Selcuk Gulmez; Aziz Serkan Senger; Orhan Uzun; Sinan Omeroglu; Cem Batuhan Ofluoglu; Ayhan Oz; Erdal Polat; Ugur Duman
Volume 24, Issue 3 , 2022
Abstract
Background: Gastric cancer is the fifth most frequent cancer worldwide and the third major cause of cancer-related fatalities
Objectives: The current study aims to investigate whether there is a relationship between tumor location and various prognostic factors in patients who underwent curative resection ...
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Background: Gastric cancer is the fifth most frequent cancer worldwide and the third major cause of cancer-related fatalities
Objectives: The current study aims to investigate whether there is a relationship between tumor location and various prognostic factors in patients who underwent curative resection for gastric cancer.
Methods: A total of 293 patients who underwent curative surgical resection for gastric cancer were analysed retrospectively. Siewert type II and III tumours were defined as proximal gastric cancer (PGC). More distally located tumours were defined as distal gastric cancer (DGC). Siewert type I tumours were excluded.
Results: Out of 293 patients, 78 were diagnosed with PGC and 215 had DGC. There was a significant relationship between preoperative/postoperative chemotherapy administration, gastrectomy type, presence of lymphatic metastasis, Tumour-Node-Metastasis stage, and tumour localization (P < 0.05). There was no significant difference between PGC and DGC in terms of length of hospital stay (P = 0.137). Five-year survival rates for PGC and DGC were 48.4% and 45.8%, respectively (P = 0.863). pT stage, preoperative and postoperative chemotherapy were determined as independent risk factors (P < 0.05). The location of the tumour and the type of surgical resection did not affect the prognosis (P > 0.05).
Conclusion: Tumour localization is not a prognostic factor in gastric cancer. When safe surgical margins were provided in DGC, total gastrectomy for DGC had no effect on the survival rate.
Andia Seyedi Moghaddam; Mahdieh Salimi; Najmeh Ranji; Hossein Mozdarani
Volume 23, Issue 10 , 2021
Abstract
Background: The miRNAs are referred to small non-coding RNAs (consisting of 18 to 25 nucleotides). Functional studies have shown their functions to be oncogenes or tumor suppressor genes in different types of cancers. The miR-106b and miR-21 have been identified to participate in the biological behaviors ...
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Background: The miRNAs are referred to small non-coding RNAs (consisting of 18 to 25 nucleotides). Functional studies have shown their functions to be oncogenes or tumor suppressor genes in different types of cancers. The miR-106b and miR-21 have been identified to participate in the biological behaviors of cells.
Objectives: This study aimed to evaluate the tissue and plasma levels of miR-21 and miR-106b in patients with breast cancer who were diagnosed with ductal carcinoma.
Methods: In total, 40 cases of breast cancer patients 180 samples were examined in this project. Samples included ductal carcinoma breast tumors (n=40), normal breast tissues of the margin of the tumor (n=40) and 20 samples from unaffected mammary tissue of females undergoing reduction mammoplasty (control group), plasma samples of patients with breast cancer (n=40), and plasma of non-affected individuals (n=40). The expression levels of miR-106b and miR-21 were determined using SYBR Green real-time RT-PCR assay in breast tissues and plasma of cancerous patients in comparison to the controls.
Results: MiR-106b and miR-21 revealed much higher expression in tissues and plasma of patients with breast cancer in comparison to that in the group of control (P<0.001). High levels of mir-106b and miR-21 expression in plasma and tumor tissues were highly correlated with tumors in higher stages and lymph node involvement (P<0.0001).
Conclusion: Based on the obtained results, upregulation of miR-106b and miR-21 in the plasma of patients with breast cancer can act as a possible non-invasive biomarker for breast cancer prognosis. Further follow-up studies are required to confirm this.
Huseyin Gunizi
Volume 24, Issue 11 , 2022
Abstract
Background: Spindle cell carcinoma (sarcomatoid carcinoma) is a rare carcinoma that accounts for 2-3% of all laryngeal malignancies. Here, we present a case with laryngeal tumor diagnosed as Spindle cell carcinoma.
Case Presentation: Fifty-nine-year-old male patient was admitted to our clinic with the ...
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Background: Spindle cell carcinoma (sarcomatoid carcinoma) is a rare carcinoma that accounts for 2-3% of all laryngeal malignancies. Here, we present a case with laryngeal tumor diagnosed as Spindle cell carcinoma.
Case Presentation: Fifty-nine-year-old male patient was admitted to our clinic with the complaint of hoarseness and shortness of breath that has been increasing for 10 months. Indirect laryngoscopy performed on the patient, and a polypoid lesion was detected in the anterior of the left vocal cord. The patient was admitted to our clinic for direct laryngoscopy and the lesion was completely excised from the base. The case was diagnosed as "sarcomatoid carcinoma in histopathological examination.
Conclusion: Sarcomatoid carcinoma is usually diagnosed and treated at an early stage. So, it has a good prognosis. However, it has a poor prognosis in the advanced stage.
Deniz Arslan; Seyda Gunduz; Olcay Akkoyun; Pembe Ta?k?n; Tennur Yerlisu Lapa; Faik Ardahan; Hakan Bozcuk
Volume 24, Issue 11 , 2022
Abstract
Background: Cancer is a critical public health problem worldwide. Some studies found that group psychotherapy, when applied to cancer patients as a psychiatric approach, also decreases the existing psychopathological symptoms.
Objectives: This study aimed to determine the effects of a Quality-of-Life ...
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Background: Cancer is a critical public health problem worldwide. Some studies found that group psychotherapy, when applied to cancer patients as a psychiatric approach, also decreases the existing psychopathological symptoms.
Objectives: This study aimed to determine the effects of a Quality-of-Life Support Program (QOLSP) for cancer patients in remission.
Methods: Twenty-six cancer patients who were monitored while in remission were included in this study. During the eight-week prospective study, a QOLSP was implemented weekly. The patients' hope, anxiety, depression, and quality of life (QoL) were assessed using different scales. Additional questionnaires assessed the status of program satisfaction and the arm utilization angle of the breast cancer patients (n=20).
Results: The total mean score on the hope scale was initially 25.6±3.9 and increased to 29.7±1.9 post-QOLSP (P?0.001). Additionally, the total mean score on the EORTC QLQ-C30 scale was initially 68.9±4.9 and increased to 92.6±2.2 post-QOLSP (P?0.001). Moreover, the total mean anxiety and depression scores on the Hospital Anxiety and Depression Scale (HADS) decreased (P<0.001) post-QOLSP. Factors affecting the hope score differences, including the hope pre-score and the sap score (Loss of Appetite), in the EORTC QLQ-C30 symptom scale were significant (P<0.001 and P=0.01, respectively). Factors affecting the anxiety and depression score differences were the HADS anxiety (P=0.001) and depression (P<0.001) pre-scores, in descending order. Moreover, the factor affecting the sql2 score, evaluating General Health Status on the EORTC QLQ-C30, was the sql2 pre-score (P<0.001). All 26 patients were "very satisfied" with the program, and the arm usage angle of the 20 operated breast cancer patients improved.
Conclusion: Facilities that can provide a multidisciplinary QOLSP throughout treatment and follow-up will favorably affect QoL, anxiety, depression, hope, and satisfaction among cancer patients.
Peyman Virani; Ali Farbod; Mahshid Dehghan; Aisan Akhgari
Volume 24, Issue 2 , 2022
Abstract
Introduction: Damage Control Laparotomy (DCL) is an appropriate technique in approaching patients with critical injuries.
Case Presentation: We report a case of road traffic injury in a 20-years-old male presented with penetrating abdominal trauma caused by a metal tube. The DCL was performed and the ...
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Introduction: Damage Control Laparotomy (DCL) is an appropriate technique in approaching patients with critical injuries.
Case Presentation: We report a case of road traffic injury in a 20-years-old male presented with penetrating abdominal trauma caused by a metal tube. The DCL was performed and the patient was stabilized. Re-exploration was carried out and the patient was discharged on the 33rd day with peroneal nerve palsy and no other associated complications.
Conclusion: Three main causes of mortality in severely injured patients are coagulopathy, hypothermia, and metabolic acidosis. These factors make a vicious cycle that leads to metabolic status disruptions and a high rate of mortality. The DCL consists of an initial laparotomy that is limited to the control of hemorrhage and contamination, followed by intra-abdominal packing. Minimizing the first operation to vital tasks can save lives that may be lost otherwise.
Dijan Tav Simsek; Cem Simsek; Irem Erdil; Halil Dogan; Dogac Niyazi Ozucelik
Volume 24, Issue 12 , 2022
Abstract
Background: Pulmonary thromboembolism can be easily diagnosed with computed tomography (CT) and pulmonary angiography (CTPA). However, diagnosis is difficult since a contrast agent cannot be used. Several criteria are recommended for the diagnosis of pulmonary embolism (PE) with non-enhanced CT.
Objectives: ...
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Background: Pulmonary thromboembolism can be easily diagnosed with computed tomography (CT) and pulmonary angiography (CTPA). However, diagnosis is difficult since a contrast agent cannot be used. Several criteria are recommended for the diagnosis of pulmonary embolism (PE) with non-enhanced CT.
Objectives: The aim of this study is to investigate the value of the increase in the pulmonary artery diameter (PA-D) and the ratio of the pulmonary artery diameter / ascending aorta diameter (Ao-D) ratio (PA-D/Ao-D) in the diagnosis of PE in the emergency department (ED).
Methods: The CTPA of patients diagnosed with PE (n=88) and a control group (n=89) were examined retrospectively. The main PA (MPA), right MPA (RMPA), left MPA (LMPA), and Ao-D were measured. The ratio of PA-D and Ao-D was calculated.
Results: Mean age of participants of this study was 67.85±17.03 (Min:18, Max:98) in the PE group and 67.31±20.17 (Min:20, Max:91) in the control group (P=0.272). The PE diagnosis of RMPA, right segmental PA, and right subsegmental PA were found to be more than the left side. Moreover, the mean D-Dimer levels were found to be higher in the PE group (7.31±3.528 mcg/L), compared to the control group (1.52±1.042 mcg/L) (P=0.000). In the PE group, the mean Ao-D (35.14±4.55 mm) was larger, compared to the control group (34.97±5.28 mm); however, it was not statistically significant (P=0,828). In the PE group, the average MPA diameter (MPA-D) (30.45±4.77 mm) was larger than that of the control group (28.35±3.81 mm) and statistically significant (P=0,001). In addition, in the PE group, the average MPA-D/Ao-D ratio (0.87±0.15) was higher in comparison to the control group (0.82±0.13) (P=0,016).
Conclusion: The increase in PA-D and PA-D/Ao-D ratio can be used in the diagnosis of PE when contrast agent cannot be given on CT or when thrombus cannot be seen on CT for the diagnosis of PE in the ED.
Ahmet Onder Porsuk
Volume 24, Issue 1 , 2022
Abstract
Background: The satisfaction level of service receivers is recognized as one of the quality indicators of health services.
Objectives: The present study aimed to determine the satisfaction level of service receivers with ambulance services as an important component of health services and the factors ...
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Background: The satisfaction level of service receivers is recognized as one of the quality indicators of health services.
Objectives: The present study aimed to determine the satisfaction level of service receivers with ambulance services as an important component of health services and the factors affecting this satisfaction.
Methods: The mean score of the scale was obtained at 120.62±10.42 (ranging from 60-130). A positive correlation was found between the age groups and the mean of scale score (rs=0.338; P<0.001). The Cronbachs alpha reliability coefficient of the scale was calculated at 0.957.
Results: The mean score of the scale was obtained at 120.62±10.42 (ranging from 60-130). A positive correlation was found between the age groups and the mean of scale score (rs=0.338; P<0.001). The Cronbachs alpha reliability coefficient of the scale was calculated at 0.957.
Conclusion: As evidenced by the obtained results, respondents overall satisfaction with ambulance services was found to be high. The level of satisfaction was enhanced with respondents age. It was concluded that effective measures should be implemented to improve the quality of services by uncovering the major reasons for service receivers dissatisfaction. Moreover, it was found that the 112 Emergency Services Patient Satisfaction Scale is reliable and measurement results should be used to improve the services.
Volume 24, Issue 1 , 2022
Abstract
Background: Patient education is essential for all patients, and nurses should be competent in patient education.
Objectives: This study aimed to investigate the effect of training patients on their self-care capabilities, heart failure health behaviors, and satisfaction levels.
Methods: This study was ...
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Background: Patient education is essential for all patients, and nurses should be competent in patient education.
Objectives: This study aimed to investigate the effect of training patients on their self-care capabilities, heart failure health behaviors, and satisfaction levels.
Methods: This study was conducted based on a quasi-experimental research method with a pretest-posttest design. The two study groups included individuals with heart failure and their nurses and a total of eight nurses working in the cardiology clinic and 31 patients. The nurses were trained on the program "Planned patient education" in three sessions and two meetings. Following the completion of this process, the nurses started their patient education (PE) in line with their training. The data on nurses were collected in pre-and post-training processes, and patients' data were collected in three stages, including pre-education, discharge, and three months after education.
Results: The mean±SD score of Heart Failure Health Behavior Scale (HFHBS) in patients in the pre-and post-education period and three months after education were obtained at 47.54±11.98, 63.12±11.12, and 66.90±10.44, respectively, indicating a statistically significant difference between the groups. The mean score of the "Self-Care Maintenance" subcategory was estimated at 32.14±15.88, 51.17±17.60, and 53.43±18.14 in pre-and post-education period, and three months after education, respectively. The mean score of the "Self-Care Management" subcategory was obtained at 44.83±21.31, 53.87±19.22, and 8.38±26.18 in pre-and post-education period, and three months after education, respectively. The mean score of the "Self-confidence in Self Care" subcategory was obtained at 32.46±22.74, 48.78±25.78, and 45.91±30.65 in pre-and post-education period and three months after education, respectively. Patients were satisfied with the efficiency of the subjects covered (75.8%), nurses making short, understandable, and explicit sentences (87.9%), the usefulness of the topics covered (93.9%), and nurses' knowledge (84.8%).
Conclusion: Based on the obtained results, PE enhanced the health behavior of people with chronic heart failure and improved patients' self-care behaviors. The PE led to an increase in patient's satisfaction.
Mevlut Harun A?ca; U?ur Topal; Cem Kaan Parsak; ismail Cem Eray; Mehmet Onur Gul; ?shak Ayd?n
Volume 23, Issue 10 , 2021
Abstract
Background: Esophageal cancer is the eighth most common cancer and the sixth most common cause of death from cancer. Esophagectomy is still the essential treatment for esophageal cancer despite its high morbidity rate. The prediction of complications that are likely to appear after surgery can be the ...
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Background: Esophageal cancer is the eighth most common cancer and the sixth most common cause of death from cancer. Esophagectomy is still the essential treatment for esophageal cancer despite its high morbidity rate. The prediction of complications that are likely to appear after surgery can be the most critical factor in reducing morbidity.
Objectives: The present study aimed to examine the postoperative complications and causes of mortality in patients undergoing esophagectomy for esophageal cancer.
Methods: Data from 34 patients with esophageal adenocarcinoma or squamous cell carcinoma undergoing esophagectomy in the general surgery clinic of Çukurova University Medical School Hospital were collected and analyzed retrospectively between January 1, 2011, and January 1, 2020. Postoperative complications were identified according to the Clavien-Dindo classification (CD). "The patients were assigned into two groups (Group 1 and Group 2). Group 1 and Group 2 included patients with CD grade <3 and CD grade >3, respectively."
Results: The mean±SD age of patients (n=34) undergoing resection for esophageal cancer was obtained at 56.38±11.00 years. The ratio of female to male patients was equal. The most common accompanying disease was diabetes mellitus. The number of patients with the American Society of Anesthesiologists score 3 was higher in Group 2 (P=0.034). The tumor was most frequently located in the lower thoracic esophagus of patients in Group 1 and Group 2, and the rate of cervical anastomosis was higher in Group 2. The rate of manual anastomosis was higher in both groups. Respiratory complications were the most frequent complication in both groups; however, a higher rate of respiratory complications was observed in Group 2 (P=0.038). The postoperative 30-days mortality and the reoperation rate were higher in Group 2.
Conclusion: Radical surgery for esophageal cancer results in a high rate of complications and death due to the location of the tumor and diagnosis at the advanced stage. Complications and mortality may result from patient-related factors and the surgical technique. The diagnosis and treatment of the correctable causes before surgery can enhance the chance of survival and the quality of life in patients.
Ebrahim Rahmani-Moghadam; Elham Nadimi; Afsoon Bordbar; Nazanin Ayareh; Ehsan Bordbar; Hossein Bordbar
Volume 24, Issue 1 , 2022
Abstract
Background: Bisphenol-A (BPA) is one of the hazardous chemicals, which is extensively used. BPA can cause oxidative stress. Resveratrol (RES) is a natural polyphenol that possesses several health benefits, such as antioxidant effects.
Objectives: This study aimed to investigate the protective effects ...
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Background: Bisphenol-A (BPA) is one of the hazardous chemicals, which is extensively used. BPA can cause oxidative stress. Resveratrol (RES) is a natural polyphenol that possesses several health benefits, such as antioxidant effects.
Objectives: This study aimed to investigate the protective effects of RES against BPA-induced oral mucosa and tongue toxicity.
Methods: A total of five groups of Sprague-Dawley male rats (n=30) were used in this study. Group 1 was the control group, and group 2 received 50 mg /kg BPA by gavage. Group 3 was given 100 mg/kg of RES, and group 4 received 50 mg/kg BPA plus 100 mg/kg RES. In group 5, the sham group, the volume of the injectable drug received from olive oil was given as gavage for eight weeks. Following that, the paraffinized samples were sectioned in 5µm thickness to estimate the volume.
Results: The results showed that BPA had a different effect on tissues. Moreover, the total volume of lamina propria, mucosal glands, the total glands of the tongue, volumetric density of the epithelium, and glands of the oral mucosa increased in the BPA group, while in the BPA+RES group, these structures reduced, compared to the BPA group. In addition, the total volume of the epithelium of the tongue decreased in the BPA group, whereas this structure increased in the BPA+RES group, compared to the BPA group.
Conclusion: BPA has different effects on the oral mucosa and tongue. These effects can exert influence on the normal function of the cells in these areas. RES, with its antioxidant properties, had a protective effect on these structures against the BPA.
Mostafa Bijani; Ali Asghar Khaleghi; Milad Ahmadi Marzaleh; Hojatolah Najafi; Gholam Ali Heidari Kochi
Volume 24, Issue 1 , 2022
Abstract
Background Disasters are unpredictable events that exert devastating effects on people, properties, and the environment. Iran is a disaster-prone country where numerous deaths and injuries happen annually due to disastrous events. Preparedness, awareness, and performance of health workers are important ...
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Background Disasters are unpredictable events that exert devastating effects on people, properties, and the environment. Iran is a disaster-prone country where numerous deaths and injuries happen annually due to disastrous events. Preparedness, awareness, and performance of health workers are important factors for service providers in disasters.
Objectives: The present study aimed to assess the preparedness, awareness, and performance of Iranian nurses as a major part of the treatment team during disasters.
Methods This systematic study was carried out based on the articles published from 1989-2019 on preparedness, awareness, and performance of Iranian nurses during disasters. In total, 14 databases and 560 articles were reviewed. The databases included Web of Science, Cochrane Library, PubMed, CINAHL, Google Scholar, Ovid, Science Direct, WILEY, Scopus, Pro-Quest, Medline, Elsevier, Magiran, and SID.
Results: After analyzing the titles, abstracts, and manuscripts, 11 papers were selected for the final analysis. They included 5 interventional studies and 6 descriptive investigations. The results of this study pointed to the poor to moderate level of nurses preparedness for disaster response in hospitals in Iran.
Conclusion: As evidenced by the obtained results, nurses had moderate to low levels of knowledge, preparedness, and competence in nursing practice concerning disasters management. Due to inappropriate levels of nurses awareness and preparedness during disasters, health system managers should use appropriate programs and measures to improve them.
Maliheh Dadgarmoghaddam; Mona Najaf Najafi; Alireza Ebrahimi; Ali Talaei; Neshat Najafnajafi; AmirAli Moodi Ghalibaf
Volume 23, Issue 11 , 2021
Abstract
Background: The potential impact of the novel coronavirus pandemic on social mental health has become a great concern, and the current situation can cause different mental disorders.
Objectives: According to the importance of mental health, this study was conducted to evaluate the mental health status ...
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Background: The potential impact of the novel coronavirus pandemic on social mental health has become a great concern, and the current situation can cause different mental disorders.
Objectives: According to the importance of mental health, this study was conducted to evaluate the mental health status of the general population of Iran in Razavi Khorasan Province, Iran.
Methods: An online survey was conducted and made available for the general population of Razavi Khorasan through the snowball sampling technique within a week. The demographic information, contact history with COVID-19, and physical symptoms history of COVID-19 were collected by the survey. To maintain the population's mental health status, the Depression, Anxiety, and Stress Scale-21, which was developed by Lovibond and Lovibond (1995), was used. To reduce the risk of bias, the online survey was supposed to be filled with a maximum of two members of a family. The data were analyzed in SPSS software (version 21) by calculating descriptive statistics and using the Chi-square test. The significance level was considered at the p-value of < 0.05 in all analyses.
Results: Finally, 461 responders from Razavi Khorasan Province were included in this study. In total, 41.8%, 32.1%, and 34.5% of the responders had depression symptoms, were in anxiety mood, and had stress symptoms, respectively. The ratio of men to women was approximately 1:2. Most participants were in the age range of 30-40 years, and the most frequent marital status was being single. Families with 3-5 members constituted 81.5% of the responders. Near one-third of the studied population had a bachelor's degree.
Conclusion: According to the results of our study, it is important to pay attention to the general populations mental health status during the COVID-19 pandemic and conduct protocols to prevent or reduce the risk of mental disorders that can be caused by the current situation.
Tahereh Yaghoubi; Yadollah Jannati; Mahmood Moosazadeh; Abolfazl Hosseinnataj; Fereshteh Aaraghian Mojarad
Volume 23, Issue 12 , 2021
Abstract
Background: Coronavirus disease 2019 (COVID-19) has made the grief process more complicated and brought about loads of unexpressed grief.
Objectives: The present study aimed to determine the severity of grief reactions following the death of first-degree relatives (FDRs) due to COVID-19.
Methods: This ...
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Background: Coronavirus disease 2019 (COVID-19) has made the grief process more complicated and brought about loads of unexpressed grief.
Objectives: The present study aimed to determine the severity of grief reactions following the death of first-degree relatives (FDRs) due to COVID-19.
Methods: This analytic cross-sectional study was conducted to determine the grief score of people aged over 18 with the experience of losing one of their FDRs (i.e., father, mother, and siblings) due to COVID-19. Convenience sampling was employed to select the participants. The instrument used in this study was the Grief Experience Questionnaire (GEQ-34) which was completed via phone calls. The inclusion criteria entailed a willingness to participate in the study, the age range of above 18, and experience of FDRs death. On the other hand, the exclusion criteria were severe discomfort and restlessness while talking on the phone. Descriptive statistics and multiple linear regression were employed to diagnose the factors affecting grief using SPSS software (version 22) with a significance level of 0.05.
Results: The findings indicated that the mean score of GEQ was 67.22±19.24 (ranging from 34 to 126). In this study, 54.5%, 40.2%, and 5.3% of subjects experienced low, moderate, and severe levels of grief, respectively. The grief score showed a positive relationship with the gender of the mourners and marital status; nonetheless, it was negatively correlated with subjects employment and the age of their deceased FDRs.
Conclusion: As evidenced by the obtained results, among the subscales of mourning, the highest scores were related to the dimensions of justification, coping, and guilt. Communication and social support were reduced due to the COVID-19 pandemic; therefore, the provision of online mental health services can be a useful way to treat and help the bereaved.
Musa Silahli; Mehmet Tekin
Volume 24, Issue 10 , 2022
Abstract
Background: Although tracheostomy is not performed as frequently as in adults, it is also used in children. There is no clear consensus on timing and risk factors, especially in early infancy and in cases who underwent cardiac surgeries. In the early infancy period, pediatric cardiac surgery patients ...
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Background: Although tracheostomy is not performed as frequently as in adults, it is also used in children. There is no clear consensus on timing and risk factors, especially in early infancy and in cases who underwent cardiac surgeries. In the early infancy period, pediatric cardiac surgery patients have to receive an inotropic agent after the cardiac surgery due to poor general condition or hemodynamic instability. As a result of prolonged intubation, tracheostomy is required to be performed in some of these patients.
Objectives: The present study aimed to investigate the relationship between vasoactive inotropic scores (VIS) and tracheostomy in pediatric cardiac surgery patients.
Methods: A total of 47 patients, 21 with tracheostomy and 26 without tracheostomy, who underwent cardiac surgery were included in this retrospective study. The VIS and inotrope score (IS) values were calculated and recorded hourly for 48 h postoperatively. Scores were calculated by multiplying the inotropes infusion rate of the patients with certain coefficients. It was attempted to determine objective formalized models and cut-off values that may benefit the relationship between VIS values and tracheostomy.
Results: The median weight was 3,630 g (range, 2,040-13,400), and the median age was 69 days (range, 1-1,081) on the surgery day. The majority (93.6%) of the patients were aged < 1 year. Preoperative C-reactive protein measurements were significantly higher by 50% in patients who underwent tracheostomy (P=0.005). The albumin levels in the tracheostomy group (TG) were low, although not significantly (P=0.057). The VIS values of TG had 50% higher values than the non-tracheostomy group (NTG) (P<0.001). In addition, formula 1 predicted with 57% accuracy that a tracheostomy could be performed (VIS =18.170-0.170* HOUR; P < 0.001), and formula 2 predicted with 72% accuracy that a tracheostomy could not be performed (VIS =17.170-0.170* HOUR; P < 0.001). Hospital stay (P<0.001), mechanical ventilation duration (P<0.001), and the number of ongoing intubation on the 7th day post-surgery were significantly higher in TG.
Conclusion: After pediatric cardiac surgery, VIS values can predict tracheostomy status and help intensive care professionals make decisions.
Abdollah Jassbi; Mostafa Jafari; Mohammad Mahdavi Mazdeh; Mansour Maleki
Volume 23, Issue 11 , 2021
Abstract
Background: Export orientation is one of the main approaches in developing the Iranian pharmaceutical industry as a key health-related part of industries. It is necessary to identify, formulate, and implement some foresightful strategies and strategic plans toward adopting the export approach in the ...
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Background: Export orientation is one of the main approaches in developing the Iranian pharmaceutical industry as a key health-related part of industries. It is necessary to identify, formulate, and implement some foresightful strategies and strategic plans toward adopting the export approach in the Iranian pharmaceutical industry.
Objectives: This paper aimed to identify, prioritize, and develop a structural model of foresightful export-oriented strategies and strategic plans for the Iranian pharmaceutical industry.
Methods: Data gathering for identifying strategies was conducted through literature review and some interviews with pharmaceutical industry experts were analyzed through qualitative content analysis. Afterward, the fuzzy DEMATEL technique was used to prioritize and develop cause and effect and structure the model of identified strategies.
Results: Policy modification, privatization, smart self-sufficiency in production, knowledge management at both national policy and industry firm levels, and quality improvement in all aspects of production and products were identified as foresightful export-oriented strategies and plans for the Iranian pharmaceutical industry.
Conclusion: Privatization is the most effective and important foresightful export-oriented strategy in the Iranian pharmaceutical industry.
C?gdem Ozdilekcan; Hikmet Firat; Ahmet Ugur Demir; Melike Banu Yuceege; Bulent Devrim Akcay
Volume 25, Issue 3 , 2023
Abstract
Background: Patients with obstructive sleep apnea (OSA), related to their disease consequences and treatment modalities, are physically and mentally vulnerable during the outbreak.
Objectives: To investigate the association between pandemic-related changes and positive airway pressure (PAP) adherence ...
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Background: Patients with obstructive sleep apnea (OSA), related to their disease consequences and treatment modalities, are physically and mentally vulnerable during the outbreak.
Objectives: To investigate the association between pandemic-related changes and positive airway pressure (PAP) adherence and sleep quality in OSA patients.
Methods: This was a multi-center cross-sectional study, and the necessary data were collected prospectively. A total of 221 patients were included in the study, who were invited from four different centers from June 1 - December 1, 2020. Pittsburgh Sleep Quality Index (PSQI) was administered to evaluate sleep quality. Information on demographics positive airway pressure (PAP) device use, Coronavirus disease (COVID-19) a questionnaire collected related changes. Patients >18 years with a diagnosis of OSA and prescribed PAP treatment before the pandemic period were included in the study. Lack of cooperation with the questionnaires and incompliant with PAP treatment for longer than one year were the exclusion criteria.
Results: Of the 221 participants, 79.2% were men. The mean apnea-hypopnea index was obtained at 40.8±24.3. A positive COVID-19 test was reported in nine cases, and three patients had hospitalization. During the pandemic, 102 (46.2%) subjects were retired, 26 (11.8%) lost their jobs, and 34 (15.3%) reported home office work or on-call or on leave. Poor sleep quality was found in 54 (24.4%) individuals. It was also reported that poor sleep quality was more common in those who reported mask use difficulty (38.7% vs. 18.9%; P=0.004) and increased or decreased PAP use (increased, decreased, no change in PAP use: 45.5%, 36.0%, 19.4%, respectively; P=0.01). The good sleep quality group had higher PAP use than the poor sleep quality group (6.2±1.5 vs. 5.3±2.4 night/week; P=0.002; 6.2±1.5 vs. 5.5±2.2 hour/night; P=0.01).
Conclusions: Pandemic period had several negative effects on sleep apnea patients regarding sleep quality and social lives which also influenced PAP adherence in OSA patients. Most patients did not change their regular PAP use attitudes during this period. Similar to the pre-COVID-19 disease period, PAP adherence and compliance positively influenced sleep quality; people who were "good sleepers" were the ones who were the "good PAP device users".
Engin Y?ld?r?m; Ercan Y?lmaz
Volume 25, Issue 3 , 2023
Abstract
Background: Hyperthermic intraperitoneal administration of chemotherapy (HIPEC) targets microscopic residues remaining after complete cytoreduction.
Objectives: We systematically presented the development process of the HIPEC treatment regimen, the most remarkable publications on this topic, the most ...
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Background: Hyperthermic intraperitoneal administration of chemotherapy (HIPEC) targets microscopic residues remaining after complete cytoreduction.
Objectives: We systematically presented the development process of the HIPEC treatment regimen, the most remarkable publications on this topic, the most productive countries, and the future of treatment in the coming years.
Methods: The source of our study was the Web of Science (WoS) database which included the Korean Journal Database, core collection index, Russian Science Citation Index, and Sci ELO citation index.
Results: We reached a total of 3,343 publications by analyzing the WoS database using the keyword of "Hyperthermic intraperitoneal chemotherapy". When the citations of the documents written about HIPEC were evaluated, we found that the highest citation was made in 2019. Co-citation analysis showed that there were 27,724 authors investigating the issue of HIPEC. The most active university was determined as Wake Forest University, USA. Collaboration and citation collaboration was observed between Wake Forest University, the University of Pittsburgh, and the University of Texas. The intersection point of all researcher countries was the USA. While reviewing the articles on HIPEC, we also identified new trends and topics in this regard. Ovarian cancers, gastric cancers, and colorectal cancers were found to be the types of cancer that had the strongest relationship with HIPEC.
Conclusion: HIPEC therapies should be considered an area of research that has been studied, published, and cited by surgeons, oncologists, and pharmacologists interested in the treatment of tumors with peritoneal spread.
Yuan Tang; Tian Zhang; Yan Zhang; Yue-Wen Que; Dan Lin; Dan Qiao; Xiong Tao Yang; Jia-Feng Zhao; Yu-Jin Zhang; Guo-Rong Wang; Zhao-Hui Wang
Volume 23, Issue 12 , 2021
Abstract
Aims: To detect the health?related quality of life (HRQoL) of Thyroid cancer (TC) patients and analyze the change tendency of TC patients reported symptoms after surgery.
Methods: A total of 102 TC patients who underwent thyroid surgery from September 2020 to January 2021 were enrolled in this study, ...
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Aims: To detect the health?related quality of life (HRQoL) of Thyroid cancer (TC) patients and analyze the change tendency of TC patients reported symptoms after surgery.
Methods: A total of 102 TC patients who underwent thyroid surgery from September 2020 to January 2021 were enrolled in this study, and received a survey on HRQoL (EORTC QLQ-C30) and disease-specific symptoms (THYCA-QoL) at 1 month and 3 months after surgery.
Results: Almost all the patients experienced TC specific symptoms after surgery. At 1 month after surgery, throat/mouth problems, voice problems, neuromuscular problems, concentration problems, and less interest in sex were the top 5 reported complains. But at 3 months after surgery, less interest in sex was the top 1 reported complain, followed by throat/mouth problems, voice problems, psychological problems, neuromuscular problems and concentration problems. Meanwhile, the scores of most specific symptoms were decreased with the increase of postoperative time, while scores of less interest in sex were increased. Fatigue, insomnia and dyspnea were the most often reported common cancer-related symptoms for TC patients at 1 and 3 months after surgery. Interestingly, the scores of fatigue measured at 3 months after surgery were much lower than those measured at 1 month after surgery.
Conclusions: Throat/mouth problems, voice problems, neuromuscular problems, concentration problems, less interest in sex and fatigue are the important patient reported complains that we should pay more attention after surgery.
Esmat Boshaq; Fereshteh Davoodi; Reza Bahari; Kimia Taheri Aligoodarzi
Volume 24, Issue 1 , 2022
Abstract
Background: Nurses have experienced severe psychological stress which seriously affected their mental health during the Coronavirus disease 2019 (COVID-19) pandemic due to exposure to numerous critically ill patients, increased working time, and their colleagues disease or demise.
Objectives: The present ...
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Background: Nurses have experienced severe psychological stress which seriously affected their mental health during the Coronavirus disease 2019 (COVID-19) pandemic due to exposure to numerous critically ill patients, increased working time, and their colleagues disease or demise.
Objectives: The present study aimed to examine clinical nurses' mental health status and elucidate its relationship with the quality of care provided by them.
Methods: This cross-sectional descriptive study was conducted in 2020 on the nurses working at two hospitals affiliated with Lorestan University of Medical Sciences. A total of 104 nurses were selected from all wards via convenience sampling. The data were collected using the Quality Patient Care Scale and Goldberg and Williams's General Health Questionnaire to check nurses general health status. Statistical tests, including canonical correlation analysis, were used to analyze the data in SPSS software (version 20).
Results: There was a negative correlation between mental health and the quality of care provided by male (=-0.556; P<0.001) and female (=-0.351; P=0.017) nurses. Social dysfunction, anxiety, and insomnia in male nurses, as well as somatic symptoms and social dysfunction in female nurses, had the largest share of their general health, while physical care had the largest share of nursing care quality
Conclusion: As evidenced by the obtained results, female nurses had better mental health status and provided higher-quality nursing care during the COVID-19 pandemic, as compared to male nurses. This higher quality may be attributed to women's better mental health status. The important findings of the current study highlight the necessity of regular programs for the improvement of nurses' mental health, thereby enhancing the quality of nursing care.
Ali Mirsadeghi; Narges Novin; Seyed Mohammad Ali Raisolsadat; Maryam Javanbakht; tooraj zandbaf
Volume 23, Issue 11 , 2021
Abstract
Background: Fissure is a common chronic anorectal disease that causes symptoms such as pain, burning, bleeding, and psychiatric problems. One of the psychiatric complications is anxiety, which might be an etiologic factor or secondary to the disease.
Objectives: The present study aimed to investigate ...
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Background: Fissure is a common chronic anorectal disease that causes symptoms such as pain, burning, bleeding, and psychiatric problems. One of the psychiatric complications is anxiety, which might be an etiologic factor or secondary to the disease.
Objectives: The present study aimed to investigate the effect of anti-anxiety medications on the clinical symptoms of patients with anal fissures.
Methods: A total of 160 patients with anal fissure were randomly divided into two groups (80 patients treated with anti-anxiety medications along with standard anal fissure treatment and 80 patients with standard anal fissure treatment alone) after obtaining patient consent and demographic data. Then, the symptoms have recorded after treatment.
Results: The results of our study indicated that the administration of anti-anxiety medications in patients with anal fissures relieved pain and anxiety scores among all patients. The anti-anxiety medications were more effective on patients younger than 40 years, men with less than two weeks duration of illness, and baseline anxiety greater than 26.
Conclusion: A high prevalence of anal fissures affects the quality of life of patients. Besides the lack of effective treatment that shortens the pain and recovers patients faster, anti-anxiety medications such as benzodiazepines can use along with standard anal fissure treatment to reduce pain and anxiety in patients with acute anal fissure.
Mohammad Faraji; Mahdi Sonei; Fatemeh Sadeghi Ardakani; Mojgan Mahmoudian Targhi
Volume 24, Issue 2 , 2022
Abstract
Background: Cystic meningioma is a rare subtype of meningioma. Various brain tumors may mimic cystic meningioma in imaging appearances.
Objectives: Herein, we reported a series of cases with cystic meningiomas primarily misdiagnosed as pilocytic astrocytoma due to a similar radiological appearance.
Methods: ...
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Background: Cystic meningioma is a rare subtype of meningioma. Various brain tumors may mimic cystic meningioma in imaging appearances.
Objectives: Herein, we reported a series of cases with cystic meningiomas primarily misdiagnosed as pilocytic astrocytoma due to a similar radiological appearance.
Methods: This case-series study included 20 patients with cystic meningiomas admitted to the Ghaem Hospital, Mashhad, Iran, between 2012 and 2019. The findings of magnetic resonance imaging (MRI), computed tomography, and neurological examination were recorded preoperatively. All patients underwent surgery, and biopsies were obtained, confirming the histopathological diagnosis of the tumor.
Results: The patients mean age was obtained at 40.7±12.5 years, and 11 and 9 subjects were men and women, respectively. Most of the patients presented with headaches (50.0%), and hemiparesis (60.0%) was the most found in the neurological examination. The results of all neuroimaging studies revealed solid-cystic supratentorial tumors, in which cysts were intratumoral, larger than solid components, and eccentric relative to them. Most of the cysts were located in the frontal lobe. The signal intensity of T2-weighted MR images showed hypointense lesions in 25.0% of the cases; however, 45.0% of the patients were hyperintense and 30.0% of them were isointense to grey matter. After contrast injection, the tumors solid and periphery experienced a homogeneous enhancement. The most common histopathological finding was meningothelial cells (30.0%) followed by fibroblastic cells (25.0%).
Conclusion: Cases with an initially diagnosed pilocytic astrocytoma in the imaging can turn out to show cystic meningioma after pathological assessments, which deserves clinicians notice.
Nizamettin Kutluer; Serhat Do?an; Ali Aksu; Hakan Ayy?ld?z; Mehmet Kalayc?; Zuhal Karaca Karagoz; Zeynep Ozkan; Burhan Hakan Kanat
Volume 24, Issue 2 , 2022
Abstract
Background: Laparoscopic Sleeve Gastrectomy is the most common type of surgical treatment for morbid obesity. One of the most important complications is leakage from the stapler line. Early detection of a leakage is important in preventing undesirable events.
Objectives: The aim of this study was to ...
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Background: Laparoscopic Sleeve Gastrectomy is the most common type of surgical treatment for morbid obesity. One of the most important complications is leakage from the stapler line. Early detection of a leakage is important in preventing undesirable events.
Objectives: The aim of this study was to evaluate the predictive value of postoperative drain fluid pH on early detection of leakage.
Methods: This study was performed with 63 patients including 33 patients who underwent laparoscopic sleeve gastrectomy for morbid obesity (Group SG) and 30 patients who underwent laparoscopic cholecystectomy (Group LC), as the control group. Fluid sample was obtained after surgery with intra-abdominal drain. The pH value of this fluid was measured using a pH meter at the Ohaus device in the biochemistry laboratory of study hospital.
Results: When the differences in the mean pH values of patients who underwent obesity surgery and gallbladder surgery were evaluated; no statistically significant difference was found between the mean pH value of patients (p: 0.808> 0.05).
Conclusion: None of our patient had leakage and unable to demonstrate how would be the drain fluid pH value if there was a leak, we suggest that drain fluid pH would not be a suitable alarming sign for a leakage in the early period. Because we know that most of the leaks occur at the proximal part of the stomach and that there is more saliva drainage through the line of leakage. Although it is known that the acidic fluid of the stomach can be drained from the same leak in this condition, it is not unlikely that saliva can bring the pH to normal levels. Therefore, if the pH of the drain fluid is close to normal, it is meaning that there is no leakage from the site.
Xinpei Ren; Zhoupeng Wu; Yukui Ma
Volume 23, Issue 11 , 2021
Abstract
Introduction: Pulsating varicose vein is a very rare clinical manifestation and mostly has been reported with tricuspid regurgitation or right ventricular dysfunction. The exact etiology and treatment options for this disease are rarely reported in the literature.
Case Presentation: This article presents ...
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Introduction: Pulsating varicose vein is a very rare clinical manifestation and mostly has been reported with tricuspid regurgitation or right ventricular dysfunction. The exact etiology and treatment options for this disease are rarely reported in the literature.
Case Presentation: This article presents the case of a 45-year-old woman with varicose veins in both her lower limbs when she came to our department. Venous ultrasound showed arterial-like pulsations in both superficial and deep veins of the lower extremities, and echocardiography showed severe tricuspid regurgitation. We administered compression therapy with elastic stockings, and the symptoms of the patient were significantly relieved. In addition, in this article, we reviewed other cases reported in the current literature and discussed appropriate treatment options for this disease.
Conclusion: Pulsating varicose veins are very rare clinical manifestations and mostly have been reported with tricuspid regurgitation or right ventricular dysfunction. For the treatment of this disease, multidisciplinary teams in cardiology, vascular surgery, and anesthesia are the best choices.
Alireza Molaei; Mohammad Gholami Fesharaki
Volume 23, Issue 11 , 2021
Abstract
Background: COVID-19 has raised a worldwide trajectory since it emerged in Wuhan, China in December 2019. The direct and indirect mortalities in the world and as well as in Iran have increased significantly after the occurrence of this pandemic.
Objectives: In this study, Excess Mortality Rate (EMR) ...
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Background: COVID-19 has raised a worldwide trajectory since it emerged in Wuhan, China in December 2019. The direct and indirect mortalities in the world and as well as in Iran have increased significantly after the occurrence of this pandemic.
Objectives: In this study, Excess Mortality Rate (EMR) was estimated by multilevel poison regression method and then this estimation was compared to the historical trends to obtain total deaths related to COVID-19. Additionally, the geographic distribution of EMR has also been presented for Iran.
Methods: All-cause mortality rates of each province of Iran from March 21, 2013 to September 22, 2021 was downloaded from National Organization for Civil Registration (NOCR). The data of COVID-19 pandemic period (spring 1399 SH (Mar 20, 2020) to summer 1400 SH (Sep 22, 2021)) was removed from the data and then the multilevel poison model was applied to estimate all-cause mortality in this period. Then, EMR= (real deaths-expected death)/(real deaths) ratio was calculated.
Results: The results of this study showed that Irans EMR in COVID-19 pandemic was 36% (Male=35%, Female=36%, P-value=0.798). Our findings also revealed four category of EMR including low (EMR?30%, n=9), moderate (30 %< EMR?35%, n=8), high (35 %< EMR?40%, n=10) and very high (40 %< EMR, n=4) in different provinces.
Conclusion: Due to the diverse EMR in different provinces of Iran, the type of disease management of provinces with low and moderate EMR can be used as an appropriate model to control EMR in provinces with high and very high EMR.
Majid Davari; Mende Mensa Sorato; Behzad Fatemi; Soheila Rezaei; Parham Sadeghipour; Abbas Kebriaeezadeh; Fatemeh Soleymani
Volume 24, Issue 1 , 2022
Abstract
Background: All patients with stable coronary artery diseases (CADs) require medical therapy (MT) to prevent disease progression and recurrent cardiovascular events, alleviate symptoms, and reduce mortality. Nonetheless, little is known about the clinical outcomes of unrevascularized patients taking ...
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Background: All patients with stable coronary artery diseases (CADs) require medical therapy (MT) to prevent disease progression and recurrent cardiovascular events, alleviate symptoms, and reduce mortality. Nonetheless, little is known about the clinical outcomes of unrevascularized patients taking MT for stable CAD and the status of CAD risk factor control in Iran.
Objectives: This study aimed to evaluate the impact of MT in unrevascularized CAD patients on risk factor modification and re-hospitalization among patients referring to the Rajaie Cardiovascular Medical and Research Center, Tehran, Iran.
Methods: This unmatched cohort study was conducted to collect demographic, risk factors, comorbidity, and re-hospitalization data about stable CAD patients in 2014 and followed until 2021. A multivariate regression analysis was applied to explore the relationship between re-hospitalization as the dependent variable and independent variables.
Results: A total of 290 stable CAD patients were included in our cohort. More than 60% of the subjects were male. The mean age of the participants was obtained at 55.9±5.4 years. It was revealed that being male (adjusted odds ratio [AOR]=0.513, 95% confidence interval [CI], 0.24-0.85, P=0.048), having hypercholesterolemia (AOR=4.10, 95% CI, 1.07-15.62, P=0.040), having an ejection fraction of below 40% (AOR=4.05, 95% CI, 1.50-10.97, P=0.006), being a current smoker (AOR=2.18, 95% CI, 1.03-4.62, P=0.042), and involving three vessels (AOR=10.39, 95% CI, 2.37-45.77, P=0.002) were independently associated with re-hospitalization.
Conclusion: Gaps were identified concerning CAD risk factor control. Higher re-hospitalization was associated with female gender, smoking, hypercholesterolemia, and reduced ejection fraction. Therefore, it is essential to improve healthy lifestyle modification interventions tailored to individual patients with a particular focus on females.
