Objective:To investigate the pattern of antibiotic resistance and biofilm production capabilities of clinical Acinetobacter baumannii(A.baumannii)isolates in this study.Methods:A.baumannii isolates were collected from...Objective:To investigate the pattern of antibiotic resistance and biofilm production capabilities of clinical Acinetobacter baumannii(A.baumannii)isolates in this study.Methods:A.baumannii isolates were collected from Tehran Imam Khomeini Hospital in this cross-sectional study,and the minimum inhibitory concentrations for 16 antibiotics were determined using Vitek2®systems.All isolates were analyzed for biofilm production,then presence of biofilm-associated genes,and class Ⅰ and Ⅱ integron genes.Results:60 non-replicate A.baumannii isolates were included in this study.The resistance rates reached 100%for aztreonam,cefepime,ceftazidime,ciprofloxacin,piperacillin-tazobactam,piperacillin,ticarcillin,and trimethoprim-sulfamethoxazole.A.baumannii isolates were most sensitive to colistin and rifampicin being the most effective treatments.Multi-drug resistant and extensively drug-resistant isolates accounted for 83.3%and 16.7%,respectively.Of the isolates,91.6%formed biofilms,categorized as 10%strong,31.6%moderate,and 50%weak.No correlation was found between antibiotic resistance and biofilm formation.The genes csuE,abaI,and ompA were prevalent,but their distribution was similar across biofilm categories.A relationship between Int1 and biofilm production was noted.Conclusions:The high rates of antibiotic resistance and biofilm formation,alongside the presence of integrons including class Ⅰ and Ⅱ,underscore the necessity for ongoing monitoring of A.baumannii.Notably,classⅠintegron presence was significantly linked to biofilm formation.Further research is needed to explore the connection between antibiotic resistance and biofilm production in A.baumannii.展开更多
Objective:To explain barriers to childbearing among working women from the perspective of working women and midwives.Methods:In this study,a qualitative study of content analysis method was employed.The study was cond...Objective:To explain barriers to childbearing among working women from the perspective of working women and midwives.Methods:In this study,a qualitative study of content analysis method was employed.The study was conducted from December 2021 to July 2022.The population consisted of working women and midwives.Data collection was conducted using semi-structured interviews and continued until data saturation was achieved.Through purposeful sampling,10 women and 11 midwives were selected as the sample.The data were analyzed by Graneheim and Lundman content analysis approach.For more rigorous,Nvivo 14 software was also used for data management,analysis,coding and organization of data.Results:This study included 21 women(10 women employees and 11 midwives)aged 25-43 years(for women employees)and 27-56 years(for midwives)with 1 to 34 years of job experience.In examination of participant’views about the barriers to childbearing,1124 codes were identified,of which we managed to extract six subthemes and two themes.Two themes emerged:“lack of social support and lack of family support”.Subthemes of“lack of social support”were“inadequate leave,long distance from workplace,and insufficient wages”.Subthemes of“lack of family support”were“lack of spouse support,lack of spouse's family support,and lack of their family support”.Conclusions:Different socioeconomic factors influence childbearing tendency in working women.Social and family supports play an important role in this regard.It is important to take these factors into account at the time of policymaking in the field of midwifery.展开更多
Objective:To investigate the prevalence,mechanisms,and trends of knockdown resistance(kdr)in Anopheles(An.)culicifacies and its impact on the efficacy of organochlorine and other insecticides.Methods:A systematic revi...Objective:To investigate the prevalence,mechanisms,and trends of knockdown resistance(kdr)in Anopheles(An.)culicifacies and its impact on the efficacy of organochlorine and other insecticides.Methods:A systematic review was conducted based on PRISMA guidelines,extracting data from biooan.org,Embase,ProQuest,PubMed,Scopus,and Web of Science without a time limit until the end of 2022.Articles meeting the inclusion criteria were assessed using the STROBE checklist.Data on kdr mutations,insecticide resistance,and effectiveness were analyzed across eight selected studies from various regions.Results:The review revealed widespread kdr-mediated resistance in An.culicifacies,primarily against dichloro-diphenyl-trichloroethane(DDT),persisting even decades after discontinued use.Key kdr mutations,including L1014F and L1014S,were identified.Resistance to deltamethrin was less stable,with increased sensitivity observed after short-term discontinuation.The findings underscore the vector's sustained resistance to organochlorine insecticides and relative sensitivity to pyrethroids.Conclusions:Stable kdr resistance in An.culicifacies to organochlorine insecticides highlights the need for periodic susceptibility assessments and strategic rotation or combination of insecticides to combat malaria effectively and prevent the development of resistance.展开更多
Objective:To determine patterns of antimicrobial resistance,analyze the prevalence of oxacillinase and molecular typing of strains of Acinetobacter baumannii(A.baumannii).Methods:A total of 121 strains of A.baumannii ...Objective:To determine patterns of antimicrobial resistance,analyze the prevalence of oxacillinase and molecular typing of strains of Acinetobacter baumannii(A.baumannii).Methods:A total of 121 strains of A.baumannii were obtained from patients admitted to Imam Hossein and Imam Khomeini Hospitals,Tehran,Iran,from January 2016 to November 2018.Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method according to the Clinical and Laboratory Standards Institute recommendations.The presence of oxacillinase genes was assessed by polymerase chain reaction(PCR).To determine clonal relatedness,all isolates were subjected to repetitive sequence-based PCR(REP-PCR).Results:The isolates were obtained from 56(46.3%)males and 65(53.7%)females with the mean age of 39.5 years.Colistin with 100.0%sensitivity rate had the highest effect,while ceftriaxone with 16.5%sensitivity rate had the least effect on A.baumannii isolates.In addition,96(79.3%)and 99(81.8%)isolates were resistant to imipenem and meropenem,respectively.A total of 109 isolates(90.0%)exhibited multiple drug resistance with 10 different resistotypes.In total,75(75.7%)of carbapenem resistant isolates were positive for blaOXA-23-like,and 14(14.1%)for blaOXA-24-like gene.The five main clones A,B,C,D,and E were detected in 25(25.2%),36(36.4%),10(10.1%),8(8.0%),and 6(6.1%)of isolates,respectively.Conclusions:Carbapenem-resistant A.baumannii strains are high in the current study.To control the spread of carbapenem-resistant A.baumannii strains,regular monitoring programs are needed.展开更多
Objective: To evaluate different doses of ivermectin in adult patients with mild COVID-19 and to evaluate the effect of ivermectin on mortality and clinical consequences.Methods: A randomized, double-blind, placebo-co...Objective: To evaluate different doses of ivermectin in adult patients with mild COVID-19 and to evaluate the effect of ivermectin on mortality and clinical consequences.Methods: A randomized, double-blind, placebo-controlled, multicenter clinical trial was performed at five hospitals. A total of 180 mild hospitalized patients with COVID-19 confirmed by PCR or chest image tests were enrolled and allocated to six arms including hydroxychloroquine 200 mg twice per day, placebo plus hydroxychloroquine 200 mg twice per day, single dose ivermectin(200 μg/kg), three low interval doses of ivermectin(200, 200, 200 μg/kg), single dose ivermectin(400 μg/kg), and three high interval doses of ivermectin(400, 200, 200 μg/kg). The primary endpoint of this trial was all-cause of mortality or clinical recovery. The radiographic findings, hospitalization and low O_2 saturation duration, and hematological variables of blood samples were analyzed. Results: A total of 16.7%(5/30) and 20.0%(6/30) patients died in arms treated with hydroxychloroquine 200 mg twice per day and placebo plus hydroxychloroquine 200 mg twice per day, respectively, and a reduction in mortality rate in patients receiving ivermectin treatment to 0%, 10%, 0% and 3.3% for arms 1-4 were observed. Risk of mortality was also decreased about 15% in the ivermectin treated arms. Conclusions: Ivermectin as an adjunct reduces the rate of mortality, time of low O_2 saturation, and duration of hospitalization in adult COVID-19 patients. The improvement of other clinical parametersshows that ivermectin, with a wide margin of safety, had a high therapeutic effect on COVID-19.展开更多
<strong>Background: </strong>Cardiac rehabilitation (CR) is a multifaceted treatment that can increase the survival and quality of life of cardiac patients by increasing their functional capacity (FC). In ...<strong>Background: </strong>Cardiac rehabilitation (CR) is a multifaceted treatment that can increase the survival and quality of life of cardiac patients by increasing their functional capacity (FC). In this study, we aimed to investigate the FC changes of cardiac patients after the CR program in different subgroups in terms of anthropometric, clinical, and psychological indices. <strong>Materials and Methods:</strong> This is a descriptive retrospective study that has been derived from the results of a Cohort study at the Rehabilitation Research Center of the Cardiovascular Research Institute of Isfahan (Iran), from 2006 to 2017. In this study, the dependent variable is functional capacity changes based on Mets obtained in exercise testing at the beginning and end of the CR program. Independent variables included age, sex, dyslipidemia, diabetes, smoking, and Body mass index, type of intervention, depression, and EF. <strong>Results:</strong> The sample size is 1250 cardiovascular patients, of which 917 (73.5%) are male and 331 (26.5%) are female. Functional capacity after the CR program significantly increased in all age, gender, body mass index, hypertension, hyperlipidemia, diabetes, smoking, depression, EF, and type of operation performed (angioplasty or open-heart surgery) subgroups, (p < 0.001). Using multiple linear regression analysis, a significant relationship was found between Mets changes and only the variables of gender, depression, and EF. <strong>Conclusion:</strong> The results of this study show the importance of rehabilitation programs in the secondary prevention of cardiovascular disease in different subgroups and factors such as gender, level of primary depression, and EF less than 35 are the most important factors affecting functional capacity increase after CR program in heart patients.展开更多
Objective:To conduct changes in sexual activity during pregnancy and its related factors in pregnant women.Methods:The present descriptive cross-sectional study was conducted in 2017 on pregnant women who referred to ...Objective:To conduct changes in sexual activity during pregnancy and its related factors in pregnant women.Methods:The present descriptive cross-sectional study was conducted in 2017 on pregnant women who referred to the women's clinic of Afzalipour Hospital in the southeast of Iran.Participants were included in the study through convenient sampling.The data collection tool was a researcher-made questionnaire consisting of two parts of personal social information of the couple and questions to measure the level of sexual activity and the attitude of the subjects during pregnancy compared to before pregnancy.Results:201 Pregnant women were included.The average age of pregnant women was(27.3±6.1)years and their average gestational age was(24.7±11.8)years.More than 62%of women had decreased sexual activity.There was a significant relationship between the amount of changes in sexual activity and delivery time(P=0.013),abortion history(P=0.001)and premature birth history(P=0.002).Most pregnant women believed that sex during pregnancy caused damage to the fetus(67.7%).A decrease in the intensity of sexual desire was reported in 63%of pregnant women.More than 60%of the subjects did not consult with doctors and midwives with regards to sexual issues(63.5%).The most common reason for not consulting was not feeling the need(32%).Most women experienced back pain during(42.8%)and after(39.8%)intercourse.Conclusions:Changes in sex life during pregnancy are often caused by the lack of sexual knowledge and the increase in misconceptions among couples,which can affect the quality of relationships.The role of education is essential.Therefore,it is suggested that by including sexual counseling along with pregnancy care,wrong beliefs and information among women will be corrected.展开更多
Objective:This study aimed to perform an evaluation of changes in spermogram parameters after follicle-stimulating hormone(FSH)therapy in infertile males having oligo-asthenospermia at different levels of DNA fragment...Objective:This study aimed to perform an evaluation of changes in spermogram parameters after follicle-stimulating hormone(FSH)therapy in infertile males having oligo-asthenospermia at different levels of DNA fragmentation index(DFI).Materials and methods:Infertile men with oligo-asthenospermia,no underlying urogenital disease(such as varicocele),and medically fertile partners were enrolled over 1 year.Semen parameters,FSH,luteinizing hormone,and testosterone levels were determined;also,a Sperm DNA Fragmentation Assay Kit(Hamun Teb Pishro,Tehran,Iran)was used for determining sperm DFI at baseline.Participants were categorized into 3 groups based on DFI:DFI<15%(group 1),DFI of 15%-30%(group 2),and DFI>30%(group 3).All participants received subcutaneous recombinant FSH(150 mg every other day)for 6 months.Sperm specimens were tested 6months after intervention(a single sperm control test).Results:Sixty males whose average age was 28.4 years were enrolled.Only group 3(poor fertility)exhibited a significant rise in sperm concentration(p=0.001)and motility(p<0.05)after FSH treatment.Group 1(DFI<15%)and group 2(DFI of 15%-30%)showed increased mean sperm concentration and motility postintervention,although these alterations were not significantly different.Folliclestimulating hormone levels increased significantly in all 3 groups after FSH administration.Serum luteinizing hormone and testosterone levels were not significantly increased in any of the groups.Conclusions:Follicle-stimulating hormone treatment improves sperm concentration andmotility in men with oligo-asthenospermia,with significant improvements observed in men with DFI>30%.DNA fragmentation index can be a predictive indicator of response to FSH treatment in such patients.展开更多
AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observation...AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observational study, neonates weighing ≤2000 grams at birth or born <34 wk gestational age(GA) and all other infants at risk of ROP admitted to the neonatal intensive care unit(NICU) or referred to our ROP clinic were investigated. The incidence of ROP and severe ROP(i.e. patients needing treatment) were determined. The associations between risk factors and the development and severity of ROP were assessed. We also examined the sensitivity of the current national screening guideline in Iran. RESULTS: Among 207 infants, the incidence of ROP and severe ROP was 33.3% and 11.1%, respectively. Mean GA and birth weight(BW) were significantly lower in ROP vs non-ROP infants(29±2 wk vs 33±3 wk, P<0.001;1274±489 g vs 1916±550 g, P<0.001, respectively). Univariate analysis displayed significant association between ROP incidence and GA, BW, NICU admission period, blood transfusion, surfactant usage, sepsis, intraventricular hemorrhage and patent ductus arteriosus(P<0.05 for all). BW [relative risk(RR): 0.857(0.711-0.873), P<0.001], GA [RR: 0.788(0.711-0.873), P<0.001] and blood transfusion [RR: 1.888(0.995-3.583), P=0.052] were independent ROP risk factors. The sensitivity of country-specific screening guidelines was 95.7% and 100% for overall and severe ROP detection, respectively. CONCLUSION: ROP incidence is relatively high in Iran. Identifying ROP risk factors results in more accurate screening and reduces the risk of irreversible vision loss. The ROP screening criteria utilized in Iran are efficient at the present time.展开更多
Due to the acute and terrible pain that patients with renal colic experience,the most essential therapeutic priority for these patients in the emergency department(ED)is to reduce pain.[1]Although numerous medications...Due to the acute and terrible pain that patients with renal colic experience,the most essential therapeutic priority for these patients in the emergency department(ED)is to reduce pain.[1]Although numerous medications are utilized to reduce pain in patients with acute renal colic,no therapy has yet been developed to totally and quickly relieve pain.[2,3]Intravenous opioids and nonsteroidal anti-inflammatory drugs(NSAIDs)are commonly administered intravenously to control pain in these patients in the ED;however,the need for frequent monitoring for possible complications and relatively slow-acting features render these strategies undesirable.展开更多
The COVID-19 epidemic caused by SARS-CoV-2 virus has turned into a worldwide pandemic.Therefore,health officials all around the world have strived for developing efficient preventive and treatment methods to deal with...The COVID-19 epidemic caused by SARS-CoV-2 virus has turned into a worldwide pandemic.Therefore,health officials all around the world have strived for developing efficient preventive and treatment methods to deal with this global crisis.Amongst them,monoclonal antibodies,anti-TNFs,and convalescent plasma appear to be effective against this disease.In addition,clinical trials are currently being conducted for viral targeting vaccines.This review summarizes major advances using biopharmaceuticals in the treatment and prevention strategies against COVID-19 that have occurred in the global medicinal system from its introduction until March 2022.展开更多
Objective: Hydatidiform pregnancy occurs in 1:1000 pregnancies worldwide;incidence is higher in Asian countries. In approximately 5% of cases of hydatidiform mole, clinical hyperthyroidism is present. The aim of this ...Objective: Hydatidiform pregnancy occurs in 1:1000 pregnancies worldwide;incidence is higher in Asian countries. In approximately 5% of cases of hydatidiform mole, clinical hyperthyroidism is present. The aim of this study was to examine the relation between HCG level and thyroid function test. Methods: During 5 years (2009-2013) we included 146 cases of molar pregnancies into the study at Imam Reza teaching hospital. The demographic and clinical data as well as serum initial HCG level and thyroid function test (TSH T3 T4) were retrieved and entered into prepared proformas. p < 0.05 was considered significant. Result: The mean age of patients was 29.31 years;mean of gestational age was 11.71 weeks;mean of gravidity was 2.32;mean of serum BHCG was 3.88E4;mean of T4 was 11.07 and mean of T3 was 1.97. In this study significantly inverse relation was observed between B-HCG and TSH (p = 0.05). We also found a significantly direct correlation between B-HCG and T3 (p = 0.01) and T4 (p = 0.01). Conclusion: We concluded significantly meaningful relationship between BHCG and T3, T4, TSH.展开更多
Objective:To describe histopathologic findings in the placentas in women with coronavirus disease 2019(COVID-19)during pregnancy.Methods:In a cross-sectional study,38 pregnant women with COVID-19 and undergoing delive...Objective:To describe histopathologic findings in the placentas in women with coronavirus disease 2019(COVID-19)during pregnancy.Methods:In a cross-sectional study,38 pregnant women with COVID-19 and undergoing delivery between March 2020 and January 2022,were included.The patients had positive polymerase chain reaction(PCR)test for SARS-CoV-2 infection and the placentas after delivery were sent for histopathologic evaluation based on the Amsterdam Placental Workshop Group Consensus Statement and assessed by two pathologists.Results:Our results showed that maternal vascular malperfusion was the most common and was present in 17 cases(44.7%).These features included accelerated villous maturation(36.8%)distal villous hypoplasia(5.3%),placental infarction(5.3%)and intervillous fibrin deposition(10.5%).Other pathologic findings included focal calcification(10.5%),intravillous congestion and hemorrhage(10.5%),sub-chorionic hemorrhage(5.3%),acute villitis,chronic histiocytic intervillositis and delayed villous maturation each in one case(2.6%).Twelve out of 38 cases showed no significant pathologic changes.Fetal outcomes included neonatal intensive care unit admission rate of 13.2%,dyspnea 31.6%,newborn’s anosmia 7.9%,intrauterine fetal demise 2.6%,asphyxia 2.6%and neonate COVID infection 5.3%.Conclusions:Microvasculopathy,as a sign of maternal vascular malperfusion,is a common finding in placentas from SARS-CoV-2 positive pregnant women in the present study.Further studies with larger sample sizes and comparative studies between COVID-19 positive and negative,as well as information from patient follow-up are suggested.展开更多
BACKGROUND It has been said that the number of orthopaedic claims has increased in the last few years. Investigation through the most prevalent cause would help to prevent further cases.AIM To review the cases of medi...BACKGROUND It has been said that the number of orthopaedic claims has increased in the last few years. Investigation through the most prevalent cause would help to prevent further cases.AIM To review the cases of medical complaints in orthopedic patients who had been involved in a traumatic accident.METHODS A retrospective multi-center review of trauma orthopaedic-related malpractice lawsuits from 2010 to 2021 was conducted utilizing the regional medicolegal database. Defendant and plaintiff characteristics along with fracture location, allegations, and litigation outcomes were investigated.RESULTS A total of 228 claims referred to trauma-related conditions with a mean age of 31.29 ± 12.56 were enrolled. The most common injuries were at hand, thigh, elbow, and forearm, respectively.Likewise, the most common alleged complication was related to malunion or nonunion. In 47% of the cases, the main problem that led to the complaint was the inappropriate or insufficient explanation to the patient, and in 53%, there was a problem in the surgery. Eventually, 76% of the complaints resulted in a defense verdict, and 24% resulted in a plaintiff verdict.CONCLUSION Surgical treatment of hand injuries and surgery in non-educational hospitals received the most complaints. The majority of litigation outcomes were caused by a physician’s failure to fully explain and educate the traumatic orthopedic patients and technological errors.展开更多
Objective: Coronary Artery Disease (CAD) would continue to concern medical society in the foreseeable future. Determining the extent of coronary luminal stenosis is a key factor in management of CAD. Methods presently...Objective: Coronary Artery Disease (CAD) would continue to concern medical society in the foreseeable future. Determining the extent of coronary luminal stenosis is a key factor in management of CAD. Methods presently used are costly and pose certain dangers, ranging from nephrotoxicity to death. Long Pentraxin or Pentraxin-3 (PTX3) has been used to predict survival or atherosclerotic process, but not to identify coronary stenosis. Calcium Score has been used to this end with some success. Methods: Individuals with chronic stable angina, without evidence of Myocardial Infarction (MI), who were categorized as intermediate-risk after completing a treadmill exercise test, according to Duke Protocol, underwent cardiac catheterization. In addition, blood samples were drawn for coronary sinus PTX3, and also PTX3, uric acid, high-sensitivity C-reactive protein (hs-CRP), cholesterol, glucose and High-Density Lipo-protein (HDL) in peripheral circulation. Calcium Scores were calculated using Agatston Score and non-contrast multi-slice CT scan. Participants were divided according to the number of stenotic coronary arteries (patent, one-, two-and three-vessel disease). Results: We found that PTX3 levels in coronary sinus and femoral vein correlated with each other, after log-transforming the values. Also we found that PTX3 levels and Calcium Scores differed among individuals with triple-vessel involvement and individuals without significant stenosis in any of coronary arteries. No significant differences were observed, regarding hs-CRP levels. Conclusion: PTX3 levels in periphery correlate with those in coronary arteries, and this variable can be measured with a less invasive procedure. In addition to Calcium Score, PTX3 levels are different in our four groups. The combined contribution of PTX3 and calcium score may help us identify individuals with significant coronary artery stenosis without needing to perform cardiac catheterization in a select group of patients.展开更多
Background and Objectives: Several drugs and methods are used to reduce postoperative shivering, the most common complications occurring after surgery. This study aimed to evaluate the effects of the oral Clonidine an...Background and Objectives: Several drugs and methods are used to reduce postoperative shivering, the most common complications occurring after surgery. This study aimed to evaluate the effects of the oral Clonidine and Tramadol premedication in reducing postoperative shivering after spinal anesthesia. Materials and Methods: In this study, patients aged 20 - 60 years, based on the American Society of Anesthesia functional class I (Anesthesiologists grade-1), were included in controlled double-blind clinical trials. Each was a candidate of a hydrocele, varicocele, and inguinal hernia under spinal anesthesia. The patients were assigned to three groups and 1 h prior to surgery, group A received 0.2 mg of Clonidine, group B received 50 mg of a Tramadol tablet, and group C received a placebo. We collected information on the severity of shivering, pain intensity levels (VAS score), duration of analgesia, and the patients’ hemodynamic condition at base time of 5, 15, and 30 min and 1, 2, 4, and 6 h postoperatively. Results: The incidence of shivering was significantly lower in the Clonidine group than that in the other groups. Analgesia duration was significantly longer in the Clonidine group than that in the control group. In this study, side effects in different groups were not significantly different from each other. Conclusion: Results of this study showed that the oral administration of Clonidine can be effective in preventing the side effects and shivering after spinal anesthesia.展开更多
Possible strategies to reduce radiation dose during CT scanning have been investigated over recent decades;here the optimization of the tube current and its link with patient’s cancer incidence are being evaluated. 1...Possible strategies to reduce radiation dose during CT scanning have been investigated over recent decades;here the optimization of the tube current and its link with patient’s cancer incidence are being evaluated. 154 consecutive trauma patients with the need for chest CT scan were included. Two different BMI-adjusted CT protocols at a fixed voltage tube and the same scan length were applied. Dose estimation parameters like CT dose index (CTDI), dose length product (DLP) and effective breast dose were calculated. Breast surface dose was obtained by using thermoluminescence dosimeters (TLDs) and eventually, the life attributable risk (LAR) of cancer incidence was estimated. The mean effective dose was 4.87 ± 2.3 mSv and 5.12 ± 2.8 mSv for patients who were scanned with tube currents of 120 mAs and 200 mAs, respectively. There was no significant difference between organ surface doses for females but in males it was notable. The risk of cancer incidence is lower for protocol 1 in comparison with protocol 2. Optimizing tube current of 120 mAs reduced breast surface dose up to 50% in comparison with the tube current of 200 mAs. In trauma patients, using lower tube current based on BMI has notable impact on the absorbed dose in the breast and can reduce the breast cancer risk by nearly 33.6% for women.展开更多
Ventilator-associated pneumonia (VAP) is one of the most important hospital infections in hospitalized patients, which is associated with increased mortality and patient costs. The tracheal tube itself seems to be a m...Ventilator-associated pneumonia (VAP) is one of the most important hospital infections in hospitalized patients, which is associated with increased mortality and patient costs. The tracheal tube itself seems to be a major risk factor for VAP. Contaminated secretions pass through the endotracheal tube and reach the lungs. Also, bacteria form a bacterial biofilm on the tracheal tube and are transferred from there to the lungs. Different tracheal tube designs have been produced to overcome these cases. The purpose of this study is to investigate the effect of an Evac tracheal tube covered with antibiotics and normal on the incidence of pneumonia caused by the ventilator. Research method: 180 patients were randomly intubated in three groups of 60 people with three types of tracheal tubes, Evac and Bactiguard. Clinical examinations, endotracheal tube aspiration culture, and chest radiography were obtained from the patients and the incidence of VAP was calculated based on the CPIS standard. The relationship between the type of endotracheal tube and the incidence of VAP and the length of stay in the intensive care unit (ICU) and being discharged alive from the ICU were investigated. Findings and conclusions: The average incidence of VAP for the group of patients intubated with a conventional tracheal tube was 50%, EVAC was 45% and Bactiguard was 40%. The results showed that there is no significant relationship between the incidence of ventilator-induced pneumonia and the type of tracheal tube. The incidence of ventilator-induced pneumonia was not significantly reduced by suctioning subglottic secretions and Bactiguard tracheal tubes. It seems that using one method alone is not effective in reducing ventilator-induced pneumonia.展开更多
Purpose:Heavy menstrual bleeding(HMB)is one of the common causes of women in reproductive age referring to gynecology centers.Methods:In this review study,the causes of HMB were assembled from reliable books of Persia...Purpose:Heavy menstrual bleeding(HMB)is one of the common causes of women in reproductive age referring to gynecology centers.Methods:In this review study,the causes of HMB were assembled from reliable books of Persian Medicine(PM).To compare with new scientific evidence,the HMB characteristics were searched using databases including PubMed,Google Scholar and Scopus as well as valid references of current medicine books.Results:The causes of HMB in PM,similar to current medicine,are divided into three categories including functional,structural and drugs.Functional and drug causes in both schools of medicine are almost concordant.In the structural category,we can consider the presence of a mass in uterus,cervix,and vagina,as mentioned in PM,equivalent with polyps and leiomyomas.Also in PM,mucosal disturbances in this tissues match cervicitis and vaginitis properties.For some causes mentioned in PM such as Akele,Hekke,and weakness of uterus and its tissues,no equivalent was available in current medicine.Conclusions:There are more similarities in menstrual bleeding in both current and Persian Medicine.In some cases,patients present with HMB for which there is no known cause in current medicine.In these cases,the etiologies mentioned in Persian Medicine and their treatment can be used.展开更多
Objective: To assess the efficacy of a curcumin supplementation on cognitive abilities in women suffering from premenstrual syndrome(PMS) and dysmenorrhea. Methods: A randomized, triple-blind, placebocontrolled trial ...Objective: To assess the efficacy of a curcumin supplementation on cognitive abilities in women suffering from premenstrual syndrome(PMS) and dysmenorrhea. Methods: A randomized, triple-blind, placebocontrolled trial was conducted from December 2019 to March 2020. A total of 124 women who had both PMS and dysmenorrhea were enrolled, and were equally and randomly assigned to the curcumin group or placebo group, 62 cases in each. Each subject received either a capsule containing 500 mg of curcuminoid, or a placebo daily, for 10 days(7 days before and until 3 days after the onset of menstrual bleeding) over 3 menstrual cycles. The cognitive abilities questionnaire was used to measures cognitive functions in 7 specific areas. Adverse reactions were monitored during and after the trial in both groups. Results: Administration of curcumin was associated with a significant increase in memory score(P=0.002), inhibitory control and selective attention(P=0.020), and total cognitive ability task(P=0.024). In addition, significant increments were found in scores of memory(3.5±3.1 vs. 0.4±3.8 in the curcumin and placebo groups, respectively;P=0.035), inhibitory control and selective attention(3.0±3.7 vs. 0.4±3.7;P=0.027) and total cognitive abilities(8.3±12.3 vs. 2.2±12.4;P=0.025) in the curcumin group versus placebo groups. Curcumin was safe and well-tolerable in current clinical trial. Conclusion: Curcumin has a beneficial efficacy on cognitive function scores in women with PMS and dysmenorrhea, with improvements in memory, inhibitory control and selective attention.(Registration No. IRCT20191112045424N1, available at: https://www.irct.ir)展开更多
基金This study was financially supported by the Vice Chancellor for Research Affairs,Ilam University of Medical Sciences,Ilam,Iran(Project No.1326).
文摘Objective:To investigate the pattern of antibiotic resistance and biofilm production capabilities of clinical Acinetobacter baumannii(A.baumannii)isolates in this study.Methods:A.baumannii isolates were collected from Tehran Imam Khomeini Hospital in this cross-sectional study,and the minimum inhibitory concentrations for 16 antibiotics were determined using Vitek2®systems.All isolates were analyzed for biofilm production,then presence of biofilm-associated genes,and class Ⅰ and Ⅱ integron genes.Results:60 non-replicate A.baumannii isolates were included in this study.The resistance rates reached 100%for aztreonam,cefepime,ceftazidime,ciprofloxacin,piperacillin-tazobactam,piperacillin,ticarcillin,and trimethoprim-sulfamethoxazole.A.baumannii isolates were most sensitive to colistin and rifampicin being the most effective treatments.Multi-drug resistant and extensively drug-resistant isolates accounted for 83.3%and 16.7%,respectively.Of the isolates,91.6%formed biofilms,categorized as 10%strong,31.6%moderate,and 50%weak.No correlation was found between antibiotic resistance and biofilm formation.The genes csuE,abaI,and ompA were prevalent,but their distribution was similar across biofilm categories.A relationship between Int1 and biofilm production was noted.Conclusions:The high rates of antibiotic resistance and biofilm formation,alongside the presence of integrons including class Ⅰ and Ⅱ,underscore the necessity for ongoing monitoring of A.baumannii.Notably,classⅠintegron presence was significantly linked to biofilm formation.Further research is needed to explore the connection between antibiotic resistance and biofilm production in A.baumannii.
基金This study was supported by Kerman University of medical sciences,with grant number:95000387.
文摘Objective:To explain barriers to childbearing among working women from the perspective of working women and midwives.Methods:In this study,a qualitative study of content analysis method was employed.The study was conducted from December 2021 to July 2022.The population consisted of working women and midwives.Data collection was conducted using semi-structured interviews and continued until data saturation was achieved.Through purposeful sampling,10 women and 11 midwives were selected as the sample.The data were analyzed by Graneheim and Lundman content analysis approach.For more rigorous,Nvivo 14 software was also used for data management,analysis,coding and organization of data.Results:This study included 21 women(10 women employees and 11 midwives)aged 25-43 years(for women employees)and 27-56 years(for midwives)with 1 to 34 years of job experience.In examination of participant’views about the barriers to childbearing,1124 codes were identified,of which we managed to extract six subthemes and two themes.Two themes emerged:“lack of social support and lack of family support”.Subthemes of“lack of social support”were“inadequate leave,long distance from workplace,and insufficient wages”.Subthemes of“lack of family support”were“lack of spouse support,lack of spouse's family support,and lack of their family support”.Conclusions:Different socioeconomic factors influence childbearing tendency in working women.Social and family supports play an important role in this regard.It is important to take these factors into account at the time of policymaking in the field of midwifery.
文摘Objective:To investigate the prevalence,mechanisms,and trends of knockdown resistance(kdr)in Anopheles(An.)culicifacies and its impact on the efficacy of organochlorine and other insecticides.Methods:A systematic review was conducted based on PRISMA guidelines,extracting data from biooan.org,Embase,ProQuest,PubMed,Scopus,and Web of Science without a time limit until the end of 2022.Articles meeting the inclusion criteria were assessed using the STROBE checklist.Data on kdr mutations,insecticide resistance,and effectiveness were analyzed across eight selected studies from various regions.Results:The review revealed widespread kdr-mediated resistance in An.culicifacies,primarily against dichloro-diphenyl-trichloroethane(DDT),persisting even decades after discontinued use.Key kdr mutations,including L1014F and L1014S,were identified.Resistance to deltamethrin was less stable,with increased sensitivity observed after short-term discontinuation.The findings underscore the vector's sustained resistance to organochlorine insecticides and relative sensitivity to pyrethroids.Conclusions:Stable kdr resistance in An.culicifacies to organochlorine insecticides highlights the need for periodic susceptibility assessments and strategic rotation or combination of insecticides to combat malaria effectively and prevent the development of resistance.
文摘Objective:To determine patterns of antimicrobial resistance,analyze the prevalence of oxacillinase and molecular typing of strains of Acinetobacter baumannii(A.baumannii).Methods:A total of 121 strains of A.baumannii were obtained from patients admitted to Imam Hossein and Imam Khomeini Hospitals,Tehran,Iran,from January 2016 to November 2018.Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method according to the Clinical and Laboratory Standards Institute recommendations.The presence of oxacillinase genes was assessed by polymerase chain reaction(PCR).To determine clonal relatedness,all isolates were subjected to repetitive sequence-based PCR(REP-PCR).Results:The isolates were obtained from 56(46.3%)males and 65(53.7%)females with the mean age of 39.5 years.Colistin with 100.0%sensitivity rate had the highest effect,while ceftriaxone with 16.5%sensitivity rate had the least effect on A.baumannii isolates.In addition,96(79.3%)and 99(81.8%)isolates were resistant to imipenem and meropenem,respectively.A total of 109 isolates(90.0%)exhibited multiple drug resistance with 10 different resistotypes.In total,75(75.7%)of carbapenem resistant isolates were positive for blaOXA-23-like,and 14(14.1%)for blaOXA-24-like gene.The five main clones A,B,C,D,and E were detected in 25(25.2%),36(36.4%),10(10.1%),8(8.0%),and 6(6.1%)of isolates,respectively.Conclusions:Carbapenem-resistant A.baumannii strains are high in the current study.To control the spread of carbapenem-resistant A.baumannii strains,regular monitoring programs are needed.
文摘Objective: To evaluate different doses of ivermectin in adult patients with mild COVID-19 and to evaluate the effect of ivermectin on mortality and clinical consequences.Methods: A randomized, double-blind, placebo-controlled, multicenter clinical trial was performed at five hospitals. A total of 180 mild hospitalized patients with COVID-19 confirmed by PCR or chest image tests were enrolled and allocated to six arms including hydroxychloroquine 200 mg twice per day, placebo plus hydroxychloroquine 200 mg twice per day, single dose ivermectin(200 μg/kg), three low interval doses of ivermectin(200, 200, 200 μg/kg), single dose ivermectin(400 μg/kg), and three high interval doses of ivermectin(400, 200, 200 μg/kg). The primary endpoint of this trial was all-cause of mortality or clinical recovery. The radiographic findings, hospitalization and low O_2 saturation duration, and hematological variables of blood samples were analyzed. Results: A total of 16.7%(5/30) and 20.0%(6/30) patients died in arms treated with hydroxychloroquine 200 mg twice per day and placebo plus hydroxychloroquine 200 mg twice per day, respectively, and a reduction in mortality rate in patients receiving ivermectin treatment to 0%, 10%, 0% and 3.3% for arms 1-4 were observed. Risk of mortality was also decreased about 15% in the ivermectin treated arms. Conclusions: Ivermectin as an adjunct reduces the rate of mortality, time of low O_2 saturation, and duration of hospitalization in adult COVID-19 patients. The improvement of other clinical parametersshows that ivermectin, with a wide margin of safety, had a high therapeutic effect on COVID-19.
文摘<strong>Background: </strong>Cardiac rehabilitation (CR) is a multifaceted treatment that can increase the survival and quality of life of cardiac patients by increasing their functional capacity (FC). In this study, we aimed to investigate the FC changes of cardiac patients after the CR program in different subgroups in terms of anthropometric, clinical, and psychological indices. <strong>Materials and Methods:</strong> This is a descriptive retrospective study that has been derived from the results of a Cohort study at the Rehabilitation Research Center of the Cardiovascular Research Institute of Isfahan (Iran), from 2006 to 2017. In this study, the dependent variable is functional capacity changes based on Mets obtained in exercise testing at the beginning and end of the CR program. Independent variables included age, sex, dyslipidemia, diabetes, smoking, and Body mass index, type of intervention, depression, and EF. <strong>Results:</strong> The sample size is 1250 cardiovascular patients, of which 917 (73.5%) are male and 331 (26.5%) are female. Functional capacity after the CR program significantly increased in all age, gender, body mass index, hypertension, hyperlipidemia, diabetes, smoking, depression, EF, and type of operation performed (angioplasty or open-heart surgery) subgroups, (p < 0.001). Using multiple linear regression analysis, a significant relationship was found between Mets changes and only the variables of gender, depression, and EF. <strong>Conclusion:</strong> The results of this study show the importance of rehabilitation programs in the secondary prevention of cardiovascular disease in different subgroups and factors such as gender, level of primary depression, and EF less than 35 are the most important factors affecting functional capacity increase after CR program in heart patients.
文摘Objective:To conduct changes in sexual activity during pregnancy and its related factors in pregnant women.Methods:The present descriptive cross-sectional study was conducted in 2017 on pregnant women who referred to the women's clinic of Afzalipour Hospital in the southeast of Iran.Participants were included in the study through convenient sampling.The data collection tool was a researcher-made questionnaire consisting of two parts of personal social information of the couple and questions to measure the level of sexual activity and the attitude of the subjects during pregnancy compared to before pregnancy.Results:201 Pregnant women were included.The average age of pregnant women was(27.3±6.1)years and their average gestational age was(24.7±11.8)years.More than 62%of women had decreased sexual activity.There was a significant relationship between the amount of changes in sexual activity and delivery time(P=0.013),abortion history(P=0.001)and premature birth history(P=0.002).Most pregnant women believed that sex during pregnancy caused damage to the fetus(67.7%).A decrease in the intensity of sexual desire was reported in 63%of pregnant women.More than 60%of the subjects did not consult with doctors and midwives with regards to sexual issues(63.5%).The most common reason for not consulting was not feeling the need(32%).Most women experienced back pain during(42.8%)and after(39.8%)intercourse.Conclusions:Changes in sex life during pregnancy are often caused by the lack of sexual knowledge and the increase in misconceptions among couples,which can affect the quality of relationships.The role of education is essential.Therefore,it is suggested that by including sexual counseling along with pregnancy care,wrong beliefs and information among women will be corrected.
基金funded by a research grant from Mashhad University of Medical Sciences(grant number 971700).
文摘Objective:This study aimed to perform an evaluation of changes in spermogram parameters after follicle-stimulating hormone(FSH)therapy in infertile males having oligo-asthenospermia at different levels of DNA fragmentation index(DFI).Materials and methods:Infertile men with oligo-asthenospermia,no underlying urogenital disease(such as varicocele),and medically fertile partners were enrolled over 1 year.Semen parameters,FSH,luteinizing hormone,and testosterone levels were determined;also,a Sperm DNA Fragmentation Assay Kit(Hamun Teb Pishro,Tehran,Iran)was used for determining sperm DFI at baseline.Participants were categorized into 3 groups based on DFI:DFI<15%(group 1),DFI of 15%-30%(group 2),and DFI>30%(group 3).All participants received subcutaneous recombinant FSH(150 mg every other day)for 6 months.Sperm specimens were tested 6months after intervention(a single sperm control test).Results:Sixty males whose average age was 28.4 years were enrolled.Only group 3(poor fertility)exhibited a significant rise in sperm concentration(p=0.001)and motility(p<0.05)after FSH treatment.Group 1(DFI<15%)and group 2(DFI of 15%-30%)showed increased mean sperm concentration and motility postintervention,although these alterations were not significantly different.Folliclestimulating hormone levels increased significantly in all 3 groups after FSH administration.Serum luteinizing hormone and testosterone levels were not significantly increased in any of the groups.Conclusions:Follicle-stimulating hormone treatment improves sperm concentration andmotility in men with oligo-asthenospermia,with significant improvements observed in men with DFI>30%.DNA fragmentation index can be a predictive indicator of response to FSH treatment in such patients.
文摘AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observational study, neonates weighing ≤2000 grams at birth or born <34 wk gestational age(GA) and all other infants at risk of ROP admitted to the neonatal intensive care unit(NICU) or referred to our ROP clinic were investigated. The incidence of ROP and severe ROP(i.e. patients needing treatment) were determined. The associations between risk factors and the development and severity of ROP were assessed. We also examined the sensitivity of the current national screening guideline in Iran. RESULTS: Among 207 infants, the incidence of ROP and severe ROP was 33.3% and 11.1%, respectively. Mean GA and birth weight(BW) were significantly lower in ROP vs non-ROP infants(29±2 wk vs 33±3 wk, P<0.001;1274±489 g vs 1916±550 g, P<0.001, respectively). Univariate analysis displayed significant association between ROP incidence and GA, BW, NICU admission period, blood transfusion, surfactant usage, sepsis, intraventricular hemorrhage and patent ductus arteriosus(P<0.05 for all). BW [relative risk(RR): 0.857(0.711-0.873), P<0.001], GA [RR: 0.788(0.711-0.873), P<0.001] and blood transfusion [RR: 1.888(0.995-3.583), P=0.052] were independent ROP risk factors. The sensitivity of country-specific screening guidelines was 95.7% and 100% for overall and severe ROP detection, respectively. CONCLUSION: ROP incidence is relatively high in Iran. Identifying ROP risk factors results in more accurate screening and reduces the risk of irreversible vision loss. The ROP screening criteria utilized in Iran are efficient at the present time.
基金supported by Kerman University of Medical Sciences.
文摘Due to the acute and terrible pain that patients with renal colic experience,the most essential therapeutic priority for these patients in the emergency department(ED)is to reduce pain.[1]Although numerous medications are utilized to reduce pain in patients with acute renal colic,no therapy has yet been developed to totally and quickly relieve pain.[2,3]Intravenous opioids and nonsteroidal anti-inflammatory drugs(NSAIDs)are commonly administered intravenously to control pain in these patients in the ED;however,the need for frequent monitoring for possible complications and relatively slow-acting features render these strategies undesirable.
基金financial support from the Food and Drug Safety Research Center at Tabriz University of Medical Sciences(Grant No.66317).
文摘The COVID-19 epidemic caused by SARS-CoV-2 virus has turned into a worldwide pandemic.Therefore,health officials all around the world have strived for developing efficient preventive and treatment methods to deal with this global crisis.Amongst them,monoclonal antibodies,anti-TNFs,and convalescent plasma appear to be effective against this disease.In addition,clinical trials are currently being conducted for viral targeting vaccines.This review summarizes major advances using biopharmaceuticals in the treatment and prevention strategies against COVID-19 that have occurred in the global medicinal system from its introduction until March 2022.
文摘Objective: Hydatidiform pregnancy occurs in 1:1000 pregnancies worldwide;incidence is higher in Asian countries. In approximately 5% of cases of hydatidiform mole, clinical hyperthyroidism is present. The aim of this study was to examine the relation between HCG level and thyroid function test. Methods: During 5 years (2009-2013) we included 146 cases of molar pregnancies into the study at Imam Reza teaching hospital. The demographic and clinical data as well as serum initial HCG level and thyroid function test (TSH T3 T4) were retrieved and entered into prepared proformas. p < 0.05 was considered significant. Result: The mean age of patients was 29.31 years;mean of gestational age was 11.71 weeks;mean of gravidity was 2.32;mean of serum BHCG was 3.88E4;mean of T4 was 11.07 and mean of T3 was 1.97. In this study significantly inverse relation was observed between B-HCG and TSH (p = 0.05). We also found a significantly direct correlation between B-HCG and T3 (p = 0.01) and T4 (p = 0.01). Conclusion: We concluded significantly meaningful relationship between BHCG and T3, T4, TSH.
基金funded by Qom University of Medical Sciences(No.1399-007).
文摘Objective:To describe histopathologic findings in the placentas in women with coronavirus disease 2019(COVID-19)during pregnancy.Methods:In a cross-sectional study,38 pregnant women with COVID-19 and undergoing delivery between March 2020 and January 2022,were included.The patients had positive polymerase chain reaction(PCR)test for SARS-CoV-2 infection and the placentas after delivery were sent for histopathologic evaluation based on the Amsterdam Placental Workshop Group Consensus Statement and assessed by two pathologists.Results:Our results showed that maternal vascular malperfusion was the most common and was present in 17 cases(44.7%).These features included accelerated villous maturation(36.8%)distal villous hypoplasia(5.3%),placental infarction(5.3%)and intervillous fibrin deposition(10.5%).Other pathologic findings included focal calcification(10.5%),intravillous congestion and hemorrhage(10.5%),sub-chorionic hemorrhage(5.3%),acute villitis,chronic histiocytic intervillositis and delayed villous maturation each in one case(2.6%).Twelve out of 38 cases showed no significant pathologic changes.Fetal outcomes included neonatal intensive care unit admission rate of 13.2%,dyspnea 31.6%,newborn’s anosmia 7.9%,intrauterine fetal demise 2.6%,asphyxia 2.6%and neonate COVID infection 5.3%.Conclusions:Microvasculopathy,as a sign of maternal vascular malperfusion,is a common finding in placentas from SARS-CoV-2 positive pregnant women in the present study.Further studies with larger sample sizes and comparative studies between COVID-19 positive and negative,as well as information from patient follow-up are suggested.
基金the Clinical Research Development Center of Taleghani and Imam Ali Hospital, University of Medical Sciences, Kermanshah, IranShohada Tajrish Clinical Research Development Center at Shahid Beheshti University of Medical Sciences in Tehran, Iran, for their support。
文摘BACKGROUND It has been said that the number of orthopaedic claims has increased in the last few years. Investigation through the most prevalent cause would help to prevent further cases.AIM To review the cases of medical complaints in orthopedic patients who had been involved in a traumatic accident.METHODS A retrospective multi-center review of trauma orthopaedic-related malpractice lawsuits from 2010 to 2021 was conducted utilizing the regional medicolegal database. Defendant and plaintiff characteristics along with fracture location, allegations, and litigation outcomes were investigated.RESULTS A total of 228 claims referred to trauma-related conditions with a mean age of 31.29 ± 12.56 were enrolled. The most common injuries were at hand, thigh, elbow, and forearm, respectively.Likewise, the most common alleged complication was related to malunion or nonunion. In 47% of the cases, the main problem that led to the complaint was the inappropriate or insufficient explanation to the patient, and in 53%, there was a problem in the surgery. Eventually, 76% of the complaints resulted in a defense verdict, and 24% resulted in a plaintiff verdict.CONCLUSION Surgical treatment of hand injuries and surgery in non-educational hospitals received the most complaints. The majority of litigation outcomes were caused by a physician’s failure to fully explain and educate the traumatic orthopedic patients and technological errors.
文摘Objective: Coronary Artery Disease (CAD) would continue to concern medical society in the foreseeable future. Determining the extent of coronary luminal stenosis is a key factor in management of CAD. Methods presently used are costly and pose certain dangers, ranging from nephrotoxicity to death. Long Pentraxin or Pentraxin-3 (PTX3) has been used to predict survival or atherosclerotic process, but not to identify coronary stenosis. Calcium Score has been used to this end with some success. Methods: Individuals with chronic stable angina, without evidence of Myocardial Infarction (MI), who were categorized as intermediate-risk after completing a treadmill exercise test, according to Duke Protocol, underwent cardiac catheterization. In addition, blood samples were drawn for coronary sinus PTX3, and also PTX3, uric acid, high-sensitivity C-reactive protein (hs-CRP), cholesterol, glucose and High-Density Lipo-protein (HDL) in peripheral circulation. Calcium Scores were calculated using Agatston Score and non-contrast multi-slice CT scan. Participants were divided according to the number of stenotic coronary arteries (patent, one-, two-and three-vessel disease). Results: We found that PTX3 levels in coronary sinus and femoral vein correlated with each other, after log-transforming the values. Also we found that PTX3 levels and Calcium Scores differed among individuals with triple-vessel involvement and individuals without significant stenosis in any of coronary arteries. No significant differences were observed, regarding hs-CRP levels. Conclusion: PTX3 levels in periphery correlate with those in coronary arteries, and this variable can be measured with a less invasive procedure. In addition to Calcium Score, PTX3 levels are different in our four groups. The combined contribution of PTX3 and calcium score may help us identify individuals with significant coronary artery stenosis without needing to perform cardiac catheterization in a select group of patients.
文摘Background and Objectives: Several drugs and methods are used to reduce postoperative shivering, the most common complications occurring after surgery. This study aimed to evaluate the effects of the oral Clonidine and Tramadol premedication in reducing postoperative shivering after spinal anesthesia. Materials and Methods: In this study, patients aged 20 - 60 years, based on the American Society of Anesthesia functional class I (Anesthesiologists grade-1), were included in controlled double-blind clinical trials. Each was a candidate of a hydrocele, varicocele, and inguinal hernia under spinal anesthesia. The patients were assigned to three groups and 1 h prior to surgery, group A received 0.2 mg of Clonidine, group B received 50 mg of a Tramadol tablet, and group C received a placebo. We collected information on the severity of shivering, pain intensity levels (VAS score), duration of analgesia, and the patients’ hemodynamic condition at base time of 5, 15, and 30 min and 1, 2, 4, and 6 h postoperatively. Results: The incidence of shivering was significantly lower in the Clonidine group than that in the other groups. Analgesia duration was significantly longer in the Clonidine group than that in the control group. In this study, side effects in different groups were not significantly different from each other. Conclusion: Results of this study showed that the oral administration of Clonidine can be effective in preventing the side effects and shivering after spinal anesthesia.
文摘Possible strategies to reduce radiation dose during CT scanning have been investigated over recent decades;here the optimization of the tube current and its link with patient’s cancer incidence are being evaluated. 154 consecutive trauma patients with the need for chest CT scan were included. Two different BMI-adjusted CT protocols at a fixed voltage tube and the same scan length were applied. Dose estimation parameters like CT dose index (CTDI), dose length product (DLP) and effective breast dose were calculated. Breast surface dose was obtained by using thermoluminescence dosimeters (TLDs) and eventually, the life attributable risk (LAR) of cancer incidence was estimated. The mean effective dose was 4.87 ± 2.3 mSv and 5.12 ± 2.8 mSv for patients who were scanned with tube currents of 120 mAs and 200 mAs, respectively. There was no significant difference between organ surface doses for females but in males it was notable. The risk of cancer incidence is lower for protocol 1 in comparison with protocol 2. Optimizing tube current of 120 mAs reduced breast surface dose up to 50% in comparison with the tube current of 200 mAs. In trauma patients, using lower tube current based on BMI has notable impact on the absorbed dose in the breast and can reduce the breast cancer risk by nearly 33.6% for women.
文摘Ventilator-associated pneumonia (VAP) is one of the most important hospital infections in hospitalized patients, which is associated with increased mortality and patient costs. The tracheal tube itself seems to be a major risk factor for VAP. Contaminated secretions pass through the endotracheal tube and reach the lungs. Also, bacteria form a bacterial biofilm on the tracheal tube and are transferred from there to the lungs. Different tracheal tube designs have been produced to overcome these cases. The purpose of this study is to investigate the effect of an Evac tracheal tube covered with antibiotics and normal on the incidence of pneumonia caused by the ventilator. Research method: 180 patients were randomly intubated in three groups of 60 people with three types of tracheal tubes, Evac and Bactiguard. Clinical examinations, endotracheal tube aspiration culture, and chest radiography were obtained from the patients and the incidence of VAP was calculated based on the CPIS standard. The relationship between the type of endotracheal tube and the incidence of VAP and the length of stay in the intensive care unit (ICU) and being discharged alive from the ICU were investigated. Findings and conclusions: The average incidence of VAP for the group of patients intubated with a conventional tracheal tube was 50%, EVAC was 45% and Bactiguard was 40%. The results showed that there is no significant relationship between the incidence of ventilator-induced pneumonia and the type of tracheal tube. The incidence of ventilator-induced pneumonia was not significantly reduced by suctioning subglottic secretions and Bactiguard tracheal tubes. It seems that using one method alone is not effective in reducing ventilator-induced pneumonia.
文摘Purpose:Heavy menstrual bleeding(HMB)is one of the common causes of women in reproductive age referring to gynecology centers.Methods:In this review study,the causes of HMB were assembled from reliable books of Persian Medicine(PM).To compare with new scientific evidence,the HMB characteristics were searched using databases including PubMed,Google Scholar and Scopus as well as valid references of current medicine books.Results:The causes of HMB in PM,similar to current medicine,are divided into three categories including functional,structural and drugs.Functional and drug causes in both schools of medicine are almost concordant.In the structural category,we can consider the presence of a mass in uterus,cervix,and vagina,as mentioned in PM,equivalent with polyps and leiomyomas.Also in PM,mucosal disturbances in this tissues match cervicitis and vaginitis properties.For some causes mentioned in PM such as Akele,Hekke,and weakness of uterus and its tissues,no equivalent was available in current medicine.Conclusions:There are more similarities in menstrual bleeding in both current and Persian Medicine.In some cases,patients present with HMB for which there is no known cause in current medicine.In these cases,the etiologies mentioned in Persian Medicine and their treatment can be used.
基金Supported by Grants from Birjand University of Medical Sciences,Birjand,Iran (No.5109)。
文摘Objective: To assess the efficacy of a curcumin supplementation on cognitive abilities in women suffering from premenstrual syndrome(PMS) and dysmenorrhea. Methods: A randomized, triple-blind, placebocontrolled trial was conducted from December 2019 to March 2020. A total of 124 women who had both PMS and dysmenorrhea were enrolled, and were equally and randomly assigned to the curcumin group or placebo group, 62 cases in each. Each subject received either a capsule containing 500 mg of curcuminoid, or a placebo daily, for 10 days(7 days before and until 3 days after the onset of menstrual bleeding) over 3 menstrual cycles. The cognitive abilities questionnaire was used to measures cognitive functions in 7 specific areas. Adverse reactions were monitored during and after the trial in both groups. Results: Administration of curcumin was associated with a significant increase in memory score(P=0.002), inhibitory control and selective attention(P=0.020), and total cognitive ability task(P=0.024). In addition, significant increments were found in scores of memory(3.5±3.1 vs. 0.4±3.8 in the curcumin and placebo groups, respectively;P=0.035), inhibitory control and selective attention(3.0±3.7 vs. 0.4±3.7;P=0.027) and total cognitive abilities(8.3±12.3 vs. 2.2±12.4;P=0.025) in the curcumin group versus placebo groups. Curcumin was safe and well-tolerable in current clinical trial. Conclusion: Curcumin has a beneficial efficacy on cognitive function scores in women with PMS and dysmenorrhea, with improvements in memory, inhibitory control and selective attention.(Registration No. IRCT20191112045424N1, available at: https://www.irct.ir)
