Internal Medicine and Medical Investigation Journal (IMMINV)
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Predictive Value of Maternal Serum Level of Procalcitonin in Diagnosing Chorioamnionitis in Mothers with Preterm Premature Rupture of Membrane (PROM)
Full text linkBackground: Premature Rupture of Membrane (PROM) refers to the rupture of fetal membranes at least 1 hour before the onset of labor pain. The present study intended to determine the predictive value of maternal serum level of Procalcitonin in the early diagnosis of Chorioamnionitis in mothers with PPROM.Methods: In this prospective cohort study, a total of 48 patients with PPROM were selected as the intended sample size due limited financial resources and in accordance with previous articles in Kosar ward of Motahhari hospital of Urmia city, Iran. Inclusion Criteria were amniotic fluid leak, positive Nitrazine and Fern test, gestational age from 28 to 33 weeks and lack of fetal tachycardia. Exclusion Criteria were chronic and congenital heart disease as well as use of NSAIDs. Data were analyzed using SPSS 19 and descriptive statistics, independent t-test and Pearson test were performed.Results: The present study was conducted on 48 pregnant women and their neonates. About %39.6 of mothers was pathologically infected with Chorioamnionitis while %60.4 of the patients were not infected with the disease. Moreover, %68.8 of the neonates had a five-minute Apgar score of ≥7. There was a significant correlation between infection of mothers with histopathologic Chorioamnionitis and neonatal hospitalization in NICU (P<0.001). The sensitivity, specificity, positive and negative predictive values of PCT inflammatory index were %100, %79, %57.5 and %100 respectively for the diagnosis of histopathologic Chorioamnionitis.Conclusion: It was found that there was a significant correlation between PCT index at delivery time and histopathologic Chorioamnionitis.
A Review on Post-Traumatic Aggression
Full text linkTraumatic brain injury is the first cause of death and disability in children and young adults in worldwide. During the acute phase of recovery from moderate to severe brain injury, a period of post-traumatic confusion state (PTCS) will arise that is a combination of cognitive and behavioral dysfunction. Seven key symptoms of PTCS are identified and measured by Confusion Assessment Protocol (CAP) Agitation can be part of PTCS in the acute phase or, part of the recovery of consciousness in chronic phase. There are different hypothesis and classifications of acute and chronic post-traumatic aggressive syndromes. While post-traumatic aggression is common, its mechanism, assessment tool, outcome and treatment plans are not well-defined. Understanding the different aspects of post-traumatic aggression; mechanism, differential diagnosis, and treatment are reviewed in this article
Established and Future Promising Fertility Preservation Options in Adolescence and Adults
Full text linkOver the past decades, due to a high number of cancer survivors, the demands for fertility preservation have been raised dramatically, and this might come from recent progress in the cancer prognosis and diagnosis procedures. For those who are involved in cancer diseases, there are multiple options regarding their fertility preservation which can be selected based on patient’s age, the risk of gonadal involvement, the time available and the type of cancer with different advantages and disadvantages. Among all possible options, embryo cryopreservation for females and semen freezing for males are the most applicable method, however other options such as gonadal tissue cryopreservation, and oocyte cryopreservation are other promising options which would be considered if the partner was not available. As conclusion, this is noteworthy that women with cancer must benefit from adequate consultations regarding their possible fertility preservation options and immediate correct consultations definitely can help families to make their mind to choose best available options
Comparing Written and Planned Training On Anxiety among Patients Undergoing Orthopedic Surgery
Full text linkIntroduction and objectives: The prevalence of preoperative state anxiety is an unavoidable complication. Aside from its type and scope, the surgical operation is considered as a severe stressful situation for patients. Considering the importance of reducing the state anxiety in patients undergoing surgery, there are different methods, one of which is patient education; therefore the aim of the current study was compare the effect of written and planned training on the state anxiety among patients undergoing orthopedic surgery.Method: In this study, 81 patients candidate for orthopedic surgery were selected using convenience sampling and were randomly divided into 3 groups, including planned training, pamphlet and control groups. All patients answered 20 questions-State-Traits Anxiety Inventory (STAI) Questionnaire the day before surgery and the intervention was later carried out in the planned training and pamphlet groups. Then the effect of preoperative state anxiety was re-evaluated about half an hour after training in three groups. For data analysis, in addition to mean and standard deviation, independent t-test and ANOVA were used in Spss16.Results: The results of comparing pre- and post-training mean score of the state anxiety in three groups showed that the mean score of state anxiety reached from 50.41 to 41.03, 52.41 to 44.37 and 45.04 to 50.56 in planned, pamphlet and control groups, respectively. ANOVA test showed that there is a significant difference in this comparison. The results of Tukey's test also revealed that the mean score of state anxiety in the planned and pamphlet groups was lower significantly than the control group (p<0.05).Conclusion: Based on research findings, the planned training method was more effective in decreasing state anxiety among patients compared to the pamphlet group before orthopedic surgery. Therefore, considering the fact that nurses play an important role in examining and relieving the state anxiety among patients and spend more time with patients undergoing surgery compared with other members of the healthcare team, therefore, the planned training method must be considered to ensure effective support to reduce the preoperative state anxiety among patients
Evaluation of Demographic, Clinical and Beyond Clinical Characteristics in Patients with Multiple Sclerosis in Rafsanjan City, Iran
Full text linkBackground and objectives: Multiple sclerosis is a chronic and progressive autoimmune disease of the central nervous system that causes motor and sensory impairment and physical disability in patients. This study was conducted to determine the demographic, clinical, and beyond clinical characteristics in patients with multiple sclerosis to help identify common disabilities and better understand of the specific needs of these ones.Materials and methods: This descriptive cross-sectional study was carried out on 50 MS patients in Rafsanjan, Iran. A definitive diagnosis has been done according to neurologist and McDonald criteria. The neurologist conducted examinations. The demographic data were recorded using questionnaire. MRI images were analyzed with the help of radiologist and all data were analyzed using SPSS software.Results: The mean age was 33.81±8.38 years and male/female ratio was 7/42. According to data, 66.7% of the patients were suffering from relapsing-remitting type (RR) disease, and most lesions on MRI in these patients were observed in pyramidal and JuxtaCortical areas. The mean EDSS scores of patients was 1.46. The duration of disease and the number of attacks had a significant correlation with educational level (P<0.05); age was significantly associated with pyramidal, mental and sphincter symptoms (P<0.05).Conclusion: These results suggest that the prevalence of MS in women is higher than in men, especially among housekeeper women. Relapsing and remitting disease showed higher frequency
Late Onset of Vitamin D-Dependent Rickets Presenting with 8 years of Low Back Pain: A Case Report
Full text linkVitamin D (Vit D) is a prohormone that can be activated during a sequential hydroxylation done by two major mitochondrial cytochrome P450 liver and renal enzymes. Vit D-dependent rickets type 1 (VDDR1) is a rare autosomal recessive hereditary disorder resulting from defective renal 1α-OHase presenting with severe rickets, hypocalcemia, and secondary hyperparathyroidism. Although homozygous Vit D hydroxylation deficient patients develop severe rickets symptom and signs before the age of 12 months, heterozygous types have minor symptoms and are extremely rare presenting as late as 14 years after birthday. Here we present a suspicious case of VDDR1 at 21 years old of age with mild symptoms and signs
Evaluation of Antibacterial Activity of Essential Oil of Ziziphora clinopodioides and Achillea wilhelmsii on Antibiotic-resistant Strains of Staphylococcus aureus
Full text linkAbstractIntroduction and aim: The use of drugs to treat diseases led to the emergence of resistant strains of bacteria. Bacterial resistance to antibiotics is the most common problems in medical science. This study is done to evaluate the antimicrobial effects of Essential Oil of Ziziphora clinopodioides and Achillea wilhelmsii on against resistant clinical strains of Staphylococcus aureus.Material and methods: After collecting plants and validate its scientific name by botanists of Agricultural Organization and after drying in shade, Essential Oil of Ziziphora clinopodioides and Achillea wilhelmsii, extracted with steam distillation method by Clevenger and antimicrobial effects of Essential Oil by well diffusion on above mentioned bacteria were interpreted. Amount of Essential Oil were injected to gas chromatography linked to mass spectrometry (GC / Ms), and the amount and type compounds of the Essential Oils were identified.Results:The results showed that the extracted essence Essential Oil from the Ziziphora clinopodioides and Achillea wilhelmsii has bactericidal effect. In the obtained results by GC/Ms chromatography, in Ziziphora clinopodioides and Achillea wilhelmsii Essential Oils, 22 and 18 compounds, were identified respectively.Conclusion: The results of this study show that can be taken Ziziphora clinopodioides and Achillea wilhelmsii in herbals groups with antibacterial properties and after evaluating their effects in vivo condition and to identify the active ingredients, as an alternative to synthetic drugs that commonly used to treat infections are used
Hematologic Changes in Patients with Graves’ disease in Gorgan During 2014-2015
Full text linkBackground: The most common cause of hyperthyroidism in areas without iodine deficiency is Graves’ disease. There are reports of some hematological alterations in hyperthyroidism. This study was designed to measure the hematologic profile in the patients with Graves’ disease before and after the treatment.Methods: In this cross-sectional study, 100 patients were selected with convenience sampling that diagnosed as autoimmune Graves’ disease in our academic endocrinology clinic during 2014-2015. Inclusion criteria included autoimmune hyperthyroidism in patients who were referred to this center during the study period. Patients who refused to take part in the research, had recent infections disease, malignancies, surgical procedures, severe trauma, received immunosuppressive drugs or corticosteroids, high erythrocyte sedimentation rate (ESR) values during the last six months, and not responded to treatment with methimazole were excluded from the study. The simple sampling technique was used to select the patients. A complete blood count (CBC) was taken before and after treatment. The P-value less than 0.05 was considered as the statistical significance level. All data were analyzed using the Statistical Package for the Social Sciences 16.0 (SPSS Inc., Chicago, IL, USA) software.Results: One hundred patients with a mean age of 38 ± 9.8 years were included. There were no significant changes in the white blood cells (WBC) count, red blood cells (RBC) count, and platelets. Mild anemia (Hb=12.16±1.23) present before treating the hyperthyroidism that was significantly improved after treatment (P= 0.000). Conclusions: Our results showed that the only significant hematologic change in patients with Graves’ disease was mild anemia that improves after treating the underlying thyroid disorder.
Determining Prognostic Value of Serum Levels of Lactate, Bicarbonate, Base Deficit and Glucose in Mortality Rate of Trauma Patients Admitted to Emergency Department
Full text linkBackground: Trauma is of the most important health problems in the world and major factor leading to mortality and morbidity, especially in the first four decades of life in injured people. So, we decided to examine in this study clinical symptoms and laboratory parameters in trauma patients and predictive value in determining prognosis and mortality of these patients.Methods: In this descriptive study, 150 cases of multi-trauma patients admitted to the emergency department of Tabriz Imam Reza hospital were enrolled in the study. Computerized block randomization method was applied to randomize the subjects The questionnaire containing basic information in the pre-hospital phase were recorded for selected patients. As well, injury severity score (ISS) and revised trauma score (RTS) were calculated. Then, blood samples were taken from patients for testing laboratory parameters, including serum lactate level, base deficit, blood glucose, serum bicarbonate levels, BUN and Cr. The data obtained were analyzed through descriptive statistics, frequency, percentage and mean difference test and chi-square test for qualitative variables examined using the software statistical SPSS v17. The P value<0.05 was considered statistically significant.Results: mean age of patients was equal to 37.05±1.58 years. 130 patients (87.8%) were discharged after treatment and recovery and 18 patients (12.2%) died. predictive values of serum lactate cut of point was 27.65 pg/ml for serum lactate with sensitivity of 80% and specificity of 48% on admission.Conclusion: It seems that the mentioned markers alone are unable to be potent prognostic factors as predictors of mortalit
Evaluation of Survival Rate and Pattern of Risk Factors and Recurrence Rate in Patients with Triple-Negative Breast Cancer with other Subtypes
Full text linkIntroduction: Breast cancer nowadays is one the major health issue especially in industrial population. Despite excessive researches in this regard, there is still no detailed and relevant information on the association between the risk factors of this cancer and its many outcomes. Due to increasing rate of breast cancer in Iran, including Yazd city, the present study was designed to evaluate the relationship between survival and recurrence rate with pattern of risk factors in breast cancer patients.Methods: This analytical study was conducted retrospectively on 333 patients with breast cancer during 8 years (2005-2013). Total survival and recurrence rates recorded in month for all samples, and then were analyzed and compared other obtained data. Chi-square and log rank were selected tests for analyzing and Kaplan-Meier was applicable curve for survival analyzing.Results: The mean age of subjects was 57.02 ± 12.32 years. The mean total survival rate was 93.15 ± 1.25 months (97.9%). The mean total recurrence rate was 84.59 ± 1.91 months (89.8%). The subgroups of breast cancer had no significant relationship with risk factors (P>0.05) though BMI and recurrence rate had significant relationship (P=0.045). Other risk factors had no significant relationship with total survival and recurrence rates. The mean duration of OCP (oral contraceptive pill) consumption was significantly more in the patients with ER-PR-Her2+ subgroup than other groups (P=0.03). Conclusion: According the findings, BMI lower than 25 is strong prognostic factor for recurrence rate in patients with triple-negative breast cancer. Because of high survival rate of patients with breast cancer during eight years, it is recommended to study on high survival period with larger sample sizes for accessing reliable evidence.