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Evaluation of Effectiveness of Combined Intra-Articular Injection of Ozone and High Molecular Weight Hyaluronic Acid in Patients With Knee Osteoarthritis 评估膝骨关节炎患者关节内联合注射臭氧和高分子量透明质酸的效果
Q3 Medicine Pub Date : 2024-04-05 DOI: 10.18502/acta.v61i9.15289
Shervin Shahinpour, Mohsen Amirsabotki, Nader Ali Nazemian Yazdi
Osteoarthritis is one of the major causes of disability and a source of social cost in the elderly. Its prevalence is increasing due to ageing and increasing obese population. The knee is one of the most common joints to be affected by osteoarthritis and it can lead to serious effects on one’s mobility, quality of life and livelihood. One of non-surgical treatments is intra-articular injection. Injection of both ozone and hyaluronic acid into knee joint are common methods for treatment of knee osteoarthritis. The aim of this study was to evaluate reduction of pain and improvement of function in patients who received combination of intra-articular injection of high molecular weight hyaluronic acid and ozone. In this retrospective case series study data of patients with knee osteoarthritis who underwent intra-articular injection of high molecular weight hyaluronic acid with ozone were evaluated. Participants had fulfilled Western Ontario and McMaster Universities Arthritis Index (WOMAC) short form questionnaire before, three days, one month and six months after the intra-articular injection. Pain reduction and function improvement factors were assessed according to the WOMAC short form questionnaire. A total of 65 patients were evaluated in this study. There was significant decrease in the total score of WOMAC SF (stiffness and function) in all three follow-ups (P<0.001). Also, patients who had more severe pain before the injection benefited more from the intra-articular injection. Our study showed that the effectiveness of intra-articular injection of high molecular weight hyaluronic acid with ozone does not depend on the age, sex and BMI of patients. Injection of high molecular weight hyaluronic acid and ozone into the joint cause to significant improvement in patient’s knee pain and function. It is recommended that the combination of high molecular weight hyaluronic acid and ozone be considered as an effective treatment in the process of these patients.
骨关节炎是老年人致残的主要原因之一,也是社会成本的来源之一。由于老龄化和肥胖人口的增加,骨关节炎的发病率也在不断上升。膝关节是受骨关节炎影响最常见的关节之一,可严重影响患者的活动能力、生活质量和生计。非手术疗法之一是关节内注射。向膝关节内注射臭氧和透明质酸是治疗膝关节骨性关节炎的常用方法。本研究的目的是评估联合使用高分子量透明质酸和臭氧进行关节内注射的患者疼痛减轻和功能改善的情况。在这项回顾性病例系列研究中,对接受高分子量透明质酸和臭氧关节内注射的膝关节骨关节炎患者的数据进行了评估。参与者分别在关节内注射前、注射后三天、一个月和六个月填写了西安大略和麦克马斯特大学关节炎指数(WOMAC)简表问卷。根据 WOMAC 短式问卷对疼痛减轻和功能改善情况进行了评估。本研究共对 65 名患者进行了评估。在三次随访中,WOMAC SF(僵硬和功能)总分均有明显下降(P<0.001)。此外,注射前疼痛较严重的患者从关节内注射中获益更多。我们的研究表明,用臭氧在关节内注射高分子量透明质酸的效果与患者的年龄、性别和体重指数无关。向关节内注射高分子量透明质酸和臭氧可显著改善患者的膝关节疼痛和功能。建议将高分子量透明质酸和臭氧的结合作为治疗这些患者的有效方法。
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引用次数: 0
Evaluation of the Effects of Lidocaine in Different Fields of Medicine 评估利多卡因在不同医学领域的作用
Q3 Medicine Pub Date : 2024-04-05 DOI: 10.18502/acta.v61i9.15292
S. Samadi, Ebrahim Espahbodi, Zahid Hussain Khan, Melika Arab Bafrani
The Article Abstract is not available.  
文章摘要不详。
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引用次数: 0
Comparison of Hemodynamic Effects of Dose Response vs. Conventional Dosing of Propofol for Anesthesia Induction Under Bispectral Index Monitoring: A Clinical Trial 在双谱指数监测下比较剂量反应与常规剂量的异丙酚对麻醉诱导的血流动力学影响:临床试验
Q3 Medicine Pub Date : 2024-04-05 DOI: 10.18502/acta.v61i9.15287
Zahra Khazaeipour, Niloufar Khoshnam-Rad, Khalil Pestei, S. Samadi
Propofol is an advantageous agent for anesthesia induction. It can cause dose-related hemodynamic adverse effects. The bispectral index (BIS) is a brain function monitor utilized to assess the depth of anesthesia. This study aimed to compare the adverse hemodynamic effects of BIS-guided response dosing with conventional weight-based dosing of Propofol. In this clinical trial, patients were anesthetized with propofol in two different orthopedic operating rooms. In one operating room, patients received propofol with dose-response method (group A), and the other received weight-based dosing (group B). For both groups, BIS was used as an index of anesthesia depth. Hemodynamic parameters were recorded at baseline, during induction, and at different time points. A total of 73 patients were included in the final analysis. The mean dose of propofol for induction was higher in the control group than in the response-guided group (1.94±1.65 vs. 1.09±0.32, respectively, P=0.006). There were no reported significant adverse hemodynamic effects in patients of the two groups. Response-guided propofol dosing can be used to decrease propofol dose during anesthesia induction. Further studies are needed to investigate the clinical benefit of this dosing strategy.
丙泊酚是一种用于麻醉诱导的优势药物。它可导致与剂量相关的血液动力学不良反应。双谱指数(BIS)是一种用于评估麻醉深度的脑功能监测器。本研究旨在比较 BIS 引导的反应剂量与传统的基于体重的异丙酚剂量对血液动力学的不良影响。在这项临床试验中,患者在两个不同的骨科手术室中接受异丙酚麻醉。在一间手术室中,患者使用剂量反应法使用异丙酚(A 组),而在另一间手术室中,患者使用基于体重的剂量法使用异丙酚(B 组)。两组均使用 BIS 作为麻醉深度指标。在基线、诱导期间和不同时间点记录血液动力学参数。共有 73 名患者被纳入最终分析。对照组的异丙酚平均诱导剂量高于反应引导组(分别为 1.94±1.65 对 1.09±0.32,P=0.006)。两组患者均未出现明显的血流动力学不良反应。反应引导的异丙酚剂量可用于减少麻醉诱导过程中的异丙酚剂量。还需要进一步研究这种剂量策略的临床益处。
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引用次数: 0
The Impact of Epidural Analgesia on Cesarean Section Rates and Neonatal Outcomes: A Retrospective Cohort Study 硬膜外镇痛对剖腹产率和新生儿结局的影响:回顾性队列研究
Q3 Medicine Pub Date : 2024-04-05 DOI: 10.18502/acta.v61i9.15284
Asghar Hajipour, Alireza Montaseri, M. Rahimi, Amirhossein Orandi, Laila Rahmah, S. Samadi
This retrospective cohort study aimed to assess the frequency of emergency cesarean sections with epidural analgesia and its implications on Apgar scores and Neonatal Intensive Care Unit (NICU) admissions among patients at Tehran University of Medical Sciences Hospitals from 2017 to 2018. Data from 7170 patients were extracted from the hospital information system (HIS) through a consensus method. Descriptive statistics, cross-tabulation, and logistic regression analyses were conducted using Stata v17 software. Out of 9387 patients, 62.7% underwent cesarean sections, and 37.1% had normal vaginal deliveries. Epidural analgesia was administered to 127 patients, with 98.4% achieving successful normal vaginal delivery. Nulliparous women constituted 64.29% of those receiving epidural analgesia. Apgar scores at five and ten minutes were comparable between epidural and non-epidural groups. Emergency cesarean rates with epidural analgesia were low (1.6%). Findings align with previous research indicating no significant impact of epidural analgesia on Apgar scores. Nulliparous women predominated in the epidural group, consistent with pain pattern disparities. The study supports recent research showing epidural analgesia does not increase emergency cesarean rates, even in high-risk pregnancies. This study suggests that epidural analgesia does not significantly impact Apgar scores, NICU admissions, or emergency cesarean rates. While the comprehensive dataset enhances reliability, retrospective design limitations are acknowledged. Prospective studies exploring factors contributing to neonatal mortality and overall labor duration are recommended for more robust evidence.
这项回顾性队列研究旨在评估德黑兰医科大学附属医院2017年至2018年使用硬膜外镇痛进行紧急剖宫产的频率及其对Apgar评分和新生儿重症监护室(NICU)收治患者的影响。通过协商一致的方法从医院信息系统(HIS)中提取了7170名患者的数据。使用 Stata v17 软件进行了描述性统计、交叉表和逻辑回归分析。在 9387 名患者中,62.7% 接受了剖宫产,37.1% 经阴道正常分娩。127名患者接受了硬膜外镇痛,98.4%的患者成功地经阴道正常分娩。接受硬膜外镇痛的产妇中,64.29%为无子宫产妇。硬膜外镇痛组和非硬膜外镇痛组在5分钟和10分钟时的Apgar评分相当。使用硬膜外镇痛的紧急剖宫产率较低(1.6%)。研究结果与之前的研究结果一致,表明硬膜外镇痛对Apgar评分没有显著影响。硬膜外镇痛组中主要是无子宫产妇,这与疼痛模式的差异一致。该研究支持最近的研究,即硬膜外镇痛不会增加紧急剖宫产率,即使在高危妊娠中也是如此。这项研究表明,硬膜外镇痛不会对阿普加评分、新生儿重症监护室入院率或紧急剖宫产率产生重大影响。虽然全面的数据集提高了可靠性,但回顾性设计的局限性也是公认的。建议进行前瞻性研究,探讨导致新生儿死亡率和总产程的因素,以获得更有力的证据。
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引用次数: 0
Effects of a Novel Blended Virtual Reality and Clinical Learning Environment on the Learning Transfer of Anesthesiology Residents 新型混合虚拟现实和临床学习环境对麻醉学住院医生学习迁移的影响
Q3 Medicine Pub Date : 2024-04-05 DOI: 10.18502/acta.v61i9.15285
S. Mousavi, Morteza Karami, S. Mireskandari, S. Samadi
The use of educational technology is considered a necessity due to the increasing changes in medical education. This study aimed to design a novel blended virtual reality and clinical learning environment (CLE) and to investigate its effectiveness in the learning transfer of anesthesiology residents during spinal anesthesia procedures. In this experimental study, 25 residents (academic year 2020/2021) were randomly divided into blended (n=11) and clinical (n=14) groups. Spinal anesthesia training for the blended group was performed in the virtual training laboratory (week 1) and the operating room (from week 2 to week 4), while for the CLE group, it was only performed in the operating room. Training, based on task-centered learning, was provided for both groups, and then, a 360-degree assessment of learning transfer was conducted by professors, patients, co-workers, and self-assessments using a standard questionnaire. Data were analyzed using non-parametric tests. There was a significant difference in the learning transfer of residents between the blended and CLE groups (U=39, P=0.03<0.05). There was also a significant difference in the subcategories of learning transfer according to the professors and co-workers; however, there was no significant difference according to the patients and self-assessments. The blended VR/CLE learning environment was more effective than CLE in improving residents’ learning transfer. Besides, an increase in scores indicated an improvement in professional competence.
随着医学教育的日益变革,教育技术的使用被认为是一种必然。本研究旨在设计一种新颖的混合虚拟现实和临床学习环境(CLE),并调查其对麻醉科住院医师在脊髓麻醉过程中学习转移的有效性。在这项实验研究中,25 名住院医师(2020/2021 学年)被随机分为混合组(11 人)和临床组(14 人)。混合组的脊柱麻醉培训在虚拟培训实验室(第1周)和手术室(第2周至第4周)进行,而 CLE 组仅在手术室进行。两组人员都接受了以任务为中心的学习培训,然后通过教授、患者、同事以及使用标准问卷进行的自我评估,对学习转移进行了 360 度评估。数据采用非参数检验进行分析。混合组和 CLE 组住院医师的学习迁移有明显差异(U=39,P=0.03<0.05)。根据教授和同事的评价,学习迁移的子类别也有显著差异;但根据患者和自我评价,没有显著差异。在提高住院医师的学习迁移方面,VR/CLE 混合学习环境比 CLE 更有效。此外,得分的增加也表明了专业能力的提高。
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引用次数: 0
Anesthesia in Ancient Persia Down to the 21st Century 古波斯直至 21 世纪的麻醉技术
Q3 Medicine Pub Date : 2024-04-05 DOI: 10.18502/acta.v61i9.15278
Z. Hussain Khan, S. Samadi
The Article Abstract is not available.  
文章摘要不详。
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引用次数: 0
Video Laryngoscopy Versus Direct Laryngoscopy in Novices: A Randomized Clinical Trial 视频喉镜与直接喉镜在新手中的应用:随机临床试验
Q3 Medicine Pub Date : 2024-04-05 DOI: 10.18502/acta.v61i9.15283
Reza Effatdoost, Babak Eslami, O. Nabavian, Maziar Maghsoudloo, Khalil Pestei, S. Samadi, Mohammad Dehghan-Tazerjani
Intubating the trachea is a challenging task, especially for novice intubators. Successful intubation, in the shortest possible time, prevents hypoxia and hemodynamic disturbances. During the last few decades, video laryngoscopy has proven to be a helpful tool for intubating patients successfully, especially in difficult cases. However, novices must be proficient with a video laryngoscopy. It is not entirely clear which method, direct laryngoscopy or video laryngoscopy, is more successful for tracheal intubation in individuals who have recently started their airway management training. In this study, we aim to investigate this issue. 150 patients were randomly assigned to either direct laryngoscopy or video laryngoscopy by first-year anesthesia assistants. Intubation time, intubation success rate, Cormack-Lehane score, and instances of using the Optimal external laryngeal manipulation (OELM) maneuver, were recorded. The rate of successful intubation was higher in the direct laryngoscopy group, and the time taken was less. The direct laryngoscopy provided a better view of the glottis than the video laryngoscopy, although this difference was not statistically significant. Direct laryngoscopy resulted in a higher frequency of OELM. Based on our study, the success rate and speed of intubation in novices were higher with direct laryngoscopy compared to video laryngoscopy.
气管插管是一项具有挑战性的任务,尤其是对于插管新手而言。在尽可能短的时间内成功插管可以防止缺氧和血流动力学紊乱。在过去的几十年中,视频喉镜已被证明是为患者成功插管的有效工具,尤其是在疑难病例中。然而,新手必须熟练掌握视频喉镜。对于刚开始气道管理培训的人来说,直接喉镜检查和视频喉镜检查哪种方法更适合气管插管,目前还不完全清楚。本研究旨在探讨这一问题。150 名患者被随机分配给一年级麻醉助理进行直接喉镜检查或视频喉镜检查。研究记录了插管时间、插管成功率、Cormack-Lehane 评分以及使用最佳喉外操作(OELM)手法的次数。直接喉镜组的插管成功率更高,所用时间更短。与视频喉镜相比,直接喉镜检查能提供更好的声门视野,但这一差异在统计学上并不显著。直接喉镜检查导致发生 OELM 的频率更高。根据我们的研究,与视频喉镜相比,直接喉镜检查的新手插管成功率和速度更高。
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引用次数: 0
Comparative Analysis of Patient Satisfaction and Sedation Outcomes in Bronchoscopy: Fentanyl/Chlorpheniramine vs. Ketamine/Chlorpheniramine 支气管镜检查中患者满意度和镇静效果的比较分析:芬太尼/氯苯那敏与氯胺酮/氯苯那敏比较
Q3 Medicine Pub Date : 2024-04-05 DOI: 10.18502/acta.v61i9.15281
M. Khajavi, Leila Sadat Hosseini, M. Pazoki, Seyed Hamidreza Sharifnia, R. S. Moharari, Pejman Pourfakhr, Parisa Kianpour, Abbas Ostadalipour, A. Najafi, F. Etezadi
This randomized clinical trial aimed to assess and compare patient satisfaction and sedation outcomes in bronchoscopy procedures using two distinct sedation protocols: fentanyl/chlorpheniramine (FC) and ketamine/chlorpheniramine (KC). Ninety patients undergoing simple bronchoscopy and bronchoalveolar lavage were randomly assigned to receive either FC (1 µg/kg fentanyl and 10 mg chlorpheniramine) or KC (0.5 mg/kg ketamine and 10 mg chlorpheniramine). Lidocaine was also administered during bronchoscopy. Primary outcomes included patient satisfaction scores, while secondary outcomes encompassed sedation levels, bronchoscopist satisfaction, cough rates, lidocaine usage, and physiological parameters. Patients in the FC group exhibited significantly higher satisfaction levels compared to the KC group (P=0.002). Bronchoscopist satisfaction was also superior in the FC group (P=0.001). Although cough rates did not differ significantly, severe persistent coughs were more prevalent in the KC group. Physiological parameters such as oxygen saturation were comparable, but the KC group demonstrated higher increases in systolic blood pressure and heart rate. The use of fentanyl/chlorpheniramine resulted in higher patient and bronchoscopist satisfaction during simple bronchoscopy and bronchoalveolar lavage compared to ketamine/chlorpheniramine. This study suggests that the combination of fentanyl and chlorpheniramine may be a preferable sedation choice for bronchoscopy procedures.
这项随机临床试验旨在评估和比较在支气管镜检查过程中使用两种不同镇静方案的患者满意度和镇静效果:芬太尼/氯苯那敏(FC)和氯胺酮/氯苯那敏(KC)。接受简单支气管镜检查和支气管肺泡灌洗的 90 名患者被随机分配到 FC(1 微克/千克芬太尼和 10 毫克氯苯那敏)或 KC(0.5 毫克/千克氯胺酮和 10 毫克氯苯那敏)方案中。支气管镜检查期间也使用利多卡因。主要结果包括患者满意度评分,次要结果包括镇静水平、支气管镜医师满意度、咳嗽率、利多卡因用量和生理参数。FC 组患者的满意度明显高于 KC 组(P=0.002)。FC 组的支气管镜医师满意度也更高(P=0.001)。虽然咳嗽率没有明显差异,但严重的持续性咳嗽在 KC 组更为普遍。血氧饱和度等生理参数不相上下,但 KC 组的收缩压和心率上升幅度更大。与氯胺酮/氯苯那敏相比,使用芬太尼/氯苯那敏进行简单支气管镜检查和支气管肺泡灌洗时,患者和支气管镜医师的满意度更高。这项研究表明,芬太尼和氯苯那敏的组合可能是支气管镜检查过程中较好的镇静选择。
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引用次数: 0
A Review of Recent Advances in Smart Homes for Improving Sleep Hygiene, and Sleep Quality 智能家居在改善睡眠卫生和睡眠质量方面的最新进展综述
Q3 Medicine Pub Date : 2024-04-05 DOI: 10.18502/acta.v61i9.15279
S. Samadi, Sepehr Samadi, Behnam Samadi, Mehrshad Samadi, Mehrdad Samadi, Mojtaba Shahbazi
With the rising attention towards improving the quality of life and mental health, sleep hygiene and sleep quality have recently been the main topics of numerous studies. Quality of sleep not only affects our physical status but also plays a pivotal role in our psychological and emotional states. Sleep deprivation can increase the risk of cardiovascular and metabolic diseases along with the risk of impaired concentration and consequent road injury and accidents. As technology has become a main figure in our daily lives, technological advances have paid a great interest in improving the quality of sleep by enhancing the detection of sleep-related disorders and sleep abnormalities, particularly in the setting of smart homes and the Internet of Things (IoT). Smartphone applications, portable wearable gadgets, and devices along with more sophisticated and precise algorithms are now endeavoring to help us improve our quality of sleep and subsequently our quality of life. Hence, this review aims to illustrate a vivid picture of recent advancements in smart homes and their related technologies for improving sleep quality.
随着人们对提高生活质量和心理健康的关注日益增加,睡眠卫生和睡眠质量最近成为众多研究的主要课题。睡眠质量不仅影响我们的身体状况,而且对我们的心理和情绪状态也起着举足轻重的作用。睡眠不足会增加罹患心血管疾病和新陈代谢疾病的风险,也会影响注意力,进而导致交通伤害和交通事故。随着科技成为我们日常生活的主角,科技进步通过加强对睡眠相关疾病和睡眠异常的检测,对改善睡眠质量产生了极大的兴趣,尤其是在智能家居和物联网(IoT)的环境中。现在,智能手机应用程序、便携式可穿戴小工具和设备以及更复杂、更精确的算法都在努力帮助我们改善睡眠质量,进而提高生活质量。因此,本综述旨在生动展示智能家居及其相关技术在改善睡眠质量方面的最新进展。
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引用次数: 0
Evaluation of the Effectiveness of Using Pulse Dose Radiofrequency for Treatment of Trigeminal Neuralgia 使用脉冲剂量射频治疗三叉神经痛的效果评估
Q3 Medicine Pub Date : 2024-04-05 DOI: 10.18502/acta.v61i9.15291
Saman Sheikhhosseini, Nader Ali Nazemian Yazdi
Trigeminal neuralgia has an incidence of 4-13 per 100000 people per year. The incidence of this disease increases in the elderly, and it is known to cause severe shock-like pain. Pharmacological therapy is the first-line treatment of trigeminal neuralgia. If pharmacological therapy fails, then different procedures are available. Pulse-dose radiofrequency is one such procedure. In this study, we evaluated Pulse dose radiofrequency's efficacy as a method in which pulse amplitude and width are considered essential variables. This research was conducted as a cross-sectional study on trigeminal neuralgia patients referred to the pain clinic of Amir A’lam Hospital in 2020. Conservative therapy has failed; therefore, the clinician decided to use pulse dose radiofrequency to reduce their pain. Among the 29 patients registered during this period, 15 (51.8%) were women and 14 (48.3%) were men. The mean (±SD) age of the patient was 57.07(±14.26) years. The tow route was interrupted in 7 (24.1%) patients. A significant difference was observed between the pain scores before and after the operation (P<0.001). Pulse-dose radiofrequency is a safe and effective therapy for treating trigeminal neuralgia and can be considered a new way to develop the pulse radiofrequency method.
三叉神经痛的发病率为每年每 10 万人中 4-13 例。这种疾病的发病率在老年人中有所增加,众所周知,它会引起剧烈的休克样疼痛。药物治疗是三叉神经痛的一线治疗方法。如果药物治疗无效,则可采用不同的治疗方法。脉冲剂量射频疗法就是其中之一。在这项研究中,我们评估了脉冲剂量射频的疗效,这种方法的脉冲幅度和宽度被认为是基本变量。本研究是一项横断面研究,对象是 2020 年转诊到阿米尔-阿兰医院疼痛诊所的三叉神经痛患者。由于保守治疗无效,临床医生决定使用脉冲剂量射频来减轻他们的疼痛。在此期间登记的 29 名患者中,15 名(51.8%)为女性,14 名(48.3%)为男性。患者的平均年龄(±SD)为 57.07(±14.26)岁。7例(24.1%)患者的牵引路线中断。手术前后的疼痛评分有明显差异(P<0.001)。脉冲剂量射频治疗三叉神经痛是一种安全有效的疗法,可以说是脉冲射频法发展的新途径。
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引用次数: 0
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Acta medica Iranica
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