Background: Kind of delivery affect many aspects of individuals, families and health systems situations. The aim of this study was to identify the Role of non-medical factors on choice of delivery (CS/NVD) in hospital...Background: Kind of delivery affect many aspects of individuals, families and health systems situations. The aim of this study was to identify the Role of non-medical factors on choice of delivery (CS/NVD) in hospitals affiliated to Tehran University of Medical Sciences. Materials and Method: This cross-sectional study was performed to identify the factors involved in the choice of delivery (CS/NVD) among women attending hospitals affiliated to Tehran University of Medical Sciences. Data was derived from the medical records of women who gave birth in the hospitals. Results: A significant statistical relationship was found between factors such as age of mother, level of education, occupational status, type of previous delivery, person supervising the pregnancy and dissatisfaction about delivery were more frequent in women who underwent CS than those who gave birth by NVD. Conclusion: The highly increasing rise in the rate of unnecessary CS during throughout the world, and its adverse effect on maternal and child health, the financial burden imposed on families and health systems, has highlighted the importance of studies to identify the non-medical factors that affect decision-making concerning type of delivery as well as to determine the appropriate medical indications of CS.展开更多
Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The obje...Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The objective of this study was determining the quality of the structural elements of the department of Communicable Diseases & determining the strengths, weaknesses, opportunities and threats to improve the quality of activities in the department under research. Materials and Methods: The employed method was Mixed methods (qualitative & quantitative research), on the basis of 10 procedural steps and within 8 sections dealing with evaluated factors;such as 1) organizational and management structure 2) scientific board members 3) students 4) Manpower 5) Space of educational research and health care 6) Equipment 7) curriculum 8) satisfaction of graduates, which were studied using 61 criteria and 172 indicators. Five-point Likert Scale was used for the responses in the questionnaire (1 - 1.75 = undesirable, to 4.2 - 5 completely desirable). Finally the data were analyzed using descriptive statistics indices and the assessment software of the Educational Development Center of TUMS. The instruments used in this method included assessment software, interview, observation and self-prepared questionnaire which consisted of 7 questionnaires and 2 check lists. Finding: The results of the research showed that general average of 8 investigating sections was 56.9% as a rather desirable research work. Conclusions: Therefore, it was concluded that function of the educational management in that group was directly in line with evaluation process, but continuing the process of evaluation seems necessary.展开更多
This pilot study evaluated effectiveness and acceptance of a new hospital-based reproductive endocrinology curriculum among Iranian medical students. A voluntary, anonymous questionnaire was used to compare two teachi...This pilot study evaluated effectiveness and acceptance of a new hospital-based reproductive endocrinology curriculum among Iranian medical students. A voluntary, anonymous questionnaire was used to compare two teaching methods as applied to junior medical students at Tehran University of Medical Sciences. Students were randomly assigned to one of two clinical teaching settings;no student experienced both modules. Coursework for the pilot (experimental) group (n = 19) utilized a teaching approach comprising lectures, genetics laboratory, pelvic ultrasound, small group sessions, and opportunities to observe advanced reproductive technologies such as in vitro fertilization, ICSI, and embryo transfer. A control group (n = 34) received reproductive endocrinology instruction by the ‘traditional curriculum’, consisting mainly of lectures. Students were sampled at baseline and again atthe conclusion of their reproductive endocrinology session. Pre- and post-test data were analyzed for both groups;post-test differences between groups were also compared. No significant differences in mean age or gender mix were identified between the two study groups. Overall, the ques- tionnaire did not identify any significant intergroup differences for any parameter investigated. Although student acceptance rate appeared similar for both educational modules, the ratio of students having a “favorable regard” for reproductive medicine declined only among students randomized to the control group (41.2% vs. 32.3%). This report offers the first data on teaching reproductive endocrinology to medical students in Iran. Both traditional and innovative approaches to teaching reproductive endocrinology were well-accepted by students, although negative post-test responses were more common among students in the control group. While periodic quality assessments for existing clinical teaching methods are necessary, introduction of alternative teaching approaches is also important. Additional studies are planned to evaluate the impact this initiative may have on results on standardized tests measuring reproductive endocrinology knowledge, as well as election of further specialization in training.展开更多
AIM:To evaluate the effects of refractive errors and binocular vision anomalies on the quality of life(QOL)of university students.METHODS:This cross-sectional analytical study was conducted on university students usin...AIM:To evaluate the effects of refractive errors and binocular vision anomalies on the quality of life(QOL)of university students.METHODS:This cross-sectional analytical study was conducted on university students using simple random sampling.Objective refraction,ocular alignment,vergence and accommodative performance were measured and assessed in all participants.Data on QOL were collected using the College of Optometrists in Vision Development-Quality of Life(COVD-QOL)Questionnaire.The effect of mentioned parameters on the QOL were evaluated.RESULTS:Totally 726 students with mean age of 21.35±1.88y were evaluated in this study,51.5%of whom were female.Esophoria was caused significantly lower QOL in the domains of somatic symptoms and occupationalphysical symptoms(P<0.05);Besides,esotropia decreased QOL in domains of somatic symptoms P=0.002 and psychological factors(P=0.023).Students with accommodation insufficiency experienced more symptoms in all domains(P<0.05)except for psychological factors(P=0.07).Increasing in the near point of convergence and accommodation and decreases QOL and increasing accommodative facility increases QOL(all P<0.05).Myopia and astigmatism cause decrease in QOL(both P<0.05),but hyperopic students had better QOL in comparison with others(P<0.05).CONCLUSION:Screening programs and treatment of refractive errors and binocular vision anomalies,especially phoria and accommodative insufficiency,positively impact the QOL and academic achievements of university students.展开更多
AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 ...AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 to Jan 2020.Selected subjects were interviewed and subjected to optometric and ophthalmic examinations.RESULTS:The age and sex standardized prevalence of pterygium and pinguecula was 3.64%[95%confidence interval(CI):2.94%–4.49%]and 55.57%(95%CI:52.89%–58.22%),respectively.The prevalence of pterygium was 4.52%(95%CI:3.5%–5.81%)in men and 2.79%(95%CI:1.97%–3.94%)in women and the prevalence of pinguecula was 64.56%(95%CI:60.92%–68.03%)in men and 46.72%(95%CI:43.74%–49.72%)in women.According to the results of multiple logistic regression,pinguecula had a significant correlation with male sex[odds ratio(OR):2.21,95%CI:1.63–2.99]and education level(OR:0.52,95%CI:0.35-0.77)and pterygium had a significant relationship with male sex(OR:2.2,95%CI:1.38–3.52),socioeconomic status(SES,OR:0.5,95%CI:0.26–0.97),education level(OR:0.22,95%CI:0.08–0.61).CONCLUSION:The prevalence of pinguecula and pterygium in this study are lower than other studies.Sex,SES,and education level are the risk factors of the prevalence of pinguecula and pterygium.展开更多
AIM:To determine the prevalence of some retinal pathologies in people over 60y and their association with demographic and ocular factors.METHODS:A cross-sectional study was conducted in Tehran using multistage cluster...AIM:To determine the prevalence of some retinal pathologies in people over 60y and their association with demographic and ocular factors.METHODS:A cross-sectional study was conducted in Tehran using multistage cluster sampling.After selecting subjects aged 60 and over,optometric,and ophthalmic examinations were done.For retinal examination,a 90 D lens was used and indirect ophthalmoscopy was performed after instilling tropicamide drops.Biometry was done using the IOL Master for all participants.RESULTS:Of 3791 people that were invited through cluster sampling,3310 participated in the study(response rate=82%).The prevalence of retinal pigmented epithelium(RPE)change,drusen,geographic atrophy(GA),hypertensive retinopathy(HTR),nonproliferative diabetic retinopathy(NPDR),proliferative diabetic retinopathy(PDR),choroidal neovascularization(CNV),central retinal artery occlusion(CRAO),myopic retinopathy(MR),branch retinal vein occlusion(BRVO),and central retinal vein occlusion(CRVO)was 27.42%,11.08%,4.52%,3.03%,4.05%,0.54%,0.82%,0.39%,0.20%,0.49%,and 0.19%,respectively.After removing the effect of age,the odds of NPDR were 1.68 times higher in women compared to men(P=0.014).After removing the effect of sex,the odds of drusen,RPE change,GA,CNV,BRVO,and CRVO increased with age.CONCLUSION:There is a higher prevalence of RPE change,drusen,GA,CNV and a lower prevalence of MR and CRAO in the elderly population of Tehran aged over 60y compared to global average values.Considering the correlation of most of the diseases with age and their effects on vision,attention should be paid to these diseases and the related screening programs to prevent vision impairment.展开更多
Rheumatoid arthritis(RA)is a chronic autoimmune disease that affects approxi-mately 0.46%of the global population.Conventional therapeutics for RA,including disease-modifying antirheumatic drugs(DMARDs),nonsteroidal a...Rheumatoid arthritis(RA)is a chronic autoimmune disease that affects approxi-mately 0.46%of the global population.Conventional therapeutics for RA,including disease-modifying antirheumatic drugs(DMARDs),nonsteroidal anti-inflammatory drugs(NSAIDs),and corticosteroids,frequently result in unintended adverse effects.Dexamethasone(DEX)is a potent glucocorticoid used to treat RA due to its anti-inflammatory and immunosuppressive properties.Liposomal delivery of DEX,particu-larly when liposomes are surface-modified with targeting ligands like peptides or sialic acid,can improve drug efficacy by enhancing its distribution to inflamed joints and minimizing toxicity.This study investigates the potential of liposomal drug delivery systems to enhance the efficacy and targeting of DEX in the treatment of RA.Results from various studies demonstrate that liposomal DEX significantly inhibits arthritis progression in animal models,reduces joint inflammation and damage,and alleviates cartilage destruction compared to free DEX.The liposomal formulation also shows better hemocompatibility,fewer adverse effects on body weight and immune organ index,and a longer circulation time with higher bioavailability.The anti-inflammatory mechanism is associated with the downregulation of pro-inflammatory cytokines like tumor necrosis factor-α(TNF-α)and B-cell-activating factor(BAFF),which are key players in the pathogenesis of RA.Additionally,liposomal DEX can induce the expres-sion of anti-inflammatory cytokines like interleukin-10(IL-10),which has significant anti-inflammatory and immunoregulatory properties.The findings suggest that lipo-somal DEX represents a promising candidate for effective and safe RA therapy,with the potential to improve the management of this debilitating disease by providing targeted delivery and sustained release of the drug.展开更多
Objective:The aim of this study was to investigate the health expectations(HEs)in patients with diabetes and the factors affecting it using an integrative systematic review.Methods:A comprehensive literature search wa...Objective:The aim of this study was to investigate the health expectations(HEs)in patients with diabetes and the factors affecting it using an integrative systematic review.Methods:A comprehensive literature search was conducted in databases including PubMed,Scopus,Science Direct,Google Scholar,ProQuest,CINAHL,SID,Iran Doc,and Magiran without time limitation using related keywords.The systematic literature search was performed using a guide provided by York University.Results:From a total of 1883 articles,17 of them finally met the eligibility criteria.According to the findings of this study,HE of diabetic patients was included in four categories:“dynamism,”“consequentialism,”“comprehensive care,”and“access to facilities.”Also,these expectations can be influenced by various factors,including“developments in societies,”“changing the conditions of health care systems,”and“individual factors.”Conclusions:Health professionals should pay attention to the expectations of diabetic patients who are involved in complex disease conditions and consider meeting them as a key factor in providing patient-centered care,improving health outcomes,and patient satisfaction.展开更多
AIM:To compare refractive error and angle of deviation in patients with basic esotropia and basic exotropia.METHODS:A retrospective review was conducted on the medical records of patients with basic-type strabismus.De...AIM:To compare refractive error and angle of deviation in patients with basic esotropia and basic exotropia.METHODS:A retrospective review was conducted on the medical records of patients with basic-type strabismus.Demographic data,refractive error,best-corrected distance visual acuity(BCVA),and the horizontal and vertical angle of deviation between basic esotropia and exotropia patients were compared.RESULTS:Among the 7129 patients(mean age 22.98±14.81y)evaluated,44.7%(3185 cases,54.9%male)exhibited basic-type esotropia,while 55.3%(3944 cases,53.9%male)presented with basic-type exotropia.Basic esotropia cases exhibited more hyperopic spherical equivalent measurements in both eyes(right:0.53±3.07 vs left:0.56±2.98 D)than those with basic exotropia(right eye:-0.33±2.84 vs left eye:-0.24±2.68 D,P<0.001 for both eyes).Patients with basic esotropia had significantly greater horizontal deviation angles(near:36.08±18.87 PD and far:35.56±18.75 PD)compared to those with basic exotropia(near:33.75±16.11 PD and far:33.26±15.90 PD,P<0.001).Conversely,patients with basic exotropia had slightly higher vertical deviation angles(near:1.67±5.80 PD and far:1.72±5.89 PD)compared to those with basic esotropia(near:1.12±4.57 PD and far:1.12±4.58 PD,P<0.001).Patients with basic esotropia underwent surgical intervention at younger ages compared to basic exotropia individuals(19.68±15.99 vs 25.66±13.20,P<0.001).CONCLUSION:Basic esotropia patients present more hyperopic refractive errors,better visual acuity,larger horizontal yet smaller vertical ocular misalignments,and tend to undergo strabismus surgery at younger ages relative to basic exotropia cases.展开更多
Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and ...Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and combination therapy with tamsulosin,silodosin,and tadalafil on stone expulsion rate(SER)and stone expulsion time(SET),as well as their comparative safety,numbers of colic pain episodes,and need for analgesics.Methods:Randomized controlled trials were retrieved by searching PubMed,Scopus,and Web of Science up to November 27,2023.Hand-searching was also conducted in Google Scholar to find additional records.Papers in English that compared the safety and efficacy of at least two of the above agents in adults with distal ureteral stones≤10 mm were included.Results:In total,27 studies were identified(six studies through database searches and 21 through checking reference lists and hand-searching in Google Scholar).More than half of them(n=15,56%)were conducted in India.The SER significantly improved with silodosin compared with tamsulosin(odds ratio[OR]2.24,p<0.001),whereas the difference in SET was non-significant.Tadalafil achieved a significantly higher SER compared with tamsulosin(OR 1.42,p=0.042)without any difference in SET.Subgroup analysis of 5-and 10-mg doses of tadalafil showed no significant difference in SER or SET.We found no significant difference in need for analgesics(mean difference(MD−53.73,p=0.2)or the mean number of colic episodes(MD−0.42,p=0.060)between tadalafil and tamsulosin.SER or SET was not significantly different between silodosin and tadalafil.Tadalafil plus tamsulosin led to a significantly higher SER(OR 1.87,p<0.001)and SET(MD−2.99,p=0.002)compared with tamsulosin,without any significant difference in adverse effects.Conclusion:Compared with tamsulosin,SER significantly improved with silodosin,tadalafil,and the combination of tadalafil plus tamsulosin.Meanwhile,the difference in SET was only significant between tadalafil plus tamsulosin versus tamsulosin.It appears that tadalafil and silodosin have similar efficacy in SET and SER.All medical expulsive therapies had comparable safety.展开更多
Objective:To determine the effect of management before and during transplantation on the quality of donated organs.Improvement of preservation methods in cases involving brain death will lead to more effective organ p...Objective:To determine the effect of management before and during transplantation on the quality of donated organs.Improvement of preservation methods in cases involving brain death will lead to more effective organ procurement.Methods:Data were collected from the 226 brain death cases enrolled in the 12-month study period.All cases,patients with a Glasgow Coma Scale(GCS)score of 3 points,appropriate age,and having medical indications for organ donation,were considered to confirm the criteria of brain death.Transplant outcome data were obtained from the transplant centers.Results:The age of the deceased ranged between 1 year and 68 years,with a mean±SD of 39.54±17.28 years.There was no significant difference between the quality of organs regarding blood group and cause of brain death(P>0.05).However,there was a significant difference in the quality of organs regarding age,body mass index(BMI),and gender.There was a significant difference between the level of urea at admission time and procurement time(P<0.001),as well as between creatinine level at admission time and procurement time(P<0.001).There was also a significant difference between aspartate aminotransferase(AST)at admission time and procurement time(P<0.001),and between alanine aminotransferase(ALT)at admission time and procurement time(P<0.001).Conclusions:Transplant outcomes using older donor livers and kidneys were comparable to those using younger or male donors.These findings provide further evidence that decision-making about organ quality is influenced by age and gender and emphasize the importance of transparency in organ acceptance practices.展开更多
AIM:To compare objective dry retinoscopy and subjective refraction measurements in patients with mild keratoconus(KCN)and quantify any differences.METHODS:This cross-sectional study was done on 68 eyes of 68 patients ...AIM:To compare objective dry retinoscopy and subjective refraction measurements in patients with mild keratoconus(KCN)and quantify any differences.METHODS:This cross-sectional study was done on 68 eyes of 68 patients diagnosed with mild KCN.Objective dry retinoscopy using autorefractometer and subjective refraction measurements were performed.Sphere,cylinder,J0,J45,and spherical equivalent values were compared between the two techniques.RESULTS:The mean age of 68 patients with mild KCN was 21.32±5.03y(12–35y).There were 37(54.4%)males.Objective refraction yielded significantly more myopic sphere(-1.44 D vs-0.57 D),higher cylinder magnitude(-2.24 D vs-1.48 D),and more myopic spherical equivalent(-2.56 D vs-1.31 D)compared to subjective refraction(all P<0.05).The mean differences were-0.87 D for sphere,-0.76 D for cylinder,and-1.25 D for spherical equivalent.No significant differences were found for J0 and J45 values,indicating agreement in astigmatism axis(P>0.05).CONCLUSION:In patients with mild KCN,objective dry retinoscopy overestimates the degree of myopia and astigmatism compared to subjective refraction.The irregular cornea in KCN likely impacts objective measurements.Subjective refraction allows compensation for irregularity,providing a more accurate correction.When determining refractive targets,the tendency of objective methods to overcorrect should be considered.展开更多
AIM:To identify differences in clinical features between thyroid eye disease(TED)patients with and without strabismus.METHODS:This retrospective,single-center,consecutive case series study was conducted on TED patient...AIM:To identify differences in clinical features between thyroid eye disease(TED)patients with and without strabismus.METHODS:This retrospective,single-center,consecutive case series study was conducted on TED patients who were determined to be surgical candidates.The patients’cohort were divided into two groups based on the presence or absence of strabismus.Demographics and complete eye examinations were recorded and compared between the TED and TED with strabismus groups.RESULTS:A total of 76 patients with TED were enrolled,including 58 males(76.3%)with a mean age of 52.68±10.45y.The 55 patients(male:female=2:1)were found to have TED with strabismus,while the remaining 21 patients(male:female=4:1)had TED without strabismus.There was nearly a four times greater likelihood of lid retraction being associated with TED without strabismus(OR=4.1,P=0.018)and they showed higher prevalence of proptosis(95.2%)than the TED strabismus group(63.6%,P<0.001).In the TED-strabismus group,20%of patients had abnormal head posture(AHP),while none were identified in the TED group(P=0.029).Despite the higher incidence of vision-threatening complications such as dysthyroid optic neuropathy(19%vs 8.1%)and exposure keratopathy(4.8%vs 1.8%)in the TED group than in the TED-strabismus group,the difference did not reach statistical significance(P>0.05).The most common types of strabismus were hypotropia(36%)and esotropia(29%),respectively.CONCLUSION:Strabismus-associated TED is characterized by a lower prevalence of proptosis and lid retraction,but a higher incidence of compensatory AHP.Identifying these differences may aid in risk stratification and early intervention for TED patients,particularly those at risk for restrictive strabismus.展开更多
AIM:To evaluate the mid-term effects of topical latanoprost 0.005%on vessel density(VD)of the bulbar conjunctiva using anterior segment optical coherence tomography angiography(OCTA).METHODS:Thirty-four eyes of 21 pat...AIM:To evaluate the mid-term effects of topical latanoprost 0.005%on vessel density(VD)of the bulbar conjunctiva using anterior segment optical coherence tomography angiography(OCTA).METHODS:Thirty-four eyes of 21 patients and 18 eyes of 9 healthy subjects were recruited as the treatment and control groups,respectively.The treatment group was instructed to apply generic latanoprost 0.005%once daily at night,while the control group received no medication.Anterior segment OCTA was performed on all eyes at baseline,3wk,and 12wk after initiation of latanoprost.The superficial bulbar conjunctival VD was measured in the superior,inferior,temporal,and nasal quadrants.A linear mixed model was used to compare the change in the VD between groups.RESULTS:The change in the VD was not different between groups in temporal,and nasal quadrants at 3-week and 12-week time points.The VD in the superior bulbar conjunctiva was significantly increased after 12wk(P=0.029)while the change from baseline after 3wk was not different between groups(P=0.218).After adjustment for age and gender superior hemi(P=0.006)and center(P=0.016)of the inferior quadrant of bulbar conjunctiva showed increased VD after 12wk.CONCLUSION:The trend of changes in the superior and inferior conjunctival VD is increased following topical latanoprost administration and these changes can be quantified using anterior segment OCTA.展开更多
Objective:Non-pharmacological treatments of traditional medical systems are becoming recognized in management of respiratory diseases,especially COVID-19.This study was designed to evaluate the effec-tiveness of acupu...Objective:Non-pharmacological treatments of traditional medical systems are becoming recognized in management of respiratory diseases,especially COVID-19.This study was designed to evaluate the effec-tiveness of acupuncture as an adjuvant therapy in hospitalized patients with COVID-19.Methods:This randomized controlled trial was performed on 70 moderate to severe hospitalized patients with COVID-19.Patients were randomized into two groups,receiving conventional treatment alone or in combination with acupuncture for 7 days.Both groups were followed up for 28 days.Respiratory rate and SpO_(2)were considered as primary outcomes.Additionally,respiratory symptoms(cough,dyspnea,chest tightness,and oxygen demand)and duration of hospitalization,ICU admission,intubation,and mortality rate were evaluated.The outcome assessor and data analyst were blinded.Results:Acupuncture significantly improved respiratory rate and SpO_(2)after 3 days(v.s.7 days in con-trol group).SpO_(2)reached 93%from the third day of conducting acupuncture.Respiratory symptoms were relieved after 7 days in the both groups,but were significant from day 3 in the acupuncture group(P<0.001).Duration of hospitalization was less in the acupuncture group(3 days v.s.11 days),with no ICU admission,intubation or death.In contrast,8 patients in the control group were admitted to ICU,of whom 4 were intubated and died.No adverse effect was reported.Conclusion:Acupuncture can play a significant role as a safe and effective complementary treatment in the management of COVID-19.展开更多
Human-derived tumor models are essential for preclinical development of new anti-cancer drug entities.Generating animal models bearing tumors of human origin,such as patient-derived or cell line-derived xenograft tumo...Human-derived tumor models are essential for preclinical development of new anti-cancer drug entities.Generating animal models bearing tumors of human origin,such as patient-derived or cell line-derived xenograft tumors,is dependent on immuno-deficient strains.Tumor-bearing immunodeficient mice are susceptible to develop-ing unwanted disorders primarily irrelevant to the tumor nature;and if get involved with such disorders,reliability of the study results will be undermined,inevitably con-founding the research in general.Therefore,a rigorous health surveillance and clinical monitoring system,along with the establishment of a strictly controlled barrier facility to maintain a pathogen-free state,are mandatory.Even if all pathogen control and biosafety measures are followed,there are various noninfectious disorders capable of causing tissue and multiorgan damage in immunodeficient animals.Therefore,the re-searchers should be aware of sentinel signs to carefully monitor and impartially report them.This review discusses clinical signs of common unwanted disorders in experi-mental immunodeficient mice,and how to examine and report them.展开更多
Due to the limited regeneration capacity of myocardial tissue after infarction,designing tissue engineering scaffolds are in demand.In the present study,electrospun nanofibrous scaffolds were made out of polyurethane,...Due to the limited regeneration capacity of myocardial tissue after infarction,designing tissue engineering scaffolds are in demand.In the present study,electrospun nanofibrous scaffolds were made out of polyurethane,collagen and gold nanoparticles with random and aligned nanofiber morphologies.The nanoparticles were green-synthesized using saffron extract.Nanoparticle characterizations with UV-Vis.spectroscopy and DLS illustrated theoretical and hydrodynamic diameters of around 7 and 13 nm,respectively,having zeta potential of−37 mV.SEM and TEM micrographs showed the morphology and diameters of obtained nanofibers.Also,further characterization were done by ATR-FTIR,XRD and TGA investigations and degradation studies.Contact angle measurements showed hydrophilic nature of the scaffolds(59±0.6°for aligned PU/Col/Au50 nanofibers compared to 120±2.6°for random PU nanofibers).Mechanical testing demonstrated appropriate tensile properties of the scaffolds for cardiac tissue engineering(Young’s modulus:1.53±0.07 MPa for aligned PU/Col/Au50 nanofibers compared to 0.4±0.05 MPa for random PU nanofibers).Finally,alamar blue assay revealed proper survival of the cells of HUVEC cell line on the prepared scaffolds,where the highest percentages were observed for random and aligned PU/Col/Au50 nanofibers.According to the findings,the fabricated PU/Col/AuNPs nanofibrous scaffolds could be considered as potential cardiac patches.展开更多
BACKGROUND It is expected that transfer of spinal accessory nerve to suprascapular nerve,which is widely used in the restoration of the shoulder function in brachial plexus birth injury(BPBI),impairs the trapezius fun...BACKGROUND It is expected that transfer of spinal accessory nerve to suprascapular nerve,which is widely used in the restoration of the shoulder function in brachial plexus birth injury(BPBI),impairs the trapezius function.AIM To hypothesize that the lower trapezius muscle remains functional after this neve transfer.METHODS In a retrospective cross-sectional study,patients with BPBI who underwent nerve transfer from accessory nerve to supraclavicular were followed for at least six months following the operation and demographic data were extracted from the database.To assess the lower trapezius function,shoulder abduction and external rotation were examined,and electromyography and nerve conduction velocity(EMG-NCV)was performed.RESULTS A total of 19 patients with a mean age of 2.69±1.40 years and a mean follow-up of 10.5 months were included in the study.Shoulder abduction was disabled completely only in one patient(5.26%);10(52.63%)had good,3(15.78%)moderate,and 5(26.31%)had poor shoulder abduction.Regarding external rotation,one(5.26%)was unable to externally rotate the shoulder;among 18(94.73%)patients who had satisfactory results,8(42.10%)were evaluated to be good,5(26.31%)moderate,and 5(26.31%)poor.EMG-NCV showed functional lower trapezius in all patients;its function was evaluated to be good in 11(57.89%),moderate in 6(31.57%),and poor in 2(10.52%)cases.CONCLUSION This study supports the hypothesis that the lower trapezius muscle has a dual motor innervation which provides the possibility of further trapezius tendon transfer to restore a better shoulder function.展开更多
BACKGROUND Rotator cuff tears are a chief cause of shoulder pain and disability,and surgical repair is often required when conservative management fails.As digital health technologies have expanded,especially since th...BACKGROUND Rotator cuff tears are a chief cause of shoulder pain and disability,and surgical repair is often required when conservative management fails.As digital health technologies have expanded,especially since the coronavirus disease 2019 pandemic,digitally augmented rehabilitation programs emerged as a potential alternative to conventional physical therapy.AIM To determine if digitally assisted rehabilitation could be as practical,or even more effective,than the traditional methods most patients currently follow.METHODS Six electronic databases,including PubMed,Scopus,Cochrane Library,Google Scholar,EMBASE,and Web of Science,were searched to find articles that compare digital-based rehabilitation and conventional treatment.Outcomes of interest were Disabilities of the Arm,Shoulder and Hand(DASH)score and range of motion.The quality assessment of the included studies was performed using the risk-of-bias tool for randomized trials tool.RESULTS Three randomized controlled trial studies were enrolled in this study,including 195 cases.We did not find any significant differences between the two groups in terms of DASH score,flexion range of motion,and external rotation range of motion.There was a significant difference between the two groups for abduction range of motion.CONCLUSION Digital home-based rehab seems to be a strong alternative to traditional methods,offering similar results for people recovering from rotator cuff surgery.This approach might also make rehab more accessible and engaging for patients.That said,further research is needed to fully understand the potential of digital rehabilitation and ensure it works effectively for everyone.展开更多
The quality of care and treatment can be impacted by a number of factors, including the rate of missed care. The present study was conducted with the aim to evaluate missed nursing care (MNC) and its association with ...The quality of care and treatment can be impacted by a number of factors, including the rate of missed care. The present study was conducted with the aim to evaluate missed nursing care (MNC) and its association with patient safety culture in the emergency department (ED). Until September 2024, the international databases MEDLINE (PubMed and Ovid), Embase and Cochrane, Scopus, Wiley Online Library, Web of Science, Cochrane Central Register of Controlled Trials, EBSCO, ISI, Elsevier, and Google Scholar were searched using the search terms including patient safety culture and MNC. A total of eight articles were reviewed. In the fixed-effect model with low heterogeneity (I^(2) = 0%, P = 1), the mean score of overall MNC was 2.07 (ES, 2.97;95% confidence interval: −2.21-6.35). According to meta-regression analyses, MNC significantly inversely correlated with patient safety culture, age, and work experience (P < 0.01). By improving the working conditions of ED nurses and providing training related to patient safety, the amount of lost nursing care will decrease.展开更多
文摘Background: Kind of delivery affect many aspects of individuals, families and health systems situations. The aim of this study was to identify the Role of non-medical factors on choice of delivery (CS/NVD) in hospitals affiliated to Tehran University of Medical Sciences. Materials and Method: This cross-sectional study was performed to identify the factors involved in the choice of delivery (CS/NVD) among women attending hospitals affiliated to Tehran University of Medical Sciences. Data was derived from the medical records of women who gave birth in the hospitals. Results: A significant statistical relationship was found between factors such as age of mother, level of education, occupational status, type of previous delivery, person supervising the pregnancy and dissatisfaction about delivery were more frequent in women who underwent CS than those who gave birth by NVD. Conclusion: The highly increasing rise in the rate of unnecessary CS during throughout the world, and its adverse effect on maternal and child health, the financial burden imposed on families and health systems, has highlighted the importance of studies to identify the non-medical factors that affect decision-making concerning type of delivery as well as to determine the appropriate medical indications of CS.
文摘Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The objective of this study was determining the quality of the structural elements of the department of Communicable Diseases & determining the strengths, weaknesses, opportunities and threats to improve the quality of activities in the department under research. Materials and Methods: The employed method was Mixed methods (qualitative & quantitative research), on the basis of 10 procedural steps and within 8 sections dealing with evaluated factors;such as 1) organizational and management structure 2) scientific board members 3) students 4) Manpower 5) Space of educational research and health care 6) Equipment 7) curriculum 8) satisfaction of graduates, which were studied using 61 criteria and 172 indicators. Five-point Likert Scale was used for the responses in the questionnaire (1 - 1.75 = undesirable, to 4.2 - 5 completely desirable). Finally the data were analyzed using descriptive statistics indices and the assessment software of the Educational Development Center of TUMS. The instruments used in this method included assessment software, interview, observation and self-prepared questionnaire which consisted of 7 questionnaires and 2 check lists. Finding: The results of the research showed that general average of 8 investigating sections was 56.9% as a rather desirable research work. Conclusions: Therefore, it was concluded that function of the educational management in that group was directly in line with evaluation process, but continuing the process of evaluation seems necessary.
文摘This pilot study evaluated effectiveness and acceptance of a new hospital-based reproductive endocrinology curriculum among Iranian medical students. A voluntary, anonymous questionnaire was used to compare two teaching methods as applied to junior medical students at Tehran University of Medical Sciences. Students were randomly assigned to one of two clinical teaching settings;no student experienced both modules. Coursework for the pilot (experimental) group (n = 19) utilized a teaching approach comprising lectures, genetics laboratory, pelvic ultrasound, small group sessions, and opportunities to observe advanced reproductive technologies such as in vitro fertilization, ICSI, and embryo transfer. A control group (n = 34) received reproductive endocrinology instruction by the ‘traditional curriculum’, consisting mainly of lectures. Students were sampled at baseline and again atthe conclusion of their reproductive endocrinology session. Pre- and post-test data were analyzed for both groups;post-test differences between groups were also compared. No significant differences in mean age or gender mix were identified between the two study groups. Overall, the ques- tionnaire did not identify any significant intergroup differences for any parameter investigated. Although student acceptance rate appeared similar for both educational modules, the ratio of students having a “favorable regard” for reproductive medicine declined only among students randomized to the control group (41.2% vs. 32.3%). This report offers the first data on teaching reproductive endocrinology to medical students in Iran. Both traditional and innovative approaches to teaching reproductive endocrinology were well-accepted by students, although negative post-test responses were more common among students in the control group. While periodic quality assessments for existing clinical teaching methods are necessary, introduction of alternative teaching approaches is also important. Additional studies are planned to evaluate the impact this initiative may have on results on standardized tests measuring reproductive endocrinology knowledge, as well as election of further specialization in training.
文摘AIM:To evaluate the effects of refractive errors and binocular vision anomalies on the quality of life(QOL)of university students.METHODS:This cross-sectional analytical study was conducted on university students using simple random sampling.Objective refraction,ocular alignment,vergence and accommodative performance were measured and assessed in all participants.Data on QOL were collected using the College of Optometrists in Vision Development-Quality of Life(COVD-QOL)Questionnaire.The effect of mentioned parameters on the QOL were evaluated.RESULTS:Totally 726 students with mean age of 21.35±1.88y were evaluated in this study,51.5%of whom were female.Esophoria was caused significantly lower QOL in the domains of somatic symptoms and occupationalphysical symptoms(P<0.05);Besides,esotropia decreased QOL in domains of somatic symptoms P=0.002 and psychological factors(P=0.023).Students with accommodation insufficiency experienced more symptoms in all domains(P<0.05)except for psychological factors(P=0.07).Increasing in the near point of convergence and accommodation and decreases QOL and increasing accommodative facility increases QOL(all P<0.05).Myopia and astigmatism cause decrease in QOL(both P<0.05),but hyperopic students had better QOL in comparison with others(P<0.05).CONCLUSION:Screening programs and treatment of refractive errors and binocular vision anomalies,especially phoria and accommodative insufficiency,positively impact the QOL and academic achievements of university students.
基金Supported by National Institute for Medical Research Development(NIMAD)affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 to Jan 2020.Selected subjects were interviewed and subjected to optometric and ophthalmic examinations.RESULTS:The age and sex standardized prevalence of pterygium and pinguecula was 3.64%[95%confidence interval(CI):2.94%–4.49%]and 55.57%(95%CI:52.89%–58.22%),respectively.The prevalence of pterygium was 4.52%(95%CI:3.5%–5.81%)in men and 2.79%(95%CI:1.97%–3.94%)in women and the prevalence of pinguecula was 64.56%(95%CI:60.92%–68.03%)in men and 46.72%(95%CI:43.74%–49.72%)in women.According to the results of multiple logistic regression,pinguecula had a significant correlation with male sex[odds ratio(OR):2.21,95%CI:1.63–2.99]and education level(OR:0.52,95%CI:0.35-0.77)and pterygium had a significant relationship with male sex(OR:2.2,95%CI:1.38–3.52),socioeconomic status(SES,OR:0.5,95%CI:0.26–0.97),education level(OR:0.22,95%CI:0.08–0.61).CONCLUSION:The prevalence of pinguecula and pterygium in this study are lower than other studies.Sex,SES,and education level are the risk factors of the prevalence of pinguecula and pterygium.
基金Supported by National Institute for Medical Research Development(NIMAD)Affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To determine the prevalence of some retinal pathologies in people over 60y and their association with demographic and ocular factors.METHODS:A cross-sectional study was conducted in Tehran using multistage cluster sampling.After selecting subjects aged 60 and over,optometric,and ophthalmic examinations were done.For retinal examination,a 90 D lens was used and indirect ophthalmoscopy was performed after instilling tropicamide drops.Biometry was done using the IOL Master for all participants.RESULTS:Of 3791 people that were invited through cluster sampling,3310 participated in the study(response rate=82%).The prevalence of retinal pigmented epithelium(RPE)change,drusen,geographic atrophy(GA),hypertensive retinopathy(HTR),nonproliferative diabetic retinopathy(NPDR),proliferative diabetic retinopathy(PDR),choroidal neovascularization(CNV),central retinal artery occlusion(CRAO),myopic retinopathy(MR),branch retinal vein occlusion(BRVO),and central retinal vein occlusion(CRVO)was 27.42%,11.08%,4.52%,3.03%,4.05%,0.54%,0.82%,0.39%,0.20%,0.49%,and 0.19%,respectively.After removing the effect of age,the odds of NPDR were 1.68 times higher in women compared to men(P=0.014).After removing the effect of sex,the odds of drusen,RPE change,GA,CNV,BRVO,and CRVO increased with age.CONCLUSION:There is a higher prevalence of RPE change,drusen,GA,CNV and a lower prevalence of MR and CRAO in the elderly population of Tehran aged over 60y compared to global average values.Considering the correlation of most of the diseases with age and their effects on vision,attention should be paid to these diseases and the related screening programs to prevent vision impairment.
文摘Rheumatoid arthritis(RA)is a chronic autoimmune disease that affects approxi-mately 0.46%of the global population.Conventional therapeutics for RA,including disease-modifying antirheumatic drugs(DMARDs),nonsteroidal anti-inflammatory drugs(NSAIDs),and corticosteroids,frequently result in unintended adverse effects.Dexamethasone(DEX)is a potent glucocorticoid used to treat RA due to its anti-inflammatory and immunosuppressive properties.Liposomal delivery of DEX,particu-larly when liposomes are surface-modified with targeting ligands like peptides or sialic acid,can improve drug efficacy by enhancing its distribution to inflamed joints and minimizing toxicity.This study investigates the potential of liposomal drug delivery systems to enhance the efficacy and targeting of DEX in the treatment of RA.Results from various studies demonstrate that liposomal DEX significantly inhibits arthritis progression in animal models,reduces joint inflammation and damage,and alleviates cartilage destruction compared to free DEX.The liposomal formulation also shows better hemocompatibility,fewer adverse effects on body weight and immune organ index,and a longer circulation time with higher bioavailability.The anti-inflammatory mechanism is associated with the downregulation of pro-inflammatory cytokines like tumor necrosis factor-α(TNF-α)and B-cell-activating factor(BAFF),which are key players in the pathogenesis of RA.Additionally,liposomal DEX can induce the expres-sion of anti-inflammatory cytokines like interleukin-10(IL-10),which has significant anti-inflammatory and immunoregulatory properties.The findings suggest that lipo-somal DEX represents a promising candidate for effective and safe RA therapy,with the potential to improve the management of this debilitating disease by providing targeted delivery and sustained release of the drug.
基金supported by Tehran University of Medical Sciences,Tehran,Iran(no.9711199007).
文摘Objective:The aim of this study was to investigate the health expectations(HEs)in patients with diabetes and the factors affecting it using an integrative systematic review.Methods:A comprehensive literature search was conducted in databases including PubMed,Scopus,Science Direct,Google Scholar,ProQuest,CINAHL,SID,Iran Doc,and Magiran without time limitation using related keywords.The systematic literature search was performed using a guide provided by York University.Results:From a total of 1883 articles,17 of them finally met the eligibility criteria.According to the findings of this study,HE of diabetic patients was included in four categories:“dynamism,”“consequentialism,”“comprehensive care,”and“access to facilities.”Also,these expectations can be influenced by various factors,including“developments in societies,”“changing the conditions of health care systems,”and“individual factors.”Conclusions:Health professionals should pay attention to the expectations of diabetic patients who are involved in complex disease conditions and consider meeting them as a key factor in providing patient-centered care,improving health outcomes,and patient satisfaction.
文摘AIM:To compare refractive error and angle of deviation in patients with basic esotropia and basic exotropia.METHODS:A retrospective review was conducted on the medical records of patients with basic-type strabismus.Demographic data,refractive error,best-corrected distance visual acuity(BCVA),and the horizontal and vertical angle of deviation between basic esotropia and exotropia patients were compared.RESULTS:Among the 7129 patients(mean age 22.98±14.81y)evaluated,44.7%(3185 cases,54.9%male)exhibited basic-type esotropia,while 55.3%(3944 cases,53.9%male)presented with basic-type exotropia.Basic esotropia cases exhibited more hyperopic spherical equivalent measurements in both eyes(right:0.53±3.07 vs left:0.56±2.98 D)than those with basic exotropia(right eye:-0.33±2.84 vs left eye:-0.24±2.68 D,P<0.001 for both eyes).Patients with basic esotropia had significantly greater horizontal deviation angles(near:36.08±18.87 PD and far:35.56±18.75 PD)compared to those with basic exotropia(near:33.75±16.11 PD and far:33.26±15.90 PD,P<0.001).Conversely,patients with basic exotropia had slightly higher vertical deviation angles(near:1.67±5.80 PD and far:1.72±5.89 PD)compared to those with basic esotropia(near:1.12±4.57 PD and far:1.12±4.58 PD,P<0.001).Patients with basic esotropia underwent surgical intervention at younger ages compared to basic exotropia individuals(19.68±15.99 vs 25.66±13.20,P<0.001).CONCLUSION:Basic esotropia patients present more hyperopic refractive errors,better visual acuity,larger horizontal yet smaller vertical ocular misalignments,and tend to undergo strabismus surgery at younger ages relative to basic exotropia cases.
文摘Objective:Medical expulsive therapy(MET)is a suitable option for facilitating stone expulsion in patients with distal ureteral stones.This meta-analysis was conducted to compare efficacy and safety of monotherapy and combination therapy with tamsulosin,silodosin,and tadalafil on stone expulsion rate(SER)and stone expulsion time(SET),as well as their comparative safety,numbers of colic pain episodes,and need for analgesics.Methods:Randomized controlled trials were retrieved by searching PubMed,Scopus,and Web of Science up to November 27,2023.Hand-searching was also conducted in Google Scholar to find additional records.Papers in English that compared the safety and efficacy of at least two of the above agents in adults with distal ureteral stones≤10 mm were included.Results:In total,27 studies were identified(six studies through database searches and 21 through checking reference lists and hand-searching in Google Scholar).More than half of them(n=15,56%)were conducted in India.The SER significantly improved with silodosin compared with tamsulosin(odds ratio[OR]2.24,p<0.001),whereas the difference in SET was non-significant.Tadalafil achieved a significantly higher SER compared with tamsulosin(OR 1.42,p=0.042)without any difference in SET.Subgroup analysis of 5-and 10-mg doses of tadalafil showed no significant difference in SER or SET.We found no significant difference in need for analgesics(mean difference(MD−53.73,p=0.2)or the mean number of colic episodes(MD−0.42,p=0.060)between tadalafil and tamsulosin.SER or SET was not significantly different between silodosin and tadalafil.Tadalafil plus tamsulosin led to a significantly higher SER(OR 1.87,p<0.001)and SET(MD−2.99,p=0.002)compared with tamsulosin,without any significant difference in adverse effects.Conclusion:Compared with tamsulosin,SER significantly improved with silodosin,tadalafil,and the combination of tadalafil plus tamsulosin.Meanwhile,the difference in SET was only significant between tadalafil plus tamsulosin versus tamsulosin.It appears that tadalafil and silodosin have similar efficacy in SET and SER.All medical expulsive therapies had comparable safety.
文摘Objective:To determine the effect of management before and during transplantation on the quality of donated organs.Improvement of preservation methods in cases involving brain death will lead to more effective organ procurement.Methods:Data were collected from the 226 brain death cases enrolled in the 12-month study period.All cases,patients with a Glasgow Coma Scale(GCS)score of 3 points,appropriate age,and having medical indications for organ donation,were considered to confirm the criteria of brain death.Transplant outcome data were obtained from the transplant centers.Results:The age of the deceased ranged between 1 year and 68 years,with a mean±SD of 39.54±17.28 years.There was no significant difference between the quality of organs regarding blood group and cause of brain death(P>0.05).However,there was a significant difference in the quality of organs regarding age,body mass index(BMI),and gender.There was a significant difference between the level of urea at admission time and procurement time(P<0.001),as well as between creatinine level at admission time and procurement time(P<0.001).There was also a significant difference between aspartate aminotransferase(AST)at admission time and procurement time(P<0.001),and between alanine aminotransferase(ALT)at admission time and procurement time(P<0.001).Conclusions:Transplant outcomes using older donor livers and kidneys were comparable to those using younger or male donors.These findings provide further evidence that decision-making about organ quality is influenced by age and gender and emphasize the importance of transparency in organ acceptance practices.
文摘AIM:To compare objective dry retinoscopy and subjective refraction measurements in patients with mild keratoconus(KCN)and quantify any differences.METHODS:This cross-sectional study was done on 68 eyes of 68 patients diagnosed with mild KCN.Objective dry retinoscopy using autorefractometer and subjective refraction measurements were performed.Sphere,cylinder,J0,J45,and spherical equivalent values were compared between the two techniques.RESULTS:The mean age of 68 patients with mild KCN was 21.32±5.03y(12–35y).There were 37(54.4%)males.Objective refraction yielded significantly more myopic sphere(-1.44 D vs-0.57 D),higher cylinder magnitude(-2.24 D vs-1.48 D),and more myopic spherical equivalent(-2.56 D vs-1.31 D)compared to subjective refraction(all P<0.05).The mean differences were-0.87 D for sphere,-0.76 D for cylinder,and-1.25 D for spherical equivalent.No significant differences were found for J0 and J45 values,indicating agreement in astigmatism axis(P>0.05).CONCLUSION:In patients with mild KCN,objective dry retinoscopy overestimates the degree of myopia and astigmatism compared to subjective refraction.The irregular cornea in KCN likely impacts objective measurements.Subjective refraction allows compensation for irregularity,providing a more accurate correction.When determining refractive targets,the tendency of objective methods to overcorrect should be considered.
文摘AIM:To identify differences in clinical features between thyroid eye disease(TED)patients with and without strabismus.METHODS:This retrospective,single-center,consecutive case series study was conducted on TED patients who were determined to be surgical candidates.The patients’cohort were divided into two groups based on the presence or absence of strabismus.Demographics and complete eye examinations were recorded and compared between the TED and TED with strabismus groups.RESULTS:A total of 76 patients with TED were enrolled,including 58 males(76.3%)with a mean age of 52.68±10.45y.The 55 patients(male:female=2:1)were found to have TED with strabismus,while the remaining 21 patients(male:female=4:1)had TED without strabismus.There was nearly a four times greater likelihood of lid retraction being associated with TED without strabismus(OR=4.1,P=0.018)and they showed higher prevalence of proptosis(95.2%)than the TED strabismus group(63.6%,P<0.001).In the TED-strabismus group,20%of patients had abnormal head posture(AHP),while none were identified in the TED group(P=0.029).Despite the higher incidence of vision-threatening complications such as dysthyroid optic neuropathy(19%vs 8.1%)and exposure keratopathy(4.8%vs 1.8%)in the TED group than in the TED-strabismus group,the difference did not reach statistical significance(P>0.05).The most common types of strabismus were hypotropia(36%)and esotropia(29%),respectively.CONCLUSION:Strabismus-associated TED is characterized by a lower prevalence of proptosis and lid retraction,but a higher incidence of compensatory AHP.Identifying these differences may aid in risk stratification and early intervention for TED patients,particularly those at risk for restrictive strabismus.
文摘AIM:To evaluate the mid-term effects of topical latanoprost 0.005%on vessel density(VD)of the bulbar conjunctiva using anterior segment optical coherence tomography angiography(OCTA).METHODS:Thirty-four eyes of 21 patients and 18 eyes of 9 healthy subjects were recruited as the treatment and control groups,respectively.The treatment group was instructed to apply generic latanoprost 0.005%once daily at night,while the control group received no medication.Anterior segment OCTA was performed on all eyes at baseline,3wk,and 12wk after initiation of latanoprost.The superficial bulbar conjunctival VD was measured in the superior,inferior,temporal,and nasal quadrants.A linear mixed model was used to compare the change in the VD between groups.RESULTS:The change in the VD was not different between groups in temporal,and nasal quadrants at 3-week and 12-week time points.The VD in the superior bulbar conjunctiva was significantly increased after 12wk(P=0.029)while the change from baseline after 3wk was not different between groups(P=0.218).After adjustment for age and gender superior hemi(P=0.006)and center(P=0.016)of the inferior quadrant of bulbar conjunctiva showed increased VD after 12wk.CONCLUSION:The trend of changes in the superior and inferior conjunctival VD is increased following topical latanoprost administration and these changes can be quantified using anterior segment OCTA.
文摘Objective:Non-pharmacological treatments of traditional medical systems are becoming recognized in management of respiratory diseases,especially COVID-19.This study was designed to evaluate the effec-tiveness of acupuncture as an adjuvant therapy in hospitalized patients with COVID-19.Methods:This randomized controlled trial was performed on 70 moderate to severe hospitalized patients with COVID-19.Patients were randomized into two groups,receiving conventional treatment alone or in combination with acupuncture for 7 days.Both groups were followed up for 28 days.Respiratory rate and SpO_(2)were considered as primary outcomes.Additionally,respiratory symptoms(cough,dyspnea,chest tightness,and oxygen demand)and duration of hospitalization,ICU admission,intubation,and mortality rate were evaluated.The outcome assessor and data analyst were blinded.Results:Acupuncture significantly improved respiratory rate and SpO_(2)after 3 days(v.s.7 days in con-trol group).SpO_(2)reached 93%from the third day of conducting acupuncture.Respiratory symptoms were relieved after 7 days in the both groups,but were significant from day 3 in the acupuncture group(P<0.001).Duration of hospitalization was less in the acupuncture group(3 days v.s.11 days),with no ICU admission,intubation or death.In contrast,8 patients in the control group were admitted to ICU,of whom 4 were intubated and died.No adverse effect was reported.Conclusion:Acupuncture can play a significant role as a safe and effective complementary treatment in the management of COVID-19.
文摘Human-derived tumor models are essential for preclinical development of new anti-cancer drug entities.Generating animal models bearing tumors of human origin,such as patient-derived or cell line-derived xenograft tumors,is dependent on immuno-deficient strains.Tumor-bearing immunodeficient mice are susceptible to develop-ing unwanted disorders primarily irrelevant to the tumor nature;and if get involved with such disorders,reliability of the study results will be undermined,inevitably con-founding the research in general.Therefore,a rigorous health surveillance and clinical monitoring system,along with the establishment of a strictly controlled barrier facility to maintain a pathogen-free state,are mandatory.Even if all pathogen control and biosafety measures are followed,there are various noninfectious disorders capable of causing tissue and multiorgan damage in immunodeficient animals.Therefore,the re-searchers should be aware of sentinel signs to carefully monitor and impartially report them.This review discusses clinical signs of common unwanted disorders in experi-mental immunodeficient mice,and how to examine and report them.
基金supported by Shiraz University of Medical Sciences,Shiraz,Iran(grant No.:17780).
文摘Due to the limited regeneration capacity of myocardial tissue after infarction,designing tissue engineering scaffolds are in demand.In the present study,electrospun nanofibrous scaffolds were made out of polyurethane,collagen and gold nanoparticles with random and aligned nanofiber morphologies.The nanoparticles were green-synthesized using saffron extract.Nanoparticle characterizations with UV-Vis.spectroscopy and DLS illustrated theoretical and hydrodynamic diameters of around 7 and 13 nm,respectively,having zeta potential of−37 mV.SEM and TEM micrographs showed the morphology and diameters of obtained nanofibers.Also,further characterization were done by ATR-FTIR,XRD and TGA investigations and degradation studies.Contact angle measurements showed hydrophilic nature of the scaffolds(59±0.6°for aligned PU/Col/Au50 nanofibers compared to 120±2.6°for random PU nanofibers).Mechanical testing demonstrated appropriate tensile properties of the scaffolds for cardiac tissue engineering(Young’s modulus:1.53±0.07 MPa for aligned PU/Col/Au50 nanofibers compared to 0.4±0.05 MPa for random PU nanofibers).Finally,alamar blue assay revealed proper survival of the cells of HUVEC cell line on the prepared scaffolds,where the highest percentages were observed for random and aligned PU/Col/Au50 nanofibers.According to the findings,the fabricated PU/Col/AuNPs nanofibrous scaffolds could be considered as potential cardiac patches.
文摘BACKGROUND It is expected that transfer of spinal accessory nerve to suprascapular nerve,which is widely used in the restoration of the shoulder function in brachial plexus birth injury(BPBI),impairs the trapezius function.AIM To hypothesize that the lower trapezius muscle remains functional after this neve transfer.METHODS In a retrospective cross-sectional study,patients with BPBI who underwent nerve transfer from accessory nerve to supraclavicular were followed for at least six months following the operation and demographic data were extracted from the database.To assess the lower trapezius function,shoulder abduction and external rotation were examined,and electromyography and nerve conduction velocity(EMG-NCV)was performed.RESULTS A total of 19 patients with a mean age of 2.69±1.40 years and a mean follow-up of 10.5 months were included in the study.Shoulder abduction was disabled completely only in one patient(5.26%);10(52.63%)had good,3(15.78%)moderate,and 5(26.31%)had poor shoulder abduction.Regarding external rotation,one(5.26%)was unable to externally rotate the shoulder;among 18(94.73%)patients who had satisfactory results,8(42.10%)were evaluated to be good,5(26.31%)moderate,and 5(26.31%)poor.EMG-NCV showed functional lower trapezius in all patients;its function was evaluated to be good in 11(57.89%),moderate in 6(31.57%),and poor in 2(10.52%)cases.CONCLUSION This study supports the hypothesis that the lower trapezius muscle has a dual motor innervation which provides the possibility of further trapezius tendon transfer to restore a better shoulder function.
文摘BACKGROUND Rotator cuff tears are a chief cause of shoulder pain and disability,and surgical repair is often required when conservative management fails.As digital health technologies have expanded,especially since the coronavirus disease 2019 pandemic,digitally augmented rehabilitation programs emerged as a potential alternative to conventional physical therapy.AIM To determine if digitally assisted rehabilitation could be as practical,or even more effective,than the traditional methods most patients currently follow.METHODS Six electronic databases,including PubMed,Scopus,Cochrane Library,Google Scholar,EMBASE,and Web of Science,were searched to find articles that compare digital-based rehabilitation and conventional treatment.Outcomes of interest were Disabilities of the Arm,Shoulder and Hand(DASH)score and range of motion.The quality assessment of the included studies was performed using the risk-of-bias tool for randomized trials tool.RESULTS Three randomized controlled trial studies were enrolled in this study,including 195 cases.We did not find any significant differences between the two groups in terms of DASH score,flexion range of motion,and external rotation range of motion.There was a significant difference between the two groups for abduction range of motion.CONCLUSION Digital home-based rehab seems to be a strong alternative to traditional methods,offering similar results for people recovering from rotator cuff surgery.This approach might also make rehab more accessible and engaging for patients.That said,further research is needed to fully understand the potential of digital rehabilitation and ensure it works effectively for everyone.
文摘The quality of care and treatment can be impacted by a number of factors, including the rate of missed care. The present study was conducted with the aim to evaluate missed nursing care (MNC) and its association with patient safety culture in the emergency department (ED). Until September 2024, the international databases MEDLINE (PubMed and Ovid), Embase and Cochrane, Scopus, Wiley Online Library, Web of Science, Cochrane Central Register of Controlled Trials, EBSCO, ISI, Elsevier, and Google Scholar were searched using the search terms including patient safety culture and MNC. A total of eight articles were reviewed. In the fixed-effect model with low heterogeneity (I^(2) = 0%, P = 1), the mean score of overall MNC was 2.07 (ES, 2.97;95% confidence interval: −2.21-6.35). According to meta-regression analyses, MNC significantly inversely correlated with patient safety culture, age, and work experience (P < 0.01). By improving the working conditions of ED nurses and providing training related to patient safety, the amount of lost nursing care will decrease.
