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Is there an association between mean platelet volume and diabetic retinopathy? A case-control study
Get PDFBackground: To the aim of this study was to evaluate the association between mean platelet volume (MPV) and diabetic retinopathy (DR). Methods: Patients with diabetes mellitus (DM) referred to Ophthalmology Clinic of Rohani Teaching Hospital in Babol, Northern Iran were entered into this case-control study. Healthy subjects in control group included individuals without history of DM. The patients were classified into four groups including I. Control (n=79), II. Diabetic patients without DR (n=68), III. Non-proliferative DR (n=61), and IV. Proliferative DR (n=64). Blood samples were collected, and necessary laboratory tests were performed. Results: The MPV value was significantly higher in each group of II, III and IV compared to group I (p<0.001). This value was also significantly higher in each group of III and IV compared to group II. On the other hand, there was no significant difference between III and IV groups in MPV. A significant correlation was found between MPV and fasting blood sugar in groups II (r=0.349, p=0.004), III (r=0.269, p=0.036) and IV (r=0.258, p=0.040). Moreover, there was a significant correlation between MPV and hemoglobin A1c in groups II (r=0.366, p=0.002), III (r=0.312, p=0.015) and IV (r=0.278, p=0.026). Conclusion: The results of this study showed that the increased MPV value was directly associated with DR and its severity. A positive association was also found between MPV and indicators of glycemic status. Considering that measurement of MPV as a suitable parameter reflecting platelet function can be easily conducted, it can be clinically used to monitor status of DR
The effect of narrowband ultraviolet B phototherapy on serum folate level
Get PDFBackground: Narrowband ultraviolet B (NB-UVB) phototherapy has been used as a common treatment for dermatologic diseases such as psoriasis and vitiligo and generally considered a safe form of therapy during pregnancy. Invitro photodegradation of folate after exposure to UVB radiation has been documented but studies on UVB-induced alternation of serum folate level have reported inconsistent results. The aim of this study was to investigate the effect of NB-UVB radiation on serum folate level. Methods: In this study, serum folate levels were evaluated in patients at baseline and after 30 sessions of NB-UVB irradiation. Results: Twenty patients completed the study: 10 psoriasis, 7 vitiligo and 3 mycosis fungoides (patch stage). Mean serum folate level had significantly decreased from 2.76±0.59 ng/ml at baseline to 1.34±0.15 ng/ml after 30 sessions. (Mean NB-UVB cumulative dose 40.35±16.80 j/cm2, P=0.001). Conclusion: Serum folate levels may decrease after long-term NB-UVB phototherapy in patients with skin disorders
The disinfecting effect of glutaraldehyde and peracetic acid on tensile load at failure of orthodontic elastomeric chains
Get PDFIntroduction: The purpose of this study was to compare the effect of peracetic acid with glutaraldehyde on tensile load at failure of elastomeric chains after disinfection.
Materials & Methods: Tensile load and extension to failure in 30 elastomeric chains were allocated in three groups was measured using Universal Testing Machine. The results were analyzed using ANOVA and Tukey’s post hoc test with a significant level at p<0.05.
Results: Glutaraldehyde and peracetic acid decreased the tensile load and elongation to failure of elastomeric chains compared to the control (P=0.03 for tensile load and P=0.01 for extension to failure). There were no significant differences between these two disinfectants (P=0.07 for tensile load and P=0.09 for extension to failure).
Conclusion: There tensile load and elongation to failure in chains decreased in both glutaraldehyde and peracetic acid, which is not clinically significant
Serum Sodium Levels and Cardiac Complications in Patients with Kawasaki Disease
Get PDFBACKGROUND AND OBJECTIVE: Kawasaki disease is an acute vasculitis of childhood and can be associated with complications such as hyponatremia. The present study was conducted to evaluate the serum sodium levels and its association with cardiac complications in children with Kawasaki disease.
METHODS: In this cross-sectional study, all Kawasaki patients (according to AHA criteria) referred to Amirkola Children's Hospital in Babol in 2017-2018 were evaluated. Patients underwent serum sodium assessment and echocardiography and the relationship between serum sodium levels and cardiac complications including ectasia and coronary aneurysm, myocarditis, pericarditis and coronary artery occlusion was investigated.
FINDINGS: Of the 60 patients with Kawasaki disease, 27 (45%) were male and 33 (55%) were female. Their mean age was 32±8 months. 28 patients (47%) had serum sodium levels lower than 135 mEq/L while normal serum sodium level (135-150 mEq/L1) was reported in 53% of patients. Cardiac complications including coronary ectasia and myocarditis were reported in 16 and 32 patients, respectively. There was no significant difference between serum sodium levels and cardiac complications. There was no difference in the incidence of cardiac complications and hyponatremia in males and females.
CONCLUSION: According to the results of the present study, serum sodium levels cannot be a good criterion for cardiac prognosis
Anticholinergic drug use in Older People: A Population- Based Study in Iran
Get PDFBackground: Elderly people are in need of several drugs due to physiological changes and multiple chronic diseases. Studies have shown that anticholinergic drugs can cause cognitive impairment, reduced physical activity, and increased mortality in elderly population. Paying attention to the anticholinergic medication use in older adults can prevent the occurrence of adverse events and increase the quality of health care. This study was conducted to quantify exposure to anticholinergic medicines in older people in Amirkola. Methods: This study is a part of the comprehensive cohort project that was being conducted from 2011 on the case patients of 60 years and above that referred to the Amirkola Health Center. A total of 1532 individuals were included, of whom 54.9 were men. The drug information was obtained by observing the patient’s prescription and self-report questionnaires and collected data were analyzed by SPSS software. Exposure to anticholinergic medications was measured using the drug burden index-anticholinergic (DBI-Ach) and the anticholinergic drug scale (ADS). Results: Among the 1532 elderly people with an average age of 69.21 years, 29 had DBI>0 and 36.3 had ADS>0. Also, there was a significant correlation between DBI and ADS (R=0.758). In addition, there is a significant relationship between sex variable with DBI and ADS (P=0.0001). So, women in comparison with men had higher values of DBI and ADS. Conclusion: The findings of this study indicate that anticholinergic exposure is relatively high especially in older women, which posed special precautions to avoid inappropriate prescribing in the elderly
Designing, Implementation and Evaluation of the OSCE Exam for Psychiatric Assistants Based on the Topics of the Educational Curriculum
Get PDFBackground and Objective: Teaching, learning and evaluation in the field of psychiatry has always been considered. During the psychiatric assistantship course, learning the skill of interviewing the patient and prescribing appropriate therapies is one of the highest educational priorities. In this study, an attempt has been made to investigate the effect of the Objective Structured Clinical Exam (OSCE) on improving the skills of residents. Methods: In this cross-sectional study from the academic year 2015-2016 to 2009-2010, all psychiatry residents were tested weekly by the OSCE method according to the curriculum topics. After the test, the satisfaction of professors and residents was assessed using a questionnaire. Also, the scores of these tests were compared with the scores at the end of the year. Findings: The mean scores of residents for OSCE and end-of-year exams were 21 ± 3.04 and 125.54 ± 18.48, respectively. Pearson correlation coefficient for the relationship between OSCE score and end-of-year score during these 4 consecutive academic years was r = 0.830 and P <0.001. The results of the survey of professors and assistants showed a high level of satisfaction with the tests. Conclusion: The relationship between end-of-year scores and OSCE test scores and the results shown in the success of residents in the specialized board exam is evidence of the success of the design and implementation of the OSCE method to improve the skills of residents in OSCE evaluation
Evaluation of Students\' Satisfaction with Virtual Education in the Self-Governing Campus of Babol University of Medical Sciences During the Pandemic of COVID-19
Get PDFBackground and Objective: Due to the change in educational methods and virtualization of university classrooms following the COVID-19 epidemic, after the necessary activities in this regard, in order to examine students' feedback on what they experienced during the academic year 1399-1400, in this Study we measured the satisfaction of students of Self-Governing Campus of Babol University of Medical Sciences about virtual education. Methods: In this cross-sectional study, the level of students' satisfaction with virtual education and end-of-semester tests was assessed using a researcher-made questionnaire. The poll was conducted through the Faradid system. Results were reported in frequency and frequency percentage. Findings: A total of 250 students with 66.85 participation in 4 fields of general medicine, general dentistry, bachelor of physiotherapy and bachelor of nursingparticipated in the study. The general satisfaction of students with virtual education, and the possibility of establishing a two-way relationship between professors and students and providing appropriate feedback, all 4 disciplines were moderate satisfaction. Regarding the evaluation method at the end of the semester, 84.5 of students had average and lower level of satisfaction. Regarding the preferred teaching method, the choice of students in all fields was face-to-face teaching method. Conclusion: Given the current situation and accepting the fact that education should move towards virtualization, it seems that more decision should be taken to raise the quality of e-learning so that interactive methods can take their place in the method of education
Factors Affecting the Adequacy of Prenatal Care Utilization Index in the First Level of Network System in Iran
Get PDFBACKGROUND AND OBJECTIVE: Prenatal care is an important strategy for achieving reproductive health. Despite the importance of maternity care in maternal health, some mothers are not adequately cared for. The aim of this study was to determine the factors affecting the Adequacy of Prenatal Care Utilization (APNCU) Index in the first level of network system in Iran.
METHODS: This cross-sectional study was conducted in six provinces of Iran in 2016. Mothers whose date of delivery was 2-6 months before the study were randomly selected. Data were collected using a researcher-made checklist and questionnaire containing 34 personal, family-related and environmental questions and 23 prenatal care-related questions based on health records and interviews with mothers and samples were divided into four groups according to the Adequacy of Prenatal Care Utilization index: 1: inadequate (less than 50% of expected care), 2: intermediate (50-79%), 3: adequate (80-109%), 4: adequate plus (110% and more), and the results were analyzed.
FINDINGS: Among 2655 studied mothers, the mean of total care during pregnancy was 6.43±1.7 times and according to the Adequacy of Prenatal Care Utilization index, 121 (4.6%) mothers had inadequate care, 603 (22.7%) mothers had intermediate, 1648 (62.1%) mothers had adequate and 283 (10.7%) mothers had adequate plus care. There was a significant relationship between the risk of maternal mortality in each province, urban population, prenatal care, time of first pregnancy care, maternal age, spouse's participation and education level, and adequacy of prenatal care (p<0.05).
CONCLUSION: This study showed that the adequacy of prenatal care, although influenced by social and personal factors, is at an appropriate level
Decreased serum testosterone level was not significantly correlated with lipid indices in elderly men
Get PDFBackground: Aging in men causes a gradual decline in endogenous testosterone levels, which may have detrimental effects on their health status. Testosterone deficiency is thought to promote atherosclerosis by modulating lipid metabolism. Therefore, this study was conducted to evaluate the serum testosterone level and its correlation with lipid profile in men aged ≥60 years old. Methods: All elderly men aged ≥60, residing in Amirkola and participating in a phase of the comprehensive project on "investigating the health status of the elderly in Amirkola" were entered into this descriptive cross-sectional study. After fasting over 12 hours, the venous blood samples were taken. Serum concentration of testosterone was determined using ELISA method. Moreover, HDL-LDL, total cholesterol, triglyceride and fasting blood glucose were measured. Results: The prevalence of hypogonadism was 91.28 among the 792 participants of this study with a cut-off point of 9.72 nmol/L (95 confidence interval, 93.25-89.31) and the prevalence of severe hypogonadism with a cut-off point of 5.2 nmol/L was reported 71.59 (95 confidence interval, 74.73-68.44). Based on the results, there was no significant statistical correlation between the serum level of testosterone and triglyceride (r=0.03, P=0.34). Furthermore, there was a negative correlation between testosterone and HDL, which was not statistically significant(r=-0.05, P=0.13). No significant statistical correlation was found between testosterone and LDL (P=0.98). There was a negative correlation between testosterone and cholesterol, which was not statistically significant (r=-0.02, P=0.49). Conclusion: According to the study results, 91 of men aged ≥60 years old had hypogonadism, no correlation was found between testosterone and lipid indices
Frequency of Cutaneous Manifestations in Diabetic Patients in Endocrinology Clinic of Babol University of Medical Sciences
Get PDFBACKGROUND AND OBJECTIVE: Diabetes is the most common endocrine disorder in the world. Understanding the cutaneous manifestations associated with diabetes can help in choosing the appropriate treatment approach in these patients. The aim of this study was to evaluate the frequency of cutaneous manifestations in diabetic patients referred to the endocrinology clinic of Babol University of Medical Sciences.
METHODS: The present cross-sectional study was performed on 300 patients with diabetes referred to Rouhani Hospital in Babol in 2019. Age, gender, BMI, type and duration of diabetes, and patients’ diabetes control status (HbA1C) were recorded and patients were thoroughly examined by a dermatologist and divided into two groups of below and above 50 years. In terms of cutaneous manifestations, they were divided into two groups; with cutaneous manifestations and without cutaneous manifestations.
FINDINGS: 293 patients (97.76%) had type 2 diabetes. The mean age of patients was 55±12 years and the mean duration of diabetes was 9.73±1.20 years. In this study, 130 patients (43%) had cutaneous lesions, of which 76 patients (58.5%) were female. Pruritus, acrochordon, cherry angioma, diabetic dermatopathy, fungal skin infections with frequencies of 25.7%, 21%, 14.3%, 6% and 5.7% were the most common skin disorders, respectively. 68 patients (69.4%) had skin manifestations and had diabetes for more than 10 years. There was a significant difference between the two groups of with and without cutaneous manifestations, gender and duration of diabetes (p<0.001). There was no significant difference between the mean age, BMI and HbA1C in the two groups (p=0.07, p=0.09 and p=0.11, respectively).
CONCLUSION: The results of the study showed that pruritus and acrochordon are the most common cutaneous manifestations and long-term diabetes and female gender are the most important risk factors for cutaneous manifestations