Research articles
Abbas Rahmati; Fahimeh Zeraat Herfeh; Seyed Omid Hosseini
Volume 21, Issue 5 , 2019, Pages 1-8
Abstract
Background: Substance abuse in women is a major public health problem, and despite the efforts to help women quit permanently, great numbers still end up in relapse.Objectives: The present study aimed to investigate the barriers to quitting addiction in Iranian women.Methods: In this descriptive qualitative ...
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Background: Substance abuse in women is a major public health problem, and despite the efforts to help women quit permanently, great numbers still end up in relapse.Objectives: The present study aimed to investigate the barriers to quitting addiction in Iranian women.Methods: In this descriptive qualitative research conducted in a university-affiliated hospital, Kerman, Iran, during 2016 - 2017, participants were selected using criterion sampling. The researchers interviewed 20 women with the mean age of 29.85 years (SD = 6.50), who were visiting two rehabilitation camps in the city of Kerman to quit the addiction. Transcripts were analyzed to find themes, which represented the shared consensus of the participants. The utilization of the qualitative analysis software MAXQDA 12 helped analyze and manage data of the study.Results: The participants of the study reported that easy access to drugs, keeping in touch with drug users, the stability of atti- tudes, lack of/insufficient social support, coercive treatment, and neglecting Narcotic Anonymous (NA) meetings were barriers to the process of quitting addiction permanently and escalating relapse.Conclusions: In order to facilitate the process of quitting addiction in women, access to drugs as well as keeping in touch with drug users must be restricted. Moreover, they should be encouraged to take part in educational and support programs, whose aim is to change the attitude of substance users and to motivate them to quit the addiction.
Research articles
Milad Ahmadi Marzaleh; Rita Rezaee; Abbas Rezaianzadeh; Mahnaz Rakhshan; Gholamhassan Haddadi; Mahmoudreza Peyravi
Volume 21, Issue 5 , 2019, Pages 1-8
Abstract
Background: The emergency department is the entrance gate of patients to a hospital. Hospitals are confronted with major chal- lenges in radiation, nuclear accidents, and nuclear terrorism. Iran is also at risk of disasters, accidents, and threats, so, the possibility of nuclear and radiation accidents ...
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Background: The emergency department is the entrance gate of patients to a hospital. Hospitals are confronted with major chal- lenges in radiation, nuclear accidents, and nuclear terrorism. Iran is also at risk of disasters, accidents, and threats, so, the possibility of nuclear and radiation accidents cannot be neglected.Objectives: The present study aimed to extract the effective factors in emergency department preparedness of hospitals for radia- tion, nuclear accidents, and nuclear terrorism in Iran.Methods: This qualitative study was conducted using in-depth semi-structured interviews with 32 key informants selected through purposive and snowball sampling. Experts were from seven different specialties. Data were analyzed using the thematic analysis method in order to extract the effective factors in emergency department preparedness of hospitals for radiation, nuclear accidents, and nuclear terrorism in Iran in 2019. The interviews were held in the cities of Bushehr, Tehran, Shiraz, and Isfahan from September 2018 to February 2019.Results: Effective factors in emergency department preparedness of hospitals were categorized into staff preparedness, equipment preparedness, and system preparedness with 20 subcategories. The experts emphasized that training courses and exercises could enhance the preparedness and response to these accidents.Conclusions: This study showed that the emergency departments of hospitals in Iran have many challenges. When the country moves towards having nuclear technology, must also provide the infrastructure of the preparedness. There must be an attempt toreduce these challenges by providing financial and structural support. Identifying effective factors in preparation can be helpful in setting up programs for emergency department preparedness of hospitals against nuclear and radiation accidents.
Research articles
Fatemeh Mohammadzadeh; Ebrahim Hajizadeh; Aliakbar Rasekhi; Sadegh Azimzadeh Jamalkandi
Volume 21, Issue 5 , 2019, Pages 1-9
Abstract
Background: Tumor stage is one of the most reliable prognostic factors in the clinical characterization of colorectal cancer. The identification of genes associated with tumor staging may facilitate the personalized molecular diagnosis and treatment along with better risk stratification in colorectal ...
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Background: Tumor stage is one of the most reliable prognostic factors in the clinical characterization of colorectal cancer. The identification of genes associated with tumor staging may facilitate the personalized molecular diagnosis and treatment along with better risk stratification in colorectal cancer.Objectives: The study aimed to identify genetic signatures associated with tumor staging and patients’ survival in colorectal cancer and recognize the patients’ risk category for clinical outcomes based on transcriptomic data.Methods: In this retrospective cohort study, two available transcriptomic datasets, including 232 patients with colorectal cancer under accession number GSE17537 and GSE17536 were used as discovery and validation sets, respectively. A Bayesian sparse group selection method in the discovery set was applied to identify the associated genes with the tumor staging. Then further screen- ing was performed using survival analysis, and significant genes were used to develop a gene signature model. Finally, the robust performance of the signature model was assessed in the validation set.Results: A total of 56 genes were significantly associated with the tumor staging in colorectal cancer. Survival analysis resulted in a shortlist of 19 genes, including ADH1B (P = 0.012), AHI (P = 0.006), AKAP12 (P = 0.018), BNIP3 (P = 0.015), CLDN11 (P = 0.015), CST9L (P = 0.028), DPP10 (P = 0.029), FBXO33 (P = 0.036), HEBP (P = 0.025), INTS4 (P = 0.003), LIPJ (P = 0.001), MMP21 (P = 0.006), NGRN (P = 0.014), PAFAH1B2 (P = 0.035), PCOLCE2 (P = 0.009), PIM1 (P = 0.007), TBKBP1 (P = 0.003), TCEB3B (P = 0.001), and TIPARP (P = 0.018), developing the signature model and validation. In both discovery and validation sets, the discrimination ability of the signature model to categorize patients with colorectal cancer into low- and high-risk subgroups for mortality and recurrence at 3- and 5-years showed good discrimination performances, with the area under the receiver operating characteristic curve (ROC) ranging from 0.64 to 0.88. It also had good sensitivity (discovery set 63.1%, validation set 61.7%) and specificity (discovery set 75.0%, validation set 59.3%) to discriminate between early- and late-stage groups.Conclusions: We identified a 19-gene signature associated with tumor staging and survival of colorectal cancer, which may repre- sent potential diagnosis and prognosis markers, and help to classify patients with colorectal cancer into low- or high-risk subgroups.
Samaneh Khoshandam Ghashang; Imad Hamdan; Ralf Lichtinghagen; Christoph Gutenbrunner; Boya Nugraha
Volume 21, Issue 5 , 2019, Pages 1-5
Abstract
Background: Brain-derived neurotrophic factor (BDNF) is associated with mood-related symptoms. Fasting can improve mood. However, there was a lack of information about BDNF during prolonged fasting in Summertime in Germany.Objectives: This study aimed to determine (1) the effect of Ramadan fasting on ...
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Background: Brain-derived neurotrophic factor (BDNF) is associated with mood-related symptoms. Fasting can improve mood. However, there was a lack of information about BDNF during prolonged fasting in Summertime in Germany.Objectives: This study aimed to determine (1) the effect of Ramadan fasting on BDNF and creatinine during the month of Ramadan in Germany; (2) the correlation of BDNF with body composition parameters and Health-related Quality of Life (HQoL).Methods: This prospective controlled clinical trial was conducted on a total of fifty healthy adult male during Ramadan 2015 in the Department of Rehabilitation Medicine affiliated to Hannover Medical School, Hannover, Germany. The participants were recruited and divided into two groups, including fasting (FG) and non-fasting groups (NFG). The FG was evaluated at T1: one week before Ramadan, T2: mid of Ramadan, T3: last days of Ramadan, and T4: one week after Ramadan. The NFG was evaluated only at T1 and T3.Results: No significant differences were found between FG and NFG at T1 or T3 with regard to BDNF and creatinine (P > 0.05). In the FG, significant alterations were demonstrated in terms of BDNF. The BDNF was significantly increased at T3 compared with T2 (P < 0.05). No significant change of creatinine was seen in the FG (P > 0.05).Conclusions: It seems BDNF plays a role in the Ramadan fasting. Normal range level of creatinine suggested that long-period Ra- madan fasting is safe for the kidney of healthy male subjects
Research articles
Abbasali Ebrahimian; Raheb Ghorbani; Mehrooz Alishah; Alieh Zamani-Kiasari; Niloofar Kianvash-Rad; Monir Nobahar
Volume 21, Issue 5 , 2019, Pages 1-8
Abstract
Background: Aromatic herbs and spices contain essential oils and are recognized by their considerable antimicrobial activity. One of the natural mouthwashes in traditional Iranian medicine is Zufa. It is not clear, however, that the extract of Zufa can affect oral health as much as Chlorhexidine gluconate, ...
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Background: Aromatic herbs and spices contain essential oils and are recognized by their considerable antimicrobial activity. One of the natural mouthwashes in traditional Iranian medicine is Zufa. It is not clear, however, that the extract of Zufa can affect oral health as much as Chlorhexidine gluconate, which is a potent antimicrobial mouthwash.Objectives: This study aimed to compare the effect of Zufa and Chlorhexidine gluconate mouthwashes on oral flora of patients under mechanical ventilation in ICUs.Methods: This double-blind, randomized clinical trial was conducted on the ninety-ICU-patients receiving mechanical ventilation in a university-affiliated hospital in Sari, Iran, from June 2017 to March 2018. The patients were randomly divided into three groups (n = 30) using block randomization method; the Zufa, Chlorhexidine gluconate, and normal saline groups; the patients’ mouth were washed with 15 mL of the Zufa 0.02%, Chlorhexidine gluconate 2%, or normal saline 0.09%, 30 seconds, twice a day (eight am and four pm), for 3 days, respectively. Oral hygiene status was evaluated before the intervention, and then up to three days after that by the Beck oral assessment scales (BOAS).Results: The data of BOAS showed no significant difference between the Zufa, Chlorhexidine gluconate, and normal saline groups before the intervention phase (P > 0.05), and in this phase BOAS means in the Zufa, Chlorhexidine gluconate, and normal saline were 6.0 ± 40.56, 6.0 ± 43.72, and 6.47 ± 0.62, respectively. A significant association was found between the BOAS score after mouth- washes and the oral health of the patients in the three groups (P > 0.05).Conclusions: Based on the results of our study, mouthwashes of Zufa and normal saline showed the same effectiveness as Chlorhex- idine gluconate on the oral health of intubated patients hospitalized in the ICU.
Case reports
Morteza Daraie; Mohammad Reza Khatami; Fatemeh Nili; Mohammad Hossein Shojamoradi
Volume 21, Issue 5 , 2019, Pages 1-5
Abstract
Introduction: Both scleroderma renal crisis and severe pericardial effusion are rare and life-threatening complications of systemic sclerosis. This article describes a case of scleroderma renal crisis heralded by severe pericardial effusion.Case Presentation: The patient was a 39-year-old woman with ...
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Introduction: Both scleroderma renal crisis and severe pericardial effusion are rare and life-threatening complications of systemic sclerosis. This article describes a case of scleroderma renal crisis heralded by severe pericardial effusion.Case Presentation: The patient was a 39-year-old woman with a history of 8 years diffuse cutaneous scleroderma and extensive skin involvement who referred to Imam Khomeini Hospital Complex, Tehran, Iran, with worsening dyspnea and pleuritic chest pain. Echocardiography revealed severe pericardial effusion, which was drained by the pericardial window. Thereafter, the patient became gradually anuric and her blood pressure was uncontrolled despite maximum doses of antihypertensive agents, including captopril. The serum creatinine level was increased progressively; thus, hemodialysis started. Concomitantly, microangiopathic hemolytic anemia complicated the course of the disease, which responded to plasma exchange. Kidney biopsy revealed pieces of evidence indicating thrombotic microangiopathy.Conclusions: This case report denotes to a probable association between scleroderma the renal crisis and severe pericardial effu- sion. Therefore, physicians should be vigilant about the renal crisis in patients with systemic sclerosis and pericardial effusion.
Case reports
Alina Benea; Adrian Penciu; Laurentiu Nedelcu
Volume 21, Issue 5 , 2019, Pages 1-5
Abstract
Introduction: The association of chronic myeloproliferative neoplasia with urogenital cancer is rare (1.6% - 1.9%), with the death risk of 1.21 - 2.28 times higher in patients with solid cancer and chronic myeloproliferative disease.Case Presentation: We present the case of a patient diagnosed with triple-negative ...
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Introduction: The association of chronic myeloproliferative neoplasia with urogenital cancer is rare (1.6% - 1.9%), with the death risk of 1.21 - 2.28 times higher in patients with solid cancer and chronic myeloproliferative disease.Case Presentation: We present the case of a patient diagnosed with triple-negative idiopathic myelofibrosis treated and monitored at the Department of Hematology of the Clinical Emergency County Hospital, Brasov, Romania. After five years of idiopathic myelofi- brosis, which was treated with hydroxyurea, a second solid neoplasia was identified as left renal cell carcinoma in Robson stage I. The complete remission of the renal carcinoma was achieved with the left nephrectomy sustained for a duration of approximately four years, overlapping with the partial remission of myelofibrosis under treatment with ruxolitinib. The recovery of the renal car- cinoma significantly influenced myelofibrosis therapy and subsequently led to the patient’s development. The global survival, in this case, is 124 months for myelofibrosis and 64 months for the concomitant evolution of the two cancers.Conclusions: Despite a number of peculiarities (age at diagnosis and complications during the treatment of two cancers), the patient had a prolonged survival.
Research articles
Mehmet Arıcan; Yalçın Turhan; Zekeriya Okan Karaduman
Volume 21, Issue 5 , 2019, Pages 1-7
Abstract
Background: Extracorporeal shock wave therapy is a noninvasive, safe, and well- tolerated treatment method which is increasingly used in the treatment of lateral epicondylitis. However, the gold standard treatment protocol is still controversial.Objectives: This study aimed to investigate and compare ...
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Background: Extracorporeal shock wave therapy is a noninvasive, safe, and well- tolerated treatment method which is increasingly used in the treatment of lateral epicondylitis. However, the gold standard treatment protocol is still controversial.Objectives: This study aimed to investigate and compare the efficacy of two different pneumatic pressure levels of radial extracor- poreal shockwave therapy (rESWT) in active patients with lateral epicondylitis, unresponsive to conservative treatment.Methods: This retrospective comparative study was carried out in the Department of Orthopedics and Traumatology, Duzce Uni- versity School of Medicine in 2018. A total of 330 patients with lateral epicondylitis unresponsive to conservative treatment were underwent rESWT during years 2010 - 2017. The patients were divided into two groups of 181 patients (group 1) with a total of 1500 impulses of 10 Hz frequency at 1 bar of air pressure during five treatment sessions at 1 week intervals, and 149 patients (group 2) with a total of 2000 impulses of 10 Hz frequency at 2 bars of air pressure during five treatment sessions at 1 week intervals. Functional and clinical outcomes were assessed just before the treatment, at six weeks and six months after treatment using the visual analogue scale (VAS) and the Quick-Disabilities of the Arm, Shoulder, and Hand (Q-DASH) score.Results: The mean VAS score had significantly decreased in group 1 from 8.34 ± 1.22 to 2.59 ± 1.49 (P = 0.0001) and had also in group 2 from 8.56 ± 1.22 to 2.56 ± 1.76 (P = 0.0001). The mean Q-DASH score decreased significantly in both groups; from 58.92 ± 18.48 to 9.27 ± 5.85 (P = 0.0001), and from 65.36 ± 19.32 to 9.25 ± 6.28 (P = 0.0001) in group 1 and group 2, respectively. No significant difference was observed between the pretreatment VAS and the 6-month scores of groups 1 and 2 (P = 0.103). The mean difference in the Q-DASH pretreatment and 6-week scores and between the pretreatment and 6-month scores in group 2 were higher than those in group 1 (P = 0.011, P = 0.003).Conclusions: Although both rESWT treatment regimens caused a decrease in pain and loss of function, the superior treatment protocol for rESWT appears to be five treatment sessions at 1-week intervals, with 2000 impulses per session and 2 bars. rESWT is a good option for treating lateral epicondylitis, as it is safe and effective and leads to no complications.
Research articles
Mohammad Reza Jafari Nakhjavani; Amir Ghorbanihaghjo; Ozra Dabagh Asadollahipour; Sima Abedi Azar; Tala Pourlak; Aida Malek Mahdavi
Volume 21, Issue 5 , 2019, Pages 1-7
Abstract
Background: The role of vitamin D and cartilage oligomeric matrix protein (COMP) in knee osteoarthritis (OA) still remains con- troversial.Objectives: This study aimed to evaluate serum COMP and 25-hydroxy vitamin D concentrations in patients with knee OA in com- parison to healthy individuals and to ...
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Background: The role of vitamin D and cartilage oligomeric matrix protein (COMP) in knee osteoarthritis (OA) still remains con- troversial.Objectives: This study aimed to evaluate serum COMP and 25-hydroxy vitamin D concentrations in patients with knee OA in com- parison to healthy individuals and to find whether there is a relationship between serum COMP, 25-hydroxy vitamin D, and disease activity in knee OA.Methods: In a case-control study, 60 patients with knee OA were selected based on the criteria of the American College of Rheumatol- ogy referred to the Rheumatology Department of Tabriz University of Medical Sciences, Tabriz, Iran, from October 2017 to February 2018. Also, 28 healthy subjects matched regarding age and sex were selected. The patients were examined, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Index) was assessed. Serum levels of COMP and 25-hydroxy vitamin D were assessed by ELISA method.Results: The mean ± SD age of the patients and controls was 57.60 ± 10.63 and 56.46 ± 5.58 years, respectively. Serum COMP was significantly higher in OA patients (40.82 ± 10.04 pg/mL) than in healthy controls (27.01 ± 9.64 pg/mL) (P < 0.001). There were no statistically significant differences in serum 25-hydroxy vitamin D between the patients and control subjects (P = 0.361). Significant correlations were found between serum COMP concentration with WOMAC score (r = -0.290, P = 0.025) as well as the grade of OA (r = 0.362, P = 0.004). No statistically significant correlations were found between serum 25-hydroxy vitamin D level with WOMAC score (r = 0.102, P = 0.438) and the grade of OA (r = - 0.063, P = 0.630) as well as between serum COMP and 25-hydroxy vitamin D levels (P > 0.05).Conclusions: Based on the results of our study, Serum COMP levels correlated with disease characteristics in patients with os- teoarthritis. Although further studies are needed to confirm our results, COMP may be used as a possible novel marker to measure osteoarthritis development and progression.
Letter to Editor
Mahmoudreza Peyravi; Ali Asghar Peyvandi; Milad Ahmadi Marzaleh
Volume 21, Issue 5 , 2019, Pages 1-1
Abstract
In the great flood of Iran, a wide range of donations was presented to the people affected by the flood as the signof altruism and philanthropy. The Red Crescent of the Is- lamic Republic of Iran was majorly responsible for man-aging the donated goods.
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In the great flood of Iran, a wide range of donations was presented to the people affected by the flood as the signof altruism and philanthropy. The Red Crescent of the Is- lamic Republic of Iran was majorly responsible for man-aging the donated goods.
