{"title":"The Role of Large Language Models in Modern Medical Education: Opportunities and Challenges","authors":"Abdollah Mahdavi, M. Amanzadeh, M. Hamedan","doi":"10.5812/semj-144847","DOIUrl":"https://doi.org/10.5812/semj-144847","url":null,"abstract":"<jats:p />","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"68 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140721819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Soheilipour, Safa Ahoon, Amir Ghaderi, Elham Tabesh, Peyman Adibi Sedeh
Objectives: In light of the global COVID-19 pandemic and the subsequent emergence of functional gastrointestinal disorders (FGIDs) post-recovery, this study aimed to evaluate the frequency and risk factors associated with FGIDs one year after recovering from COVID-19. Methods: This cross-sectional study included a total of 357 patients who had recovered from COVID-19 for a year and were seen at Al-Zahra Hospital in 2021. Participants were chosen through simple random sampling. The ROME questionnaire, alongside patients' clinical histories regarding irritable bowel syndrome (IBS) and its variants, functional dyspepsia (FD), and other GI symptoms, was utilized for data collection. Results: Findings indicated that one year post-COVID-19, the prevalence rates of IBS, GI symptoms, and FD stood at 15.4%, 44.9%, and 9.5%, respectively. It was observed that women had a higher propensity than men to develop these FGIDs (P-value = 0.044). Anxiety was linked to a 1.910-fold increase in IBS risk (P-value = 0.039), a 2.225-fold surge in GI symptoms (P-value < 0.001), and a 1.110-fold rise in FD risk (P-value = 0.042). Moreover, depression was associated with a 1.772-fold and 3.753-fold elevated risk of developing IBS (P-value = 0.040) and FD (P-value < 0.001), respectively. Conclusions: The findings suggest that FGIDs such as IBS, FD, and other GI symptoms are significant long-term sequelae of COVID-19 infection. Anxiety and depression appear to be key risk factors for these conditions, with a more pronounced impact observed in women than in men.
{"title":"Frequency and Risk Factors for Post-COVID-19 Functional Gastrointestinal Disorders After One Year","authors":"M. Soheilipour, Safa Ahoon, Amir Ghaderi, Elham Tabesh, Peyman Adibi Sedeh","doi":"10.5812/semj-134849","DOIUrl":"https://doi.org/10.5812/semj-134849","url":null,"abstract":"Objectives: In light of the global COVID-19 pandemic and the subsequent emergence of functional gastrointestinal disorders (FGIDs) post-recovery, this study aimed to evaluate the frequency and risk factors associated with FGIDs one year after recovering from COVID-19. Methods: This cross-sectional study included a total of 357 patients who had recovered from COVID-19 for a year and were seen at Al-Zahra Hospital in 2021. Participants were chosen through simple random sampling. The ROME questionnaire, alongside patients' clinical histories regarding irritable bowel syndrome (IBS) and its variants, functional dyspepsia (FD), and other GI symptoms, was utilized for data collection. Results: Findings indicated that one year post-COVID-19, the prevalence rates of IBS, GI symptoms, and FD stood at 15.4%, 44.9%, and 9.5%, respectively. It was observed that women had a higher propensity than men to develop these FGIDs (P-value = 0.044). Anxiety was linked to a 1.910-fold increase in IBS risk (P-value = 0.039), a 2.225-fold surge in GI symptoms (P-value < 0.001), and a 1.110-fold rise in FD risk (P-value = 0.042). Moreover, depression was associated with a 1.772-fold and 3.753-fold elevated risk of developing IBS (P-value = 0.040) and FD (P-value < 0.001), respectively. Conclusions: The findings suggest that FGIDs such as IBS, FD, and other GI symptoms are significant long-term sequelae of COVID-19 infection. Anxiety and depression appear to be key risk factors for these conditions, with a more pronounced impact observed in women than in men.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"110 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140724639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Reza Hatamnejad, Alireza Doostian, Setayesh Sotoudehnia korani, M. Pourhoseingholi
{"title":"ChatGPT as an Inventor: Does It Make Sense?","authors":"Mohammad Reza Hatamnejad, Alireza Doostian, Setayesh Sotoudehnia korani, M. Pourhoseingholi","doi":"10.5812/semj-144254","DOIUrl":"https://doi.org/10.5812/semj-144254","url":null,"abstract":"<jats:p />","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"702 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140749163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ziba Karimi, Bahman Kord Tamini, Sana Nourimoghadam
Background: Past studies have revealed that positive psychological intervention has a positive impact on social isolation. Objectives: The purpose of this investigation was to examine the effect of positive psychological interventions on students' social isolation during the COVID-19 pandemic. Methods: The research design of the study was quasi-experimental, comprising post-test and pre-test types with experimental and control groups. The population of this study included all female students of the 10th grade at Isfahan Conservatory during the academic year 2022 - 2023. The sample size consisted of 30 female students who were selected through convenience sampling and randomly assigned to two groups: the control group (15 students) and the experimental group (15 students). Eight sessions of positive psychological intervention were conducted with the experimental group, while the control group did not receive any intervention. Results: The results of Fisher’s Exact test and chi-square test did not reveal any significant difference between the two groups of fathers in terms of education level (P = 0.169), and there was also no significant difference between the two groups of mothers in terms of education level (P = 0.715). The mean scores of social isolation (control: 50.00 ± 7.44, intervention: 30.00 ± 7.60) significantly decreased in the intervention group (P = 0.0001), but there was no significant decrease in the control group (P = 0.45). Accordingly, the pre-test mean scores of social isolation (P = 0.143) did not show significant between-group differences, and the post-test mean scores of social isolation (P = 0.001) in the intervention group were significantly lower than in the control group. Conclusions: The positive psychological intervention had a significant effect on the students' social isolation in the experimental group during the COVID-19 pandemic, indicating that this intervention can be used to reduce the social isolation of students.
{"title":"The Effectiveness of Positive Psychological Interventions on Social Isolation of Girl Students During the COVID-19 Pandemic","authors":"Ziba Karimi, Bahman Kord Tamini, Sana Nourimoghadam","doi":"10.5812/semj-135961","DOIUrl":"https://doi.org/10.5812/semj-135961","url":null,"abstract":"Background: Past studies have revealed that positive psychological intervention has a positive impact on social isolation. Objectives: The purpose of this investigation was to examine the effect of positive psychological interventions on students' social isolation during the COVID-19 pandemic. Methods: The research design of the study was quasi-experimental, comprising post-test and pre-test types with experimental and control groups. The population of this study included all female students of the 10th grade at Isfahan Conservatory during the academic year 2022 - 2023. The sample size consisted of 30 female students who were selected through convenience sampling and randomly assigned to two groups: the control group (15 students) and the experimental group (15 students). Eight sessions of positive psychological intervention were conducted with the experimental group, while the control group did not receive any intervention. Results: The results of Fisher’s Exact test and chi-square test did not reveal any significant difference between the two groups of fathers in terms of education level (P = 0.169), and there was also no significant difference between the two groups of mothers in terms of education level (P = 0.715). The mean scores of social isolation (control: 50.00 ± 7.44, intervention: 30.00 ± 7.60) significantly decreased in the intervention group (P = 0.0001), but there was no significant decrease in the control group (P = 0.45). Accordingly, the pre-test mean scores of social isolation (P = 0.143) did not show significant between-group differences, and the post-test mean scores of social isolation (P = 0.001) in the intervention group were significantly lower than in the control group. Conclusions: The positive psychological intervention had a significant effect on the students' social isolation in the experimental group during the COVID-19 pandemic, indicating that this intervention can be used to reduce the social isolation of students.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140748200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Honarvar, Yasamin Shahgoli Gashti, Fatemeh Haseli, Amir Hossein Jalalpour, Zahra Sodagar Hendostan, Hana Javanmardi Fard, M. Baneshi, Fatemeh Shaygani, Mehrdad Arammehr
Context: This research focuses on the impact of HIV/AIDS on transgender communities, aiming to assess their knowledge, attitudes, perceptions of risk, and practices concerning HIV/AIDS. Evidence Acquisition: During this systematic review, a variety of keywords, including HIV, AIDS, knowledge, attitudes, practices, behavior, action, risk perception, perceived risk, risk susceptibility, severity perception, perceived self-efficacy, cues to action, benefit, barrier, health belief model, sexually transmitted disease, sexually transmitted infection, alcohol, drugs, amphetamine, opium, trans, transgender, transsexual, gender dysphoria were used. From Scopus, PubMed, Web of Science (ISI), and Google Scholar databases, 805 articles were initially identified and screened based on their titles, abstracts, and full texts. Exclusions were made for articles not in English and grey literature. Ultimately, 13 full-text articles met the selection criteria, adhering to COREQ and STROBE guidelines. Results: The review encompassed studies involving 3,252 transgender participants. Among these, five articles evaluated knowledge levels, nearly all addressed attitudes (including perceived threats by 12 articles, perceived benefits/self-efficacy by three, and perceived barriers by seven), and 11 examined behaviors related to HIV/AIDS. The findings indicate a generally high level of knowledge about HIV/AIDS among transgender individuals, with peer health promoters playing a significant role in enhancing knowledge and facilitating access to health services. The perceived risk and severity of HIV/AIDS varied, with 52 - 82% acknowledging a perceived risk and 25 - 65% understanding the severity. The perceived benefits of HIV prevention were generally rated high, though self-efficacy in preventing HIV ranged from low to high. Barriers to HIV testing and accessing appropriate care were identified, including discrimination, distrust in health staff, lack of guidelines, and fear of test results or treatment side effects, among others. Risky sexual behaviors were common, with two-thirds engaging in such practices, 20% reporting 3 - 51 sexual partners, up to 91% having unprotected sex, around 60% using alcohol or drugs, 21 - 45% experiencing rape, and 14 - 68% being HIV-positive. Conclusions: In conclusion, the transgender community remains overlooked. Despite an adequate knowledge level and a moderate perception of HIV/AIDS risk, the prevalence of risky sexual behaviors and significant barriers to accessing health services highlight the urgent need for establishing long-term healthcare facilities and an effective surveillance system for this marginalized group.
{"title":"Knowledge, Attitudes, Practices and Risk Perceptions Toward HIV/AIDS in Transgender Populations: A Health Belief Model-Based Systematic Review","authors":"B. Honarvar, Yasamin Shahgoli Gashti, Fatemeh Haseli, Amir Hossein Jalalpour, Zahra Sodagar Hendostan, Hana Javanmardi Fard, M. Baneshi, Fatemeh Shaygani, Mehrdad Arammehr","doi":"10.5812/semj-143389","DOIUrl":"https://doi.org/10.5812/semj-143389","url":null,"abstract":"Context: This research focuses on the impact of HIV/AIDS on transgender communities, aiming to assess their knowledge, attitudes, perceptions of risk, and practices concerning HIV/AIDS. Evidence Acquisition: During this systematic review, a variety of keywords, including HIV, AIDS, knowledge, attitudes, practices, behavior, action, risk perception, perceived risk, risk susceptibility, severity perception, perceived self-efficacy, cues to action, benefit, barrier, health belief model, sexually transmitted disease, sexually transmitted infection, alcohol, drugs, amphetamine, opium, trans, transgender, transsexual, gender dysphoria were used. From Scopus, PubMed, Web of Science (ISI), and Google Scholar databases, 805 articles were initially identified and screened based on their titles, abstracts, and full texts. Exclusions were made for articles not in English and grey literature. Ultimately, 13 full-text articles met the selection criteria, adhering to COREQ and STROBE guidelines. Results: The review encompassed studies involving 3,252 transgender participants. Among these, five articles evaluated knowledge levels, nearly all addressed attitudes (including perceived threats by 12 articles, perceived benefits/self-efficacy by three, and perceived barriers by seven), and 11 examined behaviors related to HIV/AIDS. The findings indicate a generally high level of knowledge about HIV/AIDS among transgender individuals, with peer health promoters playing a significant role in enhancing knowledge and facilitating access to health services. The perceived risk and severity of HIV/AIDS varied, with 52 - 82% acknowledging a perceived risk and 25 - 65% understanding the severity. The perceived benefits of HIV prevention were generally rated high, though self-efficacy in preventing HIV ranged from low to high. Barriers to HIV testing and accessing appropriate care were identified, including discrimination, distrust in health staff, lack of guidelines, and fear of test results or treatment side effects, among others. Risky sexual behaviors were common, with two-thirds engaging in such practices, 20% reporting 3 - 51 sexual partners, up to 91% having unprotected sex, around 60% using alcohol or drugs, 21 - 45% experiencing rape, and 14 - 68% being HIV-positive. Conclusions: In conclusion, the transgender community remains overlooked. Despite an adequate knowledge level and a moderate perception of HIV/AIDS risk, the prevalence of risky sexual behaviors and significant barriers to accessing health services highlight the urgent need for establishing long-term healthcare facilities and an effective surveillance system for this marginalized group.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"816 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140749244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Identifying reliable predictors for ventricular recovery at the outset is crucial for patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). Objectives: This study aimed to evaluate the role of baseline global longitudinal strain (GLS) in predicting myocardial recovery following an acute infarction. Methods: We enrolled 60 consecutive patients diagnosed with STEMI and admitted to Al-Zahra Hospital for PCI from March 2022 to March 2023. Echocardiography was performed on all patients within 48 hours after revascularization to measure baseline parameters, including left ventricular ejection fraction (LVEF) and GLS. Follow-up echocardiography was conducted 6 months later to reassess LVEF. Results: At the 6-month follow-up, 38 (63.3%) patients showed a ≥ 5% improvement in LVEF, indicating ventricular recovery. The change in GLS was significantly different between the groups (recovered: -4.72 ± 2.00, not recovered: -2.41 ± 2.15, P < 0.001). A baseline GLS ≤ -4.5 and > -14.8 was predictive of either failure to recover or successful recovery of LVEF with 100% negative and positive predictive values, respectively. Baseline GLS values > -9.2 were predictive of LV recovery with 50% sensitivity and 83.3% specificity (P = 0.0002, AUC (95% confidence interval) = 0.697 (0.594, 0.799)). The type of revascularization was linked to better prediction outcomes, with patients undergoing primary and rescue PCIs more likely to recover during the follow-up period compared to those receiving deferred PCI after 24 hours (P = 0.032). Conclusions: While certain baseline GLS value thresholds may serve as predictors of LVEF recovery in patients with STEMI undergoing primary PCI, further prospective studies with larger cohorts are needed to establish more precise cut-off values.
{"title":"Predictive Value of Global Longitudinal Strain on the Recovery of Left Ventricular Function Following ST-Segment Elevation Myocardial Infarction","authors":"A. Attar, Mahboobeh Zahed, Alireza Hosseinpour, Pouria Azami, Jahangir Kamalpour, Mahmood Zamirian","doi":"10.5812/semj-142307","DOIUrl":"https://doi.org/10.5812/semj-142307","url":null,"abstract":"Background: Identifying reliable predictors for ventricular recovery at the outset is crucial for patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). Objectives: This study aimed to evaluate the role of baseline global longitudinal strain (GLS) in predicting myocardial recovery following an acute infarction. Methods: We enrolled 60 consecutive patients diagnosed with STEMI and admitted to Al-Zahra Hospital for PCI from March 2022 to March 2023. Echocardiography was performed on all patients within 48 hours after revascularization to measure baseline parameters, including left ventricular ejection fraction (LVEF) and GLS. Follow-up echocardiography was conducted 6 months later to reassess LVEF. Results: At the 6-month follow-up, 38 (63.3%) patients showed a ≥ 5% improvement in LVEF, indicating ventricular recovery. The change in GLS was significantly different between the groups (recovered: -4.72 ± 2.00, not recovered: -2.41 ± 2.15, P < 0.001). A baseline GLS ≤ -4.5 and > -14.8 was predictive of either failure to recover or successful recovery of LVEF with 100% negative and positive predictive values, respectively. Baseline GLS values > -9.2 were predictive of LV recovery with 50% sensitivity and 83.3% specificity (P = 0.0002, AUC (95% confidence interval) = 0.697 (0.594, 0.799)). The type of revascularization was linked to better prediction outcomes, with patients undergoing primary and rescue PCIs more likely to recover during the follow-up period compared to those receiving deferred PCI after 24 hours (P = 0.032). Conclusions: While certain baseline GLS value thresholds may serve as predictors of LVEF recovery in patients with STEMI undergoing primary PCI, further prospective studies with larger cohorts are needed to establish more precise cut-off values.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"49 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140231170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shiva Khaleghparast, F. Shabani, Seyyed Ebrahim Hosseini Zargaz, S. Joolaee, Mahmood Sheikh Fathollahi, B. Ghanbari
Background: The do-not-resuscitate (DNR) order in end-stage patients constitutes a critical medical decision, directing healthcare providers to withhold cardiopulmonary resuscitation (CPR) in the event of cardiopulmonary arrest upon the patient's request. Objectives: This study aims to analyze the attitudes of healthcare providers and the general population toward the concept of DNR orders in end-stage patients. Methods: Conducted from September 2021 to May 2022, this cross-sectional study aimed to gauge the attitudes of healthcare providers and the general population toward DNR orders in end-stage patients using a questionnaire assessing attitudes toward DNR. The research population included healthcare providers—physicians and nurses—from healthcare centers affiliated with Iran University of Medical Sciences, selected through convenience sampling, and the general population comprising individuals frequenting parks near these healthcare centers within the relevant municipal districts. Results: Among the 164 participating healthcare providers, 139 (84.8%) were female. Participants' ages ranged from 21 to 57 years, with an average age of 36.78 ± 7.79 years. The study found that healthcare providers had a significantly higher average attitude score toward DNR (29.85 ± 9.46) compared to the general population (27.08 ± 9.78). Healthcare providers with adequate financial status exhibited a more positive attitude toward DNR in end-stage patients compared to those with excellent or poor economic status (P = 0.001). Additionally, the relative frequency of individuals experiencing a poor prognosis of disease was significantly lower among healthcare personnel than the general population (P = 0.018). Healthcare providers without family members or friends in their end-stage of life demonstrated a more favorable attitude toward DNR for these patients (P = 0.001). Conclusions: The study revealed that healthcare providers exhibited a significantly more positive attitude toward DNR compared to the general population. Furthermore, healthcare providers experienced a lower relative frequency of individuals facing a poor prognosis of disease compared to the general population. However, the relative frequency of experiencing family members or friends in the end stage did not significantly differ between healthcare providers and the general population. Healthcare providers with less than 2 years or more than 20 years of experience in the medical field demonstrated a more positive attitude toward DNR.
{"title":"The Attitude of Healthcare Providers and the General Population on the Concept of Do-Not-Resuscitate (DNR) Order in End-Stage Patients","authors":"Shiva Khaleghparast, F. Shabani, Seyyed Ebrahim Hosseini Zargaz, S. Joolaee, Mahmood Sheikh Fathollahi, B. Ghanbari","doi":"10.5812/semj-137476","DOIUrl":"https://doi.org/10.5812/semj-137476","url":null,"abstract":"Background: The do-not-resuscitate (DNR) order in end-stage patients constitutes a critical medical decision, directing healthcare providers to withhold cardiopulmonary resuscitation (CPR) in the event of cardiopulmonary arrest upon the patient's request. Objectives: This study aims to analyze the attitudes of healthcare providers and the general population toward the concept of DNR orders in end-stage patients. Methods: Conducted from September 2021 to May 2022, this cross-sectional study aimed to gauge the attitudes of healthcare providers and the general population toward DNR orders in end-stage patients using a questionnaire assessing attitudes toward DNR. The research population included healthcare providers—physicians and nurses—from healthcare centers affiliated with Iran University of Medical Sciences, selected through convenience sampling, and the general population comprising individuals frequenting parks near these healthcare centers within the relevant municipal districts. Results: Among the 164 participating healthcare providers, 139 (84.8%) were female. Participants' ages ranged from 21 to 57 years, with an average age of 36.78 ± 7.79 years. The study found that healthcare providers had a significantly higher average attitude score toward DNR (29.85 ± 9.46) compared to the general population (27.08 ± 9.78). Healthcare providers with adequate financial status exhibited a more positive attitude toward DNR in end-stage patients compared to those with excellent or poor economic status (P = 0.001). Additionally, the relative frequency of individuals experiencing a poor prognosis of disease was significantly lower among healthcare personnel than the general population (P = 0.018). Healthcare providers without family members or friends in their end-stage of life demonstrated a more favorable attitude toward DNR for these patients (P = 0.001). Conclusions: The study revealed that healthcare providers exhibited a significantly more positive attitude toward DNR compared to the general population. Furthermore, healthcare providers experienced a lower relative frequency of individuals facing a poor prognosis of disease compared to the general population. However, the relative frequency of experiencing family members or friends in the end stage did not significantly differ between healthcare providers and the general population. Healthcare providers with less than 2 years or more than 20 years of experience in the medical field demonstrated a more positive attitude toward DNR.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"95 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140236609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mona Moghaddam Vahed, Ayla Bahramian, K. Katebi, F. Salehnia
Context: Early diagnosis of head and neck squamous cell carcinomas (HNSCC) is critical for preventing further disease progression. This study aimed to compare the serum folate and homocysteine levels in patients with HNSCC and healthy controls through a systematic review and subsequent meta-analyses. Evidence Acquisition: The research question was: Is there a difference between serum folate and homocysteine levels (O) of patients with HNSCC (E) compared to healthy controls (C)? To conduct a systematic review, keywords were first identified and then searched in Medline/PubMed, Web of Science, ProQuest, EMBASE, Scopus, and Google Scholar databases within the period from January 2000 to November 2023. The searched studies were screened based on inclusion and exclusion criteria, and after assessing the quality of the selected articles using the Joanna Briggs Institute assessment checklist, 10 articles were finally included in the meta-analysis (nine articles for serum folate and eight for homocysteine). Due to the heterogeneity of studies, meta-analyses were conducted according to the random-effects model. Several meta-analyses were carried out because the selected articles were not uniform regarding smoking habits. Results: Regardless of smoking conditions, the serum folate levels of the HNSCC patients were significantly lower than those of the control groups. Similarly, the serum homocysteine levels were significantly higher in the patient groups compared to the control groups. Conclusions: The meta-analyses in this study showed an association between serum folate and homocysteine levels with HNSCC, indicating their possible use as biomarkers for the early detection of HNSCC.
{"title":"The Relationship Between Serum Folate and Homocysteine with Head and Neck Cancer: A Systematic Review and Meta-analysis","authors":"Mona Moghaddam Vahed, Ayla Bahramian, K. Katebi, F. Salehnia","doi":"10.5812/semj-140961","DOIUrl":"https://doi.org/10.5812/semj-140961","url":null,"abstract":"Context: Early diagnosis of head and neck squamous cell carcinomas (HNSCC) is critical for preventing further disease progression. This study aimed to compare the serum folate and homocysteine levels in patients with HNSCC and healthy controls through a systematic review and subsequent meta-analyses. Evidence Acquisition: The research question was: Is there a difference between serum folate and homocysteine levels (O) of patients with HNSCC (E) compared to healthy controls (C)? To conduct a systematic review, keywords were first identified and then searched in Medline/PubMed, Web of Science, ProQuest, EMBASE, Scopus, and Google Scholar databases within the period from January 2000 to November 2023. The searched studies were screened based on inclusion and exclusion criteria, and after assessing the quality of the selected articles using the Joanna Briggs Institute assessment checklist, 10 articles were finally included in the meta-analysis (nine articles for serum folate and eight for homocysteine). Due to the heterogeneity of studies, meta-analyses were conducted according to the random-effects model. Several meta-analyses were carried out because the selected articles were not uniform regarding smoking habits. Results: Regardless of smoking conditions, the serum folate levels of the HNSCC patients were significantly lower than those of the control groups. Similarly, the serum homocysteine levels were significantly higher in the patient groups compared to the control groups. Conclusions: The meta-analyses in this study showed an association between serum folate and homocysteine levels with HNSCC, indicating their possible use as biomarkers for the early detection of HNSCC.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"56 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140255918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maryam ZaareNahandi, A. Ostadi, Mahdi khodayari, Amin Azimi, Ahad Banagozar Mohammadi, Alireza Ghaffari, Ali Banagozar Mohammadi
Background: Organophosphate (OP) poisoning ranks among the leading causes of poisoning, morbidity, and mortality in developing countries due to its relatively high prevalence and potentially grave outcomes. Consequently, it is crucial to identify an easily accessible and cost-effective marker that can be utilized across healthcare facilities. Objectives: This study aimed to explore the relationship between the QTc interval and blood glucose levels with serum cholinesterase levels in patients poisoned by organophosphates. Methods: The sample consisted of all patients admitted with OP poisoning to a Northwest Poisoning Center in Iran during 2016 and 2017. Diagnosis of OP poisoning was confirmed through patient history, physical examination, or the measurement of acetylcholinesterase levels. Data collected were analyzed using SPSS software version 25. Results: Results: Out of 238 patients, 104 remained after applying exclusion criteria and were included in the study. The mean age of these patients was 30.81 ± 15.04 years. A statistically significant negative correlation was found between average blood glucose and serum cholinesterase levels (P = 0.046, Pearson Correlation = -0.196). Furthermore, patients with abnormal QTc intervals exhibited significantly lower serum cholinesterase levels (P < 0.001). Conclusions: The findings indicate a significant association between QTc intervals and blood glucose levels with serum cholinesterase levels. Serum cholinesterase levels decreased with an increase in QTc intervals and blood glucose levels. Specifically, patients with a QTc interval greater than 440 milliseconds or random blood glucose levels above 200 milligrams per deciliter showed significantly lower serum cholinesterase levels.
{"title":"The Association Between QTc-Interval and Blood Glucose with Plasma Acetylcholinesterase in Organophosphate (OP)-Poisoned Patients","authors":"Maryam ZaareNahandi, A. Ostadi, Mahdi khodayari, Amin Azimi, Ahad Banagozar Mohammadi, Alireza Ghaffari, Ali Banagozar Mohammadi","doi":"10.5812/semj-141140","DOIUrl":"https://doi.org/10.5812/semj-141140","url":null,"abstract":"Background: Organophosphate (OP) poisoning ranks among the leading causes of poisoning, morbidity, and mortality in developing countries due to its relatively high prevalence and potentially grave outcomes. Consequently, it is crucial to identify an easily accessible and cost-effective marker that can be utilized across healthcare facilities. Objectives: This study aimed to explore the relationship between the QTc interval and blood glucose levels with serum cholinesterase levels in patients poisoned by organophosphates. Methods: The sample consisted of all patients admitted with OP poisoning to a Northwest Poisoning Center in Iran during 2016 and 2017. Diagnosis of OP poisoning was confirmed through patient history, physical examination, or the measurement of acetylcholinesterase levels. Data collected were analyzed using SPSS software version 25. Results: Results: Out of 238 patients, 104 remained after applying exclusion criteria and were included in the study. The mean age of these patients was 30.81 ± 15.04 years. A statistically significant negative correlation was found between average blood glucose and serum cholinesterase levels (P = 0.046, Pearson Correlation = -0.196). Furthermore, patients with abnormal QTc intervals exhibited significantly lower serum cholinesterase levels (P < 0.001). Conclusions: The findings indicate a significant association between QTc intervals and blood glucose levels with serum cholinesterase levels. Serum cholinesterase levels decreased with an increase in QTc intervals and blood glucose levels. Specifically, patients with a QTc interval greater than 440 milliseconds or random blood glucose levels above 200 milligrams per deciliter showed significantly lower serum cholinesterase levels.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"56 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140258915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Antibiotics are used to treat and prevent oral infections. Clindamycin and penicillin are widely used drugs in this field. Poor use of antibacterial agents causes the emergence of antibiotic-resistant bacteria. Objectives: The present study examined and compared the frequency distribution of resistance of streptococci isolated from the root surface of extracted teeth to penicillin V and clindamycin. This study was conducted in 2021 in Yazd, Iran. Methods: This was an analytical cross-sectional study performed in vitro. The samples were taken from the root surfaces of 50 teeth immediately after extraction and transferred to the laboratory in a transfer medium. After cultivation, isolation, and identification, the antibiotic resistance of isolates was measured by the E-test method. The data were analyzed using SPSS software (version 23). Results: Streptococci spp. were isolated from 46 samples (92%) without environmental contamination. The minimum inhibitory concentration (MIC) 50 and MIC 90 for penicillin V were 0.5 μg/mL and 1 μg/mL, respectively, and for clindamycin, 0.125 μg/mL and 0.19 μg/mL, respectively, which was significantly (P = 0.0001) lower for clindamycin. Intermediate sensitivity to penicillin V was 95.6%, and resistance to clindamycin was 21.8%. Conclusions: It seems that except in limited cases where there is resistance to clindamycin, this antibiotic is a more effective drug to control the bacteria in the mouth. However, in some cases, aerobic isolates showed intermediate sensitivity to penicillin V; however, resistance to clindamycin was observed.
背景：抗生素用于治疗和预防口腔感染。克林霉素和青霉素是这一领域广泛使用的药物。抗菌药使用不当会导致抗生素耐药菌的出现。研究目的本研究考察并比较了从拔牙的牙根表面分离出的链球菌对青霉素 V 和克林霉素的耐药性频率分布。本研究于 2021 年在伊朗亚兹德进行。研究方法这是一项在体外进行的横断面分析研究。样本取自拔牙后的 50 颗牙齿的根部表面，并在转移培养基中转移到实验室。经过培养、分离和鉴定后，用 E 测试法测量分离物的抗生素耐药性。数据使用 SPSS 软件（23 版）进行分析。结果从 46 份样本（92%）中分离出链球菌，未受环境污染。青霉素 V 的最低抑菌浓度 (MIC) 50 和 MIC 90 分别为 0.5 μg/mL 和 1 μg/mL，克林霉素的最低抑菌浓度 (MIC) 50 和 MIC 90 分别为 0.125 μg/mL 和 0.19 μg/mL，克林霉素的最低抑菌浓度 (MIC) 50 和 MIC 90 明显较低（P = 0.0001）。对青霉素 V 的中间敏感性为 95.6%，对克林霉素的耐药性为 21.8%。结论：看来，除了对克林霉素产生耐药性的少数病例外，克林霉素是控制口腔细菌的更有效药物。不过，在某些病例中，需氧菌分离物对青霉素 V 呈中度敏感性，但对克林霉素产生了耐药性。
{"title":"Antibiotic Resistance of Streptococcus spp. Isolated from the Root Surface of Extracted Teeth to Penicillin V and Clindamycin Using an E-Test","authors":"Mohammad-Hassan Akhavan Karbassi, Faraz Kheirollahi, Hengameh Zandi, Mohammadhossein Falahzadeh, Alireza Reza Navab Azam","doi":"10.5812/semj-141304","DOIUrl":"https://doi.org/10.5812/semj-141304","url":null,"abstract":"Background: Antibiotics are used to treat and prevent oral infections. Clindamycin and penicillin are widely used drugs in this field. Poor use of antibacterial agents causes the emergence of antibiotic-resistant bacteria. Objectives: The present study examined and compared the frequency distribution of resistance of streptococci isolated from the root surface of extracted teeth to penicillin V and clindamycin. This study was conducted in 2021 in Yazd, Iran. Methods: This was an analytical cross-sectional study performed in vitro. The samples were taken from the root surfaces of 50 teeth immediately after extraction and transferred to the laboratory in a transfer medium. After cultivation, isolation, and identification, the antibiotic resistance of isolates was measured by the E-test method. The data were analyzed using SPSS software (version 23). Results: Streptococci spp. were isolated from 46 samples (92%) without environmental contamination. The minimum inhibitory concentration (MIC) 50 and MIC 90 for penicillin V were 0.5 μg/mL and 1 μg/mL, respectively, and for clindamycin, 0.125 μg/mL and 0.19 μg/mL, respectively, which was significantly (P = 0.0001) lower for clindamycin. Intermediate sensitivity to penicillin V was 95.6%, and resistance to clindamycin was 21.8%. Conclusions: It seems that except in limited cases where there is resistance to clindamycin, this antibiotic is a more effective drug to control the bacteria in the mouth. However, in some cases, aerobic isolates showed intermediate sensitivity to penicillin V; however, resistance to clindamycin was observed.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"100 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140260855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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