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Original Article:
The effect of symbiotic in the treatment of infantile colic: A double-blind, randomized, placebo-controlled clinical trial
Parisa Khoshnevisasl, Mansour Sadeghzadeh, Koorosh Kamali, Masoumeh Hasanlo
J Res Med Sci
2022, 27:42 (30 May 2022)
DOI
:10.4103/jrms.jrms_128_21
Background:
This study aims to evaluate the effect of symbiotic (Pedilact) on the treatment of infantile colic.
Materials and Methods:
In this randomized clinical trial in Zanjan, Iran, 76 infants with infantile colic were assigned to two groups of 38 cases using block randomization. The intervention group received 5 drops of Pedilact, a symbiotic containing
Lactobacillus reuteri
and simethicone (20 mg twice daily), and the control group received placebo in addition to simethicone for 4 weeks. Daily crying time, number of crying attacks per day, and sleep duration were recorded on days 1, 7, 14, 21, and 28, and the results were compared.
Results:
Thirty-three infants in the intervention group and 35 infants in the control group were enrolled. There was no significant difference between the two groups in terms of age, gender, gestational age, maternal age, type of delivery, type of feeding, and weight at the beginning and the end of the study (all
P
> 0.05). Daily crying time in the control and intervention groups decreased from 240 and 210 min/day, respectively, to 0 min/day in both the groups. Daily crying attacks decreased from 5 and 4/day in the control and intervention groups, respectively, to 0/day. Sleep duration in both the groups increased from 720 to 840 and 930 min/day in the control and intervention groups, respectively, but the changes were not significant (
P
= 0.56,
P
= 0.52, and
P
= 0.13, respectively).
Conclusion
: We did not find a significant improvement in colic symptoms in infants receiving symbiotic compared to placebo.
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Letter To Editor:
Ollier's disease associated with ovarian juvenile granulosa cell tumor and triple X syndrome: A letter to the editor
Shamim Shafieyoon, Mohammad Ali Tahririan, Ali Hekmatnia, Andrew Parviz Zarei, Farzaneh Hekmatnia, Ghazaleh Jamalipour Soufi
J Res Med Sci
2022, 27:41 (30 May 2022)
DOI
:10.4103/jrms.jrms_980_21
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Review Article:
Molecular basis of acute coronary syndrome
Natalya Balashkevich, Maxut Kazymov, Marat Syzdykbayev, Aima Adylova
J Res Med Sci
2022, 27:40 (30 May 2022)
DOI
:10.4103/jrms.jrms_695_21
Cardiovascular diseases (CVD) comprise of various heart and blood vessels-related diseases. Acute coronary syndrome (ACS) is one of them. Basic researchers and cardiologists have witnessed landmark developments related to ACS and despite rapid refinement in our understanding; scientists are seeking answers for more questions. Scientists have mapped wide ranging proteins and intricate protein networks which play central role in the pathogenesis in ACS. In this review, we have attempted to summarize underlying causes of ACS. Better understanding of the disease pathology will enable us to get a step closer to an effective clinical management.
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Short Communication:
Antibiotic resistance pattern of
Helicobacter pylori
strains isolated from patients in Isfahan, Iran
Hajarsadat Sadeghi, Tahmineh Narimani, Elham Tabesh, Fatemeh Shafiee, Rasool Soltani
J Res Med Sci
2022, 27:39 (30 May 2022)
DOI
:10.4103/jrms.jrms_829_21
Background:
The objective of this study was to evaluate the antibiotic resistance pattern of
Helicobacter pylori
strains isolated from patients in Isfahan province.
Materials and Methods:
Gastric antrum biopsy specimens of patients undergoing endoscopy were cultured. The samples with the growth of
H. pylori
underwent antibiotic susceptibility test by disk diffusion method.
Reaults:
Of 96 samples, 50 samples (53%) were positive for
H. pylori
. The rates of antibiotic resistance were as follows: amoxicillin, 6%; azithromycin, 20%; furazolidone, 22%; levofloxacin, 16%; metronidazole, 20%; rifampin, 12%; and tetracycline, 22%.
Conclusion:
H. pylori
strains in our area have high rates of resistance to azithromycin, levofloxacin, metronidazole, tetracycline, and furazolidone.
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Original Article:
Estimating the best fraction of inspired oxygen for calculation of PaO2/FiO2 ratio in acute respiratory distress syndrome due to COVID-19 pneumonia
Leila Kadkhodai, Mahmoud Saghaei, Mohammadreza Habibzadeh, Babak Alikiaii, Seyed Jalal Hashemi
J Res Med Sci
2022, 27:38 (30 May 2022)
DOI
:10.4103/jrms.jrms_558_21
Background:
The ratio of partial pressure of oxygen in arterial blood (PaO2) to the fraction of inspiratory oxygen concentration (FiO2) is an indicator of pulmonary shunt fraction. PaO2/FiO2 (P/F) ratio is used to classify severity of acute respiratory distress syndrome (ARDS). With the same shunt fraction, P/F ratio decreases with increases in FiO2 which may lead to errors in classifying severity of ARDS. The effect of FiO2 on P/F ratio has not been investigated in COVID-19 pneumonia. In this study, we estimated the best FiO2 for the calculation of P/F ratio in a sample of patients with ARDS due to COVID-19 pneumonia.
Materials and Methods:
Blood gas and ventilatory data of 108 COVID-19 ARDS patients were analyzed in a cross-sectional observational study. Using Oxygen Status Algorithm the calculated shunt fraction served a basis for calculating P/F ratio for different FiO2. The severity of ARDS determined by P/F ratios at each FiO2s was compared with the shunt-based severity to find the optimum FiO2 for calculation of P/F ratio so the resulting classification has the best match with the reference classification.
Results:
A FiO2 of 1.0 for calculation of P/F ratio and ARDS classification showed the best match with shunt-based ARDS classification. A regression model was obtained with the PaO2, patient's original FiO2, Hemoglobin concentration, and SaO2 as the independent predictors of the P/F ratio for the FiO2 of 1.0.
Conclusion:
This study shows a FiO2 of 1.0 as the best value for correct calculation of P/F ratio and proper classification of ARDS.
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Original Article:
Evaluation of the predictive value of body mass index (BMI), waist circumference, and visceral fat to differentiate non-alcoholic fatty liver (NAFLD) in women with polycystic ovary syndrome
Bita Eslami, Najmeh Aletaha, Arezoo Maleki-Hajiagha, Mahdi Sepidarkish, Ashraf Moini
J Res Med Sci
2022, 27:37 (30 May 2022)
DOI
:10.4103/jrms.JRMS_292_20
Background:
Our objective was to determine the overall prevalence of nonalcoholic fatty liver disease (NAFLD) in women with polycystic ovarian syndrome (PCOS) in our sample population. The second aim was to evaluate the predictive value of body mass index (BMI), waist circumference (WC), and visceral fat for the onset of NAFLD in these patients.
Materials and Methods:
This cross-sectional study was performed on 71 women with PCOS who were referred to Arash Women's Hospital in Tehran. Demographic and clinical information and anthropometric and biomedical indices were collected by a trained nurse. Liver ultrasonography was performed for all participants by a radiologist.
Results:
NAFLD was identified in 53.5% (
n
= 38) of subjects and the frequency of mild, moderate, and severe grades were 65.8%, 31.6%, and 2.6%, respectively. BMI and visceral fat of patients with NAFLD were significantly higher than non-NAFLD (
P
< 0.001). Receiving operating characteristic (ROC) curve analysis revealed that BMI was the best indicator of predicting NAFLD (cutoff = 25.5 kg/m
2
, sensitivity 75%, and specificity 75%), whereas visceral fat (cutoff = 5.5%, sensitivity 79%, and specificity 67%) and WC (cutoff = 89.5 cm, sensitivity 73%, and specificity 64%) were inferior for predicting NAFLD in PCOS patients.
Conclusion:
The prevalence of NAFLD in the study population is high. Our findings supported the use of BMI as a simple and practical predictive factor for the NAFLD onset, with a cutoff level of 25.5. The use of this cutoff level will enable physicians to identify PCOS patients at risk for NAFLD.
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Original Article:
Evaluation of methicillin-resistant
Staphylococcus
virulence genes and antibiotics susceptibility in Iranian population
Shahnaz Armin, Abdollah Karimi, Zahra Pourmoghaddas, Leila Azimi, Fatemeh Fallah, Sahel Valadan Tahbaz
J Res Med Sci
2022, 27:36 (30 May 2022)
DOI
:10.4103/jrms.JRMS_543_19
Background:
Methicillin resistance
Staphylococcus aureus
(MRSA) is one most important pathogens for human health. The ability of this organism for producing different kinds of disease is related to its virulence gene. The frequency of hemolysin alpha (hla), hemolysin beta (hlb), and exfoliative toxin A (eta) virulence genes of MRSA was evaluated, and the association of these genes with antibiotics susceptibility was investigated.
Materials and Methods:
In a cross-sectional study, a total of 695
Staphylococcus
clinical samples from seven different provinces of Iran were evaluated. MRSA was detected by cefoxitin disk. Virulence genes were detected by polymerase chain reaction. Susceptibility to clindamycin and ciprofloxacin was evaluated according to the Clinical and Laboratory Standards Institute guideline.
Results:
From a total of 695 samples, 170 (24.46%) were found to be MRSA. 142, 82, and 132 samples of MRSA were hla, hlb, and eta positive, respectively. hla gene was significantly found more frequently in patients at least 18 years (
P
= 0.02). 105 (68.6%) and 93 (59.6%) of MRSA samples were resistance to ciprofloxacin and clindamycin, respectively. hlb gene was significantly more resistant to clindamycin (
P
= 0.04) and ciprofloxacin (
P
= 0.01). Logistic regression analysis displayed hlb-positive MRSA strains were significantly associated with ciprofloxacin (odds ratio [OR]: 3.6, 95% confidence interval [CI] = 1.637–8.00) and clindamycin (OR: 1.93, 95% CI 1.00–3.68).
Conclusion:
MRSA strains from
Staphylococcus aureus
which isolated from hospitalized Iranian patients are significantly resistant to clindamycin and ciprofloxacin and it is may be because of hlb virulence gene. These samples consist of both community-acquired MRS) and health-care associated MRSA, so we could not use this finding as a guide for local antibiotics usage.
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Original Article:
Right ventricular diastolic function predicts clinical atrial fibrillation after coronary artery bypass graft
Mehdi Zand, Roya Sattarzadeh, Farnoosh Larti, Pejman Mansouri, Anahita Tavoosi
J Res Med Sci
2022, 27:35 (22 April 2022)
DOI
:10.4103/jrms.JRMS_816_19
Background:
Patients with moderate-severe left ventricular systolic dysfunction undergoing coronary artery bypass graft (CABG) surgery are at high risk of mortality and morbidity. Our aim is to evaluate the right ventricular (RV) diastolic function in these patients, and monitor its effects on postoperation outcomes.
Materials and Methods:
In a cohort study, patients with moderate-severe left ventricular systolic dysfunction (ejection fraction ≤35%) who were candidate for CABG were included. Baseline transthoracic echocardiography (TTE) was performed, and RV diastolic function measures were obtained. After CABG, the length of intubation, inotrope dependency, hospital stay in intensive care unit and ward, in-hospital and after discharge mortality, postoperative atrial fibrillation (POAF) were evaluated in all patients.
Results:
Sixty-seven patients were prospectively included in the study. The mean ± standard deviation age of our patients was 61.4 ± 9.3. There was no difference between grades of RV diastolic function and postoperative outcomes. However, we found significant difference between grades of RV diastolic function and onset of in hospital, and total POAF (
P
-value = 0.017). Multivariate analysis demonstrated that preoperative tricuspid E
t
/E'
t
(ratio of peak early-diastolic flow rate across the tricuspid valve orifice to peak early-diastolic velocity at the lateral tricuspid annulus), left atrial volume and “high risk” Euroscore II were independent predictors for POAF during hospitalization and total POAF in patients with moderate to severely impaired left ventricular systolic function (
P
-values were 0.04, 0.003 and 0.001, respectively).
Conclusion:
We believe that patients with increased tricuspid E
t
/E'
t
are high risk for POAF; therefore, any risk score for POAF should include a comprehensive TTE including evaluation of RV diastolic function before surgery.
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Original Article:
Association of systemic complications with mortality in coronavirus disease of 2019: A cohort study on intensive care unit patients
Mohammad Ali Ashraf, Alireza Sherafat, Zohre Naderi, Ramin Sami, Forogh Soltaninejad, Saba Khodadadi, Sanaz Mashayekhbakhsh, Negar Sharafi, Somayeh Haji Ahmadi, Azin Shayganfar, Iman Zand, Ali Ajami, Kiana Shirani
J Res Med Sci
2022, 27:34 (15 April 2022)
DOI
:10.4103/jrms.JRMS_1213_20
Background:
Since the beginning of the coronavirus disease of 2019 (COVID-19) pandemic, concerns raised by the growing number of deaths worldwide. Acute respiratory distress syndrome (ARDS) and extrapulmonary complications can correlate with prognosis in COVID-19 patients. This study evaluated the association of systemic complications with mortality in severely affected COVID-19 patients.
Materials and Methods:
This retrospective study was done on 51 intensive care unit (ICU)-admitted COVID-19 adult patients who were admitted to the ICU ward of Khorshid hospital, affiliated with Isfahan University of Medical Sciences. Only the patients who had a definite hospitalization outcome (dead vs. survivors) were included in the study. Daily clinical and paraclinical records were used to diagnose in-hospital complications in these patients.
Results:
The sample was comprised of 37 males (72.5%) and 14 females (27.4%). The median age of patients was 63 years (Min: 20, Max: 84), with the mortality rate of 47.1%. In total, 70.6% of patients had at least one coexisting disorder. Chronic kidney disease was associated with the worse outcome (29.16% of dead patients against 3.70 of survived ones). Mechanical ventilation was used in 58.8% of patients. Patients who had received invasive ventilation were more likely to die (87.50% of dead patients against 7.40 of survivors), Complications including sepsis and secondary infections (odds ratio: 8.05, confidence interval: 2.11–30.63) was the strongest predictors of mortality.
Conclusion:
Complications including sepsis and secondary infections can increase the risk of death in ICU-admitted COVID-19 patients. Therefore, it is substantial that the physicians consider preventing or controlling these complications.
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Review Article:
Hemoperfusion in combination with hemofiltration for acute severe organophosphorus pesticide poisoning: A systematic review and meta-analysis
Minghao Zhang, Wei Zhang, Shunzhong Zhao, Xiaoxi Tian, Guoqiang Fu, Boliang Wang
J Res Med Sci
2022, 27:33 (15 April 2022)
DOI
:10.4103/jrms.JRMS_822_20
Background:
Acute severe organophosphorus pesticide poisoning (ASOPP) is one of the major diseases that endanger human life and health. However, the effects of conventional therapy including gastric lavages, mechanical ventilation, muscarinic antagonist drugs, and cholinesterase reactivators were uncertain. This meta-analysis aims to investigate the safety and efficacy of hemoperfusion combined with hemofiltration besides routine therapy for ASOPP.
Materials
and
Methods:
A comprehensive search for candidate publications was performed through PubMed, Medline, Cochrane Library, WanFang, Chinese Biomedical Literature, and China National Knowledge Infrastructure from database inception to May 12, 2020. The retrieved studies were screened by the predefined inclusion and exclusion criteria. The data of important end points were extracted. The risk ratio (RR) and weighted mean difference (WMD) were pooled for categorical variables and continuous variables, respectively. Meta-analyses and publication bias were conducted by using STATA software version 15.1.
Results:
A total of 11 randomized controlled trials with 811 patients were included. Compared to conventional therapy group, patients in the hemoperfusion plus hemofiltration group were significantly superior with regard to mortality (RR 0.38, 95% confidence interval [CI] [0.25, 0.57],
P
< 0.001), total atropine dosing (WMD −147.34 mg, 95% CI [−199.49, −95.18],
P
< 0.001), duration of mechanical ventilation (WMD −2.34 days, 95% CI [−3.77, −0.92],
P
< 0.001), cholinesterase recovery time (WMD −2.49 days, 95% CI [−3.14, −1.83],
P
< 0.001), and length of stay (WMD −4.52 days, 95% CI [−5.31, −3.73],
P
< 0.001).
Conclusion:
Combined hemoperfusion and hemofiltration was a very safe and effective treatment protocol for ASOPP, not only resulting in significantly decreased mortality but also resulting in reduced total atropine dosing, duration of mechanical ventilation, cholinesterase recovery time, and length of stay.
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Original Article:
Gastrointestinal manifestations in patients with coronavirus disease-2019 (COVID-19): Impact on clinical outcomes
Elham Tabesh, Maryam Soheilipour, Ramin Sami, Marjan Mansourian, Faezeh Tabesh, Forogh Soltaninejad, Mehrnegar Dehghan, Niloofar Nikgoftar, Ali Gharavinia, Khojasteh Ghasemi, Peyman Adibi
J Res Med Sci
2022, 27:32 (15 April 2022)
DOI
:10.4103/jrms.jrms_641_21
Background:
In this study, we summarized the data on gastrointestinal (GI) involvement and the potential association with clinical outcomes among the patients admitted to Khorshid Hospital.
Materials
and
Methods:
We investigated 1113 inpatients (≥18 years old) diagnosed with coronavirus disease-2019 (COVID-19) from March to June 2020 in Khorshid Hospital. We collected demographic details, clinical information, vital signs, laboratory data, treatment type, and clinical outcomes from patients' medical records. The data of patients with GI symptoms were compared with those without GI symptoms.
Results:
A total of 1113 patients were recruited (male = 648). GI symptoms were observed in 612 (56.8%) patients (male = 329), the most common of which were nausea 387 (34.7%), followed by diarrhea 286 (25.7%), vomiting 260 (23.4%), and abdominal pain 168 (15.0%). The most prominent non-GI symptoms were cough 796 (71.5%), fever 792 (71.2%), shortness of breath 653 (58.7%), and body pain 591 (53.1%). The number of patients who were discharged, died, and were admitted to intensive care unit was significantly different in groups on the basis of GI and non-GI symptoms (
P
= 0.002, 0.009, 0.003).
Conclusion:
While COVID-19 was predominantly diagnosed in males, GI symptoms were more commonly reported by females. The results indicated that GI symptoms in COVID-19 patients are common, and the symptoms are not correlated with the severity of the disease. Moreover, the presence of GI symptoms was positively related to milder disease. Among COVID-19 positive patients, the clinical outcomes of the GI group were promising, compared to those of non-GI group.
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Short Communication:
New-onset acute ischemic stroke following COVID-19: A case–control study
Fariborz Khorvash, Mohammad Amin Najafi, Mohsen Kheradmand, Mohammad Saadatnia, Rojin Chegini, Farideh Najafi
J Res Med Sci
2022, 27:31 (15 April 2022)
DOI
:10.4103/jrms.jrms_255_21
Background:
Neurological manifestations of coronavirus disease 2019 (COVID-19) have been highlighted. COVID-19 potentially increases the risk of thromboembolism. We aimed to compare patients with COVID-19 with and without new-onset acute ischemic stroke (AIS).
Materials
and
Methods
: In this single-center retrospective case
–
control study, demographics, clinical characteristics, laboratory findings, and clinical outcomes were compared between 51 patients with both COVID-19 and AIS (group A) and 160 patients with COVID-19 and without AIS (group B).
Results:
Patients in group A were significantly older, more likely to present with critical COVID-19 (
P
= 0.004), had higher rates of admission in the intensive care unit (
P
< 0.001), more duration of hospitalization (
P
< 0.001), and higher in-hospital mortality (
P
< 0.001). At the time of hospitalization, O
2
saturation (
P
= 0.011), PH (
P
= 0.04), and HCO3 (
P
= 0.005) were lower in group A. White blood cell count (
P
= 0.002), neutrophil count (
P
< 0.001), neutrophil-lymphocyte ratio (
P
= 0.001), D-Dimer (
P
< 0.001), blood urea nitrogen (BUN) (
P
< 0.001), and BUN/Cr ratio (
P
< 0.001) were significantly higher in patients with AIS.
Conclusion:
Stroke in COVID-19 is multifactorial. In addition to conventional risk factors of ischemic stroke (age and cardiovascular risk factors), we found that patients with more severe COVID-19 are more prone to ischemic stroke. Furthermore, leukocyte count, neutrophil count, neutrophil-lymphocyte ratio, D-Dimer, BUN, and BUN/Cr ratio were higher in patients with AIS following COVID-19 infection.
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Original Article:
Saffron (
Crocus sativus
L.) supplements improve quality of life and appetite in atherosclerosis patients: A randomized clinical trial
Shonaz Ahmadikhatir, Alireza Ostadrahimi, Abdolrasoul Safaiyan, Shoyar Ahmadikhatir, Nazila Farrin
J Res Med Sci
2022, 27:30 (15 April 2022)
DOI
:10.4103/jrms.JRMS_1253_20
Background:
Atherosclerosis is the most common cause of the cardiovascular disease. Saffron is a traditional food that affects many diseases and disorders. Therefore, the aim of this study was to identify the effects of Saffron (
Crocus sativus
L.) on quality of life (QOL) and appetite in patients with atherosclerosis.
Materials and Methods:
This was a randomized, double-blind, placebo-controlled clinical trial. A total of 63 participants with atherosclerosis were recruited from Emam Sajjad Hospital, Valiasr Hospital, and Zafaranieyh Clinic in Tehran, Iran. The participants were divided randomly into two groups. Participants received 100 mg/d saffron or placebo capsule for 6 weeks. QOL and appetite levels were measured by the McNew QOL questionnaire, and visual analog scale questionnaire, respectively. Furthermore, anthropometric indices of participants were measured before and after the intervention.
Results:
Statistical analysis showed that there was a statistically significant difference between atherosclerosis patients who received placebo and those who consumed saffron in terms of the physical domain (
P
= 0.008) and social domain (
P
= 0.012) of QOL. In the saffron group increased score in Total score Macnew (
P
< 0.001), physical domain (
P
= 0.025), and social domain (
P
< 0.001) was significant after the intervention. Moreover, the consumption of saffron did not significantly affect emotional domains of QOL, and appetite levels
Conclusion:
Saffron may be considered as a novel agent in patients with atherosclerosis to improve the QOL. A great deal of further research will be needed to critically validate the efficacy of saffron and its mechanisms in atherosclerosis.
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Original Article:
Psychometric properties of persian version of five facets of mindfulness questionnaire
Sajad Khanjani, Ali-Akbar Foroughi, Meysam Bazani, Sahar Rafiee, Shima Tamannaeifar, Mojtaba Habibi
J Res Med Sci
2022, 27:29 (15 April 2022)
DOI
:10.4103/jrms.JRMS_10_20
Background:
Many tools have been designed to measure mindfulness. Five Facets of Mindfulness Questionnaire (FFMQ) is one of the most widely used tools. This study was done to investigate psychometric properties FFMQ in Iranian students.
Materials
and
Methods:
FFMQ was translated into Persian and administered in 571 students of Shahid Beheshti University of Medical Sciences and Tehran University of Medical Science. Samples were selected using convenience sampling method. A battery including Difficulty in Emotion Regulation Scale (DERS), Emotion Regulation Questionnaire (ERQ), Spielberger's Trait Anxiety Questionnaire, and Affect Control Scales was used in studies for examining divergent, convergent, and discriminant validity. Data were analyzed using Cronbach's alpha, test–retest reliability, and confirmatory factor analysis.
Results:
Results of this study supported the five-factor structure of FFMQ (root mean square error of approximation = 0.06, Comparative Fit Index = 0.81 Goodness of Fit Index = 0.91, and Normed Fit Index = 0.87). There was a significantly negative correlation between the FFMQ with DERS, Trait Anxiety, Affect Control, suppression sub-scale of ERQ, and there was a positive correlation with reappraisal subscale of ERQ. The Cronbach's alpha for the FFMQ was. 78.
Conclusion:
FFMQ have good psychometric properties in Iranian student sample, and it can be used in studies on student populations.
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Original Article:
Nigella sativa
extract in the treatment of depression and serum Brain-Derived Neurotrophic Factor (BDNF) levels
Aryan Rafiee Zadeh, Aynaz Foroughi Eghbal, Seyed Mahdi Mirghazanfari, Mohammad Reza Ghasemzadeh, Ehsan Nassireslami, Vahid Donyavi
J Res Med Sci
2022, 27:28 (15 April 2022)
DOI
:10.4103/jrms.jrms_823_21
Background:
Here, we aimed to investigate the therapeutic effects of
Nigella sativa
extract on serum brain-derived neurotrophic factor (BDNF) and depression score in patients with depression.
Materials and Methods:
This clinical trial was performed in 2021 in the hospitals of military forces in Tehran on 52 male patients with major depressive disorder treated with sertraline. We used the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) questionnaire to assess the patients. Serum BDNF levels were measured by the enzyme-linked immunosorbent assay. Patients were then divided into two groups receiving 1000 mg
N. sativa
oil extract, daily, and placebo. Both groups received sertraline for at least 3 months. DASS-21 questionnaire and serum BDNF levels were measured after 10 weeks.
Results:
After treatments, we observed significantly decreased DASS-21 score (−11.24 ± 5.69) in the intervention group (
P
< 0.001) and placebo (−2.72 ± 6.19,
P
= 0.032), but patients in the intervention group had significantly lower scores (50.1 ± 6.8 vs. 58.2 ± 5.6, respectively,
P
< 0.001). Furthermore, patients in the intervention group had significantly decreased depression score (−5.5 ± 2.47,
P
< 0.001) and lower scores compared to the placebo (
P
< 0.001) (18.6 ± 2.7 vs. 23.4 ± 2.1 in intervention and placebo, respectively). We also observed significantly increased BDNF levels in the intervention group after the treatments (6.08 ± 3.76,
P
< 0.001) compared to the placebo group (29.4 ± 3.6 vs. 24.9 ± 2.1,
P
< 0.001). Serum BDNF levels had also significant reverse correlations with DASS-21 score (
r
= −0.35,
P
= 0.011) and depression score (
r
= −0.45,
P
= 0.001).
Conclusion:
The use of
N. sativa
resulted in decreased depression score and increase in serum BDNF levels that indicate the importance and efficacy of this drug.
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Original Article:
Clinical, laboratory and imaging characteristics, and outcomes of hospitalized children with suspected COVID-19 infection: A report from Isfahan-Iran
Hamid Rahimi, Zahra Pourmoghaddas, Marzieh Aalinezhad, Fariba Alikhani, Rana Saleh, Sheida Amini, Saman Tavakoli, Shima Saeidi, Narges Sharifi, Silva Hovsepian
J Res Med Sci
2022, 27:27 (17 March 2022)
DOI
:10.4103/jrms.jrms_815_21
Background:
The aim of this study was to evaluate the clinical, laboratory and imaging characteristics, and outcomes of hospitalized children with suspected COVID-19 infection in Isfahan.
Materials and Methods:
In this cross-sectional study, all children aged < 15 years, who hospitalized as suspected case of COVID-19 were enrolled. During this study, all demographic, clinical, laboratory, and imaging characteristics as well as follow-up data and outcomes of the hospitalized children were recorded by pediatric residents using a questionnaire. The findings of studied populations in the two groups of definite/or suspected and negative COVID-19 patients were compared.
Results:
During 6 months' period, 137 children with suspected COVID-19 infection were evaluated. Mean age of studied population was 4.3 (0.38) years. The most common symptoms in order were fever, cough, dyspnea and diarrhea. The most common computed tomography scan findings were bilateral ground glass and subpleural involvements. The rate of mortality was 7.3%. COVID-19 polymerase chain reaction test was positive in 22% of the patients. Based on the specialist's diagnosis, 30/25 patients were definite/or suspected to COVID-19 and reminder (79) were negative. O2 saturation <90%, was significantly higher in children with definite/or suspected diagnosis for COVID-19 (46.7% vs. 22.4%,
P
< 0.05). Dyspnea and shivering were significantly higher in children with definite/or suspected diagnosis for COVID-19 than those negative for COVID-19(
P
< 0.05).Mean duration of hospitalization was significantly associated with level of lactate dehydrogenase (
P
< 0.05).
Conclusion:
The clinical, laboratory, and imaging findings of our studied population were similar to other studies, but outcome was not similar which may be due to our studied population (inpatients cases). It is suggested that a better understanding of the infection in children may give important insights into disease pathogenesis, health-care practices, and public health policies.
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Original Article:
The effect of COVID 19 on liver parenchyma detected and measured by CT scan hounsfield units
Jehad Z Fataftah, Raed Tayyem, Haitham Qandeel, Haneen A Baydoun, Abdel Rahman A Al Manasra, Ahmad Tahboub, Salem Y Al-Dwairy, Alaa Al-Mousa
J Res Med Sci
2022, 27:26 (17 March 2022)
DOI
:10.4103/jrms.JRMS_1228_20
Background:
COVID 19 may affect organs other than lungs, including liver, leading to parenchymal changes. These changes are best assessed by unenhanced computed tomography (CT). We aim to investigate the effect of COVID 19 on liver parenchyma by measuring the attenuation in CT scan Hounsfield unit (HU).
Materials and Methods:
A cohort of patients, who tested COVID 19 polymerase chain reaction positive, were enrolled and divided into two groups: fatty liver (FL) group (HU ≤ 40) and nonfatty liver (NFL) group (HU > 40) according to liver parenchyma attenuation measurements by high resolution noncontrast CT scan. The CT scan was performed on admission and on follow up (10–14 days later). Liver enzyme tests were submitted on admission and follow up.
Results:
Three hundred and two patients were enrolled. Liver HU increased significantly from 48.9 on admission to 53.4 on follow up CT scan (P<0.001) in all patients. This increase was more significant in the FL group (increased from 31.9 to 42.9 [P =0.018]) Liver enzymes were abnormal in 22.6% of the full cohort. However, there was no significant change in liver enzymes between the admission and follow up in both groups.
Conclusion:
The use of unenhanced CT scan for assessment of liver parenchymal represents an objective and noninvasive method. The significant changes in parenchymal HU are not always accompanied by significant changes in liver enzymes. Increased HU values caused by COVID 19 may be due to either a decrease in the fat or an increase in the fibrosis in the liver.
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Letter To Editor:
Back to basics when referring for an electrodiagnostic test
Diaa K Shehab, Ahmad Jasem Abdulsalam, Levent Özçakar
J Res Med Sci
2022, 27:25 (17 March 2022)
DOI
:10.4103/jrms.jrms_1382_20
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REVIEW ARTICLE:
Multiple sclerosis-related fatigue lacks a unified definition: A narrative review
Iman Adibi, Mehdi Sanayei, Farinaz Tabibian, Neda Ramezani, Ahmad Pourmohammadi, Kiarash Azimzadeh
J Res Med Sci
2022, 27:24 (17 March 2022)
DOI
:10.4103/jrms.jrms_1401_20
Fatigue is the most common symptom in multiple sclerosis (MS). Although MS-related fatigue (MS-F) strongly affects quality of life and social performance of patients, there is currently a lack of knowledge about its pathophysiology, which in turns leads to poor objective diagnosis and management. Recent studies have attempted to explain potential etiologies as well as treatments for MS-F. However, it seems that without a consensus on its nature, these data could not provide a route to a successful approach. In this Article, we review definitions, epidemiology, risk factors and correlated comorbidities, pathophysiology, assessment methods, neuroimaging findings, and pharmacological and nonpharmacological treatments of MS-F. Further studies are warranted to define fatigue in MS patients more accurately, which could result in precise diagnosis and management.
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Original Article:
Metabolic effects of adding Topiramate on Aripiprazole in bipolar patients aged between 6-18 years, a randomized, double-blind, placebo-controlled trial
Soroor Arman, Mostafa Haghshenas
J Res Med Sci
2022, 27:23 (17 March 2022)
DOI
:10.4103/jrms.jrms_672_21
Background:
second-generation antipsychotics (SGAs) are associated with metabolic side effects in child and adolescents. The aim of this study is to evaluate the metabolic effects of adding topiramate on aripiprazole in patients with bipolar disorder (BD) aged between 6 and 18 years.
Materials and Methods:
A 12-week, double-blind, placebo-controlled, randomized trial was conducted in the child psychiatric units of university hospitals. Forty patients aged between 6 and 18 years with new diagnosis of BD participated in the study. Eleven patients were excluded. Subjects received aripiprazole plus topiramate (Group 1,
n
= 15) or aripiprazole (Group 2,
n
= 14) for a 3-month period. Young mania rating scale (YMRS) was used for measuring the manic symptoms severity. Primary outcome measures included weight, height, body mass index (BMI), waist circumference, abdominal circumference, and blood pressure. Secondary outcome measures included fasting blood glucose, hemoglobin A1C, fasting insulin, and fasting lipid profile. Changes in metabolic profile during the study were obtained by using repeated measures of variance.
Results:
During a 3-month follow-up, YMRS measures decreased significantly in both groups with a significant difference between groups (
P
< 0.05). The mean of weight, BMI, and high-density lipoprotein levels in group 2 were significantly increased (
P
< 0.05), and the mean of low-density lipoprotein level in group 1 was decreased (
P
< 0.05). No significant differences were observed in anthropometric parameters and metabolic indices between groups (
P
> 0.05).
Conclusion:
Adding topiramate on aripiprazole is effectivefor controlling bipolar disorder as well as metabolic adverse effects of SGAs in juvenile patients.
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Original Article:
Effects of the COVID-19 pandemic on lifestyle among Iranian population: A multicenter cross-sectional study
Abdurrahman Charkazi, Fatemeh Salmani, Mitra Moodi, Ensiyeh Norozi, Fatemeh Zarei, Masoud Lotfizadeh, Mohamamd Taghi Badeleh, Azita Noroozi, Shirin Shahbazi Sighaldeh, Yusef Dadban-Shahamat, Mohammad Ali Orouji, Maryam Ahmadi-Livani, Arezoo Foroughi, Amrollah Sharifi, Mehran Akbari, Zoya Tahergorabi
J Res Med Sci
2022, 27:22 (17 March 2022)
DOI
:10.4103/jrms.jrms_506_21
Background:
Quarantine, an unpleasant experience, was implemented in many countries to limit the spread of Coronavirus disease 2019 (COVID-19), which it could associated whit lifestyle changes. The present study aimed to determine the changes in Iranian's lifestyle during COVID-19 pandemic.
Materials and Methods:
In the present cross-sectional study, 2710 Iranian people completed an online researcher-made questionnaire asking lifestyle regarding COVID-19, which includes five sections about physical activity, stress and anxiety, nutrition habit, sleep disorders, and interpersonal relationship in addition to demographic data from January to February 2021, using the multistage cluster sampling method.
Results:
The participants' mean age was 33.78 ± 11.50 years and 68.3% of them were female. Traveling, sightseeing, and family visits have been eliminated from 91%, 83.5%, and 77.5% of participants' lives, respectively. There were increase in stress level (
P
< 0.001), weight of the participants (
P
< 0.001), sleep problems (
P
< 0.001), and healthier foods (
P
< 0.001) but decrease in interpersonal communication (
P
< 0.001) and the amount of physical activity (
P
< 0.001).
Conclusion:
In summary, this study indicates some changes in lifestyle of Iranian people, including changes in some eating practices, physical activity, social communication, and sleeping habits during the pandemic. However, as the COVID-19 pandemic is ongoing, a comprehensive understanding of these behaviors and habits can help develop interventions to mitigate the negative lifestyle behaviors during COVID-19 pandemic.
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REVIEW ARTICLE:
Status of breast cancer screening strategies and indicators in Iran: A scoping review
Zahra Omidi, Maryam Koosha, Najme Nazeri, Nasim Khosravi, Sheida Zolfaghari, Shahpar Haghighat
J Res Med Sci
2022, 27:21 (17 March 2022)
DOI
:10.4103/jrms.jrms_1390_20
Background:
This scoping review aimed to investigate the status of breast cancer (BC) preventive behaviors and screening indicators among Iranian women in the past 15 years. BC, as the most common cancer in women, represents nearly a quarter (23%) of all cancers. Presenting the comprehensive view of preventive modalities of BC in the past 15 years in Iran may provide a useful perspective for future research to establish efficient services for timely diagnosis and control of the disease.
Materials and Methods:
The English and Persian articles about BC screening modalities and their indicators in Iran were included from 2005 to 2020. English electronic databases of Web of Science, PubMed, and Scopus, and Persian databases of Scientific Information Database (SID) and IranMedex were used. The critical information of articles was extracted and classified into different categories according to the studied outcomes.
Results:
A total of 246 articles were assessed which 136 of them were excluded, and 110 studies were processed for further evaluation. Performing breast self-examination, clinical breast examination, and mammography in Iranian women reported 0%–79.4%, 4.1%–41.1%, and 1.3%-45%, respectively. All of the educational interventions had increased participants' knowledge, attitude, and practice in performing the screening behaviors. The most essential screening indicators included participation rate (3.8% to 16.8%), detection rate (0.23–8.5/1000), abnormal call rate (28.77% to 33%), and recall rate (24.7%).
Conclusion:
This study demonstrated heterogeneity in population and design of research about BC early detection in Iran. The necessity of a cost-effective screening program, presenting a proper educational method for increasing women's awareness and estimating screening indices can be the priorities of future researches. Establishing extensive studies at the national level in a standard framework are advised
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Original Article:
High claudin-4 antigen expression in triple-negative breast cancer by the immunohistochemistry method
Azar Naimi, Nadereh Zare, Elham Amjadi, Maryam Soltan
J Res Med Sci
2022, 27:20 (17 March 2022)
DOI
:10.4103/jrms.jrms_1389_20
Background:
Triple-negative breast cancer is a heterogeneous subtype of breast cancer. Claudin is an epithelial tight junctional protein, and also it is a receptor for clostridium perfringens enterotoxin and shows impairment of expression in several cancers. The chief purpose of this study is to assess the claudin-4 expression in triple-negative breast cancer (TNBC) Iranian patients and evaluate its correlation with some clinicopathological factors.
Materials and Methods:
In this study, 81 TNBC patients were evaluated for the claudin-4 expression by immunohistochemistry. The slides' staining intensity was examined and scored from 0 to 3. Then, slides were reviewed to assess the percentage of cells with membrane and cytoplasmic staining; the obtaining scores were 1–4. Finally, added the resulting two numbers from two stages, and the final number was a maximum of 7. Final scores of 0–3 were considered the low expression, and 4–7 were considered the high expression. Finally, the collected data were analyzed using the Chi-square test.
Results
: Eighty-one women with breast cancer and a mean age of 49 ± 12 years participated in the study. In 80% of the patients, there was a high expression of claudin-4 marker, and 20% had low expression. The expression level of the marker was not significantly correlated with age, tumor size, lymph node involvement, tumor grade, disease stage, Ki-67, and metastasis.
Conclusion:
The present study confirmed the high frequency of claudin-4 antigen expression in TNBC patients, and no significant correlation was observed between the expression of antigen and demographic or clinicopathological factors.
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Original Article:
Influential factors on survival in gastric cancer: A single-center study
Ghodratollah Roshanaei, Azadeh Kiumarsi, Amir Kasaeian, Malihe Safari, Mohammad Abbasi, Ali Rahimi
J Res Med Sci
2022, 27:19 (17 March 2022)
DOI
:10.4103/jrms.JRMS_1286_20
Background:
Gastric cancer (GC) is one of the conspicuous causes of cancer-related death worldwide. Considering the mounting incidence of this cancer in developing countries such as Iran, determining the influential factors on the survival of involved patients is noteworthy. Hence, we aimed to ascertain the survival rates and the prognostic factors in our GC patients.
Materials and Methods:
In this retrospective cohort study, data of 314 patients with GC in a referral cancer center in Hamadan province of Iran were studied. The outcome of our study was survival time and the influential factors were gender, age at diagnosis, tumor history, tumor grade, surgery history, radiotherapy history, stage of disease, metastasis history, and lymph node involvement. Kaplan − Meier method and log-rank test were used for the calculation and comparing the survival curves and Cox-proportional hazard model was used for the multivariable analysis of prognostic factors.
Results:
In a total of 314 GC patients, the median age at the diagnosis was 63 years (range: 21–92) with most patients (74.84%) being males. The median follow-up time was 2.42 years, and the median survival time was 2 years. The multivariable cox analysis of overall survival (OS) indicated that having distant metastasis increased the hazard of death by about 2.5 times (
P
< 0.0001, heart rates [HR]: 2.53, 95% confidence interval [CI]: [1.71, 3.75]), and receiving surgery as treatment, decreased the hazard of death up to 36% (
P
= 0.02, HR: 0.64, 95%CI: [0.46–0.89]). The other variables did not have any significant effects on the OS.
Conclusion:
The results of this study showed that lower survival (greater hazard of death) strongly and significantly associated with having distant metastasis in patients with GC and receiving surgery could significantly decrease the hazard of death in these patients instead.
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Original Article:
Association of demographic variables and smoking habits with the severity of lung function in adult smokers
Arash Toghyani, Somayeh Sadeghi
J Res Med Sci
2022, 27:18 (18 February 2022)
DOI
:10.4103/jrms.jrms_854_21
Background:
This study aims to evaluate the association between demographic and smoking variables with the severity of lung function loss (Stage I to IV) and spirometry data in smokers.
Materials and Methods:
Three hundred and fifty smoker men over the age of 20 who had visited in AL-Zahra hospital were involved. Spirometry tests were performed for measuring forced vital capacity (FVC), FEV1, and FEV1%FVC. COPD was categorized into four stages by the (Global Initiative for Chronic Obstructive Lung Disease) criteria of postbronchodilator FEV1/FVC <0.70. FEV1/FVC <70%, in combination with FEV1 ≥80% (Stage I), or 50%≤FEV1 <80% (Stage II), or 30%≤FEV1 <50% (Stage III), or FEV1 ≤30% (Stage IV). Independent
t
-test, Spearman correlation analysis was used for data analysis. To determine the predicting factors for pulmonary function multiple regressions analysis was performed.
Results:
43 (19.5%) of men were defined as Chronic Obstructive Lung Disease (COPD) which 7% of them were Stage I, 23.3% were Stage II, 39.5% were III and 30.2% were stage IV. In 60 (27.1%) of men, the index of Fev1/FVC was <80%. The criteria of PRIS in 74 (33.5%) of the patients and BDR in 59 (26.7%) of participation was positive. There were significant differences in the mean of FEV1 with respect to history of lung disease in relatives (
P
= 0.035), lung disease hospitalization (
P
< 0.001) and previous diagnosis of asthma variables (
P
< 0.001). The mean of FVC was significantly different in patients categorized based on lung disease hospitalization (
P
< 0.001) and previous diagnosis of asthma (
P
= 0.018). Furthermore, there was a significant difference in the mean of FEV1/FVC for variables as follows: Time to start smoking after waking up (
P
= 0.007), lung disease hospitalization (
P
< 0.001) and previous diagnosis of asthma (
P
< 0.001). There was a significant association between stages of lung function loss and age of onset of smoking (β-0.355
P
= 0.019) and pack per year (β = 0.354
P
= 0.02). A linear regression model showed that lung disease hospitalization and age were the influential variables on FEV1 with (B = −21.79 confidence interval [CI]: −28.7, −14.87,
P
< 0.001and B = −0.418 CI: −0.63, −0.21,
P
< 0.001), respectively. The only significant influential variable on FVC was lung disease hospitalization (B = −15.89 CI: −21.49, −10.296,
P
< 0.001). Body mass index, lung disease hospitalization, time to start smoking after waking up in the morning and age had significant relationship on FEV1/FVC with (B = 0.71CI: 0.32, 1.11,
P
< 0.001, B = −14.29, CI: −19.61,-8.97,
P
< 0.001, B = 6.54, CI: 2.26, 10.82,
P
= 0.003 and B = −0.44, CI: −0.59, −0.28,
P
< 0.001), respectively.
Conclusion:
The age of onset of smoking and pack-year appears to be associated with the severity of COPD. Hospitalization history due to lung disease, age, the time between waking up in the morning and first cigarette use, BMI, lung disease history in relatives, previous diagnosis of asthma have a negative relationship with lung function.
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Original Article:
Renal function markers in single-kidney patients after percutaneous nephrolithotomy: A pilot study
Alireza Ghadian, Behzad Einollahi, Mehrdad Ebrahimi, Mohammad Javanbakht, Mousa Asadi, Reza Kazemi
J Res Med Sci
2022, 27:17 (18 February 2022)
DOI
:10.4103/jrms.jrms_880_21
Background:
The present study was performed to investigate and compare renal functions of single-kidney patients after 12 h of percutaneous nephrolithotomy (PCNL) surgery through assessing major markers of renal function with focus on serum level of cystatin that performs a consistent accuracy in various conditions.
Materials and Methods:
This pilot quasi-experimental study was done on 92 patients with single kidney having staghorn calculus who had undergone PCNL and were referred to the Al-Zahra Hospital, Isfahan, Iran, during 2019–2021. Serum levels of cystatin C, creatinine, estimated glomerular filtration rate (eGFR), and neutrophil gelatinase-associated lipocalin (NGAL) urine level were evaluated before and 12 h after surgery.
Results:
The mean cystatin C decreased significantly 1.58 ± 0.55 versus mg/L 1.46 ± 0.52 after 12 h after surgery (
P
< 0.001). Furthermore, the mean levels of creatinine (2.04 ± 0.71 vs. 1.89 ± 0.60 mg/dL) and NGAL (39.72 ± 12.87 vs. 24.05 ± 10.89 μg/ml) were decreased significantly after 12 h of procedure (
P
< 0.05) while the mean eGFR (57.62 ± 27.59 vs. 64.68 ± 31.88 ml/min/1.73 m
2
) was increased significantly after 12 h (
P
< 0.001).
Conclusion:
Due to significant improvement in all markers of renal after PCNL, this procedure can be considered a potentially effective and safe approach for treating large stone in single-kidney patients.
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Short Communication:
Prevalence of nephrocalcinosis in children with congenital adrenal hyperplasia
Yahya Madihi, Neda Mostofizadeh, Hossein Shamsipour Dehkordi, Maryam Riahinezhad, Silva Hovsepian, Noushin Rostampour, Elham Hashemi Dehkodi, Mahryar Mehrkash, Tooba Momen, Mahin Hashemipour
J Res Med Sci
2022, 27:16 (18 February 2022)
DOI
:10.4103/jrms.jrms_872_21
Background:
We aimed to investigate the prevalence of nephrocalcinosis (NC) among children with diagnosed congenital adrenal hyperplasia (CAH). Our findings would be helpful for earlier diagnosis, management, and prevention of NC-related complications.
Materials and Methods:
In this cross-sectional study, children with CAH, aged <18 years old who were regularly referred for follow-up, were included. The information of the patients was extracted from their medical files, and they underwent renal ultrasonography for evaluation of the presence of NC.
Results:
From 120 studied patients with CAH, four patients (3.3%) had NC. The prevalence of NC was higher in males than females (
P
= 0.05). Mean age and age of CAH diagnosis had a trend to be lower in CAH patients with NC than those without. Regression analysis indicated significant association between NC and sex (
P
= 0.027,
r
= 2.24).
Conclusion:
The results of this study indicated a 3.3% prevalence rate of NC for children with CAH. NC had a trend to be more prevalent in male children with CAH. Though it was not significantly different but given that the mean age and age at diagnosis of CAH in children with CAH and NC was lower that CAH patients without NC, it is suggested that in patients with CAH and NC other factors such as genetic background or unknown disease related factors are associated with hypercalcemia and NC.
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Original Article:
The frequency, related cause of disease, and treatment of hepatitis B virus infection: A systematic review and meta-analysis in Iran
Gholamreza Kalvandi, Ghobad Abangah, Yousef Veisani, Hassan Nourmohammadi, Mohamad Golitaleb, Hamed Tavan
J Res Med Sci
2022, 27:15 (18 February 2022)
DOI
:10.4103/jrms.JRMS_67_19
Background:
Hepatitis B virus (HBV) is one of the most dreadful viruses causing high mortality rates and serious damages to hepatocytes. The aim of this study was to assess the frequency, related causes/risk factors, and treatments of HBV infection in Iran by systematic review and meta-analysis.
Materials and Methods:
The data were obtained by a literature search in the PubMed, Scopus, SID, and Web of Sciences databases. Keywords included prevalence, risk factors, causes, treatment, and HBV. The Persian equivalents of these keywords were also searched. The time span included 2004 to2021. The Q and
I
2
statistics were used to check heterogeneity among studies. The data were analyzed using Stata (version 14).
Results:
The frequencies of HBV infection and its pharmaceutical therapy were
P
= 6% (95% confidence interval [CI]: 4–9,
I
2
= 95.2%,
P
< 0.001) and 19% (95% CI: 18%–30%,
I
2
= 98.9%,
P
< 0.001), respectively. The most common risk factors/causes of HBV were narcotic consumption, blood-related factors, and transmission from infected individuals with the respective frequencies of 27% (95% CI: 16%–38%,
I
2
= 88.7%,
P
< 0.001), 32% (95% CI: 11%–53%,
I
2
= 99.8%,
P
< 0.001), 25% (95% CI: 10%–41%,
I
2
= 99.3%,
P
< 0.001), and 15% (95% CI: 7%–22%,
I
2
= 98.4%,
P
< 0.001), respectively.
Conclusion:
The most important causes of HBV infection were transmission from infected people, narcotic consumption, and blood-related factors. The main therapeutic intervention for HBV was pharmaceutical therapy.
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Original Article:
A new ratio derived from inflammasome markers can serve as a marker of assessment of glycemic index in children with Type 1 diabetes
Zhian M I Dezayee, Marwan S M Al-Nimer
J Res Med Sci
2022, 27:14 (18 February 2022)
DOI
:10.4103/jrms.JRMS_773_18
Background:
Mature inflammasome markers play a role in the development of Type 1 diabetes (T1D). This cross-sectional study aimed to derive ratios from the serum levels of interleukins (ILs): IL-1β and IL-18 and to relate their values with glycemic index and anti-inflammatory markers (IL-4 and IL-10) in children with T1D.
Materials and Methods:
This study was conducted at Hawler Medical University in Erbil-Iraq from April to July 2018. Healthy subjects (Group I,
n
= 40) and patients (Group II,
n
= 76) were recruited from primary schools and the Center of Diabetes in Erbil, respectively. Glycemic indices (including fasting serum glucose, insulin, glycosylated hemoglobin, and peptide C) and pro- and anti-inflammatory markers (including high-sensitivity C-reactive protein, IL-1β, IL-18, IL-4, and IL-10 and the ratio of neutrophil or platelet to lymphocyte) were determined.
Results:
Cutoff values of 105 pg/mL, 85 pg/mL, and 1.235 for serum IL-1β, IL-18, and IL-1β to IL-18 ratio, respectively, were found to be significant discriminators of glycemic index and anti-inflammatory markers with respect to the calculated area under the curve.
Conclusion:
A ratio of IL-1β to IL-18 adjusted to 1.235 can serve as a useful marker of assessment of glycemic index. This ratio does not discriminate the status of anti-inflammatory markers (IL-4 and IL-10) in children with T1D.
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Original Article:
Correlation of serum apelin level with carotid intima–media thickness and insulin resistance in a sample of Egyptian patients with type 2 diabetes mellitus
Mervat El Shahat El Wakeel, Inass Hassan Ahmad, Marwa Abdelmonim Mohammed, Sally Mohamed Osama Ali, Marwa Khairy Abd El Wahab, Walaa Mohamed Shipl
J Res Med Sci
2022, 27:13 (18 February 2022)
DOI
:10.4103/jrms.JRMS_675_20
Background:
Type 2 diabetes mellitus (T2DM) is a growing health problem in Egypt, with a significant impact on morbidity and mortality. Measurement of the carotid Intima-media thickness (CIMT) allows early detection of atherosclerotic blood vessel diseases. Apelin is an adipose tissue-derived hormone that may be associated with insulin resistance (IR). This study aimed to assess the level of serum apelin in patients with T2DM and its relation to IR and CIMT.
Materials and Methods:
A case-control study was conducted on 60 patients with T2DM and 30 healthy controls. T2DM was diagnosed based on American Diabetes Association criteria. The study was carried out at Al-Zahraa University Hospital, Cairo, Egypt, through the period from June to December 2019. The laboratory investigations included serum apelin and blood glucose hemostasis markers. CIMT was assessed using B-mode ultrasonography.
Results:
Patients' group had a statistically significant higher apelin level than healthy controls (407.96 ± 291.07 versus 83.32 ± 10.55 ng/dL,
P
< 0.001). The correlation analysis showed that the serum apelin level correlated positively with glycemic indices, body weight, and waist circumference (
P
< 0.05). At cutoff value of >96 ng/dL, the serum apelin exhibited a sensitivity of 98.3% and specificity of 96.7%, positive predictive value of 98.1%, and negative predictive value of 96.5%, with a diagnostic accuracy of 95.1%. Serum apelin correlated positively with CIMT (
r
= 0.296,
P
= 0.022). Logistic regression analysis showed that systolic and diastolic blood pressures, Homeostasis Model Assessment of IR, and CIMT were independent predictors of serum apelin.
Conclusion:
Serum apelin may be correlated with the degree of carotid atherosclerosis and hence can be used as a prognostic biomarker.
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Review Article:
Prevalence of psychiatric disorders in patients with ischemic heart disease: A systematic review and meta-analysis
Mohamad Mehdi Derisi, Mohammad Javad Nasiri, Alisam Aryan, Alireza Moosavi Jarrahi, Parastoo Amiri, Maryam Mohseny
J Res Med Sci
2022, 27:12 (18 February 2022)
DOI
:10.4103/jrms.JRMS_864_20
Background:
Ischemic heart disease and psychiatric disorders are among the leading causes of morbidity and mortality. Plans for providing basic health services to community members require knowledge of the current state. Therefore, the aim of this study was to systematically review the literature to estimate the prevalence of psychiatric disorders among patients with ischemic heart disease.
Materials and Methods:
In this study, PubMed, Embase, and Web of Science were systematically searched to find studies published before June 6, 2021. The systematic review included all original articles on the prevalence of psychiatric disorders among patients with ischemic heart disease. Two independent researchers evaluated the quality of studies, using the Joanna Briggs Institute questionnaire. All analyses were performed in Stata/MP version 16. A random-effects model was used for data analysis.
Results:
Of 1672 studies initially identified, 13 studies were included in our meta-analysis, with a total of 2233 participants. The overall prevalence of psychiatric disorders was estimated at 46.85% (95% confidence interval [CI]: 36.08–57.62;
I
2
= 100%;
P
< 0.001 for heterogeneity). The most common disorder was depression (27.80%; 95% CI: 18.27–37.34;
I
2
= 99.99%;
P
< 0.001 for heterogeneity). Based on the results, the prevalence of psychiatric disorders had increased by 25.55% from 2000 to 2021 compared to1984–2000.
Conclusion:
The prevalence of psychiatric diseases in people with ischemic heart disease is high and increases over time. It is recommended that preventive measures be taken worldwide.
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Original Article:
Validation of Self-Assessed Form of Diagnostic Criteria for Psychosomatic Research Adapted from Diagnostic Criteria for Psychosomatic Research - Structured Interview
Farzad Goli, Hamidreza Roohafza, Azam Khani, Hamid Afshar
J Res Med Sci
2022, 27:11 (18 February 2022)
DOI
:10.4103/jrms.JRMS_938_20
Background:
As the diagnostic criteria for psychosomatic research-structured interview (DCPR-SI) is a rater-assessed questionnaire, it has not been used vastly in community-based studies and clinics. Describing and investigating self-assessed form of DCPR are an attempt to apply it easier and more worthwhile for medical settings. The aim of this study was to describe and present self-assessed form of DCPR self-assessed (DCPR-SA) and test its validity and reliability.
Materials and Methods:
The DCPR-SI was translated to Persian according to the best practice methodology and the guideline for adaptation of self-report measures. In this cross-sectional study, 540 patients and healthy individuals were recruited and answered DCPR-SA and some related questionnaires. Inter-rater (test–interview) and test–retest reliability were determined. Construct, concurrent, discriminant, and known-group validity were tested.
Results:
The kappa coefficients were expressed substantial and almost perfect agreement (0.617–0.784,
P
≤ 0.05). In addition, phi correlation coefficients were indicated adequate test–retest reliability for each cluster (0.548–0.754,
P
≤ 0.05). Three domains (anxiety-related symptoms, functional symptoms, and dysfunctional traits and emotional patterns) were confirmed by factor analysis. The results of the discriminate validity analysis were promising.
Conclusion:
The findings show that the DCPR-SA is valid and reliable and can be used by medical professionals as a psychosomatic screening tool and can be used properly in Persian-speaking population.
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Original Article:
Determining the optimum tumor control probability model in radiotherapy of glioblastoma multiforme using magnetic resonance imaging data pre- and post- radiation therapy
Shabnam Banisharif, Daryoush Shahbazi-Gahrouei, Ali Akhavan, Naser Rasouli, Saghar Shahbazi-Gahrouei
J Res Med Sci
2022, 27:10 (18 February 2022)
DOI
:10.4103/jrms.JRMS_1138_20
Background:
Glioblastoma multiforme (GBM) is the most common and malignant brain tumor. The current standard of care is surgery followed by radiation therapy (RT). Radiotherapy treatment plan evaluation relies on radiobiological models for accurate estimation of tumor control probability (TCP). This study aimed to assess the impact of obtained magnetic resonance imaging (MRI) data before and 12 weeks after RT to achieve the optimum TCP model to improve dose prescriptions in radiation therapy of GBM.
Materials and Methods::
In this quasi-experimental study, MR images and its relevant data from 30 patients consisting of 9 females and 21 males (mean age of 46.3 ± 15.8 years) diagnosed with GBM, whose referred for radiotherapy were selected. The data of age, gender, tumor size, volume, and signal intensity using analysis of MRI data pre- and postradiotherapy were used for calculating TCP. TCP was calculated from three common radiobiological models including Poisson, linear quadratic, and equivalent uniform dose. The impact of some radiobiological parameters on final TCP in all patients planned with three-dimensional conformal radiation therapy was obtained.
Results:
A statistically significant difference was found among TCP in Poisson model compared to the other two models (
P
< 0.001). Changes in tumor volume and size after treatment were statistically significant (
P
< 0.05). Different combinations of radiobiological parameters (α/β and SF
2
in all models) observed were meaningful (
P
< 0.05).
Conclusion:
The results showed that among TCP radiobiological models, the optimum is the Poisson. The results also identified the importance of TCP radiobiological models in order to improve radiotherapy dose prescriptions.
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Original Article:
A randomized clinical trial: Comparison of group acceptance and commitment therapy with drug on quality of life and depression in patients with obsessive–compulsive disorder
Amrollah Ebrahimi, Elham Nasre Esfahan, Shahla Akuchekian, Razieh Izadi, Elham Shaneh, Behzad Mahaki
J Res Med Sci
2022, 27:9 (18 February 2022)
DOI
:10.4103/jrms.jrms_449_21
Background
: Acceptance and commitment therapy (ACT) is one of the newest treatment strategies that has been developed rapidly to improve the treatment of patients with obsessive–compulsive disorder (OCD). The aim of this study was to evaluate and compare the effect of ACT and selective serotonin reuptake inhibitors (SSRIs) drugs on the severity of depression symptoms and quality of life (QOL) in obsessive–compulsive patients.
Materials and Methods:
A randomized clinical trial with a control group was conducted including 27 patients with OCD. Based on the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for OCD diagnosis, participants were recruited from Tamasha Counseling Center and obsessive–compulsive clinic in the Psychosomatic Research Center in Isfahan, Iran. Selected patients were allocated to two groups (14 in ACT the group and 13 in the drug group with SSRI with a simple random sampling method. ACT group was treated by an ACT therapist in eight 1-h sessions. Data were collected by the World Health Organization QOL Questionnaire (WHOQOL-BREF) and Depression subscale of DASS-42 at admission, after the intervention, and 3 months thereafter. Therapists and evaluators were blind to each other's work. Data were analyzed using analysis of variance with repeated measures method using IBM SPSS Statistics software (V 23, IBM Corporation, Armonk, NY, USA).
Results:
Results revealed that both treatments (ACT and SSRIs drug therapy) had significant impacts on reducing depression subscales scores and increasing WHOQOL-BREF scores at posttreatment (
P
< 0.05). There were no significant differences in QOL scores between the two groups after the intervention and follow-up (
P
> 0.05). Nevertheless, drug therapy presented a significantly greater improvement in depression scores of patients than those resulting from ACT (
P
= 0.005). The persistence of treatment effects continued after 3 months (follow-up) in both groups.
Conclusion:
ACT is equal to SSRIs drug therapy in terms of improving QOL in patients with OCD. However, SSRIs are more effective in treating depression in obsessive–compulsive patients. It may be presumed that ACT without any chemical side effect is equal to drug and is preferred for patients who either cannot use drugs or prefer not to have a drug treatment.
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Original Article:
The effectiveness of olibanum orally disintegrating tablet in the treatment of oral aphthous ulcers: A randomized, double-blind, placebo-controlled clinical trial
Rasool Soltani, Zahra Saberi, Syed Mustafa Ghanadian, Azade Taheri, Amir Entezarhojjat
J Res Med Sci
2022, 27:8 (29 January 2022)
DOI
:10.4103/jrms.jrms_247_21
Background:
Boswellia serrata
oleo-gum-resin (frankincense; olibanum) has anti-inflammatory, analgesic, and antimicrobial effects. This study aimed to evaluate the clinical effectiveness of frankincense extract in the treatment of oral aphthous ulcers.
Materials and Methods:
In a randomized, double-blind, placebo-controlled clinical trial, patients with aphthous ulcers were randomly assigned to either experimental (Frankincense extract) or placebo groups to use orally disintegrating tablets (ODT) of frankincense and placebo, respectively, four times a day for 3 days. The size of aphthous ulcers and the pain severity by visual analogue scale were recorded at days 0, 2, and 4 and compared between the groups.
Results:
Twenty-five patients in each group completed the study. Olibanum extract ODT significantly reduced the ulcer size on the second (
P
< 0.001) and fourth (
P
< 0.001) days as well as the pain score on the second (
P
= 0.002) and fourth (
P
< 0.001) days of the intervention compared to placebo. Furthermore, at the end of the intervention, the number of patients with complete ulcer healing and pain relief in the experimental group was significantly more than the placebo group (5 vs. 0,
P
= 0.02; and 11 vs. 0,
P
< 0.001, respectively).
Conclusion:
Taking olibanum extract ODTs reduces the ulcer size and pain severity and accelerates the healing process in the oral aphthous lesions.
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Original Article:
Does waterpipe smoking increase the risk of
Helicobacter pylori
infection?
Özgür Sirkeci, Emel Erkus Sirkeci, Turgay Ulas
J Res Med Sci
2022, 27:7 (29 January 2022)
DOI
:10.4103/jrms.JRMS_433_19
Background:
In this study, we aimed to evaluate whether waterpipe smoking can be associated with the transmission of
Helicobacter pylori
infection or not.
Materials and Methods:
Between March 2018 and April 2019, 445 patients aged over 18 years old who were admitted to outpatient clinics with dyspeptic complaints were recruited for the study. Patients are divided into two groups – Group 1 is
H. pylori
-positive patients and Group 2 is negative. Waterpipe smoking, smoking, age, gender, and educational status were compared among groups.
Results:
Two hundred and sixty-one women (58%) and 184 men (42%), totally 445 patients, tested for
H. pylori
infection. Seventy-nine of 261 (30%) women and 60 of 184 (32%) men had
H. pylori
positive. One hundred and sixty-two of 445 (36%) patients were smoking cigarette and 66 of 445 (14%) patients were using waterpipe tobacco. Waterpipe smoking individuals were found to be associated with the
H. pylori
positivity (
P
< 0.001); whereas, age, gender, educational level, and smoking were not found to be statistically significant (all
P
> 0.05). In binary logistic regression analysis, waterpipe tobacco smoking was found to be the only independent predictor of
H. pylori
infection (
P
< 0.001, odds ratio = 5.51, confidence interval: 3.158–9.617).
Conclusion:
Waterpipe smoking seems to be an important risk factor for
H. pylori
infection and may be one of the reasons of high prevalence of
H. pylori
infection.
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Original Article:
Comparison of adaptive support ventilation and synchronized intermittent mandatory ventilation in patients with acute respiratory distress syndrome: A randomized clinical trial
Babak Alikiaii, Saeed Abbasi, Hamideh Yari, Mojtaba Akbari, Parviz Kashefi
J Res Med Sci
2022, 27:6 (29 January 2022)
DOI
:10.4103/jrms.JRMS_905_18
Background:
Suitable mechanical ventilation strategies can reduce the incidence and severity of ventilator-associated lung injury in patients with acute respiratory distress syndrome (ARDS). In this study, the effects of adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) on respiratory parameters and arterial blood gases (ABGs) parameters were compared in ARDS patients.
Materials and Methods:
Twenty-four patients were randomly divided into two groups of ASV and SIMV. Patients were followed up for 3 days, and respiratory parameters including rapid shallow breathing index (RSBI), spontaneous breathing rate (SBR), minute volume, and peak inspiratory pressure (PIP) as the primary outcomes and ABG parameters including PaO
2
, FiO
2
, PaCO
2
, HCO
3
, and PaO
2
/FiO
2
ratio as the secondary outcomes were measured.
Results:
PIP in patients in the SIMV group on the 1
st
day (
P
= 0.013), 2
nd
day (
P
= 0.001), and 3
rd
day (
P
= 0.004) was statistically significantly more compared to those in patients in the ASV group. RSBI, SBR, and minute volume between the ASV and SIMV groups during the 3 days were not statistically significantly different (
P
> 0.05). The mean arterial blood pressure, heart rate, PaO
2
, and PH between both groups were similar (
P
> 0.05). At the end of the 2
nd
and 3
rd
days, the level of FiO
2
and PaCO
2
in ASV was significantly lower than those in ASV group. HCO
3
in each of the 3 days in the ASV group was statistically significantly lower than that in the SIMV group (
P
< 0.050). PaO
2
/FiO
2
ratio in patients in the ASV group in the 3 days was statistically significantly higher than that in the SIMV group (
P
< 0.050).
Conclusion:
By reducing PIP and improving oxygenation and ABG parameters, ASV mode may be a safe and feasible mode during mechanical ventilation in patients with ARDS.
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Case Report:
Expanding unilateral lung collapse using airway pressure release ventilation applied independently to the collapsed lung through the double-lumen endotracheal tube
Mahmoud Saghaei
J Res Med Sci
2022, 27:5 (29 January 2022)
DOI
:10.4103/jrms.jrms_390_21
Unilateral lung collapse (ULC) is a clinical challenge in the intensive care unit and requires sophisticated treatment approaches, especially if the collapse continued over several hours. If not responded to ordinary measures such as postural drainage and bronchoscopy, it may require insertion of a double-lumen endotracheal tube and independent lung ventilation or high-pressure manual re-expansion of the collapsed lung which may result in lung injury. In this article, a safe and gradual re-expansion method using airway pressure release ventilation is presented for the treatment of a ULC.
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Original Article:
Hyperuricosuria and hypercalciuria, probable etiologies of functional abdominal pain: A case–control study
Hossein Saneian, Behnoosh Esteki, Maryam Bozorgzad, Fatemeh Famouri, Mehryar Mehrkash, Majid Khademian, Peiman Nasri
J Res Med Sci
2022, 27:4 (29 January 2022)
DOI
:10.4103/jrms.JRMS_424_20
Background:
Functional abdominal pain (FAP) is a common complaint causing several referrals to pediatricians. On the other hand, the most common presentation of hyperuricosuria and also hypercalciuria is chronic/recurrent abdominal pain. Therefore, a hypothesis has been raised; abdominal pain due to hyperuricosuria and/or hypercalciuria may be misdiagnosed as FAP. The current study has aimed to respond to this theory.
Materials and Methods:
This is a case–control study conducted on children diagnosed with FAP based on Rome IV criteria and age-matched normal controls. Blood and random urine samples were taken from healthy children and those with FAP. Random urine samples were examined for calcium, uric acid, oxalate, and creatinine concentrations. Random urine calcium to urine creatinine above 0.2 mg/mg was considered hypercalciuria and random urine uric acid above 0.56 mg/dl, GFR as hyperuricosuria. The data were analyzed using logistic models.
Results:
Hypercalciuric children had a significantly lower chance of FAP (odds ratio [OR] =0.425, 95% confidence interval [CI] =0.204–0.886). Although an inverse association was seen between hyperuricosuria and FAP (OR = 0.693, 95% CI = 0.395–1.214), it was not statistically significant. In stratified analyses by gender for both hyperuricosuria and hypercalciuria, a marginal inverse significant association was seen in male gender (
P
< 0.1).
Conclusion:
Our study showed that hypercalciuria is significantly in inverse association with FAP but not hyperuricosuria. Therefore, these disorders, particularly hyperuricosuria may not be considered as the possible causes of FAP. Further studies with larger sample size for providing more reliable evidence are recommended.
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Original Article:
Are sputum autoantibodies more clinically relevant in idiopathic pulmonary fibrosis than serum autoantibodies?
Kuimiao Deng, Qun Luo, Zhenyu Liang, Fei Long, Qian Han, Fengyan Wang, Shuyu Huang, Liyue Liao, Tingting Lin, Rongchang Chen
J Res Med Sci
2022, 27:3 (29 January 2022)
DOI
:10.4103/jrms.JRMS_219_19
Background:
The adaptive immune system plays a role in the pathogenesis of idiopathic pulmonary fibrosis (IPF) has been reported previously. However, the association between airway and circulating autoantibodies (AAbs) levels is unclear. The aim of this study is to investigate the link between the AAb levels in airway and circulation in stable patients with IPF.
Materials and Methods:
From June 2016 to March 2017, 21 stable IPF patients and 22 healthy volunteers were recruited. We established Luminex interacting AAbs with bead-antigen complex to detect the immunoglobulin G antibodies levels of ten autoantigens which were matched serum (Se) and sputum (Sp) samples collected from recruited subjects, including Smith (Sm), Anti-ribosomal P antibody (P0), Sjögren syndrome type A antigen (SSA), La/Sjögren syndrome type B antigen (SSB), DNA topoisomerase (Scl-70), histidyl-tRNA synthetase (Jo-1), U1 small nuclear ribonucleoprotein (U1-SnRNP), thyroid peroxidase, Proteinase 3, and Myeloperoxidase. Spearman's rank correlation matrix was applied to explore the associations of Ab profiles between Se and Sp.
Results:
For IPF patients, Spearman's correlation matrix showed multiple intercorrelations among Sp-AAbs and Sp-AAbs (
P
< 0.05), while only the levels of AAb against Sm and anti-La in Se were correlated with those Sp-AAb counterparts (
P
< 0.05). For healthy individuals, only anti-La in Se was associated with those Sp-AAb counterparts (
P
< 0.05). For IPF patients, there was a positive correlation between carbon monoxide diffusing capacity (DL<sub>CO</sub>)% predicted and Sp-anti-P0 level (
r
= 0.464,
P
= 0.034). Forced vital capacity% predicted was positively correlated with Sp-anti-Scl-70 level (
r
= 0.466,
P
= 0.033).
Conclusion:
Comparing to Se-AAbs, Sp-AAbs are more associated with clinical parameters in the patients with IPF. In order to better understand the role of autoimmunity in the pathogenesis of IPF, detection of Sp-AAbs for local autoimmune responses may be a good choice.
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Original Article:
Selected factors determining the failure to undertake physical activity in patients with multiple sclerosis in Poland
Lidia Perenc, Adam Perenc, Halina Bartosik-Psujek
J Res Med Sci
2022, 27:2 (29 January 2022)
DOI
:10.4103/jrms.JRMS_170_20
Background:
The main aim of the study was to identify selected factors that determine patients with multiple sclerosis (MS') failure to take home therapeutic exercises (HTE) and other physical activity (OPA).
Materials
and
Methods:
The study was conducted using a self-completed online survey that was aimed at adult people diagnosed with MS, registered on the portal TacyJakJa.pl. In total, 335 persons were involved.
Results:
Almost half of all people who completed the survey (49.9%), reported that no one encouraged them to use HTE, and only 16.1% were encouraged by their doctor. As many as 51% of the respondents reported also that no one encouraged them to undertake OPA, and only 18.5% were encouraged by their doctor. As the most important reason for not using HTE, the respondents chose fear that exercises may worsen their condition (47.3%). However, the most important reason for not using the OPA was high fatigue (61.9%). The number of people exercising at home increased with age (
P
= 0.013). Those surveyed with relapsing–remitting MS significantly more often (
P
= 0.002) took up OPA (60.7%) than the respondents with a secondary progressive MS (10.0%) and a primary progressive (4.4%).
Conclusion:
Physicians relatively rarely encourage patients with MS to undertake HTE and OPA. The patients do not perform HTE primarily because of fears of health deterioration or fatigue. Undertaking HTE is influenced by age but undertaking other forms of physical activity by the type of MS. Actions should be taken to popularize HTE and OPA, especially HTE among young patients.
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Original Article:
Intranasal ketamine versus intranasal fentanyl on pain management in isolated traumatic patients
Mehdi Nasr Isfahani, Omid Shokoohi, Keihan Golshani
J Res Med Sci
2022, 27:1 (29 January 2022)
DOI
:10.4103/jrms.JRMS_505_20
Background:
Given the inadequate control of pain in patients with the trauma that refer to the emergency departments, the rapid onset of action of intranasal administration in pain management, and the avoidance of administering opioid medications, the present study aimed at evaluating the effect of intranasal ketamine versus intranasal fentanyl on pain management in isolated traumatic patients.
Materials
and
Methods:
The current study was performed on 125 patients that were divided into the following three groups: control group (
n
= 41), 1 mg/kg intranasal ketamine group (
n
= 40), and 1 μg/kg intranasal fentanyl group (
n
= 44). Then pain scores, heart rate, respiratory rate, blood pressure, and oxygen saturation were recorded at baseline, 5, 10, 15, 30, and 40 min after the intervention.
Results:
Visual analog scale (VAS) scores of patients in the intranasal ketamine group 5 and 10 min after the intervention were 61.50 ± 20.45 and 55.00 ± 21.96, respectively. The mentioned scores were significantly lower than the VAS scores of patients in the control group with the mean of 72.44 ± 22.11 and 66.59 ± 24.25 and the VAS scores of patients in the intranasal fentanyl group with the mean of 71.59 ± 22.09 and 65.00 ± 22.87 at 5 and 10 min after the intervention, respectively (
P
< 0.05).
Conclusion:
Given the onset of action in < 10 min, intranasal ketamine can be proposed as an appropriate analgesic medication in pain reduction of patients with isolated limb injuries. Moreover, the incidence rate and severity of adverse effects were insignificantly higher in the intranasal ketamine group as compared with the intranasal fentanyl group.
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Month wise articles
Figures next to the month indicate the number of articles in that month
2022
May
[
7
]
April
[
8
]
March
[
9
]
February
[
10
]
January
[
8
]
2021
December
[
13
]
November
[
16
]
October
[
16
]
September
[
19
]
August
[
17
]
July
[
9
]
June
[
8
]
May
[
8
]
March
[
7
]
February
[
9
]
January
[
10
]
2020
December
[
8
]
November
[
9
]
October
[
9
]
September
[
8
]
August
[
9
]
July
[
9
]
June
[
11
]
May
[
11
]
April
[
10
]
March
[
13
]
February
[
10
]
January
[
10
]
2019
December
[
10
]
November
[
7
]
October
[
9
]
September
[
8
]
August
[
9
]
July
[
12
]
June
[
8
]
May
[
10
]
April
[
11
]
March
[
8
]
February
[
9
]
January
[
9
]
2018
December
[
9
]
November
[
9
]
October
[
9
]
September
[
8
]
August
[
9
]
July
[
10
]
June
[
10
]
May
[
10
]
April
[
10
]
March
[
10
]
February
[
8
]
January
[
10
]
2017
December
[
10
]
November
[
9
]
October
[
8
]
September
[
10
]
August
[
11
]
July
[
9
]
June
[
11
]
May
[
14
]
April
[
14
]
March
[
14
]
February
[
14
]
January
[
14
]
2016
December
[
14
]
November
[
28
]
October
[
14
]
September
[
16
]
August
[
8
]
July
[
6
]
June
[
16
]
May
[
8
]
April
[
8
]
March
[
7
]
February
[
6
]
January
[
5
]
1900
January
[
1
]
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Online since 9
th
February, 2015