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Fatemeh Mollarahimi-Maleki , Pershang Nazemi, Maryam Yousefi,
Volume 83, Issue 5 (August 2025)
Volume 83, Issue 5 (August 2025)
Abstract
Background: One of the most common cancers in women is cervical cancer, which is the most preventable cancer leading to death among women worldwide. Among the causes related to cervical cancer, the human papillomavirus (HPV) is the main factor responsible for causing cervical intraepithelial neoplasia (CIN) and cervical cancer. The aim of this study was to investigate the prevalence of high-risk HPVs (HPV16 and HPV18) and to determine the immediate absolute risk of CIN2+ in individuals with a positive HPV test.
Methods: This cross-sectional study included women who tested positive for HPV and visited the Gynecologic Oncology Clinic at Tehran University of Medical Sciences from October 2022 to March 2025. Individuals with a positive high-risk HPV result were referred for colposcopy and biopsy. The immediate absolute risk of CIN2+ in HPV-positive patients with HPV16, HPV18, or concurrent HPV16/18 genotypes (Multi. HPV+) was evaluated across different cytologic grades, ranging from NILM (Negative for Intraepithelial Lesion or Malignancy) to SCC (Squamous Cell Carcinoma).
Results: A total of 727 patients participated in the study. The mean age and standard deviation of the participants were 35.99 and 8.48 years, respectively. Among all referrals, the number of women who were positive only for HPV 16 was 170 (23%), and 24 (3.3%) were positive only for HPV 18. The highest number of positive cases for HPV16 and HPV18 were in the age range of 30 to 39 years (45%). In the Multi. HPV+ group, the highest number was observed in individuals under 29 years old (50%). The calculated immediate absolute risk of CIN2+ in HPV16+ individuals was 14% for NILM and 8.6% for ASCUS, while in HPV18+ individuals, it was 8.3% for NILM.
Conclusion: Cytologic triage combined with HPV genotyping testing can be utilized firstly as an approach to identify cellular abnormalities in HPV-infected individuals and subsequently as an appropriate method to reduce referrals for colposcopy.
Methods: This cross-sectional study included women who tested positive for HPV and visited the Gynecologic Oncology Clinic at Tehran University of Medical Sciences from October 2022 to March 2025. Individuals with a positive high-risk HPV result were referred for colposcopy and biopsy. The immediate absolute risk of CIN2+ in HPV-positive patients with HPV16, HPV18, or concurrent HPV16/18 genotypes (Multi. HPV+) was evaluated across different cytologic grades, ranging from NILM (Negative for Intraepithelial Lesion or Malignancy) to SCC (Squamous Cell Carcinoma).
Results: A total of 727 patients participated in the study. The mean age and standard deviation of the participants were 35.99 and 8.48 years, respectively. Among all referrals, the number of women who were positive only for HPV 16 was 170 (23%), and 24 (3.3%) were positive only for HPV 18. The highest number of positive cases for HPV16 and HPV18 were in the age range of 30 to 39 years (45%). In the Multi. HPV+ group, the highest number was observed in individuals under 29 years old (50%). The calculated immediate absolute risk of CIN2+ in HPV16+ individuals was 14% for NILM and 8.6% for ASCUS, while in HPV18+ individuals, it was 8.3% for NILM.
Conclusion: Cytologic triage combined with HPV genotyping testing can be utilized firstly as an approach to identify cellular abnormalities in HPV-infected individuals and subsequently as an appropriate method to reduce referrals for colposcopy.
Samaneh Arab, Mohammad-Reza Mahmoudian-Sani , Najmeh Fattahi , Zakiye Ekhlasi, Samira Asgharzade,
Volume 83, Issue 5 (August 2025)
Volume 83, Issue 5 (August 2025)
Abstract
Background: Retinal photoreceptor degeneration is a major cause of blindness. Stem cell therapies offer promise, and the miR-183/96/182 cluster, particularly miR-182 and miR-183, plays a crucial role in photoreceptor development and survival. Targeting these miRNAs may enhance human bone marrow–derived mesenchymal stem cells) hBMSCs (differentiation into photoreceptor-like cells, improving their therapeutic potential.
Methods: This in vitro study was conducted from April 2019 to March 2021 at the Clinical Biochemistry Research Center, Shahrekord University of Medical Sciences. hBMSCs were cultured in DMEM with fetal bovine serum and transfected with miR-182 and miR-183 mimics using Lipofectamine, with a scramble miRNA control. Transfection efficiency and miRNA overexpression were evaluated at 24 and 48 hours using real-time PCR. miRNA expression was normalised to Snord, while mRNA levels were normalised to GAPDH using the 2−ΔΔCt method. Photoreceptor-like differentiation was assessed by measuring the expression of retina-specific transcription factors and markers (OTX2, CRX, NRL, SLC1A1, PKCα, Recoverin, and RHO). Statistical analyses included the Shapiro–Wilk test for normality and the Mann-Whitney U test for group comparisons. Data were reported as Mean ± SEM, with 95% confidence intervals, and significance set at α = 0.05.
Results: Transfection of miR-182 and miR-183 significantly increased miRNA levels at 24–48 hours (P < 0.001) compared to the scramble control. This led to a marked upregulation of retinal-related genes, including CRX, OTX2, PKCα, Recoverin, NRL, and RHO, indicating activation of the photoreceptor gene network. Time-resolved analysis revealed stronger effects at 24–48 hours, supporting a transient window for pro-differentiation. RHO and CRX exhibited the most significant increases, while OTX2 and PKCα showed parallel rises, suggesting coordinated activation of early and intermediate photoreceptor programs. Scramble controls did not show comparable changes.
Conclusion: Transient overexpression of miR-182 and miR-183 in hBMSCs activates a photoreceptor-like gene expression program, promoting differentiation toward photoreceptor-like cells. This finding supports the potential use of miR-182/183 in stem cell-based therapies for retinal degeneration. Further studies should confirm protein expression, functional outcomes, and in vivo efficacy.
Hedayat Heydarizadeh, Hossein Seyedkhani, Zahra Mohebinajad, Ali Heydarizadeh,
Volume 83, Issue 5 (August 2025)
Volume 83, Issue 5 (August 2025)
Abstract
Background: Chronic abdominal pain, which is defined as long-term or intermittent abdominal pain, is a common problem in children. Helicobacter pylori infection is acquired in childhood and is one of the important causes of peptic ulcer disease (PUD) and stomach cancer, so this study was conducted with the aim of investigating the prevalence of Helicobacter pylori in children with chronic abdominal pain referred to Imam Hospital in 1402.
Methods: This study is descriptive-cross-sectional and the statistical population of children with chronic abdominal pain referred to Imam Khomeini Hospital in Ilam city in 1402 was tested for Helicobacter bacteria. Helicobacter pylori was checked using stool antigen test.
Results: This study was conducted on 140 children with chronic abdominal pain with an average age of 7.06 years in the age range of 2-16 years, the majority of children living in Ilam city were boys. The type of feeding was reported in all children as regular, and the majority of them were the result of cesarean delivery (67.9%). The prevalence of 40.7% showed HP positivity in children with chronic abdominal pain. The majority of children in the age group of 4-8 years had Helicobacter pylori positive, 20 people (35.7%) and in children older than 12 years, Helicobacter pylori had the lowest frequency. The prevalence of Helicobacter pylori was reported more in girls than in boys, and among the studied cities it was the highest. The outbreak was in the city of Ilam. There was no difference between the prevalence of Helicobacter pylori with age, sex, place of residence and type of delivery.
Conclusion: The general results of our study show that Helicobacter pylori is an important factor for chronic abdominal pain in children, but factors such as sex, place of residence and type of delivery do not affect its prevalence. It is suggested that in future studies, the family history, parents' infection with Helicobacter pylori and its relationship with transmission to the child should be measured.
Methods: This study is descriptive-cross-sectional and the statistical population of children with chronic abdominal pain referred to Imam Khomeini Hospital in Ilam city in 1402 was tested for Helicobacter bacteria. Helicobacter pylori was checked using stool antigen test.
Results: This study was conducted on 140 children with chronic abdominal pain with an average age of 7.06 years in the age range of 2-16 years, the majority of children living in Ilam city were boys. The type of feeding was reported in all children as regular, and the majority of them were the result of cesarean delivery (67.9%). The prevalence of 40.7% showed HP positivity in children with chronic abdominal pain. The majority of children in the age group of 4-8 years had Helicobacter pylori positive, 20 people (35.7%) and in children older than 12 years, Helicobacter pylori had the lowest frequency. The prevalence of Helicobacter pylori was reported more in girls than in boys, and among the studied cities it was the highest. The outbreak was in the city of Ilam. There was no difference between the prevalence of Helicobacter pylori with age, sex, place of residence and type of delivery.
Conclusion: The general results of our study show that Helicobacter pylori is an important factor for chronic abdominal pain in children, but factors such as sex, place of residence and type of delivery do not affect its prevalence. It is suggested that in future studies, the family history, parents' infection with Helicobacter pylori and its relationship with transmission to the child should be measured.
Alireza Eskandarifar, Zahra Taherkhani, Soleiman Mohammadzadeh , Rama Naghshizadian, Khaled Rahmani,
Volume 83, Issue 5 (August 2025)
Volume 83, Issue 5 (August 2025)
Abstract
Background: Primary nocturnal enuresis (PNE) is a common and distressing childhood disorder characterized by involuntary urination during sleep after the age when bladder control is normally achieved. It affects not only the child’s quality of life but also family dynamics and social relationships. Previous studies have suggested a possible link between PNE and psychological or behavioral problems, yet findings have been inconsistent across populations. The present study aimed to investigate and compare the prevalence and patterns of psychiatric disorders among children with primary nocturnal enuresis and healthy controls in Sanandaj, Iran.
Methods: This case-control study was conducted in Sanandaj from October 2024 to April 2025. The study population included children referred to the Medical, Educational, and Therapeutic Center of Kurdistan University of Medical Sciences. A total of 228 participants were enrolled, comprising 108 children diagnosed with primary nocturnal enuresis and 120 age- and sex-matched healthy controls selected through convenient sampling. Psychiatric assessments were performed using the parent version of the Child Symptom Inventory-4 (CSI-4) questionnaire, which evaluates a wide range of childhood behavioral and emotional disorders based on DSM-IV criteria. Statistical analysis was performed using Stata version 18, and comparisons between groups were made using the chi-square and Fisher’s exact tests. A p-value < 0.05 was considered statistically significant.
Results: Children with primary nocturnal enuresis had significantly higher frequencies of attention deficit disorder (ADD), hyperactivity disorder (HD), attention deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), generalized anxiety disorder (GAD), and tic disorder compared with the control group (p < 0.05). In contrast, the prevalence of phobia and obsessive-compulsive disorder (OCD) was slightly higher in the control group. No statistically significant difference was found regarding post-traumatic stress disorder (PTSD) between the two groups.
Conclusion: The findings suggest that primary nocturnal enuresis may serve as an indicator of increased vulnerability to certain psychiatric disorders in childhood. Early recognition and psychological evaluation of children with enuresis are recommended to improve long-term outcomes and mental well-being.
Methods: This case-control study was conducted in Sanandaj from October 2024 to April 2025. The study population included children referred to the Medical, Educational, and Therapeutic Center of Kurdistan University of Medical Sciences. A total of 228 participants were enrolled, comprising 108 children diagnosed with primary nocturnal enuresis and 120 age- and sex-matched healthy controls selected through convenient sampling. Psychiatric assessments were performed using the parent version of the Child Symptom Inventory-4 (CSI-4) questionnaire, which evaluates a wide range of childhood behavioral and emotional disorders based on DSM-IV criteria. Statistical analysis was performed using Stata version 18, and comparisons between groups were made using the chi-square and Fisher’s exact tests. A p-value < 0.05 was considered statistically significant.
Results: Children with primary nocturnal enuresis had significantly higher frequencies of attention deficit disorder (ADD), hyperactivity disorder (HD), attention deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), generalized anxiety disorder (GAD), and tic disorder compared with the control group (p < 0.05). In contrast, the prevalence of phobia and obsessive-compulsive disorder (OCD) was slightly higher in the control group. No statistically significant difference was found regarding post-traumatic stress disorder (PTSD) between the two groups.
Conclusion: The findings suggest that primary nocturnal enuresis may serve as an indicator of increased vulnerability to certain psychiatric disorders in childhood. Early recognition and psychological evaluation of children with enuresis are recommended to improve long-term outcomes and mental well-being.
Heshmat Shahi , Fatemeh Kiaee ,
Volume 83, Issue 6 (September 2025)
Volume 83, Issue 6 (September 2025)
Abstract
Helicobacter pylori is one of the most common chronic bacterial infections worldwide, with acquisition often occurring in childhood. While its role in the pathology of gastroduodenal diseases in adults is well-established, its impact on the pediatric population presents a unique set of clinical and pathophysiological challenges. This comprehensive review examines the complex and bidirectional relationship between Helicobacter pylori infection and host iron metabolism in pediatric and infant populations. For this review, the PubMed database was utilized for studies published from April 1979 through December 2024. Studies based on English language were included using the MESH terms "Helicobacter pylori," "iron," and "ferritin." According to the inclusion criteria, studies related to H. pylori infection and iron condition in patients under 18 years old were selected. Articles such as review articles, case reports, letters to the editor, and animal or in vitro studies were excluded. The main aim of this study was to illuminate the critical role of iron as an essential micronutrient and factor for both the host and the pathogen, examining the multifaceted mechanisms involved in H. pylori-induced iron homeostasis disruption in children.
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The findings indicate a multifaceted relationship: virulent Helicobacter pylori strains are significantly and inversely associated with true body iron stores, leading to Iron deficiency anemia (IDA). However, chronic inflammatory states can paradoxically elevate ferritin levels, masking underlying iron deficiency. Complex interaction between bacterial infection, host inflammatory responses, and iron deficiency is an important factor influencing both the severity of the damage caused by this bacterial infection and its chronicity in the pediatric population. Identification and comprehensive understanding of these complex mechanisms is of great importance for the effective management of iron deficiency anemia in children with H. pylori infection. Considering, increase in the incidence of H. pylori infection in childhood, it is essential that H. pylori infection be evaluation in children with unknown reasons IDA. Finally, screening methods for H. pylori infection in children is recommended, as this could improve long-term health outcomes.
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Reza Saeidi , Mahboobe Gholami ,
Volume 83, Issue 6 (September 2025)
Volume 83, Issue 6 (September 2025)
Abstract
Background: Maternal substance abuse during pregnancy is a significant global public health concern, affecting approximately 10% of pregnant women worldwide and leading to serious adverse outcomes for both mother and fetus. Given Iran’s geographical location and its role as a transit route for narcotics, the prevalence of substance abuse, particularly opium and its derivatives, is notably higher than in many other countries. This systematic review and meta-analysis aimed to determine the prevalence of substance abuse and the most commonly used substances (including opium, heroin, crystal methamphetamine, methadone, amphetamines, and cigarettes) among pregnant Iranian women from 2000 to 2024.
Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, SID, and Iranmedex for articles published between January 2000 and January 2024. Studies investigating the prevalence of substance abuse in pregnant Iranian women were included. Case studies, reviews, letters to the editor, and studies without quantitative data were excluded. Two researchers independently extracted data. Extracted information included: author name, year of publication, province/city, sample size, mean age of participants, type of substance used, and incidence or prevalence rate. Data were analyzed using a random-effects model, and heterogeneity was assessed using the I2 index.
Results: Out of 127 identified articles, 22 were included in the meta-analysis. The overall estimated prevalence of substance abuse among pregnant Iranian women was 3.3% (CI 95%: 2.4-4.5), with high heterogeneity (I2=83%). The most prevalent substances were opium (1.7%), cigarettes (1.3%), methadone (0.5%), heroin (0.3%), crystal methamphetamine (0.2%), amphetamines/methamphetamines (0.1%), cannabis (0.4%), and alcohol (0.2%). Polydrug use was reported at 0.7%. A rising trend in substance abuse prevalence was observed, increasing from 2.1% in 2000-2009 to 3.8% in 2015-2024. A temporal trend analysis of the incidence of substance abuse showed that the incidence of substance abuse in Iranian pregnant women increased from 2.1% in 2000-2009 to 3.8% in 2015-2024. Sensitivity and publication bias analyses showed that the exclusion of low-quality studies did not significantly affect the results. The funnel plot indicated a low probability of publication bias.
Conclusion: Substance abuse among pregnant Iranian women remains a serious challenge, necessitating broader preventive and therapeutic interventions.
Keywords: neonatal withdrawal syndrome, opium, pregnancy, substance abuse.
Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, SID, and Iranmedex for articles published between January 2000 and January 2024. Studies investigating the prevalence of substance abuse in pregnant Iranian women were included. Case studies, reviews, letters to the editor, and studies without quantitative data were excluded. Two researchers independently extracted data. Extracted information included: author name, year of publication, province/city, sample size, mean age of participants, type of substance used, and incidence or prevalence rate. Data were analyzed using a random-effects model, and heterogeneity was assessed using the I2 index.
Results: Out of 127 identified articles, 22 were included in the meta-analysis. The overall estimated prevalence of substance abuse among pregnant Iranian women was 3.3% (CI 95%: 2.4-4.5), with high heterogeneity (I2=83%). The most prevalent substances were opium (1.7%), cigarettes (1.3%), methadone (0.5%), heroin (0.3%), crystal methamphetamine (0.2%), amphetamines/methamphetamines (0.1%), cannabis (0.4%), and alcohol (0.2%). Polydrug use was reported at 0.7%. A rising trend in substance abuse prevalence was observed, increasing from 2.1% in 2000-2009 to 3.8% in 2015-2024. A temporal trend analysis of the incidence of substance abuse showed that the incidence of substance abuse in Iranian pregnant women increased from 2.1% in 2000-2009 to 3.8% in 2015-2024. Sensitivity and publication bias analyses showed that the exclusion of low-quality studies did not significantly affect the results. The funnel plot indicated a low probability of publication bias.
Conclusion: Substance abuse among pregnant Iranian women remains a serious challenge, necessitating broader preventive and therapeutic interventions.
Keywords: neonatal withdrawal syndrome, opium, pregnancy, substance abuse.
Majid Vatankhah Tarbebar , Saeid Kashani, Milad Mohammadi , Zohreh Nik Eghbali, Mehrdad Malekshoar,
Volume 83, Issue 6 (September 2025)
Volume 83, Issue 6 (September 2025)
Abstract
Background: Laparoscopic cholecystectomy is the gold standard for treating gallbladder diseases; however, it is associated with physiological challenges from pneumoperitoneum and specific patient positioning. Positive end-expiratory pressure (PEEP) may mitigate these effects, but the optimal level remains uncertain. This study compared the impact of three PEEP levels on respiratory performance and hemodynamic stability during laparoscopic cholecystectomy.
Methods: This randomized double-blind clinical trial was conducted at Shahid Mohammadi Hospital, Bandar Abbas, Iran, from August 2023 to February 2024. A total of 75 adult patients aged 18-70 years with ASA class I-II scheduled for elective laparoscopic cholecystectomy were assigned to three groups (n=25 each): PEEP 0 cmH₂O (control), PEEP 5 cmH₂O, and PEEP 7 cmH₂O. Standardized general anesthesia and mechanical ventilation with tidal volumes of 6-8 mL/kg were applied. Hemodynamic variables (mean arterial pressure, heart rate) and respiratory parameters (SpO₂, EtCO₂) were recorded before intubation, during intubation, and at 15, 30, and 60 minutes post-intubation, as well as in the recovery room. Arterial blood gas analysis was performed 30 minutes after intubation. Data were analyzed using ANOVA and chi-square tests with a significance level of 0.05.
Results: The mean age of patients was 41.89±11.39 years, and baseline demographic variables showed no significant differences among groups. Oxygen saturation remained above 94% across all time points without intergroup differences. EtCO₂ values differed significantly at 30 minutes (P=0.04) and 60 minutes (P=0.01), with the highest levels observed in the PEEP 7 group and the lowest in the PEEP 5 group. Although mean arterial pressure and heart rate did not show statistically significant variation among groups, the PEEP 7 group demonstrated the smallest postoperative decline in blood pressure.
Conclusion: A PEEP level of 5 cmH₂O offers the most favorable balance between maintaining oxygenation, supporting effective ventilation, and preserving hemodynamic stability during laparoscopic cholecystectomy. This level can be recommended as a safe and optimal ventilation strategy.
Maryam Hajhashemi , Hedieh Bonakdarchian, Tahereh Khalili Borujeni , Minoo Movahedi , Roya Sahebi, Fedyeh Haghollahi,
Volume 83, Issue 6 (September 2025)
Volume 83, Issue 6 (September 2025)
Abstract
Background: Pelvic organ prolapse (POP) is a condition resulting from weakness or damage to the muscles, ligaments, and other supporting structures of the vagina, and it exposes affected women to reduced quality of life and sexual function. The present study examined the symptoms, sexual function, and quality of life of women one year after repair of pelvic organ prolapse.
Methods: This study was a prospective cohort before-after study that was conducted on 200 married women with pelvic prolapse grade 1-4 (POP-Q) in the age group of 47-75 years who underwent reconstructive surgery (anterior and posterior colporrhaphy) in Shahid Beheshti and Al-Zahra hospitals in Isfahan between October 2022 and March 2024. The data collection tools were three questionnaires: Female Sexual Function Index (FSFI), Pelvic Discomfort (PFDI-20) and Quality of Life (SF-36) which were completed before surgery and one year after surgery. Stata software version 17 was used to analyze the data. To compare the scores before and after, paired t-test or Wilcoxon statistical tests were used, to compare the severity of patients' clinical symptoms based on the levels before and after surgery, the symmetry/Bowker test was used, and to compare the status of the sexual function index (impairment/no impairment) before and after surgery, the McNemar test was used and the significance level was considered to be P<0.05.
Results: The mean age of the study participants was 59.5±12.6 years. The majority of the women (157 individuals; 78.5%) were housewives. The mean number of pregnancies was 4.3±2.1, and the mean number of live births was 3.75±1.89. All women included in the study were postmenopausal. The severity of clinical symptoms, sexual dysfunction index status, and median quality of life score were significant between before and after the intervention. The severity of clinical symptoms, the status of the sexual dysfunction index, and the median quality of life score showed significant differences before and after the intervention.
Conclusion: Pelvic prolapse surgery can significantly improve the quality of life and sexual function of patients one year after surgery, in addition to correcting the anatomical structure.
The comparison of blood loss in cesarean section undergoing
general anesthesia and spinal anesthesia
Mohammad Sadegh Sanie Jahromi , Reza Ashrafzadeh, Ahmad Rastgarian, Navid Kalani , Mohammad Hasan Damshenas,
Volume 83, Issue 6 (September 2025)
Volume 83, Issue 6 (September 2025)
Abstract
Background: In general anesthesia, anesthetic agents are administered by inhalation or intravenously, leading to loss of consciousness, immobility, analgesia, and amnesia. In spinal anesthesia, injection of a local anesthetic into the intrathecal space causes sensory and motor block. The aim of this study was to compare the volume of bleeding during cesarean section under general anesthesia and spinal anesthesia.
Methods: This study is a cross-sectional prospective study. The gauzes used were weighed before the operation and bloody gauzes were weighed after the operation. The difference between the weight of bloody and dry gauzes was recorded as the volume of bleeding. This volume was then added to the volume of blood in the suction chamber and the final bleeding volume was estimated.
Results: 70 patients who were candidates for cesarean section were included in the study. The mean age of the patients included in the study was 24.82±4.98 and their mean weight was 77.11±8.97. The mean hemoglobin in the spinal anesthesia group was 91.12±39. Volume of bleeding during cesarean section by spinal anesthesia was significantly less than general anesthesia (P=0.001). Also, the visual estimation of bleeding in spinal anesthesia was significantly lower than general anesthesia (P<0.001). In this study, there was no significant difference between heart rate, systolic and diastolic pressure before and during surgery, and the first- and fifth-minute Apgar scores between the two groups of general and spinal anesthesia.
Conclusion: We found in this study that the volume of bleeding during cesarean section under spinal anesthesia is less than general anesthesia. It is suggested that in future studies, other methods of estimating bleeding such as postoperative hemoglobin reduction, dilution method, atomic absorption spectroscopy and photometry be used. Also, a comparison should be made between the three groups of general, spinal and epidural anesthesia, and the volume of bleeding in each should be checked and the best anesthesia method should be selected for cesarean section.
Methods: This study is a cross-sectional prospective study. The gauzes used were weighed before the operation and bloody gauzes were weighed after the operation. The difference between the weight of bloody and dry gauzes was recorded as the volume of bleeding. This volume was then added to the volume of blood in the suction chamber and the final bleeding volume was estimated.
Results: 70 patients who were candidates for cesarean section were included in the study. The mean age of the patients included in the study was 24.82±4.98 and their mean weight was 77.11±8.97. The mean hemoglobin in the spinal anesthesia group was 91.12±39. Volume of bleeding during cesarean section by spinal anesthesia was significantly less than general anesthesia (P=0.001). Also, the visual estimation of bleeding in spinal anesthesia was significantly lower than general anesthesia (P<0.001). In this study, there was no significant difference between heart rate, systolic and diastolic pressure before and during surgery, and the first- and fifth-minute Apgar scores between the two groups of general and spinal anesthesia.
Conclusion: We found in this study that the volume of bleeding during cesarean section under spinal anesthesia is less than general anesthesia. It is suggested that in future studies, other methods of estimating bleeding such as postoperative hemoglobin reduction, dilution method, atomic absorption spectroscopy and photometry be used. Also, a comparison should be made between the three groups of general, spinal and epidural anesthesia, and the volume of bleeding in each should be checked and the best anesthesia method should be selected for cesarean section.
Moslem Taheri Soodejani , Roghayeh Torkpour ,
Volume 83, Issue 6 (September 2025)
Volume 83, Issue 6 (September 2025)
Abstract
Background: Autism spectrum disorder (ASD) represents one of the most significant neurodevelopmental disorders in early childhood, where early diagnosis, particularly in children under five years of age, is crucial for effective interventions. Although global autism incidence has risen due to improved awareness, enhanced screening programs, and broader diagnostic criteria, epidemiological data from middle-income countries like Iran remain limited, especially for children under five. This study aimed to examine autism incidence trends among Iranian children under five from 1990 to 2021, stratified by sex and province.
Methods: This ecological study was conducted from October 2024 to March 2025, analyzing data extracted from the Global burden of disease (GBD) database (1990-2021). Age-specific incidence data for children under five were obtained by sex and province. Incidence rates per 100,000 population were calculated for gender and provincial comparisons. Joinpoint regression analysis assessed annual trends and identified significant inflection points. Heat maps illustrated geographical distributions, while trend graphs stratified by sex and province were generated using GraphPad Prism.
Results: The incidence rate of autism in children under five gradually increased from 1990 to 2005, followed by a sharp rise between 2005 and 2009, reaching its peak during this period. A subsequent decline was observed from 2009 to 2021. The male-to-female ratio remained consistently stable at approximately 3:1 throughout the study period and across all provinces. Notable provincial disparities were observed, with border provinces exhibiting greater fluctuations compared to central regions.
Conclusion: In contrast to the continuous global increase, autism incidence among Iranian children under five demonstrated an initial rise followed by a sustained decline after 2009. This trend may be attributed to declining birth rates, demographic shifts, evolving diagnostic criteria, improved prenatal care, and persistent challenges in early screening and case registration, alongside regional disparities in access to diagnostic services. These findings emphasize the need for enhanced early-screening programs, equitable resource distribution, and evidence-based child mental health policies in Iran.
Methods: This ecological study was conducted from October 2024 to March 2025, analyzing data extracted from the Global burden of disease (GBD) database (1990-2021). Age-specific incidence data for children under five were obtained by sex and province. Incidence rates per 100,000 population were calculated for gender and provincial comparisons. Joinpoint regression analysis assessed annual trends and identified significant inflection points. Heat maps illustrated geographical distributions, while trend graphs stratified by sex and province were generated using GraphPad Prism.
Results: The incidence rate of autism in children under five gradually increased from 1990 to 2005, followed by a sharp rise between 2005 and 2009, reaching its peak during this period. A subsequent decline was observed from 2009 to 2021. The male-to-female ratio remained consistently stable at approximately 3:1 throughout the study period and across all provinces. Notable provincial disparities were observed, with border provinces exhibiting greater fluctuations compared to central regions.
Conclusion: In contrast to the continuous global increase, autism incidence among Iranian children under five demonstrated an initial rise followed by a sustained decline after 2009. This trend may be attributed to declining birth rates, demographic shifts, evolving diagnostic criteria, improved prenatal care, and persistent challenges in early screening and case registration, alongside regional disparities in access to diagnostic services. These findings emphasize the need for enhanced early-screening programs, equitable resource distribution, and evidence-based child mental health policies in Iran.
Fatemeh Eftekharian, Arnoosh Ghodsian, Reza Sahraei,
Volume 83, Issue 6 (September 2025)
Volume 83, Issue 6 (September 2025)
Abstract
Background: Dermatomyositis is a rare inflammatory muscle disease with systemic manifestations, in which muscle weakness, dysphagia, and pulmonary and cardiac involvement are common problems. The aim of this report is to examine the challenges and management of general anesthesia in a patient with dermatomyositis with the rare complication of buried bumper syndrome after PEG placement and gallbladder surgery.
Case Presentation: A 53-year-old male patient was referred to the operating room of Seyed al-Shohada Hospital in Jahrom for gallbladder stone surgery due to abdominal pain in April-May 2024. The patient had presented to the hospital approximately one month prior with complaints of myalgia and progressive lower limb weakness. He subsequently developed severe dysphagia. Based on clinical and paraclinical evaluations, a diagnosis of dermatomyositis was ultimately made and confirmed. Due to the swallowing difficulty, a Percutaneous endoscopic gastrostomy (PEG) tube was placed for him. His treatment regimen included high-dose corticosteroid pulse therapy and Intravenous immunoglobulin (IVIG). One month later, the patient was readmitted with acute abdominal pain. Imaging studies revealed multiple gallstones, leading to a referral to a general surgeon for operative management. Additionally, a complication related to the PEG tube, known as Buried Bumper Syndrome, was considered as a potential cause of the abdominal pain. Given the patient's history of dermatomyositis and swallowing disorder, a comprehensive re-evaluation was performed in the operating room. Cricoid pressure (Sellick maneuver) was applied to prevent aspiration. The surgery was successfully completed, and the patient remained hemodynamically stable throughout the procedure.
Conclusion: General anesthesia in patients with dermatomyositis requires careful preoperative evaluation, continuous muscle and hemodynamic monitoring, selection of appropriate doses of muscle relaxants, and use of stress doses of steroids. In addition, attention to specific complications such as buried bumper syndrome after PEG and proper airway management and prevention of aspiration are of particular importance. The present report emphasizes that multifaceted and planned management can lead to successful outcomes in these patients.
Case Presentation: A 53-year-old male patient was referred to the operating room of Seyed al-Shohada Hospital in Jahrom for gallbladder stone surgery due to abdominal pain in April-May 2024. The patient had presented to the hospital approximately one month prior with complaints of myalgia and progressive lower limb weakness. He subsequently developed severe dysphagia. Based on clinical and paraclinical evaluations, a diagnosis of dermatomyositis was ultimately made and confirmed. Due to the swallowing difficulty, a Percutaneous endoscopic gastrostomy (PEG) tube was placed for him. His treatment regimen included high-dose corticosteroid pulse therapy and Intravenous immunoglobulin (IVIG). One month later, the patient was readmitted with acute abdominal pain. Imaging studies revealed multiple gallstones, leading to a referral to a general surgeon for operative management. Additionally, a complication related to the PEG tube, known as Buried Bumper Syndrome, was considered as a potential cause of the abdominal pain. Given the patient's history of dermatomyositis and swallowing disorder, a comprehensive re-evaluation was performed in the operating room. Cricoid pressure (Sellick maneuver) was applied to prevent aspiration. The surgery was successfully completed, and the patient remained hemodynamically stable throughout the procedure.
Conclusion: General anesthesia in patients with dermatomyositis requires careful preoperative evaluation, continuous muscle and hemodynamic monitoring, selection of appropriate doses of muscle relaxants, and use of stress doses of steroids. In addition, attention to specific complications such as buried bumper syndrome after PEG and proper airway management and prevention of aspiration are of particular importance. The present report emphasizes that multifaceted and planned management can lead to successful outcomes in these patients.
Epidural initiation time based on fetal head position criteria in painless labor: a letter to editor
Banafsheh Mashak, Reza Taghvaei, Reza Payami , Mohammad Hossein Shakeri Goki , Fatemeh Javaheri, Roya Bolhassani,
Volume 83, Issue 6 (September 2025)
Volume 83, Issue 6 (September 2025)
Abstract
Ayoub Tavakolian, Shapour Badiee, Mahdi Mohammadi, Elahe Pourahmadi, Samaneh Sabouri, Navid Kalani , Mahdi Foroughian ,
Volume 83, Issue 7 (October 2025)
Volume 83, Issue 7 (October 2025)
Abstract
| Background: The present study is a systematic and comparative review of the studies conducted in the field of hospice centers for patients with acute incurable diseases with a life expectancy of less than six months in the world with the aim of examining the need in Iran and the experiences of other countries, identifying candidates to receive these services, type of services provided, costs and resources in these centers. Methods: The present study was conducted as a systematic review by searching the databases: Scopus, PubMed, Elsevier, and Google Scholar search engine between 2010 and 2023. To search these databases, keywords such as hospice care centers, centers providing health services for patients with life expectancy less than six months, allocation of resources, allocation were used. After selecting the articles, the following topics were extracted from each article and compared: costs, sources of funding, candidates for receiving services, families' views, quality of near-death care, quality of life, quality of death, services provided, therapeutic interventions performed, place of death, length of stay. Results: 6 articles referred to the discussion of cost, and in all articles except one case, the use of hospice was associated with reducing the cost of patients. In one study, the source of funding was philanthropic contributions and in another study, the national budget. In all the reviewed articles, the use of hospice was associated with an increase in the quality of care, quality of end of life and quality of death, and a decrease in therapeutic interventions. The care provided by hospice was also introduced in the form of symptom assessment and management, pain relief, psychosocial support and respite care. Conclusion: Based on the findings of the present study, hospices can play an effective role in reducing treatment costs and, on the other hand, improve the quality of care, life and death in eligible people. In addition, hospices improved the end-of-life quality from the perspective of the deceased's family by reducing invasive interventions and providing physical and spiritual care. |
Ardeshir Ebrahiminejad Shahroudi, Abbas Akhavan Sepahi , Anna Meyfour, Abbas Yadegar, Sedigheh Mehrabian,
Volume 83, Issue 7 (October 2025)
Volume 83, Issue 7 (October 2025)
Abstract
Inflammatory bowel disease (IBD) is a chronic, relapsing gastrointestinal disorder characterized by persistent inflammation of the intestinal mucosa, disruption of epithelial barrier function, and dysregulation of the immune system. Its pathogenesis involves complex interactions among genetic predisposition, environmental factors, gut microbiota, and host immune responses. Dysregulated cytokine signaling plays a central role, with elevated levels of pro-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), IL-6, IL-12, and interferon-gamma (IFN-γ), contributing to tissue damage, epithelial barrier dysfunction, and clinical manifestations such as diarrhea, bleeding, and weight loss. Conversely, anti-inflammatory cytokines, including interleukin-10 (IL-10), IL-35, and IL-37, counteract these inflammatory responses, inhibit excessive immune activation, and maintain mucosal homeostasis. Probiotics, particularly Lactobacillus strains, have emerged as promising adjunctive therapies for IBD due to their capacity to restore microbial balance, modulate immune responses, and enhance gut barrier integrity. Among them, Lactobacillus brevis has demonstrated significant immunoregulatory and anti-inflammatory effects. Various strains, including AL0035, SBC8803, Bmb6, HY7401, and KU15152, reduce pro-inflammatory cytokines, upregulate tight junction proteins such as ZO-1, regulate Th1/Th2/Th17 responses, and inhibit NF-κB and MAPK signaling pathways. L. brevis-derived metabolites, notably long-chain polyphosphates, attenuate fibrosis, reduce TGF-β1 and collagen expression, and protect epithelial cells from oxidative stress. Heat-killed L. brevis strains also retain immunomodulatory activity, allowing therapeutic use even when live bacteria cannot effectively colonize the gut. Preclinical studies demonstrate that oral administration of L. brevis improves disease activity indices in experimental colitis models, reduces mucosal immune cell infiltration, restores epithelial integrity, and prevents ulceration, bleeding, and goblet cell depletion. Clinical evidence, although limited, suggests that L. brevis supplementation can enhance gut microbiota diversity, increase beneficial bacterial populations, and modulate serum cytokines, further supporting intestinal homeostasis. Furthermore, L. brevis influences metabolite profiles, such as serotonin and polyamines, which are linked to gut motility, epithelial repair, and immune regulation, highlighting its multifaceted role in gut health. In this review article, for the first time, we discussed the beneficial effects of L. brevis in inflammatory bowel disease, highlighting its clinical effects and therapeutic prospects.
Aref Teymurinejad, Hossein Seidkhani , Zahra Mohebinejad, Amirreza Eidypou , Hamed Azadi ,
Volume 83, Issue 7 (October 2025)
Volume 83, Issue 7 (October 2025)
Abstract
Background: Kidney stones are the third most common urinary tract disorder after prostate disease and infection. Painful attacks are the most common clinical manifestation, which is known as renal colic. The aim of the present study is to determine the effect of pethidine, pethidine and ketorolac, and ketorolac in patients with primary renal colic.
Methods: Renal colic patients at Imam Khomeini Hospital in Ilam from April 2023 and March 2023. were divided into three groups of 36 people. The first group received pethidine 25 mg, the second group received ketorolac 30 mg, and the third group received a combination of 2 drugs. A questionnaire included demographic information of the patients, heart rate, systolic and diastolic blood pressure, respiratory rate, oxygen saturation, side effects, pain intensity, length of hospitalization, and type of treatment received.
Results: After receiving the drug, the average heart rate increased in all three groups. But in group A, this increase was less than two groups, B and C, and this difference was not statistically significant (P=0.34). The average systolic blood pressure before receiving the drug was significantly higher in the three studied groups (P=0.006), which decreased after receiving the drug, but this decrease in systolic blood pressure in the three groups was not statistically significant (P=0.98). The average pain intensity before receiving the drug was 8.56 ± 1.2 in group A, 9.17 ± 0.878 in group B, and 8.86 ± 0.961 in group C. There was no significant difference between the three groups in terms of initial pain intensity (P=0.45). While the average pain intensity after receiving the medicine was significantly reduced and there was a significant difference (P<0.000).
Conclusion: Overall, the obtained results showed that ketorolac and pethidine have a faster effect and power compared to pethidine and ketorolac alone in controlling the pain of patients with renal colic, and the need for life-saving treatment is also less in this drug, and according to numerous studies, its side effects are also less.
Hossein Majedi , Ebrahim Espahbodi, Seyedeh Fatemeh Hosseini Nejad, Mahshid Vaziri, Fatemeh Javaherforoushzadeh , Mahbubeh Rashidi, Rouzbeh Amiri Motlagh ,
Volume 83, Issue 7 (October 2025)
Volume 83, Issue 7 (October 2025)
Abstract
Background: Postoperative pain remains a major concern following abdominal surgeries, including laparoscopic cholecystectomy. Inadequate pain control may lead to increased opioid consumption, delayed recovery, prolonged hospitalization, and reduced patient satisfaction. Therefore, the use of anesthetic adjuvants with effective analgesic properties and minimal side effects has gained increasing attention. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, and dexmedetomidine, a highly selective α2-adrenergic agonist, are commonly used agents with distinct mechanisms of action. The present study aimed to compare the effects of intraoperative ketamine and dexmedetomidine on postoperative pain following laparoscopic cholecystectomy.
Methods: This randomized, double-blind, controlled clinical trial was conducted on 252 patients undergoing elective laparoscopic cholecystectomy. Patients were randomly assigned into three equal groups: ketamine, dexmedetomidine, and control. The ketamine group received an intravenous infusion of ketamine at a dose of 0.5 mg/kg/h, the dexmedetomidine group received 0.6 µg/kg/min of dexmedetomidine, and the control group received normal saline. Pain intensity was assessed using the Visual Analogue Scale (VAS) at 1, 6, 12, and 24 hours postoperatively. Hemodynamic parameters, including heart rate and mean arterial pressure, were continuously monitored throughout the perioperative period. Data were analyzed using appropriate statistical tests, including ANOVA and nonparametric analyses.
Results: The results demonstrated that postoperative pain scores were significantly lower in the ketamine group compared to both the dexmedetomidine and control groups at all evaluated time points within the first 24 hours after surgery (P < 0.001). Although dexmedetomidine also provided effective analgesia compared with the control group, ketamine showed superior pain reduction. No statistically significant differences were observed among the three groups regarding hemodynamic parameters, indicating comparable cardiovascular stability.
.Conclusion: Intraoperative administration of ketamine was more effective than dexmedetomidine in reducing postoperative pain following laparoscopic cholecystectomy, without compromising hemodynamic stability. Nevertheless, both agents proved to be safe and effective options for postoperative pain management. Ketamine may be considered a preferable.
Methods: This randomized, double-blind, controlled clinical trial was conducted on 252 patients undergoing elective laparoscopic cholecystectomy. Patients were randomly assigned into three equal groups: ketamine, dexmedetomidine, and control. The ketamine group received an intravenous infusion of ketamine at a dose of 0.5 mg/kg/h, the dexmedetomidine group received 0.6 µg/kg/min of dexmedetomidine, and the control group received normal saline. Pain intensity was assessed using the Visual Analogue Scale (VAS) at 1, 6, 12, and 24 hours postoperatively. Hemodynamic parameters, including heart rate and mean arterial pressure, were continuously monitored throughout the perioperative period. Data were analyzed using appropriate statistical tests, including ANOVA and nonparametric analyses.
Results: The results demonstrated that postoperative pain scores were significantly lower in the ketamine group compared to both the dexmedetomidine and control groups at all evaluated time points within the first 24 hours after surgery (P < 0.001). Although dexmedetomidine also provided effective analgesia compared with the control group, ketamine showed superior pain reduction. No statistically significant differences were observed among the three groups regarding hemodynamic parameters, indicating comparable cardiovascular stability.
.Conclusion: Intraoperative administration of ketamine was more effective than dexmedetomidine in reducing postoperative pain following laparoscopic cholecystectomy, without compromising hemodynamic stability. Nevertheless, both agents proved to be safe and effective options for postoperative pain management. Ketamine may be considered a preferable.
Elham Shafighi Shahri , Akram Ehsasatvatan, Sara Rigy Nejad ,
Volume 83, Issue 7 (October 2025)
Volume 83, Issue 7 (October 2025)
Abstract
Background: Phenylketonuria (PKU) is a genetic metabolic disorder that, if left untreated, leads to irreversible cognitive, behavioral, and neurological damage. Sistan and Baluchestan and West Azerbaijan provinces are among the regions that have reported high rates of the disease due to specific ethnic characteristics. This study aims to compare the frequency and pattern of clinical symptoms in the two provinces of Sistan and Baluchestan and West Azerbaijan. Methods: This cross-sectional descriptive-analytical study was conducted on 60 patients with PKU who had been referred to Imam Ali Hospital (Zahedan) and Urmia Hospital during the past ten years. Data were collected from medical records and structured interviews. Results: The mean age of the patients was 5.67 ± 6.98 years. The mean height, weight, and head circumference were 30.28 ± 113.08 cm, 13.22 ± 25.13 kg, and 1.83 ± 43.36 cm, respectively. The mean serum phenylalanine level at the time of diagnosis was 13.58 ± 14.65 mg/dL. Of the 60 patients, 31 (51.7%) were male and 29 (48.3%) were female. The difference between the two sexes in the occurrence of clinical symptoms was not statistically significant (p<0.05). Psychiatric disorders were reported in 20 (33.3%) of the patients. The prevalence of these disorders was significantly higher with increasing age (p = 0.041). Conclusion: This study indicates the existence of significant regional differences in the clinical manifestations of phenylketonuria; such that patients from Sistan and Baluchestan province experienced a higher rate of psychiatric and neurological symptoms than patients from West Azerbaijan. The severity of symptoms increased with increasing age and duration of illness, emphasizing the importance of early diagnosis and continuous therapeutic follow-up. It was also noteworthy that some patients still had severe clinical symptoms despite having lower phenylalanine levels at diagnosis. Overall, the findings of this study emphasize the need for early diagnosis, equitable access to health services, and sustained metabolic control to improve outcomes for PKU patients in the country. |
Mohammad Mehdi Khatib Shahidi, Ali Sadoogh Abbasian , Maliheh Safari ,
Volume 83, Issue 7 (October 2025)
Volume 83, Issue 7 (October 2025)
Abstract
Background: Cisplatin is one of the most effective chemotherapy agents; however, its nephrotoxicity remains the primary dose-limiting factor. This study aimed to determine the prevalence and clinical course of acute kidney injury (AKI) in patients receiving high-dose cisplatin therapy.
Methods: This cross-sectional descriptive study was conducted at Ayatollah Khansari Hospital in Arak, based on clinical records of hospitalized patients from March 2021 to June 2022. Patients who received at least four cycles of cisplatin-based chemotherapy at a dose of 260 mg/m² were included. Data were extracted from the Hospital Information System (HIS) and physical records. Ninety eligible cases were selected via random sampling. Data were summarized using descriptive statistics.
Results: Regarding gender distribution, 54.4% were female (n=49) and 45.6% were male (n=41). The relative frequency of cisplatin-induced AKI was 21.11%. Overall, 26.32% of patients developed chronic kidney disease (CKD), 10.53% reached end-stage renal disease (ESRD), and only 11.42% recovered. An 18 to 24-month follow-up revealed a mortality rate of 21.05%, while 15.79% required treatment modification, and 5.26% needed kidney transplantation. No treatment discontinuation was observed. Logistic regression analysis identified female gender, age 61-70, age >70, poor hydration status, five or more chemotherapy cycles, and diabetes mellitus as significant risk factors for AKI.
Conclusion: High-dose cisplatin is associated with a high risk of permanent renal damage. Given the low recovery rate and the potential for progression to chronic renal failure, careful monitoring of risk factors and rigorous hydration management are vital for these patients.
Methods: This cross-sectional descriptive study was conducted at Ayatollah Khansari Hospital in Arak, based on clinical records of hospitalized patients from March 2021 to June 2022. Patients who received at least four cycles of cisplatin-based chemotherapy at a dose of 260 mg/m² were included. Data were extracted from the Hospital Information System (HIS) and physical records. Ninety eligible cases were selected via random sampling. Data were summarized using descriptive statistics.
Results: Regarding gender distribution, 54.4% were female (n=49) and 45.6% were male (n=41). The relative frequency of cisplatin-induced AKI was 21.11%. Overall, 26.32% of patients developed chronic kidney disease (CKD), 10.53% reached end-stage renal disease (ESRD), and only 11.42% recovered. An 18 to 24-month follow-up revealed a mortality rate of 21.05%, while 15.79% required treatment modification, and 5.26% needed kidney transplantation. No treatment discontinuation was observed. Logistic regression analysis identified female gender, age 61-70, age >70, poor hydration status, five or more chemotherapy cycles, and diabetes mellitus as significant risk factors for AKI.
Conclusion: High-dose cisplatin is associated with a high risk of permanent renal damage. Given the low recovery rate and the potential for progression to chronic renal failure, careful monitoring of risk factors and rigorous hydration management are vital for these patients.
Moghgan Samet Zadeh , Sahar Nikouzad Shahraki , Mohammad Ghasem Hanafi ,
Volume 83, Issue 7 (October 2025)
Volume 83, Issue 7 (October 2025)
Abstract
|
Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases worldwide and is closely associated with metabolic syndrome and insulin resistance. Growing evidence suggests a link between NAFLD and cardiovascular diseases, independent of traditional risk factors. Coronary computed tomography angiography (CCTA) is a reliable noninvasive method for evaluating coronary artery disease (CAD) and identifying high-risk coronary plaque characteristics. However, data regarding the association between NAFLD and high-risk coronary plaques remain limited, particularly in Iran. This study aimed to evaluate the prevalence of NAFLD in patients with high-risk coronary plaques detected by CCTA. Methods: In this cross-sectional study, 200 patients who underwent CCTA for the evaluation of coronary plaques in outpatient clinics or the emergency department of Golestan Hospital in ahvaz ,1403 ,were enrolled. Demographic data, including age, sex, weight, and body mass index (BMI), along with clinical characteristics and cardiovascular risk factors such as hypertension, diabetes mellitus, dyslipidemia, smoking status, and medical history were collected. Patients with a history of alcohol consumption or known liver disease were excluded. NAFLD was assessed based on imaging findings. Statistical analyses were performed to compare variables between patients with and without NAFLD. Results: The mean age of patients with NAFLD was 57.89 ± 9.72 years, compared with 55.77 ± 8.97 years in patients without NAFLD, with no statistically significant difference. The prevalence of NAFLD was slightly higher in women than men; however, this difference was not significant. Patients with NAFLD had a significantly higher mean weight than those without NAFLD (85.21 ± 12.12 kg vs. 79.62 ± 11.85 kg; p = 0.001). Additionally, the prevalence of NAFLD increased significantly with higher BMI categories, particularly in obese individuals. Conclusion: Age and gender were not significantly associated with NAFLD prevalence in patients with high-risk coronary plaques. In contrast, increased body weight and higher BMI, especially obesity, were independently associated with a higher risk of NAFLD in this population. |
Somayeh Abbaspour , Hassan Karimi, Maryam Farzaneh , Zahra Karimi , Shirin Azizidoost ,
Volume 83, Issue 7 (October 2025)
Volume 83, Issue 7 (October 2025)
Abstract
Background: The duration of hospitalization of patients is considered an important indicator in health resource management and patient evaluation. This study investigated the frequency and causes of readmission in cardiovascular patients
Methods: This was a retrospective study of 105 patients with cardiovascular diseases referred to Imam Khomeini Hospital in Ahvaz who were readmitted from April 2024 until August 2024 within 30 days after discharge due to recurrence of symptoms. Demographic (including age and gender) and clinical information (including duration of hospitalization, regular medication use, regular physician visits, disease diagnosis and dietary adherence) of the patients was extracted from electronic records using a researcher-made checklist.
Results: From 105 patients, 43 (41%) were admitted in the first trimester and 62 (59%) in the second trimester. The mean age of patients in the first trimester was higher than in the second trimester with a statistically significant association with readmission (P=0.038). Most patients were male and their number was higher in the second trimester than in the first trimester and a statistically significant association was observed between the gender of patients with readmission in the first trimester compared to the second trimester (P=0.015). 72 patients with acute coronary syndrome (68.6%) and 33 patients with heart failure (31.4%) were readmitted. The mean length of stay in the first trimester was 1.6 ± 1.15 days and 2.9 ± 2.7 days in the second trimester. A significant association was observed between the duration of hospitalization and readmission (P=0.003). However, no association was observed between regular medication use and regular physician visits in readmitted patients. However, a significant association was observed between dietary adherence in readmitted patients (P=0.045).
Conclusion: Readmission of cardiovascular patients follows a seasonal pattern and is associated with factors such as age, sex, length of stay, and dietary adherence. Routine disease management measures are not sufficient to counteract these effects, and targeted educational programs are necessary at the threshold of high-risk periods.
Methods: This was a retrospective study of 105 patients with cardiovascular diseases referred to Imam Khomeini Hospital in Ahvaz who were readmitted from April 2024 until August 2024 within 30 days after discharge due to recurrence of symptoms. Demographic (including age and gender) and clinical information (including duration of hospitalization, regular medication use, regular physician visits, disease diagnosis and dietary adherence) of the patients was extracted from electronic records using a researcher-made checklist.
Results: From 105 patients, 43 (41%) were admitted in the first trimester and 62 (59%) in the second trimester. The mean age of patients in the first trimester was higher than in the second trimester with a statistically significant association with readmission (P=0.038). Most patients were male and their number was higher in the second trimester than in the first trimester and a statistically significant association was observed between the gender of patients with readmission in the first trimester compared to the second trimester (P=0.015). 72 patients with acute coronary syndrome (68.6%) and 33 patients with heart failure (31.4%) were readmitted. The mean length of stay in the first trimester was 1.6 ± 1.15 days and 2.9 ± 2.7 days in the second trimester. A significant association was observed between the duration of hospitalization and readmission (P=0.003). However, no association was observed between regular medication use and regular physician visits in readmitted patients. However, a significant association was observed between dietary adherence in readmitted patients (P=0.045).
Conclusion: Readmission of cardiovascular patients follows a seasonal pattern and is associated with factors such as age, sex, length of stay, and dietary adherence. Routine disease management measures are not sufficient to counteract these effects, and targeted educational programs are necessary at the threshold of high-risk periods.
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