Internal Medicine and Medical Investigation Journal (IMMINV)
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Evaluation of the Efficacy of Mesalazine on Irritable Bowel Syndrome Symptoms
No full textIntroduction: Irritable bowel syndrome (IBS) is a prevalent functional disorder of the gastrointestinal system in which some evidence has shown the role of inflammation in the disease. In this study, we investigated the effect of Mesalazine - is an anti-inflammatory drug - on the improvement of clinical symptoms in patients with IBS.
Material and methods: This study was a double-blind controlled clinical trial conducted on 44 patients with IBS who were divided into two groups of 22 patients. Cases group received Mesalazine at a dose of 500 mg every 6 hours, and the control group received a placebo drug in the same shape and order. Severity of primary disease and also initial and post-treatment status of patients recorded. Data were analyzed by descriptive statistics, t-test, and chi-square test was, and a significant level of 0.05 was considered.
Results: The groups were similar in terms of age (p=0.39) and disease severity (p=0.75) at the beginnings of study. According to the frequency of more than 20% improvement of symptoms in the two groups, this frequency was 86.4% in the case group and 54.5% in the control group (p=0.021). Also, the average recovery rate was 70.4 ± 32.5 % in the case group and 35.4 ± 36.9% in the control group.
Conclusion: Based on the results in this study, it can be concluded that Mesalazine is significantly more effective than a placebo in controlling the symptoms of IBS patients
Factors Affecting Loneliness as a Medical Problem in the Elderly: A Systematic Review
No full textIntroduction: To plan an appropriate program for the prevention and control of loneliness in the elderly, it is necessary to first identify the risk factors associated with loneliness. Therefore, the present systematic review study intended to determine the causative factors of loneliness in the elderly. Materials/Methods: To select appropriate previous research for the present review study, several Persian and English studies during 2005-2015 were reviewed through systematic search using keywords ‘’loneliness, elderly, risk factors, systematic review’’ in the databases of Psyc INFO, Scopus, Elsevier, Pub Med as well as advanced search on Google Scholar. Regarding the inclusion and exclusion criteria derived from 77 articles, the present study ultimately reviewed 21 articles. Results: After searching the aforesaid websites and databases, 77 articles were found, 56 of which were excluded from the study due to their inconsistency with the current inclusion criteria. Eventually, 21 articles were selected, 11 of which were reviewed for the risk factors of loneliness. Amongst the reviewed articles, 4 had had an investigation into loneliness reduction strategies and 6 had specifically investigated the effects of loneliness on the elderly. According to the review results of the selected studies, loneliness has been considered as a major factor in the quality of life of the elderly. Conclusion: The present study determined the most important causative factors affecting loneliness in the elderly in different areas. Recognizing these effective factors, many healthcare providers will be able to provide effective care to this group in order to deal with the phenomenon of loneliness
Correlation of preoperative stress, anxiety and depression in women undergoing cesarean section with postoperative nausea and vomiting
No full textBackground: Correlation between stress, anxiety and depression in pregnant women and post-cesarean section (C-section) complications such as nausea and vomiting is among the most important studies in the world.Since nausea and vomiting after C-section cause the mother to be in uncomfortable condition, the purpose of this study was to determine the correlation of stress, anxiety and depression with postoperative nausea and vomiting (PONV).
Materials and Methods: The present descriptive-correlational study was conducted in early 2018 on 125 pregnant women under the C-section referred to Shohadaye Kargar Hospital of Yazd in Iran. After obtaining informed written consent and presenting oral explanation, the Depression Anxiety Stress Scale-21 (DASS-21) questionnaire was completed before the C-section. Then, a questionnaire was filled out after the C-section to assess the presence and intensity of nausea and vomiting. Data analysis was performed with SPSS software version 19 using analysis of variance.
Results: There was no significant correlation between stress, anxiety and depression before the C-section with presence and intensity of postoperative nausea. On the other hand, there was a significant correlation between preoperative stress and postoperative vomiting (P-value=0.024), which indicates that preoperative stress leads to postoperative vomiting in this study.
Conclusion: Based on the results of this study, increasing levels of stress, anxiety and depression in pregnant women under the C-section may have their own unpleasant side effects, but they do not increase the extent and intensity of postoperative nausea, and only preoperative stress can increase postoperative vomiting
Effectiveness of Reality Therapy in Improving the Psychological Well-being in People with Leukemia
Full text linkIntroduction: Cancer is now the most important health concern endangering the patients’ physical, mental, and social health. Cancer has several types among which prostate and breast cancers are the most common tumors in men and women respectively, and the lung and colon are more prevalent in both genders, but leukemia is more common in children. The present research aimed to determine the effectiveness of reality therapy in improving the psychological well-being of people with leukemia. Materials and Methods: The present study utilized a quasi-experimental approach. This study examines cognitive and behavioral changes in subjects by pre-test- post-test due to the precise control of experimental conditions by controlling the independent variable through questionnaires. The statistical population consisted of all people with leukemia in hospitals and private offices of blood and oncology in Yazd during 2013-2014. Convenience sampling was done on those referring to an oncology office for the cancer treatment. Leukemia patients, who knew about their illness, were selected as samples and involved in reality therapy sessions considering inclusion and exclusion criteria: The sample size included 30 leukemia people who were randomly divided into two groups (experimental and control). The treatment research plan was individually conducted for 6 weekly 1-hour sessions; and Ryff’s questionnaire was recompleted at the end of the sixth session. Shapiro-Wilk test, Levene’s test, oneway analysis of covariance, and multivariate analysis of covariance were used to analyze research data. Results: During the reality therapy sessions, participants’ self-knowledge was increased (self-acceptance was also increased in participants, so it was consistent with current studies) as members discuss and contemplate themselves and share their perceptions. Conclusion: This self-knowledge is the basis for making more constructive decisions, more functional programs, changing their feelings and thoughts, improving life for remaining years, and more purposeful life
Estimated Glomerular Filtration Rate and Low Energy Hip Fracture
Full text linkIntroduction: Chronic kidney disease is commonly seen with reduced calcium and low-energy fractures. In this study, we investigated the relationship between estimated Glomerular Filtration Rate (eGFR) and low-energy hip fractures. Methods: This cross-sectional study was performed on 418 patients with low energy hip fracture in Imam-Khomeini Hospital during 2019-2020. Correlation of eGFR with other variables was investigated. Results: Of the studied patients, 203 (48.6%) had eGFR below 60 and 215 (51.4%) had eGFR above 60. Female patients with e-GFR below 60 were more common, underlying diseases of diabetes and hypertension were significantly higher in e-GFR below 60, and mean age and creatinine levels in e-GFR below 60 were significantly higher than eGFR above 60. The mean hemoglobin level in subjects with eGFR below 60 was significantly lower than those with eGFR above 60 (p <0.05). Mortality was significantly higher in subjects with eGFR below 60 than in those with eGFR above 60. There was no significant relationship between eGFR and type of fracture and ischemia (p> 0.05). Conclusion: Management in the prevention of hip fracture and treatment of patients with renal failure can be effective in the treatment of fracture and reduce its mortality
Which one is prefer and safe in auto transplantation for Repairing of full length complete avulsed ureter, immediately or delayed?
No full textIntroduction: In modern medicine in the field of urology, sometimes some techniques result in awful complications such as ureter strictures and complete avulsion. Case presentation: In this case series, we report four cases including a male and 3 female patients (age range: 55-80 years) who developed complete ureters avulsion during transurethral lithotripsy. The main action that has been done was autotransplant. All four patients discharged in good condition six days after surgery. At the time of discharge, no one had severe complications. Conclusion: As observed, repairing complete ureter avulsion can be considered as a safe and suitable procedure after complete evaluation
Effects of Hip Exercises on the pain Severity in Patients with Patellofemoral Pain Syndrome
Full text linkIntroduction: Patellofemoral pain syndrome is associated with a decrease in hip muscles strength, especially abductor and external rotator muscles. Hip abductors with femoral control have an effect on the frontal plane on the knee valgus, and the increased hip abduction capacity helps these patients. The aim of this study was to determine the effect of abductor and adductor exercises in addition to the knee exercises in knee joint pain in patients with Patellofemoral pain syndrome.
Method: This is a clinical trial study conducted on patients suffering from patellar-femoral pain syndrome who visited the Sports Medicine department of the Imam Khomeini Hospital Clinic. The NRPS questionnaire was used to evaluate the patients’ pain severity SPSS version 16 was used for statistical analysis of the data.
Results: The mean age of the patients in abductor group was 33.4±6.1 and in adductor group was 33.7±7.3, but this difference was not significant (P=0.1). The results of this study showed that in the abductor and adductor group, the results of all of the statistical tests on the change in the Scores of the questionnaires and tests after 6 weeks of training exercises were statistically significant (P<0.05). the comparison of the scores between the two groups showed only the difference between the mean scores of Step down between the two groups of adductor and abductor, which was statistical significance after exercises (P=0.03).
Conclusion: Based on the presented study, 6 weeks of abductor and adductor muscle exercises, and specially abductor muscles, helps reduce pain and the improve joint function in patients suffering from patellofemoral pain syndrome
Linkage Between Serum Vitamin D and Precancerous Colon Polyps
Full text linkColon cancer is the third most common type of cancer in the USA and accounts yearly for 11% of all cancer deaths (Center for Disease Control and American Cancer Society). Thus, identifying strategies that reduce its incidence is critically important. Calcitriol, the most active form of vitamin D, is a pleotropic hormone with a wide range of biological activities. Due to its ability to regulate calcium and phosphate metabolism, 1,25D3 plays a major role in bone health. In addition, 1,25D3 binds to the vitamin D receptor and thereby regulates the expression of a number of genes which control growth, differentiation and survival of cancer cells. Although a well-recognized physiological role of vitamin D is the regulation of calcium and phosphate metabolism, recent studies suggest a much broader range of biological functions of vitamin D, including potential anti-neoplastic effects. Garland et al. discovered in 1980 that colon cancer mortality rates in the U.S. were highest in places where populations were exposed to the least amount of sunlight, and proposed that vitamin D might be a protective factor against colon cancer. Since then, extensive studies have reported anti-neoplastic actions of vitamin D, particularly in colorectal cancer. 
Evaluating the Causes and Frequency of Frequent Referral to the Emergency Department of Imam Khomeini Educational Hospital in Sari
Full text linkIntroduction: Emergency department is one of the most important units of a hospital. In general, the most serious cases are referred to emergency department, and the highest numbers of hospital admissions occur in the emergency department. This study aimed to obtain a comprehensive estimate of the number of frequent visitors to the emergency department of Imam Khomeini educational hospital, Sari. Materials and Methods: This cross-sectional descriptive study was performed retrospectively by referring to the patient medical records at the Sari Imam Khomeini education hospital. The records were screened to identify frequent emergency department visitors in 2017. Data analysis was performed using SPSS 21. Results: The number of emergency department visitors in the Sari Imam Khomeini Hospital in 2017 was 29,765; of them, 594 (6.2%) were repeat visitors and were included in this study. The mean age of the frequent emergency department visitors was 56.17 years. The most common complaint was weakness and lethargy in 39.9% patients, abdominal pain in 30%, shortness of breath in 14%, and other causes in 14%. The most common underlying disorders were anemia, followed by obstruction pulmonary disease. Conclusion: We obtained detailed data of frequent emergency department visitors to aid the development of suitable evidence-based policies. New policies are necessary for the management of various sections of the emergency department and inpatient admissions. Such policies will allow better decision-making for non-emergency patients and outpatient admissions
Preemptive Effect of Two Different (Intracuff and Intravenous) Routes of Dexamethasone Administration on Postoperative Sore Throat and Cough
Full text linkIntroduction: The most common complications following anesthesia intubation include postoperative sore throat, post-extubation cough, and hoarse voice. Currently, the use of preoperative Dexamethasone has been effective in controlling these complications. Therefore, the present study aimed to compare the preemptive effect of intracuff and intravenous routes of Dexamethasone administration for postoperative sore throat and cough. Materials and Methods: In the present clinical trial, 96 patients who underwent general anesthesia intubation were randomly assigned to three groups. The first group received 4 mg intracuff Dexamethasone, the second group received 4 mg intravenous Dexamethasone, and the third group was administered a placebo. Cough frequency and severity of a sore throat after extubation were investigated in the three groups. Results: Any significant difference was not observed among the three groups regarding hemodynamic variables (P>0.01); however, the incidence of cough was significantly lower in all the three groups (P<0.01). Also, the average severity of a sore throat in PAR and 1 h after surgery in the three groups was significantly lower (P<0.05). Moreover, no difference was detected in the groups regarding the severity of a sore throat within 24 h post-surgery (P>0.01). Conclusion: The use of two methods of intravenous and intracuff Dexamethasone administration before surgery reduced the incidence of postoperative cough and the severity of sore throat in patients