Showing 574 results for Mohammad
Maziar Naderi , Gholamreza Ebrahimzadeh, Mahmood Alimohammadi , Vida Past,
Volume 80, Issue 2 (May 2022)
Abstract
Background: Nowadays, the COVID-19 pandemic has become a global problem that new methods must be used to prevent it. The virus is highly contagious and is mainly transmitted through the air. Ozone is a powerful oxidant that can be used to inactivate a wide range of viruses that may be resistant to other disinfectants. The purpose of this study was to review the use and effect of ozone in inactivating indoor viruses.
Methods: To conduct this review study, the keywords such as ozone, virus and air were used to search the PubMed and Scopus databases. Articles were searched from 2010 to 2020. As a result of the search, 57 articles in this field were selected and their content and results were used in this review study.
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Results: This review study showed that ozone has been successfully used to prevent several viral diseases such as COVED-19. In addition, some viruses, such as coronaviruses, contain sulfhydryl functional groups containing cysteine and tryptophan that react better with ozone gas. The infected person's sneezing may result in the formation of 40,000 droplets in the air. The droplets can be transferred to the nearest surface up to approximately 2 meters before falling and also may remain in the air for 30 hours.
Conclusion: The use of ozone gas has many potential applications in inactivating viruses in enclosed spaces. Given the importance of virus-containing aerosols in the transmission of COVED-19, ozone can be a promising way to prevent the disease. The degree of inactivation of viruses by ozone gas depends on the gas concentration, contact time, temperature, humidity and type of virus. In general, studies in this field have shown the use of ozone gas in preventing the spread of viral diseases such as COVED-19. Necessary safety measures and precautions are also recommended in using this gas.
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Milad Jalilian, Iraj Abedi, Mohammadreza Sharifi,
Volume 80, Issue 2 (May 2022)
Abstract
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Background: Magnetic resonance imaging (MRI) is a non-invasive imaging technology that shows detailed anatomical and pathological images. It is often used for disease detection, diagnosis, and treatment monitoring, in particular with neurodegenerative diseases, such as Multiple sclerosis (MS), Alzheimer's and amyotrophic lateral sclerosis. However, conventional MRI provides only qualitative information and cannot distinguish between myelin and axon destruction. One of the new methods in early detection for axonal injury is the DTI sequence, which can be used to observe and quantify the various dimensions of these plaques, including the direction of diffusion and average diffusion. In other words, in DTI, quantitative data from the image helps to estimate the physiological and pathophysiological information of plaques in the brain. This study aimed to investigate the relationship between DTI parameters including FA, MD, RD, AD, axon injury and severity of clinical symptoms in patients with MS.
Methods: This is a cross-sectional control case study that was performed in Isfahan Milad Hospital from December 2020 to August 2021. DTI imaging was performed on 41 patients with MS and 41 normal individuals, and DTI indices including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) in different areas of the brain were evaluated. A visual analog scale (VAS) was used to assess the severity of clinical symptoms in patients. The relationship between DTI indices and the severity of clinical symptoms and axon injury was analyzed by the Kolmogorov-Smirnov test.
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Results: Correlation analysis showed that there is a significant correlation between DTI sequence parameters and the VAS visual analog scale (P˂0.05) and according to the positive values of the correlation coefficient, there was a positive and significant relationship between VAS and the mentioned parameters and with increasing parameters. The DTI sequence of the Visual Analog Scale (VAS) was significantly increased.
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Conclusion: Indicators obtained from the DTI sequence can be used in the prognosis of the disease and the estimation of the severity of clinical symptoms during the patients' involvement.
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Leila Shirani-Bidabadi , Abass Aghaei-Afshar , Saeideh Kazemi , Ismaeil Alizadeh, Moghadameh Mirzaee , Mohammad-Amin Gorouhi ,
Volume 80, Issue 2 (May 2022)
Abstract
Background: Head lice is one of the threats to public health in advanced and developing societies. In previous studies in Kerman Province, the rate of head lice infection was reported to be 3.8%. The aim of this study was to determine the prevalence of head lice infection among female students of elementary schools of Kerman, and to identify the factors involved.
Methods: This study was a descriptive cross-sectional study from September 2019 to March 2019. The statistical population in the present study was female students from first to sixth grade of elementary school in districts one and two of Kerman. In selected schools, 2850 female students were examined by census. 179 people were randomly selected from different classes and after the examination; a questionnaire was completed for each of them. The extracted data were analyzed using univariate and multivariate logistic regression tests. Odds Ratio was analyzed with 95% confidence (at the level of P<0.05).
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Results: Female students whose mothers were illiterate were 3.51 times more likely to develop head lice. Students who bathed once a week were 0.03 times more likely, and those who shared personal items were 3.6 times more likely to develop the disease. In terms of father occupation, the highest incidence of head lice among the subjects was 8 people (66.7%) related to people whose father job was free and the lowest was related to other occupations of 4 people (33.4%). There was no significant relationship between father's job and head lice infection in the subjects (P=0.061).
Conclusion: The results of this study indicate the high infection rate of head lice in elementary school students of Kerman. This high level of infestation can cause more contamination among female students consequently, and may cause students to drop out of the school. Serious attention to reducing this infection by holding educational classes for school principals and teachers, as well as parents, seems necessary.
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Laya Amoozadeh, Mohammad Taghi Beigmohammadi,
Volume 80, Issue 2 (May 2022)
Abstract
Background: The decision to extubate the patient is crucial and challenging. The use of corticosteroids to reduce airway edema and extubation failure in intensive care patients is debatable.
Methods: In an observational prospective cohort study from April 2021 to July 2021, 110 patients undergoing head and neck surgery at Imam Khomeini Hospital's special wards were enrolled. Inclusion criteria: Patients undergoing head and neck surgery. Exclusion criteria: previous corticosteroid use, presence of tracheostomy tube, history of head and neck surgery. The intervention group (n=55) received intravenous dexamethasone 8 mg three times a day for the first 24 hours and 4 mg twice a day for the next 24 hours. The control group did not receive any corticosteroids (n=55). All the patients were weaned with the same protocol, including pressure support ventilation with pressure support 6-8 cm H20 and PEEP <5 cm H2o and FIO2 ≤0.4 for 1-2 hours without respiratory distress, hypoxia, tachycardia, and diaphoresis. Before extubation, the cuff leak test was done for all the patients with the cut-off point of 110 ml. The Chi-square or Fisher's exact test was performed for categorical variables, and a t-test was used to describe the quantitative variables. P-values less than 0.05 were considered statistically significant.
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Results: The mean age was 52.1±14.1, and there was no difference between the two groups. Demographic characteristics, including sex, body mass index, duration of surgery, kind of intubation, and Acute Physiology and Chronic Health Evaluation (APACHE) II score, were not significantly different. The length of stay in the intensive care unit in the dexamethasone group was significantly longer than the control group (104 vs. 79-hour, P=0.001, CI 95%: 10.995-40.878). The rate of failure in extubation and postoperative stridor was not significantly different between the two groups (P=0.237).
Conclusion: Dexamethasone usage seems not to be effective in reducing airway edema, and its routine use is not recommended in reducing stridor after endotracheal tube removal.
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Sahar Seddiq, Fatemeh Khalili , Asghar Abdoli, Fatemeh Azarkish, Kamal Abdolmohammadi ,
Volume 80, Issue 3 (June 2022)
Abstract
According to the official statistics of the World Health Organization (WHO), cervical cancer is one of the most common cancers among women after breast, colorectal, and lung cancers. The US Centers for Disease Control and Prevention (CDC) says all women have the chance to get the disease, and women over the age of 30 are more likely to get it. However, this cancer is a types of cancer that can be prevented through vaccination. This study aimed to investigate the role of vaccines in the prevention of cervical cancer. In this review study, articles published between 2016-2022 from PubMed, SID, Cochrane Library, Science Direct, and Google Scholar databases were examined. Keywords Papilloma vaccine and cervical cancer in Persian sources and HPV vaccine and Cervical Cancer in English sources were used. The subject search was also performed using MeSH medical subject headings and through the Pubmed database. Vaccination against human papillomavirus is the most cost-effective public health measure against cervical cancer. In many developed and developing countries, serious programs are underway for HPV vaccination and screening for cervical cancer. In most countries, HPV vaccination has been added to their mandatory immunization programs, effectively reducing the incidence of cervical infections and cancers. In countries where vaccination is not complete, health education and screening programs such as PAP smears every 2 years for all women and every year for those with high cancer risk or abnormal smears, have been consolidated. HPV vaccination is highly effective and has been added to immunization programs in many countries. Nowadays, three types of vaccines have been presented, of which the 9-valent Gardasil vaccine is more effective than the other two types, but in terms of cost-effectiveness, the 4-valent Gardasil vaccine is more suggested. Due to the high prevalence of cervical cancer in Iran, it is suggested that the HPV vaccine be used, screening tests be optimized and performed on a regular basis, and ways to prevent cervical cancer be taught.
Mohammad Ranaee, Yaghob Khoshsirat Tomaj , Hemmat Gholinia Ahangar , Mahmood Monadi,
Volume 80, Issue 3 (June 2022)
Abstract
Background: Pleural effusion is the accumulation of fluid in the pleural cavities resulting from an imbalance of fluid production and reabsorption. Early detection of the cause of pleural effusion leads to early treatment and reduces effects on the patient. The most important step in pleural effusion diagnosis is to determine its nature and to determine whether it is transudate or exudate. CRP(C-reactive protein) is an acute-phase protein that is synthesized by hepatocytes during inflammatory states, the highly sensitive type of CRP is more sensitive than the standard CRP test and measures lower levels. It may help differentiate the nature of pleural effusion. The aim of this research was to evaluate the hs-CRP diagnostic value in differentiating the nature of the pleural effusion
Methods: In this descriptive-analytical cross-sectional study, in Rohani hospital of Babol from March 2017 to February 2019, 75 pleural effusion patients, undergoing thoracentesis, the hs-CRP level was measured in their pleural fluid and were compared based on Light´s criteria in two groups of transudates and exudates. Using the ROC curve, the appropriate cut-off point was determined for hs-CRP to differentiate the nature of pleural effusion.
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Results: Out of 75 patients, 45 patients were in the exudative pleural effusion group and 30 patients in the transudative group. The mean of hs-CRP in the exudate group was 18.27±10.74 mg/L and in the transudative group 2.98±2.15 mg/L (p˂0.001). The cut-off point for hs-CRP of pleural fluid was calculated to be 5.94 mg / L, which has a sensitivity of 88.9% and a specificity of 93.3%. This marker was also studied in exudative subgroups, and there was a significant difference between pleural hs-CRP levels in two groups of pleural effusion due to malignancy and Parapneumonic effusion (p=0.011).
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Conclusion: The pleural fluid hs-CRP can be used as a useful marker for differentiating the nature of pleural effusion and differentiating the pleural effusion of transudate and exudate.
Seyed Mohammad Hassan Adel, Saad Fazeli, Fatemeh Jorfi , Hoda Mombeini, Homeira Rashidi,
Volume 80, Issue 3 (June 2022)
Abstract
Background: Diabetes mellitus is associated with an increased risk of cardiovascular disease. The effects of add-in Sodium-glucose cotransporter 2 (SGLT2) inhibitors to standard statin treatments in acute coronary syndrome (ACS) patients remains controversial. The effects of the empagliflozin treatment after percutaneous coronary intervention (PCI) on the lipid profile of patients with type 2 diabetes mellitus (T2DM) have not been investigated yet. This study aimed to evaluate the efficacy of empagliflozin administration on lipid profile in diabetic patients with ACS after PCI.
Methods: This randomized, double-blind, placebo-controlled trial study was conducted from March until December 2020 on type 2 diabetes patients who underwent PCI and were referred to the Golestan and Imam Khomeini Hospitals. 93 patients (56 males and 37 females, mean age of 56.55 years old) were included. The patients were randomly assigned into two groups of receiving empagliflozin (10 mg, once daily) or a matching placebo, in addition to standard therapies for 6 months. The changes in metabolic parameters including lipid profile before and 6 months after interventions were assessed.
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Results: After treatment in placebo group the level of LDL-C (median 0.90 mg/dl to 0.82, P=0.008) and HDL-C (median 0.40 mg/dl to 0.35, P=0.090) were decreased, while in the empagliflozin group the levels of LDL-C (median 0.87 mg/dl to 0.96, P=0.875) and HDL-C (median 0.38 mg/dl to 0.48), P=0.007) increased. Treatment with Empagliflozin and placebo had no significant effect on changing the levels of total cholesterol, TG and eGFR (P>0.05). The weight loss and FBS reduction in the empagliflozin group were significantly higher than placebo (P=0.001 and P=0.048, respectively).
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Conclusion: Our results showed that adding Empagliflozin to standard treatment compared with a placebo for 6 months significantly increased LDL-C and significantly increased HDL-C. Also, except for weight loss and FBS, Empagliflozin was not more effective in improving the metabolic parameters of diabetic patients after PCI compared with placebo, so it seems that the use of this drug in diabetic patients with ACS after PCI is not very cost-effective.
Mohammad Nasr Esfahani , Aref Javari, Farhad Heydari, Majid Javari,
Volume 80, Issue 4 (July 2022)
Abstract
Background: Previous studies have shown that several factors affect the outcome of cardiopulmonary resuscitation. In this study, we have evaluated the factors associated with the outcome of resuscitation in in-hospital cardiopulmonary arrest patients (IHCA) 002E.
Methods: This cross-sectional non-probability study was performed on patients with in-hospital cardiopulmonary arrest between 2015 and 2020 in the emergency department (ED) of Al-Zahra Hospital, Isfahan, Iran. Data were then collected from medical records to describe patient characteristics, arrest profile, and survival details. Factors associated with the dependent variable were examined Logistic regression.
Results: Among 848 in-hospital cardiopulmonary arrests, 18 patients (2.1%) survived and were discharged from the hospital. The mean age of patients was 62.74±21.17 years, 583 (68.8%) were male, and 265 (31.2%) were female. The mean age of patients with successful resuscitation and those with unsuccessful resuscitation was 62.33±21.79 (6 to 116 years) and 61.58±21.20 (1 month to 108 years) years, respectively. The rate of unsuccessful resuscitation increased with increasing age (P=0.04). Also, the rate of unsuccessful resuscitation increased if there was an underlying disease (P=0.01). In frequency analysis of resuscitation services, emergency medicine with 633 (57.3%) resuscitation is in the first place in the number of resuscitations, of which 22.9% of them have been successful (ROSC). In the anesthesia service, of 2 resuscitations performed, both were successful. In the general surgery service, 36.5% of 63 resuscitations were successful, and the success rate for the neurosurgery service was 32.4% of 102 resuscitations. Analyzing the duration of successful and unsuccessful resuscitation has great importance. In successful resuscitation, the average time was 18.98 minutes and in unsuccessful resuscitation was 39.20 minutes. Also, the maximum and minimum time for successful resuscitations was 63 and 1 minutes. The maximum and minimum time for unsuccessful resuscitations was recorded as 60 and 10 minutes.
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Conclusion: The results showed that several factors were influential in cardiopulmonary resuscitation. Increasing age and underlying disease reduced the success of cardiopulmonary resuscitation.
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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
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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.
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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.
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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.
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Hossein Ghorbani, Mohammad Ranaee, Alireza Firouzjahi, Zahra Ahmadnia, Samaneh Rouhi, Farzane Jafarian, Rouzbeh Mohammadi Abandansari , Somayeh Ahmadi Gorji,
Volume 80, Issue 5 (August 2022)
Abstract
Background: Infection with Strongyloides stercoralis is common in tropical and subtropical regions. To prevent and treat these diseases, information on the distribution and frequency of these parasites in different geographical areas is needed. Due to the importance of diseases in the northern provinces of Iran, the present study was performed to determine the prevalence of Strongyloides stercoralis.
Methods: From April 2011 to March 2020, stool samples from patients who were referred to Rouhani hospital in Mazandaran province, Babol, were gathered. For stool samples, microscopic detection was performed immediately using the wet expansion method, followed by a formal-ether concentration process. Based on the sample size calculation, the minimum number of patients with Strongyloides stercoralis infection was considered to be 380 patients from the years 2011-2020. Mean and standard deviation indices were used to describe quantitative data and numbers and percentages were used to describe qualitative data.
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Results: Out of the total number of 39,800 archived patient files that were reviewed, a total of 420 (1.05%) patients were confirmed for the presence of Strongyloides stercoralis in their feces. The age range of patients was 3 to 89 years. The population of male patients (249 patients) was higher than females (171 patients). In patients with positive Strongyloides stercoralis, disease symptoms were positive in 206 patients and negative in 214 patients. The most common underlying disease in patients was abdominal pain (220 patients). 271 patients received steroids.
Conclusion: Strongyloides stercoralis infection was detected in the northern region of Iran. The prevalence of this parasite was higher in men, the elderly, and people with underlying comorbidities. These results can be used to identify and compare areas where the prevalence of infection is higher. Therefore, revealing the effect of Strongyloides stercoralis infection on public health makes the need for in-depth clinical and diagnostic studies important. People with chronic diseases, whether symptomatic or asymptomatic, should be screened for parasitic diseases.
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Masoud Mohammadi ,
Volume 80, Issue 5 (August 2022)
Abstract
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Nazanin Razazian, Mohammad-Ali Sahraian, Sharareh Eskandarieh, Nooshin Jafari, Mansour Rezaei, Negin Fakhri,
Volume 80, Issue 6 (September 2022)
Abstract
Background: People with chronic diseases of the immune system, such as multiple sclerosis (MS), are at risk for Covid-19 disease. However, more research is needed with long-term follow-up. The aim of the study was to follow up people with MS (PwMS) for up to three months after AstraZeneca vaccination for the recurrence of MS and Covid-19 infection.
Methods: This study was a case study (descriptive-analytical) of follow-up type. The study population was PwMS over 18 years of age in Kermanshah province who received both doses of the AstraZeneca vaccine. This study was conducted from August to November 2021. Sampling was done with existing methods based on the National MS Registry of Iran (NMSRI). Demographic information of patients was extracted from NMSRI. A researcher-made form was used to collect information by telephone three months after vaccination about clinical characteristics, Covid-19 infection, and recurrence of MS. Data were analyzed using SPSS-25 software.
Results: Study participants were 40 MS patients with a mean (SD) age of 39.27 (8.8) years, including 32 (80.0%) women. A mean of 9.39 (4.6) years had passed since The patients were diagnosed with MS, and 29 (76.4%) had RR type MS. Four patients (10%) relapsed between the second dose and three months later, of whom two (50%) had sensory symptoms, one (25%) had optic nerve involvement, and one (25%) had motor symptoms and pyramidal pathway involvement. The symptoms of Covid-19 were mild in three patients (10%), while severe symptoms developed in one patient (10%) who received rituximab. Among the patients, no cases of thrombosis were observed. Infusion therapy, a leg fracture, and kidney stones were the only hospitalized cases.
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Conclusion: Covid-19 and MS relapse prevalence did not differ significantly in the three months before and after vaccination. There is a need for further studies with a longer follow-up period.
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Ahmad Reza Assareh , Marzieh Jafarpor, Mohammad Hossein Haghighzadeh, Nehzat Akiash,
Volume 80, Issue 6 (September 2022)
Abstract
Background: smoking enhances the risk of cardiac events in patients with coronary artery disease. So, it is necessary to evaluate the effects of exercise-based cardiac rehabilitation on endothelial function and functional capacity among smoker patients.
Methods: This randomized clinical trial study was conducted on 56 non-diabetic smokers with a history of percutaneous coronary intervention or coronary artery bypass graft surgery in Imam Khomeini Hospital from May to August 2015. Based on cardiac rehabilitation, patients were divided into intervention and control groups. Before rehabilitation, fasting blood sugar (FBS), lipid profile (LDL, HDL, triglyceride, and total cholesterol), and Ankle-Brachial Index (ABI) were measured for endothelial function. Besides, METs were measured based on the Duke activity status index. After 24 rehabilitation sessions (3 sessions of 1 hour each week for 2 months), all values were checked again and compared with the initial values.
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Results: The mean age of the subjects in the cardiac rehabilitation and control groups were 61.18 and 52.32, respectively. Before the intervention, there were no significant differences between the two groups in terms of the ABI variables, BMI, systolic and diastolic blood pressure, LDL, triglyceride, total cholesterol and FBS; only HDL and METs showed significant differences. After exercise-based cardiac rehabilitation, the mean rate of ABI changes was +0.078 on the right side of the body and +0.084 on the left side of the body. In the control group, these values were 0.002 and 0.003, respectively (P=0.001). The amount of changes in increasing METs as well as decreasing body mass index (BMI), and systolic and diastolic blood pressure in the rehabilitation group were statistically significant compared to the control group. In addition, there were no significant differences in terms of FBS and lipid profiles either (P>0.05).
Conclusion: Two months of cardiac rehabilitation with regular exercise was associated with improved ABI as an indicator of endothelial function and prognosis of cardiovascular disease, as well as improved cardiac functional capacity among smoker patients.
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Naser Ebrahimi Daryani , Mohammad Reza Pashaei ,
Volume 80, Issue 6 (September 2022)
Abstract
Nonalcoholic fatty liver disease (NAFLD) is defined by steatosis in more than 5% of liver cells, in the absence of a secondary cause such as drugs, alcohol, or other causes. The incidence of NAFLD is increasing every day; almost a quarter of the world's adult population is affected by this disease. The burden of NAFLD is affected by the epidemics of obesity and type 2 diabetes (T2DM), and therefore, we do not expect the prevalence of this disease to decrease in the future. The world is now in the process of passing on health to non-chronic diseases, like NAFLD. The most common cause of chronic liver disease worldwide is non-alcoholic fatty liver disease. About 25 percent of the world's population is affected by the disease, and it ranges from simple steatosis to cirrhosis. 1 in 4 individuals with NAFLD is a person with non-alcoholic steatohepatitis, which is associated with complications and significant mortality and morbidity due to complications such as liver cirrhosis and hepatocellular carcinoma. Non-alcoholic fatty liver disease is closely related to metabolic syndrome, and it can be said that the liver is an integral part of obesity. Diagnostic methods for this disease include laboratory tests, imaging studies and liver biopsy. Although NAFLD is observed predominantly in obese persons or type 2 diabetes, an estimated 7% to 20% of people with NAFLD have lean body habitus. Recent studies have shown that fatty liver can occur in lean individuals, even without abdominal and visceral fat. Fatty liver in lean people (Lean NAFLD) is a relatively new concept that has attracted many people to find the differences between lean and obese people. The pathophysiological mechanisms of lean NAFLD are still poorly understood. Studies have shown that NAFLD without obesity is more closely related to factors such as environmental, genetic susceptibility, and epigenetic regulation. In addition to lifestyle modifications such as weight loss, diet and physical activity, only a few NAFLD-specific drug treatment options such as vitamin E and pioglitazone are considered. This article discusses the pathogenesis of fatty liver in lean individuals, its treatment, prognosis, and its relationship with metabolic syndrome.
Parivash Parvasi, Zahra Fazelinejad, Fatemeh Mahdipour, Shahram Bagheri , Mohammad Momen Gharibvand ,
Volume 80, Issue 7 (October 2022)
Abstract
Background: Shear wave elastography (SWE) estimates the stiffness of a mass based on the velocity of shear wave propagation by sound waves. Due to higher cell density and angiogenesis, malignant masses have higher stiffness than benign ones.
Methods: The present study was a prospective study and was performed on patients who were referred to Ahvaz Golestan Hospital with breast mass during March 2020 to March 2021. Only patients with 4-5 BI-RAD were evaluated. Patients were graded based on ACR BI-RAD. All patients were subjected to ultrasound and selection of BI-RAD 4-5 patients for evaluation with SWE and sampling for pathology testing. In this study, in order to increase the maximum accuracy and take samples from the main location of the lesion, sampling was done by ultrasound-guided biopsy method. Tumor information was recorded by a specialist doctor after ultrasound and SWE. This information included tumor type, tumor size and grade, presence of metastasis, involvement of lymph nodes, average and maximum elasticity. SWE cutoffs were compared for mean and maximum elasticity to distinguish benign from malignant masses.
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Results: In this study, 115 patients were evaluated. 63.5% (73) of the patients had benign mass and 36.5% (42) had malignant ones. There was a significant relationship between tumor size and mean and maximum elasticity (P<0.001 The results showed that the diagnostic accuracy of SWE in identifying malignant masses compared to benign ones was 100%, so that the mean (16.61±8.03 kPa) and maximum (21.14±8.88 kPa) elasticity in benign masses were significantly lower than the mean (32.21±7.59 kPa) and maximum (91.62±8.84 kPa) elasticity of malignant masses (P<0.001). There was also a significant difference between the 4 BI-RAD subgroups, so that in BI-RAD 4a, the lowest mean and maximum elasticity were seen (P<0.001).
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Conclusion: The results showed that SWE parameters have sufficient diagnostic accuracy in diagnosing malignant breast masses. Therefore, the use of quantitative SWE parameters in conjunction with ultrasound and BI-RADS classification can avoid unnecessary biopsies.
Kouros Divsalar, Sara Hesami, Majid Mahmoodi, Navidreza Giahi, Fatemeh Divsalar , Mohammad Pour-Ranjbar , Amin Honarmand,
Volume 80, Issue 7 (October 2022)
Abstract
Background: Based on the studies, variation in the mitochondrial DNA (mtDNA) copy number in peripheral blood leukocytes is associated with increased susceptibility to diseases including cancer. Opiate abusers are at high risk for diseases. In this study, we measured the mtDNA copy number in peripheral blood leukocytes in a group of opiate abusers compared with those in healthy individuals.
Methods: In a case/control study, three groups were selected consisting of 32 opium abusers, 24 heroin addicts and 25 healthy individuals. The amount of 5 ml of whole blood was collected from each individual who participated in the study and stored at -20 centigrade. The sample collection was performed from November 2018 to February 2020. Case groups were recruited from the Methadone maintenance therapy center. Contro group had no history of drug use and cigarette smoking. DNA was extracted from the whole blood samples using the salting out method. The DNA from a mitochondrial gene, dehydrogenase subunit1 (-ND1 gene) and a nuclear gene, human globulin (HGB gene), were quantified by a real-time PCR-based method to measure the relative mtDNA copy number of each group number.
Results: There was no significant difference in demographic characterization between the three study groups, opium abusers, heroin addicts and healthy individuals. We found that opium users had a higher mean of mtDNA copy number than those in the healthy control group (P=0.11). Heroin addicts had also higher mean of mtDNA copy number than those in healthy group (P=0.21). The mean mtDNA copy number in opium abusers was higher than that in heroin addicts (P=0.22), although the difference was not statistically significant.
Conclusion: The results of this study indicated that mtDNA copy number increased in a group of opiate abusers. Considering that alteration of mtDNA copy number is associated with increased susceptibility to several diseases including cancer, further research on mtDNA copy number with a high number of volunteers of opiate addicts may clear the effect of opiate abuse on the human genome.
Majid Zamani, Masoudeh Babakhanian , Farhad Heydari , Mohammad Nasr-Esfahani , Mohammad Mahdi Zarezadeh ,
Volume 80, Issue 7 (October 2022)
Abstract
Background: In addition to heart disease, ECG also changes in non-heart disease, which due to its similarity, can lead to misdiagnosis of heart disease in patients. ECG changes in brain lesions such as ischemic and hemorrhagic strokes, brain traumas, etc. and have been studied in many articles, but the effects of brain midline shift on ECG changes have not been studied. In this study, we want to examine these changes.
Methods: This is a prospective cross-sectional descriptive study. Patients with brain tumors who were referred to Al-Zahra and Kashani hospitals in Isfahan from April 2019 to March 2021 were selected. Patients with a history of heart disease, patients receiving medications that cause ECG changes, patients with ECG changes due to non-cardiac and cerebral causes, and individuals under 15 years of age were not included in the study. Patients whose ECG changes were due to electrolyte disturbances or acute heart problems were also excluded from the study. After obtaining informed consent from patients, a CT scan or brain MRI was taken and patients were divided into two groups with and without midline shift. Then the ECG was taken and ECG changes (T wave, ST segment, QTc Interval, QRS prolongation) were compared in two groups of brain tumors with and without midline shift.
Results: 136 patients were included in the study. Of these, 69 patients were in the without midline shift group and 67 patients were in the midline shift group. In the midline shift group, 3% of patients had ST segment changes and 23.9% had T wave changes, which were 1.4% and 10.1% in the without midline shift group, respectively. The mean QTc Interval in the two groups without and with midline shift was 338.26 (4 28.438) and 388.66 (37.855), respectively, and the mean QRS in the without midline shift group was 86.09 (88.9.88) ms and in the midline shift group was 94.63 (±12.83) ms.
Conclusion: Brain midline shifts can cause QRS widening, QTc interval prolongation, and T-wave changes in patients' ECGs.
Fariba Zarei , Mohammadreza Sasani, Banafsheh Zeinali-Rafsanjani , Mahdi Saeedi-Moghadam ,
Volume 80, Issue 7 (October 2022)
Abstract
Background: Fine needle aspiration biopsy (FNAB) is usually used to distinguish the malignant and benign nodules. Applying a biopsy needle evokes a sense of fear and pain in the patients. Although some studies refute the usefulness of local anesthesia (LA) prior to fine needle aspiration biopsy, it is still debatable. This prospective cross-sectional study intended to evaluate the effect of LA prior to fine needle aspiration biopsy on pain and anxiety considering nodule size.
Methods: Amongst the patients who were referred to Shiraz Shahid Fagihi Hospital for Thyroid fine needle aspiration biopsy from August 2017 to January 2018, 114 patients participated in this study. LA was performed for 41 patients, and 73 underwent the thyroid nodule fine needle aspiration biopsy without LA. Patients' pain and anxiety were scored using the visual-analog-score and Spielberger anxiety scale. The nodules were categorized into five groups. Pain and anxiety of patients were compared considering their nodule sizes to assess the effects of LA in the reduction of pain and anxiety considering the nodule size.
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Results: The patients undergoing LA had a mean age of 44.69 years old and average body mass index (BMI) of 26.7, the patients who performed thyroid nodule fine needle aspiration biopsy without LA had a mean age of 48.17 years old with an average BMI of 26.0. The patients with the maximum nodule size of<10 mm, experienced more pain during the fine needle aspiration biopsy without LA, but there was no significant difference between the S/T-anxiety of these patients. There was no significant difference between the pain and anxiety scores of the patients with larger nodules.
Conclusion: The more pain experienced by the patients with the smallest nodules can be attributed to the need for more needle manipulation due to the small nodule size and less precision while piercing the needle into the nodule. Thus, it can be suggested that in patients with a small nodule size, less than 10mm, usage of LA prior to fine needle aspiration biopsy can reduce the pain significantly.
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Mahbod Kaveh, Mohammad Kaji-Yazdi , Mohsen Jafari, Armen Malekiantaghi, Seyed Yousef Mojtehedi , Kambiz Eftekhari,
Volume 80, Issue 7 (October 2022)
Abstract
Background: The neonate's Cardiopulmonary resuscitation (CPR) is the most important and common emergency condition in the delivery room. Approximately 10% of newborns are unable to initiate effective breathing and require assistance. The aim of this study was to evaluate the frequency of CPR levels of the neonates delivered during a year in Moheb Yas Hospital who were resuscitated.
Methods: This was a retrospective cross-sectional descriptive study. The sampling method in this study was census. In this study, all the live neonates born during the year (April, 2010 to April, 2011) in Moheb Yas Hospital who were resuscitated, were enrolled in the study. The information of these infants was recorded in separate checklists. This checklist included the following information: mother's age, gestational age, gender of the baby, method of the delivery, multiple births, complications of the placenta and umbilical cord, amount of amniotic fluid, fetal presentation, meconium excretion, fetal heart rate pattern, Apgar of the baby, resuscitation levels, underlying diseases of the mother, maternal diseases during pregnancy, drug use by the mother and premature rupture of the amniotic sac. Finally, the data were analyzed by SPSS software. P-values less than 0.05 were considered statistically significant.
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Results: There were 2,176 live births during the study. Of these infants , a total of 322 neonates (15.27%) underwent CPR. 51.8% were male. The mean gestational age was 36.08 weeks. The first minute Apgar was less than 5, between 5-7, and above 8 respectively in 10.5%, 33.4%, and 56% of neonates. About 42% of neonates needed initial resuscitation (warming, drying, and respiratory stimulation). 48% required respiratory ventilation with bag and mask, 5% endotracheal tube, 2.7% cardiac massage, and 1.3% needed medication. In 96.7% of cases, the CPR team was ready for resuscitation before delivery.
Conclusion: If resuscitation is performed in a timely and appropriate manner, very few of these infants will need advanced resuscitation. On the other hand, the high need for resuscitation by bags and masks can be secondary to the educational nature of this hospital.
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