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Showing 6 results for Treatment.

Mansoureh Toghae , Mohammad Reza Ghini , Seyed Mohammad Hassan Pak-Nejad, Elahe Taghvaii Zahmat Kesh , Tayeb Ramim ,
Volume 71, Issue 12 (3-2014)
Abstract

Background: Many drugs have been abused by patients for headache management. Celecoxib has not been abuse widely as a pain relief drug for headache. The aim of this study was comparison between celecoxib and prednisolone in bridge stage therapy following medication overuse headache. Methods: A double-blind randomized clinical trial was done in patients admitted to a private headache clinic in Tehran, Iran at 2012. Patients were selected with 18- 65 years old and 15 days headache per month at least. Prednisone was administered as a 75 mg/day, 50 mg/day, 30 mg/day, 25 mg/day and 10 mg/day dose, in 3 days interval. Celecoxib was administered as a 100mg dose three times per day (first 5 days), twice per day (second 5 days) and one time per day (third 5 days). Headache time, headache intensity, headache duration, analgesic consumption due to severe headache and drug side effects was assessed. We used the visual analog scale to determine the severity of the pain. Results: One hundred and three patients were enrolled in two groups: celecoxib (53 cases) and prednisolone (50 cases). Twenty and one men and eighty and one women with a mean age of 33.62±9.65 years participated in the study. The maximum fre-quency for headache time in the celecoxib group was 1-4 hours (19 cases) and more than four hours (19 cases). In the prednisolone group the maximum frequency for headache time was more than 4 hours (28 cases) (P=0.149). The frequency of side effects of prednisolone and celecoxib groups were 42% and 18.9%, respectively (Relative Risk=2.2, P=0.011). The most common side effects in both groups were weakness and lethargy. Conclusion: Considering the positive effect of both drugs in reducing patients' head-ache during withdrawal, celecoxib compared with prednisolone has better efficacy and fewer side effects.
Ahmadreza Assareh, Maryam Jozaei, Hoda Mombeini , Nehzat Akiash ,
Volume 79, Issue 10 (1-2022)
Abstract

Background: In patients with ST-segment elevation myocardial infarction (STEMI), Primary percutaneous coronary intervention (PCI) is the preferred reperfusion therapy. Timely primary PCI is essential in improving the clinical outcomes of these patients. The aim of this study was to evaluate the factors affecting balloon delay in STEMI treated patients by primary PCI and its relationship with major adverse cardiac events (MACE).
Methods: This prospective observational study was conducted on 143 cases of STEMI patients, who had the inclusion criteria and were treated by primary PCI, after obtaining written consent in Imam Khomeini hospital in Ahvaz, between May 2019 to May 2020. All-time components from symptom onset to PCI treatment include symptom-to-balloon time or ischemic time, symptom-to-door time and door-to-balloon time calculated. The incidence of major adverse cardiovascular events (MACE) including decompensated heart failure (DHF), acute coronary syndrome (ACS), sudden cardiac death (SCD) and cerebrovascular accident (CVA) was evaluated during 12 months follow up after primary PCI. left ventricular ejection fraction (LVEF) changes were evaluated 3 months after primary PCI.
Results: The median symptom-to-door time was 200.5 minutes (IQR: 90-438.75 min), the median ischemic time was 406 minutes (IQR: 231-671 min), and most patients had an ischemic time ≥120 minutes (92.4%) and door-to-device time ≥90 minutes (64.3%). The most common delay for treatment was in the symptom-to-door time (76.9%) and then the decision for primary PCI to transfer to the cat lab (17.5%). Overall, 59 (41.3%) of the patients experienced MACE during 1-year of follow-up, including ACS (13.3%), DHF (22.4%), cardiac death (9.8%) and CVA (2.1%). The patients age (OR: 0.96, P=0.020), LVEF changes (OR: 1.123, P=0.005) and STEMI type (OR: 0.705; P=0.039) predicted in-hospital MACE, while the symptom-to-balloon time (P=0.607) and door-to-balloon time (P=0.347) were not associated with MACE.
Conclusion: None of the time intervals were associated with the occurrence of MACE in one-year follow-up, and most STEMI patients were admitted to the hospital with a long delay. Therefore, efforts to shorten the time of hospitalization admission can help improve the MACE in STEMI patients under primary PCI in our medical centers.

Mehdi Alemrajabi, Seyed Hamze Musavi , Behrouz Seydi Majd , Tayeb Ramim,
Volume 80, Issue 2 (5-2022)
Abstract

Background: Supralevator abscesses make up to 9% of all cryptoglandular abscesses. Given that platelet-rich fibrin accelerates tissue growth and reduces infection, it seems necessary to investigate its effect on the healing of fistula wounds because it can accelerate the healing of morbid wounds and reduce its effect on recurrence.
Methods: The study was performed as a single-blind clinical trial in patients who were referred to the surgical clinic of Rasoul Akram Hospital (PBUH), with the approval of the supralevator collection. Before surgery, Wexner Score were identified in patients who underwent surgery, and the entire path of fistulas and cavities was identified. Clinical outcomes were monitored one day after surgery for up to two months once a week, then every month until complete recovery, and then six months after surgery. After the operation, the patients were examined for recurrence, until the PRF was absorbed, the dressing of the operation site was performed only with normal saline, and the patients were on a low-residue diet so that they could not excrete as much as possible.
Results: 10 people participated in the final analysis. The mean age of patients was 33.20 years (26-46 years). Three patients had a history of perianal abscess surgery, two patients had a history of fistula surgery and 1 patient had a history of Fisher surgery. The mean closing time of the cavity was 14.2 days (10-22 days). Two patients (20%) had a fever and two patients (20%) had a surgical site infection. Bleeding and recurrence were not observed in any of the patients. The mean preoperative Wexner score was 0.80±0.76 Which decreased to 0.68±0.50 postoperatively (P=0.045).
Conclusion: Finally, the findings of the study showed that the use of PRF to repair a complex fistula is a method that can be easily repeated with minimal side effects and can heal wounds caused by fistulas with supralevator collection. This treatment can play an important role in the treatment of complex fistulas that have moderate or extensive involvement with the sphincter, or the occurrence of fistulas with sphincter dysfunction.

 

Naser Ebrahimi Daryani , Mohammad Reza Pashaei ,
Volume 80, Issue 6 (9-2022)
Abstract

Nonalcoholic fatty liver disease (NAFLD) is defined by steatosis in more than 5% of liver cells, in the absence of a secondary cause such as drugs, alcohol, or other causes. The incidence of NAFLD is increasing every day; almost a quarter of the world's adult population is affected by this disease. The burden of NAFLD is affected by the epidemics of obesity and type 2 diabetes (T2DM), and therefore, we do not expect the prevalence of this disease to decrease in the future. The world is now in the process of passing on health to non-chronic diseases, like NAFLD. The most common cause of chronic liver disease worldwide is non-alcoholic fatty liver disease. About 25 percent of the world's population is affected by the disease, and it ranges from simple steatosis to cirrhosis. 1 in 4 individuals with NAFLD is a person with non-alcoholic steatohepatitis, which is associated with complications and significant mortality and morbidity due to complications such as liver cirrhosis and hepatocellular carcinoma. Non-alcoholic fatty liver disease is closely related to metabolic syndrome, and it can be said that the liver is an integral part of obesity. Diagnostic methods for this disease include laboratory tests, imaging studies and liver biopsy. Although NAFLD is observed predominantly in obese persons or type 2 diabetes, an estimated 7% to 20% of people with NAFLD have lean body habitus. Recent studies have shown that fatty liver can occur in lean individuals, even without abdominal and visceral fat. Fatty liver in lean people (Lean NAFLD) is a relatively new concept that has attracted many people to find the differences between lean and obese people. The pathophysiological mechanisms of lean NAFLD are still poorly understood. Studies have shown that NAFLD without obesity is more closely related to factors such as environmental, genetic susceptibility, and epigenetic regulation. In addition to lifestyle modifications such as weight loss, diet and physical activity, only a few NAFLD-specific drug treatment options such as vitamin E and pioglitazone are considered. This article discusses the pathogenesis of fatty liver in lean individuals, its treatment, prognosis, and its relationship with metabolic syndrome.

Seyed Kamal Eshagh Hossaini , Javad Hakimelahi, Mohammad Aghaali, Zahra Mehrabi, Rasool Karimi Matlob , Saeed Karimi Matlob,
Volume 80, Issue 10 (1-2023)
Abstract

Background: Idiopathic thrombocytopenic purpura (autoimmune), the most common cause of acute onset of thrombocytopenia in children who are otherwise healthy. This study was conducted with the aim of investigating the factors affecting the response to treatment in hospitalized children.
Methods: This retrospective study was conducted by examining the files of patients hospitalized due to ITP in Hazrat Masoumeh (S) Hospital from April 2009 to March 2019. The criteria for inclusion in the study included confirming the diagnosis of ITP and the age of 1 month to 14 years, and the exclusion criteria included cases of discharge with personal consent and not completing the patient's treatment course, the presence of pancytopenia or bicytopenia, the presence of moderate or severe splenomegaly or severe in clinical examinations, BMA based on the presence of a diagnosis other than ITP, not receiving any of the ITP treatment protocols, and patients whose first visit with the diagnosis of ITP was in another center or city. The information about age, sex, clinical symptoms on arrival, initial platelets and the platelets of days 3, 5, 14 and 180 were extracted from the patients' files. The type of treatment protocol, the need to repeat the treatment, the recurrence of the disease and the major complications of the treatment were extracted from the patients' files and finally the data were analyzed with SPSS software.
Results: The response to the treatment on different days was unrelated to the age, gender, and initial platelets (except for one exception) (P>0.05). In relation to clinical symptoms, the response to treatment on days three and five was related to the clinical symptoms at the time of presentation and on days 14 and 180 it was unrelated. Response to treatment on days 3 and 5 in different treatment protocols had a significant relationship (P<0.05), but there was no significant difference on days 14 and 180.
Conclusion: The best response was in the combined treatment group with methylprednisolone and IVIg, and the lowest response to treatment was observed in those receiving methylprednisolone alone.

Mohammad Reza Sabri, Bahar Dehghan, Mahsa Rafiee Alhossaini ,
Volume 81, Issue 1 (4-2023)
Abstract

Background: Syncope is a temporary loss of consciousness with a loss of postural tone. Medicinal treatment of reflex syncope has shown to have no significant effect in reducing the recurrence of syncope. A 36-month follow-up of our pilot cohort showed that non-pharmacological treatments alone were effective in reducing relapse rates. The purpose of this study is to investigate long-term results and 8-year follow-up of previous patients.
Methods: The current study is a continuation of a prospective pilot cohort which was done between August 2013 and 2014 in two academic hospitals in Isfahan (Dr. Chamran heart center and Imam Hossein children hospitals). This current study examines the 8-year follow-up results of children with reflex syncope who were treated with non-pharmacological treatments alone or with drugs. Therefore, the patients who participated in the pilot study were enrolled (30 patients in the pharmacologic group and 40 patients non-pharmacological group). Finally, on 26 patients in the pharmacologic group and 31 patients in the non-pharmacological group (after applying the exclusion criteria), the incidence of syncope and pre-syncope attacks was compared between these two groups of patients using the Chi-square test.
Results: Our study showed that within 5 years after the last follow-up, the incidence of syncope and pre-syncope in patients with a history of vasovagal syncope who did not continue the diet or tilt exercises was different between the two groups of patients (without medication and drug recipient) was not significantly different, even the incidence of presyncope increased significantly again in both groups. The incidence of syncope in the period of 5 years after the last follow-up from the previous study was slightly increased in the group of patients without medication compared to the previous periods, but in the group of patients receiving medication, this incidence decreased slightly.
Conclusion: In order to prevent recurrence, the use of non-pharmacological methods is effective, but for the stability of this recovery, follow-up and continuation of these methods is necessary.


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