Galen Medical Journal最新文献

Background: In this report, we present the case of a 19-month-old female diagnosed with hijab pin aspiration after a week of persistent coughing, along with a meta analysis and systematic review of the relevant literature.

Materials and methods: A comprehensive search was conducted across multiple databases, including Ovid Medline, Cochrane, PubMed, Web of Science, and SCOPUS, yielding 182 records until August 2024. A total of 7 published study and our case included to final analysis. The complication, morbidity, and mortality analysis has been performed using Jamovi software v2.4 MAJOR proportion analysis section.

Case description: A 19-month-old female was admitted to another hospital with a persistent cough complaint. In X-ray left hijab pin has been detected. The patient underwent a succesfull removal with rigid broncoscopy (RB). A total of 71 patients included this meta analysis. The thoracotomy rate was 8%. The bleeding rate was reported as 1.4%. The reoperation rate was reported as 9.8%. The postoperative intubation rate was reported as 1.4%. The calculated complication rate was found to be 5.6% based on the existing literature. The postoperative hemoptysis incidence was calculated as 0%. Mortality was not reported across any included studies. However, the mortality incidence was calculated as 0% based on included studies.

Conclusion: Effective and timely intervention is crucial for managing pediatric hijab pin aspiration. Multidisciplinary approaches ensure successful outcomes and prevent serious complications.

Background: Hip fractures are among the top ten causes of disability in adults worldwide. Patients with hip fracture are at significant risk of mortality and morbidity and reduced quality of life. The use of intra-wound vancomycin has been reported to be effective in reducing the incidence of infection in orthopedic surgeries. This study was conducted with the aim of investigating the effect of intra-articular vancomycin in preventing infection in patients undergoing hip hemiarthroplasty.

Materials and methods: This double-blind controlled clinical trial study was conducted on 48 patients with femoral neck fracture candidates for hip hemiarthroplasty hemiarthroplasty in Orthopedic clinic of Golestan and Imam Khomeini Hospital, Ahvaz, Iran between June and November 2023. Eligible patients were divided into two equal groups. The intervention group received 1gram vancomycin intra-articularly during the operation before closure of fascia, and the control group did not receive vancomycin. The patients were followed up for 6 months after the operation, and the rate of superficial infection, periprosthetic joint infection (PJI) and wound complications were compared in two groups. The obtained data were statistically analyzed with IBM SPSS Statistics 21.0 for Windows.

Results: The vancomycin group and the control group had no significant difference in the incidence of overall infection. The PJI in vancomycin and control groups were 4.16% and 8.33%, respectively. This difference was not statistically considerable (P=0.55). The results showed the incidence of superficial estimated 8.33% in vancomycin group and 4.16% in control group with no considerable difference in infection (P=0.52). Moreover, there was no meaningful difference in side effects between the two groups (P=0.63). There was no significant difference in wound complications between the two groups (P=0.3). After the intervention, it was found that the ESR value in the control group and vancomycin group was 32.79±9.94, 31.83±9.78 mm/hr, respectively (P=0.73).

Conclusion: Intra-articular injection of 1gram of vancomycin suspension did not reduce the overall, superficial and deep infection after surgery. It is suggested that more clinical trial studies with higher sample size be conducted in order to determine the effect of intra-articular vancomycin in preventing infection in patients undergoing hip hemiarthroplasty.

Infertility is a growing public health concern, affecting millions of individuals and couples worldwide. Despite advancements in medical treatments, prevention remains a critical strategy for reducing the burden of infertility. Nurses, as frontline healthcare providers, play a pivotal role in infertility prevention and health promotion, particularly through public health initiatives. This review aims to explore the diverse roles of nurses in infertility prevention and their contributions to public health strategies. A review of existing literature was conducted to examine the epidemiology of infertility, key risk factors, and the preventive measures that can be employed by nursing professionals. Emphasis is placed on the role of nurses in health education, screening, early detection, and community-based interventions, which are essential in reducing infertility rates. In addition, this review identifies barriers that impede effective nurse-led infertility prevention, such as disparities in access to care, cultural sensitivity challenges, and policy constraints. Evidence suggests that nurses are well-positioned to lead public health campaigns, conduct reproductive health counseling, and advocate for policy reforms to improve infertility prevention. The review concludes with recommendations for future research, suggesting enhanced nursing education and training, as well as the need for stronger integration of nurses into public health policy-making. This study underscores the critical role of nurses in promoting reproductive health and preventing infertility, advocating for their inclusion in comprehensive public health strategies aimed at addressing infertility on a global scale.

Infertility affects approximately 15-20% of couples globally, with female factors contributing to nearly half of cases. Conditions such as polycystic ovary syndrome, endometriosis, tubal damage and premature ovarian failure are leading causes of female infertility. Current treatments like in vitro fertilization (IVF) have limitations and risks. Mesenchymal stem cells (MSCs) have shown therapeutic potential due to their ability to differentiate, secrete trophic factors, and exhibit immunomodulatory and anti-inflammatory properties. They have been demonstrated to repair and regenerate reproductive organs in various preclinical models of infertility related conditions. MSCs have reduced endometriotic lesions, regenerated lost follicles in premature ovarian failure (POF) models, and promoted tubal repair in damage models. Some clinical and preclinical studies have reported improved outcomes with MSC therapy in endometriosis and premature ovarian failure patients. This review discusses the properties and sources of MSCs, their mechanisms of action, preclinical evidence for applications in conditions like POF, polycystic ovary syndrome (PCOS), endometriosis, Asherman syndrome, and preeclampsia, and preliminary clinical data on MSC therapy for female infertility management.

Background: Heart failure (HF) is a chronic and progressive condition that its management presents significant challenges in both clinical settings and patient self-care. Recent advances in wearable technology offer promising solutions to these challenges by enabling continuous monitoring, early detection of clinical deterioration, and personalized care. This review aims to critically evaluate the impact of wearable technology on HF management Materials and Methods: This narrative systematic review was conducted across multiple databases, including PubMed, Web of Science, and the Cochrane Library, to identify relevant studies published between 2010 and 2024. Studies on wearable devices for HF management and monitoring were included if they reported on clinical trials and provided data on integration into clinical workflows. Studies on other conditions or without original research data or Non-English papers were excluded.

Results: Nine studies were evaluated in this study that were focusing on a variety of technologies ranging from consumer-grade fitness trackers to specialized bioimpedance sensors and wearable cardioverter-defibrillators. These studies demonstrate the potential of wearables to continuously monitor important health metrics, which can lead to early intervention and personalized care. However, there are still challenges to be addressed, including concerns about data accuracy, patient adherence, small sample sizes, and the incorporation of wearable data into clinical practice. While consumer devices are more accessible, their accuracy in a clinical setting is uncertain, while more advanced devices like the "Volum" monitor and BioZ sensors show promise but require further validation.

Conclusion: This review highlights the growing importance of wearable technologies in HF management, actionable insights that can prevent disease progression. However, significant challenges remain, including the need for further validation, device optimization, and data standardization before routine clinical practice. Future advancements should focus on improving device accuracy, patient adherence, and data security, while ensuring equitable access to these technologies.

Background: The remote medical monitoring system can facilitate monitoring patients with cardiac arrhythmia, and consequently, reduce mortality and complications in individuals requiring emergency interventions. Hence, it is necessary to evaluate new telemedicine devices and compare them with standard devices. Therefore, this study aimed to evaluate and compare the new remote monitoring system, Smart Emergency Medical System-Health Internet of Things (SEMS-HIOT) developed by the Health Technology Development Centre of Babol University of Medical Sciences on patients with different cardiac arrhythmias and compare it with the standard device.

Materials and methods: In this case-control study, 60 patients were divided into the six most common arrhythmia groups (n=10 per each group and equal gender) as atrial fibrillation, ventricular tachycardia, paroxysmal supraventricular tachycardia, premature ventricular contractions, atrial tachycardia, and premature atrial contractions. Also, 20 healthy individuals (including 10 men and 10 women) without any arrhythmia (normal rhythm) were considered as the control group. Three similar SEMS-HIOT devices were used as test devices and a standard cardiac monitoring device as the control device. The clinical parameters, including heart rate, pulse rate, oxygen saturation, body temperature, and cardiac electrical activity via electrocardiogram (ECG) lead-II were recorded.

Results: Findings showed that the performance of the SEMS-HIOT test device was similar and in the same range for all indices in each group and there were no significant differences compared to the performance of the control device (P0.05). Also, the ECG records measured with SEMS-HIOT and standard device indicate no significant differences (P0.05).

Conclusion: Our study showed that the cardiac indices as well as ECG findings, which were measured with SEMS-HIOT and common standard devices confirmed the accuracy and reliability of the new telematics device for monitoring patients with cardiac diseases.

Background: Ultrasound examination of the thyroid has emerged as a useful diagnostic and prognostic tool, along with measuring serum titers of anti-thyroid peroxidase (TPO), anti-thyroglobulin (Tg), and thyroid hormones, in patients with Hashimoto's thyroiditis. So, we aimed at considering correlations of ultrasonographic, antibodies, and thyroid hormone levels.

Materials and methods: A total of 149 patients (118 females, 31 males; aged 18-60 years; mean age: 38.60 ± 8.03 years) who were diagnosed with Hashimoto's thyroiditis were enrolled in the study. The blood sample was taken to measure serum titers of free T3 (FT3) and T4 (FT4), TSH, anti-TPO, and anti-Tg antibody titers. The thyroid sonography of each patient was classified into one of the five grades by real-time ultrasound (US) based on echogenicity, thyroid size, and thyroid pattern. We evaluated whether there was a correlation between thyroid characteristics observed via ultrasound and serum levels of thyroid hormones, anti-TPO antibodies, and anti-Tg antibodies.

Results: Nodular structures were detected in 54 (36.2%) patients (38 micro-nodular and 16 macro-nodular). Echogenicity was recorded as isoechoic in 15(10.07%) and hypoechoic in 119 (79.87%) subjects. Euthyroid subjects had significantly thicker isthmus than overt and subclinical hypothyroid patients (P=0.018). Mean serum TSH, anti-Tg, and anti-TPO antibody titers showed a significant increase in patients with macro-nodules compared to those with micro-nodules and individuals without nodules (P0.05). The thickness of the isthmus had a significant negative correlation with FT4 (P=0.046; r=0.11) and FT3 (P=0.017; r=0.15), respectively. Thyroid autoantibodies had positive significant correlations with different parameters of thyroid volume (P0.05).

Conclusions: Thyroid US findings, in addition to serum anti-Tg and anti-TPO antibody titers, might be correlated with the severity and extent of Hashimoto's thyroiditis, but further evaluations are needed.

Background: The history of bypass surgery for coronary arteries and subsequent coronary angioplasty is a crucial and vital issue for patients with acute coronary syndrome (ACS). This study aims to investigate and compare the occurrence of cardiovascular events in patients with a history of Coronary Artery Bypass Grafting (CABG) versus those without such a history, specifically focusing on individuals diagnosed with ACS.

Materials and methods: This cohort study was conducted at Madani Hospital in Tabriz, Iran. Patients diagnosed with ACS who were hospitalized and underwent Percutaneous Coronary Intervention (PCI) from the beginning of 2018 to the beginning of 2020 were included. The records for follow-up regarding mortality and cardiovascular events were documented for the next three years (2020 to 2023). Subsequently, patients were categorized into two groups: those with a history of CABG and those without a history of CABG. Patients of each study group were divided into two groups: ST-segment elevation acute coronary syndrome (STEA)CS/primary PCI and non-ST-segment elevation acute coronary syndrome (NSTEACS)/PCI, a total of approximately 473 cases were collected. The study groups were compared in terms of in-hospital and long-term cardiovascular events as well as other clinical outcomes.

Results: A comparison of hospital and long-term events between the CABG group and the control group demonstrated a significant difference only in cases of recurrent myocardial infarction (MI)/ACS in long-term events (P=0.001). Additionally, comparing hospital and long-term events in the CABG group and the STEACS/NSTEACS control group revealed a significant difference only in cases of recurrent MI/ACS in long-term events (P=0.05).

Conclusion: Patients with a history of CABG may face a higher risk of cardiovascular events, especially in recurrent MI/ACS. A thorough examination and closer monitoring of this patient group are needed to ensure improvement and mitigate the risks associated with potential complications arising from previous CABG surgeries.