Internal Medicine and Medical Investigation Journal (IMMINV)
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Evaluation of Suspended Matter less than 10 µm and Cardiovascular and Respiratory Diseases: in Urmia City, 2015
Full text linkIntroduction: Air pollution induced by human activities is one of major challenges faced by Iran, as well as the world . The AirQ model was used to evaluate the cardiovascular and respiratory diseases attributable to the exposure to suspended particles of less than 10 µm in Urmia city of West Azerbaijan Province, Iran, in 2015. Materials and Methods: This descriptive-analytic study was conducted in Urmia in 2015. The hourly data of the PM10 (particle matter up to 10 µm) pollutant were extracted as the raw material from the Environmental Health Center. The health effects of suspended particles of less than 10 µm were estimated by statistical analysis using the World Health Organization’s AirQ model.Results: According to the results concentration of PM10 was higher in the cold seasons compared with the warm seasons. The annual average of PM10 concentration was 3.9 times higher than that prescribed as per the standards of clean air in Iran. In addition, the cumulative numbers of cardiovascular and respiratory diseases in the city of Urmia in the median estimate were 287 and 744 cases, respectively. Conclusion: As a consequently, air pollution in the Urmia city has contributed significantly to the rate of hospitalizations and deaths of people in 2015. Therefore, authorities should make appropriate, sustainable, and applicable strategies based on comprehensive research to control the Urmia air pollution crisis
Insulin Resistance in Patients with Essential Hypertension Using Homeostatic Model Assessment
Full text linkIntroduction: Insulin resistance has a strong relationship with the incidence of type II diabetes. It also has a direct relationship with other risk factors of diabetes, which together are known as metabolic syndrome. The aim of this study was to investigate the relationship between insulin resistance and hypertension.Materials and Methods: In this historical cohort study, 90 patients were divided into three different groups: those without hypertension, those with controlled hypertension, and those with uncontrolled hypertension. Systolic and diastolic blood pressure, body mass index, and laboratory test results such as cholesterol, triglycerides, low- density lipoprotein, high-density lipoprotein, fasting plasma glucose, and fasting plasma insulin were compared among the three groups. Data were analyzed with t-tests and the analysis of variance test, which were performed using statistical package for the social sciences version 20 software.Results: Age and sex were the same among the three groups; however, BMI, systolic blood pressure, and diastolic blood pressure in the uncontrolled-hypertension group were higher than in the controlled-hypertension and without-hypertension groups (P<0.05). Lipid profile (P<0.05), creatinine (P=0.77), and uric acid (P=0.233) were not significantly different among the groups, although fasting plasma insulin (P=0.012) and homeostatic model assessment of insulin resistance (P=0.038) were significantly higher in the uncontrolled-hypertension group than in the other groups.Conclusion: Homeostasis model assessment of insulin resistance in patients with uncontrolled hypertension was higher than in patients with controlled hypertension and those without hypertension. Therefore, homeostatic model assessment of insulin resistance can be used as a predictive clinical test for the early diagnosis of diabetes in patients with uncontrolled hypertension
Cycling vs Running – An in-depth analysis
Full text linkThis short letter to the editor provides ideas about exercises that improves cardiovascular fitness
A Study on the Status of Error Reporting Cultures among Nurses in Medical Sciences Hospitals of Islamic Azad University
No full textBackground:One of the goals of nursing is to provide safe patient care and medical errors are one of the most important threats in this field.Therefore, the purpose of this study is to assess the status of error reporting culture and determine its relationship with demographic characteristics.Methods:This descriptive,analytical and cross-sectional study was carried out among 239 nurses of amiralmomenin and bouali hospitals. First,face validity and then content validity were performed by 15 nursing experts and the questionnaire was distributed and collected. The normal distribution of data was confirmed by Kolmogorov-Smirnov test. The reliability and construct validity were performed with Cronbach’s Alpha test and exploratory factor analysis by PCM.The status of reporting culture was determined by computing descriptive statistics and its relation with demographic variables with Pearson correlation test and logistic regression test with SPSS software version 16.Results:The content validity with CVR &CVI of 0.820 and 0.920 were confirmed. The reporting culture was favorable with a mean and standard deviation of 2.674 and 0.475.The reliability with Cronbach's alpha of 0.747 and the construct validity with a KMO of 0.727 and Significance of the Bartlett test were confirmed and 3 subscales were extracted. The relationship between age and work experience with the reporting culture with a correlation of 0.009 and 0.013 with a significant < 0.05 were rejected But with the variable of gender(=female) with a chance of 2.536 and the significant of 0.006 was confirmed.Conclusion:Developing a safety culture in hospitals by implementing various health programs improves the reporting culture,but the mental climate is undesirable and requires major steps to reduce worries and negative outcomes after reporting.The presence of female nurses in comparison with men improves the error reporting culture.Perhaps the main reason is patriarchy in Iranian culture
Study of the Prevalence of Food Allergens in Patients with Allergies Admitted to Mofid Children’s Hospital During 2010 to 2016
Full text linkIntroduction: Allergic diseases include a wide range of symptoms such as asthma, rhinitis, urticaria, eczema, and gastrointestinal symptoms that are becoming increasingly prevalent in today’s world. Exposure to food allergens is one of the contributing factors for allergic diseases in humans. The identification of susceptibility to food allergens plays an important role in the prevention and treatment of allergic diseases.Materials and Methods: After the clinical diagnosis of allergic diseases, patients were examined using the skin prick test.The method of collecting data was observational. All data were entered in SPSS software version 21 and analyzed using descriptive and inferential statistics.Results: A total of 466 patients with a mean age of years were studied, of which 58.6% were boys and 41.4% were girls. A total of 44.2% patients had asthma, 21.7% had allergic rhinitis, 2.1% had allergic sinusitis, 1.7% had conjunctivitis, 1.1% had angioedema, 11.6% had urticaria, 19.7% had eczema, and 26.8% had gastrointestinal allergic symptoms. A total of 114 patients (24.5%) had food allergies, of which 43.9% were girls and 56.1% were boys. In terms of the age and gender of patients, no statistically significant difference was observed between different food allergens (P<.05). The most common allergens in patients under study were peanuts (7.9%), milk (7.3%), almond (6.6%), freshwater fish (6.6%), and walnuts (6.4%).Conclusion: The findings revealed that allergen prevalence in each region is influenced by its climatic conditions, people’s food habits, their racial differences, and their lifestyles
Hepatitis and Meningoencephalitis due to Enterovirus in a Toddler
Full text linkBackground: Acute hepatitis caused by viral organisms which are typically implicated in the cases of encephalitis are rarely reported in literature. The presentation of enteroviral meningoencephalitis predominated with the clinical picture of hepatitis has rarely been recorded in populations other than neonates.
Case Presentation: A male 2-year-old, presenting with a fever of 38 to 40 °C with chills and rigors, lethargy and drowsiness for 6 days. Along with the nausea, vomiting and watery diarrhea, he developed mouth ulcers (peri-oral vesicles) during the stay at the hospital. After extensive workup he was later diagnosed with meningoencephalitis and acute hepatitis due to Coxsackie virus A. After a stay of more than a month he was successfully treated and discharge.
Conclusion: A more thorough evaluation should be carried out for atypical viral infections presenting with clinical presentation of hepatitis and meningoencephalitis
Efficiency of Estrogen Replacement Therapy in Osteoporosis
Full text linkEstrogen therapy has been taken as a settled approach for both prevention and treatment of osteoporosis, especially in post-menopausal women as well as for the treatment of symptoms associated with menopause. Recent studies suggest that nuclear factor kappa-B ligand/receptor activator of nuclear factor kappa-B/osteoprotegerin system plays a signi cant role in osteoclastic activity regulation, with receptor activator of nuclear factor kappa-B ligand signaling in the presence of macrophage colony stimulating factor leading to increase in osteoclastic differentiation and functioning while osteoprotegerin neutralizing receptor activator of nuclear factor kappa-B ligand. Estrogen acts by increasing osteoprotegerin levels, and decreasing macrophage colony stimulating factor and receptor activator of nuclear factor kappa-B, thereby reducing bone resorption. Furthermore, estrogen is also known to be causing increased calcium absorption through gut and kidneys. The use of estrogen therapy in patients of osteoporosis is also considered to be highly cost effective. On the negative side, studies have shown that oral estrogen therapy can lead to complications like cholelithiasis, thrombophlebitis and pulmonary embolism, the most detrimental being endometrial cancer. But studies have shown that it can be virtually eliminated with the addition of progesterone in the cyclic combined regimen. Majority of bene cial effects occur with long term use of estrogen therapy, but the compliance by most of women appears to be poor and is usually due to lack of awareness, misconceptions, advice of physician and phobia of side effects. Additional studies should therefore be conducted to evaluate in detail the causes of non-compliance and strategies to improve compliance. The bene t of quality of life improvement with estrogen therapy should be taken into account and further evaluated via studies
Health-promoting Lifestyles and Related Factors in Pregnant Women
Full text linkIntroduction: Health-promoting behavior increases the self-care of the individuals and improves the health. It reduces the chance of maternal and fetal harm during pregnancy. The objective of this study was to determine the sociodemographic factors related to health-promoting self-care behavior in Iranian pregnant women categorized by domains.Materials and Methods: A cross-sectional study design with convenience sampling was used to recruit 384 pregnant Iranian women that were referred to the health center in Sari in 2014-2015. Self-reporting questionnaires included sociodemographic characteristics and health-promoting lifestyle profile-II questionnaires. Data were analyzed with using the statistical package for the social sciences software (version 19). One-way ANOVA and chi-square tests were used to determine the relationship between the sociodemographic characteristics and health-promoting behaviors.Results: The mean age of pregnant women was 27.65±4.753 years. Most of the participants were in the second trimester of pregnancy. The mean of the total score for health-promoting behaviors was 142.96±17.947. Among the six dimensions of health-promoting behaviors, the interpersonal relations scored maximal, and the physical activity scored the lowest. Significant correlations existed between spirituality and the wife’s education, the wife’s job, and the family income. In addition, a significant correlation was established between stress management and the wife’s education, also between the aspect of relationships and the husband’s education, the wife’s education, the family income, and the decision maker (all P<0.005).Conclusion: The findings of the present study confirmed that the sociodemographic factors were vital in health-promoting behaviors in pregnant women
Difficult airway management with a King Vision Video Laryngoscope in an anticipated patient and an unexpected patient: two scenarios, one device
Full text linkBackground: The King Vision Video Laryngoscope is a relatively new device that has been incorporated in our daily surgical practice, intensive care unit, and remote areas. It has become one of the main alternatives to the rescue of a failed intubation, a tool to manage patients with difficult intubation predictors, and the first choice in ventilate and not-intubate situations.Case Presentation: In this case report, we present the management of two difficult airway cases: one in an induced patient and the other in an anticipated patient, according to the Canadian Airway Focus Group difficult airway recommendations.Conclusion: The King Vision Video Laryngoscope is effective in most adult patients and can be used with a mouth opening of at least 13 mm. Even is an effective dispositive, it has yet to show results in the management both conventional airway both difficult airway in routine clinical practice
Evaluation of Demographic Characteristics and Therapeutic Response to ocular Chemical Burn in Patients Referred to Eye Emergency Department of Farshchian Hospital in 2015-2016
Full text linkObjective:The chemical eye burn is one of the major emergencies in the ophthalmology that will result in irreparable complications in case of inappropriate and timely treatment in severe casesMaterial and Methods:In this cross-sectional study 250 patients with ocular chemical burn who referred to Farshchian Hospital were enrolled. Demographic characteristic and information regarding the burn were obtained. The Hughes-Roper-Hall classification was used for grading the severity of injury. All patients reevaluated 6 weeks later after injury.Results:Of 250 patients with complete follow up 155 cases ( 62% ) were male and 95 cases ( 38 % ) were female. Chemical injury were more common in the 20-40 years age group ( 108 case = 43/2 % ).The most common cause of chemical injury were occupational injury( 120 case = 48 % ).127 case (50/8 % ) of patients referred during The first hour after injury. The most common material of injury was acid in 102 cases (40/8 % ).Grade I burn was seen in 92 cases ( 36/8 % ) and grade IV in 30 cases ( 12 % ).Grading of the injury was related to the referring time after chemical burn. Severity of injury was more in alkaline burn.In 50 % of grade IV causes the burn had alkaline origin, however only 13/3 % of acid burn had grade IV severity. ( p : 0/001)Conclusion:The incidence of ocular chemical burn was approximately 2/19 % of all patients who referred to emergency ophthalmology service .According to this study ocular injury are more common in the men 20-40 years age group. The most common cause was occupational injury. Delay in referring and alkaline material were poor prognostic factor