Pub Date : 2024-04-05DOI: 10.18502/acta.v61i9.15290
Nader Ali Nazemian Yazdi, A. Yoosefi
Hemodynamic changes is of great concern during awake intubation, particularly in patients with underlying medical conditions. As heterogeneities exist in regard to the best anesthesia drugs and techniques, herein, we aimed to investigate the effects of Lidocaine 10% spray compared to trans tracheal glossopharyngeal nerve block in hemodynamic stability in patients undergoing awake intubation. A total of 62 patients were included in this randomized clinical trial. Using a longitudinal interventional design, hemodynamic measures were statistically compared before intubation, one minute after intubation, and five minutes after intubation. The first group underwent topical anesthesia with Lidocaine 10% sprayed on the base of tongue and tonsillar pillar while the second group underwent trans tracheal and glossopharyngeal nerve block with simultaneous injection of Lidocaine 2%. Our results indicated that all hemodynamic parameters except for the pulse rate in both groups were significantly reduced after the intubation, which indicates the effectiveness of the interventions. However, the reduction in SBP, DBP, and MAP was significantly lower in the nerve block group compared to the Lidocaine spray group. Regarding the pulse rate, despite the significant decrease in the group of patients undergoing nerve block, those undergoing anesthesia with Lidocaine spray experienced a significant increase in the heart rate in the first minute after the operation. Finally, our research provides substantiation that employing a glossopharyngeal nerve block and trans tracheal block constitutes an efficacious method for local anesthetic during conscious intubation and can be a promising technique.
{"title":"The Effects of Topical Anesthesia With Lidocaine 10% Spray Compared to Trans Tracheal and Glossopharyngeal Nerve Block in Hemodynamic Stability During Awake Intubation: A Randomized Controlled Trial","authors":"Nader Ali Nazemian Yazdi, A. Yoosefi","doi":"10.18502/acta.v61i9.15290","DOIUrl":"https://doi.org/10.18502/acta.v61i9.15290","url":null,"abstract":"Hemodynamic changes is of great concern during awake intubation, particularly in patients with underlying medical conditions. As heterogeneities exist in regard to the best anesthesia drugs and techniques, herein, we aimed to investigate the effects of Lidocaine 10% spray compared to trans tracheal glossopharyngeal nerve block in hemodynamic stability in patients undergoing awake intubation. A total of 62 patients were included in this randomized clinical trial. Using a longitudinal interventional design, hemodynamic measures were statistically compared before intubation, one minute after intubation, and five minutes after intubation. The first group underwent topical anesthesia with Lidocaine 10% sprayed on the base of tongue and tonsillar pillar while the second group underwent trans tracheal and glossopharyngeal nerve block with simultaneous injection of Lidocaine 2%. Our results indicated that all hemodynamic parameters except for the pulse rate in both groups were significantly reduced after the intubation, which indicates the effectiveness of the interventions. However, the reduction in SBP, DBP, and MAP was significantly lower in the nerve block group compared to the Lidocaine spray group. Regarding the pulse rate, despite the significant decrease in the group of patients undergoing nerve block, those undergoing anesthesia with Lidocaine spray experienced a significant increase in the heart rate in the first minute after the operation. Finally, our research provides substantiation that employing a glossopharyngeal nerve block and trans tracheal block constitutes an efficacious method for local anesthetic during conscious intubation and can be a promising technique.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":"27 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140737873","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 : 2024-04-05DOI: 10.18502/acta.v61i9.15288
Masoomeh Nataj Majd, Asma Tahery, Raziyeh Erfani
The present study evaluates the association between epidural analgesia and the duration of the active phase of labor and pregnancy outcomes in mothers with high body mass index (BMI). All term pregnant women undergoing epidural analgesia for pain-free labor entered the study from September 2016 to March 2020. After recruiting 300 subjects into the study, mothers were categorized into six groups based on their BMI levels. Each BMI sub-group was analyzed regarding the duration of the active phase of labor and delivery mode. In addition, the relationship between BMI and labor outcome and characteristics was studied. Overall, 300 laboring women with epidural analgesia were included. 79.3% had a vaginal delivery, and 20.7% undergo cesarean section. Different BMI sub-groups showed no significant difference regarding the duration of the active phase of labor under epidural analgesia. Cox regression analysis revealed that BMI had no significant effect on the length of the active phase of labor (P=0.787). No significant association was found between BMI and the cesarean delivery rate, uterine atony, maternal pyrexia, neonatal Apgar score, and NICU hospitalization rate. However, BMI was significantly associated with the incidence of dystocia and headache. labor with dystocia exhibited a significantly higher Mother’s BMI (P<0.05). The results suggest no significant association between epidural analgesia and the active phase of labor duration in mothers with high BMI.
{"title":"Evaluation of the Effect of Body Mass Index on Labor Progress in Mothers Undergoing Epidural Analgesia: A Double-Blind Randomized Clinical Trial","authors":"Masoomeh Nataj Majd, Asma Tahery, Raziyeh Erfani","doi":"10.18502/acta.v61i9.15288","DOIUrl":"https://doi.org/10.18502/acta.v61i9.15288","url":null,"abstract":"The present study evaluates the association between epidural analgesia and the duration of the active phase of labor and pregnancy outcomes in mothers with high body mass index (BMI). All term pregnant women undergoing epidural analgesia for pain-free labor entered the study from September 2016 to March 2020. After recruiting 300 subjects into the study, mothers were categorized into six groups based on their BMI levels. Each BMI sub-group was analyzed regarding the duration of the active phase of labor and delivery mode. In addition, the relationship between BMI and labor outcome and characteristics was studied. Overall, 300 laboring women with epidural analgesia were included. 79.3% had a vaginal delivery, and 20.7% undergo cesarean section. Different BMI sub-groups showed no significant difference regarding the duration of the active phase of labor under epidural analgesia. Cox regression analysis revealed that BMI had no significant effect on the length of the active phase of labor (P=0.787). No significant association was found between BMI and the cesarean delivery rate, uterine atony, maternal pyrexia, neonatal Apgar score, and NICU hospitalization rate. However, BMI was significantly associated with the incidence of dystocia and headache. labor with dystocia exhibited a significantly higher Mother’s BMI (P<0.05). The results suggest no significant association between epidural analgesia and the active phase of labor duration in mothers with high BMI.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":"15 S4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140737343","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 : 2024-04-05DOI: 10.18502/acta.v61i9.15282
Majid Akrami, Hadiseh Hosamirudsari, Neda Faraji, Masoomeh Nataj Majd
Given that the risk factors associated with mortality and morbidity of Coronavirus Disease (COVID-19) vary among age groups, this study aimed to describe the differences in clinical characteristics and mortality-related risk factors between elderly and middle-aged COVID-19 patients. A total of 1061 patients were included in this retrospective cohort study. Patients’ radiology reports and laboratory data were extracted from the available data on the Hospital Information System (HIS), and clinical findings were added in special forms. We followed up cases until death or discharge to evaluate patients’ outcomes. Chronic obstructive pulmonary disease (COPD) (95% CI, HR 2.73 (0.97-6.62)), need for antibiotics (95% CI, HR 2.26 (1.20-4.26)), and diabetes (95% CI, HR 1.77 (0.97-3.24)) were associated with a higher risk of mortality among middle-aged COVID-19 patients; while, age (95% CI, HR 1.04 (1.01-1.06)) was associated with increased mortality rate in elderly patients. We found that the need for antibiotics was associated with a worse outcome of COVID-19. Additionally, we described the differences between elderly and middle-aged COVID-19 patients regarding their comorbidities, laboratory findings, and clinical manifestation.
{"title":"Comparison of Clinical Manifestation and Mortality-Related Risk Factors Between Elderly and Middle-Aged COVID-19 Patients","authors":"Majid Akrami, Hadiseh Hosamirudsari, Neda Faraji, Masoomeh Nataj Majd","doi":"10.18502/acta.v61i9.15282","DOIUrl":"https://doi.org/10.18502/acta.v61i9.15282","url":null,"abstract":"Given that the risk factors associated with mortality and morbidity of Coronavirus Disease (COVID-19) vary among age groups, this study aimed to describe the differences in clinical characteristics and mortality-related risk factors between elderly and middle-aged COVID-19 patients. A total of 1061 patients were included in this retrospective cohort study. Patients’ radiology reports and laboratory data were extracted from the available data on the Hospital Information System (HIS), and clinical findings were added in special forms. We followed up cases until death or discharge to evaluate patients’ outcomes. Chronic obstructive pulmonary disease (COPD) (95% CI, HR 2.73 (0.97-6.62)), need for antibiotics (95% CI, HR 2.26 (1.20-4.26)), and diabetes (95% CI, HR 1.77 (0.97-3.24)) were associated with a higher risk of mortality among middle-aged COVID-19 patients; while, age (95% CI, HR 1.04 (1.01-1.06)) was associated with increased mortality rate in elderly patients. We found that the need for antibiotics was associated with a worse outcome of COVID-19. Additionally, we described the differences between elderly and middle-aged COVID-19 patients regarding their comorbidities, laboratory findings, and clinical manifestation.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":"36 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140738101","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 : 2024-04-05DOI: 10.18502/acta.v61i9.15280
R. S. Moharari, Maryam Hatam, Pardis Emami, Mohamadreza Neishaboury, Seyed Hamidreza Sharifnia, F. Etezadi, Mohammad Shirani, A. Najafi, Pejman Pourfakhr
In craniotomy surgery, it is important to maintain hemodynamics and prevent the increase of intracranial pressure. Using semi-invasive methods such as LiDCO monitoring is a good option in this situation. This study aimed to evaluate the effectiveness of mannitol and hypertonic sodium on hemodynamic parameters in patients undergoing elective craniotomy. This randomized clinical trial was done on 40 patients of both genders. Patients whose ages were between 18-65 years, who had American Society of Anesthesiologists (ASA) score I and II, and who underwent craniotomy surgery were eligible for this study. Participants were divided into two groups receiving hypertonic sodium and mannitol. Hemodynamic parameters were evaluated before surgery, 20 minutes, and 60 minutes after surgery in both groups, under Lithium dilution cardiac output (LiDCO) monitoring. The results showed that there was no difference between groups in terms of the average fluid intake, the duration of the operation, the amount of urinary output, and the primary hemodynamic characteristics. Significant differences were recorded in the evaluation of hemodynamic parameters. The results demonstrated a reduction in systolic, diastolic, and mean arterial blood pressure during 20 to 60 minutes after mannitol injection compared to hypertonic sodium injection. Additionally, the effectiveness of both therapies on maintaining cardiac function was similar, but the use of mannitol led to a greater decrease in arterial and peripheral vascular resistance. It can be concluded that mannitol may be more effective than hypertonic sodium during craniotomy procedures in terms of reducing blood pressure monitored with LiDCO.
{"title":"The Effect of Mannitol and Hypertonic Sodium Administration on Hemodynamic Parameters Under LiDCO Monitoring in Patients Undergoing Elective Craniotomy","authors":"R. S. Moharari, Maryam Hatam, Pardis Emami, Mohamadreza Neishaboury, Seyed Hamidreza Sharifnia, F. Etezadi, Mohammad Shirani, A. Najafi, Pejman Pourfakhr","doi":"10.18502/acta.v61i9.15280","DOIUrl":"https://doi.org/10.18502/acta.v61i9.15280","url":null,"abstract":"In craniotomy surgery, it is important to maintain hemodynamics and prevent the increase of intracranial pressure. Using semi-invasive methods such as LiDCO monitoring is a good option in this situation. This study aimed to evaluate the effectiveness of mannitol and hypertonic sodium on hemodynamic parameters in patients undergoing elective craniotomy. This randomized clinical trial was done on 40 patients of both genders. Patients whose ages were between 18-65 years, who had American Society of Anesthesiologists (ASA) score I and II, and who underwent craniotomy surgery were eligible for this study. Participants were divided into two groups receiving hypertonic sodium and mannitol. Hemodynamic parameters were evaluated before surgery, 20 minutes, and 60 minutes after surgery in both groups, under Lithium dilution cardiac output (LiDCO) monitoring. The results showed that there was no difference between groups in terms of the average fluid intake, the duration of the operation, the amount of urinary output, and the primary hemodynamic characteristics. Significant differences were recorded in the evaluation of hemodynamic parameters. The results demonstrated a reduction in systolic, diastolic, and mean arterial blood pressure during 20 to 60 minutes after mannitol injection compared to hypertonic sodium injection. Additionally, the effectiveness of both therapies on maintaining cardiac function was similar, but the use of mannitol led to a greater decrease in arterial and peripheral vascular resistance. It can be concluded that mannitol may be more effective than hypertonic sodium during craniotomy procedures in terms of reducing blood pressure monitored with LiDCO.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":"7 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140736942","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 : 2024-04-05DOI: 10.18502/acta.v61i9.15286
Fariba Mansouri, Majid Akrami, Neda Faraji, Masoomeh Nataj Majd
Early commencement of enteral nutrition (EEN) in critically ill patients requiring mechanical ventilation may improve outcomes. But there is a lack of enough data regarding EEN effects on COPD exacerbation patients’ outcomes. This retrospective study involved 129 COPD exacerbation patients who received invasive mechanical ventilation in ICU. The clinical outcomes were compared based on the timing of enteral nutrition (<48h vs >48h) during 60 days of ICU stay. We surveyed and analyzed mortality, pleural effusion, ventilator-associated pneumonia, weaning failure, cardiac arrhythmias, GI bleeding, electrolyte imbalances, renal dysfunction and length of ICU stay. All analyses were performed using SPSS software version 22.0. 129 COPD-exacerbated patients (EEN group n=66; DEN group n=63) who met the inclusion criteria were enrolled in the study. EEN group had a lower death rate (39% vs 44.4%) than the DEN group, but no significant difference was found in the overall mortality during the 60-day follow-up (P 0.561). The EEN group also had lower ICU stay and pleural effusion rate than the DEN group (P:0.006 and 0.020 respectively). No significant differences were found in other outcomes. Early enteral nutrition might be associated with shorter ICU stay and lower odd ratio of acquisition of pleural effusion in COPD patients requiring invasive mechanical ventilation. EEN could not decrease mortality rate compared with DEN in the current study.
需要机械通气的重症患者尽早开始肠内营养（EEN）可改善预后。但有关肠内营养对慢性阻塞性肺病恶化患者预后的影响，目前还缺乏足够的数据。这项回顾性研究涉及 129 名在重症监护室接受有创机械通气的慢性阻塞性肺病恶化患者。在重症监护室住院 60 天期间，根据肠内营养的时间（48 小时）对临床结果进行了比较。我们调查并分析了死亡率、胸腔积液、呼吸机相关肺炎、断奶失败、心律失常、消化道出血、电解质失衡、肾功能障碍和重症监护室住院时间。所有分析均使用 SPSS 软件 22.0 版进行。符合纳入标准的 129 名慢性阻塞性肺疾病加重患者（EEN 组 66 人；DEN 组 63 人）被纳入研究。EEN 组的死亡率（39% vs 44.4%）低于 DEN 组，但在 60 天随访期间的总死亡率没有发现显著差异（P 0.561）。EEN 组的重症监护室住院率和胸腔积液率也低于 DEN 组（P:0.006 和 0.020）。其他结果无明显差异。早期肠内营养可能与需要有创机械通气的慢性阻塞性肺病患者较短的重症监护室住院时间和较低的胸腔积液发生率有关。在本研究中，与 DEN 相比，EEN 无法降低死亡率。
{"title":"Early Enteral Nutrition and Clinical Outcomes in COPD Patients Requiring Mechanical Ventilation","authors":"Fariba Mansouri, Majid Akrami, Neda Faraji, Masoomeh Nataj Majd","doi":"10.18502/acta.v61i9.15286","DOIUrl":"https://doi.org/10.18502/acta.v61i9.15286","url":null,"abstract":"Early commencement of enteral nutrition (EEN) in critically ill patients requiring mechanical ventilation may improve outcomes. But there is a lack of enough data regarding EEN effects on COPD exacerbation patients’ outcomes. This retrospective study involved 129 COPD exacerbation patients who received invasive mechanical ventilation in ICU. The clinical outcomes were compared based on the timing of enteral nutrition (<48h vs >48h) during 60 days of ICU stay. We surveyed and analyzed mortality, pleural effusion, ventilator-associated pneumonia, weaning failure, cardiac arrhythmias, GI bleeding, electrolyte imbalances, renal dysfunction and length of ICU stay. All analyses were performed using SPSS software version 22.0. 129 COPD-exacerbated patients (EEN group n=66; DEN group n=63) who met the inclusion criteria were enrolled in the study. EEN group had a lower death rate (39% vs 44.4%) than the DEN group, but no significant difference was found in the overall mortality during the 60-day follow-up (P 0.561). The EEN group also had lower ICU stay and pleural effusion rate than the DEN group (P:0.006 and 0.020 respectively). No significant differences were found in other outcomes. Early enteral nutrition might be associated with shorter ICU stay and lower odd ratio of acquisition of pleural effusion in COPD patients requiring invasive mechanical ventilation. EEN could not decrease mortality rate compared with DEN in the current study.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140739900","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 : 2024-02-18DOI: 10.18502/acta.v61i8.14902
Behrooz Amirzargar, M. Fattahi, E. Lotfali, Alireza Firooz, A. Mohammadi, Ali Khamesipoor
Otomycosis is one of the overwhelming diseases both for patients and specialists with a high recurrence rate despite adequate and proper treatment. This study aims to investigate further the various types of fungi involved in otomycosis and test their susceptibility against common antifungals. In total, among candidiasis-suspected patients, 60 samples were incorporated into the study. PCR method was used for Candida species detection. Broth microdilution method of Clinical and Laboratory Standards Institute document M60 was applied to assess MIC values of rampant antifungals. We used SPSS software (version 16.0) for statistical analysis. In this survey, 20, 3, and 1 type of Candida albicans, Candida parapsilosis, and Candida glabrata were identified, respectively. All 20 C. albicans isolates were sensitive to amphotericin B (range 0.03-1 μg/ml), voriconazole, (0.03-1 μg/ml), and itraconazole (0.03-0.5 μg/ml.); moreover, one isolate was resistant to fluconazole. Two isolates out of three isolates of C. parapsilosis, were susceptible to all agents while the other one isolate was resistant to fluconazole. C. glabrata isolate was susceptible to all agents. In summary, the results conveyed the importance of clinicians remaining vigilant in diagnosing otomycosis due to its non-specific manifestations. To manage effectively otomycosis and avoid complications or recurrence, it is imperative to diagnose the condition at the earliest time, confirm its virulence through various tests, and identify antifungal susceptibility patterns. Despite this, relapse is often seen and achieving complete remission can prove to be a major hurdle in individuals who have had mastoidectomy and those with weakened immune systems.
{"title":"Isolation, Characterization, and Antifungal Sensitivity Pattern of Candida Species Causing Otomycosis","authors":"Behrooz Amirzargar, M. Fattahi, E. Lotfali, Alireza Firooz, A. Mohammadi, Ali Khamesipoor","doi":"10.18502/acta.v61i8.14902","DOIUrl":"https://doi.org/10.18502/acta.v61i8.14902","url":null,"abstract":"Otomycosis is one of the overwhelming diseases both for patients and specialists with a high recurrence rate despite adequate and proper treatment. This study aims to investigate further the various types of fungi involved in otomycosis and test their susceptibility against common antifungals. In total, among candidiasis-suspected patients, 60 samples were incorporated into the study. PCR method was used for Candida species detection. Broth microdilution method of Clinical and Laboratory Standards Institute document M60 was applied to assess MIC values of rampant antifungals. We used SPSS software (version 16.0) for statistical analysis. In this survey, 20, 3, and 1 type of Candida albicans, Candida parapsilosis, and Candida glabrata were identified, respectively. All 20 C. albicans isolates were sensitive to amphotericin B (range 0.03-1 μg/ml), voriconazole, (0.03-1 μg/ml), and itraconazole (0.03-0.5 μg/ml.); moreover, one isolate was resistant to fluconazole. Two isolates out of three isolates of C. parapsilosis, were susceptible to all agents while the other one isolate was resistant to fluconazole. C. glabrata isolate was susceptible to all agents. In summary, the results conveyed the importance of clinicians remaining vigilant in diagnosing otomycosis due to its non-specific manifestations. To manage effectively otomycosis and avoid complications or recurrence, it is imperative to diagnose the condition at the earliest time, confirm its virulence through various tests, and identify antifungal susceptibility patterns. Despite this, relapse is often seen and achieving complete remission can prove to be a major hurdle in individuals who have had mastoidectomy and those with weakened immune systems.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":"4 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139959667","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 : 2024-02-18DOI: 10.18502/acta.v61i8.14905
Nour Mohammad Panahi, Hamidreza Khosravi, Seyed Reza Hosseini, A. Bijani, Gholamabbas Roustaei, Mehrnoosh Ghasemi, E. Mekaniki, Reza Ghadimi, S. A. Rasoulinejad
Sleep disorders are more common in diabetes mellitus (DM) cases rather than normal ones. In addition, this condition could be associated with diabetic retinopathy (DR) development with more inflammatory indices in circulation. In the present study, we have evaluated the association between DR and sleep quality. This cross-sectional study is a part of the second phase of the study of the elderly cohort of Amirkola City, which was conducted in 2015-2016 on all people aged 60 and higher. Of all diabetic cases, 44 cases had retinopathy and were selected as the case group. To compare two control groups, 135 diabetic patients without retinopathy and 135 people without diabetes were randomly selected. The presence and type of retinopathy were determined based on an eye physical examination by an ophthalmologist. In addition, sleep quality was evaluated based on the Pittsburgh Questionnaire. The obtained data were analyzed by ANOVA, t-test, and linear regression tests. In the present study, there was a significant difference in the score of the Pittsburgh questionnaire between people with DR (45.5±68.2) compared to diabetic people without retinopathy (76.5±48.2) and people without diabetes (95.4±36.2) (P=0.470), but diabetic people without retinopathy had significantly worse sleep quality than people without diabetes (P=0.019). Also, sleep quality in women with DR was worse than in men (P=014). In the linear regression analysis, it was observed that age, gender, diabetes, and history of depression significantly affect the sleep quality of the evaluated cases (P<0.05 for all). According to the results of the present study, DR does not negatively influence the quality of sleep, and DR is not related to sleep disorders.
{"title":"Association of Diabetic Retinopathy and Sleep Quality","authors":"Nour Mohammad Panahi, Hamidreza Khosravi, Seyed Reza Hosseini, A. Bijani, Gholamabbas Roustaei, Mehrnoosh Ghasemi, E. Mekaniki, Reza Ghadimi, S. A. Rasoulinejad","doi":"10.18502/acta.v61i8.14905","DOIUrl":"https://doi.org/10.18502/acta.v61i8.14905","url":null,"abstract":"Sleep disorders are more common in diabetes mellitus (DM) cases rather than normal ones. In addition, this condition could be associated with diabetic retinopathy (DR) development with more inflammatory indices in circulation. In the present study, we have evaluated the association between DR and sleep quality. This cross-sectional study is a part of the second phase of the study of the elderly cohort of Amirkola City, which was conducted in 2015-2016 on all people aged 60 and higher. Of all diabetic cases, 44 cases had retinopathy and were selected as the case group. To compare two control groups, 135 diabetic patients without retinopathy and 135 people without diabetes were randomly selected. The presence and type of retinopathy were determined based on an eye physical examination by an ophthalmologist. In addition, sleep quality was evaluated based on the Pittsburgh Questionnaire. The obtained data were analyzed by ANOVA, t-test, and linear regression tests. In the present study, there was a significant difference in the score of the Pittsburgh questionnaire between people with DR (45.5±68.2) compared to diabetic people without retinopathy (76.5±48.2) and people without diabetes (95.4±36.2) (P=0.470), but diabetic people without retinopathy had significantly worse sleep quality than people without diabetes (P=0.019). Also, sleep quality in women with DR was worse than in men (P=014). In the linear regression analysis, it was observed that age, gender, diabetes, and history of depression significantly affect the sleep quality of the evaluated cases (P<0.05 for all). According to the results of the present study, DR does not negatively influence the quality of sleep, and DR is not related to sleep disorders.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":"3 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139959243","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 : 2024-02-18DOI: 10.18502/acta.v61i8.14900
M. Karimi-Zarchi, Soheila Sayad, Mohammad Vakili, Ahmad Shirinzadeh-Dastgiri, Amirhossein Naseri, M. Antikchi, Sepideh Azizi, K. Aghili, Hossein Neamatzadeh, E. Akbarian
The coronavirus disease 2019 (COVID-19) pandemic is the main challenges to public health systems worldwide now. Cancer patients are considered as a high risk group during the COVID-19 pandemic. Considering the evidence so far, cancer as underlying comorbidities might increase the risk of death in patients with COVID-19. Many cancer patients with increased risk of contracting COVID-19 than the general population regularly visit health facilities for treatment and disease surveillance. Thus, the COVID-19 pandemic has a profound impact on cancer care and treatment. Here, we attempted to summarize the current suggestions for handling of cancer patients during COVID-19 pandemic. We carried out a integrative literature review using several online bibliographies. A total of 113 papers were accessed for the time frame between October 05 2020 and October 10 2020. After screening of titles and full-texts, 10 publications were selected in this study. In this work some recommendations and guidelines that would help for management and treatment of cancer for the purpose of address the challenges during COVID-19 pandemic were collected. We hope that this collection recommendations and guidelines assist health care providers in management of individuals with underlying malignancy during the COVID-19 pandemic.
{"title":"A Collect of Recommendations and Guidelines for Management and Treatment of Underlying Malignancies During the COVID-19 Pandemic","authors":"M. Karimi-Zarchi, Soheila Sayad, Mohammad Vakili, Ahmad Shirinzadeh-Dastgiri, Amirhossein Naseri, M. Antikchi, Sepideh Azizi, K. Aghili, Hossein Neamatzadeh, E. Akbarian","doi":"10.18502/acta.v61i8.14900","DOIUrl":"https://doi.org/10.18502/acta.v61i8.14900","url":null,"abstract":"The coronavirus disease 2019 (COVID-19) pandemic is the main challenges to public health systems worldwide now. Cancer patients are considered as a high risk group during the COVID-19 pandemic. Considering the evidence so far, cancer as underlying comorbidities might increase the risk of death in patients with COVID-19. Many cancer patients with increased risk of contracting COVID-19 than the general population regularly visit health facilities for treatment and disease surveillance. Thus, the COVID-19 pandemic has a profound impact on cancer care and treatment. Here, we attempted to summarize the current suggestions for handling of cancer patients during COVID-19 pandemic. We carried out a integrative literature review using several online bibliographies. A total of 113 papers were accessed for the time frame between October 05 2020 and October 10 2020. After screening of titles and full-texts, 10 publications were selected in this study. In this work some recommendations and guidelines that would help for management and treatment of cancer for the purpose of address the challenges during COVID-19 pandemic were collected. We hope that this collection recommendations and guidelines assist health care providers in management of individuals with underlying malignancy during the COVID-19 pandemic.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139959258","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 : 2024-02-18DOI: 10.18502/acta.v61i8.14903
Razieh Rezaeianpour, Ramin Lotfi, Seyed Hamidreza Mortazavi, A. G. Karaji, Alireza Rezaiemanesh, Farhad Salari
Allergic rhinitis (AR) is a chronic inflammatory disease involving the nasal mucosa. Leukocytes recruitment to the inflammation sites is controlled by chemokines, cytokines, and adhesion molecules. Retinoic acid (RA), a vitamin A metabolite, plays an essential role in mucosal immunity and the production of inflammatory cytokines and chemokines. This study intended to evaluate the serum levels of RA, CCL17, CCL22, CCL28, and the mRNA expression levels of α4, β1, and β7 integrins in AR patients compared to healthy subjects. Peripheral blood was collected from 37 patients with AR and 30 age- and gender-matched healthy individuals. Serum levels of RA, CCL17, CCL22, and CCL28 were measured by the enzyme-linked immunosorbent assay (ELISA) technique, and the mRNA expression levels for α4, β1, and β7 integrins were assessed using the quantitative real-time PCR method. Our results showed that the serum levels of CCL22 and CCL28 chemokines are significantly higher in the AR group compared to the healthy controls (P<0.01). However, the gene expression of the β1 integrin in the AR group was significantly lower than that of the control group (P<0.001). Besides, there was a positive association between serum RA and CCL17 levels in patients (P<0.0001, r=0.6). In conclusion, increased serum levels of CCL22 and CCL28 chemokines, as well as decreased gene expression of β1 integrin in AR patients, may contribute to the pathogenesis and/or exacerbation of AR.
{"title":"Evaluating the Serum Levels of CCL17, CCL22, and CCL28 Chemokines and the Gene Expression of α4β1 and α4β7 Integrins in Patients With Allergic Rhinitis","authors":"Razieh Rezaeianpour, Ramin Lotfi, Seyed Hamidreza Mortazavi, A. G. Karaji, Alireza Rezaiemanesh, Farhad Salari","doi":"10.18502/acta.v61i8.14903","DOIUrl":"https://doi.org/10.18502/acta.v61i8.14903","url":null,"abstract":"Allergic rhinitis (AR) is a chronic inflammatory disease involving the nasal mucosa. Leukocytes recruitment to the inflammation sites is controlled by chemokines, cytokines, and adhesion molecules. Retinoic acid (RA), a vitamin A metabolite, plays an essential role in mucosal immunity and the production of inflammatory cytokines and chemokines. This study intended to evaluate the serum levels of RA, CCL17, CCL22, CCL28, and the mRNA expression levels of α4, β1, and β7 integrins in AR patients compared to healthy subjects. Peripheral blood was collected from 37 patients with AR and 30 age- and gender-matched healthy individuals. Serum levels of RA, CCL17, CCL22, and CCL28 were measured by the enzyme-linked immunosorbent assay (ELISA) technique, and the mRNA expression levels for α4, β1, and β7 integrins were assessed using the quantitative real-time PCR method. Our results showed that the serum levels of CCL22 and CCL28 chemokines are significantly higher in the AR group compared to the healthy controls (P<0.01). However, the gene expression of the β1 integrin in the AR group was significantly lower than that of the control group (P<0.001). Besides, there was a positive association between serum RA and CCL17 levels in patients (P<0.0001, r=0.6). In conclusion, increased serum levels of CCL22 and CCL28 chemokines, as well as decreased gene expression of β1 integrin in AR patients, may contribute to the pathogenesis and/or exacerbation of AR.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":"1 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139959203","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 : 2024-02-18DOI: 10.18502/acta.v61i8.14907
Minoo Rostami, P. Hekmati, Mohsen Ebrahimnezhad, Hossein Amirzargar, Abdolmohamad Kajbafzadeh
Fibrous hamartoma of infancy is a rare benign tumor that’s mainly detected in the upper trunk. In this study authors report a 1-year-old case of perianal fibrous hamartoma which was successfully managed without need to orchidectomy or urethral manipulation.
{"title":"Perineal Mass in One-Year-Old Boy: Rare Presentation of Fibrous Hamartoma of Infancy","authors":"Minoo Rostami, P. Hekmati, Mohsen Ebrahimnezhad, Hossein Amirzargar, Abdolmohamad Kajbafzadeh","doi":"10.18502/acta.v61i8.14907","DOIUrl":"https://doi.org/10.18502/acta.v61i8.14907","url":null,"abstract":"Fibrous hamartoma of infancy is a rare benign tumor that’s mainly detected in the upper trunk. In this study authors report a 1-year-old case of perianal fibrous hamartoma which was successfully managed without need to orchidectomy or urethral manipulation.","PeriodicalId":6946,"journal":{"name":"Acta medica Iranica","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139959324","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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