Pub Date : 2024-08-01DOI: 10.30476/ijms.2024.102332.3516
Foolad Eghbali, Ali Jaliliyan
{"title":"The Complex Role of Autophagy in Cirrhosis Progression; A Call for Comprehensive Research: Letter to the Editor.","authors":"Foolad Eghbali, Ali Jaliliyan","doi":"10.30476/ijms.2024.102332.3516","DOIUrl":"10.30476/ijms.2024.102332.3516","url":null,"abstract":"","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 8","pages":"528-529"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.30476/ijms.2023.99570.3164
Jie Zheng, Gang Luo, Ming Ming Deng
Background: Sinistral portal hypertension (SPH) is the only type of portal hypertension that is entirely curable. However, it can easily cause varicose veins in the esophagus and/or stomach, as well as upper gastrointestinal hemorrhage. This study aimed to investigate the clinical characteristics and treatments of sinistral portal hypertension.
Methods: All patients with pancreatic disease were included in this retrospective cohort study at the Affiliated Hospital of Southwest Medical University (Luzhou, China) from September 2019 to September 2021. The required information including the patient's demographics, serum laboratory indicators, imaging and endoscopy examinations, and clinical features were gathered and evaluated. The results were expressed as numbers and percentages.
Results: Out of the 830 patients with pancreatic diseases, 61 (7.3%) developed SPH. The most common cause of SPH was acute pancreatitis (80.3%), followed by chronic pancreatitis (11.5%). The splenic vein was the most frequently affected vein in patients (45/61, 73.8%). The findings of the contrast-enhanced computed tomography (CECT) indicated that 51 cases (83.6%) had gastric fundal-body varices, and three cases had combined gastric and esophageal varices. In the perigastric collateral channel formation, gastroepiploic varices (43/61, 70.5%) most frequently occurred in patients with SPH. Splenomegaly was a prevalent manifestation in SPH patients (45.9%). Five cases had gastrointestinal variceal hemorrhage.
Conclusion: SPH was associated with the patency of the splenic vein and the formation of distinctive perigastric collateral veins. Surgery and/or endoscopic treatment were recommended, particularly for patients who have experienced a significant amount of gastrointestinal bleeding and have failed conservative treatment.
{"title":"Clinical Analysis of Sinistral Portal Hypertension.","authors":"Jie Zheng, Gang Luo, Ming Ming Deng","doi":"10.30476/ijms.2023.99570.3164","DOIUrl":"10.30476/ijms.2023.99570.3164","url":null,"abstract":"<p><strong>Background: </strong>Sinistral portal hypertension (SPH) is the only type of portal hypertension that is entirely curable. However, it can easily cause varicose veins in the esophagus and/or stomach, as well as upper gastrointestinal hemorrhage. This study aimed to investigate the clinical characteristics and treatments of sinistral portal hypertension.</p><p><strong>Methods: </strong>All patients with pancreatic disease were included in this retrospective cohort study at the Affiliated Hospital of Southwest Medical University (Luzhou, China) from September 2019 to September 2021. The required information including the patient's demographics, serum laboratory indicators, imaging and endoscopy examinations, and clinical features were gathered and evaluated. The results were expressed as numbers and percentages.</p><p><strong>Results: </strong>Out of the 830 patients with pancreatic diseases, 61 (7.3%) developed SPH. The most common cause of SPH was acute pancreatitis (80.3%), followed by chronic pancreatitis (11.5%). The splenic vein was the most frequently affected vein in patients (45/61, 73.8%). The findings of the contrast-enhanced computed tomography (CECT) indicated that 51 cases (83.6%) had gastric fundal-body varices, and three cases had combined gastric and esophageal varices. In the perigastric collateral channel formation, gastroepiploic varices (43/61, 70.5%) most frequently occurred in patients with SPH. Splenomegaly was a prevalent manifestation in SPH patients (45.9%). Five cases had gastrointestinal variceal hemorrhage.</p><p><strong>Conclusion: </strong>SPH was associated with the patency of the splenic vein and the formation of distinctive perigastric collateral veins. Surgery and/or endoscopic treatment were recommended, particularly for patients who have experienced a significant amount of gastrointestinal bleeding and have failed conservative treatment.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 8","pages":"487-493"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Odontogenic cysts and tumors develop from the dental follicle of asymptomatic impacted teeth. Odontogenic tissues express the epidermal growth factor receptor family (EGFR), which mediates cell proliferation, survival, and neoplastic differentiation. The present study aimed to compare the immunohistochemical expression of EGFR and human epidermal growth factor receptor 2 (HER2) in the dental follicle of impacted wisdom teeth with normal and abnormal radiographic size.
Methods: In this analytical study, immunohistochemical staining of EGFR and HER2 was performed on 30 normal and 30 abnormal follicles of impacted third molars. Follicles with a width of <2.5 mm were considered normal, whereas those with a width of ≥2.5 mm were regarded as abnormal. The immunoreactive score (IRS) was used to report the expression levels of EGFR and HER2. The obtained data were analyzed using SPSS software. Age and sex were compared in normal and abnormal groups with independent t test and Chi square test, respectively. P<0.05 was considered statistically significant.
Results: The EGFR and HER2 overall expression was high in all normal and abnormal follicles. The comparison of the percentage of stained cells and intensity of EGFR and HER2 staining in normal and abnormal follicles were not significantly different (P=0.73, P=0.63, P=0.95, respectively).
Conclusion: Due to the high expression of EGFR and HER2 in normal and abnormal follicles, as well as the lack of significant differences in these two groups, the radiographic size of dental follicles might not indicate the potential capabilities of their cells, and more research in this field is recommended.
背景:牙源性囊肿和肿瘤是从无症状的阻生牙的牙泡中生长出来的。牙源性组织表达表皮生长因子受体家族(EGFR),该家族介导细胞增殖、存活和肿瘤分化。本研究旨在比较正常和影像学大小异常的阻生智齿牙槽窝中表皮生长因子受体(EGFR)和人表皮生长因子受体 2(HER2)的免疫组化表达情况:在这项分析研究中,对影响第三磨牙的 30 个正常和 30 个异常牙泡进行了表皮生长因子受体(EGFR)和人表皮生长因子受体 2(HER2)的免疫组化染色。卵泡宽度分别采用 t 检验和 Chi square 检验。结果:所有正常和异常卵泡的表皮生长因子受体(EGFR)和表皮生长因子受体(HER2)总体表达量都很高。正常卵泡和异常卵泡中染色细胞的百分比以及表皮生长因子受体和 HER2 染色强度的比较无显著差异(分别为 P=0.73、P=0.63、P=0.95):由于表皮生长因子受体(EGFR)和 HER2 在正常和异常毛囊中的高表达以及两组间无明显差异,牙科毛囊的影像学大小可能并不代表其细胞的潜在能力,建议在该领域开展更多研究。
{"title":"A Comparison of Immunohistochemical Expression of Epidermal Growth Factor Receptor and Human Epidermal Growth Factor Receptor 2 in Dental Follicles with Different Radiographic Sizes.","authors":"Shirin Saravani, Hamed Nemati Rezvani, Mehrdad Shahraki, Hamideh Kadeh","doi":"10.30476/IJMS.2023.98602.3121","DOIUrl":"10.30476/IJMS.2023.98602.3121","url":null,"abstract":"<p><strong>Background: </strong>Odontogenic cysts and tumors develop from the dental follicle of asymptomatic impacted teeth. Odontogenic tissues express the epidermal growth factor receptor family (EGFR), which mediates cell proliferation, survival, and neoplastic differentiation. The present study aimed to compare the immunohistochemical expression of EGFR and human epidermal growth factor receptor 2 (HER2) in the dental follicle of impacted wisdom teeth with normal and abnormal radiographic size.</p><p><strong>Methods: </strong>In this analytical study, immunohistochemical staining of EGFR and HER2 was performed on 30 normal and 30 abnormal follicles of impacted third molars. Follicles with a width of <2.5 mm were considered normal, whereas those with a width of ≥2.5 mm were regarded as abnormal. The immunoreactive score (IRS) was used to report the expression levels of EGFR and HER2. The obtained data were analyzed using SPSS software. Age and sex were compared in normal and abnormal groups with independent <i>t</i> test and Chi square test, respectively. P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>The EGFR and HER2 overall expression was high in all normal and abnormal follicles. The comparison of the percentage of stained cells and intensity of EGFR and HER2 staining in normal and abnormal follicles were not significantly different (P=0.73, P=0.63, P=0.95, respectively).</p><p><strong>Conclusion: </strong>Due to the high expression of EGFR and HER2 in normal and abnormal follicles, as well as the lack of significant differences in these two groups, the radiographic size of dental follicles might not indicate the potential capabilities of their cells, and more research in this field is recommended.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 8","pages":"508-514"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.30476/IJMS.2023.99512.3168
Zahra Derakhshan, Soghra Bahmanpour, Mohammad Hossein Nasr-Esfahani, Fatemeh Masjedi, Maryam Mirani, Mahintaj Dara, Seyed Mohammad Bagher Tabei
Background: Ovarian granulosa cells (GCs) are essential for follicular development. Ovarian advanced glycation end-products (AGEs) accumulation is related to GCs dysfunction. Alpha-lipoic acid (ALA) illustrates therapeutic capabilities for infertility-related disorders. Therefore, this study assessed the effects of ALA on AGEs-induced GCs hormonal dysfunction.
Methods: The study was conducted from October 2021 to September 2022 at the Department of Medical Genetics, Shiraz University of Medical Sciences. Isolated GCs (n=50) were divided into control, human glycated albumin (HGA), HGA+ALA, and ALA treatments. Steroidogenic enzymes and AGE receptor (RAGE) genes were assessed by qRT-PCR. Steroid hormones and RAGE protein were evaluated using ELISA and Western blotting. Data were analyzed using GraphPad Prism software (ver. 9), and P<0.05 was considered significant.
Results: Our findings showed that HGA treatment significantly (P=0.0001) increased RAGE (by 140.66%), STAR (by 117.65%), 3β-HSD (by 165.68%), and 17β-HSD (by 122.15%) expression, while it decreased CYP19A1 (by 68.37%) expression. RAGE protein level (by 267.10%) was also increased in HGA-treated GCs. A significant decrease in estradiol (by 59.66%) and a slight and sharp elevation in progesterone (by 30.40%) and total testosterone (by 158.24%) levels was also observed. ALA treatment ameliorated the HGA-induced changes in steroidogenic enzyme mRNA levels (P=0.001) and steroid hormone secretion (P=0.010).
Conclusion: This work shows that ALA therapy likely corrects hormonal dysfunctions caused by AGEs in luteinized GCs. This effect is probably achieved by decreased RAGE expression. Clinical research is needed to understand how AGEs and ALA interact in the ovary, which might lead to a more targeted ovarian dysfunction therapy.
{"title":"Alpha-Lipoic Acid Ameliorates Impaired Steroidogenesis in Human Granulosa Cells Induced by Advanced Glycation End-Products.","authors":"Zahra Derakhshan, Soghra Bahmanpour, Mohammad Hossein Nasr-Esfahani, Fatemeh Masjedi, Maryam Mirani, Mahintaj Dara, Seyed Mohammad Bagher Tabei","doi":"10.30476/IJMS.2023.99512.3168","DOIUrl":"10.30476/IJMS.2023.99512.3168","url":null,"abstract":"<p><strong>Background: </strong>Ovarian granulosa cells (GCs) are essential for follicular development. Ovarian advanced glycation end-products (AGEs) accumulation is related to GCs dysfunction. Alpha-lipoic acid (ALA) illustrates therapeutic capabilities for infertility-related disorders. Therefore, this study assessed the effects of ALA on AGEs-induced GCs hormonal dysfunction.</p><p><strong>Methods: </strong>The study was conducted from October 2021 to September 2022 at the Department of Medical Genetics, Shiraz University of Medical Sciences. Isolated GCs (n=50) were divided into control, human glycated albumin (HGA), HGA+ALA, and ALA treatments. Steroidogenic enzymes and AGE receptor (<i>RAGE</i>) genes were assessed by qRT-PCR. Steroid hormones and RAGE protein were evaluated using ELISA and Western blotting. Data were analyzed using GraphPad Prism software (ver. 9), and P<0.05 was considered significant.</p><p><strong>Results: </strong>Our findings showed that HGA treatment significantly (P=0.0001) increased <i>RAGE</i> (by 140.66%), <i>STAR</i> (by 117.65%), <i>3β-HSD</i> (by 165.68%), and <i>17β-HSD</i> (by 122.15%) expression, while it decreased <i>CYP19A1</i> (by 68.37%) expression. RAGE protein level (by 267.10%) was also increased in HGA-treated GCs. A significant decrease in estradiol (by 59.66%) and a slight and sharp elevation in progesterone (by 30.40%) and total testosterone (by 158.24%) levels was also observed. ALA treatment ameliorated the HGA-induced changes in steroidogenic enzyme mRNA levels (P=0.001) and steroid hormone secretion (P=0.010).</p><p><strong>Conclusion: </strong>This work shows that ALA therapy likely corrects hormonal dysfunctions caused by AGEs in luteinized GCs. This effect is probably achieved by decreased <i>RAGE</i> expression. Clinical research is needed to understand how AGEs and ALA interact in the ovary, which might lead to a more targeted ovarian dysfunction therapy.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 8","pages":"515-527"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Guillain-Barre Syndrome (GBS) is the most prevalent acute peripheral polyneuropathy disorder. The disparities between populations and variations in the major risk factors highlight the importance of country-specific studies. This study aimed to report clinical characteristics and outcomes of ICU-admitted patients with GBS in an academic medical center in Iran.
Methods: The data were collected retrospectively from all patients with GBS admitted to Namazi Hospital, affiliated with Shiraz University of Medical Sciences, (Shiraz, Iran), between March 2016 to March 2021. Specialized neurological information and the Acute Physiology and Chronic Health Evaluation (APACHE II) score were recorded. The SPSS software was used to analyze the data. The analyzed data were reported as numbers and percentages, or mean±SD, or median(Interquartile).
Results: The study included 132 GBS patients, with an average age of 47.87±15.4 years and a male-to-female ratio of 1.69:1. More than half of the patients (58.5%) were classified as having an axonal disease. In patients with axonal illness, 51.4% of patients had lower limb powers<3, while only 36% of those had the demyelinating disease. This group also required mechanical ventilation more frequently (54% vs. 46%) and for a longer duration (26 [9-37] vs. 10 [1-61]) days. Pneumonia and sepsis were each observed in 16% of patients, and 12% developed a urinary tract infection. The most common type of GBS was acute inflammatory demyelinating polyneuropathy (AIDP). Only 6 (3.8%) patients died.
Conclusion: The axonal type of GBS was more frequent, and these patients required mechanical ventilation more frequently and for a longer duration than those in other electrophysiological categories. A preprint version of the manuscript is available at DOI: https://doi.org/10.21203/rs.3.rs-2181605/v1.
{"title":"Clinical Characteristics and Prognosis of ICU-Admitted Patients with Guillain-Barre Syndrome: A Report from a Large Teaching Hospital in South Iran.","authors":"Vida Naderi-Boldaji, Farid Zand, Naeimehossadat Asmarian, Hoda Marbooti, Mansoor Masjedi, Seyedeh Maryam Tabibzadeh, Zahra Esmaeilinezhad, Masoume Nazeri","doi":"10.30476/ijms.2023.99401.3144","DOIUrl":"10.30476/ijms.2023.99401.3144","url":null,"abstract":"<p><strong>Background: </strong>Guillain-Barre Syndrome (GBS) is the most prevalent acute peripheral polyneuropathy disorder. The disparities between populations and variations in the major risk factors highlight the importance of country-specific studies. This study aimed to report clinical characteristics and outcomes of ICU-admitted patients with GBS in an academic medical center in Iran.</p><p><strong>Methods: </strong>The data were collected retrospectively from all patients with GBS admitted to Namazi Hospital, affiliated with Shiraz University of Medical Sciences, (Shiraz, Iran), between March 2016 to March 2021. Specialized neurological information and the Acute Physiology and Chronic Health Evaluation (APACHE II) score were recorded. The SPSS software was used to analyze the data. The analyzed data were reported as numbers and percentages, or mean±SD, or median(Interquartile).</p><p><strong>Results: </strong>The study included 132 GBS patients, with an average age of 47.87±15.4 years and a male-to-female ratio of 1.69:1. More than half of the patients (58.5%) were classified as having an axonal disease. In patients with axonal illness, 51.4% of patients had lower limb powers<3, while only 36% of those had the demyelinating disease. This group also required mechanical ventilation more frequently (54% vs. 46%) and for a longer duration (26 [9-37] vs. 10 [1-61]) days. Pneumonia and sepsis were each observed in 16% of patients, and 12% developed a urinary tract infection. The most common type of GBS was acute inflammatory demyelinating polyneuropathy (AIDP). Only 6 (3.8%) patients died.</p><p><strong>Conclusion: </strong>The axonal type of GBS was more frequent, and these patients required mechanical ventilation more frequently and for a longer duration than those in other electrophysiological categories. A preprint version of the manuscript is available at DOI: https://doi.org/10.21203/rs.3.rs-2181605/v1.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 8","pages":"501-507"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.30476/ijms.2024.103325.3654
Mohammad Ali Davarpanah, Pariya Kouhi
{"title":"A New Health Threat for Iran: Dengue Fever.","authors":"Mohammad Ali Davarpanah, Pariya Kouhi","doi":"10.30476/ijms.2024.103325.3654","DOIUrl":"10.30476/ijms.2024.103325.3654","url":null,"abstract":"","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 8","pages":"470-471"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.30476/ijms.2024.99798.3193
Zahra Ebnehoseini, Hediye Khorasani, Zahra Koohjani, Mina Zibaei, Amir Deghatipour, Ali Saghebi, Ali Reza Ebrahimi, Masoumeh Boroujerdi, Mohammad Reza Mehri, Hamed Tabesh
{"title":"Investigation of Rate and Effective Factors on Discharge against Medical Advice in Psychiatric Patients Over a 10-Year Period.","authors":"Zahra Ebnehoseini, Hediye Khorasani, Zahra Koohjani, Mina Zibaei, Amir Deghatipour, Ali Saghebi, Ali Reza Ebrahimi, Masoumeh Boroujerdi, Mohammad Reza Mehri, Hamed Tabesh","doi":"10.30476/ijms.2024.99798.3193","DOIUrl":"10.30476/ijms.2024.99798.3193","url":null,"abstract":"","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 7","pages":"467-469"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The incidence of ectopic pregnancy (EP) has increased in recent years, owing to causes such as pelvic inflammatory diseases and assisted reproductive technologies (ART). The present study reported a case of a 33-year-old nulliparous woman with a history of previous ectopic pregnancies, who underwent pelvic ultrasound in August 2022, which revealed a double EP including a cervical pregnancy and a tubal stump pregnancy. Despite known risk factors and elevated beta-human chorionic gonadotropin (β-hCG) levels, a conservative approach, utilizing multiple doses of systemic methotrexate (MTX) injections, was employed to preserve fertility at the Regional Perinatal Center in Aktobe, Kazakhstan. Treatment efficacy was monitored through β-hCG levels and ultrasound imaging, with successful resolution of both EPs and preservation of reproductive function. The present case highlighted the safety and efficacy of MTX therapy in managing complex EP presentations, emphasizing the necessity of individualized treatment approaches in reproductive medicine, particularly in terms of preserving fertility in patients undergoing ART. Multiple high doses of MTX injections were beneficial for pregnancy with two distinct regions, fetal cardiac activity, and elevated serum β-hCG level. Further research is required to explore optimal treatment strategies for EP, considering patient-specific factors and treatment goals.
近年来,由于盆腔炎和辅助生殖技术(ART)等原因,异位妊娠(EP)的发病率有所上升。本研究报告了一例曾有过宫外孕病史的 33 岁女患者,她于 2022 年 8 月接受了盆腔超声检查,结果显示她患有双宫外孕,包括宫颈妊娠和输卵管残端妊娠。尽管存在已知的风险因素和β-人绒毛膜促性腺激素(β-hCG)水平升高,但哈萨克斯坦阿克托别地区围产中心仍采用了保守治疗方法,即全身注射多个剂量的甲氨蝶呤(MTX),以保留生育能力。通过β-hCG水平和超声成像监测治疗效果,成功解决了两个EP,并保留了生殖功能。本病例凸显了MTX疗法在治疗复杂EP表现方面的安全性和有效性,强调了生殖医学中个体化治疗方法的必要性,尤其是在保留接受抗逆转录病毒疗法患者的生育能力方面。多次大剂量注射MTX有利于两个不同区域的妊娠、胎儿心脏活动和血清β-hCG水平升高。考虑到患者的具体因素和治疗目标,还需要进一步研究探索 EP 的最佳治疗策略。
{"title":"Successful Management of Cervical and Tubal Stump Double Pregnancy after Assisted Reproductive Technologies Using Multiple High Doses of Methotrexate: A Case Report.","authors":"Andrey Gaiday, Akylbek Tussupkaliyev, Abay Nurken, Assel Gaiday, Ainur Primbetova, Moldir Dossimbetova, Assemgul Yeszhanova, Bibigul Karimsakova, Nurgul Ablakimova","doi":"10.30476/IJMS.2024.102119.3487","DOIUrl":"10.30476/IJMS.2024.102119.3487","url":null,"abstract":"<p><p>The incidence of ectopic pregnancy (EP) has increased in recent years, owing to causes such as pelvic inflammatory diseases and assisted reproductive technologies (ART). The present study reported a case of a 33-year-old nulliparous woman with a history of previous ectopic pregnancies, who underwent pelvic ultrasound in August 2022, which revealed a double EP including a cervical pregnancy and a tubal stump pregnancy. Despite known risk factors and elevated beta-human chorionic gonadotropin (β-hCG) levels, a conservative approach, utilizing multiple doses of systemic methotrexate (MTX) injections, was employed to preserve fertility at the Regional Perinatal Center in Aktobe, Kazakhstan. Treatment efficacy was monitored through β-hCG levels and ultrasound imaging, with successful resolution of both EPs and preservation of reproductive function. The present case highlighted the safety and efficacy of MTX therapy in managing complex EP presentations, emphasizing the necessity of individualized treatment approaches in reproductive medicine, particularly in terms of preserving fertility in patients undergoing ART. Multiple high doses of MTX injections were beneficial for pregnancy with two distinct regions, fetal cardiac activity, and elevated serum β-hCG level. Further research is required to explore optimal treatment strategies for EP, considering patient-specific factors and treatment goals.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 7","pages":"461-466"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Abdominal surgery is considered a high-risk procedure for the development of surgical site infection (SSI). Few studies have evaluated the relative importance of surgical site infection risk factors in terms of consistency in abdominal surgery. Therefore, this comprehensive review article mapped and summarized the evidence aimed to determine the relative importance of the risk factors and incidence of SSIs in abdominal surgery.
Methods: A literature review was conducted using electronic databases and search engines such as Scopus, PubMed, and Web of Science up to March 16, 2023. There was no language restriction for the papers to be included in the study. The relative consistency of the risk factors was measured and evaluated using the methodology of the Joanna Briggs Institute. Original peer-reviewed cohort and case-control studies were included if all types of SSIs were included. Meta-analysis was performed to determine the pooled estimates of SSI incidences.
Results: Of 14,237 identified records, 107 articles were included in the review. The pooled incidence of SSI was 10.6% (95% CI: 9.02-12.55%, χ2=12986.44, P<0.001). Operative time and higher wound class were both significant consistent risk factors for SSI incidence. Patients' educational status, malnutrition, functional status, and history of neurological/psychiatric disorders were all candidates for consistent risk factors, with insufficient evidence.
Conclusion: The findings of the present study indicated that SSI in abdominal surgery was a multifactorial phenomenon with a considerable risk and had different risk factors with various relative importance. Determining the relative importance of the risk factors for the prevention and control of SSI is strongly recommended.This manuscript has been released as a preprint at the research square: (https://doi.org/10.21203/rs.3.rs-3219597/v1).
背景:腹部手术被认为是发生手术部位感染(SSI)的高风险手术。很少有研究评估腹部手术中手术部位感染风险因素一致性的相对重要性。因此,这篇综合综述文章对证据进行了映射和总结,旨在确定腹部手术中 SSI 风险因素和发生率的相对重要性:使用 Scopus、PubMed 和 Web of Science 等电子数据库和搜索引擎对截至 2023 年 3 月 16 日的文献进行了综述。纳入研究的论文没有语言限制。采用乔安娜-布里格斯研究所(Joanna Briggs Institute)的方法对风险因素的相对一致性进行了测量和评估。如果包含所有类型的 SSI,则纳入同行评审的原始队列研究和病例对照研究。进行 Meta 分析以确定 SSI 发生率的汇总估计值:结果:在 14,237 份已确认的记录中,有 107 篇文章被纳入审查范围。SSI的汇总发生率为10.6%(95% CI:9.02-12.55%,χ2=12986.44,PC结论:本研究结果表明,腹部手术中的 SSI 是一种多因素现象,具有相当大的风险,而且不同的风险因素具有不同的相对重要性。强烈建议确定危险因素的相对重要性,以预防和控制 SSI。本稿件已作为预印本在研究广场发布:(https://doi.org/10.21203/rs.3.rs-3219597/v1)。
{"title":"Incidence and Risk Factors of Surgical Site Infection in Abdominal Surgeries: A Scoping Review of Cohort and Case-Control Studies.","authors":"Fereidoun Jahangir, AliAkbar Haghdoost, Hossein Moameri, Maryam Okhovati","doi":"10.30476/ijms.2024.100819.3338","DOIUrl":"10.30476/ijms.2024.100819.3338","url":null,"abstract":"<p><strong>Background: </strong>Abdominal surgery is considered a high-risk procedure for the development of surgical site infection (SSI). Few studies have evaluated the relative importance of surgical site infection risk factors in terms of consistency in abdominal surgery. Therefore, this comprehensive review article mapped and summarized the evidence aimed to determine the relative importance of the risk factors and incidence of SSIs in abdominal surgery.</p><p><strong>Methods: </strong>A literature review was conducted using electronic databases and search engines such as Scopus, PubMed, and Web of Science up to March 16, 2023. There was no language restriction for the papers to be included in the study. The relative consistency of the risk factors was measured and evaluated using the methodology of the Joanna Briggs Institute. Original peer-reviewed cohort and case-control studies were included if all types of SSIs were included. Meta-analysis was performed to determine the pooled estimates of SSI incidences.</p><p><strong>Results: </strong>Of 14,237 identified records, 107 articles were included in the review. The pooled incidence of SSI was 10.6% (95% CI: 9.02-12.55%, χ<sup>2</sup>=12986.44, P<0.001). Operative time and higher wound class were both significant consistent risk factors for SSI incidence. Patients' educational status, malnutrition, functional status, and history of neurological/psychiatric disorders were all candidates for consistent risk factors, with insufficient evidence.</p><p><strong>Conclusion: </strong>The findings of the present study indicated that SSI in abdominal surgery was a multifactorial phenomenon with a considerable risk and had different risk factors with various relative importance. Determining the relative importance of the risk factors for the prevention and control of SSI is strongly recommended.This manuscript has been released as a preprint at the research square: (https://doi.org/10.21203/rs.3.rs-3219597/v1).</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 7","pages":"402-412"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.30476/ijms.2023.99122.3118
Simin Azemati, Maryam Keihani, Mohammad Ali Sahmeddini, Fatemeh Kanaani Nejad, Laleh Dehghanpisheh, Mohammad Bagher Khosravi, Naeimehossadat Asmarian
Background: The management of preoperative anxiety in pediatric patients, as well as its implications, has remained challenging for anesthesiologists. In this study, we compared the safety and efficacy of intranasal dexmedetomidine, midazolam, and ketamine as surgical premedication in children.
Methods: This double-blinded randomized clinical trial was conducted at two tertiary hospitals in January 2014, on 90 children aged between 2-7 years old. The participants' American Society of Anesthesiologists (ASA) physical status was I or II, and they were scheduled for elective unilateral inguinal herniorrhaphy. Using the block randomization method, the patients were randomly assigned to three groups, each receiving intranasal dexmedetomidine (2 µg/Kg), midazolam (0.2 mg/Kg), and ketamine (8 mg/Kg) 60 min before induction of anesthesia. Anxiety and sedation state were evaluated before drug administration, and then every 10 min for the next 50 min. Parental separation anxiety, mask acceptance, postoperative agitation, pain, nausea, and vomiting were also recorded and compared between these groups. All the statistical analyses were performed using SPSS software (version 21.0). P<0.05 was considered statistically significant.
Results: Ketamine indicated the strongest sedative effect 10, 20, and 30 min after administration of premedication (P<0.001, P=0.03, P=0.01, respectively). However, dexmedetomidine was more effective than other drugs after 40 and 50 min (P<0.001). Other variables indicated no statistically significant difference.
Conclusion: In case of emergencies, intranasal ketamine, with the shortest time of action, could be administered. Intranasal dexmedetomidine, which was revealed to be the most potent drug in this study, could be administrated 40-50 min before elective pediatric surgeries.Trial registration number: IRCT2013081614372N1.
{"title":"Comparing the Sedative Effects of Intranasal Dexmedetomidine, Midazolam, and Ketamine in Outpatient Pediatric Surgeries: A Randomized Clinical Trial.","authors":"Simin Azemati, Maryam Keihani, Mohammad Ali Sahmeddini, Fatemeh Kanaani Nejad, Laleh Dehghanpisheh, Mohammad Bagher Khosravi, Naeimehossadat Asmarian","doi":"10.30476/ijms.2023.99122.3118","DOIUrl":"10.30476/ijms.2023.99122.3118","url":null,"abstract":"<p><strong>Background: </strong>The management of preoperative anxiety in pediatric patients, as well as its implications, has remained challenging for anesthesiologists. In this study, we compared the safety and efficacy of intranasal dexmedetomidine, midazolam, and ketamine as surgical premedication in children.</p><p><strong>Methods: </strong>This double-blinded randomized clinical trial was conducted at two tertiary hospitals in January 2014, on 90 children aged between 2-7 years old. The participants' American Society of Anesthesiologists (ASA) physical status was I or II, and they were scheduled for elective unilateral inguinal herniorrhaphy. Using the block randomization method, the patients were randomly assigned to three groups, each receiving intranasal dexmedetomidine (2 µg/Kg), midazolam (0.2 mg/Kg), and ketamine (8 mg/Kg) 60 min before induction of anesthesia. Anxiety and sedation state were evaluated before drug administration, and then every 10 min for the next 50 min. Parental separation anxiety, mask acceptance, postoperative agitation, pain, nausea, and vomiting were also recorded and compared between these groups. All the statistical analyses were performed using SPSS software (version 21.0). P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>Ketamine indicated the strongest sedative effect 10, 20, and 30 min after administration of premedication (P<0.001, P=0.03, P=0.01, respectively). However, dexmedetomidine was more effective than other drugs after 40 and 50 min (P<0.001). Other variables indicated no statistically significant difference.</p><p><strong>Conclusion: </strong>In case of emergencies, intranasal ketamine, with the shortest time of action, could be administered. Intranasal dexmedetomidine, which was revealed to be the most potent drug in this study, could be administrated 40-50 min before elective pediatric surgeries.<b>Trial registration number:</b> IRCT2013081614372N1.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 7","pages":"421-429"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}