Pub Date : 2024-07-17DOI: 10.18502/acta.v61i11.16078
Fatemeh Sarhadi Kholari, M. Nourbakhsh, G. Shekarkhar, A. Dehpour, A. Golestani
Cirrhosis is the consequence of chronic liver injury Considering the crucial role of oxidative stress in the progression of liver cirrhosis, we aimed to investigate the ameliorative effect of NTX against oxidative stress in carbon tetrachloride (CCl4)-induced cirrhotic rats. Eighty-four male Wistar rats were randomly assigned into 4 groups (21 rats /group I) receiving CCl4; (II) NTX+CCl4; (III) mineral oil (M) (as the control); (IV) NTX+M. The animals in each group were sacrificed in 3 different time-points 2 weeks, 6 weeks (early cirrhosis) and 8 weeks (advanced cirrhosis). Liver function tests, NO metabolites, GSH level, as well as the activity of antioxidant enzymes including superoxide dismutase (SOD), catalase (CAT), glutathione peroxides (GPX), and hexokinase (HK) were assessed. NTX was able to ameliorate liver injury, revealed by attenuation of ALT activity, which was significantly enhanced due to cirrhosis induction, as well as pathological evaluation. HK was also increased significantly after treatment with CCl₄ while NTX moderated this increase. Although CCl4 treatment did not have a significant effect on GSH levels, NTX was able to considerably increase GSH in blood. The activity of CAT and SOD as well as NO levels were all augmented by NTX in CCl4-treated rats. Naltrexone demonstrates antioxidative effects in liver cirrhosis and may confer a protective effect against hepatic cirrhosis through modulation of oxidative stress.
{"title":"Erythrocyte Antioxidants and Hexokinase Activity Alterations in CCl4-Induced Cirrhotic Rats Through Naltrexone Treatment","authors":"Fatemeh Sarhadi Kholari, M. Nourbakhsh, G. Shekarkhar, A. Dehpour, A. Golestani","doi":"10.18502/acta.v61i11.16078","DOIUrl":"https://doi.org/10.18502/acta.v61i11.16078","url":null,"abstract":"Cirrhosis is the consequence of chronic liver injury Considering the crucial role of oxidative stress in the progression of liver cirrhosis, we aimed to investigate the ameliorative effect of NTX against oxidative stress in carbon tetrachloride (CCl4)-induced cirrhotic rats. Eighty-four male Wistar rats were randomly assigned into 4 groups (21 rats /group I) receiving CCl4; (II) NTX+CCl4; (III) mineral oil (M) (as the control); (IV) NTX+M. The animals in each group were sacrificed in 3 different time-points 2 weeks, 6 weeks (early cirrhosis) and 8 weeks (advanced cirrhosis). Liver function tests, NO metabolites, GSH level, as well as the activity of antioxidant enzymes including superoxide dismutase (SOD), catalase (CAT), glutathione peroxides (GPX), and hexokinase (HK) were assessed. NTX was able to ameliorate liver injury, revealed by attenuation of ALT activity, which was significantly enhanced due to cirrhosis induction, as well as pathological evaluation. HK was also increased significantly after treatment with CCl₄ while NTX moderated this increase. Although CCl4 treatment did not have a significant effect on GSH levels, NTX was able to considerably increase GSH in blood. The activity of CAT and SOD as well as NO levels were all augmented by NTX in CCl4-treated rats. Naltrexone demonstrates antioxidative effects in liver cirrhosis and may confer a protective effect against hepatic cirrhosis through modulation of oxidative stress.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829263","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}
Pub Date : 2024-07-17DOI: 10.18502/acta.v61i11.16084
M. Behjati, Fatemeh Tohidi, Mohammad Karimian
Bardet-Biedl syndrome (BBS) (MIM 209900) is a genetic disorder with a wide spectrum of clinical manifestations including retinal dystrophy, hypogenitalism, polydactyly, obesity, renal abnormalities and mental retardation. We describe a 13-year-old girl, a known case of Bardet-Biedl syndrome, who was going to undergo hysterectomy due to hydrometrocolpous. She was homozygous autosomal recessive for gene BS57. She was obese and had impaired vision, renal abnormality, borderline intelligence, recurrent urinary tract infection, menstrual problems, normal secondary sex chrematistics and corrected polydactylies. She had also big nose, thin upper lip, slightly everted lower lip, small mouth and retrognathia. Her electrocardiography showed incomplete right bundle branch block. We identified atrioventricular septal defect (AVSD). In conclusion, physicians who deal with cases who suffered from Bardet-Biedl syndrome, should be vigilant about seeking for identification of cardiac anomalies such as partial AVSD. This leads to earlier identification of the existing cardiovascular disease which facilitates appliance of curative measures.
{"title":"Partial Atrioventricular Septal Defect in a Case of Bardet-Biedl Syndrome: A Rare Association","authors":"M. Behjati, Fatemeh Tohidi, Mohammad Karimian","doi":"10.18502/acta.v61i11.16084","DOIUrl":"https://doi.org/10.18502/acta.v61i11.16084","url":null,"abstract":"Bardet-Biedl syndrome (BBS) (MIM 209900) is a genetic disorder with a wide spectrum of clinical manifestations including retinal dystrophy, hypogenitalism, polydactyly, obesity, renal abnormalities and mental retardation. We describe a 13-year-old girl, a known case of Bardet-Biedl syndrome, who was going to undergo hysterectomy due to hydrometrocolpous. She was homozygous autosomal recessive for gene BS57. She was obese and had impaired vision, renal abnormality, borderline intelligence, recurrent urinary tract infection, menstrual problems, normal secondary sex chrematistics and corrected polydactylies. She had also big nose, thin upper lip, slightly everted lower lip, small mouth and retrognathia. Her electrocardiography showed incomplete right bundle branch block. We identified atrioventricular septal defect (AVSD). In conclusion, physicians who deal with cases who suffered from Bardet-Biedl syndrome, should be vigilant about seeking for identification of cardiac anomalies such as partial AVSD. This leads to earlier identification of the existing cardiovascular disease which facilitates appliance of curative measures. ","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831115","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}
Pub Date : 2024-07-17DOI: 10.18502/acta.v61i11.16080
Mehrdad Dargahi-Malamir, S. Borsi, Zahra Mehraban, Fatemeh Kianizadeh, Hoda Mohsenikia
Pinen Hydronoplacton Ribonucleic acid (PHR160) medicine contains compounds that can be useful in the recovery of respiratory patients. The aim of this study was to determine the effect of PHR spray on improving lung function, severity and asthma attacks in patients with severe asthma. This study is a pioneering interventional study (pilot study) conducted during the years 2021-2022 on patients with severe asthma resistant to treatment who referred to the lung clinic of Imam Khomeini, Golestan Hospitals and the private practice of lung specialists of this academic center. The study includes two groups of patients with asthma, both groups were given the usual treatment according to the stage of the disease, in addition, the intervention group was given two puffs of PHR spray every eight hours, and the control group was given a placebo spray with the same dose. Before and after the intervention, GSK 2002 questionnaire, six-minute walk distance (6MWD) and spirometry tests were completed. Among of 60 patients, 27 (45%) were male. The mean age of the patients was 44.33±6.94 years. Based on findings, the forced vital capacity (FVC) and forced expiratory flow between 25% and 75% (FEF 25-75%) were significantly better in the intervention group than the control group (P<0.001 and P=0.019, respectively), but there was a statistically remarkable difference between the two groups in terms of forced expiratory volume (FEV1) and FEV1/FVC (P=0.505, P=0.575, respectively). In addition, the GSK questionnaire score in the intervention group was higher than the control group (P<0.001), however there is no significant difference between the two intervention groups in terms of the 6MWD test and the number of exacerbation (P=0.114 and P=0.09, respectively). It is generally concluded that PHR160 spray can lead to improvement of spirometry parameters and severity of disease in severe asthma patients by affecting small airways.
{"title":"Evaluation of PHR160 Spray Effect on Improvement of Lung Function, Asthma Severity and Exacerbation in Severe Asthmatic Patients","authors":"Mehrdad Dargahi-Malamir, S. Borsi, Zahra Mehraban, Fatemeh Kianizadeh, Hoda Mohsenikia","doi":"10.18502/acta.v61i11.16080","DOIUrl":"https://doi.org/10.18502/acta.v61i11.16080","url":null,"abstract":"Pinen Hydronoplacton Ribonucleic acid (PHR160) medicine contains compounds that can be useful in the recovery of respiratory patients. The aim of this study was to determine the effect of PHR spray on improving lung function, severity and asthma attacks in patients with severe asthma. This study is a pioneering interventional study (pilot study) conducted during the years 2021-2022 on patients with severe asthma resistant to treatment who referred to the lung clinic of Imam Khomeini, Golestan Hospitals and the private practice of lung specialists of this academic center. The study includes two groups of patients with asthma, both groups were given the usual treatment according to the stage of the disease, in addition, the intervention group was given two puffs of PHR spray every eight hours, and the control group was given a placebo spray with the same dose. Before and after the intervention, GSK 2002 questionnaire, six-minute walk distance (6MWD) and spirometry tests were completed. Among of 60 patients, 27 (45%) were male. The mean age of the patients was 44.33±6.94 years. Based on findings, the forced vital capacity (FVC) and forced expiratory flow between 25% and 75% (FEF 25-75%) were significantly better in the intervention group than the control group (P<0.001 and P=0.019, respectively), but there was a statistically remarkable difference between the two groups in terms of forced expiratory volume (FEV1) and FEV1/FVC (P=0.505, P=0.575, respectively). In addition, the GSK questionnaire score in the intervention group was higher than the control group (P<0.001), however there is no significant difference between the two intervention groups in terms of the 6MWD test and the number of exacerbation (P=0.114 and P=0.09, respectively). It is generally concluded that PHR160 spray can lead to improvement of spirometry parameters and severity of disease in severe asthma patients by affecting small airways.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831292","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}
Pub Date : 2024-07-17DOI: 10.18502/acta.v61i11.16075
Mahdi Shooraj, Kiarash Fekri, Noushin Mousazadeh, S. Mahdavi
Pharmacology is the cornerstone of health science courses the same as biomedical programs in educational setting. New educational intuitions and methodical progresses in teaching and learning, as well as recent findings in pharmacology research, can help pharmacology educators reconsider and regulate their teaching approaches. Thus, the aim of this article is to review existing studies on the different methods of teaching pharmacology and investigate different outcomes in this regard. In the present investigation, recent articles in the databases of Web of Science, PubMed, Scopus, Embase, Google Scholar, IranDoc and Scientific Information Database (SID) were examined, and the delegated documents were reviewed. The gathered data showed that students’ cognitive, metacognitive, and cooperative learning besides collaborative skills are effective factors for teaching. Additionally, application of blended learning or flipped instruction via technologies such as computer ameliorates the process of teaching and learning pharmacology in academic setting. Consequently, to overcome the difficulties in managing the data overload, it sounds necessary to introduce new teaching methods in academic context. Therefore, the current investigation is useful for practitioners, curriculum designers and educational administrators in medical and paramedical educational context.
药理学与生物医学课程一样，是教育环境中健康科学课程的基石。新的教育直觉和教学方法的进步，以及药理学研究的最新发现，可以帮助药理学教育者重新考虑和规范他们的教学方法。因此，本文旨在回顾现有关于不同药理学教学方法的研究，并调查这方面的不同结果。在本次调查中，对 Web of Science、PubMed、Scopus、Embase、Google Scholar、IranDoc 和科学信息数据库（SID）等数据库中的最新文章进行了研究，并对委托文件进行了审查。收集到的数据表明，学生的认知、元认知和合作学习以及协作技能是教学的有效因素。此外，通过计算机等技术应用混合式学习或翻转教学，可改善学术环境中药理学的教与学过程。因此，为了克服管理数据过载的困难，有必要在学术环境中引入新的教学方法。因此，当前的调查对医学和辅助医学教育背景下的从业人员、课程设计者和教育管理者很有帮助。
{"title":"A Review on Novel Methods of Pharmacology Teaching Concerning Iranian Academic Context","authors":"Mahdi Shooraj, Kiarash Fekri, Noushin Mousazadeh, S. Mahdavi","doi":"10.18502/acta.v61i11.16075","DOIUrl":"https://doi.org/10.18502/acta.v61i11.16075","url":null,"abstract":"Pharmacology is the cornerstone of health science courses the same as biomedical programs in educational setting. New educational intuitions and methodical progresses in teaching and learning, as well as recent findings in pharmacology research, can help pharmacology educators reconsider and regulate their teaching approaches. Thus, the aim of this article is to review existing studies on the different methods of teaching pharmacology and investigate different outcomes in this regard. In the present investigation, recent articles in the databases of Web of Science, PubMed, Scopus, Embase, Google Scholar, IranDoc and Scientific Information Database (SID) were examined, and the delegated documents were reviewed. The gathered data showed that students’ cognitive, metacognitive, and cooperative learning besides collaborative skills are effective factors for teaching. Additionally, application of blended learning or flipped instruction via technologies such as computer ameliorates the process of teaching and learning pharmacology in academic setting. Consequently, to overcome the difficulties in managing the data overload, it sounds necessary to introduce new teaching methods in academic context. Therefore, the current investigation is useful for practitioners, curriculum designers and educational administrators in medical and paramedical educational context.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828544","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}
Pub Date : 2024-07-17DOI: 10.18502/acta.v61i11.16081
K. Dolatshahi, Seyed Alireza Mosaheb, Mahdi Nabi Foodani, Sahar Hosseininezahdian, S. Z. Esfahan
Fibrocystic breast disease is the most common benign breast disease in women, and it is necessary to investigate the most effective treatment method to reduce its symptoms. Therefore, the study was conducted to investigate the effect of melatonin supplementation on clinical symptoms and paraclinical outcomes in women diagnosed with fibrocystic breast disease. Investigating the Effects of melatonin supplementation on clinical symptoms and paraclinical outcomes in women diagnosed with fibrocystic breast disease. The present study is a controlled intervention-placebo treatment conducted on women suffering from fibrocystic breast disease aged 18-40. This interventional study was conducted on 66 patients (33 in the intervention group and 33 in the control group). Melatonin supplement of 3 mg was administered to the intervention group and a placebo to the control group for 12 weeks. Patient information, symptoms, and paraclinical outcomes were recorded at the beginning of the study before the intervention and 12 weeks after the intervention. After collecting the data, we analyzed it using SPSS version 16 software and appropriate statistical tests. The findings of this study showed that melatonin administration in patients with fibrocystic breast disease reduced anxiety, depression, improved sleep quality, increased TAC (Total Antioxidant Capacity), and decreased MDA (Malondialdehyde). However, both study groups did not have statistically significant differences in the average pain and hs-CRP before and after the intervention. According to the findings of the study and the identification of the positive effect of melatonin on laboratory indicators and symptoms in patients with fibrocystic breast disease, it is recommended to prescribe melatonin in addition to standard treatment to witness a better and faster recovery, and in this way, the quality of life of patients can be increased.
{"title":"Effects of Melatonin Supplementation on Clinical Symptoms and Paraclinical Outcomes in Women Diagnosed With Fibrocystic Breast Disease: An Interventional Study","authors":"K. Dolatshahi, Seyed Alireza Mosaheb, Mahdi Nabi Foodani, Sahar Hosseininezahdian, S. Z. Esfahan","doi":"10.18502/acta.v61i11.16081","DOIUrl":"https://doi.org/10.18502/acta.v61i11.16081","url":null,"abstract":"Fibrocystic breast disease is the most common benign breast disease in women, and it is necessary to investigate the most effective treatment method to reduce its symptoms. Therefore, the study was conducted to investigate the effect of melatonin supplementation on clinical symptoms and paraclinical outcomes in women diagnosed with fibrocystic breast disease. Investigating the Effects of melatonin supplementation on clinical symptoms and paraclinical outcomes in women diagnosed with fibrocystic breast disease. The present study is a controlled intervention-placebo treatment conducted on women suffering from fibrocystic breast disease aged 18-40. This interventional study was conducted on 66 patients (33 in the intervention group and 33 in the control group). Melatonin supplement of 3 mg was administered to the intervention group and a placebo to the control group for 12 weeks. Patient information, symptoms, and paraclinical outcomes were recorded at the beginning of the study before the intervention and 12 weeks after the intervention. After collecting the data, we analyzed it using SPSS version 16 software and appropriate statistical tests. The findings of this study showed that melatonin administration in patients with fibrocystic breast disease reduced anxiety, depression, improved sleep quality, increased TAC (Total Antioxidant Capacity), and decreased MDA (Malondialdehyde). However, both study groups did not have statistically significant differences in the average pain and hs-CRP before and after the intervention. According to the findings of the study and the identification of the positive effect of melatonin on laboratory indicators and symptoms in patients with fibrocystic breast disease, it is recommended to prescribe melatonin in addition to standard treatment to witness a better and faster recovery, and in this way, the quality of life of patients can be increased.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830279","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}
Pub Date : 2024-07-17DOI: 10.18502/acta.v61i11.16083
M. Behjati-Ardakani, Mohammad-Amin Behjati-Ardakani, S. Mirjalili, Mohammadtaghi Sarebanhassanabadi
Congenital coronary-cameral fistula is an abnormal connection between coronary arteries and a cardiac chamber. Although trans-catheter closure appears to be a safe alternative to surgical treatment but there is an imprecision about modality of choice. We describe a huge left coronary artery fistula to the right ventricle, found in an 8-year-old girl with dyspnea on exertion and chest pain. She was treated with an Amplatzer duct occluder. After procedure, echocardiography revealed, complete closure of fistula orifice and the girl remained completely asymptomatic during 48 months follow-up period. This study demonstrated that Amplatzer duct occluder might be a useful and safe armamentarium for coronary-cameral fistula treatment. Nevertheless, further experience and long-term follow-up studies are required to guarantee our results.
{"title":"Transcatheter Closure of a Huge Congenital Coronary-Cameral Fistula With Amplatzer Occluder","authors":"M. Behjati-Ardakani, Mohammad-Amin Behjati-Ardakani, S. Mirjalili, Mohammadtaghi Sarebanhassanabadi","doi":"10.18502/acta.v61i11.16083","DOIUrl":"https://doi.org/10.18502/acta.v61i11.16083","url":null,"abstract":"Congenital coronary-cameral fistula is an abnormal connection between coronary arteries and a cardiac chamber. Although trans-catheter closure appears to be a safe alternative to surgical treatment but there is an imprecision about modality of choice. We describe a huge left coronary artery fistula to the right ventricle, found in an 8-year-old girl with dyspnea on exertion and chest pain. She was treated with an Amplatzer duct occluder. After procedure, echocardiography revealed, complete closure of fistula orifice and the girl remained completely asymptomatic during 48 months follow-up period. This study demonstrated that Amplatzer duct occluder might be a useful and safe armamentarium for coronary-cameral fistula treatment. Nevertheless, further experience and long-term follow-up studies are required to guarantee our results.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829179","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}
Pub Date : 2024-07-17DOI: 10.18502/acta.v61i11.16079
Sara Monjezi, Shahram Rafie, Ebrahim Behzad, Shooka Mohammadi
Precise categorization of the causes of ischemic stroke (IS) is crucial for optimizing stroke treatment and assessing the prognosis of patients. This cross-sectional study aimed to determine the risk factors and various subcategories of IS in Iranian patients. The study included all patients with IS referred to Golestan Hospital (Ahvaz, Iran) for one year. Their demographics and clinical data were collected. The etiology of IS was classified based on the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria. A total of 1100 patients with IS were evaluated, 658 were male and 442 were female. They had an average age of 66 years (ranging between 20 and 99 years). The majority of them were in the 61-80 age group. The prevalence of risk factors for IS included hypertension (HTN) (71.4%), diabetes (50.4%), smoking (42.4%), history of previous stroke (28%), dyslipidemia (15.4%), and cardiovascular disease (22.5%). Three months after admission, the mortality rate was 10.7% and the majority of patients exhibited a lower level of disability based on the modified Rankin Score (mRS) compared to the time of admission. The frequency of all risk factors, except for HTN, differed significantly between genders (P<0.05). Furthermore, the prevalence of risk factors varied significantly among different stroke etiologic subgroups (P<0.05). The most common etiological factors identified by TOAST classification were associated with large artery atherosclerosis (LAA) and small artery occlusion (SAO). Significant variations were observed in the prevalence of different etiologic subtypes of stroke among genders and across different age groups.
缺血性脑卒中（IS）病因的精确分类对于优化脑卒中治疗和评估患者预后至关重要。本横断面研究旨在确定伊朗患者 IS 的风险因素和各种亚类。研究对象包括一年内转诊至 Golestan 医院（伊朗阿瓦士）的所有 IS 患者。收集了他们的人口统计学和临床数据。IS 的病因根据 TOAST（急性中风治疗中的 ORG 10172 试验）标准进行分类。共评估了 1100 名 IS 患者，其中 658 人为男性，442 人为女性。他们的平均年龄为 66 岁（20 至 99 岁不等）。他们中的大多数人年龄在 61-80 岁之间。导致 IS 的危险因素包括高血压（71.4%）、糖尿病（50.4%）、吸烟（42.4%）、既往中风史（28%）、血脂异常（15.4%）和心血管疾病（22.5%）。入院三个月后的死亡率为 10.7%，与入院时相比，大多数患者的残疾程度（根据修改后的 Rankin 评分（mRS）计算）有所降低。除高血压外，所有危险因素的发生率在性别间存在显著差异（P<0.05）。此外，不同卒中病因亚组的危险因素发生率也有显著差异（P<0.05）。根据 TOAST 分类确定的最常见病因与大动脉粥样硬化（LAA）和小动脉闭塞（SAO）有关。在不同性别和不同年龄组中，不同病因亚型脑卒中的发病率存在显著差异。
{"title":"Risk Factors and Etiological Classification of Ischemic Stroke Subtypes in Southwest Iran","authors":"Sara Monjezi, Shahram Rafie, Ebrahim Behzad, Shooka Mohammadi","doi":"10.18502/acta.v61i11.16079","DOIUrl":"https://doi.org/10.18502/acta.v61i11.16079","url":null,"abstract":"Precise categorization of the causes of ischemic stroke (IS) is crucial for optimizing stroke treatment and assessing the prognosis of patients. This cross-sectional study aimed to determine the risk factors and various subcategories of IS in Iranian patients. The study included all patients with IS referred to Golestan Hospital (Ahvaz, Iran) for one year. Their demographics and clinical data were collected. The etiology of IS was classified based on the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria. A total of 1100 patients with IS were evaluated, 658 were male and 442 were female. They had an average age of 66 years (ranging between 20 and 99 years). The majority of them were in the 61-80 age group. The prevalence of risk factors for IS included hypertension (HTN) (71.4%), diabetes (50.4%), smoking (42.4%), history of previous stroke (28%), dyslipidemia (15.4%), and cardiovascular disease (22.5%). Three months after admission, the mortality rate was 10.7% and the majority of patients exhibited a lower level of disability based on the modified Rankin Score (mRS) compared to the time of admission. The frequency of all risk factors, except for HTN, differed significantly between genders (P<0.05). Furthermore, the prevalence of risk factors varied significantly among different stroke etiologic subgroups (P<0.05). The most common etiological factors identified by TOAST classification were associated with large artery atherosclerosis (LAA) and small artery occlusion (SAO). Significant variations were observed in the prevalence of different etiologic subtypes of stroke among genders and across different age groups.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":" 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830294","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}
Pub Date : 2024-07-17DOI: 10.18502/acta.v61i11.16082
Hanieh Bayat, Shabnam Movassaghi, Mohammad Akbari
Fetal abnormalities can cause axillary artery variations. Recognize and document of these variations are essential for surgeons performing interventional or diagnostic procedures for cardiovascular diseases. During routine dissection of an old female cadaver in the department of anatomy of Islamic Azad University, Tehran of Medical Sciences, we came across a variation in the branching pattern of the left axillary artery. The third part of the left axillary artery gave rise to a common trunk which was divided into the subscapular, lateral thoracic, posterior, and anterior circumflex humeral arteries.
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Pub Date : 2024-07-17DOI: 10.18502/acta.v61i11.16077
Parisa Khosravi, S. Beiranvand, Farzad Ebrahimzadeh, Arefeh Tadayon, Maryam Hasani
This study aims to determine the effect of gestational hypertension on neonatal hemoglobin levels. This cohort study was performed on 150 pregnant women, 60 of whom had gestational hypertension and 90 were healthy. Participants were selected using sequential and quota non-probability sampling methods, respectively. The data were collected from interviews and examination forms. The newborns’ umbilical cords were clamped 30-60 sec after the delivery in both groups. Umbilical cord blood samples were taken to determine neonatal hemoglobin levels and sent to the laboratory immediately. Independent t-test was used to compare the two groups in terms of mean hemoglobin; general linear model with an identical link function was used to compare the two groups in terms of mean hemoglobin, considering the effect of confounding variables. SPSS software version 25 was used for the statistical analysis of the data. The statistical significance level in this study was considered to be 0.05. The mean neonatal hemoglobin level in women with gestational hypertension was significantly higher than that in the healthy group (16.73±1.81 gr/dl vs. 15.56±1.79, P<0.001). This difference remained significant after adjusting for demographic and background variables as well as medical records of the participants (P=0.008). The results revealed the hemoglobin level of newborns of mothers who had gestational hypertension, was higher than newborns of healthy mothers. Therefore, performing proper screening tests and knowledge of the hemoglobin level in these infants routinely helps the healthcare staff to prevent, decide and provide more and more useful services.
本研究旨在确定妊娠高血压对新生儿血红蛋白水平的影响。这项队列研究的对象是 150 名孕妇，其中 60 人患有妊娠高血压，90 人健康。研究人员分别采用顺序抽样法和配额非概率抽样法选出。数据通过访谈和检查表收集。两组均在分娩后 30-60 秒夹闭新生儿脐带。采集脐带血样本以测定新生儿血红蛋白水平，并立即送往实验室。两组平均血红蛋白的比较采用独立 t 检验；考虑到混杂变量的影响，两组平均血红蛋白的比较采用具有相同链接函数的一般线性模型。数据统计分析采用 SPSS 软件 25 版。本研究的统计学显著性水平为 0.05。妊娠高血压妇女的新生儿平均血红蛋白水平明显高于健康组（16.73±1.81 gr/dl vs. 15.56±1.79，P<0.001）。在对参与者的人口统计学变量、背景变量和医疗记录进行调整后，这一差异仍有意义（P=0.008）。结果显示，妊娠高血压母亲的新生儿血红蛋白水平高于健康母亲的新生儿。因此，定期对这些婴儿进行适当的筛查测试并了解其血红蛋白水平有助于医护人员预防、决定和提供更多更有用的服务。
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Pub Date : 2024-07-17DOI: 10.18502/acta.v61i11.16076
A. Shahriari, Masoomeh Nataj-Majd, Majid Akrami, M. Khooshideh, Mahsa Soleimani
Epidural analgesia (EA) is an effective and common method of pain relief during labor. However, EA may also have some adverse effects like prolonged labor, increased risk of operative delivery, and some unwanted complications. It's unclear how maternal position affects the outcomes of natural birth with EA. This study aimed to compare mode of delivery and maternal and neonatal outcomes between recumbent and upright positions in nulliparous women with EA. This randomized clinical trial involved 540 women who received EA at cervical dilatation of 4 to 6 cm. During the second stage of labor, they were instructed to adopt upright or recumbent position. The main outcome was the mode of delivery. The secondary outcomes included duration of labor, pain intensity, the Apgar score, and other maternal and neonatal complications. Finally, 528 women were included in the final analysis. The upright group had a higher rate of cesarean section than the recumbent group. The duration of the labor stages did not differ between the groups. The pain intensity in the second stage was higher in the upright position. The Apgar score at 1 and 5 minutes was higher in the recumbent group. There was no difference in terms of other outcomes between the groups. Recumbent positions are beneficial in the case of rate of cesarean, mother’s pain, and Apgar score in women with EA. So, adopting a recumbent position during the second stage of labor may be preferable for women with EA.
硬膜外镇痛（EA）是一种有效且常用的分娩镇痛方法。然而，硬膜外镇痛也可能带来一些不良影响，如产程延长、手术分娩风险增加以及一些不必要的并发症。目前还不清楚产妇体位如何影响使用 EA 自然分娩的结果。这项研究旨在比较 EA 非足月儿产妇的分娩方式、孕产妇和新生儿的预后。这项随机临床试验涉及 540 名产妇，她们在宫颈扩张 4 至 6 厘米时接受了 EA。在第二产程中，她们被指示采取直立或仰卧姿势。主要结果是分娩方式。次要结果包括产程、疼痛强度、Apgar 评分以及其他产妇和新生儿并发症。最后，528 名产妇被纳入最终分析。直立组的剖宫产率高于仰卧组。两组产妇的产程时间没有差异。直立姿势下第二产程的疼痛强度更高。仰卧组在 1 分钟和 5 分钟时的 Apgar 评分更高。两组在其他结果方面没有差异。就剖宫产率、母亲疼痛和阿普加评分而言，仰卧位对患有 EA 的产妇有益。因此，在第二产程中采用仰卧位可能更适合 EA 患者。
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