Case reports
Sethu Thakachy Subha; Mohamad Doi; Fathinul Fikri Ahmad Saad; Nor Yatizah Mohd Yatim
Volume 25, Issue 9 , 2023
Abstract
Background: Spindle cell sarcoma of the tonsil is an extremely rare malignancy in the head and neck region. The initial clinical presentation can be an asymptomatic mass lesion, and the biopsy of this growing mass should be conducted to exclude a malignant process. In this case report, we described a ...
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Background: Spindle cell sarcoma of the tonsil is an extremely rare malignancy in the head and neck region. The initial clinical presentation can be an asymptomatic mass lesion, and the biopsy of this growing mass should be conducted to exclude a malignant process. In this case report, we described a patient with spindle cell sarcoma of the tonsil with good clinical outcome after surgery alone.Case presentation: A 38-year-old male presented with foreign body sensation of the throat and clinical examination revealed asymmetrical enlargement of the right tonsil. Tonsillectomy was performed, and histopathological examination and immunohistochemistry analysis revealed a low-grade spindle cell sarcoma of the tonsil. He developed local recurrence at twelve months and underwent wide local excision. The patient remained well without any local recurrences and metastases eight years after diagnosis.Conclusion: We reported this case study in an effort to increase the awareness of spindle cell sarcoma of the tonsil and to emphasize the challenges in the diagnosis of this sarcoma. Surgical extirpation with a clear margin appeared to be an adequate treatment for the low-grade spindle cell sarcoma of the tonsil.
Research articles
nasim mohammadi; Esmael Sadri Damirchi; Ali Sheykholeslami; Hossein Ghamari Givi; Soliman Ahmadboukani
Volume 25, Issue 9 , 2023
Abstract
Background: At the close of 2019, the world faced a phenomenon that plunged all human beings into extreme fear and anxiety. A new type of coronavirus began to spread among people across the globe, and this was the beginning of one of the greatest pandemics and its associated problems in the world. People ...
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Background: At the close of 2019, the world faced a phenomenon that plunged all human beings into extreme fear and anxiety. A new type of coronavirus began to spread among people across the globe, and this was the beginning of one of the greatest pandemics and its associated problems in the world. People with COVID-19 have low psychological tolerance and are highly exposed to psychological disorders. One of the most important psychological disorders that can harm the mental health of people affected by COVID-19 is post-traumatic stress disorder (PTSD).Objectives: The present study aimed to evaluate the effectiveness of the crisis intervention program in PTSD symptoms among people with COVID-19.Method: This applied experimental study was conducted based on a pretest-posttest control group design. The statistical population consisted of all individuals with COVID-19 in Rasht, Iran, in 2019, of whom 30 people were selected using the available sampling method and were randomly assigned to the experimental group (n=15) and the control group (n=15). The participants in the experimental group received 10 sessions of the crisis intervention program. Mississippi (2006) PTSD analogy (Scale) was used to collect data. Data were analyzed using the analysis of covariance.Results: The results showed a significant difference between the post-test scores of the experimental and control groups, demonstrating that the crisis intervention program was effective in PTSD (re-experience, withdrawal, numbness, arousal, and masochism) in COVID-19. The subjects in the experimental group had significantly less post-traumatic stress in the post-test group than those in the control group (P<0.01).Conclusion: It can be concluded that the use of crisis intervention programs can reduce PTSD in people with COVID-19. Therefore, it is recommended that psychologists use this therapeutic approach to reduce the psychological problems of people in crisis.
Research articles
Xin Zhang; XinXin Yin
Volume 25, Issue 9 , 2023
Abstract
Background: Cancer patients with peripherally inserted central catheters (PICCs) are prone to venous thrombosis, occlusion, and other complications due to the disease itself, chemotherapy, age, and other factors.Objectives: The present study aimed to assess the effect of different catheter materials ...
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Background: Cancer patients with peripherally inserted central catheters (PICCs) are prone to venous thrombosis, occlusion, and other complications due to the disease itself, chemotherapy, age, and other factors.Objectives: The present study aimed to assess the effect of different catheter materials on thrombosis in cancer patients with PICCs.Methods: The clinical data of 110 cancer patients with PICCs implanted in an outpatient clinic of our hospital from January 2018 to June 2019 were collected. The valveless group comprised patients with catheter cancers without valvular structures and high-pressure resistant polyurethane material (n=58), and the valved group comprised patients with catheter cancers with valvular structures and high-pressure resistant polyurethane material (n=52).Results: In the valveless group, 25 (43.1%) patients had total venous thrombosis, which was significantly higher than that of the valved group (n=11 patients; 21.15%) (P=0.028). In 7 out of 11 (78.85%) patients with thrombosis in the valved group, the thrombosis initiation vein was the axillary vein/subclavian vein, while the basilica/brachial vein was the thrombosis initiation vein in 18 out of 25 patients (43.10%) in the valveless group (P=0.043). There was no statistical difference between the two groups in terms of underlying diseases, thrombosis time, and extension in patients with thrombosis(P>0.05).Conclusion: As evidenced by the obtained results, the catheter-inverted cone structure may be a factor of venous thrombosis. Therefore, the structure of catheters before catheterization should be considered and evaluated.
Research articles
Mohammad Pishgahi; Seyed Mohammad Reza Nejatollahi; Fariba Ghorbani; Sadra Montazeri
Volume 25, Issue 9 , 2023
Abstract
Background: Although hypoalbuminemia is a well-known predictor of postoperative complications, including surgical site infection (SSI) and anastomotic leakage (AL) in gastrointestinal surgery patients, which requires necessary interventions before surgery, there is limited opportunity for preoperative ...
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Background: Although hypoalbuminemia is a well-known predictor of postoperative complications, including surgical site infection (SSI) and anastomotic leakage (AL) in gastrointestinal surgery patients, which requires necessary interventions before surgery, there is limited opportunity for preoperative optimization and intervention in emergency colorectal surgeries.Objectives: Therefore, this study aimed to assess the relationship between preoperative serum albumin levels and the development of SSI and AL in emergency colorectal surgery patients.Methods: In this cohort study, patients who underwent emergency colorectal surgery during 17 months, were assessed. Albumin level was measured before surgery, and patients were followed for 1 month after surgery to identify the development of SSI and AL.Results: In total, 173 patients were enrolled in the study, but data analysis was performed on 170 patients. They were divided into hypoalbuminemia group (n=98, 57.6%) and non-hypoalbuminemia group (n=72, 42.4%). The mean ages of patients in each group were 57.17±16.19 and 51.61±16.14 years old, respectively (P=0.028). The AL was observed in 4 (2.4 %) patients; 3 patients in the hypoalbuminemia group and one patient in the non-hypoalbuminemia group (P=0.205, relative risk=2.33, 95% CI: 0.42-12.82). The SSI was observed in 13 patients (7.6%) during the 1-month follow-up; 8 patients (5.1%) had superficial SSI and 5 (3.2%) had deep ones. Albumin level was significantly lower in patients with AL (2.9±0.48), compared to those without AL (3.6±0.7 g/dL). Moreover, albumin level was higher in patients with SSI (3.11±0.62), compared to patients without SSI (3.6±0.7 g/dL). The incidence of complications, either AL or SSI, was significantly higher in hypoalbuminemia patients, compared to non-hypoalbuminemia patients (P=0.017, Odds Ratio=4.24, 95% CI: 1.29-13.9). Adjusted OR for age was 3.82 (95% CI: 1.15-12.75, P=0.029); therefore, a 13.5% reduction in OR indicated that age is a confounding factor.Conclusion: Preoperative hypoalbuminemia was significantly associated with post-development of complications in emergency colorectal surgery and older age and lower preoperative albumin levels may serve as valuable indicators for the identification of patients at higher risk of complications.
Research articles
Parvin Mansouri; Mohammadreza Rahbar; Mohammad Ali Nilforouszadeh; Mohsen Shati
Volume 25, Issue 9 , 2023
Abstract
Background: Vitiligo is a common chronic disease associated with physical effects, psychological impacts, and impaired quality of life (QoL). Lesions in acral areas are resistant to treatments. Since these areas are exposed and visible, they have a profound effect on patients' self-confidence. Despite ...
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Background: Vitiligo is a common chronic disease associated with physical effects, psychological impacts, and impaired quality of life (QoL). Lesions in acral areas are resistant to treatments. Since these areas are exposed and visible, they have a profound effect on patients' self-confidence. Despite the high prevalence of these conditions, information in this field, especially for Iranian patients, is scarce.Objectives: To study the clinical profile of patients with vitiligo lesions in the acral areas, assess the burden of QoL impairment, and investigate the association between patient's characteristics and their QoL outcomesMethods: A total of 84 patients with non-segmental vitiligo who had involvement in resistant treatment areas were recruited in this study. Clinical characteristics and disease outcomes, with a special emphasis on the quality of life (QoL), were investigated using the Dermatology Life Quality Index (DLQI) questionnaire. Furthermore, the extent of the disease was calculated by utilizing the Vitiligo Area Scoring Index (VASI). Descriptive and comparative analyses were conducted using SPSS software (version 29).Results: The most common comorbidity observed among the patients was various types of immune diseases. The mean total score of DLQI was 8.1, indicating a moderate effect of the disease on the patient's life since the score falls within the range of 6-10. The Kruskal-Wallis non-parametric test illustrated a significant difference in QoL among different age groups (P=0.020). The results indicated a positive, direct, and significant relationship between the extent of the disease and DLQI (r=0.269,;P=0.013). Nonetheless, the relationship between the engagement of the genital area in married patients and difficulties in sexual relations was not found to be statistically significant at ?=0.05.Conclusion: The involvement of end-extremities based on existing studies is a frequent occurrence in vitiligo. These affected areas hold considerable significance in terms of the patient's quality of life (QoL) due to their prominent visibility and resistance to available treatments. Considering the high prevalence of psychological consequences, diversity in skin phototypes, and social acceptance, regional studies are necessary for more efficient and responsive medical management integrated with psychosocial assistance.
Research articles
Du Jia-Shang; Li Zhong-Ming; Zong Chen-yu; Lin jun-fei
Volume 25, Issue 9 , 2023
Abstract
Background: The importance of lateral transforaminal endoscopic treatment of thoracic disc herniation lies in the fact that the use of a needle can remove some of the disc contents and cause the disc herniation to disappear. The present study aimed to evaluate the effect of percutaneous endoscopy on ...
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Background: The importance of lateral transforaminal endoscopic treatment of thoracic disc herniation lies in the fact that the use of a needle can remove some of the disc contents and cause the disc herniation to disappear. The present study aimed to evaluate the effect of percutaneous endoscopy on the treatment of patients with thoracic disc herniation.Objectives: To investigate the clinical efficacy and feasibility of transforaminal endoscopic discectomy in the treatment of thoracic disc herniationMethods: This retrospective analysis was conducted on patients with thoracic hernias between January 2014 and December 2019. A total of 13 operative cases were selected via census sampling. Lateral endoscopic treatment of thoracic disc herniation was performed on patients, and they were followed up for 6-18 months. All patients were assessed by the visual analog scale Visual Analogue Score (VAS) and Oswestry Disability Index (ODI) before the surgery, as well as one week, three months, and six months after the operation, respectively.Results: The sample included 13 patients with a mean age of 60.3 years. The location of the thoracic disc herniation varied among the patients. The VAS scores before the surgery, as well as one week, three months, and six months after the surgery, were 7±0.8, 3.3±0.6, 2.3±0.8, 1.4±0.3, and 1.3±0.4, respectively, pointing to a significant decrease (P?0.001). The ODI scores before the surgery, one day after surgery, one week after surgery, three months after surgery, and six months after surgery were 65.2±5.8%, 11.5±5.3%, 8.9±3.3%, 5.3±2.5, and 4.7±3.5, demonstrating a significant decrease (P?0.001). The score of the Macnab standard, a rating system evaluating the effectiveness of spine surgeries, was also satisfactory.Conclusion: As evidenced by the results of this study, percutaneous endoscopy in the treatment of patients with thoracic disc herniation was able to improve the clinical condition of patients and replace the previous methods of thoracic hernia surgery as an effective, efficient, and safe method.
Research articles
Tayyebeh Jahedbozorgan; Saba Abdollahzadeh Fahimi; Zohreh Ahmadvand
Volume 25, Issue 9 , 2023
Abstract
Background: Urinary incontinence (UI) may be associated with symptoms of overactive bladder (OAB) that may persist after anti-incontinence surgery.Objectives: The present study was performed to evaluate the effect of prolapse and anti-incontinence reconstructive surgery in women who had the symptoms ...
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Background: Urinary incontinence (UI) may be associated with symptoms of overactive bladder (OAB) that may persist after anti-incontinence surgery.Objectives: The present study was performed to evaluate the effect of prolapse and anti-incontinence reconstructive surgery in women who had the symptoms of OAB and UI at the same time.Methods: This descriptive cross-sectional study was performed on 56 women with OAB symptoms and stress UI (SUI)/urgency UI (UUI) with or without prolapse who were candidates for restorative and anti-incontinence surgery. At baseline, urinary symptoms, including urinary frequency, nocturia, SUI, and UUI, were recorded. Patients who finally underwent vaginal reconstructive surgery with anti-incontinence surgery were assessed for urinary symptoms six months after the operation.Results: A total of 28 patients underwent transobturator tape (TOT) surgery, of whom 23 patients were subjected to other anti-incontinence surgeries and 5 patients underwent restorative surgeries. There was no significant difference between the two groups (TOT and others) in terms of age, body mass index, number of deliveries, history of medical problems, and history of surgery or cesarean section. The urinary frequency and nocturia before surgery were observed in 46 (82%) and 20 (36%) patients, respectively, which were not significantly different between the two groups. Before the study, occult UI was observed in 2 patients (4%), UUI in 3 patients (5%), SUI in 18 patients (32%), and mixed UI in 33 patients (59%). Nocturia was completely improved in all 20 patients. Urinary frequency was partially or completely improved in 41 patients (89%), which was not significantly different between the two groups (P=0.051). Overall, 53 patients (95%) had partial or complete improvement in UI, which was not significantly different between the two groups (P=0.058). Both patients with occult UI and all three patients with UUI were completely improved. Sixteen out of 18 patients (89%) with SUI were completely improved and the other 2 patients were partially improved. Thirty patients (91%) with mixed UI had a complete or partial recovery that was not significantly different between the two groups (P=0.137).Conclusion: The findings of the present study showed that six months after anti-incontinence or reconstructive surgery, nocturia in all patients and urinary frequency in 89% of patients improved partially or completely. Various forms of UI partially or completely improved in 95% of patients, as well.
Review articles
Ali Salehinasab; Adel Rezvani Sichani; Maryam Mousavi; Zeynab Bayat; Ali Pezhhan; Beneen M. Hussien; Muhja Ahmed; Mehdi Hassanshahian
Volume 25, Issue 9 , 2023
Abstract
Background: The Corona pandemic caused by the COVID-19 disease has become a trending topic in recent years. Moreover, microbial biofilms have received a lot of attention due to the problems they cause in industry and medicine.Objectives: The present study aimed to examine the published documents concerning ...
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Background: The Corona pandemic caused by the COVID-19 disease has become a trending topic in recent years. Moreover, microbial biofilms have received a lot of attention due to the problems they cause in industry and medicine.Objectives: The present study aimed to examine the published documents concerning the Corona pandemic and microbial biofilms.Methods: Document review was performed in Web of Science Core Collection, Scopus, and PubMed databases; then, due to the publication of more documents in the Scopus database, information from this database was used for bibliographic analysis by VOSviewer and Rstudio.Results: The obtained results showed that the process of publishing documents increased during 2005-2022, and the type of documents mostly were articles (49%) and reviews (38%). Most published cases were in the field of medicine, immunology, and microbiology.Conclusion: Studies can be examined from three medical, environmental, and engineering perspectives. The structure and composition of biofilm, the interaction of microorganisms in biofilm, the investigation of the dental biofilm infection in the infected people and waste systems, as well as the use of engineered biofilms for virus isolation are among the recommended topics for further research.
Research articles
Meilin tian; Le Ma; Lan Yan; Gong Qiang; Jieping chen
Volume 25, Issue 9 , 2023
Abstract
Hepatic sinusoidal occlusion syndrome (SOS) or venous occlusive disease (VOD) is a frequent complication of allogeneic Hematopoietic stem cell transplantation (allo-HSCT). The mortality rate of patients with severe VOD is extremely high. It is of utmost importance to explore practical ways to reduce ...
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Hepatic sinusoidal occlusion syndrome (SOS) or venous occlusive disease (VOD) is a frequent complication of allogeneic Hematopoietic stem cell transplantation (allo-HSCT). The mortality rate of patients with severe VOD is extremely high. It is of utmost importance to explore practical ways to reduce the incidence of VOD. The present study aimed to evaluate the efficacy and safety of a prophylaxis strategy involving the combined use of prostaglandin E1 (PGE1), dalteparin, low molecular weight glucan dextran (LMWD), and ursodeoxycholic acid (UDCA). We conducted a single-center retrospective clinical observation of 225 patients who received allo-HSCT for hematological disorders between 2008 and 2022, all of whom received these four medicines for VOD. These 225 patients were within the age range of 6-58 years, and their donors were classified as related donors (75.5%) and unrelated donors (24.5%). All patients underwent a myeloablative conditioning regimen prior to transplantation. Each patient possessed at least one risk factor for VOD, and 167 (74.2%) cases were deemed to be at high risk. Ultimately, only two patients developed VOD, with an incidence of only 0.89%, of whom one was late-onset VOD. The bleeding rate was 32.9%, with predominantly grade 1-2 (93.2%). The incidence of bleeding aligns with findings reported in other literature. Remarkably, the mortality rate associated with bleeding during transplantation was a mere 1.8%, significantly lower than the average. The results of the study demonstrated the effectiveness and safety of the four PGE1-based medications in the prevention of VOD after allo-HSCT.
Review articles
Xiulan Zhang; Yan Zhong; JiaLi Gao; Li Zhou; Qianzhuo Zhou
Volume 25, Issue 9 , 2023
Abstract
Background: Burn injuries are caused by electricity, heat, radiation, cold, friction, or chemicals and lead to tissue destruction due to energy transfer from the sources to the tissues and cells. The present study aimed to perform a systematic review and meta-analysis of water cooling, ice pack application, ...
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Background: Burn injuries are caused by electricity, heat, radiation, cold, friction, or chemicals and lead to tissue destruction due to energy transfer from the sources to the tissues and cells. The present study aimed to perform a systematic review and meta-analysis of water cooling, ice pack application, cold and wet compress treatment of burn wounds in children before admission and to evaluate their effects on tissue healing and safety.Methods: We systematically searched PubMed, CINAHL, Cochrane Library, and Embase from inception to March 2023. Review Manager (version 5.4) was used to assess the risk of bias in the selected studies, and a meta-analysis of all dichotomous and continuous outcomes in the selected studies was performed. Out of 590 studies, seven studies based on the PRISMA protocol in the meta-analysis were included.Results: Based on the duration of cooling, no significant differences in the depth and size of burn wounds were found. Moreover, we established that cooling burn wounds significantly reduces tissue damage and limits the spread of burns to the surrounding tissues. A higher heterogeneity was observed in the selected studies based on methodology, implying different designs affecting our findings.Conclusion: There is inconclusive evidence on the recommended optimum duration of cooling burn wounds. However, cooling burn wounds has a beneficial impact on reducing tissue damage and limiting the spread of burns.
Research articles
Shuang Liu; Lu Wang
Volume 25, Issue 9 , 2023
Abstract
Background: Cerebral hemorrhage refers to a hemorrhagic disease caused by primary non-traumatic rupture of blood vessels in the brain parenchyma. It is a common acute cerebrovascular disease in the elderly.Objectives: To observe the effect of perioperative nursing on minimally invasive intracranial hematoma ...
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Background: Cerebral hemorrhage refers to a hemorrhagic disease caused by primary non-traumatic rupture of blood vessels in the brain parenchyma. It is a common acute cerebrovascular disease in the elderly.Objectives: To observe the effect of perioperative nursing on minimally invasive intracranial hematoma removal surgery in patients with cerebral hemorrhage.Methods: This randomized controlled trial study was conducted on 106 patients undergoing treatment for minimally invasive internal hematoma (MIRIH) at the First Hospital of Jilin University, Jilin, China, between January and December 2022. These patients were randomly divided into two groups, namely the control and observation groups (n=53 each). The observation group received perioperative care in addition to routine care. Differences between groups were compared using t-tests and Chi-square tests.Results: On the first day, there were no significant differences in the baseline characteristics between the groups. However, on the 7th and 14th days of admission, the observation group showed an increase in potassium ions and a decrease in chloride ions, lactate dehydrogenase, trace microalbumin, and the National Institutes of Health Stroke Scale (NIHSS) scores, compared to the control group (P<0.05). The observation group also had a lower incidence of postoperative complications, including pneumonia, lower limb vein thrombosis, and cerebral hernia, compared to the control group (P<0.05). NIHSS scores on days 7 and 14 were significantly lower in the observation group than in the control group (day 7: 9.60±4.11 vs 12.02±2.83, P<0.05; day 14: 6.77±3.47 vs 9.19±2.86, P<0.05).Conclusion: Perioperative nursing leads to improvement in electrolyte/metabolic levels, neurological recovery, and reduction in post-MIRIH surgical complications.
Research articles
Somayeh Panahi; Maryam Heidarpour; Golrokh Atighechian; Zahra Heidari; Roohangiz Norouzinia; Hassan Ashrafi-rizi
Volume 25, Issue 9 , 2023
Abstract
Background: When natural disasters occur, people with diabetes face more physical and mental challenges than healthy individuals. Therefore, innovative programs and policies are crucial for providing ongoing education to patients on how to better manage their condition.Objectives: The present study aimed ...
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Background: When natural disasters occur, people with diabetes face more physical and mental challenges than healthy individuals. Therefore, innovative programs and policies are crucial for providing ongoing education to patients on how to better manage their condition.Objectives: The present study aimed to identify the components of empowerment literacy for diabetic patients during disasters.Methods: The present research employed a qualitative content analysis approach using a conventional deductive method. Purposive sampling was conducted, and data were collected through semi-structured interviews. The panel consisted of 24 participants, including native Iranian endocrinologists, nurses, emergency medical center managers, and experts in the field of medical librarianship and information. These participants had direct experience in relief efforts during critical situations such as natural disasters. The interviews were recorded and transcribed into written format. Data analysis was performed using thematic analysis with the assistance of MaxQDA software.Results: The content analysis resulted in identification of 10 main categories, 61 sub-categories, and five themes, including Disaster risk perception literacy, Medication literacy, Resilience literacy, Nutrition literacy, and Self-help literacy.Conclusion: The obtained findings have informed the creation of targeted health literacy education materials for policymakers in disaster scenarios specifically designed for individuals with diabetes. Diabetic individuals, particularly those residing in disaster-prone areas, should possess knowledge of emergency and disaster policies to enhance their health literacy. They should actively manage their condition while keeping abreast of policymakers' guidelines.
