Search published articles
Showing 125 results for Hamid
Nima Koosha, Hamidreza Shetabi, Ahmad Moradi,
Volume 80, Issue 1 (April 2022)
Volume 80, Issue 1 (April 2022)
Abstract
Background: Cataracts are the leading diseases that cause blindness. Cataracts can be treated with surgery. Pain, itching, burning, and a foreign body sensation in the eye are common ocular complaints of patients in recovery. In this study, we compared the effect of Ketorolac eye drops and naphazoline antazoline eye drops on reducing complaints of surgery.
Methods: This randomized clinical trial study was performed from February 2016 to March 2017 on patients who were candidates for cataract surgery at Feyz University Hospital in Isfahan, Iran. In this study, 54 patients were enrolled in two groups receiving Ketorolac eye drops and naphazoline antazoline (NA) eye drops. After the operation, patients' ocular complaints such as burning, itching, pain, and severity were evaluated every 15 minutes in recovery and every half hour in the ward until discharge from the hospital.
Results: In this study, 54 patients in two groups of 27 were studied. In the post-anesthesia care unit, the burning sensation in the naphazoline-antazoline group was significantly lower than in the ketorolac group (P=0.02). Patients in the NA group had less foreign body sensation in the eye in recovery (P=0.97) and the ward (P<0.001) than in the ketorolac group. Mean Pain intensity in the recovery unit (P=0.39) and ward unit in the ketorolac group were less than NA (P<0.001). In the recovery unit in the NA group, the eye-burning sensation was significantly lower than in the ketorolac group. The foreign body sensation in the NA group was less than the ketorolac group but there was no significant difference between the two groups. In the NA group, itching of the eyes was less than in the ketorolac group.
Conclusion: It can be concluded that ketorolac drops have been more effective in reducing post-operative eye pain than NA and NA drops have been more effective in reducing burning, itching and foreign body sensation in the eyes than Ketorolac.
Methods: This randomized clinical trial study was performed from February 2016 to March 2017 on patients who were candidates for cataract surgery at Feyz University Hospital in Isfahan, Iran. In this study, 54 patients were enrolled in two groups receiving Ketorolac eye drops and naphazoline antazoline (NA) eye drops. After the operation, patients' ocular complaints such as burning, itching, pain, and severity were evaluated every 15 minutes in recovery and every half hour in the ward until discharge from the hospital.
Results: In this study, 54 patients in two groups of 27 were studied. In the post-anesthesia care unit, the burning sensation in the naphazoline-antazoline group was significantly lower than in the ketorolac group (P=0.02). Patients in the NA group had less foreign body sensation in the eye in recovery (P=0.97) and the ward (P<0.001) than in the ketorolac group. Mean Pain intensity in the recovery unit (P=0.39) and ward unit in the ketorolac group were less than NA (P<0.001). In the recovery unit in the NA group, the eye-burning sensation was significantly lower than in the ketorolac group. The foreign body sensation in the NA group was less than the ketorolac group but there was no significant difference between the two groups. In the NA group, itching of the eyes was less than in the ketorolac group.
Conclusion: It can be concluded that ketorolac drops have been more effective in reducing post-operative eye pain than NA and NA drops have been more effective in reducing burning, itching and foreign body sensation in the eyes than Ketorolac.
|
|
Behzad Hatami , Saeed Abdi , Hosein Noori, Hamid Mehrad,
Volume 80, Issue 1 (April 2022)
Volume 80, Issue 1 (April 2022)
Abstract
Background: Exposure to lead, damages vital organs and is now a global concern. Toxic effects of lead on the liver and thyroid gland have been mentioned previously, sometimes with conflicting results. Therefore, the present study aimed to assess changes in liver and thyroid function tests in patients with lead poisoning.
Methods: This case-control study was performed on 100 patients with clinical evidence of lead poisoning who were referred to Loghman-e-Hakim hospital in Tehran from April to December 2018. Also, another 100 participants with the matched sex and age, a history of opium use, and exposure to lead or non-work-related metals, and with normal lead levels, were considered as a control group. Demographic information was collected by a trained researcher by reviewing hospital records or interviewing participants. To monitor lead levels in the control group, 5 ml of venous blood was collected from the antecubital vein at 7 to 8 am in sterile tubes containing EDTA as an anticoagulant. Serum lead levels were assessed by GBC Avanta atomic absorption spectrophotometer. Values in the two groups were compared. SPSS version 16 (SPSS Inc. Chicago, Il, The USA) was used for data analysis. A P-value below 0.05 was considered statistically significant.
Results: The mean level of serum lead in case and control groups were 63.0±12.4 μg/dL and 6.0±2.1 μg/dL, respectively with a statistically significant difference (p<0.001). However, Alkaline phosphatase (ALKp), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes were significantly higher in cases compared to controls (p<0.001). The thyroid-stimulating hormone in patients with lead poisoning (0.3±0.04 MIU/L) was significantly lower than those in the control group (2.5±1.23) (P=0.04).
Methods: This case-control study was performed on 100 patients with clinical evidence of lead poisoning who were referred to Loghman-e-Hakim hospital in Tehran from April to December 2018. Also, another 100 participants with the matched sex and age, a history of opium use, and exposure to lead or non-work-related metals, and with normal lead levels, were considered as a control group. Demographic information was collected by a trained researcher by reviewing hospital records or interviewing participants. To monitor lead levels in the control group, 5 ml of venous blood was collected from the antecubital vein at 7 to 8 am in sterile tubes containing EDTA as an anticoagulant. Serum lead levels were assessed by GBC Avanta atomic absorption spectrophotometer. Values in the two groups were compared. SPSS version 16 (SPSS Inc. Chicago, Il, The USA) was used for data analysis. A P-value below 0.05 was considered statistically significant.
Results: The mean level of serum lead in case and control groups were 63.0±12.4 μg/dL and 6.0±2.1 μg/dL, respectively with a statistically significant difference (p<0.001). However, Alkaline phosphatase (ALKp), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes were significantly higher in cases compared to controls (p<0.001). The thyroid-stimulating hormone in patients with lead poisoning (0.3±0.04 MIU/L) was significantly lower than those in the control group (2.5±1.23) (P=0.04).
|
Conclusion: Lead poisoning could potentially damage liver function and elevate liver enzymes. Moreover, it can also affect the levels of TSH and levothyroxine. Understanding the exact mechanisms might help to control The hepatotoxic effects of lead in patients. Also, knowing the pattern of elevated liver enzymes and thyroid hormones changes might help discriminate lead poisoning with other differential diagnoses.
|
Hamid Arshadi, Pooya Hekmati, Hojatollah Raji, Mohammad Vasei , Mehrzad Mehdizadeh,
Volume 80, Issue 1 (April 2022)
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.
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.
|
|
Mina Mir Nezami , Hamid Hamidi , Saeed Karimi Motaleb ,
Volume 80, Issue 4 (July 2022)
Volume 80, Issue 4 (July 2022)
Abstract
Background: Vitiligo is a skin autoimmune disease that affects 0.1% to more than 8% of people in the world. About 50% of patients develop the disease before the age of 20. In this disease, melanocytes are destroyed in the skin, mucous membranes and retina. As a result, white spots appear on different parts of the body. Studies have suggested the role of oxidative stress in vitiligo. Coenzyme Q10 is a specific lipophilic antioxidant. The aim of this study was to evaluate the therapeutic effect of coenzyme Q10 in patients with generalized vitiligo.
Methods: This study was a randomized, double-blind, clinical trial of patients with generalized vitiligo who had been referred to the dermatology clinics of Vali-e-Asr Hospital and Imam Reza Clinic in May-August 2016. The sampling method was random. Patients were treated with standard treatment, and the case groups in addition to standard treatment with tablets containing coenzyme Q10. Patients were evaluated for response at the first visit, 1 and 3 months after the start of treatment.
Methods: This study was a randomized, double-blind, clinical trial of patients with generalized vitiligo who had been referred to the dermatology clinics of Vali-e-Asr Hospital and Imam Reza Clinic in May-August 2016. The sampling method was random. Patients were treated with standard treatment, and the case groups in addition to standard treatment with tablets containing coenzyme Q10. Patients were evaluated for response at the first visit, 1 and 3 months after the start of treatment.
|
Results: The mean age of 50 patients was 26.2±4.3 years. The diameter of the largest depigmented patch decreased in both intervention (P=0.000) and control (P=0.001) groups during 3 months of treatment. The difference in the frequency of patients in the grade of repigmentation was significant at the end of the third month compared to the end of the first month of treatment in both intervention (P=0.01) and control (P=0.02) groups. At the end of the third month, the frequency of patients in both intervention group with 21 patients (76%) and the control group with 18 patients (72%) were more in grades 1 and 2, while at the end of the first month, the frequency of patients in both intervention groups with 23 patients (92%) and control with 23 patients (92%) was more in grades 0 and 1.
Conclusion: Adjuvant therapy with oral coenzyme Q10 has no effect on improving depigment patch in vitiligo. |
Hamidreza Shetabi, Mehrdad Norouzi , Hossein Mahjubipour, Anahita Naviafar,
Volume 80, Issue 6 (September 2022)
Volume 80, Issue 6 (September 2022)
Abstract
Background: Coronavirus in 2019 was recognized as one of the leading causes of death worldwide. According to reports, the mortality rate in people who need mechanical ventilation varies from 50 to 97 percent. The aim of this study was to evaluate the outcome of Covid-19 disease based on different characteristics in patients and mechanically ventilated variables.
Methods: This descriptive-analytical study was conducted on 160 patients with a definite diagnosis of Covid-19 who were under mechanical ventilation and admitted to the intensive care unit of Alzahra Hospital in Isfahan from March 2020 to March 2021. Data was collected by checklist. The checklist included demographic information, including age, gender, as well as information such as underlying diseases, disease outcome, length of hospitalization, etc. After collecting the data, they were analyzed in SPSS software version 22 and at a significance level of less than 0.05.
Methods: This descriptive-analytical study was conducted on 160 patients with a definite diagnosis of Covid-19 who were under mechanical ventilation and admitted to the intensive care unit of Alzahra Hospital in Isfahan from March 2020 to March 2021. Data was collected by checklist. The checklist included demographic information, including age, gender, as well as information such as underlying diseases, disease outcome, length of hospitalization, etc. After collecting the data, they were analyzed in SPSS software version 22 and at a significance level of less than 0.05.
|
Results: In this study, the overall mortality rate among mechanically ventilated patients was 62.5%. The mean age of patients was 69.99±17.87 years and the mean duration of hospitalization in surviving patients was 15.47±11.73 days and for deceased ones was 55.21±69.14 days. The mean age of the deceased group (65.71±16.59) was significantly higher than the surviving group 53±21.17 was (P=0.0001). The length of hospital stay in the deceased group was significantly longer than the surviving group (P=0.005). As a result, ventilator mode and inotropic agent intake during treatment increased the chance of mortality in patients under mechanical ventilation (P=0.001). There was a significant relationship between underlying diseases of hypertension, kidney disease and autoimmune disease with mortality in patients (P<0.05).
Conclusion: Various factors including the length of stay in the hospital, comorbidities such as hypertension, renal disease and autoimmunity may affect the outcome of critically ill ICU patients under mechanical ventilation. Patients who require long-term invasive ventilation and the use of inotropic drugs to maintain their cardiovascular status while hospitalized in the ICU are at higher risk for mortality. |
Ghazaleh Jamshidi , Farshid Babapour Mofrad , Mahyar Ghafoori, Hamidreza Saligheh Rad ,
Volume 80, Issue 6 (September 2022)
Volume 80, Issue 6 (September 2022)
Abstract
Background: Prostate cancer (PCa) has been one of the most prevalent cancers in men in recent years. Multi-parametric magnetic resonance imaging (mp-MRI) has been increasingly applied in the diagnosis, localization and staging of prostate cancer. This approach uses a combination of morphology information obtained from T2-weighted image along with at least two functional imaging modalities, such as diffusion-weighted (DWI), dynamic-contrast-enhancement (DCE), and magnetic-resonance-spectroscopy (MRS). This review gives a comprehensive overview of the theories and methodologies of the mp-MRI for diagnosing prostate cancer. The search was fulfilled using a list of search engines.
Methods: In this study, with a systematic review of studies conducted during February 2015 to October 2021, the role and potential of integrating the results of morphological and functional imaging in a multi-parameter approach were evaluated and the optimal combination was introduced. This article collected studies that have employed mp-MRI in prostate cancer including: peer-reviews, research articles, academic reports and conferences. This review has been studied from September 2016 to January 2022.
Methods: In this study, with a systematic review of studies conducted during February 2015 to October 2021, the role and potential of integrating the results of morphological and functional imaging in a multi-parameter approach were evaluated and the optimal combination was introduced. This article collected studies that have employed mp-MRI in prostate cancer including: peer-reviews, research articles, academic reports and conferences. This review has been studied from September 2016 to January 2022.
|
Results: According to the reported results, the optimum combination of T2-w, DWI and DCE in the mp-MRI approach provides the highest sensitivity and specificity in the diagnosis, localization and staging of prostate cancer. Applying the field strength of 3T versus 1.5T improves detection accuracy including improving sensitivity and specificity as well, and also the application of endorectal coils does not provide much advantage compared to pelvic phased-array coil in term of prostate cancer detection accuracy.
Conclusion: MP-MRI as a precision instrument plays a valuable role in the diagnosis of prostate cancer. The most suitable combination of the pulse sequences to achieve the goals of this approach is T2-w, DWI and DCE. This review is comprehensive overview covered previous articles of mp-MRI in prostate cancer for all the researchers in this field and expresses the positive and negative points of each modality. Moreover, this article reports the sensitivity and the Specificity of the recent researches. |
Hassan Boskabadi , Mahdie Mir, Maryam Zakerihamidi,
Volume 80, Issue 6 (September 2022)
Volume 80, Issue 6 (September 2022)
Abstract
Background: The gender of the baby is one of the risk factors for neonatal jaundice, but the difference in the severity of jaundice and its prognosis between the two sexes is not clear. Therefore, in this study, we investigated the severity, duration and prognosis of jaundice in both sexes.
Methods: The present study is a cross-sectional study that was performed on 2847 icteric neonates over 35 weeks admitted to Ghaem Hospital in Mashhad from May 2014 to May 2021. This study is done by available sampling. After confirmation of jaundice in infants, data were recorded using a researcher-made checklist including maternal demographic information (maternal age, mode of delivery), complete infant characteristics (age, birth weight, age at onset of jaundice, jaundice recovery age) and laboratory findings (Bilirubin, Indirect Coombs, direct Coombs, G6PD), and neonatal development up to two years of age was performed based on the Denver 2 test. Then data analysis was performed by SPSS software using Chi-square test and Student’s t-test.
Methods: The present study is a cross-sectional study that was performed on 2847 icteric neonates over 35 weeks admitted to Ghaem Hospital in Mashhad from May 2014 to May 2021. This study is done by available sampling. After confirmation of jaundice in infants, data were recorded using a researcher-made checklist including maternal demographic information (maternal age, mode of delivery), complete infant characteristics (age, birth weight, age at onset of jaundice, jaundice recovery age) and laboratory findings (Bilirubin, Indirect Coombs, direct Coombs, G6PD), and neonatal development up to two years of age was performed based on the Denver 2 test. Then data analysis was performed by SPSS software using Chi-square test and Student’s t-test.
|
Results: 1642 infants (57.7%) were boys and 1205 infants (42.3%) were girls. Mean and standard deviation of bilirubin in values less than 20 mg/dl in boys was 17.20±2.48 mg/dl and in girls was 16.54±2.80 mg/dl (P=0.000), birth weight was 3.16±0.49 (kg) for boys and 3.07±0.45 for girls (P=0.000). In two groups of male and female infants, age (P=0.004), direct bilirubin (P=0.001), direct and indirect Coombs (P=0.000), and G6PD enzyme deficiency (P=0.000) had a significant difference. Acute kernicterus was reported in 25 (2.03%) boys and 4 (0.46%) girls (P<0.001). In the two-year follow-up, 23 boys (1.9%) and 11 girls (1.28%) had developmental delay (P<0.05).
Conclusion: The incidence of jaundice in male infants was higher than female infants, which is probably due to a higher prevalence of G6PD deficiency in boys. The severity of jaundice was higher in boys less than 20 mg/dl. Jaundice has a worse prognosis in male infants. |
Hassan Boskabadi, Maryam Zakerihamidi,
Volume 80, Issue 8 (November 2022)
Volume 80, Issue 8 (November 2022)
Abstract
Background: Neonatal sepsis is a severe systemic bacterial infection that affects on premature neonates prognosis. Therefore, the aim of this study was to evaluate the short-term prognosis of neonate's infection.
Methods: The present study is a cross-sectional study that was performed on 729 neonates suspected of infection, in neonatal ward in Ghaem Hospital of Mashhad since May 2015 to May 2022 by available sampling. The data collection tool was a researcher-made checklist containing neonatal characteristics (gestational age, birth weight, first and fifth minute Apgar score, and neonatal status at discharge) and laboratory information (White Blood Cell, Platelet (PLT), C-reactive Protein, Blood culture, Cerebrospinal fluid culture). Infants with congenital infection, congenital anomaly and positive blood cultures without clinical and laboratory symptoms were excluded from the study. Neonatal prognosis was compared in terms of death or discharge among neonates with and without definitive infection. First, we described the results using statistical tables and graphs, and then, data were analyzed by Kolmogorov-Smirnov, T test and SPSS software, version 26 (IBM SPSS, Armonk, NY, USA). P<0.05 considered as significant.
Methods: The present study is a cross-sectional study that was performed on 729 neonates suspected of infection, in neonatal ward in Ghaem Hospital of Mashhad since May 2015 to May 2022 by available sampling. The data collection tool was a researcher-made checklist containing neonatal characteristics (gestational age, birth weight, first and fifth minute Apgar score, and neonatal status at discharge) and laboratory information (White Blood Cell, Platelet (PLT), C-reactive Protein, Blood culture, Cerebrospinal fluid culture). Infants with congenital infection, congenital anomaly and positive blood cultures without clinical and laboratory symptoms were excluded from the study. Neonatal prognosis was compared in terms of death or discharge among neonates with and without definitive infection. First, we described the results using statistical tables and graphs, and then, data were analyzed by Kolmogorov-Smirnov, T test and SPSS software, version 26 (IBM SPSS, Armonk, NY, USA). P<0.05 considered as significant.
|
Results: According to the results of this study, low birth weight and lower gestational age and lower Apgar score increase the risk of neonatal death. About one-fifth of infants died of definitive infection. The cases of death due to infection in the group of deceased infants were about 4 times higher than in the group of discharged infants. About one third of the babies with sepsis and half of the babies with meningitis died. Forty-four percent of infants with early sepsis and 40% of infants with late sepsis died. In cases of neonatal death due to sepsis, the most common gram-negative infectious agent was Acinetobacter and the most common gram-positive infectious agent was Enterococcus.
Conclusion: Neonatal definitive infection worsens their prognosis. So, the risk of neonatal death increases by 5 times. The probability of death in meningitis is more than sepsis and in early sepsis is more than late sepsis and in sepsis due to gram-negative is more than gram-positive. |
Hamidreza Shetabi , Khosro Naghibi, Alireza Peyman, Hamed Norouzi,
Volume 80, Issue 8 (November 2022)
Volume 80, Issue 8 (November 2022)
Abstract
Background: To improve the quality of sedation in procedures, different medications are used alone or in combination with each other, but so far, no administration method that is agreed upon by anesthesiologists has been presented. This study aimed to investigate the effectiveness and safety of intranasal ketamine in comparison with intravenous ketamine in cataract surgery.
Methods: This clinical trial was performed from December 2016 to March 2017 in Feyz Hospital, Isfahan. Ninety patients over the age of 18 who were candidates for cataracts surgery were randomly assigned to receive 1 mg/kg ketamine through the nasal route (INk) or intravenously (IVK). Ten minutes before the surgery, ketamine was administered in the INK group and intranasal saline in the IVK group. Two minutes before the start of surgery, normal saline was administered in the INK group and ketamine was administered intravenously in the IVK group. Patients received intravenous midazolam 0.04 mg/kg during prep and drape. The quality of sedation and analgesia, vital signs, patient and doctor satisfaction, and side effects were recorded during the study period. Data were analyzed using of SPSS software, version 23 (IBM SPSS, Armonk, NY, USA).
Methods: This clinical trial was performed from December 2016 to March 2017 in Feyz Hospital, Isfahan. Ninety patients over the age of 18 who were candidates for cataracts surgery were randomly assigned to receive 1 mg/kg ketamine through the nasal route (INk) or intravenously (IVK). Ten minutes before the surgery, ketamine was administered in the INK group and intranasal saline in the IVK group. Two minutes before the start of surgery, normal saline was administered in the INK group and ketamine was administered intravenously in the IVK group. Patients received intravenous midazolam 0.04 mg/kg during prep and drape. The quality of sedation and analgesia, vital signs, patient and doctor satisfaction, and side effects were recorded during the study period. Data were analyzed using of SPSS software, version 23 (IBM SPSS, Armonk, NY, USA).
|
Results: In this study, 90 people were included in the study, 53 of whom (58.9%) were men. The mean age of the patients was 61.5±10.6. Two groups had a significant difference in terms of gender (P=0.696), age (P=0.960), weight (P=0.212), height (P=0.632), underlying disease (P=0.094), and type of disease (P=0.090). Two groups were not significantly different in terms of mean heart rate (P=0.77), mean arterial blood pressure (P=0.13), mean blood oxygen saturation (P=0.58), patient satisfaction (P=0.470) and surgeon satisfaction (P=0.115), pain intensity (P=0.506), level of sedation level (P=0.477) and side effects (P=0.221).
Conclusion: Intranasal administration of ketamine provides similar sedation and cardiovascular response compared to intravenous administration of ketamine. Administering ketamine intranasally is a non-invasive, safe and effective method with easy application and can be a suitable alternative to intravenous administration. |
Mehdi Ghobakhlou, Hamidreza Ghasemi Basir , Ahmad Jahdari , Elnaz Ataei, Ali Saadatmand,
Volume 80, Issue 9 (December 2022)
Volume 80, Issue 9 (December 2022)
Abstract
Background: Intestinal metaplasia in the stomach is one of the precancerous lesions of gastric tissue. If the lesions are diagnosed early before invasive cancer develops, it is possible to prevent the progression to malignant lesions. Therefore, this study was performed to evaluate the prevalence and risk factors of intestinal metaplasia in patients with dyspepsia.
Methods: This descriptive cross-sectional study was performed on patients who were referred to Shahid Beheshti Hospital in Hamadan, Iran from the beginning of 2019 to the end of 2020. A total of 250 patients over 16 years of age who complained of dyspepsia for at least more than three months were included in the study. Examination was performed for patients along with the completion of a pre-designed questionnaire including demographic information and metaplasia risk factors. Also, endoscopy and biopsy specimen of gastric mucosa were performed for histological examination. Finally, the data were analyzed using SPSS software version 16 with related statistical tests.
Methods: This descriptive cross-sectional study was performed on patients who were referred to Shahid Beheshti Hospital in Hamadan, Iran from the beginning of 2019 to the end of 2020. A total of 250 patients over 16 years of age who complained of dyspepsia for at least more than three months were included in the study. Examination was performed for patients along with the completion of a pre-designed questionnaire including demographic information and metaplasia risk factors. Also, endoscopy and biopsy specimen of gastric mucosa were performed for histological examination. Finally, the data were analyzed using SPSS software version 16 with related statistical tests.
|
Results: There was no significant relationship between job type, level of education, marital status and family history of gastric cancer, smoking, alcohol, high salt, dairy products and high-nitrate diet with the disease. There was a significant relationship between body mass index and the presence of intestinal metaplasia in men (P=0.032). The average age of men with metaplasia was about 13 years older than those without the disease. Also gastric ulcer (84%) and pan gastritis (40.4%) were the most common cases in endoscopic results. The number of female patients with epigastric pain was about 14% higher than male patients. Gastric ulcer was significantly associated with gender, with about 12% more gastric ulcers observed in men than women (P=0.014). Also, no significant relationship was observed between the presence of Helicobacter pylori and the severity of its colonization with intestinal metaplasia. (P=0.230)
Conclusion: In this study, no significant relationship was observed between the presence of Helicobacter pylori and the severity of its colonization simultaneously with intestinal metaplasia. Apart from the two factors of increasing age and type of sex, no serious risk factors for intestinal metaplasia were seen. |
Hassan Boskabadi , Nafiseh Pourbadakhshan, Maryam Zakerihamidi,
Volume 80, Issue 10 (January 2023)
Volume 80, Issue 10 (January 2023)
Abstract
Background: Maternal diseases such as diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy in pregnancy are associated with fetal and neonatal complications. The aim of this study was to compare the prognosis of neonates in maternal diseases.
Methods: This study was a cross-sectional study. The present study was performed on 600 preterm infants with mothers with diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy. This study was done in Ghaem Hospital of Mashhad from March 2015 to April 2021 with available sampling. The data collection tool was a researcher-made checklist including infant (gestational age, Apgar score of the first minute, Apgar score of the fifth minute) and maternal (mode of delivery, prenatal care, premature rupture of the membranes) characteristics. Neonatal prognosis was compared at birth. All clinical and diagnostic examinations of newborns were performed by a neonatologist. Neonatal and maternal data in the group of newborns with normal mothers and newborns with maternal diseases were analyzed by Kolmogorov-Smirnov and Chi-square tests. The significance level was considered p≤0.05 in all cases.
Methods: This study was a cross-sectional study. The present study was performed on 600 preterm infants with mothers with diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy. This study was done in Ghaem Hospital of Mashhad from March 2015 to April 2021 with available sampling. The data collection tool was a researcher-made checklist including infant (gestational age, Apgar score of the first minute, Apgar score of the fifth minute) and maternal (mode of delivery, prenatal care, premature rupture of the membranes) characteristics. Neonatal prognosis was compared at birth. All clinical and diagnostic examinations of newborns were performed by a neonatologist. Neonatal and maternal data in the group of newborns with normal mothers and newborns with maternal diseases were analyzed by Kolmogorov-Smirnov and Chi-square tests. The significance level was considered p≤0.05 in all cases.
|
Results: The results show that 161 newborns (28.90%) had normal mothers, 89 newborns (15.98%) had diabetic mothers, 117 newborns (21.01%) had hypertensive mothers, and 50 newborns (8.98%) had hypothyroid mothers. One hundred tweny newborns (21.72%) had mothers with preeclampsia, 19 newborns (3.41%) had mothers with epilepsy. Newborns with mothers with epilepsy had the lowest Apgar score of the first minute and the lowest gestational age and newborns with mothers with diabetes had the lowest Apgar score of the fifth minute. Mothers with hypothyroidism had the highest rate of premature rupture of the membranes and mothers with hypertension and preeclampsia had the highest incidence of cesarean section.
Conclusion: Maternal diseases including diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy affect the prognosis of neonates in terms of the severity of prematurity, premature rupture of the membranes, type of delivery, Apgar scores of the first and fifth minutes. Therefore, proper control and treatment of these diseases may improve neonatal prognosis. |
Hamidreza Shetabi, Behzad Nazemroaya , Mohsen Abron ,
Volume 80, Issue 11 (February 2023)
Volume 80, Issue 11 (February 2023)
Abstract
Background: In this study, the effect of intravenous dexamethasone on pain, nausea and vomiting after laparoscopic ovarian surgery was investigated.
Methods: This randomized clinical trial was conducted from June 2019 to March 2019 on patients undergoing laparoscopic ovarian cystectomy in Beheshti Hospital, Isfahan. In this study, 88 patients aged 18 to 45 years were included in the study. Patients were randomly divided into two groups receiving dexamethasone (D) and normal saline (S). Two minutes before induction of anesthesia, the first group received 8 mg (2 ml) of dexamethasone and the second group received normal saline (2 ml). The duration of surgery and stay in recovery, the frequency of pain and nausea and vomiting, the need for analgesic and anti-nausea drugs, and the cardiovascular response during the study were evaluated and recorded.
Methods: This randomized clinical trial was conducted from June 2019 to March 2019 on patients undergoing laparoscopic ovarian cystectomy in Beheshti Hospital, Isfahan. In this study, 88 patients aged 18 to 45 years were included in the study. Patients were randomly divided into two groups receiving dexamethasone (D) and normal saline (S). Two minutes before induction of anesthesia, the first group received 8 mg (2 ml) of dexamethasone and the second group received normal saline (2 ml). The duration of surgery and stay in recovery, the frequency of pain and nausea and vomiting, the need for analgesic and anti-nausea drugs, and the cardiovascular response during the study were evaluated and recorded.
|
Results: No significant difference was seen in terms of demographic characteristics between the two groups (P>0.05). The frequency of pain during recovery (P=0.4) was not significantly different between the two groups, but at 2 hours (P=0.005), 12 hours (P<0.001) and 24 hours after the operation (P=0.005) (P=0) was significantly lower than S group. The frequency of nausea in group D during recovery (P=0.003), 2 hours later (P<0.001), and 12 hours (P=0.002) was significantly lower than group S, but 24 hours after the surgery, there was no significant difference between the two groups (P=0.15). During recovery, there was no vomiting in both groups (P=1), the frequency of vomiting in 2 hours (P=0.003), 12 hours (P<0.002) and 24 hours after the operation (P=0.48) in group D was lower than S. At the time of the study, the dose of diclofenac and metoclopramide received in group D patients was lower than group S. There was no significant difference in cardiovascular response between the two groups during the study (P>0.05).
Conclusion: Dexamethasone with a dose of 8 mg before induction of anesthesia can be effective in reducing pain, nausea and vomiting after laparoscopic ovarian surgery and reducing the need for analgesics and anti-nausea drugs. |
Zahra Azizi Farsani , Mehrdad Faizi, Arash Tafrisinejad , Mona Khoramjouy, Hamidreza Azizi Farsani ,
Volume 81, Issue 2 (May 2023)
Volume 81, Issue 2 (May 2023)
Abstract
Background: Sore throat after surgery is the second most common cause of complications in recovery. It causes decreased patient satisfaction, and it affects patients’ well-being after surgery. The aim of this study was to compare the effects of ketamine and magnesium sulfate gargle on sore throat after laminectomy.
Methods: In this randomized clinical trial, 69 candidates for laminectomy patients in Shohade-Tajrish hospital from June 2021 to December 2022 were randomly assigned to three groups of ketamine (n=25), magnesium (n=23) and control (n=21). The Magnesium group received magnesium sulfate gargle (30 mg/kg in a total of 30 ml 5% Dextrose water), Ketamine gargle (0.5 mg/kg in a total of 30 ml 5% Dextrose water), and the control group received 30 ml 5% Dextrose water gargle. Standard similar anesthesia protocols were applied for all patients. In PACU (0) and 2, 4, 24 hours afterward sore throat was assessed using a visual analog scale (VAS) scoring.
| Results: The study showed that the incidence of sore throat in the magnesium group was lower than ketamine. Comparison of the three groups at the time of recovery (0), 2, 4, and 24 hours after surgery showed that the differences between the three groups were significant in terms of sore throat. Also, the difference in the incidence of sore throat within each group in the four times in all three groups was statistically significant (P=0.001). There was no statistically significant difference between age, gender, body mass index, heart rate, blood pressure, duration of intubation, duration of surgery and anesthesia, size of laryngoscopy insertion and Cormack and Lehane score in the three studied groups. A drop in systolic blood pressure was observed in the both groups half an hour after the operation, which was statistically significant. Changes in diastolic blood pressure were significant only in the magnesium group. |
Tayebeh Lakzaei, Niloofar Khoshnam-Rad , Maryam Edalatifard , Hamidreza Abtahi,
Volume 81, Issue 3 (June 2023)
Volume 81, Issue 3 (June 2023)
Abstract
Background: Despite the progress of medical science and organ transplantation, lung transplantation is associated with significant complications and mortality. In Iran, the first lung transplant was performed in 2000 at Imam Khomeini Hospital in Tehran. So far, there has been no assessment of the patients. The main purpose of this study is to investigate the status of lung transplantation status at this center.
Methods: In this retrospective longitudinal study, all lung transplant patients referred to the Lung Transplantation Center of Imam Khomeini Hospital in Tehran from April 2000 to March 2022 were examined. Demographic and clinical data, and information related to their current status, including pulmonary function tests, transplant-related complications, pharmacotherapy, and drug-related adverse events were recorded. Appropriate statistical analysis was applied.
| Results: During the study, 20 lung transplants were observed, 20 percent of transplant recipients were women, and 80 percent were men. The mean age of the patients at the time of transplantation was 39.3±11.4 years. The youngest patient at the time of transplantation was 22, and the oldest was 60 years old. The most common indication for transplantation was interstitial lung disease (70%) followed by chronic obstructive respiratory disease. The average forced expiratory volume in one second (FEV1) value of the patients in the first year was about 50%, which gradually decreased to less than 20 percent in the fifth year. The average survival after transplantation was 5.75±4.6 years. The post-transplant one month, three months, one year, three years, and five years survival were 80, 75, 70, 60, and 50 percent, respectively. Chronic lung allograft dysfunction and serious infections are the most common causes of mortality. Conclusion: The transplant center at Imam Khomeini Hospital is one of the most important lung transplant centers in Iran. The survival status and transplant outcome are comparable with those reported around the world. More attention should be paid to infection control, patient selection, and perioperative care to improve the outcomes of lung transplantation. |
Reza Shamsabadi, Seyed Hamid Zoljalali Moghadam, Hamidreza Baghani , Seyed Ali Zoljalali Moghadam ,
Volume 81, Issue 3 (June 2023)
Volume 81, Issue 3 (June 2023)
Abstract
Background: In prostate cancer radiotherapy, due to the proximity of the prostate to the rectum, it can be affected by high radiation doses. It has been reported that about 70% of secondary cancers after prostate cancer radiotherapy occur in the bladder and rectum, which are exposed to direct radiation. Since prostate cancer radiotherapy may be accompanied by side effects, the aim of this study is to investigate the risk of secondary cancers after the radiotherapy of prostate cancer inside the outfield organs.
Methods: The dose volume histogram data relevant to 39 patients with prostate cancer (who were treated with 3-dimensional conformal radiotherapy technique in 2022 in Tehran) were extracted, and the uniform absorbed dose inside the sensitive tissues was calculated according to the gEUD concept. Then, the risks of secondary malignancies following prostate cancer radiotherapy were calculated using the model introduced by the BEIR report. Accordingly, the lifetime attributable risk values (LAR) were estimated based on the desired organs and patient age at exposure time through the calculation of Excess relative risk (ERR) and Excess absolute risk (EAR) values.
| Results: From the obtained results, the gEUD values for the rectum ranged from 51.04 Gy to 74.69 Gy and for the bladder from 27.22 Gy to 75.51 Gy. The maximum calculated risk values for the rectum and bladder were calculated to be 49.85% and 74.91%, respectively. Besides, a significant level of secondary cancer risk within the rectum and bladder was obtained for most of the studied patients. Furthermore, small values of secondary cancer risks were estimated for patients who were irradiated at older ages, and higher ones were obtained for patients who were irradiated at younger ages. Conclusion: The results showed that there is a higher probability of developing secondary malignancies in the bladder than the rectum. The information obtained in this research can improve the performance of the treatment process, so that information about secondary cancers following radiation therapy for prostate cancer will ultimately help doctors design more effective and optimal treatment designs. |
Babak Vahdatpour, Mohammad Shirvani, Hamidreza Jahanbani-Ardakani , Omid Alizadehkhaiyat , Sadegh Baradaran Mahdavi ,
Volume 81, Issue 4 (July 2023)
Volume 81, Issue 4 (July 2023)
Abstract
Background: The objective of this study was the transcultural adaptation of the Rotator cuff quality of life (RC-QOL) questionnaire and the determination of the reliability and validity of the questionnaire in the Persian-speaking population with rotator cuff disease.
Methods: This study was conducted in Isfahan from April 2022 to February 2023. The participants consisted of 56 people with rotator cuff pathology. The process of adapting and translating the questionnaire was done with the methodology presented previously by Beaton et al. Content validity was first tested by a group of orthopedic and physical medicine and rehabilitation specialists and then through a pilot study consisting of 15 Persian-speaking patients with rotator cuff disease. Test-retest reliability was established with an intraclass correlation coefficient. Internal consistency was calculated using Cronbach's alpha. The measurement's error estimation was calculated with the standard error of the measurement. Reproducibility evaluation was measured with a 3-day interval between the completion of the test-retest questionnaire.
Methods: This study was conducted in Isfahan from April 2022 to February 2023. The participants consisted of 56 people with rotator cuff pathology. The process of adapting and translating the questionnaire was done with the methodology presented previously by Beaton et al. Content validity was first tested by a group of orthopedic and physical medicine and rehabilitation specialists and then through a pilot study consisting of 15 Persian-speaking patients with rotator cuff disease. Test-retest reliability was established with an intraclass correlation coefficient. Internal consistency was calculated using Cronbach's alpha. The measurement's error estimation was calculated with the standard error of the measurement. Reproducibility evaluation was measured with a 3-day interval between the completion of the test-retest questionnaire.
|
Results: The age range of the participants was 34 to 68 years (55% men and 45% women). The mean (standard deviation) of the total score of the RC-QOL questionnaire was 44.33(10.81) and ranged from 17.35 to 70.88. Cronbach's alpha was 0.971, which showed high internal consistency. The intraclass correlation coefficient was 0.99, indicating high test-retest reliability. The mean values (standard deviations) of the DASH and SPADI questionnaires were equal to 77.66(13.69) and 66.66(18.25), respectively. The results of the study showed excellent and significant convergent validity of the RC-QOL questionnaire with both the DASH and SPADI questionnaires. The correlation value with the DASH and SPADI questionnaires was equal to 0.907 and 0.941, respectively.
Conclusion: The Persian version of the RC-QOL questionnaire is a valid and reliable tool to evaluate the quality of life in patients diagnosed with rotator cuff injuries. |
Hanieh Alimiri Dehbaghi , Karim Khoshgard, Hamid Sharini, Samira Jafari Khairabadi, Farhad Naleini,
Volume 81, Issue 5 (August 2023)
Volume 81, Issue 5 (August 2023)
Abstract
Background: The use of artificial intelligence algorithms to help with accurate diagnosis in medical images is one of the most important applications of this technology in the field of medical imaging. In this research, the possibility of replacing simple chest radiography instead of CT scan using machine learning models to detect pneumothorax was investigated in cases where CT is usually requested.
Methods: This study is analytical and was conducted from November 2022 to May 2023 at Kermanshah University of Medical Sciences. The data used in this research was extracted from the files of 350 patients suspected of pneumothorax. The collected images were pre-processed in MATLAB software. Then, three machine learning algorithms, including Logistic elastic net regression (LENR), Logistic lasso regression (LLR) and Adaptive Boosting (AdaBoost) were used. To evaluate the performance of these models, the criteria of precision, accuracy, sensitivity, specificity, area under the receiver operating characteristic curve (AUC), F1 score, and misclassification were used.
| Results: In the AdaBoost model, the accuracy value in radiographic and CT images was calculated as 98.89% and 98.63%, respectively, and the precision value was calculated as 99.17% and 98.27%, respectively. In radiographic images, the AUC value for AdaBoost model was calculated as 100% and in CT scan images as 96.96%. The F1 score for the same model in radiographic was 99% and in CT images was 98.68%. The specificity value for the AdaBoost model was calculated as 99.45% in radiographic images and 94.67% in CT scan images. In the LLR model, the AUC value for radiographic and CT scan images was 99.87% and 99.02%, respectively. Conclusion: According to the criteria evaluated in the present study, two LLR and AdaBoost models have similar performance in radiographic and CT images in terms of pneumothorax detection ability, so that this complication can also be diagnosed with high precision level using machine learning techniques on the radiographic images and thus receiving higher levels of radiation doses due to CT scan can be avoided in these patients. |
Hamidreza Ghasemi Basir , Mohammad Mahdi Majzoobi , Abbas Moradi, , Ali Saadatmand,
Volume 81, Issue 5 (August 2023)
Volume 81, Issue 5 (August 2023)
Abstract
Background: Brucellosis is one of the most common infectious diseases transmitted from animal to human. Different methods of blood culture, serology, PCR and ELISA are used to diagnose brucellosis. The aim of this study was to compare the diagnostic value of ELISA tests with Brucella serological tests in patients with brucellosis.
Methods: In this cross-sectional descriptive study that was conducted from the beginning of April 2018 to the end of March 2019, 231 patients referred to the Infectious Diseases Clinic of Sina Hospital in Hamadan with clinical symptoms and possible diagnosis of brucellosis were included in the study. 5 cc of blood was taken from the patients to prepare serum, at the same time as Wright, Combs Wright and 2ME serology tests, IgG and IgM ELISA tests were also performed using the ELISA kit of Pishtaz Teb Company (Made in Iran), which is designed with the cut-off method. Then the test results were analyzed with SPSS software, version 16 (SPSS Inc., Chicago, IL, USA).
Methods: In this cross-sectional descriptive study that was conducted from the beginning of April 2018 to the end of March 2019, 231 patients referred to the Infectious Diseases Clinic of Sina Hospital in Hamadan with clinical symptoms and possible diagnosis of brucellosis were included in the study. 5 cc of blood was taken from the patients to prepare serum, at the same time as Wright, Combs Wright and 2ME serology tests, IgG and IgM ELISA tests were also performed using the ELISA kit of Pishtaz Teb Company (Made in Iran), which is designed with the cut-off method. Then the test results were analyzed with SPSS software, version 16 (SPSS Inc., Chicago, IL, USA).
|
Results: 231 patients suspected of brucellosis including 147(63.64%) men and 84(36.36%) women with an average age of 44.60±16.16 years and a minimum of 10 years and a maximum of 80 years were examined. IgG and IgM results were positive with brucellosis in 80.1% and 30.30%, respectively. The results of IgG and IgM were positive in 1/80 and 30.30%, respectively, and they were diagnosed with brucellosis. In comparison with 2ME, Wright and Coombs-Wright serology tests, the sensitivity of IgG was between 83.80% and 94.28% and its specificity was between 20 and 33.34%, the sensitivity of IgM was also between 34.78 and 40.0% and its specificity was between 78.67% and 89.47% at different cut points.
Conclusion: Compared to diagnostic serological tests for brucellosis, IgG is more sensitive and IgM is more specific. If serological tests are not available, ELISA can be used to diagnose brucellosis. But because of their lower diagnostic value, they cannot be replaced. |
Hamidreza Shetabi, Mahsa Mohammadrezaei ,
Volume 81, Issue 7 (October 2023)
Volume 81, Issue 7 (October 2023)
Abstract
Background: This study was conducted to compare the effect of two doses of remifentanil infusion on the amount of bleeding, intraoperative hemodynamic changes, and complications after rhinoplasty surgery with general anesthesia.
Methods: This prospective randomized clinical trial study was conducted on 80 patients who were candidates for rhinoplasty from March 1401 to August 1402 in Al-Zahra Hospital, Isfahan, Iran. The participants were divided into two groups of 40 people using random allocation software. remifentanil infusion was adjusted in the first group with a dose of 0.15-0.25 mg/kg/min and in the second group with a dose of 0.25-0.35 mg/kg/min. The goal was to maintain mean arterial pressure (MAP) between 60 and 65 mmHg, to achieve this goal, reducing or increasing the rate of remifentanil infusion was used. During the operation, a heart rate of less than 50 beats per minute was considered bradycardia and was treated with atropine 0.015 mg/kg. In addition, the remifentanil infusion rate was reduced if MAP fell below 60 mmHg for more than 60 seconds. Patients were evaluated and compared during operation and recovery in terms of hemodynamic parameters, intraoperative bleeding and postoperative complications.
Methods: This prospective randomized clinical trial study was conducted on 80 patients who were candidates for rhinoplasty from March 1401 to August 1402 in Al-Zahra Hospital, Isfahan, Iran. The participants were divided into two groups of 40 people using random allocation software. remifentanil infusion was adjusted in the first group with a dose of 0.15-0.25 mg/kg/min and in the second group with a dose of 0.25-0.35 mg/kg/min. The goal was to maintain mean arterial pressure (MAP) between 60 and 65 mmHg, to achieve this goal, reducing or increasing the rate of remifentanil infusion was used. During the operation, a heart rate of less than 50 beats per minute was considered bradycardia and was treated with atropine 0.015 mg/kg. In addition, the remifentanil infusion rate was reduced if MAP fell below 60 mmHg for more than 60 seconds. Patients were evaluated and compared during operation and recovery in terms of hemodynamic parameters, intraoperative bleeding and postoperative complications.
|
Results: There was no significant difference between the two groups in the changes of hemodynamic parameters during surgery and recovery (P>0.05). The average bleeding volume in the two groups receiving remifentanil 0.15-0.25 mcg/kg/min and 0.25-0.35 mcg/kg/min Remifentanil was 44.25±23.1 and 28.25±15.5 ml, respectively, and the difference between the two groups was significant (P<0.001). According to the surgeon's opinion, intraoperative bleeding in the 0.25-0.35 mcg/kg/min remifentanil group was significantly lower than 0.15-0.25 (P=0.001).
Conclusion: According to the findings of the present study, it seems that the use of 0.25-0.35 min/µg/kg dose of remifentanil compared to 0.15-0.25 min/µg/kg dose, is associated with a significant reduction in bleeding during rhinoplasty, and also the use of this dose is not associated with the occurrence of serious hemodynamic disorders, including bradycardia and severe drop in blood pressure. |
Ahmad Tahmasebi-Ghorrabi , Zahra Heydarifard, Behrouz Nemati, Majid Davari, Alireza Delavari, Hamideh Salimzadeh , Ali Akbari Sari ,
Volume 81, Issue 9 (December 2023)
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.
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.
|
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. |
Related Websites
Site Keywords
Cardiology, Anatomy, Biology, Epidemiology, Immunology, Neuroscience, Physical therapy, Physiology, Dermatology, Endocrinology and metabolicSite Statistics
- Registered users: 7722 users
- Online users: 0 users
- Guest users: 382 users
- All visits: 15237229 visits
- Visits in 24 Hours: 9085 visits
- Total articles: 11209 articles
- Published articles: 4922 articles
© 2024 , Tehran University of Medical Sciences, CC BY-NC 4.0
Designed & Developed by : Yektaweb