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Showing 136 results for Hadi
Mehdi Nikseresht, Valiollah Dabidi Roshan , Khadijeh Nasiri,
Volume 81, Issue 10 (January 2024)
Volume 81, Issue 10 (January 2024)
Abstract
Background: Exercise programs can lead to different physiological adaptations, but the effects of low-volume, low-frequency HIIT protocols with varying interval structures have not been thoroughly investigated. This study aimed to explore the impact of HIIT with high compression (HC) and low compression (LC), with or without berberine (BBR) supplementation, on hematological parameters in pre-diabetic men.
Methods: This semi-experimental study was conducted between October and December 2021 at Mazandaran University. Fifty-four overweight/obese men with a mean age of 48.6±6.6 years, a body mass index of 30.7±7.3 kg/m², and a body fat percentage of 34.4±4.3% were randomly and equally divided into one of six groups: HC, LC, HC+BBR, LC+BBR, BBR, and control. The HC group (2:1 work-to-rest ratio) and LC group (1:1 work-to-rest ratio) underwent training programs comprising 2-4 sets of 8 exercises at an intensity of 80-95% of their maximum heart rate twice a week for 8 weeks. Hematological responses to Bruce's incremental exercise test were measured before and after the intervention. Data were analyzed using a two-way ANOVA with Bonferroni's post hoc test, with a significance level set at P<0.05.
Methods: This semi-experimental study was conducted between October and December 2021 at Mazandaran University. Fifty-four overweight/obese men with a mean age of 48.6±6.6 years, a body mass index of 30.7±7.3 kg/m², and a body fat percentage of 34.4±4.3% were randomly and equally divided into one of six groups: HC, LC, HC+BBR, LC+BBR, BBR, and control. The HC group (2:1 work-to-rest ratio) and LC group (1:1 work-to-rest ratio) underwent training programs comprising 2-4 sets of 8 exercises at an intensity of 80-95% of their maximum heart rate twice a week for 8 weeks. Hematological responses to Bruce's incremental exercise test were measured before and after the intervention. Data were analyzed using a two-way ANOVA with Bonferroni's post hoc test, with a significance level set at P<0.05.
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Results: Baseline hematological indices showed no significant differences between pre-diabetic and non-diabetic groups (all, P>0.05). Following the 8-week intervention, there were significant decreases in white blood cells (WBCs) in the LC and LC+BBR groups, and in lymphocytes across all intervention groups except BBR (all, P<0.05). Additionally, hemoglobin and hematocrit levels showed significant reductions in the HC and HC+BBR groups (both, P<0.05). However, in response to Bruce's incremental exercise test, a significant decrease in WBCs was observed in the LC and LC+BBR groups, with reductions of 18% and 25%, respectively (both, P<0.05).
Conclusion: The LC protocol, even without berberine supplementation, seems to provide better immunological benefits and result in less hemolysis compared to the HC protocol, as evidenced by reductions in white blood cell counts. |
Razieh Yousefi , Payam Sasannejad, Eisa Nazar, Ali Hadianfar, Mohammad Taghi Shakeri., Zahra Jafari ,
Volume 81, Issue 11 (February 2024)
Volume 81, Issue 11 (February 2024)
Abstract
Background: Identifying factors that influence the length of hospital stay for suspected stroke patients is crucial for optimizing the utilization of hospital resources. This study aimed to determine the factors associated with the length of hospital stay for suspected stroke patients transferred to Qaem Hospital in Mashhad through emergency services using survival analysis.
Methods: In this historical cohort study, general information was gathered for all suspected stroke patients who sought emergency services in Mashhad, the largest city in northeast Iran, from March 21, 2018, to March 20, 2019, and were then transferred to the Emergency Department of Qaem Hospital. Pre-hospital emergency data were integrated with hospital records using the mission ID. The primary outcome assessed in the study was the length of hospital stay, with model implementation carried out using the statistical software Stata.
Methods: In this historical cohort study, general information was gathered for all suspected stroke patients who sought emergency services in Mashhad, the largest city in northeast Iran, from March 21, 2018, to March 20, 2019, and were then transferred to the Emergency Department of Qaem Hospital. Pre-hospital emergency data were integrated with hospital records using the mission ID. The primary outcome assessed in the study was the length of hospital stay, with model implementation carried out using the statistical software Stata.
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Results: The median hospitalization time until patients' recovery was seven days. Out of the 578 participants, 386 cases (66.8%) recovered, while the remaining 190 cases (33.2%) were censored (83 individuals had died during the study, and 107 individuals had exited the hospital for other reasons). The average age of patients at the time of hospitalization was 71.13±13.01 years. Statistical analysis employing Log-rank and Breslow tests identified a significant difference in hospitalization duration among patients receiving various levels of care and based on their insurance status. During multivariate analysis, the Cox regression model was considered unsuitable due to some variables not meeting the proportional hazards assumption, leading to the utilization of AFT models. Following the evaluation of AFT models, including Log-normal, Log-logistic, Exponential, and Weibull, the log-normal model emerged as the most suitable choice, exhibiting AIC and BIC values of 1273.909 and 1356.740, respectively. Significant variables influencing length of stay included patient admission priority, insurance status, season, and residency status.
Conclusion: The study suggests that parametric survival models are effective for analyzing lifetime data. Additionally, in light of the significant variables identified, enhancing facility readiness and resource allocation could facilitate more efficient planning and implementation. |
Maryam Behmaram, Mohammad Ghasem Hanafi, Ahmad Fakhri Zadeh , Mahsa Akhavan Sabagh , Elham Farhadi,
Volume 82, Issue 1 (April 2024)
Volume 82, Issue 1 (April 2024)
Abstract
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Background: Increasing the prevalence of non-contagious and chronic disorders such as Non-alcoholic fatty liver disease (NAFLD) takes the attention of researchers. NAFLD recognized by abnormal accumulation in the liver tissue. The aim of present study is investigating the association between liver size liver enzymes and degree of fatty liver in patients with NAFLD.
Methods: Based on the inclusion criteria, 100 Patients were selected from those referred to the radiology and ultrasonography clinic in Golestan Hospital, Ahvaz, for fatty liver evaluation. The study was carried out during May 2022 to April 2023. Liver enzymes, including alanine aminotransaminase (ALT) and Aspartate aminotransferase (AST), were measured. Based on the ultrasonography results, patients were divided into four groups: healthy, mild fatty liver, moderate fatty liver, and severe fatty liver. Ultrasonography was carried out by an experienced expert. All demographic information of patients was collected. Data were analyzed by SPSS (V25).
Methods: Based on the inclusion criteria, 100 Patients were selected from those referred to the radiology and ultrasonography clinic in Golestan Hospital, Ahvaz, for fatty liver evaluation. The study was carried out during May 2022 to April 2023. Liver enzymes, including alanine aminotransaminase (ALT) and Aspartate aminotransferase (AST), were measured. Based on the ultrasonography results, patients were divided into four groups: healthy, mild fatty liver, moderate fatty liver, and severe fatty liver. Ultrasonography was carried out by an experienced expert. All demographic information of patients was collected. Data were analyzed by SPSS (V25).
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Results: According to ultrasonography results, the mean of span was 148.4 ± 14.7 cm, which was significantly higher in patients with grade II of NAFLD (P<0.001). Further analysis revealed the highest difference between grades I and II (P<0.001). Also, a significant difference between grades II and III and grades III and I were found (P<0.001). Our data showed a significant relationship between body mass index (BMI) and NAFLD grades (P<0.001). The mean of BMI in grade I was significantly lower than in grades II and III (P<0.05). Our findings demonstrated that the mean of ALT in grade I was significantly lower than in grades II and III (P<0.05). In this line, the highest AST level was seen in grade III (P<0.001).
Conclusion: Our study showed that as NAFLD progresses, the enzymes and size of the liver increase. Based on ultrasound findings, the increasing liver size suggests NAFLD grade II, while the rise in AST and BMI suggests NAFLD grade II -III and progression of cirrhosis. |
Vahid Malekzadeh, Shadi Sheikhizadeh , Mohadeseh Taklo, Hossein Jamalifar, Younes Ghaseminezhad Koshali , Hassan Khorramian, Hossein Naseri ,
Volume 82, Issue 2 (May 2024)
Volume 82, Issue 2 (May 2024)
Abstract
Background: Considering the emergence of new diseases, increased prevalence of nosocomial infections, and microbial resistance in recent years, it is necessary to disinfect the hands with a suitable hand sanitizer, as instructed by the Center for Disease Control (CDC). This is because hand hygiene is the most important way to control infections. Surgical hand antisepsis protocols emphasize the importance of both mechanical cleaning and antimicrobial action to effectively eliminate microbial contamination. Recommendations from organizations such as the Association of Perioperative Registered Nurses (AORN), the World Health Organization (WHO), and the Association for Professionals in Infection Control and Epidemiology (APIC) underscore this principle. While routine handwashing removes visible debris and transient microbes, surgical hand antisepsis requires additional steps and the use of antimicrobial agents. This may involve a surgical scrub with an antimicrobial soap or the application of an alcohol-based hand rub (ABHR). The latter approach has demonstrated greater efficacy in reducing microbial contamination compared to soap and water alone. Since a few compressive studies in Iran have dealt with global standards for disinfectants, this study investigated the effects of surgical scrub based on the European standards with TGSept AL Plus, produced by the research team of Tajhiz Gostar Sharif , on normal flora of hands in a group of the operating room medical staff in Hazrat Fatemeh Plastic Surgery and Repair Hospital of Tehran, in 2023.
Methods: This study evaluated the short-term durability and effectiveness of this solution according to the EN12791 standard on microorganisms and microbial contamination reduction. To this end, 30 members of the surgical team were randomly selected. The bacterial sampling was performed three times: after washing the hands with common detergents, after hand scrubbing with the studied disinfectant (about 90 seconds), and three hours after surgery. The samples were immediately transferred to a laboratory for swap culture and pour plate test.
| Results: Then bacterial colonies were counted, contamination reduction was measured, and the shelf life of the solution was determined according to the standards. Results showed that a 60-to-90-second scrub with an alcohol-based disinfectant is the best way to reduce hand contamination and, thereby, nosocomial infections. Conclusion: Based on the study findings, alcohol-based solutions can be recommended for surgical scrubs, according to WHO guidelines. |
Khadije Sohrabi, Abbas Ali Gaeini , Elham Shirzad , Shahram Khorshidi , Shahriar Nafissi, Hamid Reza Fateh,
Volume 82, Issue 4 (July 2024)
Volume 82, Issue 4 (July 2024)
Abstract
Background: Spinal Muscular Atrophy (SMA) is a neurodegenerative disorder caused by a mutation in the survival motor neuron 1 (SMN1) gene. It is classified into five types (from type 0 to 4) based on the age of onset of symptoms and maximum motor function. This autosomal recessive mutation results in progressive weakness and atrophy of the proximal muscles. Due to the high cost of treatment, the critical timing of intervention, and the varied responses of patients, many individuals do not sufficiently benefit from current therapeutic methods. This study evaluates the impact of resistance training on the quality of life and fatigue in patients with SMA type III, considering the potential benefits of such training.
Methods: The present study was developmental and semi-experimental. Fourteen ambulatory patients with SMA type III were randomly assigned to exercise and control groups. The exercise group engaged in lower limb resistance training at an intensity of 6 to 8 on an adult resistance exercise scale for 10 weeks (25 sessions). During this period, the control group maintained their usual daily activities. Patients in the exercise group did not engage in any exercise activity other than the protocol of the present study. Patients' quality of life was measured with the Short Form 36 (SF-36) questionnaire, and fatigue severity was measured with the Fatigue Severity Scale (FSS), both evaluated pre- and post-intervention. The assessments and exercises were conducted in the occupational therapy department of Shariati Hospital, Tehran, from July 2023 to September 2023.
| Results: Analysis of the results showed significant improvements (P<0.05) in the exercise group compared to the control group in the subscales of physical functioning and fatigue within the quality of life assessment. Additionally, notable differences were found between the groups on the fatigue intensity scale. However, No significant difference was observed in the patients' Body Mass Index (BMI) measurements. Conclusion: Progressive resistance training of the lower limbs enhances the quality of life and reduces fatigue in patients with SMA type III. |
Majid Salmanian Mashhadi , Anoushe Haghighi, Nahid Kianmehr, Marjan Mokhtare, Sara Zarasvandnia, Parna Hosseini Meigoni , Seyede Maryam Mirghorbani ,
Volume 82, Issue 4 (July 2024)
Volume 82, Issue 4 (July 2024)
Abstract
Background: Liver fibrosis is a major concern associated with long-term side effects among patients with rheumatoid arthritis (RA) treated with methotrexate. The aim of the present study was to compare the fibrosis-4 (FIB-4) index and the results of liver fibrosis severity derived from FibroScan device in rheumatoid arthritis patients who were treated with methotrexate.
Methods: The present cross-sectional study was conducted in 70 RA patients referred to rheumatology clinic of Hazrat Rasool Akram Hospital, Tehran, from July 2022 to July 2023. First, FIB-4 was calculated and the data from transient elastography, which was performed using a FibroScan device to diagnose liver fibrosis for each patient, will be compared with the results of the FIB-4 of each patient. Furthermore, the correlation between FIB-4 index and FibroScan grade with demographic characteristic, methotrexate dose and disease duration was also evaluated.
| Results: The average age of patients was 59.59±11.75 and most of them (74.3%) were women. Most patients (75.71%) with a normal to mild FIB-4 index stage had a normal to mild elastography stage. of patients had normal to mild liver fibrosis. FibroScan grade were not related to the age, gender, body mass index, methotrexate dose and duration of the disease (P>0.05). The average FIB-4 was 1.25±0.6, which was not significantly related to gender, body mass index, disease duration and methotrexate dose but directly related to the age of patients (P<0.001, (CL95%, 0.51-0.53)).The correlation between FIB-4 and FibroScan grade of the patients showed a positive association, which was not statistically significant (P=0.594, r=0.06, CL95%, -0.24-0.4). The FIB-4 in normal to mild grade was 85% rejecting the moderate to severe grade in FibroScan but none of them were statistically significant (P=0.146). Conclusion: Overall, the FIB-4 was incapable of predicting the FibroScan result. On the contrary, this case was also inconclusive and the results of FibroScan did not justify FIB-4 results of the patients. The FIB-4 cannot replace in RA patients. It is recommended to conduct future studies with a larger sample size in RA patients. |
Najibeh Mohseni Moalem Kolae , Abdolreza Jafarirad, Mohammadhossein Hesamirostami , Khadije Moeiltabaghdehi , Mojtaba Ghorbani , Abolfazl Hosseinnattaj,
Volume 82, Issue 4 (July 2024)
Volume 82, Issue 4 (July 2024)
Abstract
Background: Death is one of the serious consequences of burns, which usually occurs as a result of hospital infections. This study was conducted with the aim of investigating the existing disagreement regarding the admission of more than 90% patients in the burn intensive care unit with the isolation room of the burn unit.
Methods: This retrospective descriptive-analytical study was conducted based on case review. The statistical population included the files of patients hospitalized in the burn wards and burn intensive care unit of Zare'e Sari Burn and Psychiatric Center from 2011 to 2023 who died. All these patients were included in the study as a census. The data was extracted through a checklist prepared by the researcher. Descriptive and inferential analysis of the data was performed using SPSS version 21 software. The variables studied included gender, age, burn percentage, burn factor, and duration of hospitalization, and determining the relationship between burn percentage and survival time in the two burn intensive care units and the isolation room of the burn unit was the main variable. The mean and standard deviation were used to describe quantitative data, and the frequency and percentage were used to describe qualitative data.
Methods: This retrospective descriptive-analytical study was conducted based on case review. The statistical population included the files of patients hospitalized in the burn wards and burn intensive care unit of Zare'e Sari Burn and Psychiatric Center from 2011 to 2023 who died. All these patients were included in the study as a census. The data was extracted through a checklist prepared by the researcher. Descriptive and inferential analysis of the data was performed using SPSS version 21 software. The variables studied included gender, age, burn percentage, burn factor, and duration of hospitalization, and determining the relationship between burn percentage and survival time in the two burn intensive care units and the isolation room of the burn unit was the main variable. The mean and standard deviation were used to describe quantitative data, and the frequency and percentage were used to describe qualitative data.
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Results: Among 882 cases, 226 patients had burns above 90%. 143 cases were related to men (63.3%). Most patients were in the age group of 19 to 40 years (61.9%). The cause of the burn (54.9%) was flame. Among the patients (83.2%) were hospitalized in the isolation room of the burn ward. Although the average days of hospitalization of patients above 90% in the burn intensive care unit was 13.71±11.82 days and the burn isolation room was 8.66±9.11 days, the Mann-Whitney test showed that the average survival time of these patients in the burn isolation room of the burn ward was significantly different from the intensive care unit. (sig.=0.001).
Conclusion: Although the average survival time in the two groups showed a significant difference, ultimately all patients in the two groups died within a few days of each other. |
Solmaz Ohadian Moghadam , , Mohsen Ayati, Erfan Amini , Faeze Salahshour, Mohsen Shiraghaei ,
Volume 82, Issue 5 (August 2024)
Volume 82, Issue 5 (August 2024)
Abstract
Background: Sarcopenia is the degenerative loss of skeletal muscle mass, which is known as a poor postoperative outcome in various cancer types. Radical cystectomy (RC) is often associated with high mortality rates, and sarcopenia is hypothesized to aid in risk stratification. Hence, this study assessed the role of Sarcopenia as an indicator of postoperative outcomes and survival rates in patients undergoing RC for bladder cancer.
Methods: This cross-sectional research was carried out between January 2022 and January 2023 on 30 patients with bladder cancer who were candidates for RC and referred to the urology clinic of Imam Khomeini Hospital in Tehran. One week before surgery, the cross-sectional area of the psoas muscle was measured using MRI to estimate muscle volume, and the sarcopenia index was calculated. Muscle area evaluation was performed by calculating the cross-sectional area of the left and right psoas muscles on MRI. The psoas muscle area was calculated by excluding blood vessels, bony structures, and intermuscular fat regions based on fat signals. The calculated psoas muscle area was then normalized to the patient's height in square meters. To improve the quality of reporting on surgical complications, the patients were re-examined and the duration of patients' hospital stays was measured.
Results: The mean sarcopenic index for the patients was 1264.6 ± 591.5 mm²/m². Seven patients (24.1%) were smokers, while 22 patients (75.9%) were non-smokers. During the 10-month follow-up period, 25 patients (83.3%) remained alive, and 5 patients (16.7%) passed away. The mean value of sarcopenic index in patients with localized cancer was higher than those with advanced cancer, but this difference was not statistically significant. Data analysis revealed a significant association between higher mortality rates and the presence of locally advanced bladder tumors (P = 0.046). Additionally, a reduced sarcopenic index in this study was significantly correlated with lymphovascular invasion. In this study, no correlation was found between perioperative complications and sarcopenic index.
Conclusion: To conclude, a significant association was observed between a reduction in the sarcopenic index and lymphovascular invasion; however, no connection was identified between mortality rates and postoperative complications following RC.
Methods: This cross-sectional research was carried out between January 2022 and January 2023 on 30 patients with bladder cancer who were candidates for RC and referred to the urology clinic of Imam Khomeini Hospital in Tehran. One week before surgery, the cross-sectional area of the psoas muscle was measured using MRI to estimate muscle volume, and the sarcopenia index was calculated. Muscle area evaluation was performed by calculating the cross-sectional area of the left and right psoas muscles on MRI. The psoas muscle area was calculated by excluding blood vessels, bony structures, and intermuscular fat regions based on fat signals. The calculated psoas muscle area was then normalized to the patient's height in square meters. To improve the quality of reporting on surgical complications, the patients were re-examined and the duration of patients' hospital stays was measured.
Results: The mean sarcopenic index for the patients was 1264.6 ± 591.5 mm²/m². Seven patients (24.1%) were smokers, while 22 patients (75.9%) were non-smokers. During the 10-month follow-up period, 25 patients (83.3%) remained alive, and 5 patients (16.7%) passed away. The mean value of sarcopenic index in patients with localized cancer was higher than those with advanced cancer, but this difference was not statistically significant. Data analysis revealed a significant association between higher mortality rates and the presence of locally advanced bladder tumors (P = 0.046). Additionally, a reduced sarcopenic index in this study was significantly correlated with lymphovascular invasion. In this study, no correlation was found between perioperative complications and sarcopenic index.
Conclusion: To conclude, a significant association was observed between a reduction in the sarcopenic index and lymphovascular invasion; however, no connection was identified between mortality rates and postoperative complications following RC.
Majid Jahanshahi , Morteza Taheri , Seyyed Abdollahadi Daneshi , Mostafa Haji Rezaei ,
Volume 82, Issue 6 (September 2024)
Volume 82, Issue 6 (September 2024)
Abstract
Background: Decompressive craniectomy (DC) is a therapeutic approach for patients with raised intracranial pressure and cerebral edema. Although DC is not a complicated procedure, it is associated with significant complications and morbidities that significantly affect clinical outcomes. This study investigates the frequency of cerebrospinal fluid (CSF) circulation disorders after DC and evaluates related factors.
Methods: This cross-sectional analytical study was conducted on 79 patients who underwent DC at Shohadaye Haftome Tir Hospital, one of the main trauma centers in Tehran. The patients' files and the Picture Archiving and Communication System (PACS) were reviewed to collect demographic, clinical, and radiologic data. After identifying patients with post-operative (after DC) CSF circulation disorders, the relevant factors were determined using multivariate logistic regression.
Methods: This cross-sectional analytical study was conducted on 79 patients who underwent DC at Shohadaye Haftome Tir Hospital, one of the main trauma centers in Tehran. The patients' files and the Picture Archiving and Communication System (PACS) were reviewed to collect demographic, clinical, and radiologic data. After identifying patients with post-operative (after DC) CSF circulation disorders, the relevant factors were determined using multivariate logistic regression.
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Results: Overall, seventy-nine patients were studied. The mean age of patients was 40.56±12.64 years and 82.3% were male. Forty-seven patients (59.5%) underwent DC due to traumatic causes and thirty-two patients (40.5%) due to vascular pathologies. In total, 36.7% (nineteen) of patients were affected by some degree of subdural hygromas of which 13 patients (44.8%) progressed to clinical and radiologic hydrocephalus. 19% (fifteen patients) developed hydrocephalus within the first six months after surgery. Considering the clinical variables, the GCS of patients was the only one that showed a significant relationship with CSF circulation disorders. Regarding radiological variables, the presence of intraventricular hemorrhage (IVH) was the only relevant factor. In addition, from the surgical perspective, performing duraplasty (autograft or allograft) and reoperation demonstrated significant relationships with CSF circulation disorders. The results of multivariate logistic regression showed that having intraventricular hemorrhage (OR, 6.15-6.9414: CI95%, P=0.003) and reoperation (75.91: OR, 3.88-3.6, 1485/43: CI95%, P=0.004) were two independent factors associated with hydrocephalus in DC patients.
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Conclusion: In patients who have undergone decompressive craniectomy, intraventricular hemorrhage (IVH) and reoperation can be independent risk factors for CSF circulation disorders. Although the incidence and presence of IVH cannot be controlled, careful and meticulous surgical technique and skill can significantly improve the outcome of decompressive craniectomy by reducing the need for reoperation
Khadijeh Rezaei Kahkhaei , Soha Shokri, Tayebeh Azarmehr, Mehdi Afshari , Maryam Nakhaee Moghadam , Kolsoum Rezaie Kahkhaie , Leili Rezaei Kahkhaei ,
Volume 82, Issue 7 (October 2024)
Volume 82, Issue 7 (October 2024)
Abstract
Background: Abortion is the termination of pregnancy before the 20th week of pregnancy, which may be spontaneous or induced. In general, therapeutic abortion is defined as the termination of pregnancy before the 20th week of pregnancy in order to save the mother's life and prevent birth defects. The purpose of this study is to investigate the causes of legal abortion in women referring to Amir al-Mominin Ali hospital in Zabol city.
Methods: This study is a descriptive-cross-sectional study. The studied population included women who had a legal abortion on March 1, 2022 to September 1, 2022 at Amir al-Mominin Ali Zabol Hospital (Zabol-Iran). The tool used was a checklist made by the researcher and approved by the faculty members of Zabol University of Medical Sciences. The researchers collected the necessary information, including demographic information, obstetrics and mother's illness, fetal disorders, test results, ultrasound screenings, pathology results of patients and other conditions that led to the issuance of an abortion license.
Methods: This study is a descriptive-cross-sectional study. The studied population included women who had a legal abortion on March 1, 2022 to September 1, 2022 at Amir al-Mominin Ali Zabol Hospital (Zabol-Iran). The tool used was a checklist made by the researcher and approved by the faculty members of Zabol University of Medical Sciences. The researchers collected the necessary information, including demographic information, obstetrics and mother's illness, fetal disorders, test results, ultrasound screenings, pathology results of patients and other conditions that led to the issuance of an abortion license.
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Results: In the specified period of time, there were 100 abortion cases that were investigated, and 78 (78%) of these abortions had maternal causes and 22% had fetal causes. The most common maternal causes of abortion were cardiovascular problems (7%) and mothers' age. Also, the most fetal causes were cerebrospinal causes (23%). Mothers who had abortions of maternal origin were significantly older than mothers with abortions of fetal origin (p=0.009).
Conclusion: The present study showed that in Sistan region, most cases of legal abortion depended on fetal reasons and mothers' age. |
Fatemeh Rasouli Amiri , Khadijeh Ezoji, Seyed Reza Hosseini, Ali Bijani , Kayvan Latifi ,
Volume 82, Issue 8 (November 2024)
Volume 82, Issue 8 (November 2024)
Abstract
Background: People with chronic pain have a shorter life expectancy than the general population, in part as a result of excess mortality from cardiovascular disease (CVD). The purpose of this study was to investigate the relationship between chronic pain and risk factors of cardiovascular diseases.
Methods: In this study, 400 elderly diabetic patients in phase one of the Amirkola Elderly Cohort Study (AHAP), which was conducted between April 2011 to March 2016, were divided into two groups of 200 people, with chronic pain and without chronic pain. Then, the risk factors for cardiovascular diseases that are available in this plan such as physical activity level, body mass index, blood sugar levels, blood lipid profile status, Hypertension and smoking were examined.
Methods: In this study, 400 elderly diabetic patients in phase one of the Amirkola Elderly Cohort Study (AHAP), which was conducted between April 2011 to March 2016, were divided into two groups of 200 people, with chronic pain and without chronic pain. Then, the risk factors for cardiovascular diseases that are available in this plan such as physical activity level, body mass index, blood sugar levels, blood lipid profile status, Hypertension and smoking were examined.
Results: In the study of baseline variables in the elderly with and without pain with diabetes, it was found that women reported more pain with 54.4% than men with 45.6% that there is a significant difference between the two sexes (P=0.0001). Education level was also associated with having pain so that 67.8% of the elderly with having pain were illiterate and this relationship was significant (P=0.006). 82.5% of the elderly with higher physical activity had less pain than the elderly with less physical activity. This indicates the effect of physical activity in reducing pain and the observed relationship was significant (P=0.001). Triglyceride levels and history of underlying disease were lower in painless elderly (P=0.009 and P=0.002). Physical activity in the elderly without pain was higher than the elderly who had pain and this significant difference was reported (P=0.002).
Conclusion: The results of this study indicate a high prevalence of chronic pain in the elderly in Amirkola. In the elderly without chronic pain, there were lower triglyceride levels, more physical activity and fewer underlying diseases. Attention to chronic pain features among elderly to identify vulnerable groups and providing better care can increase the quality of life in this group.
Conclusion: The results of this study indicate a high prevalence of chronic pain in the elderly in Amirkola. In the elderly without chronic pain, there were lower triglyceride levels, more physical activity and fewer underlying diseases. Attention to chronic pain features among elderly to identify vulnerable groups and providing better care can increase the quality of life in this group.
Meisam Rezaei, Mehdi Asgari , Amir Ashrafi, Elham Farhadi ,
Volume 82, Issue 9 (December 2024)
Volume 82, Issue 9 (December 2024)
Abstract
Background: Gallstones are a common gastrointestinal complication following bariatric surgery, potentially resulting in cholecystitis, cholangitis, and pancreatitis. These complications arise due to biliary homeostasis alterations and rapid postoperative weight loss. Ursodeoxycholic acid (UDCA) has been shown to reduce biliary cholesterol saturation, thereby preventing gallstone formation. This study aimed to evaluate the effectiveness of Ursobil (UDCA) in preventing gallstones in patients undergoing bariatric surgery.
Methods: This case-control study was conducted study was conducted at Golestan Hospital in Ahvaz, Iran, from October 2022 to March 2023. Ethical approval was obtained from the institutional review board. Patients aged 18 to 65 years with a BMI between 35 and 65 kg/m² were eligible. Exclusion criteria included a history of gallstones, previous bariatric or cholecystectomy surgery, inflammatory bowel disease, recent UDCA use, or bleeding disorders. Participants were divided into two groups: the case group received 600 mg of UDCA daily for six months postoperatively, while the control group received no UDCA. Abdominal ultrasonography was performed before surgery and six months afterward. Outcome measures included gallstone formation, weight loss, need for cholecystectomy, and health-related quality of life, assessed using the WHOQOL-BREF questionnaire.
Results: The two groups were comparable in terms of age, gender distribution, and baseline BMI. The mean weight loss was similar between groups after six months. Gallstone formation occurred in 1.7% (n=1) of the UDCA group compared to 15% (n=9) of the control group (P=0.012). None of the patients in the intervention group required cholecystectomy, whereas 11.7% (n=7) in the control group underwent the procedure (P=0.011). Quality of life scores were higher in the UDCA group, though not statistically significant.
Conclusion: Oral administration of UDCA effectively and significantly reduces the risk of gallstone formation and the need for cholecystectomy in post-bariatric surgery patients. Routine use of UDCA during rapid weight loss phases may improve clinical outcomes and reduce gallstone-related complications. Preventive use of UDCA may effectively and significantly reduce gallstone-related morbidity in patients undergoing rapid weight loss.
Methods: This case-control study was conducted study was conducted at Golestan Hospital in Ahvaz, Iran, from October 2022 to March 2023. Ethical approval was obtained from the institutional review board. Patients aged 18 to 65 years with a BMI between 35 and 65 kg/m² were eligible. Exclusion criteria included a history of gallstones, previous bariatric or cholecystectomy surgery, inflammatory bowel disease, recent UDCA use, or bleeding disorders. Participants were divided into two groups: the case group received 600 mg of UDCA daily for six months postoperatively, while the control group received no UDCA. Abdominal ultrasonography was performed before surgery and six months afterward. Outcome measures included gallstone formation, weight loss, need for cholecystectomy, and health-related quality of life, assessed using the WHOQOL-BREF questionnaire.
Results: The two groups were comparable in terms of age, gender distribution, and baseline BMI. The mean weight loss was similar between groups after six months. Gallstone formation occurred in 1.7% (n=1) of the UDCA group compared to 15% (n=9) of the control group (P=0.012). None of the patients in the intervention group required cholecystectomy, whereas 11.7% (n=7) in the control group underwent the procedure (P=0.011). Quality of life scores were higher in the UDCA group, though not statistically significant.
Conclusion: Oral administration of UDCA effectively and significantly reduces the risk of gallstone formation and the need for cholecystectomy in post-bariatric surgery patients. Routine use of UDCA during rapid weight loss phases may improve clinical outcomes and reduce gallstone-related complications. Preventive use of UDCA may effectively and significantly reduce gallstone-related morbidity in patients undergoing rapid weight loss.
Nazila Farnosh, Abdolreza Roueintan, Seyd Ebrahim Hejazian, Khadijeh Ezoji , Fatemeh Abdullah Gorji , Sadrollah Motamed,
Volume 82, Issue 9 (December 2024)
Volume 82, Issue 9 (December 2024)
Abstract
Background: Introduction & Objective: Reductive mammoplasty, which is performed for medical or cosmetic reasons, can be carried out with different techniques. In this study, we compare the results obtained from vertical mammoplasty surgery with reverse T method and purse method in patients.
Methods: In this retrospective cross-sectional study, we examined sample consisted of 58 patients referred to the 15- KORDAD educational center in Tehran for reductive mammoplasty surgery. In all patients, the scar length was 12 cm and the resected was 300 g. Patients were followed up in the first week, 1 and 3 months after surgery, and conducted photographism was assessed based on Vancouver and patient and observer scar assessment scal (POSAS) criterion .The duration of wound restoration and the presence of redness and discharge (secretion) complications or long-term itching were assessed.
Results: The obtained results showed that age, body mass index and resection weight did not have statistically significant difference between the reverse T incision groups and the purse method. However, the duration of surgery (minute) in reverse T group was longer than the purse method, which was statistically significant. Postoperative scars rate using POSAS criterion were not significantly different between the two groups in terms of redness, discharge and itching complications. Postoperative scar rate using Vancouver criterion were not significantly different in terms of hyper and hypopigmentation, vascularity and high and medium scale satisfaction, but in terms of Pliability and wound height were higher in the purse group and were significantly different. Complications of seroma, nipple areola necrosis and anesthesia in nipple areola and infection and hematoma were not significantly different in both groups.
Conclusion: Reverse T-mammoplasty had a longer operation time, but satisfaction was higher in this method, but only in a good scale. The Pliability and height of the wound were higher in the purse group.
Methods: In this retrospective cross-sectional study, we examined sample consisted of 58 patients referred to the 15- KORDAD educational center in Tehran for reductive mammoplasty surgery. In all patients, the scar length was 12 cm and the resected was 300 g. Patients were followed up in the first week, 1 and 3 months after surgery, and conducted photographism was assessed based on Vancouver and patient and observer scar assessment scal (POSAS) criterion .The duration of wound restoration and the presence of redness and discharge (secretion) complications or long-term itching were assessed.
Results: The obtained results showed that age, body mass index and resection weight did not have statistically significant difference between the reverse T incision groups and the purse method. However, the duration of surgery (minute) in reverse T group was longer than the purse method, which was statistically significant. Postoperative scars rate using POSAS criterion were not significantly different between the two groups in terms of redness, discharge and itching complications. Postoperative scar rate using Vancouver criterion were not significantly different in terms of hyper and hypopigmentation, vascularity and high and medium scale satisfaction, but in terms of Pliability and wound height were higher in the purse group and were significantly different. Complications of seroma, nipple areola necrosis and anesthesia in nipple areola and infection and hematoma were not significantly different in both groups.
Conclusion: Reverse T-mammoplasty had a longer operation time, but satisfaction was higher in this method, but only in a good scale. The Pliability and height of the wound were higher in the purse group.
Afsaneh Amirabi, Samira Mashhadi Alipouri , Elghar Khanchi,
Volume 82, Issue 10 (January 2025)
Volume 82, Issue 10 (January 2025)
Abstract
Background: Ectopic pregnancy (EP) is a leading cause of maternal mortality globally. Early diagnosis and treatment has been associated with reduction in maternal mortality and has shifted treatment to conservative methods. The most widely used drug for Medical treatment is methotrexate (MTX). This study aimed to investigate the predictive value of early changes (day 1/4) in serum β-HCG levels in managing tubal pregnancy with single-dose MTX.
Methods: In this cross-sectional analytical study, 135 eligible women with tubal pregnancy who received a single dose of methotrexate, were included. Methotrexate was administered intramuscularly (50 mg/m²), and serum β-HCG levels were measured on days 1, 4, and 7 following the injection. The percentage change in serum β-HCG levels compared to the initial values was calculated. Treatment failure was defined as the need for surgery and/or additional dose of methotrexate.
Results: The treatment success rate was 67% while the treatment failure rate was 33%. Among patients whose β-HCG levels increased on day 4 compared to day 1, the treatment failure rate was 86%. In contrast, for patients with decreased β-HCG levels, the failure rate was only 19%. The changes in β-HCG levels from day 1 to day 4 indicated that a decrease of less than 20% in β-h-CG levels on day 4 compared to day 1 was associated with a sensitivity of 72.2% ( CI95%: 62.2% to 82.4%) and a specificity of 80% (CI95%: 66.18% to 89.1%). This change in β-HCG levels also exhibited a positive predictive value of 60% and a negative predictive value of 88% for predicting treatment failure.
Conclusion: Based on the findings of this study, changes in β-HCG levels on days four and seven may serve as predictive factors for the failure of single-dose methotrexate treatment in patients with tubal pregnancy.
Methods: In this cross-sectional analytical study, 135 eligible women with tubal pregnancy who received a single dose of methotrexate, were included. Methotrexate was administered intramuscularly (50 mg/m²), and serum β-HCG levels were measured on days 1, 4, and 7 following the injection. The percentage change in serum β-HCG levels compared to the initial values was calculated. Treatment failure was defined as the need for surgery and/or additional dose of methotrexate.
Results: The treatment success rate was 67% while the treatment failure rate was 33%. Among patients whose β-HCG levels increased on day 4 compared to day 1, the treatment failure rate was 86%. In contrast, for patients with decreased β-HCG levels, the failure rate was only 19%. The changes in β-HCG levels from day 1 to day 4 indicated that a decrease of less than 20% in β-h-CG levels on day 4 compared to day 1 was associated with a sensitivity of 72.2% ( CI95%: 62.2% to 82.4%) and a specificity of 80% (CI95%: 66.18% to 89.1%). This change in β-HCG levels also exhibited a positive predictive value of 60% and a negative predictive value of 88% for predicting treatment failure.
Conclusion: Based on the findings of this study, changes in β-HCG levels on days four and seven may serve as predictive factors for the failure of single-dose methotrexate treatment in patients with tubal pregnancy.
Neda Faraji, Mahbobeh Alizadeh, Asghar Ghorbani, Hadiseh Hosami Roodsari , Samane Akbarpour , Mohammad Arefi,
Volume 82, Issue 11 (February 2025)
Volume 82, Issue 11 (February 2025)
Abstract
Background: This study aimed to evaluate serum amylase levels in hospitalized COVID-19 patients and investigate its association with disease prognosis. Elevated serum amylase levels have been reported in some COVID-19 patients, particularly in severe cases. This increase may indicate pancreatic involvement (pancreatitis) due to viral infection. This cross-sectional study aimed to evaluate the role of serum amylase levels as a prognostic marker in COVID-19 patients.
Methods: This descriptive cross-sectional study was conducted on 150 hospitalized patients with confirmed COVID-19 at Baharloo Hospital, Tehran, over a one-year period (July 2021–July 2022). The results showed that 20% of patients (30 out of 150) had elevated serum amylase levels. Patients with high amylase levels had significantly longer hospital stays (mean 14 days vs. 8 days) and higher mortality rates (15% vs. 5%). Additionally, these patients were more likely to require intensive care (25% vs. 10%). Statistical analysis revealed that elevated serum amylase levels were independently associated with poorer clinical outcomes.
Results: These results have important clinical implications for patient management. Routine measurement of serum amylase at admission could help identify high-risk patients who may benefit from closer monitoring and early intervention. Further research is needed to determine whether specific treatments for pancreatic involvement could improve outcomes in these patients.
Conclusion: These findings suggest that measuring serum amylase levels at admission can serve as a simple and accessible marker for identifying high-risk patients. Elevated amylase in COVID-19 patients is an important biological indicator of multi-organ involvement (pancreas and kidney) and severe inflammation, which is associated with worse prognosis and higher mortality. Monitoring this marker may aid clinical decision-making and improve patient outcomes
Methods: This descriptive cross-sectional study was conducted on 150 hospitalized patients with confirmed COVID-19 at Baharloo Hospital, Tehran, over a one-year period (July 2021–July 2022). The results showed that 20% of patients (30 out of 150) had elevated serum amylase levels. Patients with high amylase levels had significantly longer hospital stays (mean 14 days vs. 8 days) and higher mortality rates (15% vs. 5%). Additionally, these patients were more likely to require intensive care (25% vs. 10%). Statistical analysis revealed that elevated serum amylase levels were independently associated with poorer clinical outcomes.
Results: These results have important clinical implications for patient management. Routine measurement of serum amylase at admission could help identify high-risk patients who may benefit from closer monitoring and early intervention. Further research is needed to determine whether specific treatments for pancreatic involvement could improve outcomes in these patients.
Conclusion: These findings suggest that measuring serum amylase levels at admission can serve as a simple and accessible marker for identifying high-risk patients. Elevated amylase in COVID-19 patients is an important biological indicator of multi-organ involvement (pancreas and kidney) and severe inflammation, which is associated with worse prognosis and higher mortality. Monitoring this marker may aid clinical decision-making and improve patient outcomes
Hadi Khorsand Zak, Seyed Hasan Seyed Sharifi , Yaser Abbasi , Rasul Nikdel,
Volume 83, Issue 7 (October 2025)
Volume 83, Issue 7 (October 2025)
Abstract
Background: Intestinal lymphangiomatosis is a rare benign disorder of the gastrointestinal tract characterized by abnormal proliferation and dilatation of lymphatic channels within the intestinal wall and mesentery. It accounts for less than 1% of gastrointestinal tumors and predominantly affects the small intestine, particularly in pediatric patients. Clinical manifestations vary widely depending on the size, location, and extent of the lesions, ranging from asymptomatic presentations to acute complications. Due to its rarity and nonspecific features, early diagnosis is often difficult. Imaging modalities, especially ultrasonography, computed tomography, and magnetic resonance imaging, are crucial for initial evaluation and preoperative planning.
Case Presentation: We report an infant who presented with failure to thrive, progressive abdominal distension, and acute symptoms of gastrointestinal obstruction. The patient was admitted to Imam Reza Hospital, Bojnurd, in February 2024. A detailed clinical assessment and laboratory evaluation were performed, followed by abdominal ultrasonography, which revealed a multiloculated cystic mass originating from the small bowel, highly suggestive of a lymphatic malformation. Due to complete small bowel obstruction and worsening clinical status, urgent exploratory laparotomy was undertaken. Intraoperative findings demonstrated a cystic lesion involving a segment of the small intestine, causing total luminal obstruction. Segmental resection of the affected bowel with primary anastomosis was performed, and the resected specimen was submitted for histopathological analysis. The postoperative course was uneventful, with gradual resolution of abdominal distension and successful reintroduction of enteral feeding. Histopathological examination confirmed intestinal lymphangioma, showing dilated lymphatic channels lined by endothelial cells within the intestinal wall, with no evidence of malignancy. During follow-up, the patient demonstrated satisfactory weight gain and normalization of gastrointestinal function, without recurrence or postoperative complications.
Conclusion: Although rare, intestinal lymphangiomatosis should be considered in infants presenting with failure to thrive and signs of bowel obstruction. Timely imaging, particularly ultrasonography, is essential for early diagnosis. Surgical resection remains the definitive treatment in symptomatic cases and is associated with favorable outcomes. Increased clinical awareness can help prevent delayed diagnosis and minimize associated morbidity.
Case Presentation: We report an infant who presented with failure to thrive, progressive abdominal distension, and acute symptoms of gastrointestinal obstruction. The patient was admitted to Imam Reza Hospital, Bojnurd, in February 2024. A detailed clinical assessment and laboratory evaluation were performed, followed by abdominal ultrasonography, which revealed a multiloculated cystic mass originating from the small bowel, highly suggestive of a lymphatic malformation. Due to complete small bowel obstruction and worsening clinical status, urgent exploratory laparotomy was undertaken. Intraoperative findings demonstrated a cystic lesion involving a segment of the small intestine, causing total luminal obstruction. Segmental resection of the affected bowel with primary anastomosis was performed, and the resected specimen was submitted for histopathological analysis. The postoperative course was uneventful, with gradual resolution of abdominal distension and successful reintroduction of enteral feeding. Histopathological examination confirmed intestinal lymphangioma, showing dilated lymphatic channels lined by endothelial cells within the intestinal wall, with no evidence of malignancy. During follow-up, the patient demonstrated satisfactory weight gain and normalization of gastrointestinal function, without recurrence or postoperative complications.
Conclusion: Although rare, intestinal lymphangiomatosis should be considered in infants presenting with failure to thrive and signs of bowel obstruction. Timely imaging, particularly ultrasonography, is essential for early diagnosis. Surgical resection remains the definitive treatment in symptomatic cases and is associated with favorable outcomes. Increased clinical awareness can help prevent delayed diagnosis and minimize associated morbidity.
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