Archives of Iranian Medicine最新文献

Background: Preeclampsia is a severe pregnancy disorder linked to high maternal and neonatal mortality. This meta-analysis evaluates the effectiveness of low-dose aspirin in reducing the occurrence of preeclampsia and associated outcomes.

Methods: A total of 28 trials were included, analyzed using a random-effects model to calculate risk ratios (RR) and 95% confidence intervals (CI). The studies compared low-dose aspirin administered at or before 16 weeks of gestation to a control group. The measured parameters are the effect of low-dose aspirin on pregnancy outcomes. Study inclusion criteria consisted of studies in which low-dose aspirin was administrated at or before 16 weeks of gestation and compared to a control group.

Results: Low-dose aspirin significantly reduced preterm (RR=0.52, 95% CI [0.31, 0.88]) and term preeclampsia (RR=0.97, 95% CI [0.69, 1.38]). It also decreased intrauterine growth restriction (RR=0.63, 95% CI [0.54, 0.74]). However, no significant differences were observed for postpartum hemorrhage (RR=0.71, 95% CI [0.49, 1.02]) or gestational hypertension (RR=0.65, 95% CI [0.39, 1.07]). Aspirin doses≥100 mg were more effective in reducing preterm preeclampsia risk compared to doses<100 mg, which showed variable efficacy and greater heterogeneity.

Conclusion: Low-dose aspirin significantly decreases the risk of preterm and term preeclampsia but has limited impact on gestational hypertension and postpartum bleeding. Study limitations include the absence of large randomized controlled trials (RCTs) early in pregnancy (before 16 weeks) and small sample sizes in the included trials, complicating precise dose determination.

Acute cerebral thrombotic stroke following a viper snakebite is a rare occurrence. There have been a few documented cases of cerebral infarctions resulting from envenomation by various viper species. However, none of these reports have specifically detailed instances of stroke induced by Macrovipera lebetina envenomation or vessel occlusion without concurrent cerebral infarction. In this study, we present a case of middle cerebral artery (MCA) occlusion in a 56-year-old man who was bitten by a Macrovipera or Vipera lebetina snake. The individual experienced a snakebite on his right foot, leading to subsequent seizure activity and loss of consciousness. Non-contrast computed tomography scan of the brain revealed hyperattenuation of the right MCA, indicating clot occlusion within the artery, commonly referred to as hyperdense MCA sign or Gács sign.

Background: The obesity epidemic is a growing public health concern, making weight management a crucial aspect of overall health and well-being. Indeed, effective tools to facilitate behavior change are essential for achieving long-term success in managing weight. This study aimed to validate the Farsi versions of the S-weight and P-weight questionnaires to support personalized weight management by assessing specific aspects of psychological readiness, including motivation, self-regulation, emotional reappraisal (EmR), and environmental restructuring (EnR).

Methods: A cross-sectional study using self-administered questionnaires was conducted. The study included 455 adults aged 17-65, excluding those undergoing invasive weight-loss interventions. The measured variables included EmR, weight consequence evaluation (WCE), weight management actions (WMA), and EnR, which were assessed using structured Likert-scale questionnaires. Exploratory and confirmatory factor analyses were performed, with reliability evaluated via Cronbach's alpha and intraclass correlation coefficient (ICC). Statistical significance was set at P<0.05.

Results: The questionnaires showed strong validity and reliability (KMO=0.91; Bartlett's test χ²=3999.75; P<0.001). Overweight and obese participants scored significantly higher in change processes than normal-weight participants (P<0.001).

Conclusion: The validated instruments provide a reliable means of tailoring weight management strategies based on psychological readiness, potentially improving long-term outcomes.

Background: Induced lactation allows non-gestational mothers, such as those adopting or using surrogacy, to breastfeed their children. While widely practiced in various contexts, little research exists on its application in Iran. This study aimed to assess the success and duration of induced lactation in Iranian mothers without prior pregnancy.

Methods: This descriptive-analytical study was conducted between 2013 and 2021, recruiting mothers who became parents through surrogacy or adoption. Participants followed a protocol using hormonal (combined oral contraceptives, domperidone) and non-hormonal methods (breast stimulation). Data on breastfeeding duration, exclusivity, and reasons for cessation were collected through regular follow-up. Chi-square tests and multivariable logistic regression were used to assess factors influencing breastfeeding duration.

Results: Of the 117 mothers, 100 breastfed for<180 days and 17 for≥180 days. The median breastfeeding duration was significantly longer in the≥180 days group (240 days vs. 30 days, P<0.001). Exclusive breastfeeding up to 120 days was much more common in the≥180 days group (70.60% vs. 24%, P<0.001) while biological reasons were the primary cause of cessation in both groups but with different frequencies (100% vs. 75%, P=0.022). The results of logistic regression showed that exclusive breastfeeding for 120 days increased the likelihood of successful breastfeeding for≥180 days (OR: 5.72 (1.76‒18.61), P=0.004) adjusting for mother's age (1.02 (0.92‒1.12), P=0.755), duration of Domperidone use (1.01 (0.98‒1.04), P=0.536), duration of LD use (1.04 (0.95‒1.15), P=0.366), and reason for stopping breastfeeding (7.02 (0.39‒125.30), P=0.185).

Conclusion: This first Iranian study on induced lactation underscores the role of early exclusive breastfeeding in extending breastfeeding duration. Pharmacological support aids in initiating lactation, but long-term success relies on consistent breastfeeding practices. These findings highlight the need for culturally tailored guidelines and support for non-gestational mothers in Iran.

Chromophobe renal cell carcinoma (ChRCC) is a rare subtype of renal cell carcinoma (RCC). We present a case of a 61-year-old male with ChRCC who exhibited unusual metastasis to the retro-orbital area, a site rarely affected by RCC. The patient experienced diplopia and proptosis, prompting treatment with sunitinib and palliative radiotherapy. Remarkably, rapid improvement in ocular symptoms was observed following radiotherapy. Despite this localized response, the patient's overall condition deteriorated, highlighting the aggressive nature of ChRCC. This case underscores the importance of considering ChRCC in metastatic presentations and the potential efficacy of local palliative interventions.

Background: Blood donor selection is a crucial stage in reducing the risk of transfusion-transmissible infections (TTIs) and ensuring the safety of blood components. The objective of this study is to evaluate the impact of each question regarding deferral reasons on the risk of TTIs.

Methods: This study was conducted in twenty blood transfusion centers between March 1, 2018, and September 30, 2019, including high-risk deferred volunteers from seven different groups. All samples from deferral volunteers were screened for HBsAg, anti-HCV, and HIVAg/Ab. Negative samples were pooled and tested for HBVDNA and HCVRNA. The results were compared with those of eligible donors. The association between high-risk behaviors and TTIs was analyzed using risk ratios and 95% confidence intervals.

Results: Out of 2525 high-risk deferred volunteers, the risk of TTIs based on deferral reasons was as follows: a history of positive results of infectious tests RR: 401.6 ( 95% CI : 276.7‒582.8), drug abuse RR: 133.3 (61.9‒287.0), exposure to someone else's blood RR:39.8 (5.7‒275.3), high-risk procedures RR:14.3 (7.9‒25.9), unsafe sexual behaviors RR:9.03 (4.1‒20.1), imprisonment and medical interventions RR=0.0. The deferred group had significantly higher rates of viral markers compared to eligible donors. Furthermore, one reactive HCV RNA was detected in anti-HCV negative samples.

Conclusion: This study showed that deferring blood donations based on a history of positive results from infectious tests, drug abuse, unsafe sexual behaviors, exposure to someone else's blood, and high-risk procedures is effective for ensuring blood safety. These deferral practices should be maintained. We recommend that other deferral criteria should be regularly evaluated for effectiveness.