This paper presents a unique 12-year case analysis of a girl with Penta-X syndrome, a chromosomal abnormality characterized by five X chromosomes instead of the normal two in healthy women. Pentasomy of X is a genetic, but not a hereditary disease affecting only women. Our patient demonstrated delayed mental, speech, and motor development along with physical anomalies such as craniofacial deformities, and eye pathology and was diagnosed with pentasomy of the X chromosome at the age of 3 after a cytogenetic examination. She developed epileptic seizures at the age of nine. Magnetic resonance imaging(MRI) revealed leukoencephalopathy with ventriculomegaly. The peculiarity of this observation is that the polysomy 49, XXXXX detected in the patient is characterized by a typical phenotypic presentation combined with demyelinating leukoencephalopathy, which has not been a typical feature of the disorder.
X 五体综合征是一种染色体异常,其特征是有五条 X 染色体,而不是健康女性正常的两条。X 五体综合征是一种遗传病,但不是仅影响女性的遗传病。我们的患者表现出智力、语言和运动发育迟缓,同时伴有颅面畸形和眼部病变等身体异常,3 岁时经细胞遗传学检查被确诊为 X 染色体五体综合征。她九岁时出现癫痫发作。磁共振成像(MRI)显示白质脑病伴脑室肥大。这一观察结果的特殊之处在于,在该患者身上发现的多体 49 XXXXX 具有典型的表型表现,同时伴有脱髓鞘性白质脑病,而脱髓鞘性白质脑病并不是该疾病的典型特征。
{"title":"A 12-year Life History of a Girl with Profound Intellectual Disability and Leukoencephalopathy: A Rare Clinical Presentation of X Chromosome Pentasomy.","authors":"Akmaral Izbassarova, Aisulu Zholdybayeva, Galiya Kadrzhanova, Khadisha Kashikova, Asel Izbassarova, Natalya Petrova, Alima Tolybekova","doi":"10.47176/mjiri.38.40","DOIUrl":"10.47176/mjiri.38.40","url":null,"abstract":"<p><p>This paper presents a unique 12-year case analysis of a girl with Penta-X syndrome, a chromosomal abnormality characterized by five X chromosomes instead of the normal two in healthy women. Pentasomy of X is a genetic, but not a hereditary disease affecting only women. Our patient demonstrated delayed mental, speech, and motor development along with physical anomalies such as craniofacial deformities, and eye pathology and was diagnosed with pentasomy of the X chromosome at the age of 3 after a cytogenetic examination. She developed epileptic seizures at the age of nine. Magnetic resonance imaging(MRI) revealed leukoencephalopathy with ventriculomegaly. The peculiarity of this observation is that the polysomy 49, XXXXX detected in the patient is characterized by a typical phenotypic presentation combined with demyelinating leukoencephalopathy, which has not been a typical feature of the disorder.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559082","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 : 2024-04-09eCollection Date: 2024-01-01DOI: 10.47176/mjiri.38.39
Saba Dahaghin, Ava Aghakhani, Azadeh Memarian, Pardis Monjezi, Kamran Aghakhani
Background: A Medical Certificate of Cause of Death (MCCD) is a legal and enforceable document issued by the attending physician. However, according to the instructions, in many cases such as sudden, unexplained, and extraordinary deaths, along with some uncommon causes, such as cases suspicious of murder, the deceased patient must be referred to the Iranian Legal Medicine Organization (ILMO). Moreover, the unnecessary referral of corpses to ILMO can increase the workload of the staff, finally confronting the family of the deceased with high emotional and financial costs.
Methods: In this cross-sectional study, the medical records of all deceased patients referred from Hazrat Rasool Hospital to the ILMO (565 cases) in a three-year period from April 2016 to March 2019 were investigated and analyzed using SPSS22 software with chi-squared and T-test.
Results: Among all the patients who passed away during this time (4,239 patients), 565 were referred to ILMO, accounting for 13.3% of deaths. The most common causes of referral were car and motorcycle accidents, with a total prevalence of 27.1%, dead-on-arrival (DOA) prevalence of 21.3%, and death with an unknown cause prevalence of 15.3%. Significant correlation was also detected between causes of referral with gender, time of death, and age. For example, Car accidents and lawsuits against medical staff were more common in men and women, respectively.
Conclusion: Car and motorcycle accidents, DOA, and unknown causes were the most prevalent causes of referral in this study. In general, few studies have been conducted regarding the causes of referral of the deceased to the Legal Medicine Organization. In this study, we collected relevant variables to investigate this issue thoroughly.
{"title":"A Three-Year Investigation on Corpses Referred to Legal Medicine Organization from An Iranian General Hospital: A Cross-Sectional Study.","authors":"Saba Dahaghin, Ava Aghakhani, Azadeh Memarian, Pardis Monjezi, Kamran Aghakhani","doi":"10.47176/mjiri.38.39","DOIUrl":"10.47176/mjiri.38.39","url":null,"abstract":"<p><strong>Background: </strong>A Medical Certificate of Cause of Death (MCCD) is a legal and enforceable document issued by the attending physician. However, according to the instructions, in many cases such as sudden, unexplained, and extraordinary deaths, along with some uncommon causes, such as cases suspicious of murder, the deceased patient must be referred to the Iranian Legal Medicine Organization (ILMO). Moreover, the unnecessary referral of corpses to ILMO can increase the workload of the staff, finally confronting the family of the deceased with high emotional and financial costs.</p><p><strong>Methods: </strong>In this cross-sectional study, the medical records of all deceased patients referred from Hazrat Rasool Hospital to the ILMO (565 cases) in a three-year period from April 2016 to March 2019 were investigated and analyzed using SPSS22 software with chi-squared and T-test.</p><p><strong>Results: </strong>Among all the patients who passed away during this time (4,239 patients), 565 were referred to ILMO, accounting for 13.3% of deaths. The most common causes of referral were car and motorcycle accidents, with a total prevalence of 27.1%, dead-on-arrival (DOA) prevalence of 21.3%, and death with an unknown cause prevalence of 15.3%. Significant correlation was also detected between causes of referral with gender, time of death, and age. For example, Car accidents and lawsuits against medical staff were more common in men and women, respectively.</p><p><strong>Conclusion: </strong>Car and motorcycle accidents, DOA, and unknown causes were the most prevalent causes of referral in this study. In general, few studies have been conducted regarding the causes of referral of the deceased to the Legal Medicine Organization. In this study, we collected relevant variables to investigate this issue thoroughly.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559134","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: The survival rate in premature infants (PIs) has increased, but many have medical and developmental complications. Difficulty with sucking, swallowing, and poor nourishment are common complications. This study aimed to investigate the effects of Kinesio-tape (KT) combined with premature infant oromotor intervention (PIOMI) on feeding efficiency (mean volume intake [%MV]), oromotor skills (Preterm Oral Feeding Readiness Assessment Scale [POFRAS]), and weight gain in PIs.
Methods: In this single-subject study, 5 PIs with feeding problems were received the PIOMI-KT for 7 consecutive days. The main outcome measure was the POFRAS scale. The %MV and weight gain were the secondary outcome measures. Measurements were taken before treatment (T0), after the 4th session (T1), and after the 7th session (T3).
Results: The POFRAS scores, %MV, and weight gain improved in all infants after treatment. The maximum and minimum change in level between the baseline and treatment phase was +26 and+16 for POFRAS, +54 and, +34 for %MV, +180, and +100 for weight gain. The treatment trend was upward for all infants and shown by the directions of the slopes indicated by positive values. The feeding problems were resolved in all infants after the 7th treatment session.
Conclusion: The combination therapy of PIOMI-KT improved feeding function in PIs.
{"title":"A Single-Subject Study to Consider the Premature Infant Oral Motor Intervention Combined with Kinesio-Tape in Premature Infants with Feeding Problems.","authors":"Ehsan Naderifar, Maryam Tarameshlu, Reza Salehi, Leila Ghelichi, Arash Bordbar, Negin Moradi, Brenda Lessen Knoll","doi":"10.47176/mjiri.38.38","DOIUrl":"10.47176/mjiri.38.38","url":null,"abstract":"<p><strong>Background: </strong>The survival rate in premature infants (PIs) has increased, but many have medical and developmental complications. Difficulty with sucking, swallowing, and poor nourishment are common complications. This study aimed to investigate the effects of Kinesio-tape (KT) combined with premature infant oromotor intervention (PIOMI) on feeding efficiency (mean volume intake [%MV]), oromotor skills (Preterm Oral Feeding Readiness Assessment Scale [POFRAS]), and weight gain in PIs.</p><p><strong>Methods: </strong>In this single-subject study, 5 PIs with feeding problems were received the PIOMI-KT for 7 consecutive days. The main outcome measure was the POFRAS scale. The %MV and weight gain were the secondary outcome measures. Measurements were taken before treatment (T0), after the 4th session (T1), and after the 7th session (T3).</p><p><strong>Results: </strong>The POFRAS scores, %MV, and weight gain improved in all infants after treatment. The maximum and minimum change in level between the baseline and treatment phase was +26 and+16 for POFRAS, +54 and, +34 for %MV, +180, and +100 for weight gain. The treatment trend was upward for all infants and shown by the directions of the slopes indicated by positive values. The feeding problems were resolved in all infants after the 7th treatment session.</p><p><strong>Conclusion: </strong>The combination therapy of PIOMI-KT improved feeding function in PIs.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559083","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 : 2024-04-03eCollection Date: 2024-01-01DOI: 10.47176/mjiri.38.37
Homayoun Sadeghi-Bazargani, Hamid Soori, Seyed Abbas Motevalian, Omid Aboubakri, Ali Jafari-Khounigh, Alireza Razzaghi, Hamid Reza Khankeh, Seyyed Taghi Heydari, Forouzan Rezapur Shahkolai, Mojtaba Sehat, Davoud Khorasani Zavareh, Mohammad Asghari-Jafarabadi, Ali Imani, Mohammad Bagher Alizadeh Aghdam, Hossein Poustchi, Mahdi Rezaei, Mina Golestani
Background: Measuring socioeconomic status (SES) as an independent variable is challenging, especially in epidemiological and social studies. This issue is more critical in large-scale studies on the national level. The present study aimed to extensively evaluate the validity and reliability of the Iranian SES questionnaire.
Methods: This psychometric, cross-sectional study was conducted on 3000 households, selected via random cluster sampling from various areas in East Azerbaijan province and Tehran, Iran. Moreover, 250 students from Tabriz University of Medical Sciences were selected as interviewers to collect data from 40 districts in Iran. The construct validity and internal consistency of the SES questionnaire were assessed using exploratory and confirmatory factor analyses and the Cronbach's alpha. Data analysis was performed in SPSS and AMOS.
Results: The complete Iranian version of the SES questionnaire consists of 5 factors. The Cronbach's alpha was calculated to be 0.79, 0.94, 0.66, 0.69, and 0.48 for the occupation, self-evaluation of economic capacity, house and furniture, wealth, and health expenditure, respectively. In addition, the confirmatory factor analysis results indicated the data's compatibility with the 5-factor model (comparative fit index = 0.96; goodness of fit index = 0.95; incremental fit index = 0.96; root mean square error of approximation = 0.05).
Conclusion: According to the results, the confirmed validity and reliability of the tool indicated that the Iranian version of the SES questionnaire could be utilized with the same structure on an extensive level and could be applicable for measuring the SES in a broader range of populations.
{"title":"The Factor Structure and Generalizability of the Iranian Socioeconomic Status (SES) Questionnaire Administered in a Nationally Divergent Population.","authors":"Homayoun Sadeghi-Bazargani, Hamid Soori, Seyed Abbas Motevalian, Omid Aboubakri, Ali Jafari-Khounigh, Alireza Razzaghi, Hamid Reza Khankeh, Seyyed Taghi Heydari, Forouzan Rezapur Shahkolai, Mojtaba Sehat, Davoud Khorasani Zavareh, Mohammad Asghari-Jafarabadi, Ali Imani, Mohammad Bagher Alizadeh Aghdam, Hossein Poustchi, Mahdi Rezaei, Mina Golestani","doi":"10.47176/mjiri.38.37","DOIUrl":"10.47176/mjiri.38.37","url":null,"abstract":"<p><strong>Background: </strong>Measuring socioeconomic status (SES) as an independent variable is challenging, especially in epidemiological and social studies. This issue is more critical in large-scale studies on the national level. The present study aimed to extensively evaluate the validity and reliability of the Iranian SES questionnaire.</p><p><strong>Methods: </strong>This psychometric, cross-sectional study was conducted on 3000 households, selected via random cluster sampling from various areas in East Azerbaijan province and Tehran, Iran. Moreover, 250 students from Tabriz University of Medical Sciences were selected as interviewers to collect data from 40 districts in Iran. The construct validity and internal consistency of the SES questionnaire were assessed using exploratory and confirmatory factor analyses and the Cronbach's alpha. Data analysis was performed in SPSS and AMOS.</p><p><strong>Results: </strong>The complete Iranian version of the SES questionnaire consists of 5 factors. The Cronbach's alpha was calculated to be 0.79, 0.94, 0.66, 0.69, and 0.48 for the occupation, self-evaluation of economic capacity, house and furniture, wealth, and health expenditure, respectively. In addition, the confirmatory factor analysis results indicated the data's compatibility with the 5-factor model (comparative fit index = 0.96; goodness of fit index = 0.95; incremental fit index = 0.96; root mean square error of approximation = 0.05).</p><p><strong>Conclusion: </strong>According to the results, the confirmed validity and reliability of the tool indicated that the Iranian version of the SES questionnaire could be utilized with the same structure on an extensive level and could be applicable for measuring the SES in a broader range of populations.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559140","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: Urinary tract infections (UTIs) are extremely prevalent bacterial infections among children. They have numerous potential causes. Without proper diagnosis and treatment, UTIs can lead to serious complications in children, including impaired growth, high blood pressure, protein in urine, and eventual chronic kidney disease. Zinc and vitamin D in sufficient concentrations help to maintain the health of the immune system. Therefore, their deficiency can cause various infections. Several factors can contribute to the development of UTIs. This article deals with the role of zinc and vitamin D as immune markers in UTI in children without other risk factors.
Methods: In this case-control study, serum zinc and vitamin D levels without any other risk factors were examined in 40 healthy children and 40 children with UTIs. Data analysis was done through SPSS 26 using the chi-square, the Fisher's exact, and independent t tests.
Results: The study findings demonstrated a statistically significant distinction between the 2 groups regarding serum vitamin D and zinc levels (P < 0.001); 80% of children with UTIs and 17.5% in the healthy group had vitamin D deficiency. Also, 60% of the urinary infection group had zinc deficiency, whereas 17.5% of the healthy group had it.
Conclusion: Low serum zinc and vitamin D levels may increase susceptibility to pediatric UTI. Given the data, supplementation with zinc and vitamin D could play a significant role in treating active infections and preventing recurrence in susceptible children.
背景:尿路感染(UTI)是儿童中极为普遍的细菌感染。其潜在病因众多。如果没有正确的诊断和治疗,尿路感染会导致儿童出现严重的并发症,包括生长受阻、高血压、尿蛋白以及最终的慢性肾病。足够浓度的锌和维生素 D 有助于维持免疫系统的健康。因此,它们的缺乏会导致各种感染。有几种因素会导致尿毒症的发生。本文探讨了锌和维生素 D 作为免疫标志物在无其他风险因素的儿童尿毒症中的作用:在这项病例对照研究中,研究人员对 40 名健康儿童和 40 名尿毒症患儿的血清锌和维生素 D 水平进行了检测,其中没有发现任何其他风险因素。数据分析采用 SPSS 26 的卡方检验、费雪精确检验和独立 t 检验:研究结果表明,两组儿童的血清维生素 D 和锌水平存在显著差异(P < 0.001);80% 的尿毒症患儿和 17.5% 的健康组患儿缺乏维生素 D。此外,泌尿系统感染组中有 60% 的儿童缺锌,而健康组中有 17.5% 的儿童缺锌:结论:血清锌和维生素 D 含量低可能会增加小儿UTI 的易感性。鉴于这些数据,补充锌和维生素 D 可在治疗活动性感染和预防易感儿童复发方面发挥重要作用。
{"title":"Serum Vitamin D and Zinc Levels in Children with Urinary Tract Infection without Confounding Factors: A Case-Control Study.","authors":"Mohsen Seifollahi, Marzieh Heidarzadeh Arani, Rozita Hoseini Shamsabadi, Shahrbanoo Nakhaie, Maesoumeh Karimi Aghche, Mohammad Javad Azadchehr, Amin Sadat Sharif","doi":"10.47176/mjiri.38.36","DOIUrl":"10.47176/mjiri.38.36","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are extremely prevalent bacterial infections among children. They have numerous potential causes. Without proper diagnosis and treatment, UTIs can lead to serious complications in children, including impaired growth, high blood pressure, protein in urine, and eventual chronic kidney disease. Zinc and vitamin D in sufficient concentrations help to maintain the health of the immune system. Therefore, their deficiency can cause various infections. Several factors can contribute to the development of UTIs. This article deals with the role of zinc and vitamin D as immune markers in UTI in children without other risk factors.</p><p><strong>Methods: </strong>In this case-control study, serum zinc and vitamin D levels without any other risk factors were examined in 40 healthy children and 40 children with UTIs. Data analysis was done through SPSS 26 using the chi-square, the Fisher's exact, and independent t tests.</p><p><strong>Results: </strong>The study findings demonstrated a statistically significant distinction between the 2 groups regarding serum vitamin D and zinc levels (<i>P</i> < 0.001); 80% of children with UTIs and 17.5% in the healthy group had vitamin D deficiency. Also, 60% of the urinary infection group had zinc deficiency, whereas 17.5% of the healthy group had it.</p><p><strong>Conclusion: </strong>Low serum zinc and vitamin D levels may increase susceptibility to pediatric UTI. Given the data, supplementation with zinc and vitamin D could play a significant role in treating active infections and preventing recurrence in susceptible children.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559139","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: A wide variety of electrocardiogram (ECG) changes can manifest with antidepressant drugs, occurring at both therapeutic doses and toxic levels. Notably, ECG abnormalities like wide QRS and QT prolongation may be observed in poisoned patients with tricyclic antidepressants (TCAs), indicating severe conditions that necessitate the implementation of cardiac monitoring systems. This study aimed to investigate ECG Abnormality in poisoned patients with tricyclic antidepressants.
Methods: This retrospective patient record study was conducted at Razi Hospital in Ahvaz, Iran, from 2006 to 2009. Patient information was extracted from hospital medical records after the established protocol. The chi-square test was employed for initial analysis; subsequently, logistic regression was applied to identify risk factors associated with abnormal ECG findings. We analyzed the data using SPSS (Version 19; IBM) statistical software. P < 0.05 was defined as statistically significant.
Results: Among the 210 poisoned patients, comprising 88 men (41.9%) and 122 women (58.1%), the majority fell within the age range of 15 to 25 years. In our study, the most commonly ingested drugs by poisoned patients were amitriptyline in 134 patients (63.8%) and nortriptyline in 42 patients (20%). A significant portion of 137 patients (65.2%) exhibited poisoning symptoms within ˂ 6 hours, while 73 patients (34.8%) showed symptoms between 6 and 24 hours. Our findings indicated that the initial symptoms in poisoned patients included a decreased level of consciousness in 168 patients (80%), nausea and vomiting in 20 patients (9.5%), and various other symptoms. Notably, our results revealed ECG changes in 70 patients, with 32 patients (15.2%) showing a QRS widening (> 0.1sec), 5 patients (2.4%) displaying a tall R wave in aVR, 5 patients (2.4%) exhibiting right axis deviation, and other observed changes.
Conclusion: QRS widening in poisoned patients with tricyclic antidepressants is more frequently observed in symptomatic patients, highlighting the importance of ECG screening in these patients.
{"title":"Electrocardiogram Abnormality in Poisoned Patients with Tricyclic Antidepressant.","authors":"Mansoureh Javadipour, Elham Keshtzar, Parivash Parvasi, Seyed Farzad Hosseini, Ali Hassan Rahmani","doi":"10.47176/mjiri.38.35","DOIUrl":"10.47176/mjiri.38.35","url":null,"abstract":"<p><strong>Background: </strong>A wide variety of electrocardiogram (ECG) changes can manifest with antidepressant drugs, occurring at both therapeutic doses and toxic levels. Notably, ECG abnormalities like wide QRS and QT prolongation may be observed in poisoned patients with tricyclic antidepressants (TCAs), indicating severe conditions that necessitate the implementation of cardiac monitoring systems. This study aimed to investigate ECG Abnormality in poisoned patients with tricyclic antidepressants.</p><p><strong>Methods: </strong>This retrospective patient record study was conducted at Razi Hospital in Ahvaz, Iran, from 2006 to 2009. Patient information was extracted from hospital medical records after the established protocol. The chi-square test was employed for initial analysis; subsequently, logistic regression was applied to identify risk factors associated with abnormal ECG findings. We analyzed the data using SPSS (Version 19; IBM) statistical software. <i>P</i> < 0.05 was defined as statistically significant.</p><p><strong>Results: </strong>Among the 210 poisoned patients, comprising 88 men (41.9%) and 122 women (58.1%), the majority fell within the age range of 15 to 25 years. In our study, the most commonly ingested drugs by poisoned patients were amitriptyline in 134 patients (63.8%) and nortriptyline in 42 patients (20%). A significant portion of 137 patients (65.2%) exhibited poisoning symptoms within ˂ 6 hours, while 73 patients (34.8%) showed symptoms between 6 and 24 hours. Our findings indicated that the initial symptoms in poisoned patients included a decreased level of consciousness in 168 patients (80%), nausea and vomiting in 20 patients (9.5%), and various other symptoms. Notably, our results revealed ECG changes in 70 patients, with 32 patients (15.2%) showing a QRS widening (> 0.1sec), 5 patients (2.4%) displaying a tall R wave in aVR, 5 patients (2.4%) exhibiting right axis deviation, and other observed changes.</p><p><strong>Conclusion: </strong>QRS widening in poisoned patients with tricyclic antidepressants is more frequently observed in symptomatic patients, highlighting the importance of ECG screening in these patients.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559135","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: End-stage kidney disease (ESKD) is a global issue. Although the use of kidney replacement therapy measures has improved outcomes for patients with ESKD, the mortality rate remains significant. Identifying modifiable factors that affect patient outcomes can help improve their survival. The aim of this study was to investigate the factors affecting the clinical outcome of peritoneal dialysis patients.
Methods: This prospective cohort study was conducted between 2018 and 2021.Participants: Patients aged between 18 and 75 years with a history of peritoneal dialysis (PD) for at least six months were included. Demographic data, kt/v ratio, medical history, serum levels of albumin, creatinine, triglycerides, total cholesterol, calcium, phosphorus, parathyroid hormone, hemoglobin, and ferritin were recorded before starting PD and during the follow-up period, along with clinical outcomes. To describe the data, the central index of mean, frequency, and relative frequency was used, and for analytical statistics, Chi-square test, analysis of variance, and Kruskal-Wallis were used.
Results: A total of 64 patients with a mean age of 51.78 ± 15.31 years were included. Of these, 27 (42.18%) had a history of diabetes mellitus, and 38 (59.37%) had a history of hypertension (HTN). 48 (75%) patients survived until the end of the study, while 47 (73.4%) participants experienced peritonitis. Our findings indicate that variables such as sex, marital status, weight, history of HTN, and serum levels of hemoglobin and ferritin significantly affect outcomes.
Conclusion: We found that factors including sex, marriage, normal weight, HTN, normal hemoglobin, and ferritin can lead to better survival in PD patients. Recurrent peritonitis was the most crucial cause of PD to HD shifts.
{"title":"Investigation of Factors Affecting Clinical Outcome of Peritoneal Dialysis Patients.","authors":"Najmeh Shamspour, Maryam Eslami, Jalal Azmandian, Behnam Dalfardi, Azam Dehghani","doi":"10.47176/mjiri.38.34","DOIUrl":"10.47176/mjiri.38.34","url":null,"abstract":"<p><strong>Background: </strong>End-stage kidney disease (ESKD) is a global issue. Although the use of kidney replacement therapy measures has improved outcomes for patients with ESKD, the mortality rate remains significant. Identifying modifiable factors that affect patient outcomes can help improve their survival. The aim of this study was to investigate the factors affecting the clinical outcome of peritoneal dialysis patients.</p><p><strong>Methods: </strong>This prospective cohort study was conducted between 2018 and 2021.Participants: Patients aged between 18 and 75 years with a history of peritoneal dialysis (PD) for at least six months were included. Demographic data, kt/v ratio, medical history, serum levels of albumin, creatinine, triglycerides, total cholesterol, calcium, phosphorus, parathyroid hormone, hemoglobin, and ferritin were recorded before starting PD and during the follow-up period, along with clinical outcomes. To describe the data, the central index of mean, frequency, and relative frequency was used, and for analytical statistics, Chi-square test, analysis of variance, and Kruskal-Wallis were used.</p><p><strong>Results: </strong>A total of 64 patients with a mean age of 51.78 ± 15.31 years were included. Of these, 27 (42.18%) had a history of diabetes mellitus, and 38 (59.37%) had a history of hypertension (HTN). 48 (75%) patients survived until the end of the study, while 47 (73.4%) participants experienced peritonitis. Our findings indicate that variables such as sex, marital status, weight, history of HTN, and serum levels of hemoglobin and ferritin significantly affect outcomes.</p><p><strong>Conclusion: </strong>We found that factors including sex, marriage, normal weight, HTN, normal hemoglobin, and ferritin can lead to better survival in PD patients. Recurrent peritonitis was the most crucial cause of PD to HD shifts.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559136","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: The present study was motivated by issues with earlier studies on documenting knowledge and experiences. This scoping review investigates and maps the procedures for documenting organizational knowledge and experiences.
Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for Scoping Reviews (PRISMA-ScR) guidelines, a scoping review was conducted. Data were obtained by searching PubMed, Web of Science, Scopus, ProQuest, Embase, and Emerald Insight databases and Persian databases, such as Magiran, Noormags, and Ensani. The selected terms were searched using the Boolean AND/OR operators, phrases, parentheses, and truncations in the title, abstract, keywords, and text word fields. The inclusion criteria were resources relevant to the research question, studies in English and Persian, original research articles, and resources published between 2011 and 2022. Finally, 8 related papers were selected as the research population after screening records.
Results: The review of the selected studies indicates that there have been different steps for documenting knowledge and experiences according to the subject's scope and the goals of the studies. The included articles revealed numerous steps for documentation-including planning, acquisition, registration, evaluation, submission, maintenance, publication, application, payment, and compensation.
Conclusion: Although a systematic mechanism for documenting knowledge and experience is essential, many processes and phases are offered for documentation. Therefore, a complete review that synthesizes and integrates past study findings must still be included. Several shortcomings in past research on documenting knowledge and expertise prompted the present study. The results of the present study can be of great use to managers and employees of various organizations in topics such as the creation of standards for documenting knowledge and experiences, organizational-structural planning in this field, and training on different documentation methods.
{"title":"The Procedures for Documenting Organizational Knowledge and Experiences: A Scoping Review.","authors":"Shiva Malgard, Sirous Panahi, Leila Nemati Anaraki, Shadi Asadzandi, Hossein Ghalavand","doi":"10.47176/mjiri.38.33","DOIUrl":"10.47176/mjiri.38.33","url":null,"abstract":"<p><strong>Background: </strong>The present study was motivated by issues with earlier studies on documenting knowledge and experiences. This scoping review investigates and maps the procedures for documenting organizational knowledge and experiences.</p><p><strong>Methods: </strong>Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for Scoping Reviews (PRISMA-ScR) guidelines, a scoping review was conducted. Data were obtained by searching PubMed, Web of Science, Scopus, ProQuest, Embase, and Emerald Insight databases and Persian databases, such as Magiran, Noormags, and Ensani. The selected terms were searched using the Boolean AND/OR operators, phrases, parentheses, and truncations in the title, abstract, keywords, and text word fields. The inclusion criteria were resources relevant to the research question, studies in English and Persian, original research articles, and resources published between 2011 and 2022. Finally, 8 related papers were selected as the research population after screening records.</p><p><strong>Results: </strong>The review of the selected studies indicates that there have been different steps for documenting knowledge and experiences according to the subject's scope and the goals of the studies. The included articles revealed numerous steps for documentation-including planning, acquisition, registration, evaluation, submission, maintenance, publication, application, payment, and compensation.</p><p><strong>Conclusion: </strong>Although a systematic mechanism for documenting knowledge and experience is essential, many processes and phases are offered for documentation. Therefore, a complete review that synthesizes and integrates past study findings must still be included. Several shortcomings in past research on documenting knowledge and expertise prompted the present study. The results of the present study can be of great use to managers and employees of various organizations in topics such as the creation of standards for documenting knowledge and experiences, organizational-structural planning in this field, and training on different documentation methods.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559141","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 : 2024-03-25eCollection Date: 2024-01-01DOI: 10.47176/mjiri.38.32
Rasoul Samimi, Afra Hosseinpanahi, Roja Zaboli, Amir Peymani, Samaneh Rouhi, Somayeh Ahmadi Gooraji, Neda Rajaei
Background: Polymorphisms in the vitamin D receptor (VDR) play an effective role in the susceptibility of pulmonary tuberculosis (TB). Given the importance of this polymorphism and its association with pulmonary TB, this study aimed to investigate the prevalence of VDR polymorphisms in people with pulmonary TB.
Methods: The search process was performed from 2009 to 2023 according to PRISMA (Preferred reporting items for systematic reviews and meta-analyses). The strengthening of the reporting of observational studies in epidemiology (STROBE) checklist was used to qualify the articles. The data was entered into STATA version 14 software, then the fixed effects model and the random effects model, effect size (ES), and Q test (P < 0.10) were used for data analysis at a confidence interval level (CI) of 95%. Two-sided statistical tests were considered with α=0.05.
Results: In this research, 28 articles were analyzed. Polymorphisms showed a significant relationship with susceptibility to pulmonary TB (P = 0.000), and significant heterogeneity (P = 0.000) was seen between polymorphisms. FokI (95% CI: 0.39-0.46, P = 0.000, ES = 43%), ApaI (95% CI: 0.31-0.48, P = 0.000, ES = 39%) and BsmI (95% CI: 0.24-0.50, P = 0.000, ES = 37%) showed the most frequent gene polymorphisms after TaqI (95% CI: 0.34-0.77, P = 0.000, ES = 56%).
Conclusion: ApaI, BsmI, FokI, and TaqI polymorphisms were found in patients suffering from pulmonary TB. Polymorphisms related to the TaqI gene were the most frequent. Controlling and prescribing vitamin D may be needed in these patients.
{"title":"Prevalence of Vitamin D Receptor Genes Polymorphisms in People with Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis.","authors":"Rasoul Samimi, Afra Hosseinpanahi, Roja Zaboli, Amir Peymani, Samaneh Rouhi, Somayeh Ahmadi Gooraji, Neda Rajaei","doi":"10.47176/mjiri.38.32","DOIUrl":"10.47176/mjiri.38.32","url":null,"abstract":"<p><strong>Background: </strong>Polymorphisms in the vitamin D receptor (VDR) play an effective role in the susceptibility of pulmonary tuberculosis (TB). Given the importance of this polymorphism and its association with pulmonary TB, this study aimed to investigate the prevalence of VDR polymorphisms in people with pulmonary TB.</p><p><strong>Methods: </strong>The search process was performed from 2009 to 2023 according to PRISMA (Preferred reporting items for systematic reviews and meta-analyses). The strengthening of the reporting of observational studies in epidemiology (STROBE) checklist was used to qualify the articles. The data was entered into STATA version 14 software, then the fixed effects model and the random effects model, effect size (ES), and Q test (<i>P</i> < 0.10) were used for data analysis at a confidence interval level (CI) of 95%. Two-sided statistical tests were considered with α=0.05.</p><p><strong>Results: </strong>In this research, 28 articles were analyzed. Polymorphisms showed a significant relationship with susceptibility to pulmonary TB (<i>P</i> = 0.000), and significant heterogeneity (<i>P</i> = 0.000) was seen between polymorphisms. FokI (95% CI: 0.39-0.46, <i>P</i> = 0.000, ES = 43%), ApaI (95% CI: 0.31-0.48, <i>P</i> = 0.000, ES = 39%) and BsmI (95% CI: 0.24-0.50, <i>P</i> = 0.000, ES = 37%) showed the most frequent gene polymorphisms after TaqI (95% CI: 0.34-0.77, <i>P</i> = 0.000, ES = 56%).</p><p><strong>Conclusion: </strong>ApaI, BsmI, FokI, and TaqI polymorphisms were found in patients suffering from pulmonary TB. Polymorphisms related to the TaqI gene were the most frequent. Controlling and prescribing vitamin D may be needed in these patients.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559138","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: People with disabilities (PWD) typically face a range of obstacles when accessing healthcare, particularly when compared with the general population. This challenge becomes more pronounced for PWDs in lower socioeconomic groups. This study aimed to assess the socioeconomic-related disparity in financial access to rehabilitation services among Iranian PWDS.
Methods: A total of 766 Iranian PWDs aged ≥18 years participated in this cross-sectional study. We employed the concentration index (C) to estimate socioeconomic inequality in accessing rehabilitation services.
Results: In this study, 766 Iranian adults aged 18 to 70 took part, with a mean age of 36.50 (SD, ±10.02) years. The findings revealed that 72.15% (n = 469) of participants had to borrow money to cover the costs of rehabilitation services. The concentration index (C = -0.228, P = 0.004) demonstrated a notable concentration of inadequate financial access to rehabilitation services among individuals with lower socioeconomic status (SES). Decomposition analysis identified the wealth index as the primary contributor to the observed socioeconomic disparities, accounting for 309.48%.
Conclusion: Our findings show that socioeconomic inequalities disproportionately impact PWDs in lower socioeconomic groups. It is recommended that efforts be made to enhance the national capacity for monitoring the financial protection of PWDs and to develop equitable mechanisms that promote prepayment and risk pooling, thus reducing reliance on out-of-pocket payments at the time of service utilization.
{"title":"People with Disabilities and Financial Challenges in Access to Rehabilitation Services: Evidence of Socioeconomic Inequality in Iran.","authors":"Shahin Soltani, Kamran Arvan, Behzad Karami Matin, Javad Ghoddoosinejad, Fardin Moradi, Hamid Salehiniya","doi":"10.47176/mjiri.38.31","DOIUrl":"10.47176/mjiri.38.31","url":null,"abstract":"<p><strong>Background: </strong>People with disabilities (PWD) typically face a range of obstacles when accessing healthcare, particularly when compared with the general population. This challenge becomes more pronounced for PWDs in lower socioeconomic groups. This study aimed to assess the socioeconomic-related disparity in financial access to rehabilitation services among Iranian PWDS.</p><p><strong>Methods: </strong>A total of 766 Iranian PWDs aged ≥18 years participated in this cross-sectional study. We employed the concentration index (C) to estimate socioeconomic inequality in accessing rehabilitation services.</p><p><strong>Results: </strong>In this study, 766 Iranian adults aged 18 to 70 took part, with a mean age of 36.50 (SD, ±10.02) years. The findings revealed that 72.15% (n = 469) of participants had to borrow money to cover the costs of rehabilitation services. The concentration index (C = -0.228, <i>P</i> = 0.004) demonstrated a notable concentration of inadequate financial access to rehabilitation services among individuals with lower socioeconomic status (SES). Decomposition analysis identified the wealth index as the primary contributor to the observed socioeconomic disparities, accounting for 309.48%.</p><p><strong>Conclusion: </strong>Our findings show that socioeconomic inequalities disproportionately impact PWDs in lower socioeconomic groups. It is recommended that efforts be made to enhance the national capacity for monitoring the financial protection of PWDs and to develop equitable mechanisms that promote prepayment and risk pooling, thus reducing reliance on out-of-pocket payments at the time of service utilization.</p>","PeriodicalId":18361,"journal":{"name":"Medical Journal of the Islamic Republic of Iran","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559137","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}