain superoxide dismutase (SOD) activity compared to the Sham group. The CM group had significantly higher systolic blood pressure and O2 saturation level compared to the septic rats. The animals in the CM group showed a significant attenuation in the plasma inflammatory indices (TNF-α and IL-6) and brain MDA content while having a significantly higher brain SOD activity compared to the Sepsis group.
Conclusion: Our findings showed that conditioned medium derived from mesenchymal stem cells has protective effects in preventing the inflammatory and oxidative stress status and may be suggested as a promising treatment in patients suffering from sepsis and septic shock. |
Mohammad Ranaei, Fereshteh Gharavi, Azita Ghanbarpour, Mina Galeshi, Shahla Yazdani ,
Volume 79, Issue 8 (November 2021)
Abstract
Background: Mature cystic teratoma of the ovary is one of the most common benign ovarian tumors, which may be confused with other adnexal lesions due to its extensive manifestations on ultrasound. Therefore, in this study, we tried to reduce the need for pathology frozen sections by examining more accurate preoperative ultrasound results and classifying ovarian lesions based on them.
Methods: In this study, 200 female patients with a definitive diagnosis of mature cystic teratoma of the ovary who have undergone surgery at Ayatollah Rouhani Hospital, February 2009 March 2019 were evaluated. After reviewing the files, demographic information, Ultrasound, intraoperative findings and final pathology were extracted and finally, the data were analyzed using statistical tests.
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Results: The age range of patients who were diagnosed with mature cystic teratoma of the ovary in the final pathology was 14-71 years. Most cysts were 5-10 cm in size. 86% of patients had unilateral right-sided ovarian involvement. The most common components of this cyst in the macroscopic report were hair (81%) and fat (80%). The diagnostic value of ultrasound for the diagnosis of mature teratoma of the ovary was 74.5%. The frozen section was used to diagnose and rule out the malignancy in 32.5% of patients.
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Conclusion: The results of this study show that the prevalence of these tumors is higher in the reproductive age range. According to this study, these tumors have been seen in single people and pregnant women, Due to youth and fertility in the future, a good decision must be made about the surgical method. These tumors have a wide range of sizes. In addition, their most common complaint is abdominal pain, but it has been reported extensively in periodic ultrasounds for infertility. The diagnostic value of ultrasound for mature ovarian teratoma was high due to the presence of fat and hair in them. Therefore, the use of the frozen section (intraoperative pathology) can be reduced in more often unnecessary in cases.
Salman Daliri, Mohammad Khanbeigi, Reza Heidary Moghadam , Parisa Asadollahi, Khairollah Asadollahi,
Volume 79, Issue 8 (November 2021)
Abstract
Background: Pulse pressure has recently been considered as a predictor of coronary heart disease. The difference between systolic and diastolic blood pressure is called pulse pressure. Various factors including increased age, vascular stiffness, stenosis, and hypertension are associated with pulse pressure. The present study, therefore, aimed to investigate the relationship between some cardiovascular function indicators such as vascular stenosis, blood pressure and cardiac output with pulse pressure as a predictor of cardiovascular diseases.
Methods: This case-control study was performed on 544 patients who were referred to Imam Ali Hospital in Kermanshah, Iran, from March 2015 to February 2016. In this study, according to the angiographic findings, individuals with artery stenosis were considered as the case group (n=272) and those without artery stenosis were considered as the control group (n=272). Statistical analysis was performed using descriptive statistics, Chi-square and odds ratio estimation by SPSS22 software.
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Results: According to the findings of this study, ages over 50 (OR: 3.3, 95% CI: 2.1-5.2), high systolic blood pressure (OR: 8, 95% CI: 4.3-15.2), high diastolic blood pressure (OR: 4.9, 95% CI: 2.0-11.7), cardiac output less than 50% (OR: 1.8%, 95% CI: 1.3-2.7) and vascular stenosis (OR: 3.5, 95% CI: 2.4-5.1) were associated with high pulse pressure. The male gender had a preventive role in increasing of pulse pressure (OR: 0.7, 95% CI: 0.5-0.9). A significant relationship was demonstrated between systolic blood pressure and pulse pressure (P<0.0001).
Conclusion: Based on the findings of the present study, the chances of having high pulse pressure are high among individuals over 50 years of age, female gender, those with elevated systolic and diastolic blood pressure, and individuals with high coronary artery stenosis. This chance is associated with decreased cardiac output and coronary stenosis. Increased pulse pressure is a predictive indicator of cardiovascular disease and it is recommended that pulse pressure measurements of all referrals, especially those who are being referred to cardiology clinics, are taken into account by medical professionals to prevent adverse clinical outcomes.
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Alireza Sarmadi, Ahmad Kachoei, Mostafa Vahedian, Enayatollah Noori , Mojdeh Bahadorzadeh, Amrollah Salimi , Mohammad Hossein Assi,
Volume 79, Issue 9 (December 2021)
Abstract
Background: Cholecystectomy is one of the most common abdominal surgeries and its preferred method is laparoscopy. The difficulty of laparoscopic cholecystectomy in diabetic patients is not clear and the preferred method of cholecystectomy in these patients is still under controversy. Therefore, this study was performed to evaluate the difficulty of laparoscopic cholecystectomy in diabetic and non-diabetic patients.
Methods: This retrospective analytical study was performed in Shahid Beheshti Hospital and Forghani Educational and Medical Center from April 2019 to April 2020. Samples were easily selected and 86 people in two groups of diabetic and non-diabetic patients were included in the study. All patient records were reviewed based on inclusion and exclusion criteria for factors such as age, sex, diet, duration of surgery, bleeding, adhesions, and open surgery, and finally, diabetes as a risk factor. It was compared between the two groups. Data were analyzed in SPSS software version 22, an independent t-test was used to analyze quantitative data and the chi-square test was used to analyze qualitative data. In this study, a significance level of less than 0.05 was considered.
Results: Abdominal scar, palpable gallbladder and gallstone were not significantly different between the two groups (P=0.33). But the history of cholecystectomy attacks was significantly different between the two groups (P<0.05). Laboratory values were not significant (P>0.05) . Hard operations in diabetic patients were more than nondiabetic
patients and even two cases of open surgery were seen in the group of diabetic
patients, but there was no significant relationship (P=0.09). Intraoperative bleeding was
statistically significant between the two groups (P=0.02), But adhesion during the
operation was not related (P=0.38).
Conclusion: Finally, our study showed that diabetes can be a predictive risk factor for the difficulty of cholecystectomy.
Mojgan Mortazavi, Abdolamir Atapour, Maryam Mohammadi, Mohammad Sattari,
Volume 79, Issue 9 (December 2021)
Abstract
Background: Today, with the advancement of technology in various fields, the importance of recording data in the field of health is increasing so much that for many diseases around the world, including kidney disease, registration systems have been set up. This is happening in our country and in the future, the number of these systems will increase. The medical data set contains valuable information that will be time-consuming and costly to obtain using laboratory methods, so there is a need for low-cost methods for extracting information. This study focuses on developing a predictive model for classifying the cause of kidney stones in Isfahan using three data mining techniques.
Methods: This cross-sectional research has been done from February 2021 to May 2021. The used medical data set includes information of 353 kidney stone patients in Isfahan. In this study, six target attributes of sodium, phosphate, oxalate, citrate, cysteine and uric acid were identified. The techniques for each of the 6 attributes are used separately. The techniques used in this study were three data mining techniques including random forest (RF), artificial neural network (ANN) and support vector machine (SVM).
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Results: The best performance in terms of accuracy is related to support vector machine techniques in uric acid class, support vector machine in oxalate class and neural network in cysteine class. The worst performance is related to the random forest technique in the citrate class. The safest rules with a 66% confidence level are for the citrate and sodium classes, and the least reliable rule with a 50% confidence level is for the oxalate class.
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Conclusion: Kidney stones can occur due to various reasons such as low citrate and high calcium oxalate. For example, for citrate, factors such as blood pH (potential of hydrogen), blood sugar and blood pressure are effective. To prevent any of the causes of kidney stones, factors should be controlled.
Saeed Nateghi, Forough Goudarzi , Samad Taghavi Namin , Atefeh Rasouli , Akram Khalili Noushabadi, Safieh Mohammadnejhad ,
Volume 79, Issue 9 (December 2021)
Abstract
Background: Age is a strong risk factor for increasing the risk of severity and death from Covid-19. The risk of hospitalization for Covid-19 disease increases with age. Since the elderly constitute a large proportion of Covid-19 patients, the present study was performed to evaluate the severity of the disease in the hospitalized elderly due to Covid-19 and the delay in hospitalization and death resulting from it, for better disease management.
Methods: The present retrospective cohort study was performed on 444 elderly patients with Covid-19 admitted from 1 April until late October 2020 in Baharloo Hospital in Tehran, Iran. After being diagnosed using the results of RT-PCR and CT scan, patients, were divided into 3 groups: moderate, severe and very severe based on the severity of the disease. Analysis of variance was used to compare quantitative data and a chi-square test was used to examine qualitative variables in disease groups.
Results: From 444 elderly participants in the study, 73% were infected moderately, 15% severely, and 12% had a very severe form. The mean age was 72.90±8.42 and patients with a very severe form of the disease (75.68±8.28) were older. The average time from the onset of symptoms to hospitalization was 7 days. In the elderly with a very severe form of the disease, respiratory dyspnea (P=0.002) and decreased level of consciousness (P<0.0001) were higher. The average hospital stay was 7 days. In very severe form it lasted up to 11 days. ICU mortality and hospitalization were higher in patients with very severe forms of the disease. With the increasing delay in the days of hospitalization, the severity of the disease and mortality has increased.
Conclusion: The study showed that prolonging the onset of symptoms till hospitalization worsens prognosis and also exacerbates the disease and increases mortality in the elderly.
Shirin Assar, Fatemeh Khademi, Hamid-Reza Mohammadi-Motlagh, Kamran Mansouri, Mehran Pournazari , Parviz Soufivand, Bahareh Kardideh,
Volume 79, Issue 10 (January 2022)
Abstract
Background: Rheumatoid Arthritis patients are evaluated during treatment for various inflammatory factors such as C-reactive protein, Erythrocyte Sedimentation Rate, and Disease Activity Score, and other immune system-related factors. In the follow-up of patients with rheumatoid arthritis, hematologic factors associated with the immune system especially Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio are important. In this study, platelet to lymphocyte ratio and Neutrophil to lymphocyte ratio were compared in two groups of patients with and without ocular complications.
Methods: This cross-sectional study was performed on 246 patients with rheumatoid arthritis who were referred to the rheumatology clinic of Kermanshah from December 2018 to May 2019. This study was carried out in accordance with the approval of the ethics committee (IR.KUMS.REC1397.311) at Kermanshah University of Medical Sciences. Of these patients, 191 had no ocular complications and 55 patients had ocular complications and were matched for age and sex. The blood samples were taken from patients and blood cell count was measured by Sysmex KX-21 hematology analyzer. The Spearman correlation test was used to evaluate the relationship between platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in both groups of patients without ocular complications and with ocular complications. The Disease Activity Score was compared between the two groups using the Mann-Whitney test.
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Results: The results of this study showed no significant difference between NLR and PLR levels in both groups of patients without ocular complications and with ocular complications. But the results showed that DAS-28 was significantly lower in the group with ocular complications (P<0.0001).
Conclusion: In general, the results of the present study showed that the evaluation of inflammatory factors such as platelet to lymphocyte ratio and neutrophil to lymphocyte alone could not be judged in predicting the presence or possibility of ocular involvement, and the level of these factors in patients with ocular complications was affected. Other factors, such as the number of blood cells and the condition of each patient, are included.
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Ali Mohammad Mosadeghrad, Ali Jajarmizadeh,
Volume 79, Issue 10 (January 2022)
Abstract
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.
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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).
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Ali Torabi, Behrokh Farahmand, Mohammadreza Zolfaghari , Fatemeh Fotouhi, Mohsen Zargar,
Volume 79, Issue 11 (February 2022)
Abstract
Background: Influenza vaccines based on conserved proteins are being developed persistently. The conserved protein vaccines based on Nucleoprotein (NP) are highly protected vaccines against influenza viruses that can be used as a Universal vaccine. Aluminum hydroxide (Alum) is the most common adjuvant used in vaccine formulation to improve immunization by altering the epitopes’ folds. However, due to its toxic effects on the nervous system, especially in infants and young children exposed to multiple vaccine injections during brain development, it is better to use more desirable options such as carbohydrate-based adjuvants. Sucrose ester (SE) is a carbohydrate and non-ionic surfactant that is compatible with the human body and environmentally friendly. This study evaluated the immunogenicity of recombinant NP molecule prepared in a prokaryotic with the accompaniment of sucrose ester adjuvant against lethal influenza virus challenge in a Balb/c mice model.
Methods: The recombinant vector of PET-28a-NP was used to produce NP molecule. The vaccines containing an NP with or without Alum or sucrose ester adjuvants were injected into the mice. The Effectiveness and immunogenicity were examined by evaluating the humeral immunity induction by Immunoglobulin G (IgG), and its subunits production, and cellular immunity induction by Interferon-Gamma (IFN-γ) and Interleukin-4 (IL-4) production by ELISA Method and also animal’s
surveillance was documented. The study took part at the Influenza and other respiratory viruses department of Pasteur institute of Iran in November 2018.
Results: The animals’ surveillance in the Np group was 57.1%, NP+SE was (71.4%), and NP+SE was 64.28%. Also, IgG and its subunits, IL4, and IFN-γ production in both Alum and SE combined vaccines compared to NP alone were significant.
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Conclusion: In combination with the carbohydrate adjuvant containing sucrose ester compared to the formulation with alum adjuvant, the NP could provide proper and considerable protection and immunity against the homologous strain (H1N1) of the Influenza A virus. It is recommended that SE usage as an adjuvant results in an adequate immune response and less toxic effect.
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Negar Heidari , Paria Heidari, Nader Salari, Hakimeh Akbari, Masoud Mohammadi,
Volume 79, Issue 12 (March 2022)
Abstract
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Background: Parkinson's disease is one of the chronic neurological diseases. It is the second most common neurodegenerative disease after Alzheimer's, affecting 7.5 million people worldwide and its rate is expected to increase by 20% by 2020. three symptoms of tremor, muscle stiffness and movement disorders are among the main diagnostic symptoms of the disease. The prevalence of Parkinson's worldwide varies between 18 and 418 cases per 100,000 people per year. It is generally estimated that the prevalence of this disease in the general population is 0.3%. A systematic review study was performed to determine the factors associated with Parkinson's disease.
Methods: This study was a systematic review that was conducted by searching national and international databases until February 2020. Initially, all articles which had mentioned Parkinson-related factors were collected and accepted by researchers based on studies. Entry and exit criteria were met. Exclusion criteria included irrelevant items, duplication of studies, unclear procedure, and lack of access to the full text of the study. To reduce bias, articles were evaluated independently by two researchers, and the quality of articles was assessed using the STROBE checklist. All final articles submitted to the systematic review process were prepared by a template checklist. Checklists included article title, first author’s name, year of publication, place of study, risk factors, protective factors, and ineffective factors or the ones which their effects have not yet been determined, and the average age.
Results: In these studies, the following risk factors were reported: family history, agricultural occupation, literacy, stress, well water consumption, aging, environmental factors, genetic factors, pesticide exposure, and alcohol abuse. On the other hand, factors such as smoking and oilseeds, high levels of B-complex vitamins, female estrogen hormones, and selenium have been reported to protect against Parkinson's disease.
Conclusion: Considering the results of the present study and although there is no definitive treatment for this disease, protective factors and risk factors should be seriously considered by health policymakers for preventive measures.
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Pejman Pourfakhr, Mohammad Amin Mirzaie , Farhad Etezadi , Reza Shariat Moharrari , Mohammad Reza Khajavi ,
Volume 79, Issue 12 (March 2022)
Abstract
Background: Training of airway management and tracheal intubation skill in emergencies for resuscitation of patients are basic skills for medical students. However, the success rate of beginners in this skill is low. Video laryngoscopes are new devices that can increase the success of endotracheal intubation training.
Methods: This clinical trial was conducted with 30 medical students who came to learn anesthesia care at Sina Hospital in 2020. After dividing the students into two groups (n=15) of glide scope and Macintosh, the glide scope group first performed laryngoscopy and tracheal intubation with a glide scope on the manikin 10 times. Then, in the operating room they were trained for endotracheal intubation on 5 patients by glide scope. The Macintosh group first got trained for intubation on the manikin, 10 times and then on five patients in the operating room with a Macintosh laryngoscope. Then all students in the operating room intubated two patients with a Macintosh laryngoscope and their performance was assessed and scored by an anesthesiologist. They evaluated the training course with a questionnaire. The duration of laryngeal access and the time spent for tracheal intubation were compared in the two groups.
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Results: In the glide scope group, 76% of students were able to see the epiglottis and larynx in 20 seconds, but in the Macintosh group, 43% of students were able to see the larynx in 20 seconds. In terms of endotracheal intubation time, 72% of the students in the glide scope group were able to successfully perform endotracheal intubation within 40 seconds in their first attempt, but in the Macintosh group, 44% completed endotracheal intubation within 40 seconds (P=0.00). In the evaluation of the quality of skill, the average score of the students in the Macintosh group was 15.30±0.56, while the average score in the glide scope group was 17.20±0.83 (P=0.00). The scores and satisfaction of the students in the glide scope group were higher than the Macintosh.
Conclusion: The use of video laryngoscope in teaching of intubation in trainees will increase the speed, and accuracy of their training and satisfaction compared with the Macintosh laryngoscope.
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Hasan Asadi Gandomani , Abdorreza Naser Moghadasi , Mohammad Ali Sahraian , Sharareh Eskandarieh,
Volume 79, Issue 12 (March 2022)
Abstract
Background: The onset of primary progressive multiple sclerosis (PPMS) can be triggered by sun exposure and physical activity. The present study aimed to determine the risk of sun exposure and physical activity in PPMS development.
Methods: The case-control study recruited PPMS cases and healthy controls from the general population from September 2019 to September 2020 in Tehran, Iran. The selection of sex-matched controls from the same source population of cases was performed. Sun exposure was assessed in terms of exposure time in two age groups of 13-19 years and over 20 years in winter and summer.
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Results: This study examined 146 PPMS cases and 294 controls. The sun exposure in summer in the age group 13-19 was negatively associated with the incidence of the disease (OR=0.68 (CI=0.57-0.82)). This relationship was also observed in the groups of men (OR=0.55 (CI=0.40-0.74)) and women (OR=0.70 (CI=0.53-0.91)). Exposure to sunlight in winter in the age group 13-19 was negatively associated with the incidence of the disease (OR=0.28 (CI=0.19-0.42)). In the group over 20 years, sun exposure was negatively associated with disease incidence in summer (OR=0.49 (CI=0.36-0.66)). Exposure to sunlight on average in winter in the age group over 20 years was negatively associated with the incidence of the disease (OR=0.14 (CI=0.07-0.28)) which in the male group OR=0.12 (0.04-0.32)) and women (OR=0.06 (CI=0.02-0.21)) were seen. Regarding physical activity, only physical activity above 4000 MET per week in the group of women was negatively associated with the incidence of the disease (OR=5.30 (CI=1.05-26.59), but in other groups, this negative relationship was not observed.
Conclusion: Exposure to sunlight in winter and summer had a negative relationship with the incidence of the disease. Physical activity was only negatively associated with the incidence of the disease in very high doses and women.
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Leila Pourali, Atiyeh Vatanchi , Arezoo Sedaghati, Farnaz Hadavi , Mohammad Taghi Rajabi Mashhadi,
Volume 79, Issue 12 (March 2022)
Abstract
Background: Sigmoid volvulus is a rare complication in pregnancy. The clinical presentation is similar to that of non-pregnant volvulus, although the symptoms can be masked by the enlarged uterus and physiological changes during pregnancy and it can be challenged and delayed in diagnosis and treatment. Delay in diagnosis can also lead to ischemia, necrosis and perforation of the intestine, which can have adverse maternal and fetal outcomes.
Case Presentation: A primigravid woman with gestational age of 31 weeks was admitted to a 3rd level center with abdominal pain and abdominal distention. From the beginning of pregnancy, the patient complained of bloating and epigastric pain, And had used herbal medicine for defecation. The patient's constipation had worsened since six days before admission to the hospital. She had no vomiting and her general condition was good. Abdominal Supine X-rays were reported completely dilated sigmoid and she was treated with a possible diagnosis of ileus. Due to the progression of symptoms and abdominal distension, rectosigmoidoscopy was performed for her, and scattered mucosal erythema was seen. Discoloration of the purple mucosa was seen from a distance of about 35 cm from the annulus and the secretions inside the sigmoid lumen were seen as blood. Ischemic necrosis and sigmoid volvulus were strongly suggested for the patient and she was immediately transferred to the operating room. The abdomen was opened with a midline incision. A 30 weeks uterus was seen and sigmoid volvulus was confirmed. Detorsion and colostomy were done. Due to the unprepared intestine and the possibility of leakage from the site of anastomosis, sigmoidectomy was not performed. After 4 days, the patient was discharged in a good general condition and became a candidate for sigmoid colon resection after delivery.
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Conclusion: All abdominal signs and symptoms during pregnancy, especially in late pregnancy have a complex interpretation and management, due to the impossibility of accurate abdominal examination. The most important factors in the proper management of sigmoid volvulus in pregnancy are fast diagnosis and treatment, hydration and antibiotic therapy.
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Ali Mohammad Mosadeghrad , Parvaneh Isfahani ,
Volume 79, Issue 12 (March 2022)
Abstract
Ali Mohammad Mosadeghrad, Mahnaz Afshari, Fereshteh Karimi ,
Volume 80, Issue 1 (April 2022)
Abstract
Background: Conceptual review is a creative research method for generating new knowledge in the context of a vague and complex concept that helps to explain and clarify the concept, its components and its relation to related concepts. This study aimed to explain the methodology of conceptual review in the health system.
Methods: Articles related to the conceptual research method were searched and collected in four databases (i.e., PubMed, Scopus, Embase, Science Direct) and two search engines (e.g., Google and Google Scholar) between January 1950 and September 2021. Finally, 83 articles were selected for final review and analyzed through narrative analysis.
Results: This study was conducted using scoping review between October and December 2021. The conceptual review study is a systematic, scientific and objective inquiry that helps to identify and explain the dimensions, components, features and applications of a particular concept by defining, synthesizing and interpreting the findings of studies. It results in clarification of the meaning of concepts. An eight- steps protocol was introduced for conceptual review including concept selection, entry and exit criteria definition; selection of databases and search strategies; selection and reporting of studies using flowcharts; evaluating the validity of selected studies; extracting information about the definition, components, antecedents, consequences and evaluation criteria of the concept from selected studies, synthesizing data and developing a conceptual model and drawing conclusions from the synthesized findings. In addition, the structure of a conceptual review article was described and a checklist for evaluation of a conceptual review study was introduced.
Conclusion: A conceptual review study is a method that defines the concept by searching for scientific sources about a concept and their comprehensive review, explaining their characteristics, antecedents, consequences and applications to determine the position of the concept beyond their vocabulary definition. The conceptual review helps to develop existing theories by identifying the components of a complex concept and its antecedents and consequences and establishing a logical connection between them.
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.
Seyed Hassan Seyed Sharifi , Alireza Tavassoli, Mohammad Etezadpour,
Volume 80, Issue 1 (April 2022)
Abstract
Background: Hemorrhoids are one of the most common perianal diseases. They have several surgical and non-surgical treatment methods. Among surgical procedures, Stapler hemorrhoidopexy method has recently gained widespread acceptance. Hemorrhoidopexy with a circular stapler usually has a series of common and mild complications and a few rare and life-threatening complications such as rectal perforation, which requires emergency surgery. In this article, a case of rectal perforation in a middle-aged man following hemorrhoidopexy with Circular Stapler in a Procedure for Prolapse and Hemorrhoids (PPH) is reported that he underwent emergency surgery.
Case Presentation: The patient is a 43-year-old man who presented to the emergency department of Mashhad Ghaem Hospital in June 2020 due to acute general abdominal pain especially in the lower abdomen that started 3 days ago the patient has a history of hemorrhoidopexy with a Circular Stapler in a Procedure for Prolapse and Hemorrhoids (PPH) 5 days ago. The patient had a fever at the time of referral, other vital signs were normal. During the examination, the patient had tenderness and rebound tenderness, especially in the lower abdomen. Hydropneumoperitoneum or Retropneumoperitoneum or Hydroretropneumoperitoneum was reported on the abdomen and pelvic Computed Tomography (CT) scan with and without oral and intravenous contrast. The patient was diagnosed with intraperitoneal rectal perforation. He was then diagnosed with intraperitoneal rectal perforation and treated with intravenous antibiotics and surgery. After surgery, the patient's general condition improved and he was discharged without mortality and morbidity with the good condition after 6 days.
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Conclusion: Hemorrhoidopexy with a stapler is more widely accepted than other hemorrhoidectomy methods especially manual methods for prolapse hemorrhoids due to less postoperative pain, shorter hospital stays, and faster return to work. Although this procedure usually has mild side effects that do not require surgery, sometimes life-threatening complications such as rectal perforation may happen, which requires prompt diagnosis and appropriate treatment.
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