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Showing 27 results for Azari
Efficacy of transcervical foley catheter and laminaria on induction of labor in post-term pregnancy: a clinical study
Mahvash Zargar , Mohammad Ali Nazari , Leila Hormozy , Hasti Madovi Mohammadi,
Volume 72, Issue 3 (June 2014)
Abstract
Background: Any time before labor that termination of pregnancy for mother and fe-tus is better than keeping pregnancy, this is indication of induction for labor. The condi-tion of cervix is the most important factor for labor induction. Cervical condition, In many cases that candidate for induction of labor before labor pain, is poor. As the cervical ripening is quite important for success of labor induction. This study is attempting to compare two methods of cervical ripening. Methods: During this clinical study, 100 patients admitted in Ahwaz Imam Khomeini Hospital from 2010 to 2011. All of these patients had BISHOP score bellow 5, were di-vided to two groups for cervical ripening. Group one: trans cervical catheter and group two: laminaria. After placing transcervical foley catheter and laminaria for patient in-duction with oxytocin was started according to classic protocol. Then the time lapse from the beginning of induction to enter the active phase of labor and also from start of induction till delivery and appearing the side effect in both group was assessed. The result was analysed by SPSS 16 program. Results: Fifty three of patient (53%) were primiparous and the rest 47 (47%) were mul-tiparous. All of them had bishop score bellow 5. The average age for the patient group 1 was 27.1 and the average age for other group was 27.18. The time lapse from start of induction to enter active phase of labor in first group was 5.7±2.67 hours and this time for 2nd group was 7.51±2.33 hours. Also the time interval between the start of induction and delivery in group 1 was 10.3±4.35 hours and this time for group 2 was 12.5±4.9 hours. In both cases there was meaningful difference between two groups. There was no difference between both group for appearing the side effects. Conclusion: Based on this study, it seems using trans- cervical catheter for cervical rip-ening and aid to successful induction of labor is beneficial.
Prescription of ceftriaxone before and after implementation of physi-cian’s guidelines in a teaching hospital: a brief report
Mohammad Abbasinazari , Afshin Mohammad Alizadeh , Yusef Jamshidi,
Volume 72, Issue 3 (June 2014)
Abstract
Background: Judicious use of antibiotics is essential considering the growth of antimi-crobial resistance and escalating costs in health care. Ceftriaxone is a third-generation cephalosporin used widely for the treatment of various infections in outpatient and in-patient. The purpose of this study was to evaluate the ceftriaxone utilization before and after implementation of guidelines and physicians education. Methods: A descriptive cross-sectional, before-after intervention study was performed in 6 wards of a teaching hospital in Tehran, Iran. The study was conducted in three phases: pre-guideline, educational interventions and post guideline implementation. The pre intervention phase included chart analysis of current ceftriaxone use in 200 consecutive patients from the representative wards included in the study. The educational interventions included preparation and distribution of ceftriaxone guidelines as pamphlets among physicians working in the studied wards. Also the clinical pharmacist returned to each ward and trained physicians regarding the correct use of ceftriaxone. In the post intervention phase immediately after the instruction, and in the follow up phase, one month later, a prospective analysis of ceftriaxone utilization was performed by chart review of 200 patients to detect changes in ceftriaxone utilization pattern. Results: Four hundred cases were evaluated during study (200 before and 200 after physician’s education). The correct indication of ceftriaxone was 93% and 96% before and after the educational interventions respectively. Analysis showed that correct indi-cation of ceftriaxone did not change significantly before and after education (P= 0.188). Regarding to proper administration (dose, interval and duration) ceftriaxone utilization significantly changed after education (P< 0.001). Conclusion: Adoption of the guidelines with associated training resulted in significant improvement in ceftriaxone administration pattern in the hospitals.
Modeling trend of the immune system in HIV positive people treated with antiretroviral drugs, using Markov model
Sara Jambarsang , Alireza Akbarzadeh Baghban , Seyed Saeed Hashemi Nazari, Farid Zayeri , Ali Nikfarjam ,
Volume 73, Issue 9 (December 2015)
Abstract

Background: After primary infection, the number of CD4 T-cells decreases with disease progress. The patient’s immunological status could inform by The CD4 T-cell counts over the time. The main purpose of this study is to assess the trend of CD4 cell count in HIV+ patient that received Antiretroviral Therapy (ART) by using a multistate Markov model to estimate transition intensities and transition probabilities among various states.

Methods: A total of 122 HIV+ patients were included in this cohort study who are undergoing Antiretroviral Therapy treatment in the Iran AIDS center in Imam Khomeini Hospital in Tehran that inter during March 1995 to January 2005 and then fallow up to October 2014. All adults with at least two follow-up visits in addition to their pre-ART treatment were considered to be eligible for inclusion in the study. Continuous-time Markov processes are used to describe the evolution of a disease over different states. The mean sojourn time for each state was estimated by multi state Markov model.

Results: Sample included 22 (18%) female with a mean age of 43.32 (standard deviation 8.33) years and 100 (82%) male with a mean age of 45.28 (standard deviation 8.34) year. Age was divided in to two categories, 40 years old and lower than that 66 (54.1) patents and persons older than 40 years old 56 (45.9) patents. A total of 122 patients were included. 29 patients died during follow-up. One year transition probability for staying in state 1 of CD4 cell count was 51%. This probability for six year was 33%. The mean sojourn time for sate 4 was 21 month. The hazard ratio of transition from state 3 to state 4 was 4.4 in men related to women.

Conclusion: The use of antiretroviral therapy in the treatment of HIV infected persons reduce viral replication and increase in CD4 T lymphocyte count, and delay the progression of disease. This paper is shown the progression of this trend.


Nano polyamidoamine-G7 dendrimer synthesis and assessment the antibacterial effect in vitro
Mitra Gholami , Shahram Nazari , Mahdi Farzadkia , Seyed Mohsen Mohseni , Soudabeh Alizadeh Matboo, Fakhraddin Akbari Dourbash , Meysam Hasannejad ,
Volume 74, Issue 1 (April 2016)
Abstract

Background: Nano scale dendrimers are macromolecules synthetic which frequently used in medical and health field. Because traditional antibiotics inevitably induce bacterial resistance, which is responsible for many treatment failures, there is an urgent need to develop novel antibiotic drugs. This study was aimed to examine Synthesis and the antibacterial effect of NanoPolyamidoamine-G7 (NPAMAM-G7) dendrimer on Escherichia Coli, Proteus Mirabilis, Salmonella Typhi, Bacillus Subtilis and Staphylococcus Aureus.

Methods: In this experimental study that has been conducted in June 2015 in the Laboratory of Microbiology, Iran University of Medical Science, NPAMAM-G7 dendrimers was synthesized by Tomalia’s divergent growth approach. The antibacterial effects of NPAMAM-G7 dendrimer were studied by disc diffusion and micro-dilution method. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against gram-positive and gram-negative bacteria were determined according to Clinical and Laboratory Standards Institute (CLSI) guideline. Standard discs were prepared using different concentrations of dendrimer on Mueller-Hinton agar plates.

Results: Zone of inhibition in concentration 25 μg/ml of NPAMAM-G7 dendrimers for Escherichia Coli, Proteus Mirabilis, Salmonella Typhi, Bacillus Subtilis and Staphylococcus Aureus were 26, 38, 36, 22 and 25 mm, respectively. Regarding the zone of inhibition in gram negative bacteria with gram positive ones was P= 0.16 and was not significant difference. The MIC for Salmonella Typhi was 0.025, for Proteus Mirabilis, Bacillus Subtilis, Staphylococcus Aureus and Escherichia Coli was 0.25 μg/ml. The MBC for Salmonella Typhi was 25μg/ml, for Proteus Mirabilis and Bacillus Subtilis was 50 μg/ml and for Escherichia Coli and Staphylococcus Aureus was 100 μg/ml. The least of sensitivity against NPAMAM-G7 related to Escherichia Coli and Staphylococcus Aureus and the most of sensitivity related to Salmonella Typhi.

Conclusion: The NPAMAM-G7 dendrimer with end amine groups exhibited a positive impact on the removal of standard strains, gram-positive and gram-negative bacteria. Therefore, it is possible to use these nanodendrimers as antibacterial in the future.


Usage of capillary electrophoresis for common hemoglobinopathies screening
Alireza Ebrahimi , Zohre Niknami , Fahime Nazari , Mahasti Ghavami Adel , Amir Atashi , Abdolfattah Sarrafnejad ,
Volume 74, Issue 3 (June 2016)
Abstract

Hemoglobinopathies are most common inherited disorders in the world; approximately 7 percent of the worldwide population and 5-6 percent of population of Iran are carriers. The hemoglobin disorders inherit as autosomal recessive and are very common in the Mediterranean area and much of the Asia and Africa. The control of this inherited disorders need to genetic counseling and accurate screening by more advanced and more accurate methods. This study explains features of current Iran hemoglobin disorders, nominates the accessible methods for screening them and introduces the capillary zone electrophoresis as a rapid and more accurate method. The required data were extracted of various articles and then for good explanation, current Iran hemoglobinopathies properties were showed in the tables and electropherograms of important hemoglobin disorders in Iran population were provided for help to interpretation results of blood tests by capillary zone electrophoresis method. Hemoglobin disorders are including thalassemias and hemoglobin variants; Disruption in the production and malfunction of globin chains cause types of hemoglobin disorders. We cannot introduce one of clinical laboratory tests as critical and basic method for screening and distinguishing types of inherited hemoglobin disorders as alone. For distinguishing the types of them must be prepared enough information and data of the hemoglobin disorders and for more accurate analysis must be used simultaneously different methods as gel electrophoresis, high performance liquid chromatography, isoelectric focusing, capillary zone electrophoresis or molecular tests. The capillary electrophoresis is an accurate and rapid method for screening types of the hemoglobin disorders. Other side this method cannot analyze all of them, so must be used biochemical, biophysical and molecular methods for confirmation the results. This review showed we can use the capillary electrophoresis and HPLC as two complementary methods for hemoglobinopathies screening. We can analyze by the methods more hemoglobin disorders and decrease more laboratory errors. Moreover, we must have patient history, hematological indices, information and data of types of hemoglobinopathies. The patient history and complete blood count results as red blood cell count, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration can be useful and helpful in screening the hemoglobin disorders and then distinguishing all of hemoglobin disorders.


Assessment of nanopolyamidoamine-G7 dendrimer antibacterial effect in aqueous solution
Mitra Gholami , Shahram Nazari , Mahdi Farzadkia , Gharib Majidi , Soudabeh Alizadeh Matboo ,
Volume 74, Issue 3 (June 2016)
Abstract

Background: Poly(amidoamine) (PAMAM) dendrimer derivatives have been investigated for their biological applications, especially for delivery of drugs, including antimicrobial drugs to eukaryotic cells, but their effects on bacterial cells are largely unexplored. Nanotechnology and its application is one of the rapidly developing sciences. As demand of fresh drinking water is increasing, nanotechnology can contribute noticeable development and improvement to water treatment process. This study was aimed to examine synthesis and the antibacterial effect of Nanopolyamidoamine-G7 (NPAMAM-G7) dendrimer on Escherichia Coli (E. Coli), Klebsiella Oxytoca (K. Oxytoca), Pseudomonas Aeruginosa (P. Aeruginosa), Proteus Mirabilis (P. Mirabilis) and Staphylococcus Aureus (S. Aureus) from aqueous solution.
Methods: In this experimental study that has been conducted in August to December 2015 in the laboratory of microbiology of Iran University of Medical Sciences, initially dilution of 103 CFU/ml were prepared from each strain of bacteria. Then different concentrations of dendrimer (0.025, 0.25, 2.5 and 25 µg/ml) in the laboratory temperature (23-25 °C) was added to water. In order to determine the efficiency of dendrimers in removal of bacteria, samples were taken at different times (0, 10, 20, 30, 40, 50 and 60 min) and were cultured on nutrient agar medium. Samples were incubated for 24 hours at 37 °C and then number of colonies were counted.
Results: Antibacterial properties of dendrimers in aqueous solution by increasing the dendrimer concentration and contact time is directly related. At a concentration of 25 μg/ml at 60 minutes all bacteria except S. Aureus, and at 30 minutes, E. Coli and K. Oxytoca bacteria for 100% excluded. The concentration of 2.5 μg/ml at 60 minutes of bacteria, E. Coli, K. Oxytoca and P. Mirabilis are 100% excluded. All concentrations of dendrimers at different times were reduced bacteria in the PAMAM- G7 dendrimer effect on gram-negative bacteria, gram-positive bacteria was better.
Conclusion: The NPAMAM-G7 dendrimer with end amine groups exhibited a positive impact on the removal of standard strains, gram-positive and gram-negative bacteria. Therefore, it is possible to use these nanodendrimers as antibacterial in the future.


Removal of E. coli and S. aureus from polluted water using electrolysis method with Al-Fe electrodes
Mitra Gholami , Shahram Nazari, Ahmad Reza Yari , Seyed Mohsen Mohseni , Soudabeh Alizadeh Matboo ,
Volume 75, Issue 2 (May 2017)
Abstract

Background: Electrolysis is an electrochemical method for the treatment of water. recently water disinfection by electrochemical methods has been increasingly carried out. The aim of this applied research was to investigate the removal of Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) bacteria from drinking water by using electrolysis method with Al-Fe electrodes parallel with the monopole mode.

Methods: An experimental study was conducted in the laboratory of microbiology, Iran University of Medical Science in May 2017. In this study, the contaminated water samples were prepared through adding 103, 104 and 105 E. coli and S. aureus bacteria per 1 milliliters (mL) of drinking water. Independent variables Included: different concentrations of E.coli and S. aureus bacteria (103, 104 and 105 CFU/ml), reaction time (5, 10, 15, 20 and 25 min), initial pH (7, 8 and 9), electrode gap (1, 2 and 3 cm), current density (0.83, 1.67 and 3.3 mA/cm2) to determine the optimum conditions were investigated. One-way ANOVA was used to analyze the results.

Results: The results show that in the optimum conditions with increasing the pH from 7 to 9 removal efficiency of bacterial strains of E. coli and S. aureus were decreased significantly from 98 to 73% and 99.1 to 76%, respectively. In initial concentration of 104 CFU/ml, optimum conditions were obtained for current density, reaction time and electrodes gap, 1.67 mA/cm2, 20 min and 2 cm, respectively. With increasing current density and reaction time in both strains of bacteria, were decreased significantly. The electrodes gap do not have much impact on the efficiency of the process. The amount of electrical energy consumed in optimal conditions was calculated 0.5128 kilowatt-hour (kWh/h). Statistical analysis shows that exist significant relationship (P<0.01) between initial concentrations of bacterial strains and efficiency of the process.

Conclusion: According to the results, E. coli and S. aureus, removal efficiency were obtained more than 98%, therefore electrolysis process can be used in the removal of pathogenic bacteria from drinking water.

Pathogen inactivation of blood derived biological medicines: review article
Shahnaz Nazari , Majid Shahabi , Kamran Mousavi Hosseini ,
Volume 75, Issue 4 (July 2017)
Abstract
One of the main sources of a wide range of biological products as starting material is the human blood. These biological human plasma derived medicines play essential role in prevention and treatment of a variety of life threatening diseases. Mention to the starting material of these medicines which is blood or in another word human plasma, possibility of contamination by blood borne viruses cannot be omitted.
In recent years possibility of contamination by blood borne viruses such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) is an important concern. Nowadays most of developed countries the risk is minimum, although in developing countries it is still a challenge. Despite measures for human plasma biological derived medicines safety, such as donor selection, testing of donations, and polymerase chain reaction (PCR) testing on pooled plasma, still more actions are needed to inactivate or remove viruses such as HBV, HCV and HIV. During the process of manufacturing of biological human plasma medicines, there is several production steps which may contribute to viral reduction. These steps consist of precipitation by centrifugation, ethanol, polyethylene glycol, octanoic acid, or ammonium sulphate, chromatographic methods such as immunoaffinity chromatography or ion exchange chromatography, adsorption by aluminum hydroxide, and separation by filtration. All these steps are considered to be weakly effective as viral reduction treatment, and more effective viral inactivation methods are needed to be implemented in line of production of human plasma derived biological medicinal products. These safety measures included virus inactivation by different techniques such as acidic pH, solvent/detergent method, pasteurization and heat treatment, beta-propiolactone plus U/V and also virus removal by nanofiltration, which all these virus inactivation or virus removal methods before implementation in line of production of plasma derived biological medicines, should undergo for validation study.
Nowadays by screening and testing of donations and implementation of different measures of virus inactivation or virus removal, a good level of safety of plasma derived biological medicines has been achieved. Due to the possibility of emerging new pathogens investigation in this subject should be continued. 

Intra-rater reliability of sonographic measurement of the supraspinatus muscle thickness in Empty can, Full can and Hug up tests
Razieh Nazari , Mehri Ghasemi , Farideh Dehghan-Manshadi , Alireza Akbarzadeh-Baghban ,
Volume 75, Issue 9 (December 2017)
Abstract
Background: Sonography is used for measuring the muscle morphology including length, depth, cross-sectional area, bulk and pennation angle. The supraspinatus is the most common affected muscle among the rotator cuff muscles. There is no study about the reliability of sonographic measurement of supraspinatus thickness in the positions of empty can (EC), full can (FC) and hug up (HU) tests. The present study aims to investigate the intra-rater reliability of the measurement of sonographic thickness of supraspinatus muscle in the rest and positions of the EC, FC and HU tests.
Methods: The present study was a descriptive-analytic study which was carried out in a cross-sectional method on ten healthy women aged: 22.10±2.76 years without any tendon pathology. The study was carried out during four weeks (January to March in 2017). The supraspinatus thickness was scanned during rest and contracted states. The positions of measuring ultrasonic thickness of supraspinatus were as follow: position of EC test: the arm in 90-degree elevation in the scaption plane with the thumb-down, position of FC test: the arm in 90-degree elevation in the scaption plane with the thumb-up, position of HU test: the palm of hand was placed on the opposite shoulder with the elbow flexed using a 0.5-kg weight cuff. Intra-rater reliability of ultrasonic muscle thickness measurements were examined in one day.
Results: All intra-rater reliability values were equal or more than 0.90: the value was 0.90 (95%CI: 0.65-0.97) in the rest position, while for the measurement of ultrasonic thickness of the supraspinatus was 0.96 (95%CI: 0.87-0.99) in the position of EC test, 0.97 (95%CI: 0.90-0.99) and 0.96 (95%CI: 0.86-0.99) in the positions of FC and HU tests, respectively.
Conclusion: Measurement of ultrasonic thickness of supraspinatus muscle is a reliable method in the rest and positions of EC, FC and HU tests. This method can be used to compare the muscle thickness changes in the positions of the above tests.
 

Comparative study of predictive ability of AIDS incidence in HIV positive people using Markov model according to two criteria, WHO and CDC in CD4 cell categorization
Mahsa Nazari, Farid Zayeri , Seyed Saeed Hashemi Nazari , Sara Jambarsang, Ali Nikfarjam , Alireza Akbarzadeh Baghban ,
Volume 77, Issue 2 (May 2019)
Abstract
Background: The Multi state Markov models have extensively application with categorization of laboratory marker of CD4 cells for evaluation of HIV disease progression. These models with different states result in different effects of covariates and prediction of HIV disease trend. The main purpose of this study was comparison of four and five states models with the three- state in order to select the model with better prediction ability of occurrence of HIV and finally death in HIV positive people.
Methods: A total of 305 HIV positive people were included in this cohort study in the Iran AIDS center in Imam Khomeini Hospital in Tehran that entered during March 1995 to January 2005 and then fallowed up to October 2014. The three continuous- time Markov models of three-, four- and five- state models were fitted to data to describe the evolution of a HIV disease Trend over different states.
For comparison of models, two criteria of modification of Akaike’s criterion (DRAIC) and likelihood cross-validation criterion (DRLCV) along with their 95% tracking interval was used. For fitting of these models and estimation of transition matrix and the hazard ratio of gender and treatment independent variables, the msm package of R project for statistical computing, version R 3.2.4 (www.r-project.org) was used.
Results: The results showed that the four- state model has more prediction ability than five-state model for evaluation of HIV disease Trend. In the four-state model, the progression hazard ratio to death for people who received highly active antiretroviral therapy (HAART) was 0.64 lower than who didn’t get this therapy. Moreover, the progression hazard ratio for men was 2.33 fold in comparison to women. The disease progression hazard ratio to death was 4.9 fold for men in comparison to women.
Conclusion: The (DRAIC) and (DRLCV) criterions showed that the four-state model has more predictive ability of the progression trend of HIV disease in comparison of five-state model.

Comparison of the prevalence of HBV, HCV, HIV, EBV and CMV infections in patients with scleroderma and healthy population
Javad Moayedi , Zahra Musavi , Tayebeh Hashempour , Mohammad Ali Nazarinia , Behzad Dehghani , Zahra Hasanshahi ,
Volume 77, Issue 5 (August 2019)
Abstract
Background: Scleroderma is a chronic systemic disorder that affects the connective tissues. It is characterized by several immune manifestations, inflammation, vascular damage, and fibrosis. Some of the viral infections with complex mechanisms are involved in the development and progression of many autoimmune diseases, such as scleroderma. The present study aimed to investigate the serological prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) infections in Iranian patients with scleroderma.
Methods: In this descriptive study 65 patients with scleroderma and 65 healthy individuals who had no autoimmune diseases and matched for age and sex, from May 2017 to April 2018 at Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, were included. The serum of study participants were evaluated for cytomegalovirus specific immunoglobulin G (CMV-IgG), Epstein-Barr virus viral capsid antigen immunoglobulin G (EBV-VCA-IgG), hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (HCVAb), and human immunodeficiency virus antibody (HIVAb) using commercially available the enzyme-linked immunosorbent assay (ELISA) kit.
Results: CMV-IgG was diagnosed in serum of all patients with scleroderma, while 49 (98%) healthy subjects had positive results for this test. In addition, EBV-VCA-IgG was diagnosed in 58 (89.2%) sclerodermic patients and 40 (80%) healthy subjects. The prevalence of CMV-IgG and EBV-VCA-IgG was not significantly different between patients and healthy subjects and had no significant relationship with age and sex. However, the titer of antibodies against CMV and EBV infections in the scleroderma group was higher than that in the control group (P<0.0001, and P<0.0001), respectively. The presence of HBsAg and HIVAb was not confirmed in any of the patients with scleroderma, but HCVAb was detected only in one patient. All of the individuals in control group were serologically negative for HBsAg, HCVAb, and HIVAb.
Conclusion: Serological prevalence of HBV, HCV, HIV, EBV, and CMV infections in patients with scleroderma is similar to the healthy group.

Comparison of supraspinatus sonographic thickness in empty can, full can and hug up testing positions in healthy women
Razieh Nazari , Mehri Ghasemi , Farideh Dehghan-Manshadi , Alireza Akbarzadeh-Baghban ,
Volume 77, Issue 8 (November 2019)
Abstract
Background: Rotator cuff injuries are the most common causes of shoulder pain and supraspinatus muscle is usually involved. Clinical tests are available and inexpensive tools for assessment of shoulder dysfunctions. The empty can (EC) and full can (FC) tests are considered as shoulder gold standard tests. Recently, hug up (HU) test has been developed to assess the supraspinatus. So far, no ultrasonographic study has compared supraspinatus muscle thickness in these testing positions. The present study aimed to compare the supraspinatus muscle thickness in the hug up testing position with the full can and empty can testing positions in young and healthy women.
Methods: Forty healthy women (mean age 21.62±2.4 years) participated in this cross-sectional-comparative study from April to June 2018 in the Biomechanic Laboratory of Rehabilitation School, Shahid Beheshti University of Medical Sciences in Tehran, Iran. The supraspinatus muscle thickness was scanned during rest and contracted states with a 0.5 Kg weight cuff. For contracted states, (A) EC testing position: the arm was at 90º abduction in the scaption plane with the thumb-down, (B) FC testing position: the arm was maintained at 90º abduction in the scaption plane with the thumb-up, (C) HU testing position: the palm of hand was placed on the opposite shoulder with the elbow flexed.
Results: The Bonferroni test showed significant differences (P<0.001) between the muscle thickness in the rest and the testing positions. The muscle thickness in the empty can testing position was significantly less than the full can testing position (P=0.001), no significant difference was found between the muscle thickness in the hug up testing position compared to the full can and empty can testing positions.
Conclusion: All of the empty can, full can and hug up testing positions demonstrated increased mean muscle thickness when compared to the rest position and the greatest muscle thickness was in the full can testing position. It seems that supraspinatus muscle thickness in hug up testing position is similar with empty can and full can testing positions.

Identifying the factors influencing the re-admission of hospitalized patients in the internal wards of educational hospitals: a qualitative study
Leila Vali, Reza Goudarzi, Golnaz Azari, Rahil Ghorbani Nia,
Volume 78, Issue 7 (October 2020)
Abstract
Background: Currently many hospitals around the country face increasing demands of their patients and readmission.The rate of readmission is a useful indicator for determining the performance of healthcare system and it shows the quality of services in the medical institutions. Readmissions have high economic, social and financial impact and studying the related factors seems to be high priority for healthcare systems.
Methods: This qualitative study performed by phenomenological method in three educational hospitals in Kerman from April to September of 2017. Data collection was performed through semi-structured interviews using targeted sampling among all patients who were hospitalized at internal medicine wards, nurses who were working in those wards, and in charge physicians. In total twenty patients, fifteen nurses, and five physicians were selected for interviews. The including criteria were for patients, the history of hospitalization at least once, during one month after the initial hospitalization, and for service providers, familiarity with the subject, work experience in the relevant department of at least three years for nurses and five years for physicians. A seven-step clustering method was used to analyze the data.
Results: The analysis of the interviews led to the identification of three main themes and 11 sub-themes. The main themes included patients' characteristics, manpower and clinical factors, hospital, and environmental factors. Some of the sub-codes included economic and living conditions, marriage status, insurance coverage, patients' beliefs and expectations, the presence or absence of underlying disease, education, lifestyle habits, dietary beliefs of hospitalized patients, lack of trust in medical staff, communication and cultural barriers, ignorance of service providers in treatment, lack of facilities, lack of motivation in medical staff, stressors and finally lack of hospital equipment.

Comparison of the prevalence of HBV, HCV, HIV, CMV and EBV infections in patients with systemic lupus erythromatosus and healthy population
Ava Hashempour, Javad Moayedi, Zahra Musavi, Mohammad Ali Nazarinia , Zahra Hasanshahi, Farzaneh Ghasabi, Mehrdad Halaji ,
Volume 79, Issue 2 (May 2021)
Abstract
Background: Systemic lupus erythematosus is a systemic autoimmune disease that affects almost all organs of the body, and viral infections are involved in its development and progression. The present study aimed to evaluate the serological status of some viral infections in patients with systemic lupus erythematosus and a healthy population.
Methods: This descriptive study conducted from May 2017 to April 2018 at Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran on 70 patients with systemic lupus erythematosus and 70 healthy individuals who had no autoimmune diseases and were matched with the patient group for age and sex. All patients had active records and were routinely visited in rheumatology clinic of Hafez hospital, affiliated with Shiraz University of Medical Sciences. The evidence of active disease was assessed by the physicians of this practice according to the American College of Rheumatology criteria. Peripheral blood samples were collected in tubes containing EDTA and centrifuged at 3000 rpm for 5 min. The plasma of study participants was evaluated for HBsAg, HCVAb, HIVAb, EBV-VCA-IgG, and CMV-IgG using a commercially available ELISA kit.
Results: The seropositivity of CMV-IgG and EBV-VCA-IgG in the systemic lupus erythematosus group was 70 (100%) and 65 (92.9%), and in healthy individuals was 68 (97.1%) and 57 (81.4%), respectively. The prevalence of EBV-VCA-IgG in the systemic lupus erythematosus group was significantly higher than healthy ones (P=0.043). The optical density (OD) of CMV-IgG and EBV-VCA-IgG in patients with systemic lupus erythematosus was significantly higher than in healthy individuals (P<0.0001). All patients with systemic lupus erythematosus were negative for HBsAg and HIVAb, but HCVAb was detected in 1 (1.4%) patient.
Conclusion: Considering the higher frequency of EBV-VCA-IgG and the higher titer of antibodies against CMV and EBV in patient groups compared to healthy individuals group, it seems that periodical assessment of viral load in patients with systemic lupus erythematosus will be beneficial to prescribe medication by physicians if it is needed.

The evaluation of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with rheumatoid arthritis with and without ocular complications
Shirin Assar, Fatemeh Khademi, Hamid-Reza Mohammadi-Motlagh, Kamran Mansouri, Mehran Pournazari , Parviz Soufivand, Bahareh Kardideh,
Volume 79, Issue 10 (January 2022)
Abstract
Background: Rheumatoid Arthritis patients are evaluated during treatment for various inflammatory factors such as C-reactive protein, Erythrocyte Sedimentation Rate, and Disease Activity Score, and other immune system-related factors. In the follow-up of patients with rheumatoid arthritis, hematologic factors associated with the immune system especially Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio are important. In this study, platelet to lymphocyte ratio and Neutrophil to lymphocyte ratio were compared in two groups of patients with and without ocular complications.
Methods: This cross-sectional study was performed on 246 patients with rheumatoid arthritis who were referred to the rheumatology clinic of Kermanshah from December 2018 to May 2019. This study was carried out in accordance with the approval of the ethics committee (IR.KUMS.REC1397.311) at Kermanshah University of Medical Sciences. Of these patients, 191 had no ocular complications and 55 patients had ocular complications and were matched for age and sex. The blood samples were taken from patients and blood cell count was measured by Sysmex KX-21 hematology analyzer. The Spearman correlation test was used to evaluate the relationship between platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in both groups of patients without ocular complications and with ocular complications. The Disease Activity Score was compared between the two groups using the Mann-Whitney test.
Results: The results of this study showed no significant difference between NLR and PLR levels in both groups of patients without ocular complications and with ocular complications. But the results showed that DAS-28 was significantly lower in the group with ocular complications (P<0.0001).
Conclusion: In general, the results of the present study showed that the evaluation of inflammatory factors such as platelet to lymphocyte ratio and neutrophil to lymphocyte alone could not be judged in predicting the presence or possibility of ocular involvement, and the level of these factors in patients with ocular complications was affected. Other factors, such as the number of blood cells and the condition of each patient, are included.
 

Comparison of therapeutic results of large saphenous vein resection with conventional methods and standard bridging
Iraj Nazari, Seyed Massoud Mousavi, Hossein Minaei Turk , Davoud Fateminia,
Volume 80, Issue 2 (May 2022)
Abstract

                                                                
Background: The use of the traditional method for saphenous vein harvesting is associated with wound complications and not on-time patient mobilization. This has caused the improvement of minimally invasive vein harvesting techniques, together with general bridging. This study was designed to compare the therapeutic results of large saphenous vein harvesting with conventional and standard bridging techniques for lower extremity vascular reconstruction in patients with chronic lower extremity ischemia.
Methods: In this randomized clinical trial study, 66 patients with chronic lower extremity ischemia were randomly divided into two groups: large saphenous vein harvesting by conventional technique (continuous longitudinal incision) (n=30) and standard Bridging technique (small and multiple incisions) (n=36). Pain score (VAS), graft patency, wound complications, surgery results and patient satisfaction was recorded. The follow-up period was six months. (IRCT20190511043562N1).
Results: Graft patency (P=0.353), and Amputation-free Survival (P=0.397) did not show a significant difference between the two groups. Changes in pain score at rest (P=0.846) and movement (P=0.380) at different times did not show a significant difference between the two groups. One week after the operation, the incidence of infection in the bridging technique showed a significant decrease (P=0.045). During the six months of follow-up, the wound healing rate, ischemic pain relief, and claudication improvement were better in the bridging technique but did not show a significant difference with the conventional technique (P<0.05). Patient satisfaction was higher in the bridging technique but did not show a significant difference between the two groups (P<0.05).
Conclusion: It seems that the use of the bridging technique in venous resection large saphenous vein harvesting is associated with reducing wound complications and pain, reducing the length of hospital stay, increasing the speed of wound healing, and improving patient satisfaction. The duration of graft patency and Amputation-free Survival were similar in the two groups. We believe that each technique has advantages and disadvantages that should be considered by the patient and surgeon when choosing a surgical procedure.

Keywords: chronic limb-threatening ischemia, saphenous vein, treatment outcome.


Vagus nerve stimulation in the treatment of nervous system disease: a review article
Somayeh Nazari , Raheleh Rafaiee, Hamed Ghazvini , Elmira Beirami , Sara Chavoshinezhad , Seyedeh Masoumeh Seyedhosseini Tamijani ,
Volume 80, Issue 4 (July 2022)
Abstract
The vagus nerve (VN), the longest cranial nerve and an essential part of the parasympathetic system, connects the central nervous system to respiratory, cardiovascular, immune, gastrointestinal, and endocrine systems and is involved in the maintenance of homeostasis by controlling these systems. Vagus nerve stimulation (VNS) is related to any method that would stimulate the vagal nerve via electrical stimulation. VNS is a Food and Drug Administration (FDA)-approved treatment for medication-resistant depression, drug-resistant epilepsy, and migraine. However, VNS has also been studied for various other conditions, such as Alzheimer's disease and tinnitus, by targeting the VN in the neck and ear. Currently, there are two methods for VNS: a) invasive-VNS (iVNS), which requires surgical implantation of a pulse generator under the anterior chest wall, that is linked through a wire to an electrode cuff that wraps around a cervical vagus nerve, b) non-invasive transcutaneous VNS which is separated into cervical transcutaneous vagal nerve stimulation (ctVNS) and auricular transcutaneous vagal nerve stimulation (atVNS). The non-invasive transcutaneous VNS techniques are well tolerated and have no significant side effects, making them effective in clinical research for brain diseases. Because with these newer methods, the electrical stimulation is carried out through the skin.
The results of this study were collected using the advanced search in Scientific Information Database (SID), Google Scholar, PubMed, and Scopus between 2011 to 2021. Out of 671 articles surveyed, we used 53 articles in the study after the evaluation. Medical Subject Headings (MeSH) and Keyword Searching was carried out through the MeSH database. VNS has been shown to alter neural activity in multiple areas of the brain related to the regulation of the affective states. However, the precise mechanism of VNS action on the clinical consequences is still unknown. This study aimed to review the therapeutic effect of both methods of VNS in neuropsychiatric and neurological disorders such as depression, migraine, seizure, tinnitus and Alzheimer's disease and discuss several hypotheses on the mechanism of VNS, as a new approach, in the treatment of such disorders. It considers that a brain-mapping approach is needed to discover the therapeutic mechanisms of VNS in brain diseases.

Management of cosmetic surgery in iran: challenges and solutions
Maryam Tajvar, Parisa Pourfarokh, Najmeh Bahmanziari, Ebrahim Jaafaripooyan, Maryam Nazari , Haniye Sadat Sajadi ,
Volume 81, Issue 1 (April 2023)
Abstract
Background: Nowadays, beauty practices have attracted the attention of people following the change in lifestyle and social values. Therefore, the present study was conducted with the aim of examining the opinion of experts regarding the challenges and management solutions of the aforementioned practices in Iran.
Methods: This qualitative study was conducted through interviews with 26 policymakers and cosmetic surgery service providers in Tehran from April to September 2022. Sampling was purposeful and snowball. The interviews were semi-structured and thematic analysis was used to analyze the data obtained from the interviews. The inclusion criteria for the interviewees' entry were knowledge and experience in the subject and willingness to participate.
Results: Challenges under the four categories of service providers (improper education, non-specialist providers, moral hazards, deficiencies in the way laws are written, and the ineffectiveness of the complaint handling process), service receivers (being influenced by deceptive advertisements, low level of public health literacy and lack of mental health), the place of providing services (performing surgeries in non-standard places and non-integrated information system) and medicines, products and medical equipment (insufficient control over supply, distribution and use and price fluctuations) were categorized. Experts considered the major part of the challenges to be related to the service providers. In the category of service recipients, "being influenced by deceptive advertisements" was the main problem mentioned by the experts. Performing surgeries in non-standard places, including limited surgery centers, non-sterile places, and unauthorized places, is among the unsolved problems regarding the place of providing services. In relation to medicines, products, and medical equipment, the main problem was insufficient supply, distribution, and use supervision.
Conclusion: The main effective measure to solve the challenges is to strengthen the supervision of the health system administrator with internal and external coordination and cooperation. In this regard, it is recommended to develop educational, ethical, and legal frameworks, regulate regulatory laws, public awareness, clinical interviews and psychological counseling, especially before cosmetic surgery, and the establishment of an integrated electronic health record system.

Risk assessment of carcinogenic and non-carcinogenic effets of exposure to heavy metals in hookah smoke using the monte carlo simulation technique
Taibe Ruenifard, Ali Oghazyan, Mohammad Hossien Saghi , Mahdi Ghorbanian , Ayoob Rastegar, Shahram Nazari ,
Volume 81, Issue 4 (July 2023)
Abstract
Background: This study aimed to evaluate the carcinogenic and non-carcinogenic health risks of heavy metals in seven types of tobacco widely consumed in the east of the country through inhalation exposure.
Methods: This descriptive-analytical study was conducted from April 2022 to October 2022 in the city of Bojnord, Iran on sook of seven popular tobacco brands. Metal concentrations in sook of tobacco were determined using inductively coupled plasma-optical emission spectroscopy. In order to analyze the data and ensure the accuracy of the results, the amount of metals in the samples was repeated three times, and their average was analyzed. Monte Carlo software was used to assess possible risks.
Results: The results of this study showed heavy metal concentrations in sook tobaccos were, respectively, Fe>Zn>Mn>Ba>Pb>Ni>Cu>Mo>Cr>As>Cd. The concentration of heavy metals such as arsenic, cadmium and molybdenum in Alrah brand tobacco was higher than other types of tobacco. So that the amounts of heavy metals including arsenic, cadmium and molybdenum for this brand were 14.2±0.05, 10.4±0.06 and 11.6±0.04 micrograms per gram, respectively. The hazard index (HI) values for different types of tobacco, including Al-Rah, Amordadsub, Al-Fakher, Al-Rubi, Mazaya, traditional flavorless, and Nakhle, were 2.64, 2.41, 2.05, 1.7, 1.49, 1.46, and 1.44, respectively. The lifetime cancer risk (ILCR) for Amordadsub, Al-Rah, Nakhla, Mazaya, Al-Rubi, Al-Fakher, and traditional flavorless tobaccos was 2.8×10-3, 2.43×10-3, 1.72×10-3, 1.58×10-3, 1.43×10-3, 9.58×10-4, and 8.08×10-4, respectively. Lead in Alrah tobacco sook had the highest non-carcinogenic risk value with a value of 1.59.
Conclusion: According to the obtained results, Alrah tobacco sook has a higher cancer and non-cancer risk than regular tobacco and can cause non-carcinogenic and carcinogenic risks for consumers. Thus, it is necessary to regularly monitor the quality of prevalent tobacco to reduce delete human health risks.

Comparison of the results of different types of vascular repair methods in penetrating trauma of the forearm
Shima Kashani, Seyed Masoud Moosavi , Iraj Nazari , Hossein Minaei,
Volume 81, Issue 7 (October 2023)
Abstract
Background: Vascular traumas are among the important traumas, most of which lead to significant complications due to the lack of correct and timely diagnosis, considering the frequency of penetrating vascular injuries, especially in our country and Khuzestan province, as well as the complications and mortality caused by injuries. This study was designed to investigate the effect of vascular surgery intervention on patients with arterial injury of forearm trauma.
Methods: In this descriptive-analytical study, all trauma patients suspected of penetrating forearm arterial injuries in terms of age, sex, type of trauma, location of trauma, type of intervention, location of arterial repair, angiographic and clinical findings including damaged arteries, type of injury Arterial fracture or dislocation. The proximity of vascular damage and the complications of surgical interventions are investigated.
Results: The results of this study showed that among the penetrating trauma patients requiring surgical intervention, 90.4% were men and only 6.9% were women. The average age of the patients was 32 years. The most frequent trauma requiring surgical intervention in this study was primary repair of a stab wound in the ulnar artery and the least was due to explosive. According to the obtained results, there was a statistically significant relationship between the amount of bleeding, the days of hospitalization and the duration of the operation with the type of trauma. The most damaged artery was ulnar artery 7.50% and the most type of arterial damage was arterial cut with active bleeding (7.39%).
Conclusion: According to the results of the present study, the most damage was in the ulnar artery caused by trauma with sharp objects (knives). The incidence of complications in primary repair surgery was higher than other types of surgical interventions, and there was a statistically significant relationship between the amount of bleeding, days of hospitalization, and duration of surgery with the type of trauma.

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