Internal Medicine and Medical Investigation Journal (IMMINV)
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Prevalence of Occult Hepatitis B in Patients with Lupus Nephritis and Glomerulopathy Referred to Shahid Sadoughi Hospital in Yazd, Iran
No full textBackground: The conventional method for testing Hepatitis B (HBsAg) can be not detected occult Hepatitis B in patients. No diagnosis of hepatitis B in patients with lupus nephritis and glomerulopathy treated with Immunosuppressive drugs, can be clear Hepatitis B. Also, due to the possible role of occult Hepatitis B in the lack of a complete response to treatment and continue proteinuria Assess the prevalence of occult Hepatitis B in these patients is important.in this study we decided to the survey Prevalence of occult hepatitis B in patients with lupus nephritis and glomerulopathy referred to SHAHID SADOUGHI Hospital in Yazd.Methods: This study was a descriptive-cross sectional study. A total of 112 patients with lupus nephritis and glomerulopathy referred to internal department, nephrology and rheumatology clinic of SHAHID SADOUGHI Hospital in five-year period studied. HBsAg, HBsAb was measured in patients and those with HBsAg positive and HBsAg negative HBV-DNA was measured. Demographic was collected in the questionnaire that already provided. The collected data were entered into SPSS version 20, using statistical tests were analyzed.Result: The results showed that the mean age of participants was 40.84 ± 15.11 years. From 112 patients participated in the study,49 patients (43.8%) were men and63 patients (56.2%) were female. Also from 112 patients,97 patients (86.6%) had primary glomerulopathy and 15 patients (13.4%) had lupus nephritis. The prevalence of occult hepatitis B was 3.0% in patients with primary glomerulopathy and 13.3% in lupus nephritis patients. There was a significant relationship between the frequency of HBc-Ab and the mean age of patients with type of disease (P-value <0.05).Conclusion: The prevalence of occult hepatitis B in patients with lupus nephritis was greater than the prevalence in pateints with gleumeronephritis.
Criteria for Ethical Evaluation of Hospital Information Systems: A Protocol for Systematic Review
No full textIntroduction: The implementation of information technology is an important factor in improving the quality of patient care. Since a hospital is an organization that needs effective management of information, the implementation of information technology is necessary for improving the ef ciency of the services, quality of care, and reducing the costs. Ethical evaluation of hospital information systems is one of the existing gaps in evaluating this technology. Many evaluations have been carried out for information that is more technical and not concerned with ethical issues. Therefore, this study aims to compile a checklist for the evaluation of ethical dimensions of this technology using a systematic review. Methods: We searched international medical databases, such as the U.K. Centre for Reviews and Dissemination, MEDLINE/PubMed, and Cochrane Library; Iranian databases Irandoc, Iranmedex, Medlib, SID, and grayscale websites SInGLE, and Ideas.recp. After selecting the studies based on inclusion and exclusion criteria, two experts in the eld of information technology and ethical evaluation extract ethical issues from the full text of the articles. Results and Dissemination: The results of the study will be published in a peer-reviewed journal and presented at relevant conferences, which can be used by policy makers and healthcare decision-makers
Attitude and Use of E-Learning, education by medical students in Shiraz, Iran
No full textIntroduction: This study aimed to explore the use of e-learning in medical education in Shiraz, Iran.Materials and Methods: A convenience sample of 300 medical students of Shiraz University of Medical Sciences was interviewed using a structured questionnaire. The questionnaire contained a series of questions on the demographic characteristics, accessibility to computer and internet, use of internet for medical education and training, familiarity with e-learning, and the reasons for use of computer.Results: A total of 270 participants completed their questionnaires, 30.7% students reported familiarity with e-learning, 21.3% found e-learning beneficial, 57.6% used internet for education, 43.4% considered e-learning useful for medical education, and 57.9% students thought e-learning must be more prevalent in medical education. Most of the students (78.5%) used their personal computer for e-learning, only 6.3% did not use the computer for education.Conclusion: Considering the increasing role of computer and internet in daily life, the current results indicate that the attitude of the participants towards e-learning was positive. However, medical students have to be made aware of the advantages of e-learning. Technological limitations were less compared to reports from the other developing countries
Self-assessment of clinical competence on sexual health by Iranian medical interns: a framework for curriculum revision
Full text linkBackground: The sexual medicine education in medical faculties has been a challenging issue worldwide in recent decades. Most of medical students are dissatisfied for their sexual health education which indicates an emergent need for curriculum revision. The nobility of the study was to reveal medical students' competency gaps on sexual medicine.Methods: This cross-sectional study was conducted at a large, public medical school, topped the national ranking for its excellence in education. The target population was medical interns in their 6th and 7th year of their course. With a census sampling approach, all eligible students were included. To develop the questionnaire, the framework of ESSM (European Society for Sexual Medicine) syllabus of sexual medicine 2012 was employed after being examined by an expert panel to meet the criteria of content coverage. Recruiting 10 participants, a pilot was conducted to assess the criterions of validity and reliability. Finally a 35 item questionnaire was developed including three domains; "male sexual problems", "female sexual problems" and "common to both sexes sexual problems” with 17, 9, and 9 items, respectively. Students were asked to answer each item in a five-level Likert scale. The total score was standardized to convert scores to a range of 0-100 making it easy to interpret. In addition, a single question on the general competency was asked. Analytical statistics were used appropriate to data type and distribution (t test, one-way ANOVA). Study protocol was approved by research executive and ethics board of the institution.Results: 152 of 260 eligible students participated, with mean age of 25.0 (SD=2.3), of whom 54% were females. The standardized total competency score was 22.3 (95% CI: 20.4-24.2). Regarding to not only total but also different domains scores, there was no significant difference in different grades (PV>0.05). The female students' competency was significantly higher in the domain of "female sexual problems" and "common sexual problems, but not in the domain of "male sexual problems". None of the interns believed that they are competent enough to manage patients with sexual problems by themselves.Conclusions: We magnificently attained that medical students' clinical competency on sexual medicine is poor. Medical education system of Iran would not be able to deal with this challenge unless it provides with a comprehensive curriculum revision
Mustard Gas Effects on Iranian Veterans After 20 Years as Shown on Chest High-resolution Computed Tomography: A Follow-up Study
Full text linkIntroduction: Mustard gas is a known chemical weapon that was used in the 1980-1988 Iran- Iraq War. It causes many health problems, including serious respiratory damage. In this study, we used high-resolution computed tomography to assess the pulmonary complications after 20 years of veterans of the Iran-Iraq War who were exposed to mustard gas. Materials and Methods: This was a follow-up study conducted on 200 Iranian veterans with a history of exposure to mustard gas at least 20 years previously. High-resolution computed tomography was performed on all veterans and was interpreted by two independent expert radiologists who were blinded to the study. The frequency of high-resolution computed tomography ndings was reported. Data were analyzed with statistical package for the social sciences version 20 software. Results:One hundred twenty veterans (60%) showed HRCT abnormalities. The most frequent high-resolution computed tomography ndings were diffuse hyper-aeration, 63 (52.5%); interstitial opacity, 50 (41.7%); parenchymal opacity, 26 (21.7%); bronchiectasis, 15 (12.5%); sub-pleural air trapping, 13 (10.8%); and local brosis, 10 (8.3%). Generally, lower lobes were more frequently affected. Conclusion: This study showed a high frequency of abnormal high-resolution computed tomography ndings in veterans who were exposed to mustard gas, and most abnormalities were irreversible. These ndings included diffuse hyper-aeration, interstitial opacity, parenchymal opacity, bronchiectasis, sub-pleural air trapping, and local brosis
Experience in the Approach to Insulinoma: A Case Series
Full text linkIntroduction: Insulinomas are rare pancreatic neuroendocrine tumors derived from beta cells responsible for insulin secretion. These tumors are typically manifested by hypoglycemia signs and symptoms, which might be non-specific leading to a delay in the diagnosis. The present study describes the experience in the approach of patients with insulinoma at Fundación Valle del Lili, Cali, Colombia.Case Presentation: A retrospective search of patients with the diagnosis of insulinoma within the database of the pathology service was performed between March 2002 and February 2017. Parameters such as the lesion size and localization, the immunohistochemistry findings, the serum levels of glucose, the insulin and C-peptide levels, the presence of metastasis, and the development of diabetes after surgery were evaluated. A total of nine patients with a diagnosis of insulinoma were enrolled in the study. The cohort comprised of seven men and two women, aged 30–50 years. Whipple triad was present in seven patients. The most common symptom was hypoglycemia-related syncope. All patients underwent surgical resection of the tumor with subsequent resolution of the symptoms. Only one patient was diagnosed with diabetes in the postoperative period.Conclusion: In the last 15 years, only nine cases of insulinoma were detected at the Fundación Valle del Lili, which is consistent with the low incidence of the disease. A higher frequency of the disease is noted in men, unlike that in the literature. However, other clinical and pathological features from large studies are in agreement with the current data. Nevertheless, continual experience in the management and identification of these cases is essential as common clinical manifestations may not be observed
Association Between Intraventricular Conduction Disorders and Intrahospital Prognosis in Patients with Acute Coronary Syndrome
Full text linkBackground: Acute coronary syndrome (ACS) is one of the most common heart diseases. Interventricular conduction disorders are complications of acute myocardial infarctions and have different types, such as left and right bundle branch blocks and left anterior and posterior hemiblocks. The prognosis of this disease can affect therapeutic methods, duration of hospitalization, and timely intervention decisions. Therefore, in this study, we evaluated the relationship between interventricular conduction disorders and the prognosis of patients with ACS.Methods: Using the convenience sampling method, this analytical case-control study was conducted on 140 patients with ACS (61 patients in the case group and 79 patients in the control group) who were treated from March to August 2013. The underlying variables of the risk factors for ACS were evaluated, along with prognostic evaluation factors, in two groups: a case group (patients with interventricular conduction disorders) and a control group (patients without interventricular conduction disorders). Data were analyzed with SPSS v. 17 software using the chi-squared test, the analysis of variance test, Student’s t-test, and Fisher’s exact test. Results: The mean age of patients was 64.1 ± 5.8 years in the case group and 62.9 ± 8.8 years in the control group. No significant relationship was observed between ACS risk factors, such as hyperlipidemia, diabetes, hypertension, previous myocardial infarction, and smoking, and the prognosis of patients with ACS. The mean ejection fraction was 39.7 in the case group and 45.1 in the control group, so a significant relationship existed between the two groups (P<0.05). In addition, systolic heart failure was more common in the case group than in the control group.Conclusion: We found that the presence of auscultation (rales sound) and shortness of breath on the first day of hospital admission in the case group was significantly different from the control group (P<0.05). Furthermore, the ejection fraction in the case group was lower than in the control group, and the frequency of mitral regurgitation in the case group was higher than in the control group. These factors can effectively predict the prognosis of patients with ACS. Finally, we found that interventricular conduction disorders weakened the prognosis of patients with ACS
Factors and Prevalence of Depression in Students at Iran’s Urmia University of Medical Sciences
Full text linkBackground: Depression is characterized by decreased tendency to work, reduced pleasure from work, increased or decreased weight, increased or decreased appetite, insomnia or narcolepsy, irritability, fatigue, loss of energy, feelings of worthlessness, feelings of guilt, reduced ability to concentrate and think, and thoughts of suicide or actual suicide attempts. In this 2016 study, we examined the factors and prevalence of depression in students at Urmia University of Medical Sciences in Urmia, Iran. Methods: This cross-sectional study was conducted on 400 students. Data were collected through the Beck Depression Inventory II (BDI-II): a 21- item standard questionnaire in multiple-choice format to evaluate depression. The questionnaires were distributed randomly by trained students over a period of 5 months. Data were analyzed using SPSS ver. 19 software and by descriptive statistics, independent t-tests, logistic regression models, and the chi-squared test. Results: The mean BDI score was 14.67 ± 11.30. Of the study population, 278 (69.8%) were men and 120 (30.2%) were women. In terms of depression, 40.2% of the students were in the normal range and had no depression, 23.6% were slightly depressed, and 18.3% were partially depressed. Also, 6.03% of students had severe depression, and 3.51% of students had very severe depression. No statistically signi cant relationship was observed between depression and sex (P = 0.11). However, signi cant relationships were observed between depression and education level (P = 0.001), smoking history (P = 0.001), and age (P = 0.023). P values less than 0.05 were considered statistically signi cant. Conclusion: The prevalence of different degrees of depression in the plurality of students at Urmia University of Medical Sciences necessitates the development and institution of psychological training classes
Applied Criteria of Hospital Information Systems in Organizational Evaluation: A Systematic Review Protocol
Full text linkIntroduction: Through new and expanding technologies, the development of health information technology in today’s society is indisputable, and the use of this technology has led to the production of various products with a variety of capabilities. One of these products is the Hospital Information System. Regarding the impact of organizational factors on the successful implementation of hospital information systems and the lack of comprehensive criteria for assessing them, the purpose of this study was to determine the criteria of hospital information systems involved in organizational evaluation.Methods: Data sources included the following databases: pubmed, scopus and cochrane library. In addition, other sources were searched for ongoing studies and grey literature. Studies were independently screened for eligibility by 2 reviewers and data extraction was done by 2 people. The language limitations for article wasn’t considered, the reference of the articles that selected, review and related articles were selected. After completing the search, all the articles were entered in to EndNote, and duplicates were deleted. The Prisma protocol was used to report.Results and Dissemination: A specific and precise checklist was being prepared and developed, which is an appropriate guide to assess hospital information system from an organizational dimension in health technology assessment. The results of the study were published in a peer-reviewed journal and presented at relevant conferences. Policy makers and healthcare decision-makers can use these results
Minimum Inhibitory Concentration of Ciprofloxacin against Pseudomonas Aeruginosa in the Presence of the Efflux Inhibitor Phenylalanine-arginine Beta-naphthylamide
Full text linkIntroduction: Pseudomonas aeruginosa is a gram-negative, opportunistic pathogen causing infections in patients staying in the hospital and is resistant to multiple drugs. This study investigated the resistance to ciprofloxacin by the efflux system of Pseudomonas aeruginosa.Materials and Methods: For this purpose, the inhibitor of the efflux system phenylalanine-arginine beta-naphthylamide was used. In this study, 135 isolates of Pseudomonas aeruginosa were collected from the hospitalized patients of Imam Khomeini Hospital and outpatient clinics in Urmia during a ten-month period from June 2015 to March 2016. These isolates were re-identified by standard microbiological and biochemical methods. Finally, 51 isolates were selected for antibiotic susceptibility testing.Results: According to the antibiogram test, the Pseudomonas aeruginosa isolates exhibited highest resistance against ciprofloxacin (90.2%), tobramycin (88.2%), and gentamycin (86.3%) and the highest sensitivity towards colistin (76.4%), and imipenem (72.5%). The 51 isolates, which were selected for the minimum inhibitory concentration test, had multi-drug resistance regulators.Conclusion: The discovery and development of the efflux system inhibitors is an important strategy to deal with bacterial infections