Showing 120 results for Akbar
Masoud Mohammadi , Ali Akbar Vaisi-Raygani , Rostam Jalali , Akram Ghobadi , Nader Salari , Mitra Hemmati ,
Volume 77, Issue 9 (December 2019)
Abstract
Background: Infant mortality is important as a standard indicator for the development of health, educational and social health systems in each country. Considering the fact that in different studies of the country there are different statistics on the prevalence of infant mortality in the intensive care unit and the general statistics on the prevalence of mortality in neonates in the country are unclear and unclear, the aim of this study was systematic review and meta-analysis for determine the prevalence of mortality in infants admitted to the intensive care unit (ICU) of hospitals in Iran.
Methods: A meta-analysis was performed for relevant articles in scientific databases including scientific information database (SID) and Magiran, ScienceDirect, Scopus, Medline (PubMed) and Google Scholar. Entrance criteria included cross-sectional studies between March 2000 to September 2018. The search process in these databases was performed using keywords: Neonatal, Intensive Care Unit, Mortality, and Iran. Non-relevant articles included review articles, interventions, cohorts and case-control studies, excluded from the study list. Heterogeneity of study was checked using I2 index and the possibility of publication bias by funnel plot and Egger test. Data were analyzed using the comprehensive meta-analysis software, version 3 (Biostat, Englewood, NJ, USA).
Results: The overall prevalence of infant mortality in ICU hospitals was 21.8% (95% CI 14.4-31.6%), the highest prevalence of infant mortality in Isfahan was 64.4% percentage (95% CI 57.5-70.9%) and the lowest mortality rate in babies in Babol's intensive care unit with 5.1% (95% CI 3.8-6.7%). The results of the study showed that the prevalence of infant mortality was significantly reduced with increasing sample size (P<0.05). Also, with an increase in years of research, the frequency of infant mortality in the intensive care unit increases, which is also statistically significant respectively (P<0.05).
Conclusion: Considering the high prevalence of infant mortality in ICU hospitals in Iran, health policy makers need to take effective measures to raise awareness of parents as well as effective measures to reduce infant mortality.
Maria Zahiri , Khalil Pourkhalili , Sadegh Darvishi , Hossein Heydari , Zahra Akbari,
Volume 77, Issue 10 (January 2020)
Abstract
Background: Aphanizomenon flos-aquae (AFA) is a type of blue-green algae and contains a source of biological compounds. These microalgae have many beneficial health effects. Recently, fucoidan, known sulfated polysaccharide component of AFA algae, has been claimed to stimulate stem-cell mobilization in animal models. Stem cells play an essential role in tissue repair process. In this study, we use excisional full thickness wound model to investigate the effectiveness of trademark AFA extract on skin wound repair process.
Methods: In this experimental study, 21 adult male Wistar rats (weighing 200-250 g) were used and under general anesthesia (intraperitoneally with a ketamine/xylazine solution), two round excisional wounds were created under sterile conditions by a 6 mm punch on the dorsum (paravertebral area) of all rats. Animals were randomly assigned into 3 groups. In groups 1 and 2 (SE-200, SE-400), StemEnhance© (StemTech Health Sciences Inc. British Columbia, Canada) were given respectively 200 or 400 mg/kg by oral gavage once daily and in group 3 (Sham), distilled water (DW) was given to all subjects. Post-wounding gavage of StemEnhance or DW started from 1st day and continued to 7th day. The wound surface area was monitored daily by digital camera and assessed by Image Tool™ software, version 3.5 (UTHSCSA, San Antonio, TX, USA). At 9th day post-wounding animals were sacrificed and repaired tissues were harvested by and assessed by a 8 mm punch. Repaired skin areas were processed for hematoxylin and eosin (H&E). Histopathological parameters of healing including inflammatory cell infiltration, angiogenesis, and fibroblast count were assessed by pathologist. Our study was conducted in the Physiology Department of Medical School, Bushehr University of Medical Sciences, Iran, from October 2016 to March 2016.
Results: Macroscopic imaging of wound area revealed that there was statistically significant difference in wound area reduction between SE-200 group and sham group on day 6 post wounding (P=0.032). Moreover, histological findings showed that the number of neutrophils, macrophages, fibroblasts, and microvessel density decreased in both StemEnhace-treated groups. There were no significant differences between two treatment groups.
Conclusion: According to the obtained results it seems that the extract of Aphanizomenon flos-aquae algae positively affects wound healing process by ameliorating inflammatory response in early healing phases.
Saied Bokaie , Hessameddin Akbarein , Behnaz Beygi , Ehsan Mosa Farkhani ,
Volume 78, Issue 1 (April 2020)
Abstract
Background: Today, due to changes in human lifestyle and consumer demand incidence of foodborne diseases is on the rise. The aim of this study was to investigate the mortality rate of foodborne diseases and their related factors.
Methods: In this cross-sectional study, data on deaths registered according to the International Classification of Diseases (ICD-10th revision) were extracted from death registration and classification of causes system in the Ministry of Health and Medical Education of Iran from 2011 to 2018. Data on deaths from food and water borne diseases including Salmonella, Shigella, Escherichia coli O157:H7, Staphylococcus aureus, Clostridium botulinum, and other foodborne diseases were extracted from database of death registration and classification of causes system. The demographic variables of dead people considered in this study include age (under 5 years, 5-20 years, 20-40, 40-60s and over 60 old), gender, nationality, and the location where people died (urban, rural and unknown).
Results: The majority of deaths cases occurred at the age of 60 years and in older age groups (P<0.001). The results show that across all the age groups mortality rate from foodborne diseases was higher among men than among women (P=0.110). Most of foodborne diseases were reported by people living in urban areas (P<0.0001). The results of this study showed that most of the deaths from these diseases occur in the warm seasons. In this study, the crude death rate was 10 cases per one million inhabitants.
Conclusion: The results of this study showed that there was a significant difference between the mortality rate due to different bacterial agents. This study suggests that demographic variables are important predictors of mortality from foodborne illness and should be further investigated.
Akbar Derakhshan, Somaye Bazdar, Shahram Bamdad,
Volume 78, Issue 7 (October 2020)
Abstract
Background: Color vision has an important role in daily activities and also learning special talents in different jobs, especially in the field of medicine. However, they are many people all over the world that has no insight into their color blindness and choose the study fields that are completely dependent on vision. Due to the importance of color vision in the field of medicine, we conducted this study to evaluate the prevalence of color blindness in Mashhad medical school, Mashhad, Iran.
Methods: A total number of 200 male medical students from June to September 2016 were enrolled in this study by a simple sampling method. Ishihara test was applied for the evaluation of color vision. Required data were written down in questionnaire sheets, which were designed for this study. A T-test was used to compare the mean value of quantitative data. Chi-square test and Fisher exact test were used to compare the qualitative data in different groups.
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Results: The results of the current study showed that among 200 participants who were evaluated in this study, 8 of them (4%) suffered from color blindness. Among these 8 color blinded cases, 6 of them (75%) had the insight into their disease while 2 of them (25%) had no insight into their condition. Moreover, the results of evaluating the type of color blindness showed that 7 of them had green-red color blindness, while 1 of them had complete color blindness.
Conclusion: Comparing results of the current study with previous ones, we concluded that color blindness has a lower prevalence in our study population (4%), in comparison with the general population (8%). Moreover, obtained results about patients’ insight into their disease showed that a considerable percentage of cases (25%) had no insight to their disease, which indicates the importance of conducting color blindness screening test for medical students due to the importance of color vision in the field of medicine.
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Hasan Alinezhad, Reza Vazirinezhad , Ahmadreza Sayadi, Zeinab Hajaliakbari, Mahdi Alinezhad,
Volume 78, Issue 10 (January 2021)
Abstract
Background: One of the most important duties of a family physician is primary health care. The family doctor plan is one of the developmental measures to provide easy and low-cost access for patients to health care centers. The family doctor and her team are fully responsible for the health of the individuals and families covered. Therefore, this study was conducted to assess the satisfaction of rural areas of Rafsanjan city with the family physician plan.
Methods: This study is a descriptive-analytical study that was conducted in rural areas of Rafsanjan from October to December 2018. The study population consisted of twelve randomly selected villages in Rafsanjan. The required sample size was examined according to the size of the statistical population of 480 people. In this study, to collect the required data, a researcher-made checklist was used, which was prepared by reviewing the texts of the questions. The sampling method was cluster random. To check the validity of the checklist, the opinions of 10 health education experts were used. To check the reliability, the checklist was provided to 20 villagers and the reliability was determined using Cronbach's alpha method of 82%. The mean was used to describe the data and inferential statistics t-test and ANOVA were used to analyze the data and analyzed by SPSS.
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Results: The average satisfaction of villagers with the family physician program was relatively good. The Highest satisfaction is with diploma education and income below 1 million 2.21% and the lowest satisfaction score is 21-30 years old and income over three million 2.16%.
Conclusion: Satisfaction with the implementation of the family physician program in rural areas indicated that the health system reform processes were successful and to increase this satisfaction, we must improve the level of service and improve the quality of family physician services day by day because the health system with effective health care is an important element of family physicians.
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Banafshe Safaeifard, Mehri Ghasemi, Khosro Khademi-Kalantari , Alireza Akbarzadeh-Baghban, Yaghoub Shavehee,
Volume 79, Issue 4 (July 2021)
Abstract
Background: Posturography is a method in which the postural stability of adults is evaluated by measuring the center of pressure sway. This study aims to evaluate the reproducibility of measuring the center of pressure oscillation in standing position with internal perturbation in healthy young women with and without hyperkyphosis.
Methods: Ten women with dorsal hyperkyphosis with the mean age of 23.5±2.65 years and 10 healthy women with the mean age of 21.9±1.3 years (October 2018 to February 2019) were recruited for the study. Subjects were asked to perform rapid bilateral arm elevation while standing on a force plate. Standard deviation of the amplitude and The standard deviation of the velocity of the center of pressure sway in anterior-posterior, Medio-lateral directions and the area of sway were used for statistical analysis. Measurements were carried out by one examiner with a 1-day interval in The Biomechanics laboratory of The School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences. The relative reproducibility of the measurements was calculated by Intra-class Correlation Coefficient (ICC), standard error of measurement (SEM) and minimal detectable changes (MDC).
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Results: The intra-rater reliability of standard deviation of the center of pressure sway velocity and amplitude of both directions in both groups were more than 0.75. The intra-rater reliability of the area of the center of pressure sway in the healthy and hyperkyphosis group were 0.42 and 0.38 respectively.
Conclusion: Standard deviation of the amplitude and standard deviation of the velocity of the center of pressure sway can be considered as reliable variables for assessing static balance in young women with and without dorsal hyperkyphosis in future studies. However, the inconsistency of sway area especially in women with hyperkyphosis suggests that the use of it for differentiation between subjects and the assessment of the outcome of any interventions on the postural stability should be considered with caution.
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Masoumeh Abbasabadi-Arab , Ali Mohammad Mosadeghrad , Hamid Reza Khankeh, Akbar Biglarian,
Volume 79, Issue 7 (October 2021)
Abstract
Background: The preparedness and safety of hospitals in disasters are essential to maintain the health and survival of the community. Numerous studies have shown that the level of preparedness of Iranian hospitals is moderate and low. Lack of comprehensive hospital standards for disaster preparedness is one of the reasons. This study aimed to develop hospital accreditation standards for hospital disaster risk management.
Methods: This comparative study was conducted between April and September 2016. Hospital disaster risk management accreditation standards were extracted from the hospital accreditation standards of 11 countries including the United States, Canada, Australia, Malaysia, India, Thailand, Egypt, Turkey, Saudi Arabia, Denmark and Iran. Overall, 27 hospital disaster risk management accreditation standards were introduced. The opinions of 22 disaster risk management experts were used to assess the content validity of the proposed disaster risk management accreditation standards.
Results: Differences were observed in the quality and quantity of those countries’ disaster risk management standards. The national accreditation standards of the United States, Australia, and Canada had comprehensive standards and covered all aspects of the disaster risk management cycle. Finally, 27 standards were proposed for developing Iranian hospitals’ disaster risk management accreditation standards. The CVI & CVR validity of the proposed standards were acceptable.
There were significant differences in the quantity and quality of hospital disaster risk management accreditation standards in selected countries. The most comprehensive standards belonged to the US National Standards (12 standards and 113 sub-standards), followed by the Australian and Canadian accreditation standards. The accreditation standards of the developing countries and Iran were not comprehensive and did not meet the international goals of disaster risk management. The proposed hospital disaster risk management accreditation standards had high content validity.
Conclusion: Disaster risk management accreditation standards in Iran and developing countries need to be revised and upgraded. Comprehensive standards based on international experiences and expert opinions were introduced in this study that can be used to develop hospital accreditation standards in Iran and other countries.
Seyed Ali Akbar Arabzadeh, Vahid Jamshidi , Masoud Saeed, Rostam Yazdani, Mahdieh Jamshidi,
Volume 79, Issue 10 (January 2022)
Abstract
Background: The clinical field has vast sick data that has not been analyzed. Discovering a way to analyze this raw data and turn it into an information treasure can save many lives. Using data mining methods is an efficient way to analyze this large amount of raw data. It can predict the future with accurate knowledge of the past, providing new insights into disease diagnosis and prevention. Several data mining methods exist but finding a suitable one is very important. Today, coronavirus disease (COVID-19) has become one of the causing deadly diseases in the world. The early diagnosis of pandemic coronavirus disease has a significant impact in preventing death. This study aims to extract the key indications of the disease and find the best data mining methods that enhance the accuracy of coronavirus disease diagnosis.
Methods: In this study, to obtain high accuracy in diagnosing COVID-19 disease, a complete and effective workflow over data mining methods was proposed, which includes these steps: data pre-analyzing, indication selection, model creation, the measure of performance, and display of results. Data and related indications of patients with COVID-19 were collected from Kerman Afzalipour Hospital and Rafsanjan, Ali Ebn Abi Taleb Hospital. Prediction structures were made and tested via different combinations of the disease indications and seven data mining methods. To discover the best key indications, three criteria including accuracy, validation and F-value were applied and to discover the best data mining methods, accuracy and validation criteria were considered. For each data mining method, the criteria were measured independently and all results were reported for analysis. Finally, the best key indications and data mining methods that can diagnose COVID-19 disease with high accuracy were extracted.
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Results: 9 key indications and 3 data mining methods were obtained. Experimental results show that the discovered key indications and the best-operating data mining method (i.e. SVM) attain an accuracy of 83.19% for the diagnosis of coronavirus disease.
Conclusion: Due to key indications and data mining methods obtained from this study, it is possible to use this method to diagnose coronavirus disease in different people of different clinical indications with high accuracy.
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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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Reihaneh Pirjani, Ali Akbari Sari, Mahbobeh Shirazi, Amin Nakhostin Ansari, Maryam Rabiei, Amene Abiri,
Volume 80, Issue 3 (June 2022)
Abstract
Background: Streptococcus beta group (GBS: Group B Streptococcus) is a gram-positive coccus that colonizes in the rectovaginal area. About 4.6% to 31.3% of women of childbearing age carry GBS infection. GBS colonization is a risk factor for subsequent infections in pregnant women that can be transmitted to the fetus through vertical transfer and aspiration of infected amniotic fluid. 2% of cases lead to an invasive infection in the baby. In most countries, treatment is done according to the CDC (Centers for Disease Control and Prevention) protocol which is based on culture results. According to studies conducted in our country, treatment is based on risk factors. Therefore, during this study, we decided to compare the results of treatment based on risk factors and treatment based on culture results and other maternal and neonatal complications in these two groups.
Methods: This case-control study was performed on 98 pregnant women aged 35 to 37 weeks who were referred to the perinatal clinic of Arash Hospital from April 2018 to the end of March 2020 and also 200 pregnant women with a GBS risk factor. Samples of rectovaginal discharge of 98 pregnant women were sent to a selected laboratory for culturing. In this group, treatment was performed based on the culture result. The control samples included 200 pregnant mothers who were treated based on risk factors without culture. Then the two groups were compared in terms of pregnancy outcomes.
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Results: Out of 98 subjects, 24 (24.5%) had positive rectovaginal culture. Individuals treated with antibiotics based on positive culture results did not show a significant difference in terms of observed pregnancy outcomes compared with the control group.
Conclusion: The prevalence of GBS colonization was significantly higher in patients with a history of vaginal discharge than in those without a history. Due to the small number of studies conducted in Iran, it is recommended to conduct studies with a larger sample size in order to explain a more appropriate protocol in terms of effectiveness and economics.
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Masoumeh Asgharpour, Khadijeh Ezoji, Roghayeh Akbari, Kayvan Latifi , Shahram Seyfi,
Volume 80, Issue 5 (August 2022)
Abstract
Background: Information on the coronavirus infection 2019 (COVID-19) which can clinically range from asymptomatic infection to severe pneumonia, in transplant recipients is still low. Infections are a major cause of death in kidney transplant recipients, and kidney transplant recipients, like other organ recipients, appear to be more vulnerable to a variety of infections due to comorbidities and immunosuppressive drugs that predispose them to infection.
Case presentation: In this study, we reviewed 10 transplant recipients with a mean age of 50.3±11.25 years who were admitted to Ayatollah Rouhani Hospital in Babol due to COVID-19 From April 2019 to September 2019. Four patients were female and six ones were male. Fever (100%) and cough (60%) were the most common symptoms in patients. All patients used standard immunosuppressive drugs (tacrolimus, corticosteroids, mycophenolate, and cyclosporine). The mean level of oxygen saturation at the time of admission in these patients was 87.9±11.3 and in two patients with death outcomes of 57% and 95%, it was at the beginning of hospitalization. The mean leukocytes of patients at the beginning of hospitalization was10470±5784.08 per ml and the mean lymphocytes of these patients were 1081.5±516.05. In the studied patients, the mean of previous years of transplantation was 8/05±7.13 and two patients died 20 years and 5 years after their kidney transplantation. Two patients (20%), aged 57 and 50 years, died from progressive respiratory symptoms and the other eight patients recovered and were discharged from the hospital.
We reported COVID-19 infection in ten kidney transplant recipients with different clinical outcomes and periods, which may be a reference for the management of COVID-19 in such patients.
Conclusion: It seems that more information is needed to better understand the effect of anti-transplant immunosuppressive therapy on the outcome of COVID-19 infection in kidney transplant recipients. Long-term follow-up studies and more cases are needed to clarify the diagnosis, outcome, and treatment options for COVID-19 in these patients.
Mahdi Akbarzadeh, Danial Habibi , Goodarz Kolifarhood , Mohammad Bidkhori, Fereidoun Azizi , Maryam S. Daneshpour,
Volume 80, Issue 11 (February 2023)
Abstract
Background: Mendelian randomization (MR) is a new generation in the statistical method that uses genetic variants as instrumental variables in data from non-experimental studies to evaluate and estimate the causal effects of risk factors.
Methods: The weakness of observational studies to detect causality, the difficulties of conducting clinical trials, the dramatic advancement of Genome-Wide Association Studies (GWAS) have led to the emergence of a new type of study called MR. It is increasingly being used to determine causality MR is an approach based on meta-analysis methods. The main idea of the MR is based on using the instrument variable (IV) to find the causality between exposure and outcome. This variable does not need to adjust the confounding effects found in observational studies.
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Results: Data for this study were collected from the beginning of January 2003 to October 2020 in PubMed. Our results showed that MR has an increasing trend. The data used in MR includes summarized statistical data, individual-level data, and meta-analysis. Choosing the suitable IV is essential to successfully conduct an MR. For an unbiased estimate, three main hypotheses should be considered: 1) The IV has a strong relationship with the desired exposure (i.e., potential risk factor), 2) The IV is not related to the confounding variable, and 3) The IV is not directly related to the outcome and should only relate to the outcome through exposure. If these conditions are not met, one solution is to use robust methods. Besides, this research introduced the study designs, estimation methods, limitations, software packages, and some applications of MR in medical research.
Conclusion: When we seek to find a causal relationship, but it is not possible to use a clinical trial as a standard method, the MR design can be used in observational studies. Therefore, it is possible to obtain causal relationships between exposure and outcome using the MR.
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Maryam Soheilipour, Aliakbar Gorjipour , Mojtaba Mohammadpour, Elham Tabesh, Mohammad Javad Tarrahi ,
Volume 81, Issue 8 (November 2023)
Abstract
Background: Most people often complain of abdominal bloating. The present study was designed and conducted with the purpose of examining the effect of sequential treatment of Metronidazole and Probiotics, and Probiotics alone in reducing the severity of symptoms of functional bloating.
Methods: The present study was a randomized clinical trial that was carried out from March 2022 until June 2023 in Isfahan and Khurshid Hospital. The studied population were suffering from flatulence and were diagnosed with functional bloating by a gastroenterologist based on Rome III criteria. Then they entered one of the two study groups in a double-blind manner. The first group was treated with Metronidazole for two weeks and then with Probiotic for two weeks. The second group was treated with Probiotic for four weeks. The severity of patients' bloating was measured by a 4-question questionnaire in five stages: before the start of the study, two weeks after, four weeks after, six weeks after, eight weeks after and 12 weeks after the start of the study. Finally, the obtained information was entered into SPSS software version 24 Repeated measures ANOVA was used to investigate the relationship between variables.
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Results: After collecting the data, 43 patients in the first group and 44 patients in the second group were examined. 72.1% of the first group were women and 27.9% were men. In group two, this ratio was 72.7% for women and 27.3% for men. In this intervention, it was seen that in the 1st group, the average severity of bloating decreased until the end of the eighth week and after the second week of drug treatment, and then increased. In the second group, the average intensity of bloating decreased until the end of the fourth week and at the same time as the end of drug treatment, and then increased.
Conclusion: It was shown that in the study, the effect of this combined treatment had a greater effect in reducing the severity of functional bloating among patients with functional bloating.
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Ahmad Tahmasebi-Ghorrabi , Zahra Heydarifard, Behrouz Nemati, Majid Davari, Alireza Delavari, Hamideh Salimzadeh , Ali Akbari Sari ,
Volume 81, Issue 9 (December 2023)
Abstract
Background: Screening is a cost-effective method for prevention, early detection of the disease and reducing the burden of the third deadliest cancer in the world, i.e. colorectal cancer. This study aimed to analyze the cost-effectiveness of colonoscopy screening compared to sigmoidoscopy for colorectal cancer in high-risk individuals in Iran.
Methods: This economic evaluation study was conducted using the cost-effectiveness method between July 2016 and February 2017. Evaluation of the effectiveness of screening methods was done using a systematic review. Cost evaluation was also done using the costs obtained from the tariff approved by the Iranian Ministry of Health in 2015 for colonoscopy and sigmoidoscopy. Finally, the combined model of decision tree and Markov was used to evaluate the cost effectiveness. Incremental Cost Effectiveness Ratio (ICER) formula was used for cost effectiveness analysis considering the final outcome of 5-year survival of high-risk individuals. Excel and TreeAge software were used for data analysis.
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Results: The effectiveness of sigmoidoscopy and colonoscopy in increasing 5-year survival is 11 and 15.7%, respectively, and colonoscopy screening is 4.7% more than sigmoidoscopy. The cost of colonoscopy and sigmoidoscopy screening was calculated as 1000 and 19920 billion Rials, respectively. Based on cost-effectiveness analysis, the cost of treating patients in the case of screening with colonoscopy and sigmoidoscopy is lower than without screening. The ICER ratio of colonoscopy and sigmoidoscopy compared to no screening was -4/441/389/160 and -4/757/954/940 Rials respectively, and colonoscopy compared to sigmoidoscopy was -3/699/785/880 Rials, respectively. Finally, the use of colonoscopy leads to spending 3/699/785/880 Rials less in exchange for obtaining 4722 additional survivals with the prevention of colorectal cancer compared to sigmoidoscopy.
Conclusion: Screening by colonoscopy and sigmoidoscopy methods are effective in reducing the incidence and death of colorectal cancer compared to no screening. Screening by colonoscopy is a dominant option for the high-risk population in Iran. Colonoscopy screening is more cost effective compared to sigmoidoscopy. However, decisions about colorectal cancer screening and screening methods depend on local resources and personal preferences.
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Shokoufeh Akbari, Monireh Rahimkhani, Reza Mirnejad,
Volume 81, Issue 10 (January 2024)
Abstract
Background: Today, Methicillin-Resistant Staphylococcus Aureus (MRSA) has become one of the public health concerns due to its resistance to antimicrobial drugs, and this problem makes treating patients with infections caused by this bacterium difficult. Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) strains are pervasive in both community and hospital settings, primarily attributable to Staphylococcus aureus' capacity to colonize areas like the nose or skin. In this study, with the aim of comparing phenotypic (disc diffusion method) and genotypic (PCR) methods, to detect methicillin-resistant Staphylococcus aureus isolated from patients of hospitals under supervision of Tehran university of medical sciences, and also detection of nor A, that is the one of the most important genes in efflux pump cluster genes.
Methods: The present research was a cross- sectional study that was conducted from February 2022 to September 2023. In this research, 43 isolated strains of Staphylococcus aureus from wound discharge and blood samples, were collected from different departments of Tehran hospitals and had submitted to the research laboratory of the school of allied medical sciences in Tehran university of medical sciences. After identifying the strains, the resistance of the isolates to 14 types of antibiotics was checked by disk diffusion method.
Results: Staphylococcus aureus diagnostic tests including gram staining on colonies, catalase, coagulase, DNase tests were performed and it was found that all strains were Staphylococcus aureus. In the next step, all samples were resistant to Cloxacillin by disc diffusion method, and the presence of mec A gene in them was confirmed by PCR method, thus the presence of MRSA strains was confirmed from the genotypic point of view. Of the 43 Staphylococcus aureus strains, 26 samples were identified as having the nor A gene by PCR and electrophoresis.
Conclusion: The results of the present research have shown that the prevalence of Staphylococcus aureus bacteria in hospital samples is significant and resistance to methicillin and ciprofloxacin has increased in the strains of this bacteria. |
Mohamad Sarkheil, Mehran Mohseni, Akbar Ali Asgharzadeh , Ali Rasouli Bozcheloie ,
Volume 82, Issue 5 (August 2024)
Abstract
Background: Based on the recommendation of the European Committee and ICRP, DRL values should be determined at the local, national and regional levels for CTDIvol (Computed Tomography Dose Index volume) and DLP (Dose Length Product) dose indicators. According to the radiation protection guidelines, it is essential study has determined DRL in Saveh hospitals
Methods: This study was conducted with two methods based on the results and calculations obtained from the annual Quality Control (QC) reports and the Data Collection (DC) method related to patient scans. In this study, by referring to the annual reports of each device and using radiation components during dosimetry and determining CTDIair or CTDIw, the correction factor was obtained. Using this factor and existing equations, DLP and CTDIvol were calculated based on quality control standards. The second quartile or the median was determined as DRL for head, sinus, chest and abdomen/pelvis imaging protocols and its values were compared with each other and other studies. This study was conducted in February and March 2023 in three hospitals in Saveh city.
Results: The diagnostic reference levels of CTDIvol index were obtained in both QC and DC methods for head (32.76 and 32.36), sinus (11.73 and 9.89), chest (6.06 and 5.11) and abdomen/pelvis (11.86 and 10.56) imaging. The highest DRL values of DLP index in both QC and DC methods are for head, abdomen/pelvis, chest and sinus CT scans, respectively. In the QC method, these values were (603.99), (478.15), (187.15), and (132.65) respectively, and in the DC method, the values were (601.84), (427.76), (219.01), and (114.81) mG.cm.
Conclusion: According to the results of this study and the lack of significant difference between the DRL values of CTDIvol and DLP indicators in both QC and DC methods, it is recommended that the centers, if they have the acceptance criteria for annual quality control, can determine the DRL by referring to the device console information from the DC method.
Saeed Rahmani, Aliakbar Shafiee, Abbas Riazi , Alireza Akbarzadeh Baghban , Alireza Jafari , Maryam Dashti,
Volume 82, Issue 6 (September 2024)
Abstract
Background: Problems related to blue light exposure are among the various issues experienced by individuals who have undergone Photorefractive Keratectomy (PRK).Given the growing concerns regarding blue light’s effects on visual health, this study aimed to thoroughly investigate the impacts of blue blocker filters on the improvement of vision in patients post-refractive surgery of the PRK type. The primary objective was to evaluate the overall effectiveness of these filters in enhancing visual quality and in reducing complications associated with the surgery, which can significantly affect a patient’s quality of life.
Methods: In a quasi-experimental study conducted from September 1, 2024, to the end of October 2024, individuals who had undergone PRK surgery were examined at the optometry clinic of Dr. Labbafi Nejad Hospital in Tehran. Participants were subjected to assessments both with and without the application of blue blocker filters. Key parameters, including visual acuity and contrast sensitivity among attendees, were meticulously measured under both conditions. The results were then systematically compared and analyzed to draw meaningful conclusions about the impact of blue blocker filters in this context.
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Results: A total of thirty-four participants, comprising 73.5% females and 26.5% males, with an average age of 32.6 years, were incorporated into the study. Post-surgery, the average refraction measured in the right and left eyes was documented as -0.42±0.16 D and -0.30±0.16 D, respectively. Notably, visual acuity in both eyes significantly improved with the use of the blue light blocking filter (P<0.005) Moreover, contrast sensitivity at varying spatial frequencies of 1.5, 6, and 18 cycles per degree (c/d) also exhibited significant enhancement (P<0.005).
Conclusion: The incorporation of blue blocker filters for individuals with a history of PRK surgery has led to noteworthy improvements in visual acuity and enhanced contrast sensitivity. These findings underscore the critical importance of integrating blue light protection in the post-operative care of patients, as it significantly elevates the overall visual experience and may contribute to better long-term outcomes following refractive surgery.
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Maedeh Afshar, Mahboubeh Haddad , Aliakbar Heydari, Majid Khadem Rezaiyan ,
Volume 82, Issue 8 (November 2024)
Abstract
Background: Brucellosis is the most frequently encountered zoonosis and one of the most important health challenges, especially in developing countries. This disease can be accompanied by bacteremia and may result in severe complications. A definitive diagnosis may be made by culture of the organism from blood, body fluids or tissues, although serum agglutination test is often recognized as the reference test. While bacteremic brucellosis is not uncommon, research on this topic remains limited. The present study was conducted to determine the epidemiological, clinical, and para-clinical characteristics of patients hospitalized with bacteremic brucellosis.
Methods: This retrospective cross-sectional study evaluated the epidemiological, clinical, and para-clinical characteristics, and clinical outcomes of patients hospitalized with bacteremic brucellosis from March 2011 to February 2021 at Imam Reza and Ghaem hospitals in Mashhad, Iran. A list of adult patients with confirmed brucellosis was assembled from microbiology laboratory records. The inclusion criterion was a positive blood culture for Brucella, regardless of the Brucella serology results. According to the laboratory report, the BACTEC culture medium was used to identify the organism, and the reported results did not specify the Brucella species. Demographic data, clinical presentations, paraclinical findings (including Wright, 2ME Wright, and Coombs Wright), and clinical outcomes were extracted from archived medical records.
Results: The mean age was 38.8±18 years, and 17 patients (53.1%) were male. Cardiac diseases were the most common underlying disease, and 15.7% of patients were immunocompromised. Fever and mono-arthritis were the most common symptoms and signs, respectively. Serologic investigations were negative in 12 patients (37.5%). 84.4% of patients had anemia. There was no mortality among patients.
Conclusion: A significant property of patients with positive blood culture for Brucella may not be identified with serologic assays, so if there is strong clinical suspicion of brucellosis, blood culture should also be considered. According to this study, bacteremic brucellosis is not accompanied by mortality, and the patients respond well to common antibiotic regimens.
Neda Faraji, Mahbobeh Alizadeh, Asghar Ghorbani, Hadiseh Hosami Roodsari , Samane Akbarpour , Mohammad Arefi,
Volume 82, Issue 11 (February 2025)
Abstract
Background: This study aimed to evaluate serum amylase levels in hospitalized COVID-19 patients and investigate its association with disease prognosis. Elevated serum amylase levels have been reported in some COVID-19 patients, particularly in severe cases. This increase may indicate pancreatic involvement (pancreatitis) due to viral infection. This cross-sectional study aimed to evaluate the role of serum amylase levels as a prognostic marker in COVID-19 patients.
Methods: This descriptive cross-sectional study was conducted on 150 hospitalized patients with confirmed COVID-19 at Baharloo Hospital, Tehran, over a one-year period (July 2021–July 2022). The results showed that 20% of patients (30 out of 150) had elevated serum amylase levels. Patients with high amylase levels had significantly longer hospital stays (mean 14 days vs. 8 days) and higher mortality rates (15% vs. 5%). Additionally, these patients were more likely to require intensive care (25% vs. 10%). Statistical analysis revealed that elevated serum amylase levels were independently associated with poorer clinical outcomes.
Results: These results have important clinical implications for patient management. Routine measurement of serum amylase at admission could help identify high-risk patients who may benefit from closer monitoring and early intervention. Further research is needed to determine whether specific treatments for pancreatic involvement could improve outcomes in these patients.
Conclusion: These findings suggest that measuring serum amylase levels at admission can serve as a simple and accessible marker for identifying high-risk patients. Elevated amylase in COVID-19 patients is an important biological indicator of multi-organ involvement (pancreas and kidney) and severe inflammation, which is associated with worse prognosis and higher mortality. Monitoring this marker may aid clinical decision-making and improve patient outcomes
Ali-Akbar Shafiei , Saeed Rahmani , Abbas Riazi, Alireza Akbarzadeh Baghan ,
Volume 83, Issue 4 (July 2025)
Abstract
Background: This study investigates the use of color filters, which represent a scientific and standardized approach to assist individuals with visual impairment. Although there is no fixed protocol for prescribing color filters, these filters, which are often prescribed by ocular care providers in a trial-and-error manner today, help improve visual performance, control glare, and enhance motor skills in affected individuals. Given the absence of formal guidelines and standardized protocols in this area, this study tested common diseases leading to visual impairment against various color filters.
Methods: The study population consisted of patients visiting the Optometry Clinic of Labbafi Nejad Hospital. Participants were voluntarily referred from retinal and corneal departments to this clinic. This quasi-experimental study evaluated acuity at distance and near and contrast sensitivity function with and without color filters, and compared the results. After analysis, filter(s) suitable for each participant were identified and applied clinically, with one-month monitoring and re-evaluation.
Results: A total of 99 participants (54 male, 45 female) with a mean age of 32.19±15.41 years were included. The results showed that after using color filters, distance visual acuity (BCVA) improved significantly in most diseases (P<0.001). However, in albinism and diabetic retinopathy patients, there was no significant improvement in distance vision. At near distance, there was generally a significant improvement in near vision in most diseases after applying the filters (P=0.001). Exceptions included albinism and glaucoma, where no significant difference was observed (P=0.073). For contrast sensitivity (CSF), most patients showed improvement and increased contrast sensitivity (P<0.001), but this increase was not significant in albinism and glaucoma (P=0.483).
Conclusion: The study suggests that the use of certain color filters in visually impaired patients leads to significant improvements in both distance and near acuity and contrast sensitivity function, potentially enhancing quality of life. Based on the quantitative results, selecting the appropriate filter should be disease-specific and done with greater precision. However, the diversity and severity of diseases, the degree of vision loss, and genetic differences among individuals require greater attention to practical experiences and statements from this patient group. Additionally, patients with more than one ocular condition often changed the type and color of the filter.