Original Article
Medicine
Abdolreza Mehdinavaz Aghdam; Fariborz Rousta
Abstract
Introduction: NSAIDs are widely used in the treatment of back pain as they avoid most of the side effects of opioids such as respiratory depression, sedation, hallucinations, euphoria, addiction, shortening of bowel movements, periods and constipation. They are mostly used for mild to moderate pain where ...
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Introduction: NSAIDs are widely used in the treatment of back pain as they avoid most of the side effects of opioids such as respiratory depression, sedation, hallucinations, euphoria, addiction, shortening of bowel movements, periods and constipation. They are mostly used for mild to moderate pain where patients can tolerate oral medications. Ketorolac trometamol is a parenteral NSAID, thus eliminating the need for patients to avoid entering the body, which is a problem immediately after abdominal surgery. Ketorolac inhibits prostaglandin synthesis by inhibiting the cyclooxygenase system. Material and Methods: At PACU, patients receive morphine at the discretion of the counseling program. All patients were given PCA morphine (1 mg bolus, 5 min lockout, 4-hour limit 30 mg) after discharge from the unit. Medicated analgesia is administered by the Pain Unit and stopped on the third postoperative day if the patient is urinating, has used less than 30 mg of morphine in the last 12 hours, and has less than 4/10 pain. During this time, all patients received 500 mg of BID oral naproxen supplemented with 1000 mg of oral acetaminophen every 6 hours.Results: The ketorolac group held this drug until day 6, when all eight patients were hospitalized. Two patients in the ketorolac group developed anastomotic leakage early after surgery and their care was excluded from further analysis due to significant differences in the study. The first leak occurred 4 days later in a 37-year-old man who had undergone a sigmoidectomy for diverticulitis with peritonitis. Conclusion: The main effect of short hospital stay is uncertain, possibly due to insufficient power for early decision making. Anastomotic leakage rate was higher than normal, especially in the ketorolac group, but there is no example of this in other studies and we can only evaluate it as negative.
Original Article
Medicine
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Cardiovascular care has become an important part of the continuity of care for cardiac patients. Its use is recommended in today's cardiac diagnostic procedures. Despite well-documented morbidity and mortality outcomes, cardiac services are underutilized. The basic principles of cardiac ...
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Introduction: Cardiovascular care has become an important part of the continuity of care for cardiac patients. Its use is recommended in today's cardiac diagnostic procedures. Despite well-documented morbidity and mortality outcomes, cardiac services are underutilized. The basic principles of cardiac therapy are explained in detail. Improvements in cardiac referrals, recording, and completion are possible using new performance measures. Material and Methods: Most guidelines recommend moderate-intensity exercise (60 to 75% of your maximum heart rate based on your target heart rate or ideal heart rate) for at least 30 minutes a day, at least 5 days a week, and preferably every day. Borg aerobic exercise, such as brisk walking, should be supplemented with daily water sports (such as walking after work, gardening, and housework). Results: Regular physical activity has been shown to have many cardiovascular benefits, including weight loss, lowering blood pressure, controlling diabetes and improving blood lipids. An analysis of 11 rehabilitation studies involving 115 patients found that regular physical activity was associated with a 28% reduction in all-cause mortality (6.2% vs. 9.0%) with a difference of 0.72, 95% CI 0.54–0.95)), there was a 24% reduction in myocardial infarction recurrence, but this was not significant (hazard ratio 0.76, 95% CI 0.57–1). Conclusion: Cardiovascular therapy has been shown to be safe and effective in improving quality of life and reducing morbidity and mortality in cardiac patients. Despite proven benefits, it is still not used in the treatment of heart disease. More patients will benefit from effective technology by improving referral and participation in cardiovascular care programs and personalized services involving the patient's condition.
Review Article
Medicine
Vahid Fattahi; Mohammad Irajian
Abstract
The term arthroplasty refers to joint replacement through open surgery, which is used for cases where the joint has lost its function and the patient no longer has the ability to perform daily activities in the joint. In patients with knee osteoarthritis (arthrosis), the concentration of hyaluronic acid ...
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The term arthroplasty refers to joint replacement through open surgery, which is used for cases where the joint has lost its function and the patient no longer has the ability to perform daily activities in the joint. In patients with knee osteoarthritis (arthrosis), the concentration of hyaluronic acid in the synovial fluid is lower than the normal value. As a result, by injecting hyaluronic acid (viscosupplementation), the patient's knee pain is reduced and the patient can carry out his daily activities as before. The pain reduction effect of hyaluronic acid injection usually lasts for 3 to 9 months, and after this period, the injection can be repeated up to 2 times. At this time, the surgeon can replace the joint by considering the patient's physical conditions as well as his age and activities. Joint replacement or arthroplasty is one of the methods considered to treat patients with advanced arthritis. Complications after arthroplasty are things that can be reduced by specialized physiotherapy. Many patients will gain appropriate abilities after surgery and recovery in physiotherapy clinics in such a way that they will return to normal conditions in daily activities, but some of them may need to extend the sessions or at least reduce the pain after surgery in different ways. The useful life of the joints depends on their conditions and how their use is different in different people and mainly the joints that bear more weight or those joints that are used more are more exposed to joint damage and destruction such as arthritis. Also, diseases such as rheumatic diseases, metabolic disorders can lead to the destruction of joints and the need for joint replacement. Most of the involved joints include hip and knee, and the incidence of involvement of these two joints is much higher than other joints.
Original Article
Medicine
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Coronary artery bypass grafting (CABG) surgery is associated with a high frequency of allogeneic blood transfusions in CABG patients due to acquired hemostatic complications. However, allogeneic blood transfusion increases the risk of infection, morbidity and mortality, as well as prolonged ...
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Introduction: Coronary artery bypass grafting (CABG) surgery is associated with a high frequency of allogeneic blood transfusions in CABG patients due to acquired hemostatic complications. However, allogeneic blood transfusion increases the risk of infection, morbidity and mortality, as well as prolonged hospital stay and increased hospital costs. It is important to identify patients who need injections to reduce their risk and minimize the use of allogeneic blood. The aim of this study was to determine the factors affecting the decision of red blood cell transplantation in patients undergoing elective primary CABG.Material and Methods: This is a cross section search based on reverse data analysis. All patients who underwent elective primary CABG were included in this study. Variables analyzed included age, gender, body weight, pre-hemoglobin (Hb) levels, patient comorbidities, and other medical conditions. Data were analyzed using SPSS software version 20.Results: 83.4% patients underwent RBC transfusion. Based on multiple logistic regression analysis, age only (odds ratio [OR] = 1.040, 95% confidence interval [CI]: 1.003, 1.001), Hb level (OR = 0.500, 95% CI: 0.387, 0.644, P < 0.001), and extracorporeal circulation time (OR = 1. 013, 95% CI: 1.004, 1.023, P < 0.001) was an important indicator of RBC cycle.Conclusion: By classifying patients according to the risk of RBC transfusion, high-risk patients can be identified and should be included in blood transfusion programs to reduce the risk of allogeneic infections.
Original Article
Medicine
Amir Abbas Esmaeilzadeh; Fatemeh Nasirzadeh
Abstract
Breast cancer, which is caused by rapid and abnormal growth of cells in the breast, is a complex disease in which many factors can be involved. Some factors such as age, family history, genetics and gender are not under the control of the individual. However, a person can control other factors such as ...
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Breast cancer, which is caused by rapid and abnormal growth of cells in the breast, is a complex disease in which many factors can be involved. Some factors such as age, family history, genetics and gender are not under the control of the individual. However, a person can control other factors such as smoking, physical activity, proper weight and diet to prevent breast cancer. Some researchers believe that diet can be responsible for 30-40% of all cancers. This study raises an interesting point in research to identify breast cancer risk by focusing on estrogen- or progesterone-enhancing chemicals. However, without in vivo studies, it is premature to attempt to make a definitive connection. A multifaceted approach is necessary to fully understand the role that chemicals play in the development of breast cancer. According to Dr. Truss, this should include all data from cell studies, animal studies, and human observations. The human body is [also] very complex, and studying one piece of the puzzle individually may be very different than what happens when all the pieces are put together, said Dr. Lauren Truss. Dr. Gramley added: "Even if the findings are interesting, we can't take it and apply it to humans." Evaluating the effects of these chemicals on humans is still challenging and most of them have not been studied enough. So we expect more care to be taken in interpreting observations of chemically induced changes in breast tissue, Rudel said. A new cell culture study joins the list of research investigating the link between environmental chemicals and breast cancer. Although this is a bold and premature claim, the paper overlaps with what experts currently believe. A new study suggests that certain synthetic chemicals can increase the risk of breast cancer by stimulating hormones.
Review Article
Medicine
Mohammad Irajian; Vahid Fattahi
Abstract
Introduction: Most patients experience moderate to severe pain after ankle surgery. Early and appropriate treatment of postoperative pain is essential for effective treatment that leads to preservation of lung function, normal breathing, rehabilitation and prevention of chronic pain. In this retrospective ...
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Introduction: Most patients experience moderate to severe pain after ankle surgery. Early and appropriate treatment of postoperative pain is essential for effective treatment that leads to preservation of lung function, normal breathing, rehabilitation and prevention of chronic pain. In this retrospective study, we aimed to identify potential predictors of moderate-to-severe postoperative pain in the post-anesthesia care unit (PACU) in patients undergoing gastric bypass surgery.Material and Methods: In this systematic review VAS/vNRS score of 4-6 is considered moderate, and 7-10 is considered severe. Additional factors investigated included time from ankle fracture to surgery, anesthesia procedure, preoperative anesthesia, medication use and postoperative medication use, classification radiation, bone complexity, surgical technique, and tourniquet operative time.Results: Data from 336 patients who underwent ankle arthroplasty between January 2009 and December 2022 were analyzed. None of the following variables had a significant effect on pain; age, weight, smoking, time from fracture to surgery, type of anesthesia, opioids to control dysfunction, complexity of the fracture, surgical procedure or tourniquet technique increase. Gender predicted moderate to severe pain after PACU by 2 differences.31 (1.39–3.86, P = 0.001). To our knowledge, this is the first study to report gender differences in pain reporting in the hours following joint surgery.Conclusion: Female patients who had surgery for ankle sprains reported higher pain scores in the PACU than men.
Original Article
Medicine
Amir Abbas Esmaeilzadeh; Shima Kordjazi; Ataollah Salari
Abstract
Cervical cancer chemotherapy means the use of drugs that destroy cancer cells. Medicines are injected into a vein or taken by mouth as pills. These drugs enter the bloodstream and reach the whole body. For this reason, chemotherapy is used to treat uterine cancer when uterine cancer spreads to parts ...
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Cervical cancer chemotherapy means the use of drugs that destroy cancer cells. Medicines are injected into a vein or taken by mouth as pills. These drugs enter the bloodstream and reach the whole body. For this reason, chemotherapy is used to treat uterine cancer when uterine cancer spreads to parts that are not accessible for surgery. This method can be used to prevent the recurrence of the disease and its spread to other parts of the body. Chemotherapy is not used to treat endometrial cancer in stages I and II. Chemotherapy is often prescribed in a cycle, meaning a period of treatment and a period of rest. Chemotherapy drugs may be administered on one or more days per cycle. Uterine cancer chemotherapy can be administered intravenously, tablets, ointments and injections. Treatment is often done as an outpatient visit in a hospital, clinic, and in very few cases at home. In most cases, you can return home after the treatment, but in some cases, you may need to stay in the hospital for a while. Chemotherapy can be very hard on your veins, so having a venous access device or an indwelling catheter during treatment can be a good option. The catheter is a thin and flexible tube that may be placed in your body so that there is no need to insert the catheter into the body during subsequent treatments. One end of the catheter is placed in a vein near your heart.
Original Article
Mohsen Nabiuni; Jaber Hatam; Maryam Milanifard; Elham Seidkhani; Amin Jahanbakhshi
Abstract
In American football, athletes regularly suffer minor head injuries. In fact, these blows are those that are not strong enough to cause symptoms of brain damage or even clinical symptoms. However, the repetition of these blows during a football season is associated with changes in neurophysiology and ...
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In American football, athletes regularly suffer minor head injuries. In fact, these blows are those that are not strong enough to cause symptoms of brain damage or even clinical symptoms. However, the repetition of these blows during a football season is associated with changes in neurophysiology and neuropsychology in athletes, and their accumulation in the long term can be the cause of severe neurological diseases such as Alzheimer''s and chronic traumatic encephalopathy (CTE). Because minor head concussions do not cause symptoms, it is very difficult to ascertain brain damage and determine when an athlete should be out of action. To conduct these experiments, Oliver and his colleagues used a simple and readily available diagnostic test to identify and monitor minor head impacts in sample athletes during a football season. They also emphasized that it is better to periodically measure the biomarkers of head injuries. A new study from the University of Eastern Finland shows that certain plasma microRNAs can serve as diagnostic biomarkers in mild concussion injury. Biomarkers have been discovered in an animal model and successfully used to diagnose mild brain injury in a subgroup of patients. This study was published in the International Journal of Molecular Sciences.
Original Article
Medicine
Amin Moradi; Naghi Abedini
Abstract
Introduction: Our study compared the effectiveness of tranexamic acid in patients undergoing TKA using the three different administration methods—IV, IA, and combined IV and IA—in terms of total blood loss and the rate of allogeneic transfusion. We also wanted to compare the frequency of ...
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Introduction: Our study compared the effectiveness of tranexamic acid in patients undergoing TKA using the three different administration methods—IV, IA, and combined IV and IA—in terms of total blood loss and the rate of allogeneic transfusion. We also wanted to compare the frequency of wound complications and venous thromboembolism (VTE) among these regimens.Material and Methods: 66 TKA patients were divided into four groups based on the route of tranexamic acid administration: IV only, IA only, low-dose combined (IV + IA injection of 1 g), and high-dose combined (IV + IA injection of 2 g). This research involved 66 patients who underwent TKA between March 2019 and March 2020. Comparing the groups revealed differences in the estimated total blood loss, allogeneic transfusion rate, hemoglobin loss, frequency of symptomatic deep vein thrombosis and pulmonary embolism, wound complications, and periprosthetic joint infection.Results: There were no differences between the other three groups, but the combined high and low dose group and the IA only group lost less blood overall than the IV only group did. None of the study groups' patients received an allogeneic transfusion. There were no other symptomatic VTE events in any group, with the exception of one patient in the IV-only group who developed a symptomatic pulmonary embolism.Conclusion: Regardless of whether it is combined with IV administration, IA tranexamic acid administration further reduces blood loss after unilateral TKA compared to IV use alone. With respect to further reducing blood loss in comparison to IA alone, this study did not find any additional effects of IV combination.
Original Article
Medicine
Ramesh Baradaran Bagheri
Abstract
Introduction: The common perception that this treatment has no serious side effects is probably influenced by this flawed evidence. In this large population-based study, our goals were to determine whether there was an independent relationship between the amount of oxytocin exposed during labor and the ...
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Introduction: The common perception that this treatment has no serious side effects is probably influenced by this flawed evidence. In this large population-based study, our goals were to determine whether there was an independent relationship between the amount of oxytocin exposed during labor and the risk of developing severe PPH and to determine whether the prophylactic use of oxytocin after delivery affected this relationship. Material and Methods: women who had straightforward pregnancies and delivered term singletons vaginally. Cases were 1483 women with severe PPH, which was indicated by peripartum hemoglobin changes of less than 4 g/dl or the requirement for blood transfusions. 90 women from a randomly selected group of expectant mothers without PPH served as the controls. Using two-level multivariable logistic regression modeling, the independent relationship between the oxytocin level during labor and the risk of developing severe PPH was examined and quantified with ORs. Results: After adjusting for all possible confounders, oxytocin exposure during labor was linked to a higher risk of severe PPH when prophylactic oxytocin was not given after delivery. With more oxytocin injected, the association became stronger. The risk of severe PPH was approximately three times higher for total doses between 2 and 4 IU and six times higher for total doses over 4 IU. Conclusion: A separate risk factor for severe PPH appears to be oxytocin during labor. Our findings add to the body of evidence highlighting the need for precautions to reduce maternal complications when oxytocin is used to speed up labor, including strict indications, the use of the lowest effective dose, and careful efficacy evaluation.
Original Article
Covid
Sanaz Yasrebi; Ramesh Baradaran Bagheri
Abstract
Introduction: The analysis of a cohort of patients during the embryo transfer phase was the main focus of this study. The aim of the study was to examine the effects of thirteen adjuvant therapies on the success of embryo transfer, including the clinical pregnancy and live birth rates with enoxaparin. ...
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Introduction: The analysis of a cohort of patients during the embryo transfer phase was the main focus of this study. The aim of the study was to examine the effects of thirteen adjuvant therapies on the success of embryo transfer, including the clinical pregnancy and live birth rates with enoxaparin. Materials and Method: A random number was applied to each transfer in order to ensure data independence, and it was then used to select a single transfer for each patient while erasing the other 90 duplicate cycles. Gonadotropin stimulation was either downregulated or gonadotrophin antagonist stimulation—with or without pre-treatment with the oral contraceptive pill—was used to stimulate. Vitrification was used to freeze the embryos. Results: 16 known seropositive IVF implantation failure patients had 25 additional transfers of 47 embryos, resulting in two clinical pregnancies (fetal heart implantation rate, 42%). These patients did not want to participate in the trial and did not receive heparin and aspirin from their treating physician. Conclusion: A large number of the interventions examined in this study fall short of demonstrating any effects on the success of embryo transfers. According to the findings of our analysis enoxaparin use has shown promising, possibly advantageous results.
Original Article
Medicine
Reza Eghdam Zamiri; Farshad Mahdavi
Abstract
Introduction: More than 400 colorectal tissues, including colorectal adenomas and cancers, and a panel of six CRC cell lines were used to study the epigenetic regulation of miR-137. Material and Methods: We go over miR-137's epigenetic control and how it affects the development of colorectal cancer. ...
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Introduction: More than 400 colorectal tissues, including colorectal adenomas and cancers, and a panel of six CRC cell lines were used to study the epigenetic regulation of miR-137. Material and Methods: We go over miR-137's epigenetic control and how it affects the development of colorectal cancer. Six CRC cell lines, 50 colorectal tissues, 21 healthy individuals' normal colonic mucosa (N-N), 160 primary CRC tissues, and their corresponding normal mucosa (N-C), as well as 68 adenomas, were used to determine the methylation status of the miR-137 CpG island. We examined the expression of miR-137 using TaqMan RT-PCR and in situ hybridization. Results: MiR-137 was only expressed in colonic epithelial cells, which cover the entire colonic crypt, in normal colonic mucosa. However, none of the adenomatous and CRC samples exhibited miR-137 expression, supporting our finding that miR-137 is silenced in the majority of colonic neoplastic tissues. As a result of our discovery that CpG island methylation causes miR-137 to be epigenetically silenced in CRC, we then carried out functional studies to see if miR-137 had tumor-suppressive properties in vitro after transfecting CRC cell lines with miR-137 precursor. Conclusion: In conclusion, this study first explains that miR-137 acts as a tumor suppressor in the colon, is frequently silenced in CRC through promoter hypermethylation, and its restoration inhibits cell proliferation in vitro.
Original Article
Chemistry
Lida Saboktakin
Abstract
Introduction: The purpose of this study was to assess the contribution of digital education to the enhancement of knowledge, skills, attitudes, and satisfaction of medical students learning communication skills in comparison to various controls. Material and Methods: In order to find randomized controlled ...
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Introduction: The purpose of this study was to assess the contribution of digital education to the enhancement of knowledge, skills, attitudes, and satisfaction of medical students learning communication skills in comparison to various controls. Material and Methods: In order to find randomized controlled trials (RCTs) and cluster RCTs (cRCTs) published between January 1990 and September 2018, we conducted a systematic review and searched seven electronic databases and two trial registries. Two reviewers independently examined the citations, gathered information from the studies that were included, and determined the bias risk. The Grading of Recommendations, Assessment, Development, and Evaluations assessment (GRADE) was used to evaluate the quality of the evidence as well. Results: The quality of the evidence varied from moderate to very low, and the overall risk of bias was high. A meta-analysis of four studies comparing the effectiveness of blended digital education (i.e., online or offline digital education plus traditional learning) and traditional learning revealed no statistically significant difference in postintervention skills scores between the groups for the skills outcome. Conclusion: We found low-quality evidence demonstrating the effectiveness of digital education in the development of communication skills in medical students as compared to traditional learning. For knowledge and communication skills, blended digital education appears to be at least as effective as traditional learning and possibly even more so.
