Pub Date : 2023-11-18DOI: 10.32592/ircmj.2023.25.11.2040
Background: Pain control is one of the most important issues in femoral fractures. One of the most effective methods is the fascia iliaca compartment block. Objectives: The aim of this study was to compare the efficacy of the addition of dexmedetomidine to bupivacaine on the quality of ultrasound guided blockade of the fascia iliaca compartment in adults undergoing femoral shaft fracture surgery. Methods: This study was a double-blind clinical trial. We studied 60 adults who were hospitalized for a femoral shaft fracture. The patients were divided into two equal groups receiving either bupivacaine alone or bupivacaine and dexmedetomidine for compartment blockade of the iliac fascia. Group allocation was based on the method of randomization from concealed envelopes. Primary outcomes were pain intensity, sedation and analgesic consumption assessed at 1, 2, 6 and 24 hours after surgery in two groups. Data were analyzed using SPSS software. Results: Pain intensity was lower in the dexmedetomidine group 1, 2, 6 and 24 hours after surgery (p<0.05). The sedation score was also higher in the dexmedetomidine group 6 and 24 hours after surgery (p<0.05). The dose of analgesics used by the dexmedetomidine group was significantly lower 6 and 24 h after treatment. No hypotension, respiratory depressionand bradycardia occurred in the patients participating in this study. Conclusion: The addition of dexmedetomidine to bupivacaine during ultrasound-guided blockade of the fascia-iliac compartment is associated with reduced pain intensity and improved sedation in patients undergoing femoral fracture surgery.
{"title":"Dexmedetomidine and Bupivacaine Versus Bupivacaine Alone in Ultrasound Guided Fascia Iliaca Compartment Blockade for Femoral Fractures","authors":"","doi":"10.32592/ircmj.2023.25.11.2040","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.11.2040","url":null,"abstract":"Background: Pain control is one of the most important issues in femoral fractures. One of the most effective methods is the fascia iliaca compartment block. Objectives: The aim of this study was to compare the efficacy of the addition of dexmedetomidine to bupivacaine on the quality of ultrasound guided blockade of the fascia iliaca compartment in adults undergoing femoral shaft fracture surgery. Methods: This study was a double-blind clinical trial. We studied 60 adults who were hospitalized for a femoral shaft fracture. The patients were divided into two equal groups receiving either bupivacaine alone or bupivacaine and dexmedetomidine for compartment blockade of the iliac fascia. Group allocation was based on the method of randomization from concealed envelopes. Primary outcomes were pain intensity, sedation and analgesic consumption assessed at 1, 2, 6 and 24 hours after surgery in two groups. Data were analyzed using SPSS software. Results: Pain intensity was lower in the dexmedetomidine group 1, 2, 6 and 24 hours after surgery (p<0.05). The sedation score was also higher in the dexmedetomidine group 6 and 24 hours after surgery (p<0.05). The dose of analgesics used by the dexmedetomidine group was significantly lower 6 and 24 h after treatment. No hypotension, respiratory depressionand bradycardia occurred in the patients participating in this study. Conclusion: The addition of dexmedetomidine to bupivacaine during ultrasound-guided blockade of the fascia-iliac compartment is associated with reduced pain intensity and improved sedation in patients undergoing femoral fracture surgery.","PeriodicalId":14628,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139261984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-04DOI: 10.32592/ircmj.2023.25.10.2899
Background: One major drawback of using ultrasound for diagnosing thyroid nodules is its limited ability to distinguish between benign and malignant nodules. In China, the common methods for risk stratification and guiding fine needle aspiration (FNA) in diagnosing thyroid nodules are the Chinese Thyroid Imaging Reports and Data Systems (C-TIRADS) and American College of Radiology-Thyroid Imaging Reporting and Data System (ACR-TIRADS). Objectives: This review seeks to assess the effectiveness of C-TIRADS and ACR-TIRADS in accurately identifying the risk of malignancy in Chinese patients suspected of thyroid cancer. Methods: A detailed search was conducted in PubMed, Google Scholar, Medline, Embase, Web of Science, Cochrane, and China National Knowledge Infrastructure (CNKI) databases from January 2018 to December 2022. The analysis only considered original articles from China reporting the use of C-TIRADS and ACR-TIRADS confirmed by histology and FNA. Results: This review analyzed 26 studies with a total of 23,064 thyroid nodules from 19,114 patients to compare the diagnostic performance of C-TIRADS and ACR-TIRADS in predicting malignancy risk in thyroid nodules. Although the malignancy rates in each risk category were similar between the two systems, the TIRADS showed better diagnostic performance than C-TIRADS in terms of pooled specificity (95.0 % vs. 66.8 % of C-TIRADS). However, the pooled analysis showed that C-TIRADS had a better pooled sensitivity (94.6 % vs. 76.5% of ACR-TIRADS). The diagnostic odds ratio was 1.37 (95 % CI: 0.75-2.51) for ACR-TIRADS and 0.89 (95 % CI: 0.36-2.16) for C-TIRADS. Conclusion: Based on the results, both C-TIRADS and ACR-TIRADS are effective in predicting the risk of malignancy in thyroid nodules with similar overall diagnostic accuracy. The combination of both systems can be beneficial in enhancing accuracy in suspicious or uncertain cases. The long-term experience of the trained radiologists can readily help in concluding the diagnosis. As no single system or combination of systems can provide a 100% accurate prediction of the malignancy of thyroid nodules, the ultimate diagnosis relies on the concluding assessment of experienced radiologists and the medical team.
{"title":"A Systematic Review and Meta-analysis on Ultrasound Detection of Thyroid Cancer in China","authors":"","doi":"10.32592/ircmj.2023.25.10.2899","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.10.2899","url":null,"abstract":"Background: One major drawback of using ultrasound for diagnosing thyroid nodules is its limited ability to distinguish between benign and malignant nodules. In China, the common methods for risk stratification and guiding fine needle aspiration (FNA) in diagnosing thyroid nodules are the Chinese Thyroid Imaging Reports and Data Systems (C-TIRADS) and American College of Radiology-Thyroid Imaging Reporting and Data System (ACR-TIRADS). Objectives: This review seeks to assess the effectiveness of C-TIRADS and ACR-TIRADS in accurately identifying the risk of malignancy in Chinese patients suspected of thyroid cancer. Methods: A detailed search was conducted in PubMed, Google Scholar, Medline, Embase, Web of Science, Cochrane, and China National Knowledge Infrastructure (CNKI) databases from January 2018 to December 2022. The analysis only considered original articles from China reporting the use of C-TIRADS and ACR-TIRADS confirmed by histology and FNA. Results: This review analyzed 26 studies with a total of 23,064 thyroid nodules from 19,114 patients to compare the diagnostic performance of C-TIRADS and ACR-TIRADS in predicting malignancy risk in thyroid nodules. Although the malignancy rates in each risk category were similar between the two systems, the TIRADS showed better diagnostic performance than C-TIRADS in terms of pooled specificity (95.0 % vs. 66.8 % of C-TIRADS). However, the pooled analysis showed that C-TIRADS had a better pooled sensitivity (94.6 % vs. 76.5% of ACR-TIRADS). The diagnostic odds ratio was 1.37 (95 % CI: 0.75-2.51) for ACR-TIRADS and 0.89 (95 % CI: 0.36-2.16) for C-TIRADS. Conclusion: Based on the results, both C-TIRADS and ACR-TIRADS are effective in predicting the risk of malignancy in thyroid nodules with similar overall diagnostic accuracy. The combination of both systems can be beneficial in enhancing accuracy in suspicious or uncertain cases. The long-term experience of the trained radiologists can readily help in concluding the diagnosis. As no single system or combination of systems can provide a 100% accurate prediction of the malignancy of thyroid nodules, the ultimate diagnosis relies on the concluding assessment of experienced radiologists and the medical team.","PeriodicalId":14628,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139289411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-23DOI: 10.32592/ircmj.2023.25.10.2933
Background: Pelvic fractures require surgery to restore pelvic stability and ensure the restoration of normal physiological structure and function. In pelvic fracture surgery, the choice of surgical approach may have a significant impact on the postoperative recovery and prognosis of patients. This study compared the postoperative recovery effect, coagulation function, and inflammatory indicators of patients through two different surgical approaches: the pararectus abdominis approach and the traditional ilioinguinal approach, aiming to provide more evidence and guidance for clinical practice. Objectives: To observe the differences in fibrinogen (FIB), D-dimer (D-D), and inflammatory factor levels between patients undergoing pelvic fracture surgery through the Pararectus abdominis approach and traditional ilioinguinal approach. Methods: A total of 86 patients with pelvic fractures were divided into a control group (n=43) and an observation group (n=43). The control group received traditional ilioinguinal approach surgery, while the observation group underwent surgery through the Pararectus abdominis approach. Comparisons were between the two groups for the postoperative coagulation function level, inflammatory factor level, and postoperative hip joint function scores. Results: Before surgery, there was no difference in FIB and D-D levels between the two groups (P>0.05). At 3 days and 7 days after the surgery, the levels of FIB and D-D in the two groups increased compared to before the surgery; however, the observation group was lower in this regard than the control group at the same time (P<0.05). The results of the repeated analysis of variance showed that there were group, time, and interaction effects between the two groups (P<0.05). One week after the operation, the scores of hip joint function were compared between the two groups (P>0.05). The hip joint function scores of the two groups were higher at 1 month and 3 months postoperatively than at 1 week, and the observation group was higher than the control group at the same time. Conclusion: Compared with traditional ilioinguinal approach surgery, surgery through the Pararectus abdominis approach can reduce surgical stimulation, decrease coagulation factor secretion, and alleviate systemic inflammatory reactions after the surgery, promoting the recovery of hip joint function.
{"title":"Analysis of Differences in FIB, D-D, and Inflammatory Factor Levels between Patients Undergoing Pelvic Fracture Surgery through the Pararectus Abdominis Approach and Traditional Ilioinguinal Approach","authors":"","doi":"10.32592/ircmj.2023.25.10.2933","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.10.2933","url":null,"abstract":"Background: Pelvic fractures require surgery to restore pelvic stability and ensure the restoration of normal physiological structure and function. In pelvic fracture surgery, the choice of surgical approach may have a significant impact on the postoperative recovery and prognosis of patients. This study compared the postoperative recovery effect, coagulation function, and inflammatory indicators of patients through two different surgical approaches: the pararectus abdominis approach and the traditional ilioinguinal approach, aiming to provide more evidence and guidance for clinical practice. Objectives: To observe the differences in fibrinogen (FIB), D-dimer (D-D), and inflammatory factor levels between patients undergoing pelvic fracture surgery through the Pararectus abdominis approach and traditional ilioinguinal approach. Methods: A total of 86 patients with pelvic fractures were divided into a control group (n=43) and an observation group (n=43). The control group received traditional ilioinguinal approach surgery, while the observation group underwent surgery through the Pararectus abdominis approach. Comparisons were between the two groups for the postoperative coagulation function level, inflammatory factor level, and postoperative hip joint function scores. Results: Before surgery, there was no difference in FIB and D-D levels between the two groups (P>0.05). At 3 days and 7 days after the surgery, the levels of FIB and D-D in the two groups increased compared to before the surgery; however, the observation group was lower in this regard than the control group at the same time (P<0.05). The results of the repeated analysis of variance showed that there were group, time, and interaction effects between the two groups (P<0.05). One week after the operation, the scores of hip joint function were compared between the two groups (P>0.05). The hip joint function scores of the two groups were higher at 1 month and 3 months postoperatively than at 1 week, and the observation group was higher than the control group at the same time. Conclusion: Compared with traditional ilioinguinal approach surgery, surgery through the Pararectus abdominis approach can reduce surgical stimulation, decrease coagulation factor secretion, and alleviate systemic inflammatory reactions after the surgery, promoting the recovery of hip joint function.","PeriodicalId":14628,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139336895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-23DOI: 10.32592/ircmj.2023.25.10.1758
Objectives: This study aimed to investigate the therapeutic effect of trigger point (TrP) injection of paravertebral muscle to control postoperative lumbar pain. Methods: The medical records of 46 patients who underwent lumbar surgery in our hospital between January 2013 and January 2020 were retrospectively analysed. The patients included in the study were divided into an observation group (n=26) and a control group (n=20) based on the certainty of their myofascial pain TrP diagnosis. The TrPs were found and injected with a 1:5 mixture of compound betamethasone/lidocaine (2 mL). The Visual Analogue Scale (VAS) scores and Patient Satisfaction Index (PSI) scores of the two groups were recorded before injection, on the day after injection, and one and two weeks after injection. The two groups’ postoperative bedridden time and analgesic medication treatment duration were calculated. All the scores were then compared. Results: The VAS scores of the observation group and the control group before injection were 7.00 ± 0.63 and 6.85 ± 0.59, respectively, and no significant difference was observed between the two groups (P>0.05). The VAS scores on the day and one and two weeks after injection were 2.65 ± 0.63, 3.46 ± 0.51, and 2.62 ± 0.50 in the observation group and 3.75 ± 0.44, 4.70 ± 0.47 and 4.95 ± 0.51 in the control group. Within the same group, the difference in patients at different time points was statistically significant (P<0.01), and the difference between the two groups at the same time point after injection was also statistically significant (P<0.01). The PSI score of the observation group was significantly lower than that of the control group (P<0.01). The bedridden time of the observation group was 2.71 ± 0.45 d, which was shorter than the bedridden time of the control group (4.42 ± 0.49 d; P<0.01). The duration of non-steroidal drug use was also shorter in the observation group than in the control group (P<0.01). Conclusion: Accurate injection of compound betamethasone/lidocaine mixture at the pain TrP can effectively control the early pain response after lumbar surgery. It is also beneficial to the early recovery of postoperative function and improves the patient’s satisfaction with the surgery.
{"title":"Management of Post-lumbar-operation Back Pain using Myofascial Trigger Point Injection: A Retrospective Study","authors":"","doi":"10.32592/ircmj.2023.25.10.1758","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.10.1758","url":null,"abstract":"Objectives: This study aimed to investigate the therapeutic effect of trigger point (TrP) injection of paravertebral muscle to control postoperative lumbar pain. Methods: The medical records of 46 patients who underwent lumbar surgery in our hospital between January 2013 and January 2020 were retrospectively analysed. The patients included in the study were divided into an observation group (n=26) and a control group (n=20) based on the certainty of their myofascial pain TrP diagnosis. The TrPs were found and injected with a 1:5 mixture of compound betamethasone/lidocaine (2 mL). The Visual Analogue Scale (VAS) scores and Patient Satisfaction Index (PSI) scores of the two groups were recorded before injection, on the day after injection, and one and two weeks after injection. The two groups’ postoperative bedridden time and analgesic medication treatment duration were calculated. All the scores were then compared. Results: The VAS scores of the observation group and the control group before injection were 7.00 ± 0.63 and 6.85 ± 0.59, respectively, and no significant difference was observed between the two groups (P>0.05). The VAS scores on the day and one and two weeks after injection were 2.65 ± 0.63, 3.46 ± 0.51, and 2.62 ± 0.50 in the observation group and 3.75 ± 0.44, 4.70 ± 0.47 and 4.95 ± 0.51 in the control group. Within the same group, the difference in patients at different time points was statistically significant (P<0.01), and the difference between the two groups at the same time point after injection was also statistically significant (P<0.01). The PSI score of the observation group was significantly lower than that of the control group (P<0.01). The bedridden time of the observation group was 2.71 ± 0.45 d, which was shorter than the bedridden time of the control group (4.42 ± 0.49 d; P<0.01). The duration of non-steroidal drug use was also shorter in the observation group than in the control group (P<0.01). Conclusion: Accurate injection of compound betamethasone/lidocaine mixture at the pain TrP can effectively control the early pain response after lumbar surgery. It is also beneficial to the early recovery of postoperative function and improves the patient’s satisfaction with the surgery.","PeriodicalId":14628,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139336943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-19DOI: 10.32592/ircmj.2023.25.9.2931
Background: Cerebral hemorrhage refers to a hemorrhagic disease caused by primary non-traumatic rupture of blood vessels in the brain parenchyma. It is a common acute cerebrovascular disease in the elderly. Objectives: To observe the effect of perioperative nursing on minimally invasive intracranial hematoma removal surgery in patients with cerebral hemorrhage. Methods: This randomized controlled trial study was conducted on 106 patients undergoing treatment for minimally invasive internal hematoma (MIRIH) at the First Hospital of Jilin University, Jilin, China, between January and December 2022. These patients were randomly divided into two groups, namely the control and observation groups (n=53 each). The observation group received perioperative care in addition to routine care. Differences between groups were compared using t-tests and Chi-square tests. Results: On the first day, there were no significant differences in the baseline characteristics between the groups. However, on the 7th and 14th days of admission, the observation group showed an increase in potassium ions and a decrease in chloride ions, lactate dehydrogenase, trace microalbumin, and the National Institutes of Health Stroke Scale (NIHSS) scores, compared to the control group (P<0.05). The observation group also had a lower incidence of postoperative complications, including pneumonia, lower limb vein thrombosis, and cerebral hernia, compared to the control group (P<0.05). NIHSS scores on days 7 and 14 were significantly lower in the observation group than in the control group (day 7: 9.60±4.11 vs 12.02±2.83, P<0.05; day 14: 6.77±3.47 vs 9.19±2.86, P<0.05). Conclusion: Perioperative nursing leads to improvement in electrolyte/metabolic levels, neurological recovery, and reduction in post-MIRIH surgical complications.
{"title":"Perioperative Nursing Influence on Cerebrospinal Fluid Biochemical Markers in Cerebral Hemorrhage Patients Undergoing Minimally Invasive Intracranial Hematoma Removal Surgery","authors":"","doi":"10.32592/ircmj.2023.25.9.2931","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.9.2931","url":null,"abstract":"Background: Cerebral hemorrhage refers to a hemorrhagic disease caused by primary non-traumatic rupture of blood vessels in the brain parenchyma. It is a common acute cerebrovascular disease in the elderly. Objectives: To observe the effect of perioperative nursing on minimally invasive intracranial hematoma removal surgery in patients with cerebral hemorrhage. Methods: This randomized controlled trial study was conducted on 106 patients undergoing treatment for minimally invasive internal hematoma (MIRIH) at the First Hospital of Jilin University, Jilin, China, between January and December 2022. These patients were randomly divided into two groups, namely the control and observation groups (n=53 each). The observation group received perioperative care in addition to routine care. Differences between groups were compared using t-tests and Chi-square tests. Results: On the first day, there were no significant differences in the baseline characteristics between the groups. However, on the 7th and 14th days of admission, the observation group showed an increase in potassium ions and a decrease in chloride ions, lactate dehydrogenase, trace microalbumin, and the National Institutes of Health Stroke Scale (NIHSS) scores, compared to the control group (P<0.05). The observation group also had a lower incidence of postoperative complications, including pneumonia, lower limb vein thrombosis, and cerebral hernia, compared to the control group (P<0.05). NIHSS scores on days 7 and 14 were significantly lower in the observation group than in the control group (day 7: 9.60±4.11 vs 12.02±2.83, P<0.05; day 14: 6.77±3.47 vs 9.19±2.86, P<0.05). Conclusion: Perioperative nursing leads to improvement in electrolyte/metabolic levels, neurological recovery, and reduction in post-MIRIH surgical complications.","PeriodicalId":14628,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139338764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-08DOI: 10.32592/ircmj.2023.25.10.3041
Background: Hypertensive intracerebral hemorrhage (HICH) is a spontaneous cerebrovascular disease occuring in the brain parenchyma. Objectives: To characterize the predictive role of miR-155-5p and BDNF in the prognosis of HICH. Methods: All patients with HICH who underwent CT-guided minimally invasive surgery were classified into the good and poor prognosis groups using the modified Rankin Scale (mRS). The level of miR-155-5p was determined by qRT-PCR, and the level of brain-derived neurotrophic factor (BDNF) in serum was determined by ELISA. The relationship between miR-155-5p and BDNF was tested by Pearson correlation and luciferase reporter assay. The logistic regression method was used to determine the risk factors. The ROC curve was drawn to explain the predictive role of miR-155-5p, BDNF, or their combination. Results: A high level of miR-155-5p and a lower level of BDNF were observed in the poor prognosis group. BDNF level was negatively related to the level of miR-155-5p. BDNF is a target of miR-155-5p. BDNF and miR-155-5p were associated with prognosis. BDNF, miR-155-5p or their combination were predictive biomarkers for the prognosis of HICH. Conclusion: BDNF and miR-155-5p were associated with the outcome of HICH patients.
{"title":"Correlation of miR-155-5p and BDNF with Prognosis of Patients with Intracerebral Hemorrhage Undergoing CT-guided Minimally Invasive Surgery","authors":"","doi":"10.32592/ircmj.2023.25.10.3041","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.10.3041","url":null,"abstract":"Background: Hypertensive intracerebral hemorrhage (HICH) is a spontaneous cerebrovascular disease occuring in the brain parenchyma. Objectives: To characterize the predictive role of miR-155-5p and BDNF in the prognosis of HICH. Methods: All patients with HICH who underwent CT-guided minimally invasive surgery were classified into the good and poor prognosis groups using the modified Rankin Scale (mRS). The level of miR-155-5p was determined by qRT-PCR, and the level of brain-derived neurotrophic factor (BDNF) in serum was determined by ELISA. The relationship between miR-155-5p and BDNF was tested by Pearson correlation and luciferase reporter assay. The logistic regression method was used to determine the risk factors. The ROC curve was drawn to explain the predictive role of miR-155-5p, BDNF, or their combination. Results: A high level of miR-155-5p and a lower level of BDNF were observed in the poor prognosis group. BDNF level was negatively related to the level of miR-155-5p. BDNF is a target of miR-155-5p. BDNF and miR-155-5p were associated with prognosis. BDNF, miR-155-5p or their combination were predictive biomarkers for the prognosis of HICH. Conclusion: BDNF and miR-155-5p were associated with the outcome of HICH patients.","PeriodicalId":14628,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139341617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-07DOI: 10.32592/ircmj.2023.25.9.3059
Background: When natural disasters occur, people with diabetes face more physical and mental challenges than healthy individuals. Therefore, innovative programs and policies are crucial for providing ongoing education to patients on how to better manage their condition. Objectives: The present study aimed to identify the components of empowerment literacy for diabetic patients during disasters. Methods: The present research employed a qualitative content analysis approach using a conventional deductive method. Purposive sampling was conducted, and data were collected through semi-structured interviews. The panel consisted of 24 participants, including native Iranian endocrinologists, nurses, emergency medical center managers, and experts in the field of medical librarianship and information. These participants had direct experience in relief efforts during critical situations such as natural disasters. The interviews were recorded and transcribed into written format. Data analysis was performed using thematic analysis with the assistance of MaxQDA software. Results: The content analysis resulted in identification of 10 main categories, 61 sub-categories, and five themes, including Disaster risk perception literacy, Medication literacy, Resilience literacy, Nutrition literacy, and Self-help literacy. Conclusion: The obtained findings have informed the creation of targeted health literacy education materials for policymakers in disaster scenarios specifically designed for individuals with diabetes. Diabetic individuals, particularly those residing in disaster-prone areas, should possess knowledge of emergency and disaster policies to enhance their health literacy. They should actively manage their condition while keeping abreast of policymakers' guidelines.
{"title":"Improving Diabetes Self-Help in Natural Disasters: Qualitative Parameters and Recommendations","authors":"","doi":"10.32592/ircmj.2023.25.9.3059","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.9.3059","url":null,"abstract":"Background: When natural disasters occur, people with diabetes face more physical and mental challenges than healthy individuals. Therefore, innovative programs and policies are crucial for providing ongoing education to patients on how to better manage their condition. Objectives: The present study aimed to identify the components of empowerment literacy for diabetic patients during disasters. Methods: The present research employed a qualitative content analysis approach using a conventional deductive method. Purposive sampling was conducted, and data were collected through semi-structured interviews. The panel consisted of 24 participants, including native Iranian endocrinologists, nurses, emergency medical center managers, and experts in the field of medical librarianship and information. These participants had direct experience in relief efforts during critical situations such as natural disasters. The interviews were recorded and transcribed into written format. Data analysis was performed using thematic analysis with the assistance of MaxQDA software. Results: The content analysis resulted in identification of 10 main categories, 61 sub-categories, and five themes, including Disaster risk perception literacy, Medication literacy, Resilience literacy, Nutrition literacy, and Self-help literacy. Conclusion: The obtained findings have informed the creation of targeted health literacy education materials for policymakers in disaster scenarios specifically designed for individuals with diabetes. Diabetic individuals, particularly those residing in disaster-prone areas, should possess knowledge of emergency and disaster policies to enhance their health literacy. They should actively manage their condition while keeping abreast of policymakers' guidelines.","PeriodicalId":14628,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139341938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-07DOI: 10.32592/ircmj.2023.25.10.2843
Background: Identification of genetic abnormalities in multiple myeloma (MM) patients is of particular importance in order to design their treatment and management. Therefore, it is necessary to use the diagnostic methods with high sensitivity to detect abnormalities. In this study, we investigated the sensitivity of conventional cytogenetic and FISH methods in the diagnosis of genetic abnormalities in MM patients. Methods: This retrospective study included 246 patients who referred to the Kariminejhad Center for the Diagnosis of Genetic Abnormalities between 2009-2019. All patients were diagnosed based on diagnostic tests, as well as the approval of the relevant physician. The diagnosis of cytogenetic abnormality was made based on the two methods of conventional cytogenetic and FISH. Result: The results showed that out of 246 patients examined by conventional cytogenetic, only 17.8% had abnormal karyotypes. While out of 67 patients examined by FISH, 64.1% had abnormal results. The results also showed that 31 out of 50 patients with normal karyotype had abnormal FISH result. In the present study, the results showed that 25% of the patients had hyperdiploidy (57-47), which was diagnosed by conventional cytogenetic. Also, 40.90% had diploid abnormalities (pseudodiploid or structural abnormalities). FISH detected del 13q in 27.9% and t(11;14) IGH-CCND1 in 18.6% of patients, which were the most frequent compared to other abnormalities. Conclusion: Considering that the variety of mutations and translocations is high in different parts of the world and every day new mutations are detected, using both methods together can help to identify genetic disorders.
背景：鉴定多发性骨髓瘤（MM）患者的基因异常对设计治疗和管理方案尤为重要。因此，有必要使用灵敏度高的诊断方法来检测异常。在这项研究中，我们探讨了传统细胞遗传学方法和 FISH 方法在诊断 MM 患者基因异常方面的灵敏度。方法：这项回顾性研究纳入了 2009-2019 年间转诊至 Kariminejhad 遗传异常诊断中心的 246 名患者。所有患者的诊断均基于诊断测试以及相关医生的批准。细胞遗传异常的诊断基于常规细胞遗传学和 FISH 两种方法。结果结果显示，在接受常规细胞遗传学检查的 246 名患者中，只有 17.8%的患者核型异常。而在 67 名接受 FISH 检查的患者中，64.1% 的患者结果异常。结果还显示，在 50 名核型正常的患者中，有 31 人的 FISH 结果异常。在本研究中，结果显示 25% 的患者有超二倍体（57-47），这是通过常规细胞遗传学诊断出来的。此外，40.90%的患者存在二倍体异常（假二倍体或结构异常）。FISH 检测出 27.9% 的患者存在 del 13q，18.6% 的患者存在 t(11;14) IGH-CCND1，与其他异常相比，这两种异常最为常见。结论考虑到世界各地的突变和易位种类繁多，而且每天都有新的突变被检测到，因此同时使用这两种方法有助于鉴别遗传疾病。
{"title":"Evaluation of the Sensitivity of Conventional Cytogenetic and Fluorescence in Situ Hybridization Methods for the Detection of Cytogenetic Abnormalities in Multiple Myeloma Patients: A Retrospective Study","authors":"","doi":"10.32592/ircmj.2023.25.10.2843","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.10.2843","url":null,"abstract":"Background: Identification of genetic abnormalities in multiple myeloma (MM) patients is of particular importance in order to design their treatment and management. Therefore, it is necessary to use the diagnostic methods with high sensitivity to detect abnormalities. In this study, we investigated the sensitivity of conventional cytogenetic and FISH methods in the diagnosis of genetic abnormalities in MM patients. Methods: This retrospective study included 246 patients who referred to the Kariminejhad Center for the Diagnosis of Genetic Abnormalities between 2009-2019. All patients were diagnosed based on diagnostic tests, as well as the approval of the relevant physician. The diagnosis of cytogenetic abnormality was made based on the two methods of conventional cytogenetic and FISH. Result: The results showed that out of 246 patients examined by conventional cytogenetic, only 17.8% had abnormal karyotypes. While out of 67 patients examined by FISH, 64.1% had abnormal results. The results also showed that 31 out of 50 patients with normal karyotype had abnormal FISH result. In the present study, the results showed that 25% of the patients had hyperdiploidy (57-47), which was diagnosed by conventional cytogenetic. Also, 40.90% had diploid abnormalities (pseudodiploid or structural abnormalities). FISH detected del 13q in 27.9% and t(11;14) IGH-CCND1 in 18.6% of patients, which were the most frequent compared to other abnormalities. Conclusion: Considering that the variety of mutations and translocations is high in different parts of the world and every day new mutations are detected, using both methods together can help to identify genetic disorders.","PeriodicalId":14628,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139341884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-04DOI: 10.32592/ircmj.2023.25.9.2900
Background: Burn injuries are caused by electricity, heat, radiation, cold, friction, or chemicals and lead to tissue destruction due to energy transfer from the sources to the tissues and cells. The present study aimed to perform a systematic review and meta-analysis of water cooling, ice pack application, cold and wet compress treatment of burn wounds in children before admission and to evaluate their effects on tissue healing and safety. Methods: We systematically searched PubMed, CINAHL, Cochrane Library, and Embase from inception to March 2023. Review Manager (version 5.4) was used to assess the risk of bias in the selected studies, and a meta-analysis of all dichotomous and continuous outcomes in the selected studies was performed. Out of 590 studies, seven studies based on the PRISMA protocol in the meta-analysis were included. Results: Based on the duration of cooling, no significant differences in the depth and size of burn wounds were found. Moreover, we established that cooling burn wounds significantly reduces tissue damage and limits the spread of burns to the surrounding tissues. A higher heterogeneity was observed in the selected studies based on methodology, implying different designs affecting our findings. Conclusion: There is inconclusive evidence on the recommended optimum duration of cooling burn wounds. However, cooling burn wounds has a beneficial impact on reducing tissue damage and limiting the spread of burns.
{"title":"Water Cooling, Ice Pack Application, and Cold Wet Compress Treatment of Burn Wounds in Children before Admission, Effects on Tissue Healing and Safety Research: Systematic Review and Meta-Analysis","authors":"","doi":"10.32592/ircmj.2023.25.9.2900","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.9.2900","url":null,"abstract":"Background: Burn injuries are caused by electricity, heat, radiation, cold, friction, or chemicals and lead to tissue destruction due to energy transfer from the sources to the tissues and cells. The present study aimed to perform a systematic review and meta-analysis of water cooling, ice pack application, cold and wet compress treatment of burn wounds in children before admission and to evaluate their effects on tissue healing and safety. Methods: We systematically searched PubMed, CINAHL, Cochrane Library, and Embase from inception to March 2023. Review Manager (version 5.4) was used to assess the risk of bias in the selected studies, and a meta-analysis of all dichotomous and continuous outcomes in the selected studies was performed. Out of 590 studies, seven studies based on the PRISMA protocol in the meta-analysis were included. Results: Based on the duration of cooling, no significant differences in the depth and size of burn wounds were found. Moreover, we established that cooling burn wounds significantly reduces tissue damage and limits the spread of burns to the surrounding tissues. A higher heterogeneity was observed in the selected studies based on methodology, implying different designs affecting our findings. Conclusion: There is inconclusive evidence on the recommended optimum duration of cooling burn wounds. However, cooling burn wounds has a beneficial impact on reducing tissue damage and limiting the spread of burns.","PeriodicalId":14628,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139342869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-04DOI: 10.32592/ircmj.2023.25.9.2885
Hepatic sinusoidal occlusion syndrome (SOS) or venous occlusive disease (VOD) is a frequent complication of allogeneic Hematopoietic stem cell transplantation (allo-HSCT). The mortality rate of patients with severe VOD is extremely high. It is of utmost importance to explore practical ways to reduce the incidence of VOD. The present study aimed to evaluate the efficacy and safety of a prophylaxis strategy involving the combined use of prostaglandin E1 (PGE1), dalteparin, low molecular weight glucan dextran (LMWD), and ursodeoxycholic acid (UDCA). We conducted a single-center retrospective clinical observation of 225 patients who received allo-HSCT for hematological disorders between 2008 and 2022, all of whom received these four medicines for VOD. These 225 patients were within the age range of 6-58 years, and their donors were classified as related donors (75.5%) and unrelated donors (24.5%). All patients underwent a myeloablative conditioning regimen prior to transplantation. Each patient possessed at least one risk factor for VOD, and 167 (74.2%) cases were deemed to be at high risk. Ultimately, only two patients developed VOD, with an incidence of only 0.89%, of whom one was late-onset VOD. The bleeding rate was 32.9%, with predominantly grade 1-2 (93.2%). The incidence of bleeding aligns with findings reported in other literature. Remarkably, the mortality rate associated with bleeding during transplantation was a mere 1.8%, significantly lower than the average. The results of the study demonstrated the effectiveness and safety of the four PGE1-based medications in the prevention of VOD after allo-HSCT.
{"title":"Four-drug Combination Therapy for Venous Occlusive Disease Prophylaxis after Allogeneic Hematopoietic Stem Cell Transplantation","authors":"","doi":"10.32592/ircmj.2023.25.9.2885","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.9.2885","url":null,"abstract":"Hepatic sinusoidal occlusion syndrome (SOS) or venous occlusive disease (VOD) is a frequent complication of allogeneic Hematopoietic stem cell transplantation (allo-HSCT). The mortality rate of patients with severe VOD is extremely high. It is of utmost importance to explore practical ways to reduce the incidence of VOD. The present study aimed to evaluate the efficacy and safety of a prophylaxis strategy involving the combined use of prostaglandin E1 (PGE1), dalteparin, low molecular weight glucan dextran (LMWD), and ursodeoxycholic acid (UDCA). We conducted a single-center retrospective clinical observation of 225 patients who received allo-HSCT for hematological disorders between 2008 and 2022, all of whom received these four medicines for VOD. These 225 patients were within the age range of 6-58 years, and their donors were classified as related donors (75.5%) and unrelated donors (24.5%). All patients underwent a myeloablative conditioning regimen prior to transplantation. Each patient possessed at least one risk factor for VOD, and 167 (74.2%) cases were deemed to be at high risk. Ultimately, only two patients developed VOD, with an incidence of only 0.89%, of whom one was late-onset VOD. The bleeding rate was 32.9%, with predominantly grade 1-2 (93.2%). The incidence of bleeding aligns with findings reported in other literature. Remarkably, the mortality rate associated with bleeding during transplantation was a mere 1.8%, significantly lower than the average. The results of the study demonstrated the effectiveness and safety of the four PGE1-based medications in the prevention of VOD after allo-HSCT.","PeriodicalId":14628,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139342921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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