Pub Date : 2023-05-09DOI: 10.32592/ircmj.2023.25.7.2308
Background: Diabetes is a non-communicable disease with fatal complications. Diabetic patients are highly susceptible to COVID-19 side effects and persistent post-discharge symptoms that impact health-related quality of life (HRQoL). Objectives: This study aimed to assess HRQoL and examine factors affecting diabetic and non-diabetic COVID-19 patients after hospitalization. Methods: In a cross-sectional study, 220 diabetic and non-diabetic COVID-19 patients were randomly selected after hospitalization in Sirjan, Iran, from January 2020 to October 2021. The European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) questionnaire was used to measure HRQoL as a dependent variable and its dimensions (including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) as independent variables. In addition, a checklist was used to identify determinants of HRQoL, including age, gender, education, family income, household ownership, occupation, number of family members, and access to health services, that might affect the HRQoL participants. Results: The mean HRQoL score in COVID-19 diabetics (0.766±0.110) was significantly lower than that in their non-diabetic counterparts (0.859±0.077). The EQ-5D-5L scores in the diabetic group were significantly higher in younger participants, men, employed subjects, patients with higher educational levels, higher income, higher health status, supplemental insurance, access to health services, and fewer family members. According to the results of the Betamix model, education and diabetes were significant independent predictors of HRQoL scores. Conclusion: Diabetic COVID-19 cases experienced a significant decrease in HRQoL after hospitalization. This drop might have been due to more side effects of COVID-19 in diabetic patients and lower utilization of health services during this period. It is suggested that the health sector changes the management of diabetics during the COVID-19 epidemic by taking measures such as using telemedicine, providing home services, or prescribing medications for a longer period.
{"title":"Factors Associated with Health-related Quality of Life after Hospitalization for COVID-19 in Diabetic and Non-diabetic Patients: A Cross-sectional Study","authors":"","doi":"10.32592/ircmj.2023.25.7.2308","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.7.2308","url":null,"abstract":"Background: Diabetes is a non-communicable disease with fatal complications. Diabetic patients are highly susceptible to COVID-19 side effects and persistent post-discharge symptoms that impact health-related quality of life (HRQoL). Objectives: This study aimed to assess HRQoL and examine factors affecting diabetic and non-diabetic COVID-19 patients after hospitalization. Methods: In a cross-sectional study, 220 diabetic and non-diabetic COVID-19 patients were randomly selected after hospitalization in Sirjan, Iran, from January 2020 to October 2021. The European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) questionnaire was used to measure HRQoL as a dependent variable and its dimensions (including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) as independent variables. In addition, a checklist was used to identify determinants of HRQoL, including age, gender, education, family income, household ownership, occupation, number of family members, and access to health services, that might affect the HRQoL participants. Results: The mean HRQoL score in COVID-19 diabetics (0.766±0.110) was significantly lower than that in their non-diabetic counterparts (0.859±0.077). The EQ-5D-5L scores in the diabetic group were significantly higher in younger participants, men, employed subjects, patients with higher educational levels, higher income, higher health status, supplemental insurance, access to health services, and fewer family members. According to the results of the Betamix model, education and diabetes were significant independent predictors of HRQoL scores. Conclusion: Diabetic COVID-19 cases experienced a significant decrease in HRQoL after hospitalization. This drop might have been due to more side effects of COVID-19 in diabetic patients and lower utilization of health services during this period. It is suggested that the health sector changes the management of diabetics during the COVID-19 epidemic by taking measures such as using telemedicine, providing home services, or prescribing medications for a longer period.","PeriodicalId":48912,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135806599","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 : 2023-05-08DOI: 10.32592/ircmj.2023.25.7.2804
Background: An increasing number of studies have been conducted on the prevalence of COVID-19 to develop strategies to combat the disease. However, less attention has been paid to the mental health of medical professionals. Objectives: To investigate whether a mindfulness-based stress reduction (MBSR) course in Tibet could improve the mental health of medical personnel during the COVID-19 epidemic. Methods: One hundred and eighteen medical staff were randomly selected from July 2022 to September 2022. After baseline enrolment, the control group (n=59) received baseline healthcare services, while the intervention group (n=59) received a 2-month positive intervention MBSR course in addition to baseline healthcare services. After the intervention, the intervention group underwent a final assessment, and the control group was subjected to MBSR for 2 months. The Self-Rating Depression Scale (SDS), Self-Consciousness Scale (SCS), and the Chinese version of the Cohen Perceived Stress Scale (CPSS) were used to measure the emotional well-being of medical personnel. Results: The intervention group had significantly lower CPSS and SDS scores at the end of the MBSR course (P<0.01), and SCS scores were significantly increased during M2 (P=0.009), compared to M0. In the control group, the scores of SDS (P=0.223), SCS (P=0.112), and CPSS (P=0.131) in M2 were not significantly different from those in M0. The intervention and control groups showed statistically significant differences in CPSS scores (P=0.013), SDS scores (P=0.001), and SCS scores (P=0.029) at the end of the MBSR session. Conclusion: It can be concluded that MBSR sessions can effectively alleviate negative emotions triggered by work stress and depression and improve self-compassion during an epidemic. It is recommended to participate in a scientific MBSR course to improve emotional well-being to some extent.
{"title":"Impact of COVID Pandemic on the Mental State of Health Workers: A Study of Mindfulness-based Interventions","authors":"","doi":"10.32592/ircmj.2023.25.7.2804","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.7.2804","url":null,"abstract":"Background: An increasing number of studies have been conducted on the prevalence of COVID-19 to develop strategies to combat the disease. However, less attention has been paid to the mental health of medical professionals.\u0000\u0000Objectives: To investigate whether a mindfulness-based stress reduction (MBSR) course in Tibet could improve the mental health of medical personnel during the COVID-19 epidemic.\u0000\u0000Methods: One hundred and eighteen medical staff were randomly selected from July 2022 to September 2022. After baseline enrolment, the control group (n=59) received baseline healthcare services, while the intervention group (n=59) received a 2-month positive intervention MBSR course in addition to baseline healthcare services. After the intervention, the intervention group underwent a final assessment, and the control group was subjected to MBSR for 2 months. The Self-Rating Depression Scale (SDS), Self-Consciousness Scale (SCS), and the Chinese version of the Cohen Perceived Stress Scale (CPSS) were used to measure the emotional well-being of medical personnel.\u0000\u0000Results: The intervention group had significantly lower CPSS and SDS scores at the end of the MBSR course (P<0.01), and SCS scores were significantly increased during M2 (P=0.009), compared to M0. In the control group, the scores of SDS (P=0.223), SCS (P=0.112), and CPSS (P=0.131) in M2 were not significantly different from those in M0. The intervention and control groups showed statistically significant differences in CPSS scores (P=0.013), SDS scores (P=0.001), and SCS scores (P=0.029) at the end of the MBSR session.\u0000\u0000Conclusion: It can be concluded that MBSR sessions can effectively alleviate negative emotions triggered by work stress and depression and improve self-compassion during an epidemic. It is recommended to participate in a scientific MBSR course to improve emotional well-being to some extent.","PeriodicalId":48912,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47820477","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 : 2023-05-08DOI: 10.32592/ircmj.2023.25.7.2599
Ultrasound is very important for the diagnosis and treatment of vascular emergency patients. In recent years, the number of deaths caused by atherosclerosis, represented by ischemic heart disease, has increased rapidly and become a very important part of emergency medicine. This article aimed to review the application and research progress of various vascular ultrasound techniques in emergency medicine to provide a reference for the diagnosis and treatment of panvascular diseases in early first-aid emergencies.
{"title":"Ultrasonography Techniques for Atherosclerosis Assessment: A Narrative Review","authors":"","doi":"10.32592/ircmj.2023.25.7.2599","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.7.2599","url":null,"abstract":"Ultrasound is very important for the diagnosis and treatment of vascular emergency patients. In recent years, the number of deaths caused by atherosclerosis, represented by ischemic heart disease, has increased rapidly and become a very important part of emergency medicine. This article aimed to review the application and research progress of various vascular ultrasound techniques in emergency medicine to provide a reference for the diagnosis and treatment of panvascular diseases in early first-aid emergencies.","PeriodicalId":48912,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49617847","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 : 2023-05-08DOI: 10.32592/ircmj.2023.25.7.2600
Background: Fat embolism syndrome (FES) is caused by a systemic inflammatory response arising from embolized fat particles that block blood vessels and disrupt blood supply, particularly in the respiratory microcirculation. Despite its high morbidity and mortality, FES is still challenging to diagnose due to its versatile symptoms. Case Presentation: In this article, we describe case reports of two patients with pulmonary FES from Zhongnan Hospital of Wuhan University, Wuhan, China. The two patients were diagnosed based on their detailed medical histories, such as a history of liposuction surgery, low oxygen saturation, dyspnea, and chest computed tomography (CT). Both of them received continuous oxygen inhalation therapy and antibiotic treatment. The first patient received additional anti-inflammation and anticoagulation treatment. The symptoms and CT improved after treatments. They were discharged and completely cured. Literature Review: We obtained and analyzed the clinical manifestations, treatments, and prognosis data of 206 patients diagnosed with pulmonary FES between January 1900 and July 2021 from the China National Knowledge Infrastructure database. Conclusion: The analysis of our two cases and the literature review suggest that patients with symptoms (such as respiratory system symptoms, nervous system symptoms, cardiovascular system symptoms, and mucocutaneous bleeding) combined with a history of fracture and other risk factors should be considered pulmonary FES cases. Furthermore, respiratory support and glucocorticoid treatment may be effective in preventing the death of pulmonary FES patients.
{"title":"Pulmonary Fat Embolism Syndrome: A Case Report and Literature Review","authors":"","doi":"10.32592/ircmj.2023.25.7.2600","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.7.2600","url":null,"abstract":"Background: Fat embolism syndrome (FES) is caused by a systemic inflammatory response arising from embolized fat particles that block blood vessels and disrupt blood supply, particularly in the respiratory microcirculation. Despite its high morbidity and mortality, FES is still challenging to diagnose due to its versatile symptoms.\u0000\u0000Case Presentation: In this article, we describe case reports of two patients with pulmonary FES from Zhongnan Hospital of Wuhan University, Wuhan, China. The two patients were diagnosed based on their detailed medical histories, such as a history of liposuction surgery, low oxygen saturation, dyspnea, and chest computed tomography (CT). Both of them received continuous oxygen inhalation therapy and antibiotic treatment. The first patient received additional anti-inflammation and anticoagulation treatment. The symptoms and CT improved after treatments. They were discharged and completely cured.\u0000\u0000Literature Review: We obtained and analyzed the clinical manifestations, treatments, and prognosis data of 206 patients diagnosed with pulmonary FES between January 1900 and July 2021 from the China National Knowledge Infrastructure database.\u0000\u0000Conclusion: The analysis of our two cases and the literature review suggest that patients with symptoms (such as respiratory system symptoms, nervous system symptoms, cardiovascular system symptoms, and mucocutaneous bleeding) combined with a history of fracture and other risk factors should be considered pulmonary FES cases. Furthermore, respiratory support and glucocorticoid treatment may be effective in preventing the death of pulmonary FES patients.","PeriodicalId":48912,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45908779","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 : 2023-05-05DOI: 10.32592/ircmj.2023.25.7.2232
Background: Mycobacterium seedling is rich in co-antigens and, a good immunomodulator with bidirectional immunomodulatory function. Objectives: The present study aimed to explore whether the Mycobacterium vaccae vaccine can improve the incomplete immune recovery of acquired immunodeficiency syndrome (AIDS) patients. Methods: According to the number of patients receiving human immunodeficiency virus (HIV) long-term treatment in the Ninth People’s Hospital of Chongqing, China, 100 patients with HIV-RNA quantitation of less than 103 cepies/ml, CD4 + T cell count less than 500/UL, and CD4+T cell count of more than 50/UL after 3 years of Haart treatment were selected. In total, they were randomly assigned to one of three groups, one group received an intramuscular injection of M. vaccae vaccine, one group received an intramuscular injection of growth hormone, and the last group received only a placebo injection. The levels and changes of naive T cells, Treg cells, total CD4+ T cells, T helper 1 (Th1), T helper 2 (Th2) cells, and interleukin 7 (IL-7) cytokine were measured at baseline and after 12, 48, and 50 weeks. Results: After 48 weeks of treatment, the total CD4+T cells, Th1 cells, and naive T cells in AIDS patients increased, while IL-7 cytokines, Treg cells, and Th2 cells decreased in M. vaccae vaccine and growth hormone group. There was no change in the placebo group, indicating that M. vaccae vaccine and growth hormone can improve the immune function of AIDS patients. After treatment, in group A (M. vaccae vaccine), there was an increase in the total CD4+T cells, Th1 cells, and naive T cells as well as a decrease in Treg cells, Th2 cells, and IL-7 cytokines. The only significant difference between M. vaccae vaccine and growth hormone groups was a decrease in Th1 cells in the M. vaccae vaccine group. After a 12-week follow-up, it was found that there were no cases of secondary infection in the M. vaccae vaccine group, one case in the growth hormone group, and five cases in the placebo group, demonstrating that the secondary infection rate in M. vaccae vaccine and the growth hormone groups was lower than that in the control group. Conclusion: The M. vaccae vaccine may decrease the levels of IL-7 as well as Treg and Th2 cells by increasing the levels of CD4+T cells, Th1 cells, and pure T cells in AIDS patients, leading to the improvement of immune reconstitution of AIDS patients to some extent.
{"title":"Mycobacterium Vaccae Vaccine Improve Incomplete Immune Recovery in AIDS Patients","authors":"","doi":"10.32592/ircmj.2023.25.7.2232","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.7.2232","url":null,"abstract":"Background: Mycobacterium seedling is rich in co-antigens and, a good immunomodulator with bidirectional immunomodulatory function.\u0000\u0000Objectives: The present study aimed to explore whether the Mycobacterium vaccae vaccine can improve the incomplete immune recovery of acquired immunodeficiency syndrome (AIDS) patients.\u0000\u0000Methods: According to the number of patients receiving human immunodeficiency virus (HIV) long-term treatment in the Ninth People’s Hospital of Chongqing, China, 100 patients with HIV-RNA quantitation of less than 103 cepies/ml, CD4 + T cell count less than 500/UL, and CD4+T cell count of more than 50/UL after 3 years of Haart treatment were selected. In total, they were randomly assigned to one of three groups, one group received an intramuscular injection of M. vaccae vaccine, one group received an intramuscular injection of growth hormone, and the last group received only a placebo injection. The levels and changes of naive T cells, Treg cells, total CD4+ T cells, T helper 1 (Th1), T helper 2 (Th2) cells, and interleukin 7 (IL-7) cytokine were measured at baseline and after 12, 48, and 50 weeks.\u0000\u0000Results: After 48 weeks of treatment, the total CD4+T cells, Th1 cells, and naive T cells in AIDS patients increased, while IL-7 cytokines, Treg cells, and Th2 cells decreased in M. vaccae vaccine and growth hormone group. There was no change in the placebo group, indicating that M. vaccae vaccine and growth hormone can improve the immune function of AIDS patients. After treatment, in group A (M. vaccae vaccine), there was an increase in the total CD4+T cells, Th1 cells, and naive T cells as well as a decrease in Treg cells, Th2 cells, and IL-7 cytokines. The only significant difference between M. vaccae vaccine and growth hormone groups was a decrease in Th1 cells in the M. vaccae vaccine group. After a 12-week follow-up, it was found that there were no cases of secondary infection in the M. vaccae vaccine group, one case in the growth hormone group, and five cases in the placebo group, demonstrating that the secondary infection rate in M. vaccae vaccine and the growth hormone groups was lower than that in the control group.\u0000\u0000Conclusion: The M. vaccae vaccine may decrease the levels of IL-7 as well as Treg and Th2 cells by increasing the levels of CD4+T cells, Th1 cells, and pure T cells in AIDS patients, leading to the improvement of immune reconstitution of AIDS patients to some extent.","PeriodicalId":48912,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48044273","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 : 2023-05-04DOI: 10.32592/ircmj.2023.25.6.2382
Background: Thromboangiitis obliterans (TAO) is a vasculopathy involving small and intermediate vessels of extremities with various medical and surgical treatment strategies. Objectives: This cohort study aimed to compare the outcomes of medical and surgical interventions in patients with TAO. Methods: Patients with a definite diagnosis of TAO were enrolled in the study and evaluated on the first day, as well as three and six months follow-up visits. A total of 70 patients with TAO were followed for 30 months. Improvements in the primary complaints (claudication of calves and soles, rest pain, paresthesia, thrombophlebitis migrans, gangrene, scars, Raynaud's phenomenon) were compared between the groups. Results: In terms of gender, 98.6% of participants were male. The mean age of the patients was 43.24± 9.8 years. Based on the results, 37 sympathectomy surgery, 11 amputation surgery, 15 bypass surgery, and 12 medical therapies with ILOPROST were considered for the patients (Medical treatment as combination therapy in patients with severe symptoms). The final results demonstrated that primary complaints were significantly improved in patients who underwent bypass surgery than in others. Conclusion: As evidenced by the obtained results, patients in our study significantly benefited more from bypass surgery than sympathectomy and pharmacotherapy
{"title":"Effect of Surgical Sympathectomy in Patients Diagnosed with Thromboangiitis Obliterans Compared to Pharmacotherapy and Bypass Surgery","authors":"","doi":"10.32592/ircmj.2023.25.6.2382","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.6.2382","url":null,"abstract":"Background: Thromboangiitis obliterans (TAO) is a vasculopathy involving small and intermediate vessels of extremities with various medical and surgical treatment strategies.\u0000\u0000Objectives: This cohort study aimed to compare the outcomes of medical and surgical interventions in patients with TAO.\u0000\u0000Methods: Patients with a definite diagnosis of TAO were enrolled in the study and evaluated on the first day, as well as three and six months follow-up visits. A total of 70 patients with TAO were followed for 30 months. Improvements in the primary complaints (claudication of calves and soles, rest pain, paresthesia, thrombophlebitis migrans, gangrene, scars, Raynaud's phenomenon) were compared between the groups.\u0000\u0000Results: In terms of gender, 98.6% of participants were male. The mean age of the patients was 43.24± 9.8 years. Based on the results, 37 sympathectomy surgery, 11 amputation surgery, 15 bypass surgery, and 12 medical therapies with ILOPROST were considered for the patients (Medical treatment as combination therapy in patients with severe symptoms). The final results demonstrated that primary complaints were significantly improved in patients who underwent bypass surgery than in others.\u0000\u0000Conclusion: As evidenced by the obtained results, patients in our study significantly benefited more from bypass surgery than sympathectomy and pharmacotherapy","PeriodicalId":48912,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48754458","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 : 2023-05-04DOI: 10.32592/ircmj.2023.25.7.2490
Background: Ankylosing spondylitis (AS) is a type of inflammatory arthritis. Due to the rigid and brittle nature of spinal joints and multisystem involvement in the patients affected by ankylosing spondylitis, they are more prone to developing various complications. Different deformities require several surgical manipulations and perioperative anesthetic challenges, such as difficult intubation and positioning within the operating room. Case presentation: A 42-year-old man was diagnosed with ankylosing spondylitis, which has progressed over the last six years. He suffered from increasing pain and could not look forward, therefore; he has been scheduled for a corrective surgical procedure to address his spinal deformity to alleviate his pain and enhance the quality of his life by improving his functional abilities. Conclusion: Effective management of difficult airway cases with ankylosing spondylitis involving anatomical changes and reduced spinal mobility can be achieved by using awake fiberoptic-assisted nasal intubation. Intraoperative neuromonitoring and careful attention to proper positioning should be considered during the corrective spinal surgery to reduce complications.
{"title":"Common Anesthesia Challenges in a Case of Ankylosing Spondylitis Posted for the Correction of Spinal Deformity","authors":"","doi":"10.32592/ircmj.2023.25.7.2490","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.7.2490","url":null,"abstract":"Background: Ankylosing spondylitis (AS) is a type of inflammatory arthritis. Due to the rigid and brittle nature of spinal joints and multisystem involvement in the patients affected by ankylosing spondylitis, they are more prone to developing various complications. Different deformities require several surgical manipulations and perioperative anesthetic challenges, such as difficult intubation and positioning within the operating room.\u0000\u0000Case presentation: A 42-year-old man was diagnosed with ankylosing spondylitis, which has progressed over the last six years. He suffered from increasing pain and could not look forward, therefore; he has been scheduled for a corrective surgical procedure to address his spinal deformity to alleviate his pain and enhance the quality of his life by improving his functional abilities. \u0000\u0000Conclusion: Effective management of difficult airway cases with ankylosing spondylitis involving anatomical changes and reduced spinal mobility can be achieved by using awake fiberoptic-assisted nasal intubation. Intraoperative neuromonitoring and careful attention to proper positioning should be considered during the corrective spinal surgery to reduce complications.","PeriodicalId":48912,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43992982","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 : 2023-05-04DOI: 10.32592/ircmj.2023.25.7.2624
Background: Population has long been known as the most important pillar of governments and societies. However, in recent years, the rate of infertility is increasing rapidly due to various reasons. Objectives: This study aimed to identify the factors and challenges affecting the implementation of insurance coverage program for infertility services in Iran for the policymakers and implementers of the program. Accordingly, the correct implementation of this program provides the possibility for infertile couples to benefit from the services of this program. Methods: This qualitative study was conducted in 2022. Purposive sampling was used for selecting a total of 20 Iranian scientific and executive experts of health system with work experience, especially in the field of infertility. The interviews were conducted in a semi-structured manner and analyzed using the content analysis method and MAXQDA 2020 software. Results: The results showed that the challenges of this program include 6 main themes along with 39 sub-themes. The main themes are challenges of upstream laws and legal requirements; provision of health services; human resources; the service package and its pricing; financial issues, budgets, and methods of service cost reimbursement; and information technology challenges. Conclusion: Although the service package is defined and announced, the implementation of this plan faces many challenges due to not taking into account the implementation conditions and requirements. By examining the problems of infertility insurance coverage, the present study provides a comprehensive and practical picture of these problems. Accordingly, the factors that can make the program successful in the future consist of inclusion of a part of the services related to infertility treatment in the package of insurance services, the awareness of managers and policy makers about the challenges of implementing this program, providing financial, electronic, and human resources needed by the program, and development and modification of standards of the program.
{"title":"Challenges of Implementation of Insurance Coverage Program for Infertility Services in Iran","authors":"","doi":"10.32592/ircmj.2023.25.7.2624","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.7.2624","url":null,"abstract":"Background: Population has long been known as the most important pillar of governments and societies. However, in recent years, the rate of infertility is increasing rapidly due to various reasons.\u0000\u0000Objectives: This study aimed to identify the factors and challenges affecting the implementation of insurance coverage program for infertility services in Iran for the policymakers and implementers of the program. Accordingly, the correct implementation of this program provides the possibility for infertile couples to benefit from the services of this program.\u0000\u0000Methods: This qualitative study was conducted in 2022. Purposive sampling was used for selecting a total of 20 Iranian scientific and executive experts of health system with work experience, especially in the field of infertility. The interviews were conducted in a semi-structured manner and analyzed using the content analysis method and MAXQDA 2020 software.\u0000\u0000Results: The results showed that the challenges of this program include 6 main themes along with 39 sub-themes. The main themes are challenges of upstream laws and legal requirements; provision of health services; human resources; the service package and its pricing; financial issues, budgets, and methods of service cost reimbursement; and information technology challenges.\u0000\u0000Conclusion: Although the service package is defined and announced, the implementation of this plan faces many challenges due to not taking into account the implementation conditions and requirements. By examining the problems of infertility insurance coverage, the present study provides a comprehensive and practical picture of these problems. Accordingly, the factors that can make the program successful in the future consist of inclusion of a part of the services related to infertility treatment in the package of insurance services, the awareness of managers and policy makers about the challenges of implementing this program, providing financial, electronic, and human resources needed by the program, and development and modification of standards of the program.","PeriodicalId":48912,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45486046","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 : 2023-05-02DOI: 10.32592/ircmj.2023.25.7.2474
Background: Transurethral ureterolithotripsy (TUL) is a common and highly efficient procedure for treating ureteral stones. The need for preoperative antibiotic prophylaxis to prevent post-TUL infections remains controversial. Objectives: This study aimed to investigate whether the removal of preoperative antibiotic prophylaxis affects the rate of postoperative complications in patients undergoing TUL. Methods: A total of 62 patients (aged 15-65 years) undergoing TUL between November 2021 and March 2022 were included in this controlled clinical trial. Patients were divided into two groups by the available gradual and sequential sampling methods: 33 had positive preoperative urine culture (UC), and 29 had negative preoperative UC. None of the patients in the two groups received preoperative antibiotic prophylaxis. Perioperative and postoperative outcomes, such as the operative time, stone-free rate, postoperative analgesic use, fever, urinary tract infection (UTI), and hospital stay, were reviewed in both groups. Results: Patients with positive UC were significantly older than those with negative UC (P=0.018), and had a higher BMI (P=0.016). No significant differences were observed between the two groups in most perioperative variables or postoperative outcomes (P>0.05). In addition, patients in the positive UC group had significantly more underlying diseases than the other group (P=0.022). Postoperative symptomatic UTI was found in neither of the two groups. Fever was reported in 3 (9.1%) and 1 (3.4%) patients in the positive and negative UC groups, respectively, with no statistically significant differences between the two groups (P=0.616). In the matched logistic regression model, the effect of preoperative UC on postoperative fever was not significant (P=0.40). Conclusion: The results of our study showed that prophylactic antibiotics can be eliminated at the discretion of the surgeon in patients without symptomatic positive UC.
{"title":"Safety of Omitting Preoperative Antibiotic Prophylaxis in Patients Undergoing Transurethral Ureterolithotripsy","authors":"","doi":"10.32592/ircmj.2023.25.7.2474","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.7.2474","url":null,"abstract":"Background: Transurethral ureterolithotripsy (TUL) is a common and highly efficient procedure for treating ureteral stones. The need for preoperative antibiotic prophylaxis to prevent post-TUL infections remains controversial.\u0000\u0000Objectives: This study aimed to investigate whether the removal of preoperative antibiotic prophylaxis affects the rate of postoperative complications in patients undergoing TUL.\u0000\u0000Methods: A total of 62 patients (aged 15-65 years) undergoing TUL between November 2021 and March 2022 were included in this controlled clinical trial. Patients were divided into two groups by the available gradual and sequential sampling methods: 33 had positive preoperative urine culture (UC), and 29 had negative preoperative UC. None of the patients in the two groups received preoperative antibiotic prophylaxis. Perioperative and postoperative outcomes, such as the operative time, stone-free rate, postoperative analgesic use, fever, urinary tract infection (UTI), and hospital stay, were reviewed in both groups.\u0000\u0000Results: Patients with positive UC were significantly older than those with negative UC (P=0.018), and had a higher BMI (P=0.016). No significant differences were observed between the two groups in most perioperative variables or postoperative outcomes (P>0.05). In addition, patients in the positive UC group had significantly more underlying diseases than the other group (P=0.022). Postoperative symptomatic UTI was found in neither of the two groups. Fever was reported in 3 (9.1%) and 1 (3.4%) patients in the positive and negative UC groups, respectively, with no statistically significant differences between the two groups (P=0.616). In the matched logistic regression model, the effect of preoperative UC on postoperative fever was not significant (P=0.40).\u0000\u0000Conclusion: The results of our study showed that prophylactic antibiotics can be eliminated at the discretion of the surgeon in patients without symptomatic positive UC.","PeriodicalId":48912,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43868341","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 : 2023-05-02DOI: 10.32592/ircmj.2023.25.7.2738
M. Sarkardeh, Hassan Vaezi, S. Javad, Amirhasan Sarkardeh
Background: Hydatid disease is a parasitic infection that occurs primarily in Mediterranean countries. Skeletal and muscular involvement is a rare feature of hydatid disease, making the diagnosis of this condition difficult, especially in children. Case presentation: In this case report, a hydatid cyst in the medial compartment of the right thigh was presented in a 9-year-old girl who referred to the emergency department with a bump and pain in the area. Conclusion: It is important to pay attention to the rare localization of hydatid cysts in endemic areas, particularly in children.
{"title":"A Case Report of a Hydatid Cyst on the Right Thigh in a 9-Year-Old Girl: A Difficult Diagnosis","authors":"M. Sarkardeh, Hassan Vaezi, S. Javad, Amirhasan Sarkardeh","doi":"10.32592/ircmj.2023.25.7.2738","DOIUrl":"https://doi.org/10.32592/ircmj.2023.25.7.2738","url":null,"abstract":"Background: Hydatid disease is a parasitic infection that occurs primarily in Mediterranean countries. Skeletal and muscular involvement is a rare feature of hydatid disease, making the diagnosis of this condition difficult, especially in children.\u0000\u0000Case presentation: In this case report, a hydatid cyst in the medial compartment of the right thigh was presented in a 9-year-old girl who referred to the emergency department with a bump and pain in the area.\u0000\u0000Conclusion: It is important to pay attention to the rare localization of hydatid cysts in endemic areas, particularly in children.","PeriodicalId":48912,"journal":{"name":"Iranian Red Crescent Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43535759","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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