Pir-Hossein Kolivand; Hassanali Faraji Sabokbar; Peyman Saberian; Mahdi Bahmanabadi; Parisa Hasani-Sharamin; Alireza Baratloo
Volume 22, Issue 7 , 2020
Abstract
Objectives: We intended to map the geographical distribution of patients with acute stroke who called the Tehran EMS center based on the geographic information of the incident location on a map. The distributions of these centers and patients access within a standard period were evaluated.
Methods: ...
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Objectives: We intended to map the geographical distribution of patients with acute stroke who called the Tehran EMS center based on the geographic information of the incident location on a map. The distributions of these centers and patients access within a standard period were evaluated.
Methods: A cross-sectional study based on the registered data was conducted on suspected acute stroke patients > 18 years of age that were transferred by EMS. The analysis was performed based on pointing the patients locations and locating the hospitals in ArcGIS software plus a review of the polygons and focal points.
Results: Totally, 1,606 patients suspected to stroke with a mean age of 64.89 ± 17.48 years were evaluated, of whom 947 (58.6%) were
male. The mean time of arrival of an ambulance in the patients location from the EMS station was 11.94 ± 6.67 minutes, and the longest time was 69.32 minutes. The mean time from the patients location to the stroke center was 17.79 ± 11.42 minutes (range 2.4 - 83.70 minutes). Stroke centers in Tehran are not distributed in a balanced manner, and they are concentrated on the central and northern parts of Tehran, limiting access to hospital services.
Conclusions: The multiplicity of hospitals in the west and center of Tehran led to an increase in access times in eastern Tehran. It
emphasizes the necessity of revision of service locating, especially because the east of Tehran has a denser texture than the west.
Ya-Chen An; Yu-Xun Wang; Yan-Ru Jiang; Yan-Zheng Li; Jing-Yu Feng; Song-Xin Shi; Jing-Jun Chen
Volume 22, Issue 7 , 2020
Abstract
Background: Ischemic stroke is a major cause of disability and mortality in patients with type 2 diabetes mellitus (T2DM), and diabetic stroke has a high recurrence rate.
Objectives: This prospective cohort study aimed at investigating the risk factors and establishing Coxs regression model and per- ...
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Background: Ischemic stroke is a major cause of disability and mortality in patients with type 2 diabetes mellitus (T2DM), and diabetic stroke has a high recurrence rate.
Objectives: This prospective cohort study aimed at investigating the risk factors and establishing Coxs regression model and per- sonal prognosis index for the recurrence of ischemic stroke at a two-year follow-up in T2DM patients.
Methods: T2DM patients with ischemic stroke, who were consecutively admitted to the Neurology Department of North China Uni- versity of Science and Technology Affiliated Hospital between January 1, 2015, and December 31, 2015, were retrospectively reviewed. These cases were followed up since the onset of ischemic stroke for 2 years. Univariate and multivariate Coxs proportional haz- ard regression model was used to analyze risk factors associated with the recurrence rate. Thus, a recurrence model and personal prognosis index were set up.
Results: During the follow-up period, 44 cases relapsed. Furthermore, the 1-year recurrence rate was 16.48%, while the 2-year recur- rence rate was 24.18%. The univariate and multivariate Cox proportional hazard regression model revealed that the independent risk factors associated with recurrence were TOAST criteria (X1) (RR = 1.663; 95% CI = 1.015 - 2.760, P = 0.032), hypertension grade (X2) (RR = 1.897; 95% CI = 1.097 - 3.280, P = 0.022), duration of diabetes mellitus (X3) (RR = 1.151; 95% CI = 1.009 - 1.991, P = 0.039), total cholesterol (X4) (RR = 1.13; 95% CI = 1.006 - 1.876, P = 0.035), and Essen stroke risk score (ESRS) (X5) (RR = 2.055; 95% CI = 1.357 - 3.134, P = 0.001). The
personal prognosis index of the recurrence model was as follows: PI = 0.504 X1 + 0.640 X2 + 0.345 X3 + 0.759 X4 + 0.823 X5. Conclusions: TOAST criteria, hypertension grade, duration of diabetes mellitus, total cholesterol, and ESRS were the independent risk factors associated with the recurrence of ischemic stroke with diabetes mellitus. The recurrence model and personal prognosis index equation were successfully established.
Iraj Alimohammadi; Fakhradin Ahmadi Kanrash; Shahram Vosoughi; Jamileh Abolaghasemi; Mohammad Hossein Chalak; Kazem Rahmani
Volume 22, Issue 7 , 2020
Abstract
Background: Noise is considered as one of the most significant and dangerous physical factors in work environments, and due to the advancement of industries, it has become a threat to physical and psychological health in the current era. In addition to its undesirable effects on the hearing system, noise ...
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Background: Noise is considered as one of the most significant and dangerous physical factors in work environments, and due to the advancement of industries, it has become a threat to physical and psychological health in the current era. In addition to its undesirable effects on the hearing system, noise can have harmful non-auditory effects that may cause physiological disorders and cognitive impairment.
Objectives: This study aimed to investigate the relationship between hearing loss and workers cognitive performance in an indus- trial environment.
Methods: A total of 300 individuals were enrolled in this study after their informed consent was obtained, and their compliance with the inclusion and exclusion criteria was confirmed. Based on the sound intensity level, the individuals were classified into two groups of exposure to > 85 dB (n = 196) and 85 dB (n = 104). To measure the individuals occupational exposure at an 8-hour equivalent level based on the ISO 9612: 2009 standard, the Testo device (Model CEL-815) was used with the precision of 0.5 dB. The most common weighting that is used in noise measurement is A-weighting. Like the human ear, this effectively cuts off the lower and higher frequencies that the average person cannot hear. The DANPLEX-AS54 device was also used to check audiometry. To investigate the workers hearing performance, two psychological tests, namely Stroop and TOL, were used as well.
Results: Hearing loss was higher among workers exposed to a sound intensity level of > 85 dB than those exposed to a sound in- tensity level of 85 dB, and this difference was significant in all sound level frequencies (NIHL left ear: for 85 dB: 25.92 and for
Conclusions: The results of this study showed that noise-induced hearing loss in work environments had a significant positive relationship with cognitive indicators. In other words, an increase in the hearing loss level would result in changes in cognitive indicators such as number of errors and response time.> 85 dB: 27.49) (NIHL right ear: for 85 dB: 27.62 and for > 85 dB: 29.50) (P value < 0.05). The results showed a significant positive relationship between cognitive indicators and hearing loss (P value < 0.05). Moreover, the study of cognitive indicators in the two groups revealed that the mean change of cognitive performance indicators was higher among subjects exposed to a higher sound intensity level (P value < 0.05).
Ali Ashraf Mozafari; Mohammad Ali Mansournia; Kourosh Sayehmiri; Bahareh Ghiasi; Mehdi Yaseri; Golnaz Azami
Volume 22, Issue 7 , 2020
Abstract
Background: Lipid disorders are a well-documented risk factor for chronic kidney disease (CKD), but the impact of lipid abnormal- ities in the progression of the disease remains mixed.
Objectives: The current study aimed to extend the existing knowledge about the effect of lipid disorders in disease ...
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Background: Lipid disorders are a well-documented risk factor for chronic kidney disease (CKD), but the impact of lipid abnormal- ities in the progression of the disease remains mixed.
Objectives: The current study aimed to extend the existing knowledge about the effect of lipid disorders in disease progression from moderate to severe stage using Flexible parametric survival models.
Methods: This retrospective cohort study included 308 moderate CKD patients who received the nephrologist follow-up visits at the nephrology clinic, Ilam (Iran), from 2012 to 2019. The survival time was determined based on the time medically diagnosed with moderate stages (GFR = 59 - 55 mL/min per 1.73 m2) to the time of progression to the severe stage (GFR = 29 - 25 mL/min per 1.73 m2) hazard using flexible parametric survival models.
Results: In univariate analysis, high levels of TG, LDL, and cholesterol were important risk factors which affect the CKD progression. The hazard of patients with TG > 200 mg/dL was 1.69 times higher than patients with desirable TG levels (P = 0.09). Moreover, for patients with LDL > 160 mg/dL, the hazard was 2.12 times higher than patients with desirable LDL levels (P = 0.01). The hazard of patients with total cholesterol levels > 240 mg/dL was 2.10 times higher than patients with desirable cholesterol levels (P = 0.003). The adjusted model was shown to better fit the PH model. Cholesterol levels > 240 mg/dL remains a significant risk factor for CKD progression (P = 0.03).
Conclusions: Effective treatment programs should pay closer attention to screening and treatment of hyperlipidemia in patients diagnosed with moderate CKD.
Elham Shafiei; Arash Nademi; Ali Ashraf Mozafari; Elham Bastani; Taleb Kokhazadeh; Kosar Yousefi; Ali Sahebi
Volume 22, Issue 7 , 2020
Abstract
Background: The incidence of limb fractures in children depends on environmental factors and socioeconomic backgrounds.
Objectives: This study aimed to evaluate the epidemiology of limb fractures in 1 to 15-year-old children in Ilam City, Iran. Methods: This retrospective study enrolled all children ...
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Background: The incidence of limb fractures in children depends on environmental factors and socioeconomic backgrounds.
Objectives: This study aimed to evaluate the epidemiology of limb fractures in 1 to 15-year-old children in Ilam City, Iran. Methods: This retrospective study enrolled all children aged 15 and below admitted to the Emam Khomeini Hospital of the Ilam University of Medical Sciences between July 2012 and March 2018. Data including age, sex, injury mechanism, and injured organs were recorded in SPSS software and analyzed using a chi-square test.
Results: Out of 4877 children, 74.3% were boys, and 25.7% were girls, with the men to women ratio of 2.87 and the mean age of 9.10± 4.3 years. Elbow and forearm with 39.35% and leg with 21.61% were the most common sites of fractures. Home, street, and sports fields were the commonplaces of injury with 50.7%, 28.3%, and 7.2%, respectively. The age range of 8 - 15 years, with 3693 cases (75.72%) was the most vulnerable age group. Fractures occurred mostly in spring and summer and less frequently in the other seasons.
Conclusions: Specific attention should be paid to the home environment and its safety for controlling injuries in preschool chil-
dren. This includes increasing parents knowledge of preventive measures. Moreover, improving the physical condition of pave- ments and crosswalks in the streets is necessary for the prevention of injuries.
Hossein Shahdosti; Seyed Reza Mazlom; Saeed Vaghee; Shahram Amini
Volume 22, Issue 7 , 2020
Abstract
Abstract
Background: Anxiety and depression are among the most important and common problems in patients admitted to the intensive care unit open-heart (ICU-OH). While the family plays a vital supportive role in decreasing these complications, patients are deprived of this supportive source ...
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Abstract
Background: Anxiety and depression are among the most important and common problems in patients admitted to the intensive care unit open-heart (ICU-OH). While the family plays a vital supportive role in decreasing these complications, patients are deprived of this supportive source during the important post-operative days due to visiting restrictions at these wards.
Objectives: Therefore, this study aimed to evaluate the role of online video visitations on the anxiety and depression of patients at ICU-OH.
Methods: This randomized clinical trial was carried out among 66 patients at ICU-OH of Imam Reza Hospital in Mashhad, Iran. The subjects were selected by the convenience sampling method and were randomly allocated to the intervention and control groups. Data were collected using a demographic characteristics checklist and HADS. In the intervention group, online video visitations with the family were carried out three times in the morning, evening and night on the second and third days of hospitalization in ICU-OH. In the control group, patients received the routine care of the ward and had no visitations with their families. Data were collected before the surgery, as well as 24 and 48 hours after admission to the ICU-OH. In addition, data analysis was performed in
SPSS using independent t-test, Mann-Whitney U test, paired t-test, and Chi-square test.
Results: No significant difference was observed between the intervention (7.8 ± 2.2) and control (8.3 ± 2.3) groups regarding the
mean anxiety score 24 hours after the intervention (P = 0.416). However, the mean anxiety scores 48 hours after the intervention were 6.1 ± 2.3 and 7.7 ± 2.6 in the intervention and control groups, respectively, showing a significant decrease in the intervention group, compared to the control group (P = 0.010). However, the mean depression scores 24 and 48 hours after the intervention were estimated at 8.0 ± 2.0 and 7.1 ± 2.0, respectively, demonstrating no significant difference from the control group (P = 0.933 and P =0.269).
Conclusions: According to the study results, online video visitations decreased anxiety in patients at ICU-OH. Therefore, it is recom- mended that this method be used as an alternative to in-person meetings of patients at this ward.
Samira Faraji; Rasoul Zarrin; Asma Zamanian; Reza Hajizadeh; Parvin Ayremlou; Behzad Rahimi
Volume 22, Issue 7 , 2020
Abstract
Background: Hypertension is one of the most serious global concerns since it has affected over 1.2 billion people.
Objectives: The present study aimed to determine the effect of vitamin D supplementation on blood pressure, fasting blood sugar, and lipid profile in hypertensive patients with ...
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Background: Hypertension is one of the most serious global concerns since it has affected over 1.2 billion people.
Objectives: The present study aimed to determine the effect of vitamin D supplementation on blood pressure, fasting blood sugar, and lipid profile in hypertensive patients with vitamin D deficiency.
Methods: In this double-blinded randomized placebo-controlled clinical trial study, 116 hypertensive patients (intervention and placebo groups, 58 each) with vitamin D deficiency (< 30 ng/mL with ECL) for 14 weeks, started from the beginning of autumn 2019 in Seyed-al-Shohada Educational Hospital in Urmia City. Fifty-five patients (49%) were male with the mean vitamin D 15.89 ± 5.09 ng/mL and 57 females with 17.29 ± 6.31 ng/mL. In a stratified blocked randomization scheme, the patients were randomly allocated into similar sized intervention and control groups based on body mass index (BMI), then the randomization with four block size was performed in each of strata by random allocation software. The intervention group received six doses of 50,000 IU vitamin D supplements for 6 weeks, then two supplements for two following months (one capsule per month). Blood pressure (24/h blood pressure measured by an ambulatory blood pressure monitoring device), vitamin D, FBS, and lipid profile (HDL, LDL, CL, and TG) were all measured at baseline and end of the study. Physical activity (measured by short IPAQ questionnaire), sun exposure using a questionnaire, dietary intake of vitamin D using three 24-hour recalls during the intervention, and anthropometric indices were measured at baseline, middle, and end of the study. Fifty-six patients in each group completed the study. The study was approved by the Ethics Committee of the Urmia University of Medical Sciences (ethics code: IR.UMSU.REC.1398.192).
Results: The office blood pressure, 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP), nighttime SBP and DBP were significantly reduced in the intervention group compared to the control group, whereas the reduction of daytime SBP and DBP was not statistically significant. Vitamin D supplementation significantly decreased serum triglyceride, cholesterol, and LDL levels.
Conclusions: Vitamin D supplementation had positive effects on blood pressure, triglyceride, cholesterol, and LDL levels in patients with low serum vitamin D.
Ahmad Amouzeshi; Seyyed Ali Moezi Bady; Vahid Nabati Bonyabadi
Volume 22, Issue 7 , 2020
Abstract
Background: Stroke as a complication of open-heart surgery can be a cause of death and widespread disability.
Objectives: This study aimed to determine the relationship between the SYNTAX Score and carotid artery stenosis and evaluate patients undergoing open-heart surgery in terms of postoperative ...
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Background: Stroke as a complication of open-heart surgery can be a cause of death and widespread disability.
Objectives: This study aimed to determine the relationship between the SYNTAX Score and carotid artery stenosis and evaluate patients undergoing open-heart surgery in terms of postoperative complications and mortality in a six-month to two-year follow- up period.
Methods: A cross-sectional study was conducted on 113 patients with CAD who underwent open-heart surgery at our hospital from 2016 to 2017. After collecting demographic data, the SYNTAX score, and color Doppler sonography report, the data were recorded and analyzed by SPSS22.
Results: In our study, most patients were male and aged between 50 and 70 years. The mean SYNTAX score was 32.667 + 13.668 in the group with significant carotid stenosis, 33.926 + 9.387 in the group with no significant carotid stenosis, and 30.868 + 9.963 in the group without carotid stenosis. The results showed no significant relationship between carotid artery stenosis and the SYNTAX score (P = 0.512) and no significant relationship between the SYNTAX score and surgical complications (P = 0.666).
Conclusions: According to the results, there is no significant relationship between the SYNTAX score and various indices related to heart disease, carotid artery stenosis, and postoperative morbidity and mortality. Thus, this index cannot be used to check and follow patients. However, further studies are needed to reach a definitive conclusion.
Victoria Momenabadi; Elham Goodarzi; Maryam Seraji; Ahmad Naghibzadeh-Tahami; Reza Beiranvand; Elham Nejadsadeghi; Maryam Zahmatkeshan; Leili Moayed; Zaher Khazaei
Volume 22, Issue 7 , 2020
Abstract
Background: Insufficient physical activity, particularly in low- and middle-income countries, plays an important role in the spread of non-communicable diseases.
Objectives: The purpose of this study is to investigate the insufficient physical activity and its relationship with the human devel- opment ...
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Background: Insufficient physical activity, particularly in low- and middle-income countries, plays an important role in the spread of non-communicable diseases.
Objectives: The purpose of this study is to investigate the insufficient physical activity and its relationship with the human devel- opment index (HDI) in the world.
Methods: This is an ecological study, and the study data, including the human development index and the incidence of insufficient physical activity, were extracted from the World Banks database. The descriptive analysis included mean and standard deviation. The inferential analysis consisted of two-way correlation and ANOVA at a significance level of less than 0.05. The analyses were performed using Stata-14 software.
Results: The highest insufficient physical activity in both sexes (39.26 [37.42, 40.95]) was found in the Americas, especially in high- income regions. There was a significant positive correlation between the incidence of insufficient physical inactivity and HDI in the world (r = 0.446, P < 0.0001). This correlation was also significant in Asia and Africa (P < 0.05). The results showed a positive correla- tion between components of HDI (i.e., gross national income per 1000 capita, mean years of schooling, life expectancy at birth, and expected years of schooling) and insufficient activity (P < 0.0001). The results of ANOVA also exhibited a significant relationship between the mean prevalence of physical inactivity and the level of development (P < 0.0001).
Conclusions: Given the significant correlation between the incidence of insufficient physical inactivity and HDI, understanding this correlation and its components, especially in low- and middle-income countries can alleviate the impact of physical inactivity epidemics in the future, thereby contributing to the effective global prevention of non-communicable diseases.
Maryam Seraji; Zaher Khazaei; Victoria Momenabadi; Reza Beiranvand; Ahmad Naghibzadeh-Tahami; Elham Nejadsadeghi; Maryam Zahmatkeshan; Leili Moayed; Elham Goodarzi
Volume 22, Issue 7 , 2020
Abstract
Background: Exposure to radiation is a major risk factor for skin cancer so that 65 to 90% of skin cancers can be attributed to the exposure with sunlight.
Objectives: The current study aimed to investigate the association between the human development index and the incidence of UV-related melanoma.
Methods: ...
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Background: Exposure to radiation is a major risk factor for skin cancer so that 65 to 90% of skin cancers can be attributed to the exposure with sunlight.
Objectives: The current study aimed to investigate the association between the human development index and the incidence of UV-related melanoma.
Methods: This is an ecological study. Data on the incidence of UV-induced melanoma were extracted from the GLOBOCAN estimates (GLOBOCAN 2012), and data on the human development index were extracted from the World Health Organization (WHO) database. Data analysis was conducted by Stata software (Ver. 14). The descriptive analysis involved mean and standard deviation. The corre- lation method was used to evaluate the association between the population attributable fraction (PAF) of melanoma for ultraviolet (UV) and the HDI components. A P value < 0.005 was considered as statistically significant.
Results: The results revealed a significant positive association between UV-attributable melanoma cancer and HDI in women (r = 0.401, P < 0.0001), men (r = 0.488, P < 0.0001), and both sexes (r = 0.455, P < 0.0001). In Americas (r = 0.452, P < 0.05) and Europe (r
= 0.740, P < 0.05), a significant positive correlation was observed between UV-induced melanoma and HDI, but this association was not significant in Asia (P > 0.05). In Africa, a negative correlation was observed, though it was not statistically significant (r = -0.301, P > 0.05). The results of the analysis of variance (ANOVA) showed a significant statistical relationship between the incidence of UV- related melanoma and the levels of development (F = 25.1, P < 0.0001) so that the higher the score of HDI, the higher the incidence of this cancer.
Conclusions: Since there is a positive correlation between UV-related melanoma and HDI, further attention should be paid to this risk factor, especially in countries with a high HDI to reduce the UV-induced melanoma cancer.
Paola Fugazzola; Francesco Favi; Matteo Tomasoni; Claudia Zaghi; Chiara Casadei; Enrico Prosperi; Giacomo Sermonesi; Davide Corbella; Federico Coccolini; Beniamino Pratico'; Vanni Agnoletti; Luca Ansaloni
Volume 22, Issue 7 , 2020
Abstract
Background: The Coronavirus Disease 2019 (COVID-19) pandemic has necessitated the alteration of the organization of entire hos- pitals to try to prevent them from becoming epidemiological clusters. The adopted diagnostic tools lack sensitivity or specificity. Objectives: The aim of the study was to create ...
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Background: The Coronavirus Disease 2019 (COVID-19) pandemic has necessitated the alteration of the organization of entire hos- pitals to try to prevent them from becoming epidemiological clusters. The adopted diagnostic tools lack sensitivity or specificity. Objectives: The aim of the study was to create an easy-to-get risk score (Ri.S.I.Co., risk score for infection with the new coronavirus) developed on the field to stratify patients admitted to hospitals according to their risk of COVID-19 infection.
Methods: In this prospective study, we included all patients who were consecutively admitted to the suspected COVID-19 depart- ment of the Bufalini Hospital, Cesena (Italy). All clinical, radiological, and laboratory predictors were included in the multivariate logistic regression model to create a risk model. A simplified model was internally and externally validated, and two score thresh- olds for stratifying the probability of COVID-19 infection were introduced.
Results: From 11th March to 5th April 2020, 200 patients were consecutively admitted. A Ri.S.I.Co lower than 2 showed a higher sensitivity than SARS-Cov-2 nucleic acid detection (96.2% vs. 65.4%; P < 0.001). The presence of ground-glass pattern on the lung-CT scan had a lower sensitivity than a Ri.S.I.Co lower than 2 (88.5% vs. 96.2%; P < 0.001) and a lower specificity than a Ri.S.I.Co higher than 6 (75.0% vs. 96.9%; P < 0.001).
Conclusions: We believe that the Ri.S.I.Co could allow to stratify admitted patients according to their risk, preventing hospitals from becoming the main COVID-19 carriers themselves. Furthermore, it could guide clinicians in starting therapies early in severe- onset cases with a high probability of COVID-19, before molecular SARS-CoV-2 infection is confirmed.
Reza Alizadeh-Navaei; Majid Saeedi; Reza Valadan; Fatemeh Roozbeh; Omolbanin Amjadi; Ehsan Zaboli; Mahmood Moosazadeh; Hossein Ranjbaran; Zinab Qazizadeh; Ali Akbari-Malekshah; Touraj Assadi; Versa Omrani-Nava; Akbar Hedayatizadeh-Omran
Volume 22, Issue 7 , 2020
Abstract
Background: Coronavirus is a single-stranded RNA virus, causing an epidemic of pneumonia and acute respiratory distress syn- drome (ARDS) worldwide in late 2019.
Objectives: In addition to the clinical symptoms, laboratory diagnosis can greatly help diagnose the diseases; therefore, this study aimed ...
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Background: Coronavirus is a single-stranded RNA virus, causing an epidemic of pneumonia and acute respiratory distress syn- drome (ARDS) worldwide in late 2019.
Objectives: In addition to the clinical symptoms, laboratory diagnosis can greatly help diagnose the diseases; therefore, this study aimed to analyze laboratory parameters in patients with COVID-19.
Methods: In this cross-sectional study, the laboratory data of 2563 patients with COVID-19 admitted to hospitals affiliated with Mazandaran University of Medical Sciences were extracted from hospital information systems (HIS). The data were recorded on Excel and analyzed through t-test, chi-squared, and Fishers exact tests in SPSS 19 at the significance level of P < 0.05.
Results: Out of 2563 patients with a mean age of 55.1 ± 16.7 years, 1409 (55%) were male, and 1154 (45%) were female with a mean age of 55.7 ± 16.8, and 54.3 ± 16.6 years, respectively. As the most frequent clinical findings, ESR, CRP, and LDH were increased by 83.5%, 71%, and 69.3% of the patients, respectively. Other research findings included lymphopenia, disturbed INR, abnormal SGOT, abnormal alkaline phosphatase (ALP), and increased lactate dehydrogenase (LDH), which were significantly higher in men than in women and was different between age groups.
Conclusions: Conducting simple, convenient, and inexpensive laboratory tests can be helpful in the diagnosis of COVID-19.
Zhe Zhang; Cong Wang; Zhengmao Guan; Hui Ma
Volume 22, Issue 6 , 2020
Abstract
Background: High dose intravenous (i.t.) injection of methylprednisolone (MPSS) for spinal cord injury (SCI) is clinically contro- versial.
Objectives: This study aimed to investigate whether i.t. MPSS would have a beneficial effect on SCI and whether or not it is a safe operation for SCI patients.
Methods: ...
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Background: High dose intravenous (i.t.) injection of methylprednisolone (MPSS) for spinal cord injury (SCI) is clinically contro- versial.
Objectives: This study aimed to investigate whether i.t. MPSS would have a beneficial effect on SCI and whether or not it is a safe operation for SCI patients.
Methods: An animal experiment was conducted to explore the safety and feasibility of i.t. Administration of MPSS. Male Sprague- Dawley rats were randomly divided into four groups: (1) sham group, i.t. injection of normal saline (NS) (n = 25); (2) control group, SCI surgery (created using the Infinite Horizon IH-400 impactor) with i.t. injection of NS (n = 25); (3) i.t. MPSS1 group, SCI with i.t. injection of MPSS by a pulse therapy (n = 25); (4) i.t. MPSS2 group, SCI with i.t. injection of MPSS intermittently (n = 25). Malondialde- hyde (MDA), superoxide dismutase (SOD), and inflammatory cytokines in serum were measured at 6h, 24h, 48h, 7d, and 14d after surgery with commercial assay kits. Glial fibrillary acidic protein (GFAP) level was observed at 14 days after surgery by immunohis- tochemistry. Motor evoked potentials (MEP) and somatosensory evoked potential (SEP) were monitored and recorded separately before surgery and 1, 7, and 14 days after surgery. Also, locomotor function was evaluated using the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale.
Results: The results showed that the levels of MDA and SOD, and three inflammatory cytokines, including IL-1b, IL-6, and TNF-?
were reduced in i.t. MPSS groups than that of the control group (all P < 0.05). The expression of GFAP was inhibited after i.t. MPSS treatment. The amplitude was reduced, and the latency period of SEP and MEP recovery was prolonged (all P < 0.05) after MPSS administration. In addition, the recovery of limb function (BBB score) was significantly ameliorated (P < 0.05) in SCI rats treated with MPSS compared with the control group.
Conclusions: Our results demonstrated that i.t. MPSS was a potential strategy for reducing the secondary damage after SCI, espe- cially the MPSS pulse therapy.
P?nar Kocaay
Volume 22, Issue 6 , 2020
Abstract
Introduction: 17 alpha-hydroxylase deficiency (17-OHD) is an infrequent autosomal recessive disorder in adrenal and gonadal steroidogenesis due to the CYP17A1 defect. Affected girls are characterized by delayed puberty, absence of secondary sex characteris- tics at puberty, and primary amenorrhea. Affected ...
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Introduction: 17 alpha-hydroxylase deficiency (17-OHD) is an infrequent autosomal recessive disorder in adrenal and gonadal steroidogenesis due to the CYP17A1 defect. Affected girls are characterized by delayed puberty, absence of secondary sex characteris- tics at puberty, and primary amenorrhea. Affected boys show female or ambiguous genitalia. Hormone imbalances result in varying degrees of hypertension and hypokalemia. The increase in corticosterone levels prevents the development of typical adrenal insuf- ficiency symptoms. Glucocorticoid and sex steroid supplementation is the preferred treatment.
Case Presentation: We reported two phenotypically female siblings, aged 14 and 25 years, with the 17-OHD from Ankara, the capital city of Turkey. The younger child had a 46,XX karyotype and the older had a 46,XY chromosome pattern. Another feature of the second patient (aged 25 years), was the presence of a large myelolipoma in her right adrenal gland.
Conclusions: 17 alpha-hydroxylase patients are usually diagnosed late, and unlike patients with other forms of congenital adrenal hyperplasia, hypertension is the major finding, and 10% - 15% of patients have normal blood pressure at diagnosis. The delay in diagnosis causes hypertension and renovascular changes, psychological problems, osteoporosis, and irreversible damage to breast tissue.
Bing-Bin He; Guo-Sheng Liu; Jia-Yong Zhuang; Bo-Ran Ye
Volume 22, Issue 6 , 2020
Abstract
Context: The purpose of this analysis was to explore the effects and safety of Pulmonary Surfactants (PS) combined with budesonide in Bronchopulmonary Dysplasia (BPD) by a meta-analysis of Randomized Controlled Trials (RCTs).
Evidence acquisition: Literature searches were performed in PubMed, the Cochrane ...
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Context: The purpose of this analysis was to explore the effects and safety of Pulmonary Surfactants (PS) combined with budesonide in Bronchopulmonary Dysplasia (BPD) by a meta-analysis of Randomized Controlled Trials (RCTs).
Evidence acquisition: Literature searches were performed in PubMed, the Cochrane Library, EMBASE, the China Knowledge Net- work, and the Wanfang database to collect data from RCTs. The primary outcomes were BPD incidence and BPD-related mortal- ity, while the secondary outcomes were BPD-related complications. Bias was evaluated by the Cochrane risk assessment tool. The RevMan 5.3 software was used for the meta-analysis, and the Eggers test was used for publication bias assessment.
Results: A total of 720 subjects were enrolled from six RCTs, including 352 in the experimental group and 368 in the observation group. The BPD incidence (RR = 0. 42, 95% CI [0. 37, 0. 89], P < 0.001) and BPD-related mortality (RR = 0.54, 95% CI [0.38, 0.89], P < 0.05) differed significantly between the two groups. Significant differences were also found in intraventricular hemorrhage, infection/sepsis, Retinopathy of Prematurity (ROP), and Patent Ductus Arteriosus (PDA). There were no significant differences in the incidence of PDA, Neonatal Necrotizing Enterocolitis (NEC), hyperglycemia, and hypertension.
Conclusions: The intratracheal instillation of pulmonary surfactants with budesonide can reduce the incidence of BPD and BPD- related mortality with no increased risk of short-term complications.
Raymond Dieu Kiat Yeak; Yee Yee Yap; Nizlan M. Nasir
Volume 22, Issue 6 , 2020
Abstract
Introduction: Nevus lipomatosus cutaneous superficialis (NLCS) is uncommon and can be encountered in various medical special- ties. In this study, we report a rare case of solitary pedunculated nevus lipomatosus cutaneous superficialis in a middle-aged female patient and highlight its clinical and histopathological ...
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Introduction: Nevus lipomatosus cutaneous superficialis (NLCS) is uncommon and can be encountered in various medical special- ties. In this study, we report a rare case of solitary pedunculated nevus lipomatosus cutaneous superficialis in a middle-aged female patient and highlight its clinical and histopathological features.
Case Presentation: A 43-year-old Malaysian female patient presented to our center with a 2-cm long and 1-cm wide solitary, flesh- colored nodule over the anterolateral aspect of her thigh. Excisional biopsy was performed, and the histopathology report showed NLCS. There are three types of NLCS, namely the solitary, multiple, and generalized forms. The etiology of NLCS is usually idiopathic, with no gender or familial preponderance. NLCS is usually misdiagnosed and should be differentiated from nevus sebaceous, con- nective tissue nevus, neurofibroma, lymphangioma, hemangioma, and focal dermal hypoplasia (also known as Goltz syndrome). Conclusions: In conclusion, NLCS is rare and benign condition, which should be differentiated from other malignant skin condi- tions as it is commonly misdiagnosed. Therefore, physicians and surgeons should be aware of its clinical and histopathological features.
Sara Zangiabadi; Shahrokh Navidpour; Hossein Zolfagharian; Gholamhassan Vaezi
Volume 22, Issue 6 , 2020
Abstract
Background:MesobuthuseupeusvenomisamemberofButhidaefamily,whichcanenterthebloodcirculationexertingdetrimental e?ectsonbodyorgans,suchastheliverandkidneythroughin?ammation. Cyclosporine,knownasananti-in?ammatorydrug,is usedtotreatmanyin?ammation-associateddiseases. Objectives: Inthisstudy,cyclosporinewasselectedtoinhibitthescorpiontoxine?ectsonratorgans.
...
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Background:MesobuthuseupeusvenomisamemberofButhidaefamily,whichcanenterthebloodcirculationexertingdetrimental e?ectsonbodyorgans,suchastheliverandkidneythroughin?ammation. Cyclosporine,knownasananti-in?ammatorydrug,is usedtotreatmanyin?ammation-associateddiseases. Objectives: Inthisstudy,cyclosporinewasselectedtoinhibitthescorpiontoxine?ectsonratorgans.
Methods: Thisexperimental studywas conductedinthe RaziVaccine andSerum ResearchInstitute, AgriculturalResearch EducationandExtensionOrganization,Karaj,Iran,fromJunetoNovember2019.Fiftymaleratswererandomlydividedinto?vegroupsof 10,includingthecontrol(10mg/kgoliveoili.p),M.eupeusvenom(10mg/kgi.p.),cyclosporine10mg/kg(venom10mg/kgfor30min i.pfollowedbycyclosporine10/kgmgfor7dayi.p.),cyclosporine20mg/kg(venom10mg/kgfor30mini.pfollowedbycyclosporine 20mg/kgfor7dayi.p.),andcyclosporine30mg/kg(venom10mg/kgfor30mini.pfollowedbycyclosporine30mg/kgfor7dayi.p.). Aftertreatmentwithcyclosporine,theliverandkidneyfunctionwasanalyzedbycalculatingsomebiochemicalenzymes,including serumglutamate-pyruvatetransaminase(SGPT),serumglutamicoxaloacetictransaminase(SGOT),nitricoxide(NO),interleukin-2 (IL-2), malondialdehyde(MDA), creatinine, andurea viaELISAand spectrophotometry. Then, to determinethe rateof apoptosis in tissue,terminaldeoxynucleotidyltransferase-mediateddUTPnick-endlabelingmethodwasdone. Results:Attheendof thestudy,theresultsshowedasigni?cantelevationinSGPT(164.5±10vs.126.2±7,P< 0.0001),SGOT(190.37 ±11vs. 148±10,P< 0.0001),NO(24.4±1.17vs. 17.4±1.4,P=0.02),andMDA(0.42±0.05vs. 0.22±0.04,P< 0.0001)inthevenom groupcomparedwiththecontrolgroup. Therewerenosigni?cantdi?erencesintheurea,IL-2,andcreatininebetweenthevenom andcontrolgroups.However,thegroupreceivingcyclosporine(30mg/kg)showedasigni?cantdeclineinSGPT(96.42±5.7vs.164.5 ±10, P < 0.0001), SGOT (144.57±9.24 vs. 190.37±11, P < 0.0001), urea (28.83±1.32 vs. 38.83±1.6, P = 0.00), creatinine (0.023± 0.01vs. 0.29±0.005,P< 0.0001),andMDA(0.10±0.01vs. 0.42±0.05,P< 0.0001),aswellasincreasedapoptosisrate(P< 0.05), compared with the venom group. No signi?cant di?erence was observed between the cyclosporine and venom groups in NO and IL-2.
Conclusions: Cyclosporineatadoseof 30mgwasabletodecreasein?ammatoryresponsesandinduceapoptosisrate. Therefore, itcouldbeasuitabledrugforpatientsbittenbyascorpionsting.
Nazli Batar; Seda Kermen; Sezen Sevdin; Aybuke Ersin; Sevil San; Mustafa Genco Erdem; Halime Pulat Demir; Duygu Guclu
Volume 22, Issue 6 , 2020
Abstract
Abstract
Background: The prevalence of type 2 diabetes mellitus (T2DM) has increased dramatically in the past 30 years. The World Health Organization has prepared an action plan to stop the increase in diabetes and obesity by 2025.
Objectives: This study was conducted to assess the effect of ...
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Abstract
Background: The prevalence of type 2 diabetes mellitus (T2DM) has increased dramatically in the past 30 years. The World Health Organization has prepared an action plan to stop the increase in diabetes and obesity by 2025.
Objectives: This study was conducted to assess the effect of pilates on body composition and some biochemical parameters in women with T2DM on a high-complex-carbohydrate diabetic diet or a low-carbohydrate/high-monounsaturated fatty acids (MUFA) diet.
Methods: This experimental study was conducted on 120 woman patients with T2DM, referring to the Fatih Medical Park Hospitals
Internal Medicine Department, Istanbul, Turkey, between December 2018 and June 2019. Participants were divided into 4 groups and were followed up for 12 weeks. The mean participants age was 41.67 ± 3.83 years. The first group received a low-carbohydrate and high MUFA (LC, MUFA) diet, the second group received a low-carbohydrate and a high-MUFA diet and did pilates (LC, MUFA + PL), the third group received a higher complex carbohydrate (HCC) diet, and the fourth group took the HCC diet and did pilates (HCC + PL).
Results: According to the applied intervention method, there were significant differences between the preliminary and final mea- surements of body mass index, body fat percentage, muscle mass, and fasting blood glucose, insulin, HbA1c, total cholesterol, high- density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride (TG) values (P < 0.05). In this study, only an increase in body muscle composition of the women in the LC, MUFA + PL group was found significant (P < 0.05). The highest decrease in body fat ratio was determined again in the LC, MUFA + PL group (P < 0.05). HDL levels of the women who did pilates increased significantly than other groups (P < 0.05).
Conclusions: In the treatment of diabetes, the patient should be evaluated with a multidisciplinary team. Diet and exercise are
important non-pharmacological interventions in the treatment of diabetes.
Manouchehr Hekmat; Zahra Ansari Aval; Alireza Omidi Farzin; Ali Dabbagh; Hamid Ghaderi
Volume 22, Issue 6 , 2020
Abstract
Introduction: COVID-19 is an emerging disease that has been spread all over the world. Not all the dimensions and manifestations of the disease have yet been fully explored. One such manifestation is vascular thrombosis that occurs in the lungs and other vessels. However, it is often ignored or mistaken ...
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Introduction: COVID-19 is an emerging disease that has been spread all over the world. Not all the dimensions and manifestations of the disease have yet been fully explored. One such manifestation is vascular thrombosis that occurs in the lungs and other vessels. However, it is often ignored or mistaken for pulmonary manifestations. Herein, we presented a case with dominant pulmonary em- bolism manifestations. The COVID-19 symptoms were detected in the patient a few days after heart surgery, and he was appropriately treated and discharged.
Case Presentation: The patient was a 62-year-old man visiting with the signs and symptoms of pulmonary embolism. In the CT- angiography, massive pulmonary embolism was reported in the right and left pulmonary arteries of the patient. Moreover, the patients echocardiogram showed a clot in the right ventricle in addition to severe right ventricular dysfunction. The patient un- derwent emergency heart surgery to remove the clot. In the 3 - 4 postoperative days, the pulmonary manifestations of COVID-19 emerged. The throat swab test was positive for COVID-19, and the patient received treatment. After receiving appropriate treatments for about two weeks, the patient was discharged with good general health.
Conclusions: The presented case had the primary pulmonary embolism symptoms. However, in the 2 - 3 postoperative days, he showed the COVID-19 symptoms and received treatment. Pulmonary embolism can be a manifestation of COVID-19.
Fariba Sadeghi; Seyed Mohammad Bagher Fazljou; Bita Sepehri; Laleh Khodaie; Hassan Monirifar
Volume 22, Issue 6 , 2020
Abstract
Background: The cardinal symptoms of gastroesophageal reflux disease include heartburn (pyrosis) and regurgitation. Conven- tional treatment is done by proton pump inhibitors. In Persian traditional medicine, several herbs (single or combined) have been used to treat gastrointestinal disorders.
Objectives: ...
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Background: The cardinal symptoms of gastroesophageal reflux disease include heartburn (pyrosis) and regurgitation. Conven- tional treatment is done by proton pump inhibitors. In Persian traditional medicine, several herbs (single or combined) have been used to treat gastrointestinal disorders.
Objectives: This study aimed to assess the effects of Pistacia lentiscus (mastic) and Coriander Triphala on reflux symptoms compared to omeprazole in a double-blinded randomized clinical trial.
Methods: In a double-blinded, multicenter, randomized clinical trial, we assessed the effects of Pistacia lentiscus L., Coriander Triphala, and omeprazole on the symptoms of GERD in Tabriz, Iran, in 2018 - 2019. Thus, 105 patients with GERD symptoms were assigned randomly to three groups as group A (Pistacia lentiscus L., 1000 mg/TDS), group B (Coriander Triphala, 1000 mg/TDS), and group C (omeprazole, 20 mg/day plus five placebo capsules per day). The assessments were done at the beginning and the end of the study using FSSG, VAS, RS, and GERD-HRQL questionnaires.
Results: In the beginning, no significant differences were observed between the groups in the background characteristics. There was no statistically significant difference between Pistacialentiscus, Coriander Triphala, and omeprazole in the improvement of FSSG, VAS, GERD-HRQL, and reflux scores. In all groups, the FFSG, VAS, reflux, and GERD-HRQL scores significantly decreased and improved after four weeks of intervention compared to the respective baselines. The FSSG score improvements after four weeks of intervention were 73.68%, 83.33%, and 68.62%, in groups A, B, and C, respectively. The VAS score improvements were 66.66%, 75.00%, and 62.50% in groups A, B, and C, respectively. Improvements in GERD-HRQL were 90.00%, 91.28%, and 82.00%, in groups A, B, and C, respectively. Reflux improvements were 66.66%, 80.00%, and 66.66% in groups A, B, and C, respectively.
Conclusions: The results showed that Pistacia lentiscus and Coriander Triphala are as effective as omeprazole in the treatment of GERD.
Habib Allah Aghaei; Zahra sadat Asadi
Volume 22, Issue 6 , 2020
Abstract
Background: Organizational culture is the most essential tool of an organization to increase the resilience of personnel in a health- care system. Promoting organizational culture is an effective factor in increasing job satisfaction and reducing psychological bur- den, and burnout in nurses.
Objectives: ...
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Background: Organizational culture is the most essential tool of an organization to increase the resilience of personnel in a health- care system. Promoting organizational culture is an effective factor in increasing job satisfaction and reducing psychological bur- den, and burnout in nurses.
Objectives: This study aimed to investigate the influence of organizational culture on resilience by mediatory effects of occupa- tional stress, job satisfaction, and burnout in nurses using structural equation modeling.
Methods: This cross-sectional study was conducted among 712 nurses working in seven hospitals in Tehran during the 2018 - 2019. The participants were selected by thee stratified random sampling method with proportional allocation. In detail, after determin- ing the number of samples of each hospital, sampling was performed using a random number sequence. The data gathering was performed by using questionnaires. Data were analyzed by the SPSS, version 23.0, and LISREL, version 8.8.
Results: We found a significant positive correlation between organizational culture and job satisfaction (r = 0.29) and resilience (r
= 0.21) (P < 0.05). There was a significant negative correlation between organizational culture and occupational stress (r = -0.22), and burnout (r= -0.14) (P < 0.05). The goodness of fit index (GFI) for organizational culture, occupational stress, job satisfaction, burnout, and resilience was 0.97, 0.97, 0.98, 0.96, and 0.95, respectively. RMSEA index for organizational culture, job satisfaction, burnout, and resilience was 0.069, 0.093, 0.057, and 0.050, respectively, which showed that the model is appropriately fit.
Conclusions: The findings of the present study indicated that promoting organizational culture and reducing occupational stress and burnout can improve job satisfaction and mental health in nurses.
Mehmet Suleyman Sabaz; Sinan Asar; Zafer Cukurova; Nagihan Sabaz; Halil Dog?an; Gokhan Sertcakacilar
Volume 22, Issue 6 , 2020
Abstract
Background: Increasing in emergency department need to critical care, the number of intensive care unit bed worldwide is inad- equate to meet these applies.
Objectives: The aim of this study was to investigate the effect of waiting for admission to the Intensive Care Unit (ICU) in the Emer- gency Department ...
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Background: Increasing in emergency department need to critical care, the number of intensive care unit bed worldwide is inad- equate to meet these applies.
Objectives: The aim of this study was to investigate the effect of waiting for admission to the Intensive Care Unit (ICU) in the Emer- gency Department (ED) on the length of stay in the ICU and the mortality of critically ill patients.
Methods: This retrospective cohort study carried out between January 2012 - 2019 patients admitted to the ICU of a training and research hospital. The data of 1297 adult patients were obtained by searching the Clinical Decision Support System.
Results: The data of the patients were evaluated in two groups as those considered to be delayed and non-delayed. It was determined that the delay of two hours increased the risk of mortality 1.5 times. Hazard Ratios (HR) was 1.548 (1.077 - 2.224). Patients whose ICU admission was delayed by 5 - 6 hours were found to have the highest risk in terms of mortality (HR = 2.291 [1.503 - 3.493]). A statistically significant difference was found in the ICU mortality, 28-day and, 90-day mortality between the two groups. ICU mortality for all patients general was 25.2% (327/1297). This rate was 11.4% (55/481) in the non-delayed group and 33.3% (272/816) in the delayed group (P < 0.001). The 28-day mortality rate for all patients general was 26.9% (349/1297). This rate was found to be 13.5% (65/481) in the non-delayed group and 34.8% (284/816) in the delayed group (P < 0.001). The 90-day mortality for all patients general was 28.4% (368/1297). This rate was 14.1% (68/481) in the non-delayed group and 36.8% (300/816) in the delayed group (P < 0.001).
Conclusions: Prolonged stay in the ED before admission to the ICU is associated with worse consequences, and increased mortality.
Mohammad Eshagh Hosseini; Mohammad Heidary; Seyed Mahmoud Eshagh Hosseini; Samira Alesaedi; Iraj Salehi Abari
Volume 22, Issue 5 , 2020
Abstract
Introduction: Acro-osteolysis is characterized by resorption of distal phalanges of fingers and toes. Plain radiography is the best imaging technique for the detection of acro-osteolysis.
Case Presentation: Our report describes a 38-year- old man with a history of rheumatoid arthritis and ...
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Introduction: Acro-osteolysis is characterized by resorption of distal phalanges of fingers and toes. Plain radiography is the best imaging technique for the detection of acro-osteolysis.
Case Presentation: Our report describes a 38-year- old man with a history of rheumatoid arthritis and celiac disease, who presented with shortness of distal phalanges. Roentgenograms disclosed terminal phalangeal resorption in the ?ngers.
Conclusions: All work-ups were normal from tests and surveys for secondary causes. According to longstanding and poor-controlled celiac disease, after excluding secondary causes, we presume that celiac disease is the leading cause of acro-osteolysis in this patient.
Yan Lou; Dan Gao; Qiaoyan Guo; Yixian Zhang; Ping Nie; Wenpeng Cui
Volume 22, Issue 5 , 2020
Abstract
Background: The prevalence of Idiopathic Membranous Nephropathy (IMN) among patients with Primary Glomerular Disease (PGD) has increased in China.
Objectives: This cross-sectional study aimed to investigate changes in the clinicopathological features associated with IMN in northeast China.
Methods: We ...
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Background: The prevalence of Idiopathic Membranous Nephropathy (IMN) among patients with Primary Glomerular Disease (PGD) has increased in China.
Objectives: This cross-sectional study aimed to investigate changes in the clinicopathological features associated with IMN in northeast China.
Methods: We analyzed clinical and pathological data of 1,198 patients with IMN among 4,083 patients hospitalized with PGD undergoing renal biopsy from January 1, 2005, to December 31, 2018 at the Second Hospital of Jilin University in northeast China. Enrollees were divided into two groups: those seen from 2005 to 2011 (Group 1) and those seen from 2012 to 2018 (Group 2). We compared the clinicopathological features between Group 1 and Group 2.
Results: The percentage of patients with IMN among those with PGD increased over the 14 years of the study (P = 0.001). The male-to-female ratio, prevalence of microscopic hematuria, and proteinuria levels were higher in Group 2 than in Group 1 (P < 0.05). Among those with PGD, the percentages of patients with IMN-total, IMN-I, IMN-II, and IMN-III+IV, as well as Tubulointerstitial Lesion (TIL) scores, were higher in Group 2 than in Group 1 (P < 0.05). Finally, age (P < 0.001), degree of proteinuria (P < 0.001), and serum triglyceride level (P = 0.027) were significantly associated with TIL scores among patients with IMN.
Conclusions: Membranous nephropathy is now the leading cause of PGD, with increased TIL scores during the study period. Advanced age, high proteinuria, and serum triglyceride levels represent the independent risk factors for severe TIL among patients with IMN.
Zahra Sepehrmanesh; Mehdi Adel; Afshin Ahmadvand; Mojtaba Sehat
Volume 22, Issue 5 , 2020
Abstract
Background: Serotonin and dopamine are involved in the development of obsessive-compulsive disorder (OCD). Approximately 40% of OCD patients do not respond to the first-line therapy of treatment using selective serotonin reuptake inhibitors. Reportedly, the response to the treatment is increased ...
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Background: Serotonin and dopamine are involved in the development of obsessive-compulsive disorder (OCD). Approximately 40% of OCD patients do not respond to the first-line therapy of treatment using selective serotonin reuptake inhibitors. Reportedly, the response to the treatment is increased by enhancing dopamine blockers.
Objectives: The purpose of this study was to evaluate the efficacy and immunogenicity of ondansetron as a booster in the treatment of OCD patients.
Methods: The present double-blind, randomized clinical trial (RCT) was conducted on 40 patients (16 males and 24 females) aged 18 to 60 years who met the DSM-V-TR-based OCD diagnostic criteria and had a minimum score of 16 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The patients were randomized to receive standard treatment and ondansetron (8 mg/day) or placebo for 12 weeks. They were examined using Y-BOCS and side-effect checklist at baseline, fourth, eighth, and twelfth weeks.
Results: The patients in both groups were homogeneous and comparable in terms of age, marital sex status, type of obsession, anxiety, depression, age at the onset of disease, and the duration of disease. The Y-BOCS scores in the intervention and placebo groups were 27.15 ± 3.94 vs. 26.15 ± 4.94 at baseline, 25.40 ± 3.75 vs. 25.00 ± 4.79 in the fourth week, 20.85 ± 3.69 vs. 24.05 ± 4.97 (P = 0.026) in the eighth week, and 17.95 ± 3.43 vs. 21.65 ± 4.85 (P = 0.008) in the twelfth week, respectively. Significant changes occurred between the two groups at weeks 8 and 12; the difference between the two groups was significant (P = 0.015), whereas no significant difference was observed between the two groups before week 8.
Conclusions: This 12-week, double-blind, and randomized clinical trial showed that ondansetron was a booster agent with a significant effect on patients with moderate to severe OCD. This study also showed that ondansetron is generally well tolerated by OCD patients. The response to the treatment also increased from the eighth week of treatment onwards. The severity of the disease was decreased at the end of the ondansetron intervention. The adjunct ondansetron treatment was recommended for OCD patients
